Covid Epi Weekly: Turning the Corner on Covid in the US ... Into an Oncoming Tsunami of Cases, Hospitalizations, and Death

You know who’s NOT tired of winning? Covid, that's who. Unless we up our game, it will keep winning, keep spreading, keep killing Americans preventably.

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Test positivity increasing in ALL age groups. Positivity in >65s increased 44%, from 3.6% 5 weeks ago to 5.2%; 5 weeks ago rate in young adults was 50% higher than in over 65s; last week 20% higher. What started in the young didn’t stay in the young. 2/
https://bit.ly/3jq6k0n 

Cumulative hospitalizations people >65 in US
1 in 300 Caucasians
1 in 120 American Indian/AN
1 in 110 Latinx
1 in 87 (!) Black people

Covid+ failure to protect essential workers, many Black/Latinx+ baseline less access to healthcare = exacerbated racial injustice in health. 3/

Years of life lost measures burden, although imperfectly. 2.5 million life years lost already. More than 13 years for each of the 225,000 people killed. Think of the joy, happiness and meaning lost for each of those 13 years. Each of the 2.5 million. https://bit.ly/2TmZoqc  4/

Working paper by @DrMaryTBassett: years of life lost before age 65

White 33,446
Black 45,777
Hispanic 48,204

Black and Latinx people in US: 33% of adults, 74% of early death. Valid responses to this information include rage, action. https://bit.ly/3kqGL0E  5/

Other than Northeast, bleak. Positivity less informative than before. Case rates are an even worse indicator - 77,000 infections reported today only ~20% of all infections. Failure of federal leadership means we’re not tracking the right indicators: https://wapo.st/2B1GaAt  6/

Look at the Dakotas. No mask mandates. Losing to Covid. Reported rates are slightly higher in North Dakota (1,000 vs. 800/million/day), but, correct for test intensity and South Dakota has about 4x the rate of North Dakota and 20x rate of the Northeast. https://bit.ly/3eVJdsl  7/

Rural areas are getting slammed. https://n.pr/3kr0D3L  and https://nyti.ms/34oT0VX . Graphs from @NYTimes show this clearly. Meat packing and agricultural outbreaks are part of, but only part of, the factors driving the increase. No place is immune to Covid. 8/

Increasing cases in Alaska suggest that colder weather may favor the virus. Sun Tzu’s 5 factors that determine success or failure in war: moral influence, weather, terrain, leadership, and strategy. The US is not organized for success in any of the 5. 9/ https://nyti.ms/3onOcrG 

Parts of Europe are also getting hit hard. Places that didn’t drive cases down enough to find and stop clusters face ever-present risk of explosive spread. Some didn’t flatten the curve sufficiently (Spain, France, Italy, UK, Belgium) and some did (Germany, Norway, Finland). 10/

Economic pain is real, and deadly. Paraphrasing Carville, to fix the economy, it’s the pandemic, stupid. More evidence that it's the virus rather than control efforts suppressing economic recovery most. “It has almost nothing to do with regulations”
https://nyti.ms/3mcrxN2 
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Balance is key. More granularity to circuit breakers to stop Covid. Schools, healthcare, workplaces, stores CAN open more safely. Outdoors is great. Travel from high to low Covid prevalence is a recipe for spread. Restaurants, bars, and indoor get-togethers amplify the virus. 12/

The higher the peak, the longer it lasts. The lower Covid goes, the longer it takes to come back. As you sow, so shall you reap. Hyperbolic discounting is not in our favor. As night follows day, hospitalizations and deaths follow cases, which follow letting our guard down. 13/

Civic responsibilities include not harming (e.g., infecting with coronavirus) others, staying informed, paying taxes, participating in your community. And VOTING. We released materials on voting safely. I like message below. Please spread the word. https://bit.ly/3kruHfv  14/End