Cozumel COVID-19 updates

[WetInPortland]

From the 11-June noon update:

                             Previous  ->  Today
Q Roo Confirmed Cases           2,282  ->  2,329
     Social Isolation             391  ->    398
     Hospitalized                 136  ->    130
     Recovered                  1,309  ->  1,347
     Deaths                       446  ->    454
Q Roo Tests pending               220  ->    258

Cozumel
     Confirmed Cases               54  ->     54
     Recovered                     30  ->     31
     Deaths                        13  ->     13
     % Hospital rooms in use                  21%

Data from https://twitter.com/SESA_QROO/status/1271132432776015873/photo/1
See post #147 for more information about how these numbers are generated and why they may seem low or the the percentages unusual.

New stat that the state started publishing today -- the percentage of available hospital rooms in use. Like all the Mexican numbers this requires some explanation, and in this case, some speculation. Based on 10 active cases (54 total, less 31 recovered and 13 deaths) and 21% capacity, that gives a total capacity of about 48 beds. However, the document the city put out just a few days ago shows a total of 79 beds in Cozumel. The best I can figure is that this is capacity percentage is only for beds at IMSS and SESA, the two public health systems. The total hospitalization capacity in Cozumel from the city's document is 79, including ISSSTE (Mexican senior/disabled/federal worker) system, plus the four private hospitals.

 

[WetInPortland]

From the 12-June noon update:

                             Previous  ->  Today
Q Roo Confirmed Cases           2,329  ->  2,384
     Social Isolation             398  ->    391
     Hospitalized                 130  ->    142
     Recovered                  1,347  ->  1,393
     Deaths                       454  ->    458
Q Roo Tests pending               258  ->    226

Cozumel
     Confirmed Cases               54  ->     59
     Recovered                     31  ->     31
     Deaths                        13  ->     13
     % Hospital rooms in use       21% ->     21%

Data from https://twitter.com/SESA_QROO/status/1271490340437069826/photo/1
See post #147 for more information about how these numbers are generated and why they may seem low or the the percentages unusual.

Five new cases in Cozumel today. Not the best sign.

No change in the semaphore for the week of June 15-21 -- Northern QRoo Orange; Southern QRoo Red: Semáforo de Riesgo Epidemiológico del 15 al 21 de junio 2020 | ¡Reactivemos Quintana Roo!

Something I just noticed and that jumped out at me today -- in the daily report, the state gives stats by type of facility, and one can calculate the mortality rate. In the table below, SESA is the public health system mostly for the poor; IMSS is employer paid or one can buy into the system individually; ISSSTE is a system for the elderly, disabled, and for federal workers; and others would be private healthcare systems. Just for comparison, I've included the state of Florida, USA, and global totals. When considering these stats, keep in mind that over 2/3rds of cases in QRoo are in Cancun.

Institution         Cases         Deaths     Mortality %

SESA                1,099         111          19%
IMSS                1,087         230          21%
ISSSTE                142          16          11%
Others                 56           5           9%

Florida            67,371       2,848           4%
USA             2,031,173     113,924           6%
World           7,563,929     422,760           6%

Some of this may relate back to how Mexico tests; Mexico tends to only test people who present two or more symptoms, so only the sickest people are showing up in the Mexican stats. The rates are still striking. I wish we had more consistent numbers around world, but if you're going to grant me a wish I think just making COVID-19 just go away would be a higher priority.

 

[nwflyboy]

Based on what you wrote above, I'm guess (please feel free to correct me if I'm mischaracterizing this) that the quality of care at IMSS would be higher than SESA (people are paying, either directly or indirectly, to access IMSS while the majority of those using SESA are receiving state-provided care ). But the mortality figures make IMSS (at 21%) look worse than SESA (at 19%). Unless IMSS is just better at collecting their metrics (quite possible), that appears the opposite of what I would expect.

In any case, all the mortality figures look utterly disastrous. Yikes.

 

[DandyDon]

In any case, all the mortality figures look utterly disastrous. Yikes.

Only if you accept the infected case numbers, which are not at all accurate.

I saw a news video the other day about the handling of the deceased. Of course, the video was produced to sell ads and not a documentary, but it quoted one crematory operator saying that they cannot keep up with demand. I think the video said that all Covid deaths are supposed to be cremated, but it followed one lady who bribed the handlers to take her father's coffin to the family burial plot. It's difficult to tell what to believe.

Ah, found it:

 

[WetInPortland]

I'm guess that the quality of care at IMSS would be higher than SESA

We looked at both at one point, and we understood the quality of care to be similar. IMSS is considered to be a little better, but places significant restrictions on pre-existing conditions for those buying individual coverage. SESA (the replacement for Seguro Popular) doesn't have the pre-existing condition limitations, but access to care generally isn't as good (longer waits).

