Wednesday COVID-19 Briefing

Top news, reports and insights for today:

  1. Curated headline summaries for Wednesday:
  • Top story: U.S. daily deaths top 3,000 for the first time on Wednesday with additional data still rolling in. Reports of hospitals running out of ICU beds are on the rise (CNN)
  • The first signs of a post-Thanksgiving surge in coronavirus cases are beginning to show up in data released by states across the country in a troubling prelude of what may become the deadliest month of the pandemic so far. In the summer wave, the virus was spreading fastest in Arizona, where at its peak 380 residents per 100,000 were becoming infected every week; now, 35 states have per capita infection rates higher than that (The Hill).
  • New poll says American’s COVID-19 fears are stronger than they have been in months as worries intensify about job security, paying bills and the prospects of returning to normal (Axios, See Figure A).
  • Los Angeles county passes 8,000 COVID-19 deaths with cases, hospitalizations and new deaths spiraling out of control. Public Health Director Barbara Ferrer calls it an “incalculable loss” for the region (USA Today)
  • Chief infectious disease doctor Anthony “Uncle Tony” Fauci says (again) that we should “close the bars and keep the schools open” as evidence mounts that indoor congregation at drinking establishments is pouring gas on the fire (Eat This Not That).
Figure A.
  1. It’s now 9/11 every day
     On Tuesday more than 191,000 COVID-19 cases were reported putting the U.S. at 14.5 million total cases and over 1.3 million in the last week (See Figure B). That 7-day rise increased the total by over 10% – an indicator that this country is back to exponential growth in cases after the Thanksgiving dip. It is my view that we are starting to see the consequences of Thanksgiving-related exacerbation of transmission intensity. Where are new cases the highest? Everywhere except Hawaii (Figure C). After weeks of sky-high transmission intensity in the Mid-west and West, we now see all but two states in the South above 40 daily cases per 100,000 with two states above 70 (Arkansas and Tennessee). The worst state at the moment is Rhode Island which soared to over 124 reaching Dakotas territory. The Northeast is rapidly catching up with the Midwest and now has three states over 70 (the other 2 being Connecticut and Delaware). As the Northeast catches fire, the Midwest remains white hot with 9 states still over 70 (Illinois, Indiana, Kansas, Minnesota, North Dakota, Nebraska, Ohio, Oklahoma and South Dakota).
       Bottom line: The September 11th terrorist attacks of 2001 killed an estimated 2,977 Americans in what was widely seen as the worst tragedy of the 21st century in the United States. At this writing, WORLDOMETER reports more than 3,200 deaths for Wednesday, after 2,581 on Tuesday (Figure D) and likely more than 3,000 tomorrow. We are recording 9/11-level mortality every day. Where are deaths rising? Everywhere (except Montana, See Figure E).
Figure B
Figure D
Figure E
  1. U.S. Government releases new, more complete data for monitoring COVID-19-related hospital burden. What it says: 21 states are running out of ICU beds and 25 states are under stress
     Last week I was complaining about the lack of good data for monitoring hospital utilization, telling you we were flying blind. NPR just had a story about a new release of government hospitalization data on Monday. This data is not perfect but represents a step forward and shows that I am not the only one complaining about this important weakness in our national surveillance. I spent the day digging into the numbers; I made two graphs (I had to do it myself because the HealthData website is hardly close to user-friendly). I’ll spare you the technical details, but the thing I was most interested to see is the estimated fraction of an entire state’s ICU bed capacity that is currently filled. The most recent data available is for December 4 (Figure F). Any state that has headroom of less than 20% of it’s ICU capacity is under stress. Having parts of one or two states in this situation would be bad news. There are currently 21 states with 80 percent or more of ICU beds occupied, with five over 90 percent (North Dakota, Rhode Island, Oklahoma, Alabama, and Missouri). North Dakota is estimated at 100% full on 12/4. This data is a few days behind. COVIDACTNOW reports that 5 states are now 100% maxed out in terms of ICU capacity (Oklahoma, New Mexico, New Jersey, Tennessee and Nevada). That’s five U.S. states where there are zero ICU beds available in the entire state!
    Another measure of hospital stress is the percent of all in-patient hospital beds taken up by COVID-19 patients. It is similar to the test positivity rate in the testing data but applied to hospitals. When more than 15% of a state’s hospital beds are filled with COVID-19 patients, the hospital system is under stress in terms of staff, resources and equipment. The December 4 data showed that 25 states meet that standard (Figure G) with seven states at 20% COVID-19 patients (Michigan, Maryland, South Dakota, Rhode Island, Arizona, New Mexico and Nevada).
    Bottom Line: I welcome the federal government’s attempt to increase access to vital information. The new release reported by NPR is welcome. There is still a long way to go. The bottom line is that U.S. hospitals are under tremendous strain right now with reports increasing by the day that the situation is quickly turning code red.
Figure F
Figure G.
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