I am finding that even the death count varies widely. No matter what the count on either list the number is staggering.

Until there is an accurate antibody test and it is known if and at what level of antibodies will protect a person to me it is not reasonable to test everyone. My reasoning is that a person could be negative in the morning but acquire the virus later in the day. The only reason for the testing is so that if a person is ill the doctors can treat or tell the person to go home and isolate themselves if they test positive. It also takes days for the results to return.

Once it is known what level of antibodies is necessary to protect people then test as many as can be tested. It has been found that some people who tested positive then tested negative later had a second round of illness weeks or days later.

Ten years from now someone will write a fascinating book about what we knew, when we knew it, what went wrong, what shoulda coulda woulda been better, etc. Doesn't help the public much today, though, does it.

I'm comfortable that my state's officials are using what data is available, in a mathematically valid manner. Not sure all 50 states are so lucky.

Chisue, have you heard any info about the costs & practicalities of testing for the active virus, versus testing for antibodies?

My county has 137 verified cases and 3 deaths. The neighboring county has 1800 verified cases and 51 deaths. As for us, we're staying home. But for those who shop and do carry out foods, being aware of those numbers can be helpful toward avoiding it.

Our thinking has been much like Michaels. At least as we've been seeing it - it could be helpful to know where more virus exists, places one may want to avoid. Right now we are at 12, no deaths in my county.

Would I particularly want to be in downtown Seattle right now? Not really. I have an appoint there May 18 I'm still deciding on. Do I want to be in an elevator to the 7th floor of Polyclinic with strangers for an annual check in. I'm thinking not, but will depend on the next couple of weeks 'numbers'.

I think a test for antibodies and see who has survived is of the greatest use. That gives a more honest perspective of the risk to the general public.

Mass testing of the population to see who has it isn't helpful. I could test negative today and test positive tomorrow like Chisue said.

The death counts would be useful if they were transparent. The stats are corrupted when elderly people who are already dying of something else are counted as dying of the virus just because they tested positive. When a dozen people die of "the virus" in a nursing home a rational person would ask why they were in a nursing home to begin with.

I have noticed those lists vary widely. Most of the lists show more than 50,000 but the CDC only shows 48,816. Something called Virus Update shows the largest number of new deaths at 44 was recorded today.

The antibody test is needed to determine herd immunity and real % of deaths. Our state is using recovered patients plasma on currently infected patients. The covid 19 tests only for presence of RNA. Not specifically covid 19 RNA. Many viruses have RNA. They are just assuming it is covid 19 when tests are positive. So a patient tested positive at one date and then positive at a later date could involve 2 different viruses.

Death certificates often list several causes of death and I would never be surprised to see the virus listed on it.

Absolutely right maifleur. If a person is tested as a inpt for certain conditions and the person dies before the test results are complete it is considered suspected and coded as positive and listed. The people got wise to this in our state and the state removed 200 people from being covid 19 until the test results are final.

The stats are corrupted when elderly people who are already dying of something else are counted as dying of the virus just because they tested positive.

And conversely, many people who have died at home are not being counted as having died from the virus:

In recent weeks, residents outside Boston have died at home much more often than usual. In Detroit, authorities are responding to nearly four times the number of reports of dead bodies. And in New York, city officials are recording more than 200 home deaths per day — a nearly sixfold increase from recent years.

As of Tuesday afternoon, the United States had logged more than 592,000 cases of COVID-19 and more than 24,000 deaths, the most in the world, according to the Center for Systems Science and Engineering at Johns Hopkins University. But the official COVID-19 death count may, at least for now, be missing fatalities that are occurring outside of hospitals, data and interviews show. Cities are increasingly showing signs of Americans succumbing to the coronavirus in their own beds.

https://www.propublica.org/article/theres-been-a-spike-in-people-dying-at-home-in-several-cities-that-suggests-coronavirus-deaths-are-higher-than-reported

Our governor has started opening stuff up. I am not ready... and I will stay as safe as I feel is good for me.

Be prepared, this is LOOOOOOOONG!

