Coronavirus dashboard for June 23: focusing on deaths, and the Trumpist South and Southwest
Coronavirus dashboard for June 23: focusing on deaths, and the Trumpist South and Southwest
Confirmed total US infections: 2,312,302. (+31,433 in past 24 hours)
Confirmed total US deaths: 120,402 (+425 in past 24 hours)
We know that new cases are accelerating again. Is it translating into an increase in deaths? The answer appears to be: not yet, but getting close.
Here is the 7 day average of new deaths in the US:
Figure 1
In the past 3 days, the decline has ceased at roughly 610/day.
A regional look shows that the decline in new deaths has stopped everywhere except in the Northeast.
The first graph shows the 7 day average of deaths in the Northeast and Midwest; the second the South and West:
The Northeast still has the highest death rate per capita, at 2.8 deaths per day per million, with the Midwest at 2, the South at 1.6, and the West at 1.4. But the trend in the South and West has been flat for the past week, and the Midwest for the past few days. Only in the Northeast has the rate continued to decline sharply, masking the ominous trends in the other regions.
Finally, here are the 10 highest jurisdictions by 7 day average in death rates per capita:
Since the graph doesn’t show trends that well, here is the list, including whether the rate has been rising, falling, or flat over the past 7 days:
RI 7.0 (declining)
The list remains dominated by States in the Northeast, plus Illinois, where the rate of deaths has continued to fall. Three States where cases have been increasing (Mississippi, Louisiana, and Arizona) have joined the list with rising death rates.
I expect this transition to continue. I expect US death rates as a whole to begin to climb in the next few days, and for States in the South and West to replace States in the Northeast over the next 10 days. Very discouraging.
The question now is, are Trumpist GOP States subject to the same pain threshold that others were earlier? I think they are, but they will arrive there kicking and screaming, and ready to relax again at the very first opportunity.
https://www.nytimes.com/2020/06/24/health/coronavirus-dexamethasone.html
June 24, 2020
Breakthrough Drug for Covid-19 May Be Risky for Mild Cases
That study about dexamethasone has arrived with a big asterisk: While it appears to help severely ill patients, it harms others.
By Roni Caryn Rabin
Scientists in Britain announced a major breakthrough in the battle against the coronavirus last week, reporting they had found the first drug to reduce deaths among critically ill Covid-19 patients.
The results were first made public in a sparsely detailed news release. Now the full study, neither peer reviewed nor published yet, has been posted online, * and it holds a surprise.
The drug — a cheap, widely available steroid called dexamethasone — does seem to help patients in dire straits, ** the data suggest. But it also may be risky for patients with milder illness, and the timing of the treatment is critical.
The drug “may harm some patients, and we’re not entirely sure which patients those are,” said Dr. Samuel Brown, an assistant professor of pulmonary and critical care medicine at University of Utah School of Medicine in Salt Lake City, who was not involved in the research.
Following the announcement last week, officials at some American hospitals said that they would begin to treat coronavirus patients with dexamethasone, and the World Health Organization called for accelerating production to ensure an adequate supply. U.K. health officials moved to limit exports of the steroid.
The drug was tested in a clinical trial that included some 6,425 patients in Britain. One-third were randomly assigned to receive the drug, while the others received the usual care. Patients in the first group received a very low dose of the drug, given daily for up to 10 days.
Dexamethasone was beneficial for those who had been sick for more than a week, reducing deaths by one-third among patients on mechanical ventilators and by one-fifth among patients receiving supplemental oxygen by other means.
Patients given the steroid who were not receiving respiratory support, however, actually died at a slightly higher rate than similar patients who were not given the drug, although the difference was not statistically significant.
That the drug might have disparate effects at different stages of the disease makes sense, given the biology of the illness, according to Dr. Martin J. Landray, the study’s senior author and a professor of medicine and epidemiology at Oxford University.
In the most severely ill patients, the immune system flies into a harmful overdrive mode, triggering a so-called cytokine storm that damages the body, including the lungs.
“It’s almost like a disease with two phases,” Dr. Landray said in an interview. “A phase where the virus dominates, and the immunological phase, where the damage the immune system causes is dominant.”
Doctors have worried about using steroids such as dexamethasone to fight Covid-19, because steroids are anti-inflammatory drugs that dampen the body’s protective immune response. In mildly ill patients, that may do more harm than good, Dr. Landray said.
“In the early phase of the illness, the immune system is your friend,” Dr. Landray said. “It’s fighting the virus, and dampening it is not a good idea.”
“In the later phase, the immune system is no longer your friend — it’s responsible for the lungs failing, and dampening it down with steroids helps the situation and improves the chance of survival.”
Other experts agreed, saying the study showed dexamethasone cannot be used to treat mild illness, or as a preventive.
