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Wondering what definitions people are using for defining "recovered"?
Lynn
Comments & Events
Lisa McHugh,Assistant Bureau Director, Bureau of Epidemiology
We have been trying to avoid using because there is no clear definition. On our daily count dashboard we are posting hospital discharges which are reported by the hospitals but not sure this fully captures recovery. We were looking to try to incorporate the symptom based strategy definition for clearance of isolation as a good proxy for recovery in our long term care facilities but given the symptoms can linger or be intermittent in recovery this has been challenging especially in this population.
Notified 158 people
Jim Collins
Good Morning,
We were under pretty intense pressure to report out on "recovered" status. Clearly, we've barely got the bandwidth here to keep our heads above water right now so the idea of structuring some kind of reach back to confirmed cases was out of the question. So, I came up with a plan to use a measure of survival as a surrogate for recovered. I know, it's clunky, and it is not a great indicator and you all can spend a nice Sunday poking holes in it. But it is something to post and explain, and it seems to have satisfied folks here in Michigan.
When we update our "recovered" numbers, we include the following
*During this response, MDHHS is reviewing vital records statistics to identify any laboratory confirmed COVID-19 cases who are 30 days out from their onset of illness to represent recovery status. As the pandemic continues to impact Michigan, this pool will expand to include more cases. Recovered is defined as the number of persons with a confirmed COVID-19 diagnosis who are alive 30 days post-onset (or referral date if onset is not available). The number of persons recovered on May 1st, 2020 represents COVID-19 confirmed individuals with an onset date on or prior to April 1st, 2020. If an individual expires from a COVID-related cause >30 days from onset/referral, they are removed from the number of persons recovered. These numbers will be updated every Saturday.
Source: Michigan Disease Surveillance System and Vital Records
Notified 158 people
Johnathan Ledbetter
In Texas, we also found it difficult to define and calculate the number of people “recovered”. To calculate the number of “recovered” we used the following methodology:
The compartmental model approach based on the Susceptible, Infected, and Recovered epidemic model (see attached) can be used to simulate recovered cases, but requires assumptions of R0 and infectious period. Infectious period is assumed to be exponentially distributed. I wonder if Texas' approach is akin to equating infectious period with recovery period, and separately simulating recovered cases with differential assumptions of R0 for hospitalized and non-hospitalized cases?
Notified 158 people
Jennifer Miller
We have been using release from isolation (either time or testing based) as recovered as a proxy for recovery with the acknowledgment that some individuals are still dealing with the effects of more severe disease. Most thus far have used the symptom based strategy for release, so it is a close proxy overall. Like Lisa, we do also track total and current hospitalizations. There is tremendous public pressure to report recoveries, but I don’t think the public has a good handle on what recovery really means by definition. This seems to be the most understandable.
Notified 159 people
Erik Zabel
Our release from isolation and reporting of recovered cases has been similar. Their release is based on being 10 days past the onset of symptoms and 3 days free of fever, plus other symptoms improving. I think in the press these are reported as recovered even though many of them are still dealing with symptoms of varying severity. Previously we were calling cases to release them after confirming their symptoms but now it is more automated.
Notified 158 people
Eve Mokotoff
It would be helpful if, unless there is some reason you don’t want to, the people posting on this site would identify their state/locality. It gives context to the comments. Thank you (from Michigan but not the state health department).
Eve
Notified 158 people
Erik Zabel
Erik Zabel is from Minnesota Department of Health.
Notified 158 people
Ken Komatsu,EB Member-At-Large
Arizona is considering a "survived" category: remove deaths and still alive 30 days after collection date. Ken
We were under pretty intense pressure to report out on "recovered" status. Clearly, we've barely got the bandwidth here to keep our heads above water right now so the idea of structuring some kind of reach back to confirmed cases was out of the question. So, I came up with a plan to use a measure of survival as a surrogate for recovered. I know, it's clunky, and it is not a great indicator and you all can spend a nice Sunday poking holes in it. But it is something to post and explain, and it seems to have satisfied folks here in Michigan.
When we update our "recovered" numbers, we include the following
*During this response, MDHHS is reviewing vital records statistics to identify any laboratory confirmed COVID-19 cases who are 30 days out from their onset of illness to represent recovery status. As the pandemic continues to impact Michigan, this pool will expand to include more cases. Recovered is defined as the number of persons with a confirmed COVID-19 diagnosis who are alive 30 days post-onset (or referral date if onset is not available). The number of persons recovered on May 1st, 2020 represents COVID-19 confirmed individuals with an onset date on or prior to April 1st, 2020. If an individual expires from a COVID-related cause >30 days from onset/referral, they are removed from the number of persons recovered. These numbers will be updated every Saturday.
* Include: Total confirmed cases
* Remove any deaths
* Estimate that ~20% of remaining cases required hospitalization and ~80% of remaining cases did not
* Estimate that recovery time for hospitalized patients is ~32 days, and recovery time for non-hospitalized patients is ~14 days (*https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf)
Of course there are limitations to this method, but it was the best method that the team could think of at this time.
Johnathan Ledbetter
Eve