On Friday, the United States reported 5,100 new cases of 2019 novel coronavirus, an increase from the previous day. It’s difficult to call this good news … because it’s not. But it could be an indicator of something good, if only in the most tenuous, iffy, stretching it definition of “good.”
Also on Friday, the United States achieved one of those real milestones when the number of COVID-19 cases passed the number of Donald Trump lies logged by the Washington Post. That took some time, because if there is anything that has been epidemic in the United States for three years, it’s lies. With the total cases at mid-day on Saturday reaching 22,000 and the number of deaths up to 280, it may be difficult to find any good news. But we’re going to try ...
On Saturday morning, I got a hot tip that the delivery truck had arrived at the Dollar General store about two miles from my home. As soon as I turned in my next article, I took a break and drove up to see. Sure enough, the lot was nearly full and people were coming out the door with, miracle of miracles, toilet paper. I went in, got some liquid hand soap, a single pack of paper towels, and some frozen chicken for my sadly empty (but now repaired) fridge. Just about every staple item in the store now bears a sign that sets a limit at 1, 2, or 3 per family. Those signs did not exist last week. Neither did the phone chain that brought me word of the sainted truck’s arrival. Both of those things are features of life that are common in some countries, just not in the “you want us to get a fork lift and take that out for you” United States.
But, despite having just finished an article on how badly people screwed up economic predictions about the impact of the coronavirus, and how I was right there with them, here’s a prediction … I think the kind of thing I experienced this morning, both waiting on the delivery truck and some effort at rationing the available stock, is the “new normal.” And I hate that term.
Anyway … I have soap. And if anyone is wondering about my routine in scoring these supplies.
- Don “hot zone” windbreaker and shoes.
- Take container of cleaning wipes to car.
- Carry in wipe for use on cart handle, any other item touched.
- Place all the packages in the trunk.
- Use second wipe to clean hands, door handle, trunk handle, steering wheel, etc.
- Remove items from trunk and place by door.
- Strip off the coat, shoes.
- Using inside wipes (containing bleach, which isn’t good for the car interior) wipe down the purchased items before carrying them to the kitchen.
- Wash hands thoroughly to the elbow.
I am nothing if not OCD and prone to generating new rituals. A friend called me last night to joke about someone they had seen performing their own ritual. I took notes. May have to incorporate additional steps.
Anyway, now that I have soap for the next few days … Looking at this chart, it’s very, very hard to see anything good about it.
COVID-19: United States
Really, there is nothing good about it. Just look at the incredible slope of those last few days. The United States isn’t acting like Italy, it’s far worse. That’s a rate of climb that exceeds the rate seen anywhere else in the world. Anywhere.
COVID-19: Tertiary epicenters
Stick the United States on a graph along with other countries that were in a similar position two weeks ago, and it’s easy to see that the United States is shooting upward at a rate that is overtaking others even when they had a several thousand case head start. No one—not China, not Italy, not anyone—has racked up increases of the sort seen in the United States over the last handful of days.
Which is, weirdly enough, why there may be some good news hiding in this data. Many, many countries (like Spain and Germany above) have demonstrated curves that are extremely similar in the middle-phase of growth in their countries. Because those curves are all so similar, it’s likely that they are a very good track of the transmisibility of SAR-COV-2. But the United States has been going up faster because … good testing. Or rather, bad, inadequate testing that is finally being replaced by testing that is somewhat closer to adequate. The sharp upturn in the last three days corresponds to states genuinely improving their level of testing and additional private labs getting into the act. As charts like this one from University of Washington Virology show, the testing, particularly in some of the “hottest” regions of the country, has ramped up to the point where it might genuinely be reflecting the scale of the outbreak.
By the way, all of the above charts only run through Friday. As of this writing, Italy and France haven’t yet provided their latest updates, and of course the U.S. has only partial data for Saturday.
That’s why this funny little chart might reveal some good news hidden in the scary one at the top of the page. What this chart is showing is a comparison between the number of new cases each day as a factor of the number of cases on the previous day. So if one day had 1,000 new cases, and the next day had 2,000, the rate of increase would be 2. Starting back around a week ago, the United States began a period in which new cases weren’t just increasing, the rate of increase when compared to the previous date was increasing, defining a genuinely exponential curve. But on Thursday, and again on Friday, those numbers improved. Honestly, “improved” may be putting too much of a good spin on it. At 5,008 cases, the number of new cases on Thursday was far ahead of the 3,000 cases on Wednesday. And the 5,117 new cases on Friday set another new record. But those numbers—the worst two days on the chart by most measures—might also be an indicator that we are finally getting a handle on this in terms of applying enough tests so that future values are more of an indicator of actual growth, rather than just a measure of ignorance. With 2,700 new cases at 1 PM ET, it’s too soon to see if this trend will continue even as far as Saturday, and a similar “straightening” of the curve in Italy was subsequently blown away by additional sharp increases. But … we can hope that, at least when it comes to testing, the United States is getting it’s very, very late act together. A first step toward what I’ve repeatedly suggested is the only real way out of this.
