In a recent post, we wrote about how hospital numbers were expected to rise in the week before the new year due to the rapidly rising hospital admissions from the previous week; unsurprisingly, this has come to pass. Now, we can confidently say that the 7-day average hospital census should be about 7,000 by January 6 (as of December 30, it is just under 3,400 with a likely underestimate of today’s numbers as these are simply carried forward from yesterday’s census). In other words, the number of people hospitalized with COVID-19 in Florida will probably double in the next week, reaching 40% of the summer’s maximum hospitalization numbers with case numbers still increasing seemingly unabated.
We all know the screwy way Florida likes to report deaths in an effort to mislead the public. Fortunately, Florida hospitals report hospital COVID deaths daily and this is an excellent approximation to total deaths on a given day (see section 3 here). As a quick rule of thumb (at least up until this point), the total deaths on a given day is about 40% greater than those reported by hospitals. For example, if hospitals report 100 deaths, the overall statewide deaths are expected to be about 140. Of course, there are many unknowns with a new variant and opaque government processes, but we will assume that this relationship will remain true in this wave.
Given Florida state officials’ proclivity toward shameless self-promotion at the expense of its citizens, expect many embarrassing and juvenile tweets from state employees/paid trolls or favorable media coverage about how deaths have remained low despite record cases and rapidly increasing hospitalizations. But just as every DeSantis victory lap precedes a massive wave of death and suffering, this latest round of propaganda will be proven embarrassingly wrong in just a few weeks’ time.
Consider the following graph showing weekly averages of hospital census with hospital-reported deaths (shifted seven days back). Note that this is all inpatient beds with COVID, not just those in ICU. We can see the near-perfect relationship between the number hospitalized and those dying within the hospital seven days later (the correlation over the past 200 days is 0.998). Considering that hospitalizations have only just begun rapidly increasing the past week (and deaths lag another week), hospital deaths were not expected to rise very much – until now, that is.
As of December 30, the seven-day average of hospital deaths was 25. Following the rapid increase in census numbers beginning two weeks ago, hospital deaths are expected to nearly quadruple to about 100 deaths on January 13. Using the 40% estimate from before, this would be about 140 overall deaths by mid-January with the peek likely a month away (last winter’s wave peeked at 200 deaths/day). These death estimates rely not only on predictions from the hospitalizations to hospital deaths seven days away (see formula), but also those from hospital admissions to census seven days away (used here). To estimate the number of hospital deaths on a given day, use the following formula:
Hospital Deaths = exp(–6 + 1.2 x log(7-Day Average Census 7 Days Ago))
These estimates could be totally wrong, remember. The relationship between cases and hospitalizations seems significantly different than previous waves, but less is known about hospitalizations and deaths. Thus far, hospital reported deaths have increased as expected following an increase in hospitalizations. If past relationships continue, Florida will almost assuredly experience yet another wave with over 200 deaths/day.