How do we know a pandemic's over?

[dann]

Go to this page and click on "Hospitalization" in the sidebar.

Thanks.

That happens to be Los Angeles County data ...

Did you notice the conspicuous uptick of percent of Confirmed Hospitalized Covid-19 Cases in ICU on Dec 6, the most recent date so far?

... but, as another example, take a look at New York state (click on "Hospitalization" above the figure), which shows the same pattern.

If we begin with cases, did you notice the rise from Nov 5 (483) to Dec 1 (919)/Dec 4 (817)? It's still considerably less than last year but probably still rising.
As for deaths and hospitalizations, the NYC numbers are enviably low! NYC has a population of 8.5 million. In comparison, Denmark has 5.9 and Sweden 10.4. Sweden now has about 30 deaths a day. Recent daily C19 deaths in Denmark: Dec 4: 4, Dec 3: 11, Dec 2: 8, Dec 1: 9, Nov: 30: 6, Nov 29: 12, Nov 28: 9, 27: 13, Nov 26: 5, Nov 25: 6, Nov 24: 7, Nov 23: 7, Nov 22: 7, Nov 21: 3, 20: 9.

For your sake (if you live in NYC), I hope the NYC numbers are correct, but the numbers you have been presented with from other countries show that the pandemic is far from over!

 

[dann]

We're getting warnings about an ongoing surge in demand at hospital emergency departments.
Ambulance 'ramping' is at an all-time high.
(Ramping is where patients cannot leave the ambulance because there is nowhere in the hospital to put them).
We're very lucky that this surge is happening out of step with seasonally repiratory viruses (our summer has just started).

In a Twitter/X thread started by someone who was trying to predict how the current variants would behave but apparently based only on trends from the northern hemisphere and thus assuming that the currently rising C19 numbers were a mere seasonal effect, I tweeted a link to your post.
I got this reply (not from the one who had started the thread):

Thank you! I was just going to say I’m in South Australia and have Covid for the first time (day 9). Numbers are getting bigger here for sure.

 

[jt512]

Did you notice the conspicuous uptick of percent of Confirmed Hospitalized Covid-19 Cases in ICU on Dec 6, the most recent date so far?

Yeah, I don't think it means anything. There were only 23 cases in the ICU that day, half as many as one week before.

If we begin with cases, did you notice the rise from Nov 5 (483) to Dec 1 (919)/Dec 4 (817)? It's still considerably less than last year but probably still rising.

So what? There are always going to be fluctuations in the number of cases. That does't mean we're still in a pandemic. There have been fewer severe cases every year. The peak last winter (2022–23) was around 1300. That compares with peaks of 8000 in 20–21 and 4800 in 21–22. That was the last extraordinary peak; the pandemic was essentially over after that winter. There is no reason to think that this winter will be any more severe than last.

I hope the NYC numbers are correct, but the numbers you have been presented with from other countries show that the pandemic is far from over!

There is nothing in the L.A. data to suggest that we are still in a pandemic. Quite the contrary, the incidence of severe disease has been fluctuating with seasonal summer and winter peaks, with declining trends in each (sharply declining in the more-severe summer peaks).

 

[dann]

Yeah, I don't think it means anything. There were only 23 cases in the ICU that day, half as many as one week before.

An uptick in the percentage of positives indicates that too few are tested: When your testing strategy is to test only those who are severely ill, the percentage of positives tends to go up along with the (statistical) CFR.

So what? There are always going to be fluctuations in the number of cases. That does't mean we're still in a pandemic. There have been fewer severe cases every year. The peak last winter (2022–23) was around 1300. That compares with peaks of 8000 in 20–21 and 4800 in 21–22. That was the last extraordinary peak; the pandemic was essentially over after that winter. There is no reason to think that this winter will be any more severe than last.

