Total US infections: 5,777,710
Average last 7 days: 41,185/day
Total US deaths: 178,488
Average last 7 days: 952/day
Source: COVID Tracking Project
Today let’s look at both death infections and deaths. I’ve started to rate each State according to a system, so we’ll look at that after the overall picture.
When it comes to new infections, only the Northeast is doing well. The best that can be said for the other regions is that the rate of new infections, while awful, has at least come down in the South and West in the past several weeks:
A similar pattern is the case as to deaths. In the Midwest, the pace of deaths has not increased nearly so much as infections:
Here is my own internal rating system as to how each State is doing:
Deep Red (general alarm out-of-control fire): 200+ infections per million, 5+ deaths per million.
Red (3 alarm fire): 100-200 infections, 2-5 deaths
Orange (2 alarm fire): 60-100 infections, 1-2 deaths
Yellow (1 alarm fire):40-60 infections, 0.5-1 deaths
Blue (smoldering/1 alarm fire): 20-40 infections, 0.2-0.5 deaths
Green (embers): 0-20 infections, 0-0.2 deaths
Applying this first to new infections, first, here are all States with 100 or more infections per million:
Next, those with less than 100 infections:
Finally, those with less than 50 infections:
Applying my rubric, here is the breakdown:
Deep red/general alarm fire:
Red/3 alarm fire:
Orange/2 alarm fire
Yellow/1 alarm fire
Now let’s turn to deaths per million. First, here are all States with deaths of 5 or higher per million:
Next, States with 2 – 5 deaths per million:
Next, States with 1-2 deaths per million:
Finally, States with less than 1 death per million:
Applying my rubric, here is the breakdown as to deaths:
Deep red/general alarm fire:
Red/3 alarm fire:
Orange/2 alarm fire:
Yellow/1 alarm fire
The only State that is in the clear (green) on both metrics is Vt. In contrast, most of the Deep South remains out of control. Most of the Northeast outside from MA and PA is doing quite well. A lot of the Midwest and Mountain West, which had been doing well several months ago, are in very poor shape, although not completely out of control.
I expect the situation to remain similar, with States waxing and waning between relative control and new exponential growth as people range between complacency and panic. This is only going to change with new national leadership and/or a vaccine.
New study finds staggering racial disparities in COVID-19 cases in Massachusetts
via @BostonGlobe – August 27
A slight increase in a city’s Black or Latino population is associated with hundreds more COVID-19 cases, a new study found.
While COVID-19′s disproportionate toll on Black and Latino communities throughout Massachusetts has been well documented, this study is the first to quantify those disparities and explore the extent to which other demographic factors — including cities’ foreign-born non-citizen population, average household size, and essential worker population — explain racial and ethnic gaps.
The results, drawn from an analysis of 351 Massachusetts cities and towns, are staggering. A 10 percentage point increase in the Black population is associated with 312.3 more cases per 100,000. The same increase in the Latino population is associated with 258.2 more cases per 100,000.
From the early days of the pandemic, Massachusetts cities with large Latino and Black populations have suffered high infection rates and death tolls. Chelsea, the city with the highest number of total cases per capita in the state, is 66.9 percent Hispanic or Latino. Of Massachusetts COVID-19 cases where the infected person’s race is known, 45.6 percent are non-Hispanic white, a group that makes up 71.1 percent of the state’s population.
Similar patterns have played out nationally. The Centers for Disease Control and Prevention reported last week that COVID-19 infection rates are 2.8 times higher for Hispanic or Latino persons versus white, non-Hispanic persons. The same is true for the non-Hispanic American Indian and Alaska Native population. Non-Hispanic Black or African American persons have a 2.6 times higher case rate and 2.1 times higher death rate. Cases and death rates for the non-Hispanic Asian population are roughly the same as for non-Hispanic White persons.
“We knew that these communities were being hit harder, and the question was, how much more,” said Dr. Jose Figueroa, the study’s lead researcher and an assistant professor at Harvard T.H. Chan School of Public Health. “We can now put a number to the burden on these Latino and Black communities. And it is significant.” …
Trump Program to Cover Uninsured Covid-19 Patients Falls Short of Promise
NY Times – August 29
(Coronavirus)… care is supposed to be covered under a program Mr. Trump announced this spring as the coronavirus pandemic was taking hold — a time when millions of people were losing their health insurance and the administration was doubling down on trying to dismantle the Affordable Care Act, the law that had expanded coverage to more than 20 million people.
