Numerous agencies report that after a spike of 1,247 cases (a 20% rise) on Saturday in Italy, the government has announced strict control measures in 15 Northern provinces. This puts up to 17 million Italians under quarantine, although the details of these restrictions vary across provinces. Doctors warn that some hospitals are “close to collapse” as patients flood in from impacted areas. Italy is important to watch because it may be a look at how the epidemic will play out in Western, developed nations. This dramatic move also illustrates how a sudden spike in cases can trigger the need for control measures considered unthinkable days before. Italy now has 7,375 cases and 366 total deaths.
South Korea, Italy, and Iran now experiencing the highest rates of infection (cases per one million population) at 143, 122 and 78 per 1,000,000, respectively. If the U.S. were now experiencing the average of these rates, we would have 37,600 cases (calculations mine). Currently, there is no way to estimate what the rate is in the U.S. due to the lack of adequate (let alone comprehensive) testing.
The U.S. now has over 500 cases. Over the weekend, new cases reported in New York (50), Washington (24), California (19), Oregon (7), Colorado (6), Massachusetts (6), Florida (3), Connecticut (2), New Hampshire (2), New Jersey (2), Indiana (1), and Tennessee (1). The first cases were also reported in Hawaii; Kansas; Missouri; South Carolina; Utah; Vermont; Virginia; and Washington, D.C. Eight states have declared states of emergency.
A March 6th story in The Atlantic reports on an investigation of U.S. testing. Their investigation shows only 1,895 people have been tested in the U.S. due to confusion and problems in testing. Their results suggest that about 10% of tests have been positive. Based on that figure, we could speculate that if one million tests had been done (as was promised by the White House a week ago), we would now have evidence of 100,000 cases. They note that the CDC pulled information from their website on how many tests have been done. While testing is ramping up, the lack of adequate supplies and protocols remains the biggest barrier to effective response in the U.S. Because so few tests have been done, the current data on the state of the pandemic in the U.S. must be regarded as an extreme lower-bound estimate of the situation. South Korea had tested more than 66,000 people within a week of its first case.
USA Today reports on significant disruptions in the pipeline for drug availability in the U.S. in light of supply chain disruption in China and India. FDA said it expects “potential disruptions to supply or shortages of critical medical products in the U.S.” Antibiotics are particularly vulnerable as penicillin shipments from China have stopped.
CNN reports on new guidance from the CDC: “Older adults should stay home as much as possible.” The CDC website suggests that older adults and those with serious chronic conditions should stock up on supplies, take social distancing precautions and avoid crowds.
Messaging from public health officials has shifted significantly this weekend. For example, Dr. Anthony Fauci, director of National Institutes of Allergy and Infectious Disease, warned that community spread is happening, and people should avoid cruise ships (“Meet the Press,” via Politico). Both FDA Commissioner Stephen Hahn and U.S. Surgeon General Jerome Adams describe a shift from strategies of “containment” to strategies of “mitigation.” This suggests that federal officials are now admitting what epidemiologists already knew: it’s too late to stop COVID-19 in the U.S.