Written by Steven Hansen
New coronavirus cases continue to slowly trend up globally whilst the U.S. new cases continue to slowly trend down. At the end of this post is a set of interactive graphs and tables for the world and individual states – as well as today’s headlines which include;
- Dr. Fauci Says Coronavirus Vaccine Doses Will Be Manufactured ‘Before We Even Know That the Vaccine Works’
- WHO shifts guidance on masks and urges governments to encourage people to wear them
- Long term care facilities are where most COVID-19 deaths occur
- Government Budgetary Effects of the 2020 Coronavirus Pandemic
The May 2020 BLS job report today was very good – as one would have expected as the country begins to reopen [our analysis is here]. But even with this good job report, remember that employment is still down 17,665,000 Year-over-Year. The headline unemployment improving from 14.7% to 13.3 %. CNBC says the real unemployment number likely exceeds 16% as there is an error in how furloughed workers are counted.
Coronavirus News You May Have Missed
Pharmaceutical company AstraZeneca is aiming to produce 2 billion doses of a coronavirus vaccine, including 400 million for the U.S. and U.K. and 1 billion for those in low- and middle-income countries.
It plans to start distributing the vaccine to the U.S. and U.K. in September or October, with the balance of deliveries likely to be made by early 2021, according to AstraZeneca CEO Pascal Soriot, on a call with journalists Thursday.
AstraZeneca said it had signed a licensing deal with the Serum Institute of India to provide 1 billion doses to low- and middle-income countries, with 400 million of those shots set to be delivered by the end of 2020, according to a press release Thursday.
No indication that ACE inhibitors, ARBs cause harm in Wuhan data – MedPage Today
Hypertension and the discontinuation of blood pressure-lowering medications were associated with increased mortality in COVID-19, according to data from Wuhan, China.
People with high blood pressure (BP) were more likely to die during COVID-19 hospitalization (4.0% vs 1.1% without hypertension, adjusted HR 2.12, 95% CI 1.17-3.82), as were those with a history of hypertension who were not on antihypertensive medication (7.9% vs 3.2% on medications, adjusted HR 2.17, 95% CI 1.03-4.57).
Between those on renin-angiotensin-aldosterone system (RAAS) inhibitors and peers on other antihypertensives, mortality was similar (2.2% vs 3.6%, adjusted HR 0.85, 95% CI 0.28-2.58), reported Fei Li, MD, PhD, of Xijing Hospital in Xi’an, China, and colleagues in European Heart Journal.
Common Heartburn Drug for COVID-19 Symptoms? — In case series, non-hospitalized patients felt better within 1-2 days of starting famotidine – MedPage Today
Self-administered high-dose oral famotidine (Pepcid AC) was well tolerated and associated with improved patient-reported outcomes in non-hospitalized COVID-19 patients, a small case series found.
At daily doses ranging from 60 to 240 mg, the histamine-2 receptor antagonist widely used to suppress gastric acid production was linked to reduced severity across a range of symptoms 24 to 48 hours after starting treatment in 10 outpatients with a clinical diagnosis of COVID-19, reported Tobias Janowitz, MD, PhD, of Cold Spring Harbor Laboratory in New York. Symptoms cleared within 14 days, the team said.
With novel coronavirus cases surpassing 6.5 million across the globe, doses of a vaccine would be manufactured before its efficacy has been confirmed in a bid to save time given the urgency of the ongoing pandemic, said Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID).
Speaking to Newsweek, Fauci, who is also member of the White House COVID-19 task force, said last week: “We would start manufacturing vaccines before we know that it even works or not, which means that you’ve picked up several months, instead of waiting to see if the vaccine works.”
In an coronavirus Q&A broadcast Tuesday on the Journal of the American Medical Association (JAMA) YouTube channel,Fauci said: “By the beginning of 2021, we hope to have a couple hundred million doses [of the vaccine],” adding that hopefully there will be nearly 100 million doses available by November or December.
WHO shifts guidance on masks and urges governments to encourage people to wear them – CNN
Here’s what the WHO’s new recommendations say:
1. “In areas with community transmission, we advise that people aged 60 years or over, or those with underlying conditions, should wear a medical mask in situations where physical distancing is not possible,” Tedros said.
2. “In areas with widespread transmission, WHO advises medical masks for all people working in clinical areas of a health facility, not only workers dealing with patients with Covid-19,” WHO’s Director-General added.
3. WHO recommends that where there is widespread transmission, limited capacity to contain Covid-19 outbreaks and physical distancing of at least a meter can not be achieved, then governments should encourage their public to wear a fabric mask, Maria Van Kerkhove, WHO’s technical lead for coronavirus response and head of the emerging diseases and zoonoses unit, told CNN.
