Season Officially Suspended -- COVID-19/Coronavirus Talk

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bleedblue1223

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So what exactly is going on in Texas? Does the news stack up with reality?
I keep hearing about how bad it is from people (on the other side of the country) who quite obviously have zero ties to Texas.
My company is based in Houston and phase 2 of the office reopening has been delayed, so yes, the spike is being taken seriously. With positive test rates well above 10%, the concern is real.

Now, I haven't look at the data to know what the average age is, to know if the death count will stay low or rise or what the hospitalization looks like to know if they will be overwhelmed, but those are the next factors to really know if there will be major issue.
 

Robb_K

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My company is based in Houston and phase 2 of the office reopening has been delayed, so yes, the spike is being taken seriously. With positive test rates well above 10%, the concern is real.

Now, I haven't look at the data to know what the average age is, to know if the death count will stay low or rise or what the hospitalization looks like to know if they will be overwhelmed, but those are the next factors to really know if there will be major issue.

I don't think the death rate will ever be quite as high in places where it was high early during the pandemic, because before we knew what was happening lots of old and feeble people were dying in care homes because of their overcrowding, and lack of safety policies in place to ensure their protection, which have since been implemented. In addition, some of the areas around the country sent Covid patients to care facilities instead of to hospitals when the latter were overbooked. Those mistakes won't be happening during this spike.
 

Stupendous Yappi

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So what exactly is going on in Texas? Does the news stack up with reality?
I keep hearing about how bad it is from people (on the other side of the country) who quite obviously have zero ties to Texas.
I can tell you about my neck of the woods, and I can tell you about the children’s hospitals around the state.

- There is a spike in cases. It is due in part to additional testing, but is demonstrably a real spike because the percentage of tests coming back positive is higher than it was a few weeks ago.

- The average age of the positive cases and of the hospitalized patients is lower than it was. This includes the ICU patients.

- The hospital capacity issue is a little complicated. There has been a high census of non-Covid ‘catch up’ work going on, due to a combination of hospitals trying to recover financially from the huge hit they’ve taken when elective procedures were suspended, and partly due to the patients who’ve been putting things off finally coming out of their caves. The lady who needed a hip replacement or the guy who needed an invasive biopsy who thought they could gut it out for a couple months have been suffering with their issues, but have been getting stuff taken care of now.

State/federal hospital rules dictate that hospitals could only reopen for elective procedures if they abide by certain safety measures, have sufficient PPE and pretty much promise they won’t ask for more later from the state, and are required to retain 15% of beds specifically for Covid only.

So now the Covid admissions are rising (but so far still not deaths) and some hospitals in the mot populous areas are getting close to filling their normal capacities. The governor has re-suspended elective procedures in those 4 biggest counties (Houston, Austin, Dallas and San Antonio). Basically those hospitals could shift to take on a lot more Covid patients if necessary, but they’re not on that footing immediately because of the high census of non-Covid elective admissions. It shouldn’t take too long to shift that footing, so my opinion is that the noise about overwhelming capacity is probably overblown. There is a lot of slack in the system.

I’ve also seen false rumors even among medical people who should be better informed and should know better. I’m on a bulletin board for pediatric pulmonology, and several people believed Texas Children’s Hospital (Texas) was “full”. The head of the PICU responded and debunked the rumor.

My own county, the hospitals have also re-suspended non-essential admissions and procedures pre-emptively, although it’s not ordered by the state government yet.

I will be surprised if there is not a rise in deaths with a wave form lagging behind this surge. But I also think the amplitude will be much lower, with nowhere near the numbers the nursing home wave incurred. But so far, the death numbers have been steady. Scroll to the bottom of the link for graphs of new cases and daily deaths.
Texas Coronavirus: 159,310 Cases and 2,437 Deaths (COVID-19 ) - Worldometer

Its clear that there are a LOT of mild cases being detected. But there are people requiring hospitalization. I think less of these cases will prove fatal due to relatively healthier people combined with better knowledge for treatment. For example, some early reports were that steroids hastened death. Later data is showing benefit from a course of dexamethasone (now recommended by the NIH if the patient is intubated or requiring supplemental oxygen). The threshold to admit someone to the hospital is probably lower, too.

