Wednesday COVID-19 Briefing

Top news, reports and insights for today:

  1. Curated headline summaries for Wednesday:
  • Researchers combined information from 32 studies of COVID-19 risk in children, finding that children and adolescents had 44% lower odds of secondary infection with SARS-CoV-2 compared with adults (JAMA Pediatrics)
  • Moderna CEO says its coronavirus vaccine won’t be ready until spring of next year (CBS News)
  • The White House coronavirus task force again this week strongly recommending mask usage in some states like Iowa and Georgia that still do not have statewide mask mandates (CNN Politics)
  • Hospitals feel the squeeze as cases spike in upper Midwest states Wisconsin, North Dakota (ABC News)
  • Facebook removes 38 versions of Trump campaign ads claiming (without evidence) that admitting refugees increases COVID-19 risk (NBC News)
  • Largest study yet of COVID-19 transmission in India published in Science highlights the role of super-spreaders, a small subset responsible for a high percentage of infections. Study also finds that children transmit the disease as easily as adults (Los Angeles Times)
  • Remember how COVID-19 exploded on a cruise ship? The Trump administration has again over-ruled the CDC recommendation to extend the “no-sail” order on cruise ships to next year (ARS Technica)
  1. U.S. passes 7 million lab-confirmed COVID-19 cases. Last million cases added in 26 days
     Let’s start with the big picture today. Over the weekend, based on the Wikipedia data, the U.S. passed 7 million cases (See Figure A). On average, the U.S. has added a half million cases every 12 days. We went from 6.5 to 7 million in exactly 12 days. On average, each million cases has been accruing every 26 days. The jump from 6 to 7 million was just that (26 days). That’s a million cases a month. The more important idea here is that the COVID-19 outbreak is now steady-as-she-goes in terms of the pace of growth. On a big picture basis, the epidemic is locked in to an oddly consistent, even robust degree. Seasonality has been less than expected, surges and falls have been less steep than might have been predicted, and overall, the epidemic curve looks more like an endemic than a pandemic.
    What does this mean: Buckle up for the long hall because SARS-CoV-2 is not going away.
Figure A
  1. U.S. daily cases holding largely steady. Transmission intensity highest in the Midwest, growing fastest in the West
     Figure B shows daily cases; the 7-day average remains just over 40,000 a day. We are now adding cases about twice as fast as the nadir of the epidemic in the first week of June. Today, I wanted to point out how different ways of looking at the same data are needed to address different questions. What questions? First, where are infections being generated most intensively right now? Second, where is the rate of new infections growing the fastest? Sometimes the answers will be the same. But, if a particular state has high sustained transmission intensity for a long time, the rate of growth of new cases will be very low. Conversely, a state with very low transmission intensity might be growing the fastest through regression to the mean in a natural cycle of change.
     Take a look at Figure C showing new daily cases per 100,000 residents by state over the last week. Let’s remind ourselves that the benchmarks we care about are a) less than 5 indicating “low” transmission intensity, and b) greater than 20, or 4-fold higher, indicating “high” transmission intensity. As has been consistently true for weeks, the Northeast is in the best shape with 5 states in the low category and only Delaware is over ten. The South is, thankfully, also relatively quiet with only Arkansas reporting high spread. The region that is clearly most hot is the Midwest with eight of thirteen states in the red zone. Three stand out in particular: North Dakota (54) is 10x higher than the “low” benchmark, while South Dakota (45) and Wisconsin (39) are surging at a white hot pace. Michigan (9.6) and Ohio (7.8) are the only “warm” states below 10. Iowa (29), Kansas (32), Missouri (22), Nebraska (24) and Oklahoma (26) are all hot. In the West, while Arizona remains coolish, Idaho (25), Montana (27) and Utah (32) are all hot.
     So what about the second question? Have a look at Figure D showing 7-day growth factors in cases. The picture is different. Intensity is low in the Northeast, but growth in new cases is strong with five states seeing a week-over-week increase of 10% or more: Delaware, Massachussetts, New Jersey, New York and Pennsylvania. New cases are falling in nine of thirteen states in the South. The region where the most growth is occurring is the West. Cases are rising fastest in New Mexico (+58%), Wyoming (+53%), Nevada (+46%), Washington (+41%), Alaska (+39%), and Montana (+39%) in that order. Whereas transmission intensity is highest in the Midwest, case growth is over 20% in only Michigan (+21%), South Dakota (+28%), and Wisconsin (+23%). Let’s take special notice of the states that pop out of both figures. Montana, South Dakota and Wisconsin, all regionally propinquitous, all have both high intensity and rapid growth.
     Bottom line: Something big and scary is going on in the upper midwest plains states!
Figure B
Figure C
Figure D
  1. Quirky Qorner: Republic of Kazakhstan social influencer Borat tweets praise for U.S. coronavirus handling: “Because of Trump, 350 million Americans still alive”
     If rumors are correct, the long awaited followup to Borat is on its way to Amazon Prime Video sometime soon. According to this piece in Vanity Fair, twitter was shaken by a video appearing just before the first debate, handle @KazakhstanGovt, congratulating “Premier Trump” for his handling of the crisis. Very Nizzzze!

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