Wednesday COVID-19 Briefing

Top news, reports and insights for today:

  1. Curated headline summaries for Wednesday:
  • Top story: Hospitals grow increasingly overwhelmed. In the last week, 18 states have set single-day records in patients hospitalized for COVID-19, as cases soar all over the country (Washington Post).
  • FDA authorizes first COVID-19 home test developed by Australian company Ellume. It will be sold over-the-counter and produces results that can be read at home. This is an important milestone that may help fill in gaps in our testing regime. The FDA claims the new test has very good accuracy (CNN).
  • Nurses in 3 Southern California hospitals strike over staff shortages as intensive care unit availability falls dramatically amid a surge in COVID cases. Consider this the canary in the mine teaching the nation an important lesson about how dire things are in U.S. hospitals (Newsweek).
  • FDA says Pfizer vaccine vials hold extra doses which may boost supply of newly authorized preventive treatment (Politico).
  • By combining many other studies, researchers have come up with the best estimate yet of the level of increase risk men face from COVID-19. We aren’t yet sure why but compared to women, men who get COVID-19 are almost 3-times more likely to need ICU treatment and have a 39% higher risk of death. That’s all the more striking because men and women are getting the disease at about the same rate (Nature Communications)
  1. Possible sign of slowing in new cases. Deaths keep rising. The West is in trouble.
     Yesterday was the first Tuesday in weeks that new cases didn’t jump appreciably higher than the Sunday-Monday totals (See Figure A). It’s hard to find anything positive about a daily new case total of 178,000 but as the red moving 7-day average shows, there is potentially a flattening trend that may foreshadow a slowdown in transmission intensity. This figure alone isn’t compelling, but the state new case growth factors tell a similar story (Figure B). Compared to the previous week, new cases were lower in every Midwestern state for the first time in months. Thankfully, new cases fell by half in North Dakota and a quarter in South Dakota. Decliners outnumbered risers in the West, however California stands out with a case growth of 38 percent. That state recorded 228,000 cases just last week with more than 30,000 cases a day. Worrisomely, this doesn’t include a record high 54,000 cases reported today. Cases are rising in more states than are falling in the South and Northeast. The standout numbers come from Tennessee (+68%), Maine (+42%) and New Hampshire (+22%).
     The death numbers are less hopeful (Figure C). After a typically lugubrious weekend, 2,812 American COVID-19 deaths were reported, capping a week of over 16,500 deaths, a 10 percent rise over the previous week. The trend remains upward; it will be weeks before any decline in new cases translates to lower mortality. The weekly growth factors (Figure D) signal a regional surge in deaths in Arizona (+57%), California (+36%), Colorado (+170%) and Idaho (+23%), New Mexico (+30%) and Nevada (+23%). With ICU beds growing increasingly scarce in several of these states, the West is the region of greatest concern at the moment. Other states with notable growth rate in deaths include Virginia (+46%), New York (+42%), and Pennsylvania (+38%).
      Bottom line: There is some early evidence that new case growth may be slowing this week. We will wait to see if this is real. Even if it is, hospitalizations continue to climb, which means that it will be weeks before the surge in deaths might slow. What American’s do over Christmas and New Years will determine whether the coronavirus has a happy holiday or whether we start to get a better handle on this disease.
Figure A
Figure B
Figure C.
Figure D.
  1. Is SARS-CoV-2 worse than influenza? COVID-19 has now killed more Americans than 4 of 5 previous flu pandemics combined
     Since modern epidemiology has been counting, the United States has faced five major influenza pandemics. The one most people have heard of was the erroneously named “Spanish flu” (it actually started in Kansas) that ran from 1918-1919. Over two years, that strain of H1N1 flu killed between 550,000 and 650,000 Americans, which makes it the second worst national disaster behind the Civil War in terms of total loss of life. I have showed you a version of the figure below several times, showing that COVID-19 has killed more Americans than died in various combinations of events. This virus has killed more than the Gulf war, September 11 terrorist attacks, the Korean War, Vietnam War and World War I combined (Figure E). Only the Spanish flu has that beat. COVID-19 deaths also now exceed the number of combat deaths from the Civil war (214,938) although total civilian deaths remain greater. Fewer people may know about the four other influenza pandemics that have struck the world and the U.S. including the “Russian flu” (1889-90), “Asian flu” (1957-58), “Hong Kong flu” (1968-69) and “Swine flu” (2009-10). Combined, those four pandemics are blamed for over 242,000 American deaths over a combined eight years, a total matched by COVID-19 on November 22.
      Bottom Line: As the U.S. approaches 300,000 officially recognized lab-confirmed COVID-19 deaths (the true number is 30-40 percent greater), coronavirus has already claimed almost 50,000 more lives than those four pandemics. All that death has taken place in just ten months. Despite the good news about the arrival of the vaccine, COVID-19 will likely match or exceed the deaths from Spanish flu and become the worst infectious disease crisis in U.S. history. Except for 1918, there has never been a flu like this coronavirus.
Figure E
  1. Quirky Qorner: The hottest trend you didn’t see coming during COVID-19: tooth straightening
      A recent story in VICE caught my eye this week. It’s the latest pandemic trend I didn’t see coming. Apparently, companies like invislign and Smile Direct Club are on to something. At first I thought it made sense since social distancing requires us to stay home and away from the social limelight. Perfect time to do a home project that takes months and is best not carefully observed. But then it hit me. Why not straighten the old choppers as long as I have to wear a mask anyway. Oh, to be a bandit or an orthodontist!


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