The number to watch is the deaths. Surely it will go up some, but if it’s a modest rise and fall which accompanies a high number of cases, Texas areas will probably follow NYC as place where new Covid activity is very slow because so many people have already recovered.
 

Celtic Note

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Has anyone else come across any information on asymptomatic people having lung damage due to the virus. There was an article in Newsweek with quotes from a doctor saying that he was seeing lung damage in those people and the doctor thought that 50-100% of people who get the virus will sustain damage. He was basing this off CT scans he had done on a group of those people. That number seems high to me, but I am in no way qualified to know.
 

Stupendous Yappi

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Has anyone else come across any information on asymptomatic people having lung damage due to the virus. There was an article in Newsweek with quotes from a doctor saying that he was seeing lung damage in those people and the doctor thought that 50-100% of people who get the virus will sustain damage. He was basing this off CT scans he had done on a group of those people. That number seems high to me, but I am in no way qualified to know.
I’m not familiar with that specific article, but asymptomatic people may still be experiencing negative effects...like as if they had an infection, which they did. It doesn’t mean permanent damage. There isn’t evidence of that, just alarmist speculation which is being given a platform because it suits someone’s agenda. I would argue that every respiratory virus known to man can cause permanent damage if the infection is severe, or leave no trace if it’s mild. There is nothing magical about Covid, and people who have experienced severe infections may show scarring or measurable declines in lung function afterward. It also may take months to fully recover from a severe infection. I see people all the time with severe influenza pneumonias who have permanent scarring and take up to a year to recover to their new baseline. I took care of an athletic teenager a couple years ago who nearly died from influenza, went home with a tracheostomy, but ultimately was able to get rid of it and resume her normal life. She still had a drop in her lung function I could measure many months later, but she was back doing sports.

Fortunately, you can lose a significant amount of lung function without impacting your activity level. For most measures, 80% of predicted capacity is considered within the normal range. Maybe an Olympic level athlete would perceive the difference, but not most of the rest of us.

Having the virus means that individual cells in your body are invaded by virus, which hijacks the cellular machinery and results in the eventual death of the cell. Groups of similar cells in the body are called tissues. If enough cells die in a tissue (like the lung), you’ll have symptoms and you’ll have measurable effects we can test for or image. I think situations like the asymptomatic cases of Covid are just on the fringe where not enough cells in groups are being affected for the person to register it. Some folks are less attuned to their bodies, and sometimes it’s just been fought off by the immune system so quickly that not much happened.

Let me ask you this: If you had an illness that didn’t cause you any symptoms or change your life in any way at any point of the illness or after, would it matter to you if your CT scan showed scars? Really, if it doesn’t have any effect on you, what’s the point? I shouldn’t waste your time and money doing a CT scan on you in that case, unless I can prove that it’s a risk to your future. But in this scenario it’s just looking at the rubble of what happened in the past. Sure, it’s interesting that I can see it, but it’s not going to change anything you do. We won’t know until there is time to study people years in the future, but it’s not like we don’t have experience with severe viral infections of many kinds which we can draw parallels from. This isn’t some plague from outer space that does stuff no one has seen before. The difference with this virus is that no one was immune to it and a higher percentage of infected people had severe courses.
 

Celtic Note

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I’m not familiar with that specific article, but asymptomatic people may still be experiencing negative effects...like as if they had an infection, which they did. It doesn’t mean permanent damage. There isn’t evidence of that, just alarmist speculation which is being given a platform because it suits someone’s agenda. I would argue that every respiratory virus known to man can cause permanent damage if the infection is severe, or leave no trace if it’s mild. There is nothing magical about Covid, and people who have experienced severe infections may show scarring or measurable declines in lung function afterward. It also may take months to fully recover from a severe infection. I see people all the time with severe influenza pneumonias who have permanent scarring and take up to a year to recover to their new baseline. I took care of an athletic teenager a couple years ago who nearly died from influenza, went home with a tracheostomy, but ultimately was able to get rid of it and resume her normal life. She still had a drop in her lung function I could measure many months later, but she was back doing sports.

