Top news, reports and insights for today:
- Rise in new U.S. cases appears too slow. What does it mean?
If you follow my blog, you are used to seeing the figure below, showing the daily tally of newly reported COVID-19 cases across the U.S. Today, we see something brand new. Tuesday, March 24 was the first day since we began tracking that the number of new cases did not break a daily record. Monday, however, we saw more than 10,000 new cases for the first time. This was consistent with the trend of new cases doubling every 2-3 days. But, on Tuesday, fewer new cases were reported (9,915). That’s still a large increase in cases, but it is the first glimmer of news to suggest the possibility that the rate of new cases may be slowing.
What does this mean? It is tempting to think that the speed of the epidemic is slowing and that we may be getting closer to the “peak” of cases in the U.S.. My opinion is that we can’t rule this out, but it is too early to draw that conclusion. As I have said here before, right now the rise in cases represents 2 forces that are combined and difficult to separate: the rise in testing and the true spread of the disease. I believe that our testing is finally starting to catch up to reality in places like Washington, California and New York. But, the backlog of tests waiting to be processed has also grown substantially, so the slow down in new cases is partly related to bottlenecks in the testing pipeline. Also, there are some states where the explosive increases in cases we saw in New York remains hidden because of slower ramp-up in testing. We see this in the last state to report a case (West Virginia) where new cases jumped by 95% overnight. More to the point, the data will begin to look more jagged as testing catches up. We will need to be patient and wait a few more days to see if the rate of new cases is really slowing, or if we are in a period of daily see-saw movement.
- U.S. remains near the bottom of impacted nations in testing
While testing is rising in the U.S., the scope of that effort continues to lag behind where it needs to be in the view of public health leaders. Take a look at the chart below that I created to compare the rate of testing (tests per 100,000 people) using the best available data up to March 20 from OurWorldInData.org. Italy has tested 10 times the number of it’s citizens compared to the U.S.. Only Japan and France have tested at a lower rate. That is probably why Japan only reports 1,307 cases. It’s important to look not only at the total number of tests done, but at the rate of testing in order to gauge the effectiveness of surveillance. Consider Iceland, which is now the model nation in the world in having tested 2,700 per 100,000 persons. For that reason, we can believe that their reported cases (737) and deaths (2) are accurate. Iceland and the U.S. represent opposite ends of the spectrum of national response when it comes to testing; it remains to be seen how this will alter the burden of suffering and death the two nations experience.
- It’s time for the President to use the Defense Production Act to address the needs of workers on the front line [a commentary]
Hospitals and clinics are running out of basic personal protective equipment (PPEs) needed to fight this disease. Everyday, new reports surface of doctors and nurses having to go without equipment they need or to re-use masks, gloves and gowns in ways that put them at risk. It is outrageous that the richest country in the world is sending soldiers to the front line of this battle without adequate ammunition. This problem will get worse and will cripple the ability of our health sector to treat the rising burden of cases. The nation has a Strategic National Stockpile of supplies, and that is now being tapped into. However, it won’t be enough. As reported in the Atlantic, the CDC is now telling nurses to use “bandanas and scarves as a last resort”. It is critical that the Defense Production Act be implemented immediately to get American manufacturers to switch to making needed medical supplies and equipment. The act was technically invoked last Wednesday by President Trump, but he has thus far failed to make use of DPA authority due reportedly to lobbying pressure from the U.S. Chamber of Commerce and corporate heads who are against it. The time to act is now. Failure to do so will cost lives and result in national shame.