Our mayor said, and I might add, I feel very much like him:

Mayor David Holt

Today, I provided an update to Oklahoma City on the COVID-19 situation. Below is the full transcript. Be well, OKC.

****************************************

Good afternoon. Thank you for joining us once again for a COVID-19 update. We have a lot to discuss today, so let’s get right to it.

COVID-19 has ripped through cities around the world and in our country. As we stand here today, over 50,000 people have died in the United States in just two months, and hotspots have appeared in high-density cities like New York and low-density cities like New Orleans. COVID-19 is very real and our city has treated it as such from Day One.

Doing nothing in the face of COVID-19 is what would produce the true worst-case scenario, but of course there is no city that does nothing, so we can only imagine what that would look like, but we don’t have to imagine the terrible toll COVID-19 has taken on numerous American cities.

In New York, they have lost 135 lives for every 100,000 residents. In Detroit, they have lost 82 for every 100,000 residents. In New Orleans, they have lost 79 for every 100,000 residents.

In Oklahoma City, seeing these potential scenarios, we acted fast. On March 15th, we had our first case of local spread. We moved aggressively and declared an emergency that day and began the process of closing off high-risk opportunities for local spread. Now we are sheltering in place through April 30th, and we will do so because it is saving lives. In taking these actions, we waited for no one. We did what we had to do to save lives. Nevertheless, we have suffered 54 deaths in the metro, four lives for every 100,000 residents. Every life is a person, not a statistic. We mourn each one and we send our deepest condolences to their families. We are at the same time heartened that we have not experienced what could have been. Those numbers pale in comparison to other cities near and far. You should be proud, and if this is the trajectory on which we can remain, you will remain proud all the rest of your days. Oklahoma City will be a case study for how you save lives in a pandemic.

As we stand here today, we are six weeks into this pandemic. We have lived through the rapid changes, we have settled into new routines, we have grown tired of those new routines, we have cried, we have laughed, we have suffered, and many still do. It has been an epic time in our lives that we will always remember.

Today, we face a bit of a crossroads. Not because of any changes in the virus. It’s still here. It’s still capable of great harm. It doesn’t know the dates on the calendar. But external factors dictate that we have reached a point as a people where we have to make some decisions. As we make those decisions, two conflicting realities stare us right in the face, and there is no realistic way to alter either one.

On the one hand, COVID-19 has no vaccine and no proven treatment. And no such thing appears to be coming any time soon. We are likely to live in its shadow for many months, maybe years. Without a vaccine or a proven treatment, May 1st isn’t likely going to feel any different than August 1st or November 1st. No matter how much we try, we’re going to have new cases every day, and deaths will continue to occur as well. The fundamentals of this crisis don’t really change until there is a vaccine or a proven treatment. This is our life now.

On the other hand is another reality. We can’t shelter in place for two years straight. I recognize this. This city has risen to this moment beautifully, and we have done all the right things these last few weeks. I am moved to tears by the sacrifices the people of this city have made to save lives. But I recognize that doing this just as we have for one to two years is not a realistic option.

So, what do we do?

First of all, there’s no perfect path forward. I’m sure there’s lots of Facebook epidemiologists and Libertarians who think they know the answer, but they don’t. No one does. I’ve said from the beginning of this odyssey, all we have are bad options, we’re just trying to muddle through and pick the least worst. We want to do the best we can, transparently and thoughtfully, to find a new, temporary normal, a middle ground that operates within realities but still prioritizes life and minimizes transmission and deaths.

Part of the reason we face this choice now is that there is a deadline looming April 30th. This is an external factor. This has always been an artificial deadline, but it is a deadline nonetheless. Based on an earlier White House recommendation, April 30 is the day current proclamations at the state and local level expire.

