Daily COVID-19 Briefing: Monday


Top news, reports and insights for today:

  1. Daily deadline summaries for Monday:
  • Exponential increase in COVID-19 cases continue in Florida as local leaders attempt to crack down on people and businesses. Evidence mounts that recent surges have been mostly among young people (CBSNews)
  • Hospitals are gaining new knowledge about how to combat COVID-19 in patients by sharing information and trying new strategies. One promising approach involves using old treatments to address blood clots (Scientific American)
  • Oxford university researchers have begun testing their vaccine in Brazil and other hard-hit countries to evaluate potential efficacy (BMJ)
  • New poll says 64% of adults believe the CDC mostly gets the facts about the outbreak right; 30% say the same about Trump and his administration. A rising fraction of both Democrats and Republicans now say the epidemic is exaggerated (Pew Research Center)
  1. U.S. now in exponential growth of daily cases, fastest rate of increase since the epidemic began. Does anyone care?
    The U.S. has exceeded the highest previously recorded daily total cases in each of the last 5 days. We are used to seeing significant drops in reported cases on Sunday and Monday for each week since March due to reporting lags (darker blue bars). Astonishingly, the Sunday and Monday reports are still higher than any day that occurred during the first “peak” in late April. Not only are cases rising past that first peak, it is now more evident that it’s rising exponentially. For a clearer view, see the bottom figure showing the total accumulating case totals for the U.S. since March 1. The tell-tale sign of exponential growth is the curvature in the rise in cumulative cases, evident here in the last two weeks. For further context, consider the time it takes to arrive at each 500,000 case plateau. It took 40 days for the first half million cases to be reported. Then, the first peak arose as it took just 19 days to hit 1 million cases. After lockdowns, the pace slowed; it took 21 days to get to 1.5 million and 24 days to reach 2 million. However, the next 500,000 cases have come in just 17 days, the shortest interval yet.
    The bottom line: The U.S. is back to where it was before lockdown, with sustained and widespread community transmission resulting in exponential growth of the epidemic. Cases are now rising in 37 states.
    Are we growing numb to the reality?

Daily COVID-19 Briefing: Thursday

Top news, reports and insights for today:

  1. Daily headline summaries for Thursday:
  • Optimism about a coronavirus vaccine may be premature. Moderna safety study was only 8 patients and they won’t show anyone the data. Experts warn that despite the hopeful timetable, there is a long way to go before a vaccine is proven to be effective and can be mass produced and distributed (New York Times)
  • At least 4 states (Virginia, Texas, Georgia, and Vermont) have combined numbers from viral and antibody tests, providing a misleading picture of testing capacity and hampering our ability to track the epidemic (CNN)
  • Brazilian health minister resigns after just weeks on the job after clashing with President Bolsonaro over coronavirus response. Today, Brazil reported its highest daily incidence to date of 19,951 new cases. Brazil now has the third most cases in the world as the epidemic begins to surge in South America. (Aljazeera)
  • Researchers at Carnegie Mellon University say that nearly half of the accounts tweeting about coronavirus are ‘bots’ rather than real people. Researchers have identified over 100 false narratives tied to these fake accounts. This is further evidence of the potential role of Chinese and Russian intelligence services in spreading mistrust and misinformation (NPR)
  1. U.S. cases are flat, deaths remain volatile
     On Wednesday, the U.S. reported 22,368 new cases (up 1.4%) and 1,528 deaths (+1.8%). The recent trend in overall cases has been flat, while daily deaths have been quite volatile. The 7-day pattern has been fairly steady for cases (growth factor = 0.99) and a modest slowing of deaths (growth factor = 0.89). More regional patterns, as always, tell a better story. Growth in cases has slowed in the northeast, with cumulative cases rising less than 10% in New Jersey, New York and Vermont last week. Maryland saw the largest increase in cases in the region growing 22%. New cases grew by 25% or more in two midwest states (Minnesota and North Dakota) and in North Carolina. In the west, only Arizona saw cases rise by more than 20%.
  1. Rhode Island again leading the nation in testing. Overall, testing declines for the first time
     Today’s headlines describe the practice in at least 5 states of combining reports of viral and antibody testing. Experts agree that this is a big problem because the two types of tests do very different things and should be kept separate. Treating antibody tests the same risks exaggerating the testing capacity of the state and doesn’t allow us to tell the fraction of people who have active infection. The latter is the information we need to assess reopening benchmarks and to track the resurgence of cases.
     The figure below shows how each state is doing on testing. The bars show completed tests per 10,000 residents as of yesterday. Rhode Island continues to lead the nation by a wide margin, now having tested more than 11% of Rhode Islanders. The four states with the lowest testing rates are all in the West. Pennsylvania and Maine are the only northeast states that are below the national average of 339 per 10,000. States with patterned bars are likely to be doing less of the most important testing than this graph depicts. The magnitude of the problem is not known. Of particular concern are the three states near the bottom already (Pennsylvania, Texas and Virginia) all of whom are experiencing significant rises in cases in recent weeks.
    Why this matters? States that have moved toward reopening are under the microscope to determine whether infections surge. There is every epidemiological reason to expect they will. The political pressure to blunt the apparent impact of reopening is tremendous. Now is the worst possible time for states to play games with their numbers. Of greater concern is that despite the unanimous opinion of experts that more testing is needed, last week marks the first since the start of the epidemic that the number of COVID-19 tests actually declined (see the lower figure from the CDC website).
Taken from CDC website on May 20: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/05152020/images/clinical-labs.gif

