Daily COVID-19 Briefing: 5/9/20

Top news, reports and insights for today:

  1. Daily headline summaries for Saturday:
  • Ditch the valve masks; they are selfish. The whole point of wearing a mask is to protect others from being infected by you. If your mask has a valve, it doesn’t do that. That valve just spews your respiratory secretions straight out potentially infecting others if you are sick and don’t know it (ABC News)
  • COVID-19 deaths in Los Angeles County pass 1,500 with 1,800 currently hospitalized as trails, golf courses and some businesses reopen (Los Angeles Times)
  • U.S. FDA has granted emergency use authorization to a more rapid kind of COVID-19 test called an antigen test. It’s basically similar to the rapid flu test done in doctor’s offices. They give quick results but are less accurate than the PCR test we all love to hate. In my opinion, this is a bad move because these tests have a higher false-negative rate than the current test (which already has an unacceptably high false-negative rate). Use of this test will mean more infections and deaths because people who actually have COVID-19 will falsely believe they don’t and are likely to behave less carefully (The Verge)
  1. U.S. deaths fell yesterday, but grew by 21% last week, surpassing 70,000
    On Friday, an additional 1,695 Americans lost their lives to COVID-19, a rise of 2% and a third straight day of declines. Arizona had the highest increase in deaths last week, rising 62%, roughly doubling every 10 days. As I reported yesterday, Arizona has tested fewer of its residents than any other state. New record highs were set in Arizona (67) and Washington DC (19) yesterday. In addition to Arizona out west, there are 4 midwestern states reporting more than 40% growth in deaths last week (Iowa, Minnesota, North Dakota and South Dakota), along with 1 southern state (Mississippi) and 3 northeastern states (New Hampshire, Pennsylvania and Rhode Island). Overall, there were 4,369 COVID-19 deaths last week, an increase of 21% in the cumulative total. Several midwestern states that had been slowing have surged in the last 3 days including Illinois and Ohio. Pennsylvania has had a very rough week, adding more than 1,000 deaths in the last 4 days.
    What this means: Deaths have plateaued in the U.S. over the recent few weeks averaging 1,780 a day. That tells us the epidemic remains in a steady state of linear growth. This means the epidemic is not waning, it is not ending soon and the worst is not yet behind us.
  1. Global cases pass 4 million, how epidemiologists see the big picture
    Most major data sites suggest that more than 4 million global cases have occurred. The graphic below is a screen capture of the WORLDOMETER dashboard at this moment. This is a useful big picture summary of the pandemic. How do epidemiologists look at this information?
    1. First, what is the ratio of active to closed cases. Here, it’s considerably greater than 1, indicating the global pandemic is still growing significantly. There are almost half a million more estimated active cases than closed cases now.
    2. Next, we look the breakdown of cases by severity. In this case, we can see 3 categories: mild, serious/critical and death. The vast majority of active cases are mild (98%), a proportion that has been rising around the globe as more nations are testing people other than just those who are sick. That sounds like good news to most people, but not to us. The very high proportion of mild cases is bad news because it tells us why this pandemic will be remembered for generations. Paradoxically, it is much easier to stop an epidemic that kills or sickens a far higher fraction of its victims.
    3. We note with sadness that the global death toll is now above 280,000 human beings. That represents 16% of the closed cases. Epidemiologists don’t confuse this with the case-fatality rate because we know that the denominator (total number of infections) is no where near accurately estimated by this case total. Also, because the duration of illness is long for a virus, closed cases are not a good metric even for the crude death ratio, especially when there are more active cases than closed cases. Finally, we can’t forget that deaths are being undercounted probably by half.
    4. The bottom two curves show us global cases and deaths on the log scale. We look at the data this way because we want to tell the difference between exponential and linear growth. When the curves rise on the log scale, that’s exponential growth. Flat sections indicate a transition to linear growth. Everyone is talking about a “second wave” in the fall. Based on this graph, I would say there is partial evidence that on a global scale, we are in the second wave now, having seen a plateau in cases and deaths in early March. More importantly, the trend in both the blue and orange is for continued non-linear growth if not acceleration in the pandemic in the last 2 weeks.
      Bottom Line: There is no evidence here that the global pandemic is weakening.
Worldometer dashboard screen grab at 7:30pm EST, May 9: https://www.worldometers.info/coronavirus/
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