Weekend COVID-19 Briefing

Top news, reports and insights for today:

  1. Curated headline summaries for Saturday/Sunday:
  • Top story: Head of Federal “Warp Speed” vaccine effort says U.S. vaccinations for prevention of COVID-19 will “hopefully” start in weeks. Two vaccine makers have applied for FDA approval, a process expected to take about 3 weeks. The first round of vaccines will to go to nursing homes and health workers. Availability for the general public is expected to ramp up in the first half of 2021 (Bloomberg).
  • CDC warns against Thanksgiving travel amid COVID-19 surge (CIDRAP).
  • Dr. Sanjay Gupta, CNN Chief Medical Correspondent (along with many others) says he won’t be visiting family this Thanksgiving and you shouldn’t either (CNN).
  • Over 1 million U.S. travelers flew on Friday, despite calls to avoid holiday travel (Axios).
  • Los Angeles county has the most infections of any in the U.S. since the start of the pandemic. Amid a recent surge in cases, greater Los Angeles added 4,522 new COVID-19 cases on Saturday bringing the area close to the decision point to (once again) lock down restaurants, bars, breweries and other businesses (Bloomberg).
  • Scientists in the U.K. find that tocilizumab (Actemra), a drug used to treat arthritis, showed signs promise in treating severe COVID-19 patients. While not yet definitive, this is important because it illustrates how science is narrowing down effective therapies thanks to our growing understanding of how SARS-CoV-2 works. This drug, like steroids, works by reducing inflammation, the fatal culprit for many seriously ill patients (Imperial College Healthcare News).
  • If states were countries, 16 of the highest rates of new COVID-19 infections in the world this week would be U.S. states (Federation of American Scientists, See Figure A)
Figure A: https://twitter.com/euromaestro/status/1329996608981905408/photo/1
  1. U.S. about to reach 12 million cases, now reporting a million cases a week
      When COVID-19 hit the U.S., it took almost 3 months (58 days) before we hit one million cases (See Figure B). Nine months later, cumulative cases jumped from 10 to 11 million in just one week, and is poised to cross 12 million in even fewer days. Would anyone have believed you in May if you said we would have a million cases a week in November? How did we arrive at a million a week? By recording 150,000 cases or more for 6 of the last 7 days, peaking on Friday at a record high 187,000 (Figure C). As each day passes and each record is broken, this third peak increasingly dwarfs the magnitudes of the first and second peak periods.  If you are looking for a scrap of good news, it might be that weekly cases declined for the first time in both North (-10%) and South Dakota (-23%), as well as in Iowa (-17%) (Figure D). That’s about where the good news ends; cases are increasing weekly in every state in the South, Northeast and West (except Hawaii). Growth factors of +40% or more include previously hard-hit states Arizona (+42%), California (+54%), New Mexico (+71%), Oklahoma (+49%), Florida (+49%), Louisiana (+55%) and Virginia (+54%). No state is below 5 new daily cases per 100,000, a measure of good outbreak control, but 47 are at 20 or more and 32 states are at 40 or higher. Ten states are out of control at 100 or more daily new cases per 100,000 including Montana (116), New Mexico (111), Utah (102), Wyoming (120), Iowa (119), Minnesota (114), North Dakota (163), Nebraska (120), South Dakota (115) and Wisconsin (110).
    Bottom line: The U.S. is now at a million cases a week. New daily cases are highest in the Midwest and West, but numbers are growing more in the South and Midwest. This is a perfect storm, even as hopes for a vaccine rise.
Figure B
Figure C
Figure D.
  1. North and South Dakota have the first and third highest COVID-19 death rates in the world this week, as the third mortality peak rages across the nation
     Total U.S. death toll from COVID-19 passes 240,000 this week as almost 10,000 deaths were reported, a nation-wide increase of 29 percent over the previous week (Figure E). The weekly high daily death toll of 1,956 on Thursday marks the first time since May 6 that 2,000 daily deaths were reported. Figure F shows the three distinct mortality peaks, each with a different state experiencing the worst. During the first (and most severe) peak this spring, deaths per one million peaked at 39 in New York on April 15, with New Jersey, Connecticut and Massachussetts all soaring over 20. As the first peak waned and the Northeast gained control, the epicenter swung to the west leading to a second mortality peak in Arizona at a much lower 11 per one million on July 21; Mississippi also peaking at 11 a week later. As the third mortality peak takes shape, four states have already exceeded the July peak including the Dakotas, Wyoming and Montana. Consider how “resourceful” SARS-CoV-2 has been in this country. The three peaks are remarkably different qualitatively having occurred first in the densely populated, urban, transportation-heavy New York corridor. The third peak, in contrast, is happening in the smallest, most remote and least populace states. This peak is most intense in the Dakotas, two states that have refused to implement coordinated transmission control measures, and where death rates are mid-way between the terrible carnage of the first peak and the worst of the second.
     Just how bad is it in North and South Dakota? Well if those two states, with total populations of just 72,000 and 68,000 respectively, were separate countries, they would have the first and third highest COVID-19 death rates in the world last week according to the Federation of American Scientists (Figure G). Nobody thought that could happen in tiny states with such low density and no big city. More broadly, weekly deaths are rising in all but three states (Figure H) with the most alarming increases in California (+52%), Colorado (+93%), Nevada (+78%), Oregon (+100%), Kansas (+71%), Arkansas (+82%), North Carolina (+65%), New Jersey (+53%), and Pennsylvania (+103%).
    Bottom Line: A third mortality peak is underway, with deaths lagging behind cases by about a month and hospitalizations about 2 weeks (see Wednesday briefing). Right now the third peak is worse than the second but not as bad as the first. Prediction models are too imprecise as of yet to give fool-proof guidance about how bad this peak will get. North Dakota, with the worst death rate in the world and a governor that refuses to take action, remains the control group for the world showing what happens when governments do nothing to stop this virus.
Figure E
Figure F: Three mortality peaks
Figure G: https://twitter.com/euromaestro/status/1328244083308040192/photo/1
Figure H.
  1. Quirky Qorner:This is the way….to mask up
     We should all be wearing masks when we go out, which includes going to Michael’ for Christmas stuff. That’s what a California mom told her 5-year old daughter. According to an article in Buzzfeed.news, mom didn’t expect her daughter to choose the mask she did (See image below posted on twitter). When it comes to masking up, this is the way!

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