Also, we face a choice now because the ground is shifting under our feet. Governor Stitt is lifting his statewide restrictions on all non-essential businesses effective May 1st. He already lifted some effective today. This is another external factor, and it is not at all insignificant. At the city level, we were never a part of the non-essential business closure, that was entirely Governor Stitt’s decision, but we did separately close certain businesses with a high-risk of spreading the virus, like bars, restaurants and personal care services. So, there is overlap with what he is doing and what we have done. His state-level decisions do not preclude our ability to retain restrictions in Oklahoma City, but there are a lot of practical complications to that approach after his new orders fully take effect May 1st. A patchwork of regulations across the metro is largely unworkable for any extended period of time, and the effectiveness of such an approach in limiting spread would be almost non-existent. Not being able to eat in a restaurant on one corner of an intersection but being able to eat on another corner is not going to save any lives.

Also, as I have said from the beginning, in a free society, restrictions are largely self-enforcing, and mixed messages make widespread buy-in almost impossible.

I do appreciate that the Governor kept me and other mayors in the loop as to his actions, and it is important to our unified public health effort that we are communicating. Would I have picked April 24th or May 1st as the date to start a new phase? My gut says no, but let me also say, I recognize, as I said before, there is a date. We won’t shelter in place forever. So how do we find that date? We rely on public health officials, science and data to help guide us, as best it can, to a date for commencing a new phase in our pandemic response.

So let me set aside the external factors for a moment. Not that they don’t matter, they do, but let’s pretend for a moment they don’t. What does public health tell us about when we could or should start a new phase in this journey?

At some point, someone has to put some public health criteria on the table. Last week, the White House did just that. The guidance provided by Dr. Fauci and his team since we entered this story on March 15th has been very useful and has served us well in Oklahoma City. On March 16th, they recommended we close bars, restaurants and gyms. We did so the next day. In late March, they recommended we extend our shelter in place to April 30th, and so we did. Last week, they offered what they call “gating criteria” that must be fulfilled to move into a new phase. I asked Dr. Patrick McGough, executive director of the Oklahoma City-County Health Department and chair of my public health advisory group, to consider that criteria. His response was that this was good criteria from the White House.

The criteria falls into three categories – symptoms, cases and hospitals. I think this neatly captures the two main priorities we have always been focused on – saving lives and protecting our health care system from collapse.

In the last 24 hours, we gathered the best local data we had available to compare against the White House gating criteria. This is current data, not future data, obviously. I accept the reality that after being closed for many weeks, businesses need some notice before they can reopen. Business owners from all industries have repeatedly told me that in recent days. This means that by necessity we will make decisions for a future date that are based on today’s data.

With all of that as a qualifier to the data and conclusions I’m about to share, here is how the best available data lines up with the White House gating criteria today.

In regards to symptoms, a community must have a downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period. As you can see from the chart, based on the best available data, and based on where it stands today, we appear to meet this criteria.

Also in regards to symptoms, a community must have a downward trajectory of COVID-like syndromic cases reported within a 14-day period. As you can see from the chart, based on the best available data, and based on where it stands today, we appear to meet this criteria.

In regards to cases, a community must have one of two things occurring. It must have a downward trajectory of documented new cases within a 14-day period OR a downward trajectory of positive tests as a percentage of total tests within a 14-day period. The rationale for this option is reasonable. If you are administering more tests than you were before, you are likely to have more positives. But this may not mean your spread is actually increasing, it could merely be because you are administering more tests. So they allowed you to also look at the percentage of people who are testing positive. In our community, we have increased our testing, and though new cases have not spiked by any means, they are not necessarily on a downward trajectory, and we do not meet the first option. However, this chart illustrates the second option, and based on the best available data, based on where it stands today, we appear to meet this criteria.

In regards to hospitals, we must be able to treat all patients without crisis care, which I am told we can, and we must have a testing program in place for at-risk healthcare workers, which I am told we do. Therefore, we meet this criteria as well. All of this means that, based on the best available data, and as of today, we appear to meet the White House gating criteria.

To summarize, it is the advice of our local public health professionals that the White House gating criteria is worthy of merit. As of today, based on the data we have available, it appears that our situation satisfies that gating criteria. Is it a slam dunk? No. But you can see the charts as well as I can. We appear to meet the criteria today, based on the best available data we have, and I can certainly say with confidence we are not in any kind of surge. We appear to be in some sort of decline or perhaps a plateau after a decline. Even saying all of that, is May 1st the date I would have picked given no external factors? Absolutely not, but I cannot deny that there are external factors and they are not irrelevant. Also, I cannot deny that the data is, if not overwhelming, at least cautiously encouraging, and it appears to satisfy the gating criteria today.

