NedNotes (not blog): COVIData sweep 30oct20

 

B.L.U.F. (bottom-line, up front): Not much new to report; at a possible inflection point. Biggest challenge appears to be cultural aversion to tracing surveys and pandemic fatigue; warnings coming in from Europe.

NOTE: the basis for data now aggregates four sources – Johns Hopkins, Microsoft, The New York Times, Worldometers.

Introduction
News is mixed this week as America’s second wave may mimic Europe’s spike. Data collected conflict on post-infection immunity (i.e., five months versus three), declining mortality versus new mutations, and some possible treatments being deferred (e.g., Eli Lilly), perhaps due to cyber-attacks. One bright spot on cures: Regeneron’s testing of its anti-body hybrid drug indicates preliminary effectiveness among eight hundred test subjects. One must remember two over-riding facts of life-&-death in 2020:

• that this epidemic is expected to have a high penetration and low mortality rates; as well as,
• that miracle cures, like any easy out, are a slime a dozen.

The world’s second oldest profession
Election year politics being what it is, the coronavirus contagion is part of the fray. Widespread criticism of the Trump Admin., backed by evidence that late action does not explain enough of the higher than expected number of deaths, mounts daily. The reality, of course, is not that simple. President Trump has done some things right (e.g., public-private partnerships) and other things wrong (e.g., failing to enforce the scientific efficacy of masking). The majority of the national press reproaches President Trump for his ad-hoc approach.

Some of this criticism, of course, is unjustified. The President’s response has been one of letting states and municipalities decide what to do while leading a national effort to produce a vaccine. Otherwise, President Trump has seemingly hit the ‘mute’ button on the ‘China plague’ during the home-stretch of the 2020 campaign. The larger question vis à vis the Trump Admin. remains an absence of visible oversight and apparent corruption.

Vice President Biden counters with a proposal of national, scientifically-driven leadership; Federal minimum standards of response; citizen engagement in the fight; and, block resource grants to poorer areas. Vice President Biden’s proposals address the issues involved, but there is no guaranty that events would have unfolded differently had these measure been adopted.

Trick or beat
The epidemic builds in the Midwest as one already knows, to his or her growing fatigue. The Dakotas provide an interesting case-in-point on the outcome of a laissez-faire approach. Many people there took their cues from President Trump’s rally at Mount Rushmore and the biker rally, each proving to be an epicenter of a new spike. Data now show that one meter of social distancing and masking work. The Badlands have the lowest masking rates in the country.

Pandemic fatigue and complacency have permeated the country. Nevertheless, rural parts of states now seeing rapid growth are beginning to bump up against capacity constraints. Hospitals throughout the South and Midwest are recording high usage of intensive care units. The urban areas at risk are ex-urbs of Atlanta, Saint Louis, Dallas, and Northern Virginia. Threatening to compound this second wave is the ‘twindemic’ of a flu and COVID co-infection. Getting one virus weakens the immune system to the other.

One reason for the fatigue remains the mixed messaging inherent in the data. Cases climb faster than testing – a regrettable sign. While longer term indicators of mortality inch up, deaths from full-blown COVID-19 appear to be decreasing in the U.S. and U.K. thanks to community measures, hard experience, and better medicine. Though projections of first year mortality remain bleak (i.e., 500-600,000), the projections through 05mar21 – pushed back a week to synchronize with the last cluster analysis letter – stay at 336,000 (¡via offsetting miscalculations!).

Clusters and Costumes
The counties hardest hit, with 1-2% weekly penetration rates, lie overwhelmingly in rural areas with populations generally less than 25,000 people. Only El Paso County, Tejas is a significant population center with 840,000 stricken by this second wave; it is shutting down for two weeks. A review of the counties shows that none in the clusters approach crisis levels, though the New Jersey suburbs of New York, Chicago, and Denver display elevated risk levels.

A fertile source for drilling down to the local level on data is the “COVID ACT NOW” website.

