Three weeks ago … which seems a year ago … I was dismissive of epidemiological experts who predicted that the 2019 novel coronavirus was going to escape containment and become pandemic. Instead, I leaned on the evidence of slowing growth of the disease in China as a sign that the overall epidemic centered in Hubei province would eventually be halted, and that the freshly named COVID-19 would ultimately crest somewhere below 100,000 cases. It would be like SARS, just … bigger.
And I actually said this: “The biggest thing that concerns me is not the numbers, but ... the frequent statements coming out of officials at the Centers for Disease Control and various epidemiology experts, all of whom seem to be playing some off-key version of ‘Swing Low, Sweet Chariot.’ I do not see what’s in the statistics that makes them believe that a global pandemic is so likely.”
And now you know why CNN has not asked me to opine about coronavirus.
Writing about coronavirus every day is its own walk down a razor blade. I’m trying to do more than relay the latest numbers, but I’m also trying not to replace expert opinion with my own. Except, back there on Feb. 17, when I allowed some “You sound like you’re panicking” comments to get me to do exactly that. I looked at the statistics I was carefully logging in spreadsheets every day, looked at what the experts were telling me, and decided that my expertise—in fisheries biology, dinosaurs of the Hell Creek Formation, and making cool display screens for trucks—qualified me to disagree with their gloomy predictions. I was wrong.
In that way, I wasn’t all that different from anyone else. A quick glance up the screen at the latest Civiqs charts shows that Donald Trump is currently “enjoying” both his lowest job approval rating and his lowest net favorability rating in a year. And if there’s one issue that’s weighing down Trump’s numbers, it’s probably this one, picked up at Morning Consult. Net approval of Trump’s handling of the coronavirus stood at 40% on Feb. 9, before he made his first appearance to discuss the issue and put Mike Pence at the head of the federal response. But by the end of the month, that approval had dropped 28 points. It’s almost as if every time Trump, Pence, and their assortment of financial cronies appear to talk about the outbreak of COVID-19, they make things worse. Because they did make things worse.
The big difference is that, since it became clear that this virus wasn’t going to be tweeted, bullied, or campaign-rallied into staying behind red lines, Trump hasn’t admitted to making a mistake. He’s done what he’s done in every other instance—doubled down on seeking someone else to blame.
I may not be able to tell you where the virus is going next, but I can confidently predict that Trump’s responses on the topic will become much worse. He will continue to claim he’s done a great job. He will continue to blame every delay, every new case, every American death on Democrats—and often on a specific Democrat. He will put forward conspiracy theories as if they are facts. I know this is the case because, in the field of Trump behavior, we are all unfortunate experts.
So before Trump pops up for his next we-are-so-winning press event, let’s review the questions that the World Health Organization says should be answered by every country in the face of this outbreak:
Do we have enough medical oxygen, ventilators, and other vital equipment?
There are only about 100,000 ventilators in the United States, and many of these are in burn units, pediatric wards, and cancer centers where they cannot be easily made available to victims of COVID-19. Also, about 75% of them are currently in use at any time. So … no. Not by a long shot.
How will we know if there are cases in new areas of the country?
As of Sunday, the United States had still only tested around 500 people. China has tested 320,000. Knowledge about the extent of community transmission is, at this stage, limited to those cases that are displaying severe illness. This is changing, but it’s not changing quickly enough.
Do our health workers have the training and equipment they need to stay safe?
Multiple cases in California and Washington involve health care workers, but these cases likely result not from a lack of materials or skill, but from a still-lingering impression that there are “safe” areas where precautions do not yet need to be taken. This isn’t true.
Do we have the right measures in place at airports and border crossings to test people who are sick?
So far the United States has continued to value convenience over safety, with very limited restrictions on travel or testing of those returning from abroad.
Do our labs have the right chemicals to allow them to test samples?
This has definitively not been true up until the last few days. Hopefully it is beginning to change. Definitely it is far too late to generate the maximum benefit.
Are we ready to treat patients with severe or critical disease?