Fortunately, you can lose a significant amount of lung function without impacting your activity level. For most measures, 80% of predicted capacity is considered within the normal range. Maybe an Olympic level athlete would perceive the difference, but not most of the rest of us.

Having the virus means that individual cells in your body are invaded by virus, which hijacks the cellular machinery and results in the eventual death of the cell. Groups of similar cells in the body are called tissues. If enough cells die in a tissue (like the lung), you’ll have symptoms and you’ll have measurable effects we can test for or image. I think situations like the asymptomatic cases of Covid are just on the fringe where not enough cells in groups are being affected for the person to register it. Some folks are less attuned to their bodies, and sometimes it’s just been fought off by the immune system so quickly that not much happened.

Let me ask you this: If you had an illness that didn’t cause you any symptoms or change your life in any way at any point of the illness or after, would it matter to you if your CT scan showed scars? Really, if it doesn’t have any effect on you, what’s the point? I shouldn’t waste your time and money doing a CT scan on you in that case, unless I can prove that it’s a risk to your future. But in this scenario it’s just looking at the rubble of what happened in the past. Sure, it’s interesting that I can see it, but it’s not going to change anything you do. We won’t know until there is time to study people years in the future, but it’s not like we don’t have experience with severe viral infections of many kinds which we can draw parallels from. This isn’t some plague from outer space that does stuff no one has seen before. The difference with this virus is that no one was immune to it and a higher percentage of infected people had severe courses.

I figured quite a bit of this was the case. I know Pneumonia can cause permanent scaring or show as temporary cloudiness in imaging. The severity of the individual case seems to be the most decisive element. The same being true of other respiratory viruses. that’s my layman’s understanding.

I was wondering if what was reported in Newsweek was higher than the typical respiratory virus. It’s seemed higher to me and potentially not accurate. The study seemed more antidotal than anything and there was no link to a study. Thus the question about other reports or studies.

I had not heard the 80% functional baseline. That’s good to know.

As for the hypothetical, I have had a very similar scenario happen. Sick in December with many of the Covid symptoms. 2 weeks of low fever, 1 month of coughing. Then I have imagine for something unrelated issue a month later and they see something in my lungs. Follow up CT shows scarring, but it’s unclear if it was Covid (not sure I even had it) or something else. It is also unclear if it was that most recent illness or a previous one. If anything that whole situation has just reinforced that healthcare is imprecise just like other professions. We do our best with the information we have.

I often wonder if it would be better not knowing about it. It would be personally less stressful not knowing the damage exists. But, I will certainly be more diligent when it comes to my respiratory health now that I know. But, will that diligence even matter? Who knows. So we are back to the question of whether I would want to know or not. I am not sure I even have my personal answer.
 
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Stupendous Yappi

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I figured quite a bit of this was the case. I know Pneumonia can cause permanent scaring or show as temporary cloudiness in imaging. The severity of the individual case seems to be the most decisive element. The same being true of other respiratory viruses. that’s my layman’s understanding.

I was wondering if what was reported in Newsweek was higher than the typical respiratory virus. It’s seemed higher to me and potentially not accurate. The study seemed more antidotal than anything and there was no link to a study. Thus the question about other reports or studies.

I had not heard the 80% functional baseline. That’s good to know.

As for the hypothetical, I have had a very similar scenario happen. Sick in December with many of the Covid symptoms. 2 weeks of low fever, 1 month of coughing. Then I have imagine for something unrelated issue a month later and they see something in my lungs. Follow up CT shows scarring, but it’s unclear if it was Covid (not sure I even had it) or something else. It is also unclear if it was that most recent illness or a previous one. If anything that whole situation has just reinforced that healthcare is imprecise just like other professions. We do our best with the information we have.