Only if you accept the infected case numbers, which are not at all accurate. ...

... quoted one crematory operator saying that they cannot keep up with demand

Regarding deaths and over running mortuaries and crematoriums, I've read/heard the same about Mexico City. DF was *very* late to go into lockdown, and being so heavily and densely populated, that was disastrous. Without going into all the gory details (again) Mexico's official case number are intended to be a representative sample. For the country as a whole, the Minister of Health has said they use a multiplier of 8x-9x. But that doesn't make sense when you try to get more granular. We know there are more cases than are being reported, but don't know, for example, what a reasonable multiplier would be for QRoo, or Cozumel.

In any case, all the mortality figures look utterly disastrous. Yikes.

That's the point I was really trying to make. When I looked at those numbers it was easy to see the deaths were in the 20% range from SESA and IMSS.

My wife points out that people may just not be going to the doctor until they are very ill, and so have a lower chance of survival by the time they arrive at the hospital. But even at the private hospitals, which is where a lot of expats go, and there are many in QRoo, the mortality rate is double the USA and rest of the world.

 

[loosenit2]

 

[yle]

Some of this may relate back to how Mexico tests; Mexico tends to only test people who present two or more symptoms, so only the sickest people are showing up in the Mexican stats. The rates are still striking. I wish we had more consistent numbers around world, but if you're going to grant me a wish I think just making COVID-19 just go away would be a higher priority.

This is a very important point, and why the 9 to19% "fatality rate" showing for QR can't really be compared to the "fatality rate" in other countries. We still don't have an idea how many asymptomatic people there are, and we won't have that until we are able to do systematic testing of large random groups. (Some small scale studies of this type suggest that as many as 90% of those infected could be asymptomatic... which, if they are included, really drives down the fatality rate.)

Until that happens, the best proxy we can use is to consider the number of tests administered as a fraction of the total population. The US is currently at about 7.2% (24 million tests, 330 million population), which is a pretty sizeable fraction. Many European countries, as well as Canada, are between 5 and 10%. Mexico is currently around 0.3% (390,000 tests for 128 million population.) Which makes sense: as you said, they are focusing their resources on those with symptoms.

But it's reasonable to extrapolate and imagine if Mexico were able to test 5% of its population... 6 million tests instead of the current 390,000. If so, there would probably be a lot more positive tests of asymptomatic people, which would bring Mexico's "fatality rate" in line with the rest of the world.

"Lies, damn lies, statistics..."

 

[ggunn]

This is a very important point, and why the 9 to19% "fatality rate" showing for QR can't really be compared to the "fatality rate" in other countries. We still don't have an idea how many asymptomatic people there are, and we won't have that until we are able to do systematic testing of large random groups. (Some small scale studies of this type suggest that as many as 90% of those infected could be asymptomatic... which, if they are included, really drives down the fatality rate.)

It also really drives up the risk of infection taken by going out in public.

 

[yle]

It also really drives up the risk of infection taken by going out in public.

Oh, absolutely. It's likely there are ten times as many asymptomatic carriers as there are confirmed cases. Which is great for the real "fatality rate", because it means the virus isn't nearly as dangerous as it might otherwise seem. But it also means that we're never going to get rid of it, and it will continue to spread through undetectable paths. (Well... undetectable unless we systematically test the entire population. Of the planet. All at the same time.)

Some have said since the beginning that the only way to really control it will be to build herd immunity or develop a vaccine. And it's very likely they're right. In the meantime, life will be a bit of a gamble... everywhere.

 

[WetInPortland]

From the 13-June noon update:

                             Previous  ->  Today
Q Roo Confirmed Cases           2,384  ->  2,442
     Social Isolation             391  ->    430
     Hospitalized                 142  ->    139
     Recovered                  1,393  ->  1,409
     Deaths                       458  ->    464
Q Roo Tests pending               226  ->    241

Cozumel
     Confirmed Cases               59  ->     63
     Recovered                     31  ->     31
     Deaths                        13  ->     13
     % Hospital rooms in use       21% ->     21%

Data from https://twitter.com/SESA_QROO/status/1271851868990451714/photo/1
See post #147 for more information about how these numbers are generated and why they may seem low or the the percentages unusual.

Five new cases yesterday, four more today. Not going in the right direction. No comment from the mayor.

Another stat on the report is regional velocity of increase in cases. This apparently relates to the semaphore level. QRoo north (Level Orange) is given at 1.0, QRoo South (Level Red) is 4.6. It will be interesting see how this changes over time