"There are always going to be fluctuations" is a pretty cavalier attitude to have about a virus that kills a considerable number of people and leads to organ and vascular damage in more.
20-21 was pre-vaccination. Last winter, Dec, Jan, Feb 2022-23, Omicron killed about 40,000 in the USA.
It remains to be seen how many it kills and maims in the winter of 2023-24, but so far things aren't looking good in many other countries ... and New Mexico ... and

COVID-19 hospitalizations in the U.S again rose week over week, according to the lates figures from the Centers for Disease Control and Prevention.
The U.S. tallied approximately 19,400 new hospitalizations of people with COVID-19 over the seven days ending with Nov. 25, according to provisional data - about 1,700 more than the total for the previous week and a rise of approximately 10%. The uptick marks the third weekly increase in a row after COVID hospitalizations in the U.S. had largely been trending downward since early September when they totaled about 21,000.
The Top Covid-19 Hot Spots in the U.S. (U.S.News, Dec 4, 2023)

Coming to a movie theater, a pub, a restaurant, a school, an office ... near you.

There is nothing in the L.A. data to suggest that we are still in a pandemic. Quite the contrary, the incidence of severe disease has been fluctuating with seasonal summer and winter peaks, with declining trends in each (sharply declining in the more-severe summer peaks).

We are still in a pandemic whether you like it or not. And as mentioned in previous posts, this is not a seasonal virus like the flu, which tends to disappear in the summer. Since you mention the "summer peaks," you seem to be aware of that, but unfortunately, we don't know exactly what happened in the summer of 2023. CNN has also stopped tracking the virus.

 

[The Atheist]

Hospital admissions are up to the same as they were in the middle of last year, soon after we let the virus rip.

Should've gone to Specsavers, because that is absolutely false.

The numbers are nowhere near what they were in mid-2022 - that is plainly visible from the graph you posted! In fact, if you were being honest you'd say they're not even half what they were in mid-'22, but I'm not even slightly surprised you'd try to falsify something you actually posted.

Also, the current number is a whopping double the hospital numbers for almost the entire first half of 2023. It's not even close to being a crisis, and you know bloody well how broken our hospital system is.

There are a whole 3 people in ICU. That's not a crisis, it's life. Check the ages of the deceased to find out who's dying of covid this year. The average age is just a tick under 90. Tragic.

Wastewater detections and reported cases continue to diverge.

Yes, and if you adjust those spectacles and look at the graph, you'll see that numbers are up to half of what they were in January.

 

[marting]

In San Diego County (pop 3.3M), Covid-19 is roughly as bad as the flu in a high flu season with deaths running about 300/y since Aug 1, 2023. The main difference from flu is that Covid-19 is spread out more without the sharp, seasonal peaks of flu. These tend to max out hospitals. For instance, in the 2017-18 season there were 342 flu deaths and the large majority were in a 4 week period. Since Covid-19, flu has been markedly lower than normal. That may change this season.

Here's a link to the weekly Respiratory Virus Surveillance Report:

https://www.sandiegocounty.gov/cont...SDC_Respiratory_Virus_Surveillance_Report.pdf

And the high flu 2017-18 report.
https://www.sandiegocounty.gov/cont...rams/phs/documents/Season_Summary_2017-18.pdf

Because Covid-19 is so spread out compared to flu that even though its impact is similar to a bad flu season overall, it's not stressing health care and most people are just going about their business normally. Few masks. Crowds everywhere. Latest vax uptake just over 10%. No evidence of a big surge after the Thanksgiving holiday (a big deal in the States). Flu is starting to ramp strongly and likely catch up with Covid in the next few weeks.

 

[jt512]

Yeah, I don't think it means anything. There were only 23 cases in the ICU that day, half as many as one week before.

An uptick in the percentage of positives indicates that too few are tested: When your testing strategy is to test only those who are severely ill, the percentage of positives tends to go up along with the (statistical) CFR.

I wasn't talking about the percentage of positives. I was talking about the percentage of hospitalized cases there are in the ICU.

So what? There are always going to be fluctuations in the number of cases. That does't mean we're still in a pandemic. There have been fewer severe cases every year. The peak last winter (2022–23) was around 1300. That compares with peaks of 8000 in 20–21 and 4800 in 21–22. That was the last extraordinary peak; the pandemic was essentially over after that winter. There is no reason to think that this winter will be any more severe than last.