Daily COVID-19 Briefing: 4/30/20

Top news, reports and insights for today:

  1. Daily headlines for Thursday:
  • At least 31 states will reopen in the coming days as stay-at-home orders expire across the U.S. (CNN)
  • As states move to re-open, none has met federal criteria: 14-day drop in cases (NBC News).
  • L.A. County becomes first in California to offer testing to all residents as cases surge in the city (Los Angeles Times).
  • Dr. Anthony Fauci (America’s Uncle Tony) says that a viable coronavirus vaccine is possible by January (NBC News).
  • Georgia reopening: an experiment with lives at stake, puts working-class in the cross-hairs of the pandemic (The Atlantic)
  1. States that never issued stay-at-home orders, and those that did so late, have steeper epidemic curves
    On April 19 I posted a graph that shows how states compared in the rate of case growth since the day of the 100th case comparing three groups of states among those with moderate-sized outbreaks. This compares the pace of the epidemic in states that issued stay-at-home (SAH) orders early, vs. late vs. never. Today I present an update on that graph after 10 more days of data (see below). It’s a busy graph, but contains I think very compelling evidence that SAH orders have been effective. The black line is the average growth across all states and DC. States below that line are below average growth in cases, states above that line have more rapid growth. All states start on the day they reached 100 cases. There are 3 big take home messages here.
    1. All states that adopted SAH restrictions before March 30 (solid lines) are growing cases slower than the national average. Wisconsin was above the black line until day 26 but has since remained below the US average.
    2. All states that adopted SAH orders after March 30 had more rapid growth than the US average except South Carolina and Nevada.
    3. Among states that never adopted SAH orders (dotted lines), 3 have seen dramatic acceleration of their curves. I have marked Nebraska, Arkansas and Iowa. In those states, on different days, their curves turned dramatically upward after a period of slower growth. This pattern is not seen in any state that adopted early. Utah’s inflection is less severe but still evident at day 35.
    The bottom line: These data suggest that stay-at-home restrictions have slowed the epidemic generally, that early adopting states have done better, and that states that never adopted have been vulnerable to dramatic periods of accelerated growth. This provides a template for looking over time at what happens as these restrictions are lifted.
  1. U.S. deaths spike again to second highest daily total, new cases remain flat
    On Wednesday, reported COVID-19 deaths spiked again to the second highest daily total of 2,549, a rise of 5%. While the 7-day moving average, had showed a trend toward decline since April 21, the last two days have adjusted the trend back in the direction of rising deaths (top graph). Nine states matched or set new record high deaths, including 5 in the midwest (Iowa (12), Indiana (63), Nebraska (13), Ohio (138), and South Dakota (2)). In the Northeast, records were set in DC (15), Massachussetts (252) and Pennsylvania (479). New cases in the U.S. have passed 1 million rising by 3% on Wednesday by more than 25,000 (bottom graph). The 7-day moving average has been trending flat over the last week, however it remains unclear if this is flat case growth or flat testing capacity.
    What this means? The disconnect between the push from states to reopen and the story the data are telling is more striking every day. Neither deaths nor new cases show sustained declines. The White House continues to say we are on the cusp of getting past this epidemic. I have no idea where they get that assessment.
  1. Brazil ranks second yesterday in new cases (behind U.S) raising concerns about South America as temperatures there fall
    On Wednesday, Brazil reported the second highest new case totals (6,462), a 1-day rise of 9%. The graph below from WORLDOMETER shows that new cases and active cases have been rising exponentially over the last two weeks. Brazil joins Peru, Chile and Mexico as nations in the top 25 in new cases. Of further concern, Brazil has tested only 1,600 per million, suggesting that these case totals may be severely under-estimated.
    Bottom line: So far, few have paid much attention to Latin America. This may soon change. As temperatures begin to fall in the southern hemisphere, all eyes will be on South America and Africa to see what happens when COVID-19 collides with an entire season of “normal” respiratory illnesses. Brazil is an especially important country to watch due to high population density, intense tourism and substantial areas of poverty. Brazil is also in the midst of a severe recession.
Accessed from WORLDOMETER April 30, 2020: https://www.latimes.com/california/story/2020-04-29/talk-of-reopening-grows-in-l-a-orange-county-despite-rising-death-toll