- Cases and deaths soar across the globe, U.S. ranks third
According to data from Johns Hopkins, the total number of COVID-19 cases is now over 335,000 with 14,600+ deaths (as of this moment). Significant rises in deaths are reported in Italy (now at 5,476) and Spain (1,772). The U.S. now ranks 3rd in total cases among all nations with over 33,000, behind China (81,000+) and Italy (59,000+). Spain, Germany and Iran round out the list of countries that have more than 20,000 cases.
What does it mean? Just as we see the epidemic going from 1 state, to a region, to the entire country in the U.S., a similar pattern of regional and global expansion is evident across the globe. Countries that were in the news every day a week ago (South Korea and Iran) have been displaced by new epicenters in the U.S., Germany and Spain. One curiosity is Japan, where large numbers of cases were expected but have not yet been documented (1,086 confirmed cases and 40 deaths). The world waits to see if Japan will see an explosion of new cases currently hidden in the epidemic pipeline, or if instead Japanese authorities have hit upon an effective containment strategy.
- The COVID-19 epidemic spreads out across the U.S.
The U.S. added 6,236 domestically-acquired cases on Saturday, a one-day increase of 36%. While the epidemic first struck the pacific northwest, and later big cities in the East, smaller, less populated states are now in the cross-hairs of COVID-19. The figure below shows 1-day rises in cases as a percentage in the 50 states and DC for Saturday. Hot-spot states (where cases rose by a third or more) include Arizona, Idaho, Nevada in the West, Iowa, Michigan, Missouri, and Ohio in the Midwest, Tennessee, Texas and West Virginia in the South, along with previous hot-spot states in the Northeast (New Jersey and New York). Vermont added 20 new cases, a rise of 69%.
What does it mean? At first, many American’s believed that COVID-19 was a Chinese problem. Look no further than President Trump who began to refer to a “Chinese virus” on March 16. Then, it looked like a problem in Italy, Iran and South Korea (not to mention cruise ships). Days later, it became was in the U.S., but way “over there” in Washington state and California. For many, COVID-19 remained a problem of “otherness” (PoO). A few short days after that, it’s New York and it’s the Big apple, followed by outbreaks in New Jersey, Chicago, and Massachusetts. Still, some rural American’s believed it was still a PoO. Saturday should make two things starkly self-evident: One, this virus does not discriminate on the basis of race, wealth, politics, urban/rural, or any other social division along which we are cleaved as a Nation. Two, we truly are now, all in this together.
- Social distancing may be working!
Evidence is now emerging that social distancing measures may be effective in flattening-the-curve, at least in some places. The figure below has been circulating in a variety of news outlets, including a piece by Joshua Cohen in Forbes Magazine. This striking figure compares daily cases in two provinces in Italy between late February and mid-March. The Italian government opted for a step-wise approach to lockdown across provinces. This becomes a natural experiment to study (in part) the impact of such restrictions. Lodi was locked down first, starting February 23rd, while Bergamo did not do so until a nation-wide quarantine was declared over the entire country on March 9. The graph shows that in Lodi, early restrictions slowed the pace of the epidemic (otherwise known as flattening-the-curve) while a faster pace of new cases continued in Bergamo.
What does it mean? Let’s be cautious. Cases and deaths keep mounting in Italy. And, there is evidence from several countries in Asia that social distancing measures have not always worked. Remember that the point of these measures is not to halt the epidemic, so we should not expect that the river of cases will stop. The point is to press down on the epidemic curve to buy time for our increasingly challenged health sector to keep up. It’s not a perfect experiment, but it is a sign of hope.
-Posted 11:00 pm EDT, March 22