Top news, reports and insights for today:
- Daily deadline summaries for Friday:
- Coronavirus now in a second wave? Nope. The U.S. is still stuck in the first one (NPR)
- CDC deputy director told reporters today that states may need to reimplement strict social distancing measures if coronavirus cases rise “dramatically” (CNBC)
- A new study suggests that population-wide face masks and coverings could push coronavirus transmission down to manageable levels. This matches new WHO recommendations that everyone wear a mask in public (Reuters)
- WHO says cases in Africa have doubled in the last 18 days to more than 200,000 (New York Times, see graph below)
- U.S. cases remain stable and flat at 20,000 a day: this wave isn’t over
On Thursday, 21,773 new COVID-19 cases were reported in the U.S., a cumulative rise of about 1%, bringing the total number of U.S. cases to at or above the 2 million mark, depending on the data source. Last week, 139,959 new cases were reported, less than 1,000 fewer than the week previously. The 7-day moving average has been right around 20,000 daily cases a day since Memorial day and it remains there on Thursday. The bottom graph shows what’s going on by state. The first thing to notice is just how much Arizona remains an outlier, with almost 17 new daily coronavirus cases per 100,000 residents. Total cases grew by 37% last week, a figure that we have not seen in a month in any other state. Other states with 10 or more daily new cases per 100,000 include Utah, Alabama, Arkansas, and South Carolina. In the Northeast, only Washington DC and Rhode Island had more than the benchmark 5 cases per 100,000, the other states continue to have low transmission. On contrast, in the South, transmission is low only in Kentucky and West Virginia. California, Nevada, New Mexico, Iowa, Illinois, Minnesota, Nebraska and South Dakota still have vigorous and active community transmission.
The bottom line: Despite talk of the epidemic being under control, the data continue to tell us that the first wave is not over. The U.S. looks to be on a continued pace of 20,000 daily new cases, which may soon rise with the increase in social mixing.
- Coronavirus and influenza: What might happen when 2 epidemics collide this fall?
Two articles caught my attention this week, related to the perils and possibilities arising from the joint occurrence of interlaced epidemics of influenza and coronavirus this fall and winter. One, by ethicist and policy expert Lawrence Gostin published in JAMA, tackles what needs to be done to prepare for these “dual epidemics”. The other, an editorial in Science, emphasizes how little we know about what happens when flu and coronavirus happen together. The bottom line here is that we must take steps as a nation now to prepare for the possibility that the two concurrent public health challenges will produce the kind of over-whelming devastation seen in 1918-1919.
Based on these articles, here are the top 10 key issues:
- Because the flu season is just starting in the Southern hemisphere, we will get some clues by watching what happens there.
- It’s very unlikely that we will have a COVID-19 vaccine available before the coming flu season gets under way. The two diseases are likely to peak at the same time.
- It is not known if co-infection of flu and SARS-CoV-2 amplifies viral shedding or increases disease severity. Both are possible.
- Because symptoms for both overlap, a critical challenge is to improve our ability to distinguish flu and COVID-19 in testing to avoid draining scarce testing materials.
- To avoid putting hospitals under extreme stress, it is critical that we do all we can to vaccinate as many people as possible against influenza.
- Uncertainty about demand for flu vaccine leaves manufacturers uncertain about how much to make. The U.S. government must step in now to absorb that risk.
- The urgent need for an evidence-based communication strategy to ensure the highest possible compliance with flu vaccination, especially among vulnerable groups.
- Declining vaccination rates for other diseases (especially among children) during the COVID-19 pandemic raises concerns about the success of flu vaccination next season.
- Adult influenza vaccination has never been mandatory in the U.S., but given the risks this fall, mandatory vaccination should be a “last resort” that remains on the table.
- While most experts now do not expect a COVID-19 vaccine before 2021, when it does arrive, a lingering concern is vaccine hesitancy. Surveys suggest that only 30% of adults say they would get a new vaccine as soon as it is made available.