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Sharp Health News

COVID-19 numbers: what they mean, why they matter

Sept. 15, 2020

Illustration of connection between five people

Whether you’re a parent of school-age children, work in the hospitality industry or just can’t wait to get back into your favorite fitness studio, you may have been closely monitoring the local COVID-19 numbers. These numbers are the metrics used by state and local authorities when determining which businesses and activities can open and which restrictions should be enforced.

But do you know what the numbers really mean and why they’re so important?

Understanding state guidelines
In California, state authorities use a four-tier, color-coded system — ranging from minimal spread of the disease to widespread — to determine whether a community is in the position to safely open businesses and other activities. California counties must stay in a tier for at least three weeks before being moved to a less restrictive tier, and will be moved to a more restrictive tier if metrics worsen for two consecutive weeks.

The state focuses on the following numbers to make a determination:

New cases: This number represents the daily number of confirmed COVID-19 cases per 100,000 people. If more than an average of 7 out of 100,000 people test positive each day of a seven-day period, the state would consider this “widespread.” With an estimated 3.37 million residents in San Diego County, that means an average of 236 or more people would have to test positive each day over a period of two weeks for the state to consider the county’s COVID-19 cases widespread, and many nonessential indoor business operations would be at risk of closure. On the other end of the spectrum, an average of less than one new daily case per 100,000 puts the county in the “minimal” tier, allowing most indoor business operations to be open with modifications.

Positive tests: This number is determined by looking at the number of COVID-19 tests with a positive result out of the total number of tests performed over a seven-day period. For example, if 100 tests are performed and 6 of those tests are confirmed positive, the percentage is 6%. California classifies a county’s risk level as minimal if less than 2% of tests are positive, and widespread if more than 8% are positive.

Understanding county guidelines
Along with new cases, also known as “case rate,” and positive tests, or “testing positivity,” the County of San Diego looks at several other numbers to determine whether the local health officer order should be modified, thus increasing or reducing restrictions. Using a “trigger” system, the county looks at 11 additional metrics related to epidemiology, health care and public health that indicate the level of local COVID-19 activity, including the following:

Community outbreaks: This is the number of outbreaks — defined as three or more COVID-19 cases in people from different households — in a community setting, such as in restaurants, bars, schools, gyms, businesses and health care settings. The county trigger calls for no more than seven community outbreaks over a seven-day period.

Hospital/ICU capacity: This represents the percentage of hospital or ICU beds filled in the county. The trigger will be activated if the county approaches 80% capacity of hospital beds and if less than 20% of ICU beds are available.

Increasing hospitalization: This is a three-day measurement of the average number of people hospitalized with a confirmed case of COVID-19. If more than 10% of people in the county with confirmed COVID-19 are hospitalized, the trigger would be activated.

Case investigation and contact tracing: These metrics track the percentage of COVID-19 confirmed cases that are investigated and the percentage of close contacts of people with confirmed COVID-19 that are contacted within 24 hours. The county trigger requires that 70% or more of case investigations must begin and 70% or more of positive case close contacts must be notified within 24 hours.

Additional numbers to know
Along with the numbers the state and county use to determine the level of COVID-19 spread and how businesses and other activities may be affected, experts and the general public also look at the total numbers of COVID-19 cases, probable cases, deaths to date and where the cases are located. These numbers help us:

  • Monitor the spread of the disease
  • Understand illness severity
  • Recognize risk factors for severe illness or death
  • Track transmission of the disease
  • Forecast virus spread
  • Determine COVID-19’s overall impact on communities and the health care system

“It is important to mention that although vast majority of the people who died of COVID-19 had preexisting conditions such as diabetes, high blood pressure and obesity, the exacerbating factor and the primary cause of death is the COVID-19 infection,” says Dr. Hai Shao, an infectious disease doctor affiliated with Sharp Chula Vista Medical Center. “Meanwhile, those comorbidities could greatly increase the risk of severe infection and death by COVID-19 infection, making certain population of the society more vulnerable to progress to severe infection and death once infected.”

According to the U.S. Department of Health and Human Services, up to 50% — 1 in every 2 people — of Americans 64 or younger have some type of preexisting condition, putting them in the high-risk category. “The best way to protect them from severe infection and death is to practice preventive measures, such as social distancing, wearing face coverings and frequent hand washing, to slow the transmission of COVID-19 in the society,” Dr. Shao says.

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