Tag: home

What does release from home isolation mean in Maryland?

Since the beginning of this pandemic, one metric intrigued many of us in Maryland: the cumulative number of people released from isolation. Initially (before the data release via API, when there was only the MDH dashboard), it was even thought to be the number of hospital patients released from isolation. It’s not: the API page mentions:

Total Number Released from Isolation data layer is a collection of the statewide cumulative total of individuals who tested positive for COVID-19 that have been reported each day by each local health department via the ESSENCE system as having been released from home isolation. As “recovery” can mean different things as people experience COVID-19 disease to varying degrees of severity, MDH reports on individuals released from isolation. “Released from isolation” refers to those who have met criteria and are well enough to be released from home isolation. Some of these individuals may have been hospitalized at some point.

Definition of “release from isolation” according to the MDH API (emphasis is mine)

Therefore, mentioning the number of patients released from (home) isolation just below the current number of patients in hospital (as it is currently the case on the MDH dashboard) is a bit misleading: this metric is related to home isolation, which is very different than isolation in hospital.

Screenshot of data from the MDH COVID-19 dashboard, showing the potential issue: hospitalization data is shown just above *home* isolation data

According to the MDH FAQ on isolation and quarantine, there is no mandate to isolate newly diagnosed positive COVID-19 cases. These cases should follow their healthcare provider’s guidance. In the same document, it also appears that there is no mandate to be notified of the end of isolation. There is a guidance with 3 conditions from the CDC (≥ 10 days since first symptoms, ≥ 24 hours without fever and all COVID-19 symptoms are better – note they don’t need to disappear). These are exactly the conditions written in the CDC Guidance on Discontinuing Home Isolation for Persons with COVID-19 (consulted on August 5, 2020). So I don’t know exactly how this “released from isolation” data is collected.

To add to the confusion, the API page indicates that the data is provided by Maryland’s ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics). But this system takes most if its data from Maryland acute care hospitals. So would that mean that hospitals direct the end of home isolation and report these numbers? It could be patients released from hospital and asked to isolate at home: so far, there were a total of 12,888 hospitalizations due to COVID-19 in Maryland. It would mean less than half of these patients would have been asked to continue to isolate at home after their hospital release (up to August 4, 2020, the data says that a total of 5,740 COVID-19 cases were released from home isolation). This is 1/20th of the total of positive cases so far (91,854) so I’m not sure we can link these two metrics.

On a daily basis, the second chart (above) shows a kind of cycle with a peak around mid-May – early-June and a trend that increases again end of July. This blue, smoothed curve really looks like the curve of positive cases so I plotted them both below (cases in blue, releases in red). We can see the 2 peaks for both curves but we can’t really distinguish any relay in patients released (red), compared to the positive cases (blue) (this would have made sense since releases follow reporting of cases, by definition – a confounding factor may be the delay in case reporting that may blur the time difference). But the graph also shows us the difference in magnitude between the number of cases (high) and, indirectly, the number of people that were in isolation at home (then released – low).

So I still don’t really know what to think of this metric. If you have any idea, please tell me! Thanks!

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github (including these ones).

We don’t need a computer at home

Historically, computers were invented to solve issues in the factory or the office (university office or company office) but recently invaded home and are becoming ubiquitous.

IBM System/370 Model 145

At the beginning of this invasion, computers for home were (and are still) very similar to the ones for the industry/office: a CPU, a keyboard to enter data or commands and a screen to see what was happening. Artifacts to be attached to the computer were first invented for the corporate world and then progressively entered into homes. I still remember the first mouse we had at home: it was like a mini-revolution. After years there were still some software that could not take advantage of it or its usage was implemented but in a rudimentary way. Idem for the first webcam we acquired: only the provided software was able to use it. Now it comes embedded in most computer screen and can be used for various purposes (video chat, take pictures, read bar codes, art, …).

More and more, computers are now declined its various avatars like calculators, mobile phones, game consoles, car dashboards, ATMs, cashiers, … All of them affect our daily lives in a way or another. But in my opinion the computer shouldn’t have left the corporate world. Its home avatars should have directly been via adapted technologies. Because Mr. and Mrs. Everyone don’t need any computer at home.

Although some bosses want their employees to behave differently, the factory/office is were we work and home is were we don’t work. At home, we read, eat, sleep, play, interact with other family members and neighbors, perform personal care, watch the television, etc. None of these activities requires a computer as we know it (CPU, keyboard, mouse and screen). However some of them can be enhanced or at least affected by it.

Whatever how it is materialized, a “computer” can enhance your reading experience. It can monitor your sleep while you snore or, more broadly, it can monitor your health while performing your daily activities. Computers can enhance your movie experience (by linking to related content, e.g.). They can help you improve your cooking skills and watch your savings.

Without pretending to know the future, I think miniaturization is and will put thing back “in order”: you will no longer have a computer on your desk but a bunch of small devices, each of them responsible for a small part of your daily life activities. You probably already have a mobile phone or a smartphone, i.e. a mini portable computer allowing us to phone. You probably already used a calculator, i.e. a mini portable computer specialized for calculus. Computer-like devices are becoming more and more small and powerful. They are also doing more than one simple thing at a time.

Another interesting trend is that computer-like devices are becoming more and more transparent, i.e. becoming more and more hidden or at least embedded in our daily lives. This is obviously allowed by miniaturization. The soda distributor contains a small computer-like device. Your electronic watch contains more electronics than ever. Your television screen is flat and is more capable but takes less space than your grandma’s television (relatively to the size of the screen of course).

To go beyond that, people started to experiment with wearable devices and electronics. These devices are part of your daily clothes. Currently these artifacts are merely gadgets and most of them are monitoring devices, just collecting and sometimes displaying information to the outside world. But other applications can be found like being able to carry your electronic documents (without the need for a USB key or CDs) or actually being your receiver/transmitter (“phone” without the actual plastic object we always lose somewhere when we need it). Without becoming cyborgs these guys below won’t soon need cellphones anymore:

Suits & Cells

Now is this an praise of closed platforms like the iPad, the iPod, etc.? No. I don’t say that no computer should be allowed at home: some people are working from home and they obviously need a computer. On top of that, in order to become part of our everyday habits, these devices would need to be transparent, open: people should be aware of what these devices are doing, what are their benefits and potentially what are the drawbacks of using / wearing them. One of the main concerns about these closed platforms and future platforms is privacy: how much of you do you agree to reveal “in exchange” of being empowered by these devices? I think people should be able to refuse to reveal anything and still be able to use these devices.

Photo credits: IBM System/370 Model 145 by John Keogh (CC-by-nc) and Suits & Cells by Alexa Clark (CC-by-nc), both on Flickr.