October | 2020 | Thomas A. Glass, Ph.D.

Top news, reports and insights for today:

Curated headline summaries for Wednesday:

U.S. COVID-19 cases surpass summer peak and are climbing higher fast (NPR, See Figure A)
As U.S. cases surge to new highs, President Trump falsely claims COVID-19 numbers are “way down” (the Guardian)
New Jersey just surpassed 1,000 patients hospitalized for COVID-19 for the first time since July 2. While still below the peak in April, it’s 421 more than a month ago and a potential warning flare that things are heating up in the Northeast (The Hill)
Coronavirus cases are surging here and in Europe. The national responses could not be more different. Germany just announced a four-week national shut down of restaurants, bars, cinemas, theaters and leisure facilities to curb the rise in infections. With half it’s intensive care beds now filled with COVID-19 patients, France has also announced a second lockdown to begin on Friday. Other countries are doing what we should do and won’t (NBC news)
In the past month, the number of Americans hospitalized with COVID-19 has risen 40%. At least 14 states saw hospitalizations higher in the last week than any point in the epidemic, and 7 more states are nearing their peaks. (New York Times)
Influenza vaccine demand creates minor regional U.S. shortages. The CDC says however it’s a temporary issue and expects no national shortage (CIDRAP)

Figure A: From the NPR article, October 27

U.S. daily cases edge past previous summer peak levels, rising in all but 3 states. Northeast states showing biggest surges
You probably have heard that cases are really starting to pick up across the U.S. in the last week. It’s been hard to miss the alarm sounding. It seems like deja vu from the summer. But it is not; there is a big difference. When cases ramped up in the summer (see the peak in Figure B of 75,000+ daily cases in mid-July), there was a swift reaction to shut things back down in many states. When it was recognized the virus was roaring back starting memorial day, state leaders saw that the reopening experiment had been too fast and too soon. It’s hard to find evidence that this surge is prompting the same reaction. Case in point: California’s governor has given the green light to reopening the state’s amusement parks. Geez. In response to a similar spike in cases, Germany and France announced national lock downs (see Headline 4).
The epidemic curve over October looks quite similar to mid-June to mid-July. On Saturday, daily cases leapt past the previous daily high passing 78,000. Let’s not make too big a deal of that number, however since the testing regime has changed substantially since the summer. Compared to the 891,000+ tests done on the previous peak of July 17, the U.S. is now processing in excess of 1.1 million tests a day on average (Figure C). In mid-July we had 65,000 cases a day and over 60,000 people hospitalized, compared to more cases now but only 42,000 in hospital (Figure D).
The story regarding daily deaths is less positive. While hospitalizations are a third lower than the July peak, daily deaths are about the same at around 1,000 a day (Figure E). While cases peaked July 17, deaths continued to rise for another month. I expect that to be true now as well.
At the state level, the surge in cases appears to be occurring across all regions and nearly all states (Figure F). Week-over-week growth factors are >1.0 everywhere except Missouri, Mississippi and Delaware. This is one of the grimmest sets of growth factors I have posted yet. Weekly cases jumped by fifty percent or more in Alaska (+72%), Connecticut (+52%), Rhode Island (+66%) and Vermont (+124%). Another 23 states, saw cases jump by 20 percent or more including all Northeast states except Delaware and Maryland. The Northeast looks increasingly like the next big hot spot region.
The bottom line: A third major wavelet of high transmission intensity is now clearly in progress across all regions. Thanks to greater testing, daily cases burst old records. Hospitalizations tell us it is not as severe as the mid-July peak. Recent hot spot states like North and South Dakota remain sizzling hot, while worrisome jumps in transmission intensity are now visible on the horizon in the Northeast. The main difference I see now compared to the summer peak is that state leaders are not making moves to counter the surge. This inaction, along with environmental conditions trending favorably for the virus, suggest we are quickly moving toward the worst period of suffering and death in the coronavirus pandemic.

Figure C: U.S. daily testing, taken from: https://covidtracking.com/data/charts/2-metrics-7-day-average-curves

Figure D: https://covidtracking.com/data/charts/2-metrics-7-day-average-curves

U.S. passes 8.5 million cases adding the last half million in just 7 days. If North and South Dakota were countries, their incidence rates would be #1 and #4 highest in the world respectively
Here is a big-picture look at the cumulative epidemic curve for the U.S. since the beginning (Figure G). The dark blue bands show the durations between each successive half million cases. The previous fastest rate of rise was between late June (2.5 million) and start of August (4.5 million). As the U.S. passed 8.5 million cases on Monday, we also take note that the interval has dropped from 2 weeks back down to 1. The 8th million cases were added in just 21 days and the 9th will likely be the fastest million yet. Where is this national surge coming from? Figure H shows the change in COVID-19 incidence rates by state over the last two months. The national average incidence rate rose from 1,750 sixty days ago (black dashed line) to 2,600 yesterday (red dashed line). No state doubled it’s rate in the Northeast in that period. In the South, rates about doubled in only Kentucky and West Virginia, the Southern states with the lowest rates to begin with. Out West, rates doubled or more in Alaska, Hawaii, Idaho, Utah and Wyoming, and went through the roof rising 4-fold from 648 to more 2,748 in Montana! But the big shifts were seen in the Midwest. North and South Dakota are now at over 5,100 and 4,400 COVID-19 cases per 100,000 respectively, having tripled in two months. Not only does that make them the highest rates in the U.S., with double the overall U.S. incidence, but North Dakota now has a rate higher than any nation on earth with a population greater than 1 million. If South Dakota were a country, it’s rate would be 4th highest in the world behind Qatar at (4,699) and Bahrain (4,696). Both countries have about the same testing rate as this country. Another 8 Midwest states have roughly doubled rates including Iowa, Indiana, Kansas, Missouri, Nebraska, Oklahoma and Wisconsin.
The bottom line: The COVID-19 epidemic is accelerating in the U.S. again. The Dakotas now have the highest infection rates in the world. Neither state has yet to impose even minimal infection control measures.

Quirky Qorner: An unlikely pandemic winner: Tupperware!
Growing up in the 60s and 70s, I admit I have a soft spot in my heart for Tupperware. For half a century, Tupperware’s business model has been based on the Tupperware party, a hyperlocal retail model premised entirely on the absence of social distance. One would guess that Tupperware would be in bad shape in the era of a global infectious disease pandemic that makes social gathering a life-and-death non-starter. That guess would be wrong, as I leaned in an ABC News story out today. As the article puts it, “Restaurant pain has turned into Tupperware’s gain with millions of people in a pandemic opening cookbooks again and looking for solutions to leftovers. They’ve found it again in Tupperware, suddenly an “it brand” five decades after what seemed to be its glory days.”
The bottom line: It just goes to show you that coronavirus confounds us in every domain from platelets to plastics.

Thomas A. Glass, Ph.D.

An epidemiologist’s perspective on the COVID-19 pandemic

Month October 2020

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Top pick of the day: Wednesday

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