When it comes to Trump’s predictions that “like magic” the coronavirus would just go away in April, there seemed to be one good way to look at this — check out the Southern Hemisphere. So last week, I put together a simplistic map of where things stand when it comes to epicenters of disease. At the time, no nation on the other side of the line had more than 1,000 cases. That’s no longer true.
COVID-19: World Map
At the moment, both Brazil and Australia are barely over 1,000, both seem to be following the same sort of growth path that’s been seen in other countries once some level of community spread appears. Considering the growth there, and countries tropical or semi-tropical climates, there doesn’t seem to be any great evidence that COVID-19 will be limited to operation in colder months.
And since we’re talking about the world, here’s a chart that hasn’t been seen in some time.
COVID-19: Global Case Status
The last few days have rendered this chart almost unrecognizable. The entire outbreak in Hubei province has now become a literal foothill to the still building mountain. Of the 185,000 active cases around the globe, China now accounts for only 6,000 — far smaller than the U.S. or several other nations. Saturday represented the fourth day in a row in which China reported no cases of COVID-19 from community spread. That continues to be a good news story that this thing can be stopped.
One very bad news story … since falling to around 5.7% on March 7 the outcome mortality (number of deaths divided by the number of deaths plus the number of recoveries) around the world has rising to 11% as of March 20. That very bad news story is another aspect of the sheer speed with which that spike above has grown and the rapidity with which health care systems are coming under stress. Here’s another look at some of the factors that are driving huge differences in the case fatality rates.
Forces behind case fatality rates
|
Hospital Beds / 1000 |
Occupancy Rate% |
COVID Cases |
Cases / 1000 |
Deaths |
CFR |
| Italy |
3.18 |
78.9 |
47,021 |
0.79 |
4,032 |
8.57% |
| Spain |
2.97 |
75.3 |
20,412 |
0.54 |
1,050 |
5.14% |
| U.K. |
2.54 |
84.3 |
4,094 |
0.06 |
180 |
4.39% |
| China |
4.34 |
? |
80,967 |
0.06 |
3,248 |
4.01% |
| France |
5.98 |
75.6 |
12,612 |
0.19 |
450 |
3.57% |
| USA |
2.75 |
64.0 |
18,121 |
0.07 |
233 |
1.29% |
| S. Korea |
12.27 |
? |
8,652 |
0.17 |
94 |
1.09% |
| Switzerland |
4.53 |
82.0 |
5,407
|
0.72 |
56 |
1.04% |
| Germany |
8.00 |
79.8 |
19,848 |
0.26 |
67 |
0.34% |
There’s a huge difference between those countries, like Italy, where the rate is over 8% and countries right next door, like Germany, where that case fatality rate is fantastically low. So, what’s the difference? Well, we’re still early enough in this thing that all kind of factors weigh in, but this is one that’s fairly easy to model.
In Germany, there are eight hospital beds for every 1,000 people. On average, about 80%of those beds are occupied at any given time, so at any given moment there are around 1.7 empty hospital beds available for each 1,000 members of the German population. Right now, there are only around 260 cases per million German citizens … or 0.26 cases per 1,000. Even if every diagnosed case needed a bed, which they do not, the strain on Germany’s system would be about 15% of the available capacity.
Over in Italy, there are only about 3.18 hospital beds per 1,000 people and 78.9% are occupied on average. So, even without coronavirus around, there are fewer than 0.7 hospital beds waiting out there for every 1,000 Italians who might need them. And how many coronavirus cases are there … 0.79. So, there are more coronavirus cases overall than there are available hospital beds. And yes, only something like 15-20% of coronavirus cases need critical care, but only around 10% of hospital beds are capable of providing critical care. So the situation is likely worse than those numbers indicate … they are simply swamped because their system does not have the capacity to handle these numbers.
New cases in the U.S. for today are now up to 3,400. Not great, but still unclear the day is going to total up compared to the last few and whether there will be any improvements in trends. Stay tuned.
All right … time for the daily bleaching of the keyboard. Don’t forget the mouse.
Resources on novel coronavirus:
World Health Organization 2019 Coronavirus information site.
World Health Organization 2019 Coronavirus Dashboard.
2019-nCoV Global Cases from Johns Hopkins.
BNO News 2019 Novel Coronavirus tracking site.
Worldometer / COVID-19 Coronavirus Outbreak.
CDC Coronavirus-2019 (COVID-19) information site.
European Centre for Disease Prevention and Control.
Information on preparing yourself and your family:
Some tips on preparing from Daily Kos.
NPR’s guide to preparing your home.
Ready.gov
Request — if you know of an organization that is supporting a volunteer effort, whether it’s to sew hospital masks or deliver groceries to the elderly, please include it in the comments. I’m planning to add a section at the end of these daily updates to deal with just that kind of information. Thanks.
