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  • Peter Lombard MD

Guam COVID update for April 11th, evening edition

3 positive cases today. The moving 7 day growth rate is now 1.05x and moving 7 day new cases is now down to 5 daily cases. We are recovering more than we are adding and active cases are going down.

As mentioned in the comments yesterday, the 22 cases from April 5th, if they are destined to get hospitalized, should manifest within the next few days. And the 11 cases from April 7th, of course a couple days behind. At least we haven't been adding a lot more cases since then.

Why does it appear our hospitalization rate is lower than expected? Has the admission rate been overestimated in previous studies? Is our threshold for admission too low? I don’t think so. I'm a little perplexed by this because we know there are more positive cases out there we haven't caught. If they were sick enough they should have found their way to the hospital. Maybe the community spread cases have mild viral load transmission so the cases are less severe. It's all I can come up with right now.

No testing will be done tomorrow. Because Easter Sunday...

About 5 days incubation, from exposure to symptoms, on average. 1 of 100 will have prolonged incubation even 14 days until symptoms show. That's scary. https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

Excellent compilation of clinical trials related to coronavirus at Doximity. I see hydroxychloroquine clinical trials, pre-exposure and post-exposure prophylaxis trials. ACE-inhibitor and ARB studies, and so many more. https://www.doximity.com/articles/4e44e726-a61a-4bab-b528-10837024cba9?redirectToPublic=true

I’ve said this for a couple days now but case counts aren’t as meaningful as we once thought. If we see a spike in case counts with increased testing, as long as admissions don’t increase, the increase in cases may not foretell an impending surge. https://fivethirtyeight.com/features/coronavirus-case-counts-are-meaningless/

(charts accessible at https://docs.google.com/presentation/d/1YmBfAcbLcCk3TUdP4zV4oOTqipp_p32-Vfdh3IJ2XCE/edit?usp=sharing)

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