The Minnesota daily coronavirus briefing is worth tracking because every now and then someone asks a good question which throws the state’s messaging agents a bit off their game. In this case, it was a question relating to the CDC’s revelation that antibody testing across the country were revealing that there were about ten times more infections than had been confirmed by infection testing. (I will more on this in a separate post shortly, as a paper was just released that gave some results from the large commercial lab antibody testing.) The Commissioner of the Department of Health confirmed that this was consistent with their belief and that they thought around 10% of all cases had been captured by testing. Now, if you recall that evidence is accumulating that T cells may be as or more important in the memory or adaptive defense to re-infection, the rate of missed cases could be even higher, as no one is routinely testing for T cell presence. I am not sure I endorse that 10 times more case number, but the state does have the results of the commercial lab antibody tests, so let us assume it is accurate.
In any event, after the release of yesterday’s numbers, there are 34,616 cases in Minnesota by confirmed test, there have been 3966 hospitalizations and 1411 deaths. So if only one in ten cases is detected, there are actually around 346,000 cases of infected Minnesotans. As I never tire of pointing out, all of these undetected cases would be asymptomatic or so mild that the person did not seek care. They are no burden on the health system and no threat to the person. And, the evidence is clear at this point that those who are asymptomatic or have mild illness are less contagious. The hospitalization rate is then 1.1%, and it will be heavily skewed to the elderly. The case fatality rate is .4%. Now that would imply that 22,000 Minnesotans would die if we all got infected. But that would only be the case if the epidemic has evenly moved through the population. It hasn’t, our deaths are very concentrated in a group of long-term care residents and the frail elderly and at this point, that small subset of our population has been largely exposed. In the general population, where the vast majority of the cases are occurring, hospitalization and death rates are far lower.
The other notable item at yesterday’s briefing was more lecturing about young people getting infected at bars and other gatherings and how this is dangerous to other people. The state’s messagers said several things worth noting. One is that they acknowledged in response to a question that given that the vast majority of cases haven’t been detected, isn’t it likely that before expanded testing and contact tracing that there were a lot of infections among this group. So let’s see, before we knew these infections were happening they didn’t appear to have any untoward consequences, but now that we know they are, let’s shame the young people who are just trying to have some kind of a life. Of course, in Minnesota, it would be okay if they gather in large groups and burn down buildings and loot. The state also hemmed and hawed around being reminded that the whole point of the lockdown was supposedly to be to just buy time to deal with the eventual passage of the virus through the population, so isn’t what is happening now what was supposed to occur? The commissioner said they were trying to control the rate of growth. Well if that is the goal, tell us what the optimal rate of spread is, what are you shooting for? And if 99% plus of cases among young adults aren’t serious enough to merit hospitalization, why would we stop the spread among that group at all? We have examples here in Minnesota–Worthington–showing that wide occurrence in a population results in very few hospitalizations or deaths. We need a clear enunciation of what the strategy is from our Dictator.
An alert reader pointed out that when I commented yesterday on the CDC’s revelation that antibody tests are revealing that there are ten times more infections than revealed by infection testing, and I calculated hospital rates, the hospitalization number I used must have been too low. The number came from the CDC’s weekly report, but it isn’t clear how that number was derived, was it sampled, was it a stricter number that were cases clearly hospitalized because of coronavirus not just with the virus. In any event, in looking at the COVID tracking site, 35,000 is clearly too low. I would see no reason to think Minnesota’s percent, above, is much different from the national average.