“This should alleviate any concern uninsured Americans may have about seeking the coronavirus treatment,” Mr. Trump said in April about the program, which is supposed to cover testing and treatment for uninsured people with Covid-19, using money from the federal coronavirus relief package passed by Congress.
The program has drawn little attention since, but a review by The New York Times of payments made through it, as well as interviews with hospital executives, patients and health policy researchers who have examined the payments, suggest the quickly concocted plan has not lived up to its promise. It has caused confusion at participating hospitals, which in some cases have mistakenly billed patients … who should be covered by it. Few patients seem to know the program exists, so they don’t question the charges. And some hospitals and other medical providers have chosen not to participate in the program, which bars them from seeking any payment from patients whose bills they submit to it.
Large numbers of patients have also been disqualified because Covid-19 has to be the primary diagnosis for a case to be covered (unless the patient is pregnant). Since hospitalized Covid patients often have other serious medical conditions, many have other primary diagnoses. At Jackson Health in Miami, for example, only 60 percent of uninsured Covid-19 patients had decisively met the requirements to have their charges covered under the program as of late July, a spokeswoman said.
Critics say the stopgap program is among the strongest evidence that Mr. Trump and his party have no vision for improving health coverage, and instead promote piecemeal solutions, even in a national health crisis. Mr. Trump had promised a plan to replace the Affordable Care Act by the beginning of August, but none has been announced and he and other Republicans barely mentioned health policy in their national convention last week.
For now, as tens of thousands of new coronavirus cases are reported each day in the United States — and as Democrats eagerly frame the election as a referendum on Mr. Trump’s handling of the pandemic and his efforts to wipe out the health law in the Supreme Court — the Covid-19 Uninsured Program is his best offer. …
New Trump pandemic adviser pushes controversial ‘herd immunity’ strategy, worrying public health officials
The Washington Post via @BostonGlobe – August 31
The approach’s chief proponent is Scott Atlas, a neuroradiologist from Stanford’s conservative Hoover Institution, who joined the White House earlier this month as a pandemic adviser.
WASHINGTON – One of President Donald Trump’s top medical advisers is urging the White House to embrace a controversial “herd immunity” strategy to combat the pandemic, which would entail allowing the coronavirus to spread through most of the population to quickly build resistance to the virus, while taking steps to protect those in nursing homes and other vulnerable populations, according to five people familiar with the discussions.
The administration has already begun to implement some policies along these lines, according to current and former officials as well as experts, particularly with regard to testing.
The approach’s chief proponent is Scott Atlas, a neuroradiologist from Stanford’s conservative Hoover Institution, who joined the White House earlier this month as a pandemic adviser. He has advocated that the United States adopt the model Sweden has used to respond to the virus outbreak, according to these officials, which relies on lifting restrictions so the healthy can build up immunity to the disease rather than limiting social and business interactions to prevent the virus from spreading.
Sweden’s handling of the pandemic has been heavily criticized by public health officials and infectious-disease experts as reckless – the country has among the highest infection and death rates in the world. It also hasn’t escaped the deep economic problems resulting from the pandemic.
But Sweden’s approach has gained support among some conservatives who argue that social distancing restrictions are crushing the economy and infringing on people’s liberties.
That this approach is even being discussed inside the White House is drawing concern from experts inside and outside the government who note that a herd immunity strategy could lead to the country suffering hundreds of thousands, if not millions, of lost lives. …
The only way this ends: herd immunity
via @BostonGlobe – April 11
… if a disease can’t be contained — and it’s too late for that in the COVID-19 pandemic — then there’s only one possible ending to the story: We must collectively develop immunity to the disease. In lieu of a vaccine, that means most of us will need to be exposed to the virus, and some unknowably large number of us will die in the process.
This is the simple, scary math that Harvard epidemiologists Marc Lipsitch and his colleague Yonatan Grad have tried to convey in a series of recently published papers: If each person infected with COVID-19 disease in turn infects three more, as we now think, then in order to bring the disease to heel, Grad says, two of those people must already be immune. “If one person can only spread the disease to one other person, the virus is no longer an epidemic,” he says. …
As awful as this approach might seem, the main reason it was avoided was that it would disastrously overload all hospitals everywhere, not to mention medical staffs, and lead to mass panic everywhere.
But after Election Day, sure, why not, depending on how that goes.
Or, we could get a few billions inoculated with that vaccine we’ve all been waiting for first.