I often wonder if it would be better not knowing about it. It would be personally less stressful not knowing the damage exists. But, I will certainly be more diligent when it comes to my respiratory health now that I know. But, will that diligence even matter? Who knows. So we are back to the question of whether I would want to know or not. I am not sure I even have my personal answer.
Incidental findings occur all the time, where imaging is done for some other reason, and discovers something ‘wrong’ that the person may have lived with their whole lives. It could be something that needs urgent attention, or it could be something that’s just a curiosity with no consequences.

One thing people who are just going by TV portrayals of medicine often don’t think about, is that you shouldn’t do a test without a good reason. EVERY medical test (including imaging) has false positives and false negatives. If I order a test and we respond to a false positive result, it could cost you time, money, distress and possible harm if we do a treatment with side effects or procedure (like maybe a biopsy) to follow-up. There needs to be enough suspicion of a problem to outweigh the chances for harm from false results to justify doing any given test in the first place.

Even Covid testing falls into this category.
 
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SaintLouHaintBlue

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Incidental findings occur all the time, where imaging is done for some other reason, and discovers something ‘wrong’ that the person may have lived with their whole lives. It could be something that needs urgent attention, or it could be something that’s just a curiosity with no consequences.

One thing people who are just going by TV portrayals of medicine often don’t think about, is that you shouldn’t do a test without a good reason. EVERY medical test (including imaging) has false positives and false negatives. If I order a test and we respond to a false positive result, it could cost you time, money, distress and possible harm if we do a treatment with side effects or procedure (like maybe a biopsy) to follow-up. There needs to be enough suspicion of a problem to outweigh the chances for harm from false results to justify doing any given test in the first place.

Even Covid testing falls into this category.

One of the most enlightening things that I've learned as an undergrad (biomedical engineering) is the exact sort of paradox that you kind of allude to - except the context was cancer screening, not virological testing.

Some forms of cancer can be screen using methods that are visual (skin cancer), or palpable (breast/testicular cancer).

However, in the case of cancer that begins in major organs - particularly organs that are located deep within the body (such as the pancreas) - the "best" way to screen would be to perform an annual biopsy - which is also, paradoxically, the "worst way", due to the associated risks/costs of surgery - which are exacerbated if the procedure is performed routinely.

With screenings, biomarkers - etc; it's quite elusive to come up with a "perfect" screening strategy, perhaps impossible.
No matter what the test strategy is - as long as there is some type 1 or type 2 error present - then somebody's life is going to change drastically depending on the prognosis.
If a person has cancer (and the screening misses it), then by the time they are symptomatic, it will likely have already metastasized beyond what is treatable.
If someone is informed (incorrectly) that they have a potential life ending cancer, when they don't - that isn't a situation that can be ignored either, because the person is faced with making major, life changing decisions (treatment costs, wills, bucket list, etc.). If the false positive is not identified in time, the person's life will still be irrevocably changed.
 

Stupendous Yappi

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With the NBA and MLB moving forward with their plans to play, things have got to be solidifying for the NHL. I still can't find any information about plans for a player vote before reporting to their camps. But the reference that was quoted on here had said it would occur before July. Well, its July.

The training camps are scheduled to start July 10th. I don't think there is another vote coming. There's no way you could make arrangements on such short notice for something that is due to start in 9 days. I think the vote the NHLPA made WAS the vote and that some reporters must have misunderstood.
 

BlueDream

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With the NBA and MLB moving forward with their plans to play, things have got to be solidifying for the NHL. I still can't find any information about plans for a player vote before reporting to their camps. But the reference that was quoted on here had said it would occur before July. Well, its July.

The training camps are scheduled to start July 10th. I don't think there is another vote coming. There's no way you could make arrangements on such short notice for something that is due to start in 9 days. I think the vote the NHLPA made WAS the vote and that some reporters must have misunderstood.
The NHL isn’t solidifying anything. The reason the vote hasn’t happened is because the league is taking f***ing forever to even decide on where to play. For the past month at least we heard Vegas was basically a lock. Now it seems like that’s out the window and there’s still no decision. The league looks extremely dumb and inept right now that they still haven’t finalized details that should have been in place by now. The MLB and NBA are both way ahead of the 8 ball and the NHL is, as usual, far behind.

