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I'm more worried about the US outbreak than at any point since early March.
We're on a similarly devastating trajectory, minus the political will to do something about it. That's a catastrophic situation. https://twitter.com/jaysbookman/status/1283922151582638084?s=20
We're on a similarly devastating trajectory, minus the political will to do something about it. That's a catastrophic situation. https://twitter.com/jaysbookman/status/1283922151582638084?s=20
After a steep decline in daily deaths through March and June, they are trending upward again and are back at a level of 30K/month and rising. I fear they have considerably further to rise. https://twitter.com/COVID19Tracking/status/1283517747377221632?s=20
Which means we're still in the early stages of the uptick in deaths.
Test positivity has been rising steadily since early June, even as we're testing more. That's extremely grim.
Test positivity has been rising steadily since early June, even as we're testing more. That's extremely grim.
And bear in mind that deaths lag hospitalizations lag test-confirmed cases.
So when you see an uptick in case counts, you'll see a corresponding uptick in hospitalizations 2ish weeks later, and a corresponding uptick in deaths after another 1-2 weeks.
So when you see an uptick in case counts, you'll see a corresponding uptick in hospitalizations 2ish weeks later, and a corresponding uptick in deaths after another 1-2 weeks.
This weekly data from @COVID19Tracking shows it pretty clearly.
- Case counts trending up starting week of June 11
- Hospitalizations follow suit the week of June 25 (2wks)
- Deaths follow suit the week of July 9 (2wks)
- Case counts trending up starting week of June 11
- Hospitalizations follow suit the week of June 25 (2wks)
- Deaths follow suit the week of July 9 (2wks)
Rising death counts now reflect the transmission that was rising ~1 month ago.
Transmission has continued rising steadily since then.
Cases have been growing for a month straight, and are approach 4x the mid-June level.
Transmission has continued rising steadily since then.
Cases have been growing for a month straight, and are approach 4x the mid-June level.
Perhaps deaths won't increase at the same rate - we're testing more widely now and catching more non-fatal cases.
Even if four-fold case increases yield only a two-fold increase in deaths - we'd already be locked into a level of death approaching the worst peaks in April.
Even if four-fold case increases yield only a two-fold increase in deaths - we'd already be locked into a level of death approaching the worst peaks in April.
And what really worries me is that in March/April, we acted MUCH earlier to slow things down.
We're close to surpassing the peak level of hospitalizations from April, but haven't yet taken sufficient action to reduce transmission.
We're close to surpassing the peak level of hospitalizations from April, but haven't yet taken sufficient action to reduce transmission.
National stay-at-home orders went into effect in mid-late March around the country.
At that time hospitalizations & deaths were still at a low level.
At that time hospitalizations & deaths were still at a low level.
Hospitalizations began leveling off through mid-April and then had a very, very slow decline back downward.
Deaths leveled off late April through early May and then began a similarly gradual decline.
Deaths leveled off late April through early May and then began a similarly gradual decline.
But this time, the country still has yet to reimpose measures anywhere close to what we did in March/April. People are moving around much more, far more is open.
So there's not much indication we're close to the peak of this yet.
So there's not much indication we're close to the peak of this yet.
I don't think we need to fully reimpose March-style lockdowns; we know enough now to be more strategic in how we apply distancing measures.
Widespread masking and avoiding super-spreading opportunities would achieve much. But at this level of transmission, probably not enough.
Widespread masking and avoiding super-spreading opportunities would achieve much. But at this level of transmission, probably not enough.
At a minimum we should be rolling back reopening measures, re-closing any business or activity with super-spreading potential (those that involved prolonged indoor contact, esp with large groups), and imposing masking orders.
And this must be nationwide, not just hotspots.
And this must be nationwide, not just hotspots.
No state is in a *good* place right now. Cases are trending upward nearly everywhere. Which means even those with comparatively lower case levels are still struggling to suppress transmission.
Meanwhile the Sun Belt surge is going to shoot a lot of sparks into other areas.
Meanwhile the Sun Belt surge is going to shoot a lot of sparks into other areas.
And even in the better-off states, the surge in Sun Belt testing demand is slowing down testing times *everywhere*. This in turn paralyzes contact tracing.
So if testing capacity is overwhelmed, it elevates the risk greatly for every state. https://www.nytimes.com/2020/07/16/opinion/coronavirus-testing-us.html
So if testing capacity is overwhelmed, it elevates the risk greatly for every state. https://www.nytimes.com/2020/07/16/opinion/coronavirus-testing-us.html
We are already locked into a very, very bad trajectory. The longer we wait to take serious action, the higher the potential peak.
If we can't muster the political will and public cooperation to apply another round of distancing measures, August and September will be disastrous.
If we can't muster the political will and public cooperation to apply another round of distancing measures, August and September will be disastrous.
And that in turn would set the stage for an even greater disaster. Because battling COVID in the fall will be considerably harder than battling it in the summer.
Less outdoor activity, more flu cases to mask potential COVID and to strain the testing infrastructure.
Less outdoor activity, more flu cases to mask potential COVID and to strain the testing infrastructure.
We've got a narrow window here. We need to seize it.
And doing so as a state-by-state patchwork won't suffice. Has to be a harmonized national approach.
Hence my alarm.
And doing so as a state-by-state patchwork won't suffice. Has to be a harmonized national approach.
Hence my alarm.
The White House and most Sun Belt governors have shown no political appetite for this.
The President has his head in the sand and is maintaining that we're in good shape.
DeSantis, Ducey, Kemp, Abbott all reluctant or outright opposed to reimposing major restrictions.
The President has his head in the sand and is maintaining that we're in good shape.
DeSantis, Ducey, Kemp, Abbott all reluctant or outright opposed to reimposing major restrictions.
And even in California, despite better and more science-informed policymaking, there is public exhaustion and a lot of resistance. https://www.theatlantic.com/ideas/archive/2020/07/end-californias-coronavirus-miracle/614002/
Stopping the wave will be harder this time around. Both policy choice and public compliance will be harder.
Politicians are less willing, Trump is less interested, and the public is confused, tired, afraid, and receiving little confidence-inspiring guidance from their leaders.
Politicians are less willing, Trump is less interested, and the public is confused, tired, afraid, and receiving little confidence-inspiring guidance from their leaders.
We still need all the things we've needed since April:
- Order-of-magnitude more testing and tracing capacity
- Enough economic support to incentivize distancing
- Federal intervention to scale test supplies & PPE
- More protection for high-risk groups
- Help for hospitals
- Order-of-magnitude more testing and tracing capacity
- Enough economic support to incentivize distancing
- Federal intervention to scale test supplies & PPE
- More protection for high-risk groups
- Help for hospitals
But the feds seem to have given up on most of this; the states are at the limits of what they can do on their own; the public needs better risk communication than they're getting; and there's no real mobilization toward stopping this wave.
So that's why I'm cursing to reporters. https://twitter.com/BethCameron_DC/status/1284121754370277378?s=20