"There are always going to be fluctuations" is a pretty cavalier attitude to have about a virus that kills a considerable number of people and leads to organ and vascular damage in more.

I wasn't expressing any attitude. I was stating a fact. I don't know what you think a pandemic is, but I know that whatever you think it is is wrong.

A pandemic has nothing to do with the absolute incidence of a disease or a disease's severity. A pandemic is, by definition, a worldwide significant increase in the incidence of a disease above its usual level. Once the incidence of a disease diminishes to its usual level, a pandemic is over—by definition. The disease is endemic. That's what we see now. There has been no major spike in incidence since winter of 2021–22. The incidence has settled down to an endemic level with what seem to be predictable increases in winter and summer. I'm not alone in saying that this. The US CDC, European CDC, and the WHO have all stated that Covid-19 is now endemic rather than pandemic.

 

[Roger Ramjets]

Should've gone to Specsavers, because that is absolutely false.

The numbers are nowhere near what they were in mid-2022 - that is plainly visible from the graph you posted!

Ha! you got me. Turns out the exact middle of the year is July 2. The number for week ending July 3 is 597. Compared to 408 on Nov 26 that's 46% higher. But if we look 2 weeks earlier on June 19 it's 404, 1% lower.

Nitpicking, the favorite trick of dishonest debaters.

Check the ages of the deceased to find out who's dying of covid this year. The average age is just a tick under 90. Tragic.

Because if you don't die immediately it's all good, right?

The second highest age group of people catching it is 60-69 (almost equal to 50-59). I'm 66 and if the last 'cold' I got is any indication it could be very nasty indeed. I know people in their 80's who are still very active and I certainly don't want to see them die or be incapacitated by this virus.

Yes, and if you adjust those spectacles and look at the graph, you'll see that numbers are up to half of what they were in January.

Coronavirus disease (COVID-19) pandemic

On 5 May 2023, more than three years into the pandemic, the WHO Emergency Committee on COVID-19 recommended to the Director-General, who accepted the recommendation, that given the disease was by now well established and ongoing, it no longer fit the definition of a PHEIC. This does not mean the pandemic itself is over, but the global emergency it caused is – for now.

Wastewater detections in New Zealand are now higher than they were on August 28 2022. I sure hope they don't go much higher, because if they do it means we are still well in pandemic territory.

 

[Roger Ramjets]

...and you know bloody well how broken our hospital system is.

But we have a National government now, so no worries - provided you have good medical insurance or a ton of money in the bank.

For the rest of us, every hospital bed taken up by Covid is one that can't be filled by other deserving cases. It took me 2 years to get a hernia operation even though it was severely affecting my ability to work, and even then the assessor said I didn't qualify. But he saw my predicament and got a contract job at the local private hospital (same hospital and same surgeon who did the operation I paid for 15 years prior. Can't afford to go private now). And that was before Covid.

 

[Myriad]

We really should be vaccinating all pregnant women as well as six-month-olds - and the rest of the population.

Maybe fix this little problem first.

 

[The Atheist]

Ha! you got me. Turns out the exact middle of the year is July 2. The number for week ending July 3 is 597. Compared to 408 on Nov 26 that's 46% higher. But if we look 2 weeks earlier on June 19 it's 404, 1% lower.

Nitpicking, the favorite trick of dishonest debaters.

That is pure gold. During almost all of July 2022 the number of hospital cases was over 900, double the present load, so you pick a date that suits your false claim.

Love it!

Maybe fix this little problem first.

From my reading, that's not good.

Is it possible that shift is why some kids are getting sicker with pneumonia? Hmm.

 

[dann]

Is it possible that shift is why some kids are getting sicker with pneumonia? Hmm.

"... there are no adverse outcomes reported from mistranslation of mRNA-based SARS-CoV-2 vaccines in humans ..."

Is it possible that someone, a well-known C19 minimizer who warned against C19 vaccinations for kids because that would somehow prevent them from getting vaccinated against the old childhood infectious diseases, is it possible that he is again warning against the vaccines that protect children from C19? Hmm.

Currently, everything seems to indicate that repeated infections with C19 weakens the immunity of (not only) kids, making them more susceptible to other infectious diseases, but C19 inimizers and antivaxxers blame it on the vaccines. Hmm.

