New COVID-19 Projections For West Virginia Give Optimism. But Even Researchers Say There Are Caveats

New projections on the impact of the coronavirus pandemic show cause for cautious optimism in West Virginia, but as the state braces for the virus to peak in the coming weeks, researchers and health care officials urge residents of the state to remain at home. 

Updated projections, released Monday by the University of Washington’s Institute for Health Metrics and Evaluation, show the anticipated death toll in West Virginia is lower than once forecasted. The projections also show fewer health care resources are expected to be needed to fight the COVID-19 pandemic, including ICU beds and ventilators.

The updated visualizations show the virus is expected to peak in West Virginia around mid April. The previous set of projections published by the researchers predicted the state’s peak for early May. 

Last week, projections showed West Virginia could see about 500 deaths as a result of the virus. Updated modeling puts that number most likely somewhere just under 200. 

But these projections exist in a range, with the number reported serving as a mean. Current projections show West Virginia is likely to see anywhere between 64 and 577 deaths.

Researchers note a 95 percent confidence interval for the projections. Meaning, that deaths are highly probable to fall within the projected range they have offered.

To date, West Virginia officials have reported four people have died as a result of COVID-19 out of 345 cases confirmed statewide. In a virtual news conference Monday, Gov. Jim Justice announced the latest confirmed death and offered sympathies. 

“While [we’re] pacing significantly below all the other states — and it’s surely significantly below the national average — it is sad and it’s not good enough,” Justice said. “But, you know, we just have to deal with it. We know this pandemic is really rough stuff.”

IHME’s lead researcher, Dr. Christopher Murray, said Monday that early data projections have been largely based on data on COVID-19-related deaths and factoring in social distancing measures like the shutdown of non-essential businesses, school closures and stay at home orders. The projections take into consideration those practices continuing.

Speaking to reporters in a separate virtual news conference, Murray explained the differences between previous and current projections. He also said the rise of COVID-19 came later in West Virginia compared to other places, so there’s less data available to input into the model. 

“It’s one of the most challenging. There’s almost no signal in the state that tells us how West Virginia differs from the average U.S. epidemic experience,” Murray said. “And that’s why our estimates have been changing over time.”

But even though the projections will become updated as more data becomes available, Murray said he remains confident in the current forecast. He and other researchers will be watching as more data on reported deaths comes in from West Virginia. 

“As new data comes in, if we suddenly see a big upswing in deaths that will be telling us something,” Murray said. “For West Virginia — because we think these big upswings are related to density and use mass transit and other factors — [that’s] unlikely we’ll see that big change there.”

West Virginia’s so-called coronavirus czar, Dr. Clay Marsh, said the latest projections from the University of Washington come with the caveat that — like any statistical modeling — it’s only as good as the amount of available data. He said Monday that the state should expect the modeling to continue to change. 

“We know that prediction models have many limitations. They are only as good as the information that’s fed to them — and they’re very dynamic,” Marsh said. “So as the information changes that is fed to them, so do the models. And, in fact, little differences in what is put in can lead to big differences on the other side of the models.”

Marsh said the projections from the University of Washington are encouraging, but he urged residents to remain at home. He said the state is far from the end in terms of fighting the COVID-19 outbreak.

“It’s not time to become complacent. It’s not time to turn back and say, ‘Oh, we’re good,’” Marsh said. “In fact, this is a time that we know doubling down really helps.”

Projections Show COVID-19’s Peak In West Virginia Is A Month Away. Here’s What That Could Look Like

West Virginia has about a month until coronavirus peaks here. 

And when it does, about 500 West Virginians — give or take a few hundred — are expected to die, according to current projections from the University of Washington’s Institute for Health Metrics and Evaluation.

Dr. Ali Mokdad, one of the researchers working on the projections, said deaths in the state may be high per capita because West Virginia’s population is high risk. Coronavirus has hit older adults and people with underlying health conditions the hardest.

In an interview with West Virginia Public Broadcasting, Mokdad said residents of the state should be mindful of those demographics by adhering to mitigation practices.

“So you have to be extra careful in enforcing these [measures] and making sure that people stay at home,” Mokdad said. 

