Dr. Williams Talks about the Latest Numbers - Do we have to worry?


Good am everyone!  I hope your week is off to a great start. 


I apologize for taking time off from my Covid updates, but I have been trying to interpret these rising case numbers and reconcile them to what I have observed in the community and in the local hospitals. 


As I think everyone knows, South Carolina, and Charleston particularly, have seen a huge rise in cases over the last 2 weeks.  Simply put, this rise is due to  pretty much a total abandonment of practices such as social distancing, avoidance of mass gatherings, lack of mask wearing, etc. 


The most dramatic rise has been in younger individuals.  I believe I saw a stat last week that the increase in this age group was almost 500%.  However, most of these cases are reporting little or no symptoms. 


The lack of symptoms is good in terms of suggesting that the virus may be losing its strength, but bad in that people, especially young adults, feel less incentive to adhere to government guidelines.  The other benefit of the rising numbers is that we may be acquiring a herd immunity, which may help facilitate a return to normal, ie opening schools in the fall.


I learned early in my career while working at NIH that you can get numbers to tell you many different things. 


Many of the reports over the last week or so have been quite dire, reporting "highest daily cases on record," etc. 



However, we are doing much more testing.  In fact, there are so many tests being performed that it is taking longer to get test results back, which in turn alters the numbers and the narrative.  For instance, we keep hearing that the percent positive number is increasing. 


On Sunday it was as high as 20%.  This number is the number of positives divided by the total tests run.  However, you would expect the number of tests being performed on a Sunday to be lower, yet the tests results being reported on Sunday were actually performed days earlier. 


This would create a falsely high number.  There is also a delay effect on reporting, because is may take several days for a patient to undergo testing after symptoms started, with an additional delay in the reporting of the results.  As I have said many times, look at hospital utilization. 


Yesterday the number reported was down to 68% for the lowcountry and 71% statewide, which is pretty consistent to recent numbers. 


I also learned that daily bed utilization may take into account ER daily ER visits, but we know that many of those patient are immediately discharged.  I have not been able to verify this yet, but  while the number of Covid patients being treated at our hospitals has increased,


I am left to wonder how many of those roughly 900 patients on Sunday were simply seen in the ER and sent home? One other question I have but I cannot find the answer is what was the bed utilization this time last year? 


It would be great to have a year over year comparison.   I can tell you that the local OR's, where I am based, seem to be operating pretty much "business as usual,"  but with precautions in place.  Now my pulmonologist may disagree with me, as they are likely swamped right now, but as health care professionals we are generally used do dealing with waves of outbreaks.


I hope I've provided some useful information, and in short I would advise people to remain vigilant, and if you are elderly or have a lot of comorbid health conditions, care must be taken to protect yourself since there is a lot of virus out there. 


I would also encourage people to question the numbers and the reports, and as always, feel free to call me with any questions.

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