The Centers for Disease Control (C.D.C.) has issued suggested minimum guidelines for local celebrations of Halloween earlier this month which mirrors guidelines already in place: distancing, (double) masks, small groups, no large gatherings, try to distribute loot outdoors, and a general discouragement of trick or treating. States plan largely to apply these guidelines plus locally imposed restrictions where necessary. This caution has impacted some of America’s most popular spook-fests.

• Baltimore-Annapolis: C.D.C. guidelines plus strong discouragement of trick-or-treat; ¡great I have two big bags of loot!
• Boston and the Cape: C.D.C. guidelines plus a few suburbs cancelling trick or treating
• Chicago: C.D.C. guidelines plus foraging groups restricted to six people at most
• Colorado: C.D.C. guidelines plus no more than five marauders in a group
• Detroit metro: C.D.C. guidelines
• METRO New York: C.D.C. guidelines
• Philadelphia metro: C.D.C. guidelines plus limited cancellations in emergency areas
• Pittsburgh metro: C.D.C. guidelines plus fixed trick or treating hours, either 5-7 or 6-8 p.m.

Around the country, death tolls have started to accelerate as fewer states stay below the re-opening threshold of positive testing rates at or below 5% for fourteen days. Only ten of the states and territories studied below meet the World Health Organisation criterion for containment, with only a quarter showing improved weekly positivity rates (i.e., a lower number of tests indicating passive or active infection).

Additionally, another ten states have endured deterioration in testing results for at least two consecutive weeks, possibly from younger carriers at school. These states – lead by Pennsylvania and Alabama (10.9% and 25.9% positivity rates, respectively) – may be headed for severe spikes. METRO New York has placed Pennsylvania on its quarantine list.

Ominously, there is a coincidence of negative indicators in several states, mainly rural, of mortality growth at or above twice the national rate, testing results, and testing capacity.

1. South Dakota: 16.6% weekly growth in fatalities; 46.3% weekly positivity rate; substandard testing capacity
2. Wisconsin: 13.4% weekly growth in fatalities; 13.3% weekly positivity rate; substandard testing capacity
3. Idaho: 10.8% weekly growth in fatalities; 34% weekly positivity rate; substandard testing capacity
4. Tennessee: 8.9% weekly growth in fatalities; 9.4% weekly positivity rate; strong testing capacity
5. Missouri: 8.8% weekly growth in fatalities; 11.7% weekly positivity rate; above average testing capacity
6. Oklahoma: 7.1% weekly growth in fatalities; 8.1% weekly positivity rate; below average testing capacity
7. Arkansas: 6.5% weekly growth in fatalities; 9.9% weekly positivity rate; strong testing capacity
8. Kentucky: 6.1% weekly growth in fatalities; 11.3% weekly positivity rate; above average testing capacity
9. Utah: 6.0% weekly growth in fatalities; 16.1% weekly positivity rate; above average testing capacity
10. Iowa: 5.6% weekly growth in fatalities; 30.6% weekly positivity rate; substandard testing capacity
11. North Carolina: 5.5% weekly growth in fatalities; 6.9% weekly positivity rate; substandard testing capacity

Some states have improved. The leading performance comes from the N.Y.C. tri-state area and Vermont with substantially below 1% mortality weekly growth rates in their second wave as well as others below a 2% growth, including Arizona (1.1%); Massachusetts (1.4%); Maryland (1.4%); California (1.7%); and, Louisiana (1.7%).

Internationally, France, Benelux, and Spain are locking down due to a second wave, while Germany is restricting social activities entailing larger numbers of people. In many areas, confirmed daily case counts in Europe now exceed peak levels of the first wave. Case counts for the continent exceed ten million with mortality run rates now similar to those of the United States; some American epidemiologists believe the U.S. is as little as three weeks behind in the spike. In at least one country, teens are being drafted to assist full-blown COVID patients. While rumors of increased domestic violence have surfaced, the epidemic may be elevating murder rates, too.