As such, it is my intention to let Oklahoma City’s shelter in place order expire on April 30th. In the next week, I will replace the existing proclamation with one that reflects the elements of a new phase in our pandemic response that will be effective May 1st. I do not expect that this proclamation will deviate from the openings in the Governor’s statewide orders. Keep in mind, and I know this can be confusing, but we never closed non-essential businesses in Oklahoma City separately from the Governor, so you do not need to look to our proclamation for guidance there. Our proclamation was always focused on the places that are a high risk for spread of the virus. On the question of whether those places are open or closed, I expect our proclamation to align with the Governor’s, effective May 1st. Having said that, there will be many social distancing and sanitation conditions placed on openings so that public health is still a priority. We will consult the White House guidelines, best national practices, and our local public health officials to develop those conditions. It is my understanding that the state is offering such conditions at the state level as suggestions. They will not be suggestions in Oklahoma City.
Also, in keeping with White House recommendations, gatherings of 10 or larger will still be prohibited.

Let me very clear - May 1st is still a week away. If there is a dramatic change in existing trends, we will re-evaluate. Also, May 1st is not a light switch, it is a dimmer. If we show signs of becoming a hotspot, I will not hesitate to act aggressively, as I did not hesitate before. I know sometimes it can feel like you’re alone, and you wonder if your leaders prioritize your life. Well, I do, and I live with that obligation every day.

As such, I have very mixed emotions about this. You likely do as well. In fact, I think this is the hardest speech I’ve given in this pandemic. But as I have thought about this, I recognize that I would always have mixed emotions, because until there is a vaccine or a treatment, there simply is no right answer. We could be standing here talking about June 1st or July 1st and I would feel almost the same. I’m never going to stand here with a big smile on my face until the day we have a vaccine or a proven treatment. Until then, every new phase is an uncomfortable balancing act. I didn’t feel very good on March 17th either. I didn’t sign-up to be the Mayor who closed all the bars at 5:00 on St. Patrick’s Day. But even as I recognize that no new phase in our pandemic response is going to feel comfortable, I recognize we have to move out of shelter in place at some point. If we’re going to do it, then let’s at least resolve to do so safely. Just because we are opening up economic opportunities – which is a good thing - does not have to inherently mean we are opening up new opportunities for spreading this virus. It can mean that, but it doesn’t have to mean that. Remember, not all the tough choices in this pandemic are mine.

In fact, I would argue my role in this fight is minor compared to yours. In the days, weeks and months ahead you will make 1,000 choices a day that will determine your fate and the fate of this pandemic. Your life is at stake, and so are the lives of those you love.

You must social distance, you must wash your hands, you must wear a mask, you should still telework or otherwise stay home if you can. If you are a decision maker for a business, church, or other group of any kind, you still have to make decisions knowing there is a deadly virus making its way through our community. Just because you can do something doesn’t mean you will, and I respect those decisions.

May 1st may represent a new phase and we’ve earned it through hard work, but it is not a day to run into the streets and hug each other. This virus doesn’t care that it’s May 1st. My proclamation doesn’t make the virus go away. May 1st is a day we should resolve to continue the actions necessary to halt the spread of this virus and continue saving lives.

We control whether the changes on May 1st will lead to a new peak. In fact, we control all the peaks ahead. You can throw out the models, because if you want a peak two weeks from now, we have the dark power to make that happen any day of the week. Let’s use our powers for good. I have reason to believe after this experience of the last month that you will.

And while we wait for a vaccine or a treatment, we as a city, state and nation must continue our efforts to create a robust testing, tracing and quarantining program that can give people the confidence they need to regain some normalcy. This should be the priority of political leaders, business leaders and public health officials, because it is false hope to believe that May 1st will bring a full economic return. The virus is keeping people home more than a proclamation is. I commit to you that your local government is going to do everything it can to bring about the infrastructure in this area that we need.