Looking like it will be Edmonton and Toronto but not officially announced yet. McKenzie is reporting the final player vote on all of this will come this weekend.
 
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Robb_K

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The NHL isn’t solidifying anything. The reason the vote hasn’t happened is because the league is taking f***ing forever to even decide on where to play. For the past month at least we heard Vegas was basically a lock. Now it seems like that’s out the window and there’s still no decision. The league looks extremely dumb and inept right now that they still haven’t finalized details that should have been in place by now. The MLB and NBA are both way ahead of the 8 ball and the NHL is, as usual, far behind.

Looking like it will be Edmonton and Toronto but not officially announced yet. McKenzie is reporting the final player vote on all of this will come this weekend.
Canada would be safer than any US City. But, I wonder if Winnipeg might be better than Toronto.
 

Stupendous Yappi

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The NHL isn’t solidifying anything. The reason the vote hasn’t happened is because the league is taking f***ing forever to even decide on where to play. For the past month at least we heard Vegas was basically a lock. Now it seems like that’s out the window and there’s still no decision. The league looks extremely dumb and inept right now that they still haven’t finalized details that should have been in place by now. The MLB and NBA are both way ahead of the 8 ball and the NHL is, as usual, far behind.

Looking like it will be Edmonton and Toronto but not officially announced yet. McKenzie is reporting the final player vote on all of this will come this weekend.
It sounds like a vote with the outcome already assumed, if they are supposed to report in 8 days and guys are supposed to arrive from overseas in some cases.
 

shpongle falls

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So what exactly is going on in Texas? Does the news stack up with reality?
I keep hearing about how bad it is from people (on the other side of the country) who quite obviously have zero ties to Texas.
Here's why there has been so many cases since June, starting around May 24th the CDC implemented a model to count "Covid Cases," for every one single person that tests positive they are going to assume that person has infected 15 other people, so now every single person that tests positive counts as 16 official "cases." They started this in late May and then a few weeks later cases spiked like crazy in June and continue to do so, this is why. This is the type of insanity were up against.

Go to the 15:25 minute mark on the video on this page and a health official spokesperson breaks it down in this meeting.

https://collincountytx.new.swagit.com/videos/62477
 
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shpongle falls

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It get's better too, turns out the CDC is mixing up different test results and inflating the case numbers that way as well.

“We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus…The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral [PCR] and antibody tests, even though the two tests reveal different information and are used for different reasons.” - ‘How Could the CDC Make That Mistake?’
 

Brockon

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Canada would be safer than any US City. But, I wonder if Winnipeg might be better than Toronto.

Winnipeg would definitely be a safer venue than Toronto from COVID-19 case numbers with seven confirmed COVID-19 deaths and 325 probable positives (from the gov website for province wide numbers, that's the exact wording... I shit you not.) - I just question if there is the necessary practice facilities and ice sheets to accommodate. Outside of the Manitoba Moose and Jets facilities (which could be one and the same for all I know), I'm unsure if there are other full sized rinks available...

I don't doubt there are the vacancies to accommodate the NHL, but I do wonder if the government is wanting such a large international arrival. I don't doubt the local businesses would love to have the guaranteed business - as the hospitality industry is definitely hurting for clientele and hosting the playoffs successfully would be a huge step in proving their viability as a safe place to stay.
 

Robb_K

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Winnipeg would definitely be a safer venue than Toronto from COVID-19 case numbers with seven confirmed COVID-19 deaths and 325 probable positives (from the gov website for province wide numbers, that's the exact wording... I shit you not.) - I just question if there is the necessary practice facilities and ice sheets to accommodate. Outside of the Manitoba Moose and Jets facilities (which could be one and the same for all I know), I'm unsure if there are other full sized rinks available...