“It would likely be harmful to take dexamethasone as an outpatient treatment for Covid-19,” said Dr. Brown. Patients with mild infections “should not be trying to get people to prescribe them dexamethasone just in case.”
Many scientists want to see the trial results repeated in another study, and note that some questions aren’t fully answered in the paper, including information about long-term outcomes and neurological damage.
“If a reasonable fraction of patients are recovering in a way that’s satisfactory and welcome, what you have is a gigantic victory,” said Dr. Jeremy Faust, an emergency room physician at Brigham and Women’s Hospital in Boston.
Generally, however, patients who have spent a long time on ventilators “have a rough road ahead,” he added, even if dexamethasone improves their odds of survival.
* https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1
** https://www.nytimes.com/2020/06/16/world/europe/dexamethasone-coronavirus-covid.html
NDd:
For something to happen in AZ, the death rate amongst confirmed cases must go up. Right now the death rate (~1850) is 2.5% of confirmed cases (~60,000). They will not do much more with so few deaths in the state. Michigan was i in 11 while AZ is ~ 1 in 40.
The news reports from Texas suggest hospital beds and available nurses are key factors in the pain threshold for behavior change.
June 25, 2020
Coronavirus
US
Cases ( 2,489,126)
Deaths ( 126,423)
What a frightening day; I do not have any clear understanding of what is happening.
June 25, 2020
Coronavirus (Deaths per million)
Belgium ( 839)
UK ( 637)
Spain ( 606)
Italy ( 574)
Sweden ( 518)
France ( 456)
US ( 382)
Netherlands ( 356)
Ireland ( 350)
Switzerland ( 226)
Canada ( 225)
Luxembourg ( 176)
Portugal ( 152)
Germany ( 107)
Denmark ( 104)
Austria ( 78)
Finland ( 59)
Norway ( 46)
Greece ( 18)
India ( 11)
Japan ( 8)
China ( 3)
June 25, 2020
Coronavirus
UK
Cases ( 307,980)
Deaths ( 43,230)
Germany
Cases ( 193,465)
Deaths ( 9,005)
Canada
Cases ( 102,573)
Deaths ( 8,501)
Sweden
Cases ( 63,890)
Deaths ( 5,230)
This is why since Trump wanted to do herd immunity, there shouldn’t have been any shutdowns, instead pushing for mitigation so the hospitals don’t overflow.
All the shutdowns did was delay the progress of the disease and it has done a surprisingly good job this summer in air conditioning. We are now at the UV peak and it will weaken back to a April sun by August, increasing viral loads.
As the organ damage problems in asymptomatic and “recovered” patients emerge, exclusive attention to the death rate may change; particularly since the young and middle aged are more involved.
Jack:
That is correct according to my knowledge. The damage is permanent.
Correcting the US count in which I mixed up 2 numbers, and further adding:
June 25, 2020
Coronavirus
US
Cases ( 2,492,562)
Deaths ( 124,784)
Correcting the US ratio:
June 25, 2020
Coronavirus (Deaths per million)
Belgium ( 839)
UK ( 637)
Spain ( 606)
Italy ( 574)
Sweden ( 518)
France ( 456)
US ( 377)
Netherlands ( 356)
A day of 37,000 new confirmed coronavirus cases, and additional deaths necessarily added to the New Jersey count:
June 25, 2020
Coronavirus
US
Cases ( 2,500,995)
Deaths ( 126,720)
Adding the New Jersey deaths:
https://www.worldometers.info/coronavirus/
June 25, 2020
Coronavirus (Deaths per million)
Belgium ( 839)
UK ( 637)
Spain ( 606)
Italy ( 574)
Sweden ( 518)
France ( 456)
US ( 383)
Netherlands ( 356)
https://www.nytimes.com/2020/06/25/us/coronavirus-cases-young-people.html
June 25, 2020
As Virus Surges, Younger People Account for ‘Disturbing’ Number of Cases
People in their 20s, 30s and 40s account for a growing proportion of the cases in many places, raising fears that asymptomatic young people are helping to fuel the virus’s spread.
By Julie Bosman and Sarah Mervosh
But, but, but; I thought the rise in heat brought on by late Spring and Summer would slow the virus and we would not see it again till Fall! Catch the virus and you may die. In Michigan, it was one in 11 died after contracting the virus. If you do contract the virus, you rick permanent damage to your lungs, heart, brain, etc. even if you are young and do survive.
“The Northeast still has the highest death rate per capita, at 2.8 deaths per day per million, with the Midwest at 2, the South at 1.6, and the West at 1.4. But the trend in the South and West has been flat for the past week, and the Midwest for the past few days. Only in the Northeast has the rate continued to decline sharply, masking the ominous trends in the other regions.”
This is a very good point but please check your graphs as the key information about the peaks are truncated the way the graph is drawn.
The Trumpist Death Cult – Trump wants to know, will you die for him?