Daily COVID-19 Briefing: 3/15/20

  1. Today, Worldometer reports 167,638 global confirmed cases and 6,456 deaths as of 18:22 GMT. They present graphs of total global cases and deaths that look like this:
    I interpret this graph as evidence that the COVID-19 pandemic is in a phase of rapid spread and sustained community transmission on a global scale. This is not good news because the slowing of the epidemic in China is being overshadowed by failure of containment in other countries. Notable one-day case increases are reported in Malaysia (80%), Switzerland (61%), Pakistan (61%), South Africa (61%), Mexico (58%), Morocco (56%), Estonia (49%), Greece (45%), Portugal (45%), Thailand (39%), Czechia (34%), Austria (31%), Ireland (31%), Belgium (29%), Germany (26%), Philippines (26%) and Canada (26%). All this suggests that countries that have been the focus (notably Italy and South Korea) are not special cases, but instead reflective of a larger pattern of national and regional outbreaks across the globe.
  2. The situation in the U.S. reflects a similar picture. Case totals of persons presumed to have been infected domestically (not due to travel to impacted countries or cruise ships) again shows that we are doubling cases approximately every 2–3 days:
    Numerous sources indicate that the U.S. continues to follow in Italy’s footsteps. Algebris Policy and Research Forum finds that the U.S. is currently where Italy was 16 days ago. They further project that daily increases of cases are not likely to peak until the end of March 2020 in the top 4 EU countries. In the U.S., cases rose substantially since yesterday in Colorado (31%) Nevada (73%), Illinois (39%), Michigan (32%), Minnesota (50%), Ohio (100%), Wisconsin (42%), Florida (51%), Georgia (57%), Louisiana (114%), North Carolina (53%), Texas (31%), Virginia (37%), Maryland (53%), New Jersey (38%) and New York (46%) among states reporting ten or more cases as of yesterday. The situation in New York State is particularly striking. On March 14th, that state reported an additional 192 new cases, bringing their total to 613, which ranks second only to Washington State and which is 22% of all U.S. cases.
  3. I’m starting to hear people use the term ‘carrier’ to refer to those who have been sickened by this virus. I urge caution in the use of this term. The term has a solid foundation in biology for some viruses, such as the one that causes chickenpox. That’s because once someone gets chickenpox, the virus remains in their bodies for a lifetime. After the first nasty outbreak of red bumps, the virus tends to come out of hiding on a regular schedule (about every 30 days). When it does, a person might be able to transmit the virus to someone else due to what virologists call ‘viral shedding’ even though they have no symptoms and don’t know this is even happening. Chickenpox is caused by a virus that becomes latent within a person’s cells. This latency is why the term ‘carrier’ applies.

    We are still learning about the SARS-CoV-2 virus that causes COVID-19, but there is no solid evidence that this coronavirus acts like chickenpox. People who get this disease will have symptoms (when they have them at all) for approximately two weeks for mild cases and 3–6 weeks for severe or critical cases. While we aren’t sure yet, current guidance says patients who have had COVID-19 should be assumed to remain contagious for a period of up to several weeks after symptoms have subsided. However, once a patient has fully recovered, and tests negative for the virus, there is no reason at this time to think they will remain ‘carriers’. The casual use of that term has the potential to exacerbate stigma, prejudice and maltreatment toward persons (or groups) who have been stricken. That kind of “scarlet letter” effect can spread like the virus and lead to negative consequences for us all.

Updated 3/15/20 at 4:30 pm EDT.

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