See the question on respirators above. Now compound that with an overall number of hospital beds around 900,000—many of those, again, in facilities that are not suited to handle COVID-19 patients. The time to deal with this was ... two months ago. But now would certainly beat out waiting until 899,000 of those beds are occupied.
Do our hospitals and clinics have the right procedures in place to prevent and control infections?
As it happens, I went to the doctor yesterday. As he has on previous visits, the doctor shook my hand, twice, over the course of our interaction. There was no evidence of social distancing in the office or waiting area. There were no wipes or sanitizer on offer to those waiting—although those coughing or sneezing did have a box of disposable masks available. I like this doctor—he’s a sharp guy—but, like every other medical facility across the nation, my local clinic doesn’t seem to feel it needs to practice procedures designed to stop COVID-19 until COVID-19 is already confirmed to be present. And that’s not good.
And now … let’s go to the charts.
This overall chart is actually about a day behind (total cases as of this writing really are at about 95,000, not the 91,000 seen here). The reason that I’ve not included the partial data for March 4 is that there’s a mismatch between nations that have reported recoveries and those that have reported cases. It’s typical that a day later I go back into the sheet to adjust the numbers to the best available at the end of the day, but today they’re just a bit too uneven to use until more come in. There is enough there to guess that within the next two days the total number of confirmed cases will exceed 100,000. That does not require an expert.
As promised, I’ve dropped the 3D-esque regional map of hot spots. But here’s a super simple line chart that’s a lot easier to digest.
Any look at COVID-19 overall is still dominated by the now three-month-old outbreak in China. That’s true for total cases counts, deaths, and recoveries. It was also true for cases by day … until recently. Because that rapid acceleration of new cases beginning in the last week of February means that China is now only one of several nations contributing to a steepening curve all too similar to the original epidemic centered around Wuhan. Only this time it’s on a global scale, with multiple epicenters.
COVID-19: Status within United States
Total Cases |
New Cases |
Critical /
Serious |
Recoveries |
Deaths |
137 |
26 |
8 |
9 |
9 |
Among the new cases on Tuesday and Wednesday were patients in Los Angeles, Contra Costa, Alameda, Placer, and Orange counties in California. Not a good day for the Golden State. The single-day mini-explosion of six cases in Los Angeles has led to the declaration of a “coronavirus emergency” by Los Angeles County. None of these new cases are considered really community spread, as all were traceable to contact with known cases.
A cluster of four cases in New York (announced in a press conference by New York Gov. Andrew Cuomo) are all connected to the state’s second case, with the new cases being the spouse, children, and an immediate neighbor of that case.
Across the country, multiple universities announced the suspension of study-abroad programs on Tuesday. Students—especially those studying in Italy, South Korea, and Japan—are being brought back to the U.S. How this will affect completion of their degrees is not clear. It’s also unclear whether all universities have made provisions to quarantine or otherwise isolate returning students. More details upcoming.
On previous days, I had left off my map states such as Texas and Nebraska, where all the known cases of COVID-19 involved patients who were diagnosed overseas and were being held there in quarantine or isolation facilities. Though this seemed like a distinctly different situation than those states where cases had been initially confirmed within the U.S., that difference was causing some confusion in comments yesterday. So I changed it. Between cases confirmed within the U.S. and American citizens who have been returned to the United States from abroad, California now has over 50 cases identified.
The most interesting case of the day may be a patient from Placer County, California. This patient is a recent cruise ship passenger, but was not on the Diamond Princess or any other ship that has been the subject of early concern. Instead, according to the county health department,
The new case is an older adult whose exposure likely occurred during international travel on a Princess cruise ship that departed from San Francisco to Mexico – the same Feb. 11-21 cruise associated with a confirmed Sonoma County case announced previously. The Placer patient is critically ill and in isolation at a local hospital. Close contacts of the patient are being quarantined and monitored.
Once again, this pandemic is not exactly a friend to the cruise industry. But this is a case in which the disease likely traveled from the United States by ship. With an increasing number of cases, the U.S. could easily become the kind of regional hub for cases in the Americas that Italy has become for Europe.