{"id":699,"date":"2026-08-30T16:35:44","date_gmt":"2026-08-30T20:35:44","guid":{"rendered":"https:\/\/grieve-smith.com\/ftn\/?p=699"},"modified":"2026-08-30T16:35:47","modified_gmt":"2026-08-30T20:35:47","slug":"we-still-need-to-know-the-total-number-of-emergency-department-visits-due-to-covid-19","status":"publish","type":"post","link":"https:\/\/grieve-smith.com\/ftn\/2026\/08\/we-still-need-to-know-the-total-number-of-emergency-department-visits-due-to-covid-19\/","title":{"rendered":"We still need to know the total number of emergency department visits due to COVID-19"},"content":{"rendered":"\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"372\" src=\"https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image-1024x372.png\" alt=\"Percent of Visits to the Emergency Department that have a COVID-19 Diagnosis\n\nVisits for the week ending August 22, 2026 have increased to 0.38% from 0.34% the previous week.\nData as of: Aug 27, 2026\nThe percentage falls to a low of 0.06% the week ending June 20 and then rises, with fluctuations, to 0.38% the week ending August 22.\" class=\"wp-image-701\" srcset=\"https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image-1024x372.png 1024w, https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image-550x200.png 550w, https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image-768x279.png 768w, https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image-1536x559.png 1536w, https:\/\/grieve-smith.com\/ftn\/wp-content\/uploads\/2026\/08\/image.png 1815w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Chart from the New York City Department of Mental Hygiene Respiratory Illness Data pages<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Over the past several years I&#8217;ve written about why I try to avoid spreading infectious diseases like COVID-19 and influenza.\u00a0 I don&#8217;t like getting sick, and I don&#8217;t like the risk of dying or being permanently disabled, but above and beyond that I&#8217;ve realized <a href=\"https:\/\/grieve-smith.com\/ftn\/2023\/05\/the-end-of-the-emergency\/\" data-type=\"post\" data-id=\"567\" target=\"_blank\" rel=\"noreferrer noopener\">it&#8217;s one of the easiest ways to save lives<\/a>.\u00a0 I don&#8217;t have to dive into an icy river or throw myself in front of a bullet.\u00a0 All I have to do is strap some paper over my face at certain times, and work from home, eat outdoors and do karaoke over zoom at other times?\u00a0 Sign me up!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One of the great things about protecting others from infectious diseases is that <a href=\"https:\/\/grieve-smith.com\/ftn\/2024\/08\/when-to-go-into-outbreak-mode\/\" data-type=\"post\" data-id=\"625\" target=\"_blank\" rel=\"noreferrer noopener\">we don&#8217;t have to take these precautions all the time<\/a>.\u00a0 Diseases like the flu have seasons &#8211; they almost always have a peak some time in mid-winter.\u00a0 COVID is less seasonal, but still comes in waves.\u00a0 That means we can go to concerts, sing karaoke, work in offices and eat indoors for most of the year.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The tricky part is knowing when to take precautions to avoid catching or passing on respiratory diseases, and <a href=\"https:\/\/grieve-smith.com\/ftn\/2024\/05\/how-do-we-know-its-safe\/\" data-type=\"post\" data-id=\"612\" target=\"_blank\" rel=\"noreferrer noopener\">when to stop<\/a>.\u00a0 And this is what public health reporting should be able to help me with.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Public health agencies can&#8217;t tell me to care about whether my neighbors get sick, or how many deaths I should be prepared to tolerate.\u00a0 Those are my personal moral decisions.\u00a0 But they can tell me how many deaths we&#8217;ve tolerated in the past, and what are <a href=\"https:\/\/grieve-smith.com\/ftn\/2026\/02\/so-you-want-to-monitor-carbon-dioxide-levels\/\" target=\"_blank\" rel=\"noreferrer noopener\">the most effective measures<\/a> I can take to protect my neighbors.\u00a0 They can also tell me when is a good time to start being more careful, and when I can relax more.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">I particularly liked the metric of hospitalizations per 100,000 residents used by the United States <a href=\"https:\/\/www.cdc.gov\/resp-net\/dashboard\/\" target=\"_blank\" rel=\"noreferrer noopener\">Centers for Disease Control and Prevention<\/a> (until 2025), because it speaks directly to our goals: to minimize suffering from these diseases.\u00a0 Death rates are another good measure, but they&#8217;re a lagging indicator &#8211; we rarely know them soon enough to take action.\u00a0 Test positivity rates don&#8217;t tell us how severe the symptoms are.\u00a0 Case counts can vary depending on how many people make the effort to take a test and report it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In May 2024 I set a personal threshold of 6 hospitalizations for COVID per 100,000 residents per day for when I would go into Outbreak Mode.