US COVID Update (19-04-2020)

It's Saturday, so the numbers may be a bit hinky, but since they are for yesterday through various times today (different “closing times” for different states) and I close at what I have found at midnight GMT I think they are reasonably close. The numbers reported on Monday are usually the least reliable.

Anyway, I'm still watching the new cases although I don't think they are as important as they were. New deaths are because they lag new cases and hospitalizations. Since many states either don't report hospitalizations where it is easy for me to find, or maybe report them at all, nor do they seem to correlate well with they day on which they are reported I try to keep an eye on them, but I assume that as new deaths go down hospitalizations (and ICU admits) went down around a week earlier.

So, new cases in the data today are down 4000, or around 13% that is a really big drop. New deaths were down 700+ or nearly 30%. That is at least partly I think, because the data drop of “suspected” deaths in the bigger states has ended. Don't let anyone kid you. We are well on the downside of the curve, even with “added” suspected new cases and new deaths. There is no way to get those numbers if the epidemic is still 'raging'. The medical and health care people have fought a hard battle and won that. But it is just one, major, battle. The war goes on and more people will die. But our system (unlike Italy, Spain, maybe the UK,and maybe Japan [currently]) was not overwhelmed. Stressed to near the limit, yes. But it held. I'm hoping those who need it most can get some rest now.

Really bad COVID is still mostly a localized phenomenon. It is really bad in the NYC area. One report I found used Kings, Queens, New York, Suffolk, Bronx, Nassau, Westchester, and Richmond Counties and the 12+M people there, but I prefer to use those and the northern 1/3 or so of NJ counties, plus RI, DE, and CT. Sometimes I add MA jut to see what that does. Roughly the area I use has over half of the cases and 55% of the deaths in the entire US. Then Detroit Metro and Chicago Metro are smaller hotspots. If you add them to the NYC area almost 2/3 of the cases and deaths are in those three areas.

They are different, and they should be handled differently. But the rest of the country is nothing like (an average) those three. Even in CA Los Angeles, San Diego, San Francisco/Oakland are nothing like the Big Three. I'm sure a lot of research will be done on the differences as soon as possible. I've mentioned several possibilities before: high numbers of household members (homes with 3+ living in them have way more cases and deaths than those with 2 or fewer); mass transit (maybe not in Detroit so much, but for sure in NYC and Chicago), high overall population density in the area; lots of movement in, around, and out of the Metro area by any means, and high exposure to international travelers.

Even in states with low numbers there are usually local hotspots that correspond with some sort of network effect in the area. Viruses do not spread randomly. They spread along the lines of contact among nodes of groups who interact a lot. NYC, Detroit, and Chicago have a lot more “network effect” and a lot more, bigger (more people in close, regular contact) nodes, and more links between nodes that pretty much any other places in the US.

So, to the data. About an hour after 2400 GMT two states added together a total of about 900 new cases but no new deaths. sigh I'll ignore that and add them tomorrow. It doesn't really change much of anything anyway.

Of the top 15 states, only four recorded an increase in new deaths. IL – 63, PA – 25, CA – 16, MD -5. All the rest dropped. NY down About 500, NJ 100, MI 50, FL and GA not quite 50, and all the rest of the states in low double digits or less up and down. This is a very strong indicator that we're on the downside of the death curve as well. It is April 18 and the worst really seems to be behind us. It's still going to be rough for a while, but if we persevere we can make it to the end.

Having said that, we know a couple of important things:

1. The virus was not that bad in almost all of the country. That is, nowhere did we come very close to even the low predictions that were made early.
2. We should be able to open most of the economy very soon (like Monday in many cases) as long as we take proper precautions to protect the most vulnerable – that would be anyone over the age of 60 with one or more of the deadly comorbidities including heart problems, BMI above 30, diabetes, lung problems (including asthma), and high blood pressure.

For those under 60 the things that make them most vulnerable seem to be BMI over 30 and lung problems. And always those with compromised immune systems. Otherwise I see no reason not to open up relatively close to what Sweden has been doing. I would probably not open entertainment/sports venues that hold a lot of people. I would want people to practice reasonable social distancing, but I REALLY want people to get out into the sunshine as much as possible. Lots of sunshine is one of the best things to do for almost any viral infection.

So. Be serious. Be careful. Try to protect the vulnerable among us. Don't be hysterical. And open up the damn economy. Let individuals decide what risks to take.