 

[dann]

Maybe fix this little problem first.

Maybe you should take a look at this little problem before you spread your little problem:

A new study is making the rounds in the antivax crankosphere. The study found that the modified mRNA used in the Pfizer vaccine can cause a frame shift (to be explained) that results in the production of proteins besides the intended spike protein. The findings are, as you probably guessed, a big nothingburger compared to how they are being spun.
Do mRNA vaccines produce harmful “junk proteins” that “gunk up” the cell and cause unintended “off-target” immune responses? (Science-Based Medicine, Dec 11, 2023)

You already managed to get The Atheist's hopes up!

 

[TragicMonkey]

Cases are rising in my part of the US Midwest, but it's still manageable: nowhere near running out of hospital beds or medicine or staff. Total number of inpatients with covid diagnosis is low, percentage of ambulatory patients with covid is also low. Staff on site in clinical settings are masking again, the notification cited both covid and RSV together.

I shall probably wear a mask myself when I go out in public for the next few weeks, just in case. Would hate to spend Xmas sick.

 

[dann]

It sounds like the rational thing to do in the current situation.
The Danish public-health authorities like to cite COVID-19 together with RSV, flu and mycoplasma. I suspect that it serves the purpose to make C19 appear to be 'just another one of those respiratory diseases'. But whenever you get to see the actual numbers, C19 outnumbers all the others combined in cases, hospitalizations and deaths, much like marting's San Diego numbers in post 366.

 

[theprestige]

Oh snap, dog! It happened to me! I traveled for the holidays, and now I have a head cold! That pandemic sure is something!

Well I ended up taking a covid test, since this thing has been kicking my ass for over a week now... and it came back negative. So I guess it's just a really bad cold. Still not enough to put me in the hospital though.

 

[dann]

In San Diego County (pop 3.3M), Covid-19 is roughly as bad as the flu in a high flu season with deaths running about 300/y since Aug 1, 2023. The main difference from flu is that Covid-19 is spread out more without the sharp, seasonal peaks of flu. These tend to max out hospitals. For instance, in the 2017-18 season there were 342 flu deaths and the large majority were in a 4 week period. Since Covid-19, flu has been markedly lower than normal. That may change this season.

Flu has been markedly lower than normal everywhere, and markedly lower than C19 since it's less contagious. The precautions taken against C19 seem to have worked even better against the flu.

Here's a link to the weekly Respiratory Virus Surveillance Report:
https://www.sandiegocounty.gov/cont...SDC_Respiratory_Virus_Surveillance_Report.pdf

And the high flu 2017-18 report.
https://www.sandiegocounty.gov/cont...rams/phs/documents/Season_Summary_2017-18.pdf

Your San Diego link says:

COVID-19: Cases 25,164, Deaths 143, Outbreaks 219.
Influenza: Cases 3,028, Deaths 6, Outbreaks 1.
RSV: Cases 1,944, Deaths 2, Outbreaks 3.

So C19 has not only killed far more people, the CFR is also considerably higher than the flu.
When you think that the flu is "likely [to] catch up with Covid in the next few weeks," are you then talking about cases, deaths or outbreaks? Or 'all of the above'?

Because Covid-19 is so spread out compared to flu that even though its impact is similar to a bad flu season overall, it's not stressing health care and most people are just going about their business normally. Few masks. Crowds everywhere. Latest vax uptake just over 10%. No evidence of a big surge after the Thanksgiving holiday (a big deal in the States). Flu is starting to ramp strongly and likely catch up with Covid in the next few weeks.

