1/10 Another week, more spread of #Covid19. Bottom line: it’s worse, will continue to get worse, and will take months to improve substantially.We are going in the wrong direction, fast. @CDCgov’s Covid-View here: https://bit.ly/30Fj11C 

2/10 No single indicator sufficient, but if I had to pick one, it would be the proportion of tests positive. This increased from 8.1% to 8.7%. We should measure and report turnaround time: symptoms to test and isolation. Lab turnaround times of more than a day limit test utility.

3/10 Look carefully at the yellow line and bar. The bar shows that public health labs have been testing about 125,000 people age 18-49 each week, and the positivity rate has been rising for a month, from about 5% to about 7%, driving the overall increase.

4/10 The trend is even more marked in commercial labs. Up to 1 million tests a week in young adults, with positivity increasing from around 7% to around 10%. What starts in young adults will spread. Bars and restaurants, among other places, are driving transmission.

5/10 Influenza-like and Covid-like illness visits to emergency departments are increasing in most of the US, particularly in the South. CDC should also report numbers, not just percent of all visits, since people stop going to ERs for non-Covid conditions when Covid is spreading.

6/10 Native Americans, Black and Hispanic/Latinx people all now have 5x the hospitalization rate of whites. Rates are increasing among Hispanic/Latinx. More than one out of every 200 people over age 85 have been hospitalized for Covid. (Cumulative rate of 573 per 100,000.)

7/10 Deaths reached seasonal baseline - but still hundreds a day and will increase. Increase in deaths lags increase in cases by weeks, and maybe by months because of the initial predominance of younger adults.

8/10 Switching to https://www.covidexitstrategy.org , which uses the CDC formulas for state trends. A few states still reassuring: NY, NJ, CT, VT, and HI. WY has low case numbers. MA, MI, ME, Alaska so far stable. All are at risk - a rising tide can swamp all communities.

9/10 Of particular concern - too many states to count. Because of size and numbers, Texas, Florida, California of most concern. Alabama, GA, LA, MS, NV and SC all have high detection rates (>200/M/d) and high and rising positivity. Deaths are already increasing in Arizona.

10/10 Huge viral reservoir in the US: at least 1 million people with contagious COVID19 among us today. No national strategy. Basic prevention activities neglected. We have months of risk, suffering, economic hardship, and restrictions ahead. Still, we can stop Covid together.