And we should also resolve to continue taking care of those who are suffering. Just because the government has unlocked the doors will not mean that customers will open them. I ask you to support our local, state and federal governmental efforts to care for those who are most affected. I ask you to donate to philanthropic efforts, shop from local businesses, and support each other on an individual level. I’m still sending Venmos to the person who cuts my hair everytime I would have had a haircut. I’m not sure when I will get back in that chair, but until I do, the Venmos are still coming.

This will be a long journey and in the words of Churchill, “…this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” So as we potentially move into a new phase, what did we accomplish in this beginning?

First of all, as I have demonstrated here every week, when I compare our numbers to other cities, you have saved lives. You stopped an outbreak when our health care system and when we as individuals were least-prepared. You bought us time. A lot of work has happened behind the scenes this last month, especially in the health care sector, that will prepare us should we have peaks still ahead of us. And meanwhile, all of us individually have conditioned ourselves for the road ahead. We weren’t ready for this new phase on March 15th. We weren’t ready for any of this. We are now. I am very optimistic that people will respond wisely in the weeks ahead in the decisions they make for themselves and others. I believe we will all make better decisions than we would have made on March 15th because we have seen a thing or two these last six weeks. I believe we as individuals are as ready for this as we’re going to be.

Mark Twain supposedly said, “history doesn’t repeat, but it often rhymes.” In 1918, Oklahoma City waited 11 days to close anything after their first case of local spread. Ultimately, more than 7,000 Oklahomans died from Spanish Flu, many of them in Oklahoma City. Hospitals were overrun and churches were converted to house the sick. Just over a month later, much wiser, the worst had seemingly passed, and they reopened many of the gathering places they had closed, with conditions in place that lasted many weeks more. Threats of another outbreak loomed for many months, but sometime in 1919, the threat had passed. This too shall pass for us, but it doesn’t pass on April 30th. This is a chapter in our journey. I assure you there is another chapter on the other side of this one, and we’ll get there together. We’re all in this together.

As always, I want to think the frontline workers in the health care sector and so many others that have made it possible for us to shelter in place this last month.

Now I’d like to bring to the stage a man who hardly needs any introduction at this point, but a man who leads a team that is certainly responsible for saving thousands of lives during this pandemic. Thank you, Dr. Patrick McGough for your wise counsel as we have made some tough decisions this week.

Bookwoman, for a home death the treating doctor has to agree to sign the death certificate before the body can be released to the mortician. If a patient doesn't have a chronic condition such as CHF, etc or dies by accident the body goes to the coroner. The body can be swabbed at the coroner for covid 19. If you have pneumonia due to covid 19 more than likely you are going to reach out to your doctor or go to the hospital because of the severe breathing problems. It also states the increased home deaths may be attributed to the people not seeking medical treatment for non related covid 19 conditions, because of the fear of going to the hospital due to the pandemic. I have a feeling the later is true. Hospitals are a cesspool of dz to begin with and with no visitors allowed you also are void of a patient advocate.

Nice speech, OklaMoni. You've got a good leader there.

I believe the antibody test is a simple blood test. The machines that process these tests are widely available, having been used for decades in doctors offices, labs, hospitals, etc. Results are available within minutes.

The 'kits' (testing materials) to put INTO the machines are scarce. The Feds are not making them available nationwide. This results in each State competing for them, along with hospital supplies, PPEs, etc. -- profiting the manufacturers and suppliers while stalling the fight against Covid-19.

(All of this works to *divide*, not unite America. How can it not be deliberate?)

At the moment we don't have a reliable antibody test:

These tests are crucial to reopening the economy, but public health experts have raised urgent concerns about their quality. The new research, completed just days ago and posted online Friday, confirmed some of those fears: Of the 14 tests, only three delivered consistently reliable results. Even the best had some flaws.

https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html

There have been quite high percentages of the illness in a number of our seniors' care homes, especially when some staff are found to be carriers.l

And as much of it is part time work, as employers do not want the added responsibility for full time employees, and as part-timers' pay is low, a substantial number of the caretakers work in more than one institution. There was quite a lot of fuss about this above average level of illness, and the provincial authorities required that workers serve in only one institution.