It's obviously good if C19 isn't stressing health care like last year: ERs stressed as COVID-19 cases increase in San Diego County (San Diego Union-Tribune, Dec 8, 2022)

However, something appears to be stressing health-care workers even if it isn't C19:

The strike targets Kaiser hospitals and medical offices in California, Colorado, Oregon, Virginia, the District of Columbia, and Washington state.
(...)
People hold placards, as a coalition of Kaiser Permanente Unions representing 75,000 healthcare workers at Kaiser Permanente start a three day strike across the United States over a new contract, in San Diego, California, U.S. October 4, 2023.
Unions that represent Kaiser workers are demanding long-term investments to address a staffing shortage in addition to better pay and benefits. Negotiations between Kaiser executives and workers are ongoing.
Caroline Lucas, executive director of the Coalition of Kaiser Permanente Unions, said the staffing crisis has led to unsafe working conditions and deteriorating care for patients.
“We continue to have front-line health-care workers who are burnt out and stretched to the max and leaving the industry,” Lucas told CNBC.
“We have folks getting injured on the job because they’re trying to do too much and see too many people and work too quickly. It’s not a sustainable situation.”
Kaiser said it has contingency plans to ensure patients continue to receive care during a strike.
More than 75,000 workers strike at hundreds of Kaiser Permanente health facilities across U.S. (CNBC, Oct 4, 2023)

I don't think you're right, marting!
And as for people "just going about their business normally. Few masks." I am not sure that you are aware what this means. It's The Atheist's favorite argument whenever his comparisons and predictions are debunked.

It means that more people will get infected, hospitalized and die because they don't take precautions - for their own sake or for the sake of those who are particularly vulnerable.
I doesn't mean that the pandemic is over.

It's a well-known and unfortunate phenomenon in disaster research that people often respond irrationally to a crisis, be it a fire, a tsunami or a pandemic.
A short Twitter/X thread about the three typical kinds of behavior in those situations and how it relates to the current pandemic.

But enogh for now. It's time to relax with another episode of The Walking Dead:
Did Watching All Those Zombie Movies Prepare You For The Pandemic? Research Says Yes! (Forbes, Jan 12, 2021)

 

[dann]

Well I ended up taking a covid test, since this thing has been kicking my ass for over a week now... and it came back negative. So I guess it's just a really bad cold. Still not enough to put me in the hospital though.

Even if it isn't C19 - and I hope it isn't - the severity might still be C19-related: Does COVID-19 Mess with the Immune System? (McGill, Feb 10, 2023).
How come we don't have a single Get-well emoji when Southern Living has no less than 76 Heartfelt Get Well Wishes To Write In A Card?

 

[theprestige]

Even if it isn't C19 - and I hope it isn't - the severity might still be C19-related: Does COVID-19 Mess with the Immune System? (McGill, Feb 10, 2023).

Betteridge's Law of Headlines.

How come we don't have a single Get-well emoji when Southern Living has no less than 76 Heartfelt Get Well Wishes To Write In A Card?

I have no opinion about that.

 

[dann]

I wasn't talking about the percentage of positives. I was talking about the percentage of hospitalized cases there are in the ICU.

I wasn't expressing any attitude. I was stating a fact. I don't know what you think a pandemic is, but I know that whatever you think it is is wrong.

A pandemic has nothing to do with the absolute incidence of a disease or a disease's severity. A pandemic is, by definition, a worldwide significant increase in the incidence of a disease above its usual level. Once the incidence of a disease diminishes to its usual level, a pandemic is over—by definition. The disease is endemic. That's what we see now. There has been no major spike in incidence since winter of 2021–22. The incidence has settled down to an endemic level with what seem to be predictable increases in winter and summer. I'm not alone in saying that this. The US CDC, European CDC, and the WHO have all stated that Covid-19 is now endemic rather than pandemic.

Dream on. Your definition is wrong, and your claim that the CDC, the ECDC and WHO agree with you is a delusion. What the US CDC said was that "as a nation, we now find ourselves at a different point in the pandemic." In the pandemic! Do you understand the meaning of those words?!
WHO says, "The COVID-19 Pandemic is not over yet," and, "This does not mean the pandemic itself is over, but the global emergency it caused is – for now."
I also don't see the ECDC declaring anywhere that the pandemic is over.

It is nothing new that minimizers make up whatever they want to believe. That's why you're "not alone in saying that," but it's a delusion to think that the CDC, the ECDE and WHO back you up on this. Particularly now when the levels of infection are rising all over the world - and in Australia, too, in spite of all the talk about C19 being a seasonal flu.