&nbsp; That was based on historical data from the CDC&#8217;s RESP-NET showing that we tolerated about that many hospitalizations for the flu in December 2019.&nbsp; I&#8217;m sure we can do better, but it seemed like a good starting point.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Department of Health and Mental Hygiene in New York City, my hometown, also <a href=\"https:\/\/www.nyc.gov\/assets\/doh\/respiratory-illness-data\/#\/\" target=\"_blank\" rel=\"noreferrer noopener\">reports hospitalization rate<\/a>s, but not per 100,000 residents, or as totals.\u00a0 You can get emergency room visits or admissions, but they are only available as percentages of total emergency room visits or admissions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It&#8217;s understandable why the Department of Health and Mental Hygiene would want to track the percentage of emergency room visits and admissions due to COVID, the flu and RSV.\u00a0 I am also interested in that statistic.\u00a0 <a href=\"https:\/\/grieve-smith.com\/ftn\/2020\/09\/our-society-is-just-prepared-to-accept-some-deaths-or-is-it\/\" target=\"_blank\" rel=\"noreferrer noopener\">Remember in 2020<\/a> when we were trying to &#8220;flatten the curve&#8221;?\u00a0 The whole idea was to keep COVID care from overwhelming our hospitals and making them unavailable to people who needed care for car crashes, heart attacks and accidental poisonings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But the point of open data is that the staff of the Department of Health and Mental Hygiene are not the only people who care about health statistics.  Some of us care about other things, like the number of hospitalizations per 100,000 residents.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Part of basic numeracy is to be careful about your denominators.&nbsp; The Department of Health and Mental Hygiene is reporting COVID hospitalizations as a percentage of total hospitalizations.&nbsp; But the total number of hospitalizations is not constant.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Imagine that there is a COVID outbreak on the scale of those that we&#8217;ve seen in the past few years, but at the same time there is also an outbreak of an unrelated disease, possibly an intestinal infection.&nbsp; If the two diseases are both increasing, they could increase the total number of emergency room visits faster than the number of COVID visits.&nbsp; The percentage due to COVID will drop, even if the absolute number of visits due to COVID is actually increasing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Under those circumstances, the average person will likely care about whether our hospitals are overwhelmed, but we will care much more about how likely we are to wind up in the emergency room for one of those diseases.&nbsp; The New York City Department of Health and Mental Hygiene should continue to report percentages of emergency department visits for COVID, influenza and RSV, but it should also release the total numbers, and ideally also the number of emergency department visits per 100,000 residents.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We know that the Department of Health and Mental Hygiene can report total COVID-related hospitalizations, because<a href=\"https:\/\/data.cityofnewyork.us\/Health\/COVID-19-Daily-Counts-of-Cases-Hospitalizations-an\/rc75-m7u3\/about_data\" target=\"_blank\" rel=\"noreferrer noopener\"> they did that<\/a> from Spring 2020 right up to October 2025.  At that point they expanded their open data to include the flu and RSV, which they had previously only reported as percentage graphs <a href=\"https:\/\/contagion.grieve-smith.com\/api\/0.1\/documents\/\" target=\"_blank\" rel=\"noreferrer noopener\">in a PDF<\/a>.  It&#8217;s great that we can now get data about the flu and RSV; all we need now are the totals for all three viruses!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chart from the New York City Department of Mental Hygiene Respiratory Illness Data pages Over the past several years I&#8217;ve written about why I try<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19,36],"tags":[],"class_list":["post-699","post","type-post","status-publish","format-standard","hentry","category-commentary","category-covid-19"],"_links":{"self":[{"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/posts\/699","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/comments?post=699"}],"version-history":[{"count":3,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/posts\/699\/revisions"}],"predecessor-version":[{"id":704,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/posts\/699\/revisions\/704"}],"wp:attachment":[{"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/media?parent=699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/categories?post=699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/grieve-smith.com\/ftn\/wp-json\/wp\/v2\/tags?post=699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}