But where to find additional workers and a number of the inmates lacked food and water and had overflowing diapers.

ole joyful

I always think the numbers keep up sheltering in place. Many are really not having this and getting restless. The numbers are sobering for me, help me persevere anyway.. Hind sight is 20/20 so of course the book will have lots of what we should have done, should have seen. It is soooo easy to be a back seat driver!!!

The number for my area still show counties with zero cases, the other counties have small numbers as in single digits to twenty. Only one death in a 6 county area surrounding me.

In watching the news daily there's at least one or more businesses announcing that they are closing permanently. So business closures are much high that the infection count here.

“The number for my area still show counties with zero cases, the other counties have small numbers as in single digits to twenty. Only one death in a 6 county area surrounding me.”

Have the numbers changed from 10 days ago?

Very little, less than one new case a day in the counties that have any, two of the six nearest counties cases numbers haven't changed in the past week.

I don't know if infected counts are that meaningful or not. What I want to know is how many are recovered and what the extent of their sickness is in hospitalization numbers. Of all the thousands of tests here in Ohio, only about 10% are testing positive.(This tells me that a lot of people are very sick from something other than CV19!) We know nothing about if the people are sick or hardly sick at all. Of all the people I know, only one person knows anyone that knows anyone that tested positive. They work at a prison and had almost no symptoms(slight cough and slight fever) and their wife shows no symptoms at all. He said that if he had not been forced(works at prison) to be tested, he wouldn't have thought anything of his illness and would not have been tested.

Interesting thing here is that on some lists if you die within the city limits of KCMO but in the are in any of the five counties that make up the city the death is listed as having happened in the original county where KCMO started. I am aware of two deaths which for whatever reason are not listed on a couple of the various listings that are on line. The number of listed deaths have not been changed after their deaths.

One of the problems with tallying positives is that you can only find them IF you are testing...and testing more than a tiny percentage of the population...maybe only people complaining of illness, or who are tested because they work or live closely with others (hospitals, nursing homes, prisons, etc.).

Research is finding a lot of people with antibodies who never even had symptoms -- but were presumably contagious. Once we establish the amount or type of antibodies that confer Covid-19 immunity, that simple blood test should provide a much more accurate 'count' -- along with being simple, cheap and fast.

This virus has a long incubation period, up to two weeks. Unlike flu, which is a couple of days. Mass testing would determine if someone is positive and doesn't realize it, thus spreading the virus. Because we don't have sufficient testing people need to self isolate to prevent them catching the virus from an unsuspecting carrier.

Not sure we'll ever be able TO mass test, though! We need something for home use...maybe similar to a colorectal 'sample' that could be sent back for testing. Is there anything like that yet? A DIY kit?

Alberta tests more people per capita than anywhere in the world. It's why our numbers have gone up so much in the past week: we now test ANYONE with ANY symptoms. A lot of people may think it's just their allergies, but nope: Covid. It's important to test no matter what symptoms you may have. This is allergy season here so more and more people are being tested (one of the test centers is across the street from where I work, ti's always so busy). My son will be tested as he has asthma and while he hasn't left his house in over a month (other than to drive to the store, and his wife goes into the store while he waits in the car with their son), he does cough a lot and he had streaks of blood in his mucous a few days ago. The nurse he spoke to the Alberta Health Services said it's just asthma but he and his girlfriend will be tested to set their minds at ease. I have a much bigger chance of contracting it as I work in a drugstore and PEOPLE WON'T STAY HOME!

Well, I know that in Ohio, there are a lot of people being tested and of those they are the most sick and people that work in places that are required to be tested, only approximately 10% are testing positive. So it isn't really like if you have a symptom you probably have covid...in fact it is quite the opposite!

Debby, I have asthma too and blood streaks in his mucous is not normal. I have had asthma for 40 years and that has never happened to me.

Chisue, mass testing is what needs to be done. It is a monumental failure that it not occurring.