I don't doubt there are the vacancies to accommodate the NHL, but I do wonder if the government is wanting such a large international arrival. I don't doubt the local businesses would love to have the guaranteed business - as the hospitality industry is definitely hurting for clientele and hosting the playoffs successfully would be a huge step in proving their viability as a safe place to stay.
Now that you mention this, I forgot that most of the teams are coming from highly infected areas of The US. And having about 1/4 of my family in Greater Winnipeg (including my sister and her family), I think I'd rather NOT have the playoffs held there.
 

SaintLouHaintBlue

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I've seen so many out of state license plates where I live..Lots of Illinois (most likely Chigago), but I've also seen Montana, Colorado, Virginia, Wisconsin, Tennessee, and somehow even California.
There's a lot of perseveration about the southern US, but each time I see one of these plates, I can't help but think how that relates to the spread, and perhaps how futile it (ultimately) is to have perfect control over.
 

Brockon

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Now that you mention this, I forgot that most of the teams are coming from highly infected areas of The US. And having about 1/4 of my family in Greater Winnipeg (including my sister and her family), I think I'd rather NOT have the playoffs held there.

That kind of my thought, every time I consider going anywhere out of town to enjoy a "vacation". I had thoughts of doing a leg of Mount Robson, but I'll probably settle for doing a string of short kayak trips locally instead. The Northern health district has a total of 65 cases for a district counting everything North of Kamloops (approximately 60% of the province's landmass).

I don't expect the hospitality to be as welcoming as usual in small towns I tend to pick as supply refill points for extended camping trips. There's a lot of paranoia out there right now.

Especially in the light of my grandparents hometown just reporting their first confirmed COVID case having just attended a grad party with 120 attendees - a blatant violation of the gathering size restriction...

It's a community of 2000 (largely retirees) near the Okanagan in the Central interior of BC... I shudder to think of what the community impact will be - given the average age of residents and lack of a hospital closer than Kamloops, 2 hours away.
 

Robb_K

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That kind of my thought, every time I consider going anywhere out of town to enjoy a "vacation". I had thoughts of doing a leg of Mount Robson, but I'll probably settle for doing a string of short kayak trips locally instead. The Northern health district has a total of 65 cases for a district counting everything North of Kamloops (approximately 60% of the province's landmass).

I don't expect the hospitality to be as welcoming as usual in small towns I tend to pick as supply refill points for extended camping trips. There's a lot of paranoia out there right now.

Especially in the light of my grandparents hometown just reporting their first confirmed COVID case having just attended a grad party with 120 attendees - a blatant violation of the gathering size restriction...

It's a community of 2000 (largely retirees) near the Okanagan in the Central interior of BC... I shudder to think of what the community impact will be - given the average age of residents and lack of a hospital closer than Kamloops, 2 hours away.
My best friend and childhood neighbour lived near the shore of the lake.
 

Thallis

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Here's why there has been so many cases since June, starting around May 24th the CDC implemented a model to count "Covid Cases," for every one single person that tests positive they are going to assume that person has infected 15 other people, so now every single person that tests positive counts as 16 official "cases." They started this in late May and then a few weeks later cases spiked like crazy in June and continue to do so, this is why. This is the type of insanity were up against.

Go to the 15:25 minute mark on the video on this page and a health official spokesperson breaks it down in this meeting.

https://collincountytx.new.swagit.com/videos/62477

They specify that this is a new metric that is seperate from the confirmed case methodology. Outlets are reporting on confirmed cases, which is not effected by this. Further, each state's R0 number(the average number of people an infected person spreads the virus to) is being kept track of. The "probable case" would have no effect on that.
 

ChicagoBlues

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They specify that this is a new metric that is seperate from the confirmed case methodology. Outlets are reporting on confirmed cases, which is not effected by this. Further, each state's R0 number(the average number of people an infected person spreads the virus to) is being kept track of. The "probable case" would have no effect on that.
Bunk
 
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