As you read about the increase in the positive test rate and hospitalization numbers in Cabarrus County due to the Delta variant, it is important to keep two things in mind:
• The fatality rate for those in Cabarrus County who were COVID positive has improved.
• Hospitalization numbers include patients who are not in the hospital, but are being treated virtually through a “hospital-at-home” program.
Last September, I asked Cabarrus Health Alliance (CHA) Director Dr. Bonnie Coyle to drill down on the aggregate level data related to Cabarrus County COVID-19 fatalities and break the data up into age ranges. Dr. Coyle had her epidemiologist complete this task. The data covered the time period from March 2020 to October 2nd, 2020.
• Out of all youth through age 19, there was a 0% case fatality rate, meaning everyone in this age range that were a known COVID-19 positive, 100% survived.
• Out of all adults age 20 through 64, the case fatality rate was .45%, meaning out of everyone in this age range that were a known COVID-19 positive, 99.55% survived.
So what has changed since October 2nd, 2020? The data through August 5th, 2021 show the following:
• For all youth through age 19, there has still been no deaths and the case fatality rate remains 0%.
• For adults age 20 through 64, the case fatality rate decreased 33%. It is now .3%, meaning out of everyone in this age range that were a known COVID-19 positive, 99.7% survived.
A similar drop in the case fatality rate has been for individuals age 65+, which include long-term care patients. The case fatality rate has decreased 35% from 12.4% to 8.08%. With long-term care fatalities removed, this percentage would decrease significantly.
The above case fatality rates are all overestimates due to the nature of COVID-19. CDC guidance has estimated the percent of asymptomatic carriers to be 40% of people who have COVID-19. Asymptomatic carriers are unlikely to be tested. This means that the Cabarrus fatality rates above are overestimated and the actual fatality rates are lower.
When we hear the hospitalization numbers increasing in the local media we assume that each of those patients is actually taking up a bed in the hospital. This is not actually the case. The Cabarrus hospitalization numbers include “virtual hospital patients” otherwise known as “Hospital at Home.”
Virtual patients receive digital tools to monitor temperature, blood pressure, pulse, and oxygen levels that deliver data via Bluetooth to a smartphone app. Atrium Health’s call center monitors data and checks in with patients daily. Some patients may receive home visits from paramedics to administer IV fluids, IV antibiotics, breathing treatments, EKGs, and other interventions such as in-home remdesivir. None of these patients are taking up a bed at a hospital facility.