Top news, reports and insights for today:
- Curated headline summaries for Saturday/Sunday:
- President Trump tests positive for COVID-19, checks in to Walter Reed hospital. Doctors say he is on steroids and improving after brief ‘episodes’. Treatments indicate possible serious disease. (NBC News)
- U.S. has reported nearly 100,000 new COVID-19 cases and 1,600 deaths since the news of the President’s positive test (VOX)
- Freshman New Jersey congressperson Mikie Sherrill introduces a bill to jumpstart U.S. testing program by rewarding testers for quick turnarounds and increasing capacity (ARS Technica)
- New study summarizes lessons learned as countries ease COVID-19 restrictions including a) success comes from gradual shift to a new normal, not return to prepandemic conditions, b) decisions should be based on the epidemiology, c) restrictions should not be lifted until capacity to track and trace new infections is in place, and d) the need for ongoing transmission control measures will remain in effect for a long time (Lancet)
- A patient information page published in JAMA reports that risk of COVID-19 during air travel is low; planes are safer than an office building, classroom, supermarket or commuter train (JAMA, See Figure A)
- U.S. daily cases again leap over 45,000. Most new infections in the Midwest but alarming surge on the horizon in the Northeast. Just how crazy is Wisconsin?
This week started on a promising note as daily cases dipped below 45,000. That changed on Friday and Saturday when more than 47,000 cases were logged both days (See Figure B). Rates of new infections remain highest in the Midwest (Figure C) where eight states exceed 20 cases per day per 100,000 people. Again today, the states with the highest transmission intensity are North Dakota (52), South Dakota (46) and Wisconsin (42). In the West, Idaho (27), Montana (33), and Utah (30) remain high, contributing to a continuation of the regional hot spot in the upper plain states. In the South, only Arkansas remains “hot” (27) while things appear to be quiet in the Northeast.
However, alarms sounded for me when I saw the case growth factors (Figure D) showing brush fires igniting in seven Northeast states (indexed here by weekly case growth of 30% or more). In New Hampshire, weekly totals more than doubled from 201 to 476 with a new record high 217 cases reported on Friday. From the beginning to the end of the week, daily cases about doubled in Washington DC, New York and Vermont. Some of these growth factors are understated due to lack of Saturday reporting in Connecticut, Pennsylvania and Rhode Island. Substantial surges in weekly cases in Massachussetts (+48%), New Jersey (+33%) and New York (+50%) are especially disconcerting. It is my opinion that we are about to see a new wavelet of higher transmission intensity in the Northeast region, likely intensified by the start of cold and flu season.
On Wednesday, I pointed out how important it is to look both at new case rate (Figure C) and growth factors (Figure D). While the former remains very high in North and South Dakota, thankfully both states have very modest increase in new cases. Then there is Wisconsin, where things have gone from bad to worse. Not only are they currently white hot at 42 cases per day per 100K, but new weekly cases rose another 22%. While there was some hint that things may be slowing there, the pace of the epidemic has been dramatic. To paint a picture, have a look at Figure E from Covid Trends showing the problem states on a linear scale. Wisconsin now has over 138,000 confirmed cases, rising at 17,769 per week. One month ago (September 3) they were at 83,000 total cases and 4,900 a week. September was a very bad month for Wisconsonians, with weekly cases more than tripling. According to an article in the Wall Street Journal, state health officials initially blamed returning college students for the surge, but then the plot thickened; more recent numbers show big rises in towns and cities without colleges.
The bottom line: U.S. epidemic remains robust. The upper Midwest remains a hot spot of hot spots. I see the potential for a significant explosive rise in transmission intensity in the Northeast.
- Global COVID-19 deaths exceeded 1 million on September 28. Simulations show that without strong action, that number could triple by the start of next year. U.S. deaths remain steady at 700 a day.
According to most data sources, the number of global COVID-19 deaths shot past 1 million last week. At a moment when individuals, organizations and governments struggle against pandemic fatigue and the ceaseless groundhog day feeling, it’s easy to lose track of just what is at stake. Here is a graphic that I find chilling in its naked simplicity (Figure F). It shows a rough timeline of deaths. What is so stark about this figure is how unbending the escalating global trend has been. There is no end in sight to the onslaught of death and suffering. The figure comes from an article in Nature News that asks “How many more will die?” The answer depends in a big way on what countries do in terms of retaining or ending transmission control measures.
The article draws attention to the latest projections from The Institute for Health Metrics and Evaluation (IHME) at the University of Washington (Figure G) showing 3 scenarios. They project that by January 1, 2021, deaths will increase to 2.3 million under current conditions. However, if nations were to mandate universal masking policies, deaths would rise to only 1.7 million. On the other hand, if current masking and social distancing policies were eased, that number would balloon to 3.2 million deaths. One can always quibble with such projections; the point is that holding other things constant, this model says that up to 1.5 million people will either die or remain alive by New Years day 2021 depending on the choices nations make.
Meanwhile, the U.S. reported 4,699 more deaths last week (Figure H) as average daily mortality remains above 700.
- Quirky Qorner: The pandemic’s silver lining? We put away our gold cards
I like to find good news about the impact of the coronavirus pandemic wherever I can find it. That lead me to a University of Chicago Beckman/Friedman Institute working paper on the effect of the pandemic on consumer behavior, spending and savings. It’s based on analysis done by economists at JP Morgan Chase using credit card data matched to national household surveys. Compared to last year, American households cut non-essential credit card spending by half in the first month of the pandemic. By the end of May, that spending had rebounded but remained about a third lower than the previous year. What’s more, essential spending fell about 20% and remained about 15% lower than previous years. This trend, along with increases in savings shows that Americans know how to tighten their belts when the going gets tough. To be certain, a good chunk of this lower spending is the result of lost wages, but that’s not the whole story. The authors see most of the decline as direct pandemic impacts, pointing to rising household supplies of liquidity indicative of the effectiveness of pandemic wage replacement policies.
What it means: I guess we are learning that what seemed “essential” before may be easier to live without than we might have guessed.
Thomas A. Glass, Ph.D. 