NedNotes (not blog): COVID-19 round-up for week ending 18sep20

BACK TO CAMPUS: ¿SPECIAL or SPITTLE? 

B.L.U.F. (bottom-line, up-front): The second wave in Europe may be starting in the United States. Mortality rates in the U.S. remain level at 3.0% for the run-rate and 6.0% for the static pool rate. Testing reveals some signs of the second wave in the South and Southwest as well as Midwest and pockets of the Northeast.

GLOBAL REVIEW 
The three big issues in the United States this week include a lagging testing regimen with no meaningful resolution likely in the near-term; the election in November; and, the rush toward a vaccine. Despite mixed messages, the earliest roll-out date of a vaccine to the general population appears to be next Summer. Even that ‘conservative’ estimate for a vaccine looks to be aggressive.

Supply and distribution chain constraints (e.g., deep-freeze storage during delivery) make a speedy miracle cure less likely. The timing of vaccine use remains critical since the United States is still far away from ‘herd immunity’ (i.e., roughly 3.2% of the way there). Now, volunteers for testing are having second thoughts due to perceived haste and ‘micro-biological mercantilism’. 

This resource from the New York Times is a handy reference tool on vaccines. Internationally, Europe is reporting a second wave of infections leading to renewed restrictions in Spain and the U.K. The leading cause for the Euro-spike is the widespread custom of August vacations, concentrating people in Summer resorts. 

India is confirming 100,000 new cases daily, while posting a low mortality run rate of 1.6%. These data are suspicious since India’s, and the sub-continent’s, testing capacity is limited and popular protests over a gang rape and murder of a young woman, apparently justified by her driving alone, has led to massive gatherings at protests. On the up-side many countries have conducted elections during this pandemic, enjoying fair contests, often with high participation rates.

McCLUSTER SUMMARY
The family clusters continue to perform well. New York City has reported this week that the number of total deaths (i.e., from all causes, including COVID-19) has increased from 30,964 to 65,712 year-over-year. Only two-thirds of this number is documented as attributable to COVID-19; additional homicides (i.e., the 27% increase) account for 1% of this 11,000 death gap between the increased death toll and that attributable to COVID-19. 

More evidence of an undercount in a city as meticulous as N.Y.C. implies a higher death rate across the country of up to 45%. Massachusetts may be entering a second wave ahead of the flu season, which is expected to aggravate a second wave, with a 20%+ weekly case growth rate and mortality run rate for the week at 3.9%, 3-5x higher than levels recorded in New York, Pennsylvania, or Maryland, Michigan, or Colorado. 

As in other states, Colorado is performing well but facing a challenge with her student age population. This class-room exposure and the fact that recent graduates tend to be working more often outside their homes currently drive the spread of the virus among younger people. 

BELLWETHER STATES RE-CAP
The bellwether states showed renewed growth in cases and in mortality during the week, led by Texas and Florida. Arizona and Oklahoma showed improvements in mortality run rates, while California’s rate grew at twice the national average, led by the Bay area. Florida trended up in deaths as entertainment venues re-opened. Texas challenge appears to be focussed in Houston and San Antonio.

Smokey air from forest fires may have spiked California’s periodic rates since the number of new cases grew significantly week-over-week. California’s positivity rates for the week remained at 3.4%, or two-thirds the W.H.O. 5% benchmark. California remains much improved since July. In view of these numbers, the likely death toll for the United States after one year will be less than the 336,000 fatalities forecast almost half a year ago.

33+6 OVERVIEW

This week’s comparative mortality study adds a new datum plus an assessment. The new datum, provided by Johns Hopkins, calculates a state’s positivity rate for testing over the previous week. The World Health Organisation defines a 5% positivity rate as the threshold, sustained for two weeks, below which it is safe for a given country, state, city, or region to re-open. 

(The number of positive results, or people with the coronavirus, relative to the number of tests administered during a given period, equals the ‘positivity rate’). With each percentage of positive test results, one will see hand-sign indicating the cumulative level of testing to date, with:

• 30% penetration of the population for testing being benchmark;
• slightly above or below falling in the 25-35% range;
• far above average being greater than 45%; and,
• far below being less than 15%.

A specific positivity datum that requires additional explanation is that of Washington, D.C. and the six territories. The capital territory has tested thoroughly and maintains a low positivity rate. The numbers for Puerto Rico lag the U.S. mainland significantly. 

The states that appear to be vulnerable this week are Idaho, Pennsylvania, Maryland, and Virginia, as well as the Deep South and the Southwest. What one may be seeing here is the spread of the virus into rural areas of larger states like Pennsylvania, Texas, and Florida as well as across less populated states across the Midwest and mountain states.