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Comments on recent #COVID19 US developments, some positive, some not: US still in plateau w/ daily 25-30,000 cases and average of ~2000 daily deaths for ~5 wks. For perspective, the average number of US deaths on a given day is ~ 7,700. https://www.cdc.gov/nchs/fastats/deaths.htm 1/x
Also for perspective, ~ 78,000 people have died in the US from COVID, the majority over the past 5 wks. In 2018-2019 in the US, ~ 34,200 people died of influenza over the course of the flu year.2/x https://www.cdc.gov/flu/about/burden/2018-2019.html
Nick Reich’s lab has forecasts for 4 weeks from now ranging from 92K-111K deaths in total. That does not include forecasts regarding what will happen beyond that point in time https://reichlab.io/covid19-forecast-hub/ @reichlab 3/x
The US national plateau in cases reflect a combination of 1/3rd of states w/ still increasing daily numbers of cases, 1/3rd mostly unchanged day to day, and 1/3rd that have decreasing numbers or baseline small numbers https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html 4/x
More than half the states have COVD test positivity rate below 12%, and that is good news because trending in the right direction. https://coronavirus.jhu.edu/testing/testing-positivity 5/x
Still many places need more testing for those w/ possible COVID symptoms. Also many businesses, universities, orgs want access to diagnostic testing for COVID as part of their reopening plans. For most part, there is not enough testing to make that happen yet. 6/x
States are moving ahead with plans to do contact tracing -- 44 states and the District of Columbia now have plans to expand their contact tracing workforce, reaching a total of 66,197 workers https://www.npr.org/sections/health-shots/2020/04/28/846736937/we-asked-all-50-states-about-their-contact-tracing-capacity-heres-what-we-learne 7/x
From same NPR story -- so far only 1 state has met anticipated contact tracing need, with a small number of others on track to get to their benchmark. Some states continue to have many hundreds of new COVID cases a day which will make contact tracing hugely complex operation 8/x
To bring epidemic under far better control in US, we need to be able to diagnose great majority of cases, and we need rapid contact tracing and isolation to break the chains of transmission. High number of cases presently are “community transmission” – we need to end that. 9/x
There have been 143,000 cases of COVID in nursing home pts and staff, w/ 25,600 deaths. It’s terribly high proportion of all those who have lost their lives to COVID. We need continued and stronger focus on protecting pts and staff in nursing homes https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html 10/x
Also good to focus on fact that ~50,000 US deaths have occurred outside nursing homes. So focusing all energies on protecting the nursing homes would not help those outside that are at risk of getting sick and dying. 11/x
For those who think only the elderly are getting sick, useful to see Gov Cuomo's briefing this week where he said that out of 1000 pts hospitalized in NYC recently, about a quarter of them were age 50 and below. 12/x
Another way to look at this -- if you add up US 65 y/o and older population together with those w/ underlying conditions that put them at risk for COVID, you get >90M adults https://www.kff.org/global-health-policy/issue-brief/how-many-adults-are-at-risk-of-serious-illness-if-infected-with-coronavirus/ 13/x
