Daily COVID-19 Briefing: Saturday

Top news, reports and insights for today:

  1. Daily headline summaries for Saturday:
  • Nineteen states this week set new highs for coronavirus infections recorded in a single day (Axios)
  • White House has blocked CDC Director Redfield and other officials from testifying on school reopenings (USA Today)
  • FDA approves pooled testing for coronavirus, promising to increase testing efficiency and reduce backlogs (Axios)
  • 85 children under age 2 tested positive for coronavirus in 1 Texas county (NBC News)
  • Studies in both the U.S. and U.K. show evidence that several candidate vaccines show early signs in Phase II studies showing they produce an immune response. Still, the highest hurdle remains as drug makers move to initiate Phase 3 trials in coming weeks (BBC News)
  1. New daily high case records set Thursday and Friday. Deaths rising. Increasing transmission seen in all but 5 states
    New record high daily case totals were established on Thursday and Friday, with more than 145,000 cases reported in two days (Figure A). This brings total U.S. cases to over 3.5 million. A half million cases were added in just 8 days, faster than any previous period (Figure B). At the state level, while the nation has been watching a Arizona and Florida, community transmission this week is increasing across the board. Figure C shows one week growth factors (ratio of cases in last 7 days to the previous week) by state. All but 5 (46 of 51) states are increasing. Unlike last week, cases are rising again in the Northeast, where new cases rose by 20% or more in Washington DC (+21%), Maryland (+51%), New Hampshire (+30%), and Rhode Island (+50%). All states in the South saw cases rise by 10% or more, lead by Alabama (+43%) and Virginia (+46%). Transmission increased in all Midwest states except South Dakota. The largest 1-week rise was in the West, lead by Colorado (+96%), Alaska (+58%), Montana (+66%) and Nevada (+42%). Thankfully, new cases finally went down in Arizona by 2%. The trend toward rising deaths continued as 936 deaths were reported Friday (Figure D). Still, the number of deaths remains far lower than the peak period in April and May despite twice the number of cases.
    What does it mean: Instead of summer suppression, we see summer surge. Deaths, thankfully remain lower than cases would suggest. This tells us that we are capturing a larger percentage of the true cases in our testing. Instead of isolated state hot spots, transmission is intensifying more broadly across all states and regions than at any time in the past.
Figure A
Figure B
Figure C
Figure D
  1. The summer story: The rest of the nation catches up with New York and New Jersey
    Over the last few months, I have been repeatedly checking the overall rates of confirmed COVID-19 infections per 100,000 population by state to see how the epidemic’s distribution has shifted. Disease detectives look most closely at rates (rather than raw numbers) when comparing different places. The graphs below show state rates at 4 different time points. Three short months ago (Graph A), New York and New Jersey were “off the charts” at 1,143 and 848 cases per 100K. No other state was above 500, the national average was 202 and it seemed that New York would never be exceeded. By memorial day (Graph 2), New Jersey doubled and New York neared 2,000, while the national average rose to 541. Rates were still 4 times higher in the Northeast compared to the West. One month ago, it was clear other states were catching up (Graph C). New York and New Jersey saw new cases finally subside, just as the surge erupted in the Midwest and South. The Northeast was still 3-fold higher than the West, but there were now 8 other states over 1,000 and two were outside the Northeast (Illinois and Louisiana). With this context in mind, the picture has changed dramatically over the last month (Graph D). Infection rates in the Northeast are now only 2/3 higher than the west. Arizona had just 58 confirmed COVID-19 cases per 100,000 on April 16. Yesterday, they had all but matched New Jersey at 1,903. The average infection rates in the South were 1/10th of those in the Northeast in April and will soon be about the same (1,165 vs. 1,513).
    What does it mean? Three months ago, many were convinced the epidemic was a crisis of the greater New York region. We waited for the summer to deflate the epidemic so we could get back to normal. That has not been the story. Instead, the success of the Northeast in curtailing the epidemic and flattening the curve has been more than matched by the inability and unwillingness of other states to halt transmission. While it was unthinkable 3 months ago, the rest of the nation has rapidly caught up. There is no evidence that the new hot spot states have learned from the successes of New York and New Jersey.

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