However, Mokdad said it is possible to improve outcomes depending on what governments do to stop the spread of the disease and whether residents adhere to public guidance. The researchers are taking these mitigation practices into consideration as part of their projections.

“We assume, unlike anybody else, that there are measures in place to fight the pandemic,” Mokdad said.

For example, he said, a stay at home measure, the closure of the schools and shutting down non-essential businesses will help reduce the number of cases a state experiences. West Virginia has implemented all of those measures.

“So, like, you cannot assume a fire will run wild,” Mokdad said. “You will have [firemen] and fire trucks working against it.”

And having those fire trucks, so to speak, available, may make all the difference — especially in a place like West Virginia that actually has time to prepare.

The most current projections show West Virginia will see the worst impact of the coronavirus in early May.  

“That gives time for hospitals in West Virginia to prepare, to get more ventilators on time. And then, for example, some of the operating rooms or some of the recovery rooms after an operation could be switched to be an ICU bed,” Mokdad said. “So, that fact that the peak is delayed is very good news for West Virginia.”

Right now, Mokdad and his team are trying to forecast the impact of the coronavirus on each state in the U.S. But, looking into the future has its challenges. 

“We don’t know how many people have coronavirus in the U.S. right now – because as, you know, we are lagging in testing,” he explained. “We don’t have enough tests and we don’t know how many people are sick.”

The main goal of their work is to pinpoint when states will see the highest number of cases. As cases rise, hospitals will experience surges, which can cause shortages of resources like intensive care unit beds and ventilators. When hospitals don’t have enough of those resources in place, more people die — as was seen in Italy. 

So Mokdad and others on the team at the University of Washington are using reported deaths and mitigation practices to project trends on when deaths will spike in the U.S. and in individual states. 

“In the United States now, with all the reporting, we know for sure that people are dying from coronavirus and how many of them are dying on a daily basis,” he said.

The researchers are updating their projections when new data on reported deaths becomes available — usually daily, but sometimes more frequently. 

Based on the institute’s current projections, West Virginia will likely have enough hospital beds available to handle the expected surge in COVID-19 cases. But, there’s also likely to be some real challenges ahead. If the projected curve rings true, the state will be short dozens of ICU beds when the virus peaks.

The more a population stays at home, Mokdad said, the more likely it is to reduce the spread of the virus and prevent resource strains at hospitals — which, in turn, could reduce deaths. 

Dr. Clay Marsh is vice president and executive dean of health sciences at West Virginia University. Last week, Gov. Jim Justice appointed Marsh to be the state’s coronavirus czar. 

Marsh said in a phone interview with West Virginia Public Broadcasting, that while modeling is a good guide for officials leading the response to the virus, these are unprecedented times. 

“I think that the benefit of these kind of models, it starts to demonstrate what are the critical things that you can do as a state, as a person and as a community — that are within your control to do — to change models that look like bad things are going to happen and replace it with models or the reality that shows that it’s not nearly that bad,” Marsh said.

Marsh said the state’s supply of ventilators should be enough to cover the expected need when the peak hits West Virginia. He also said hospitals should be able to flex resources to make sure enough ICU beds are available when a surge happens. 

And, as Marsh noted at Thursday’s virtual news conference, projections for West Virginia continue to improve.

“The projection is [that] we’ll need less ICU beds today than we did yesterday and that fewer people are predicted to to die from this COVID-19 pandemic than was [predicted] yesterday,” Marsh said. “And as we talked about — although following these trends can be very useful as a guide for us —  the future will be written by what we keep doing, not what we’ve done to date.”

Marsh cautions that there is a reality to the pandemic that is inescapable at this point. 

“It doesn’t mean that people aren’t gonna get sick from the virus. They will. It doesn’t mean that people won’t die from the virus here in West Virginia. They will,” Marsh said. “That doesn’t mean that we’re not going to see celebrities and people that we have seen on TV and maybe even some of our friends die — because that’s going to happen, too, I believe.”

But Marsh said he’s hopeful that — if West Virginians continue following public guidance — the state can have outcomes better than what projections currently show.

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