The new guidance recommends for these fabric masks — which can be homemade — to be at least three layers: an inner layer of an absorbent material such as cotton; a middle layer that acts like a filter or barrier, such as non-woven material polypropylene; and an outer layer of a non-absorbent material, such as polyester or polyester blend.
Don’t Skip Opiates for ‘Air Hunger’ From COVID-19 Ventilation – MedPage Today
Easing the traumatic “air hunger” created by mechanical ventilation settings for COVID-19 acute respiratory distress syndrome (ARDS) may take more than just sedation or paralytics, one group argued.
Lung protective ventilation, with low tidal volumes and permissive hypercapnia, is a recipe for “the most uncomfortable form of dyspnea,” Richard Schwartzstein, MD, of Beth Israel Deaconess Medical Center and Harvard in Boston, wrote in the Annals of the American Thoracic Society.
The feeling of wanting to breathe but being unable due to ventilation “evokes fear and anxiety, so much so that involuntary air hunger has been used as a very effective form of torture (e.g. waterboarding),” the group noted. “Among ICU survivors, the experience of air hunger is associated with post-traumatic stress disorder (PTSD).”
COVID-19 Cases per Million Inhabitants: A Comparison – Statista
Although the situation is fluid, the countries worst hit by the COVID-19 pandemic are by now well known. How does this look though when accounting for population size?
Using Johns Hopkins University and World Bank figures, this infographic takes countries with a population of at least four million and over five thousand confirmed cases and calculates the rate per one million inhabitants. Using this measure, Singapore has the most severe rate with 6,548 cases, followed by Chile and Peru. The United States, now approaching two million total cases, is fourth with 5,724 per million people.
Of course, the number of actual cases in a country is going to be higher than official figures show, with testing rates also varying dramatically. As with all figures relating to confirmed cases, they should be treated with caution.
You will find more infographics at Statista
Where Is the ID in COVID-19? – Annals of Internal Medicine
… in recent weeks, the nation’s need for more infectious disease (ID) expertise has become a clear focal point.
… In 2017, the national average density was 1.76 ID physicians per 100 000 persons; the distribution is geographically skewed (Figure 1). Of the 3142 U.S. counties, 331 (10.5%) and 312 (9.9%) have above- and below-average ID physician densities, respectively; 2499 counties (79.5%) do not have a single ID physician. Therefore, 208 million citizens live in counties with no or below-average ID physician coverage.
Among the 785 counties with the highest quartile of COVID-19 disease burden (Figure 2), 147 (18.7%) and 117 (14.9%) have above- and below-average ID physician densities, respectively; 521 (66.4%) have no ID physician coverage. In the second highest quartile of counties, 88 (11.2%) and 110 (14.0%) have above- and below-average ID physician densities; 588 (74.8%) have no ID physicians. Among counties with the lowest COVID-19 burden, approximately 95% do not have a single ID physician.
Wall Street Warning to Corporate America: Get Cash While You Can – Bloomberg
Bankers have a message for America’s debt-laden companies: raise money now, because things could get a lot worse.
The gradual reopening of businesses after months-long shutdowns and a pick up in manufacturing activity have given investors reason for optimism in recent weeks. But underwriters who cater to heavily indebted corporations are offering their clients a bleak preview of what may lie ahead.
The long list of worries includes a new wave of coronavirus contagion in the fall, an extended period of double-digit unemployment, a spike in defaults and a slower-than-expected economic recovery as businesses around the globe adapt to the realities of prolonged social distancing.
Long term care facilities are where most COVID-19 deaths occur – Medical Xpress
Long-term care facilities (LTCFs) are a major driver of total COVID-19 deaths. Reported today in the Journal of the American Geriatrics Society, Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) geriatricians Rossana Lau-Ng, Lisa Caruso and Thomas Perls studied the past month’s case and death data reported by the Massachusetts Department of Health’s COVID-19 daily Dashboard along with data provided by the Kaiser Family Foundation and other countries. As the pandemic drags on, the proportion of COVID-19 deaths in Massachusetts that occur in LTCFs (nursing homes and group homes) has climbed from 54 percent to 63 percent as of May 29t.
Some states have even higher proportions of COVID-19 deaths in LTCFs. According to Kaiser Family Foundation data, as of May 28, 81percent of COVID-19 deaths in Minnesota and Rhode Island had occurred in nursing homes. In Connecticut the proportion was 71 percent and in New Hampshire it was 70 percent. Another 22 states reported that 50 percent or more of their COVID-19 deaths occurred in LTCFs. Despite these lopsided figures, 11 states (Alabama, Alaska, Arizona, Arkansas, Hawaii, Michigan, Missouri, Montana, New Mexico, North and South Dakota) continue to not report the number of COVID-19 deaths occurring in LTCFs, which has contributed to a vast underestimation of the total number of COVID-19 deaths in the United States.
Other causes of under-reporting nursing home COVID-19 deaths include incomplete data collection by states and that up through mid-April, many states and the Centers for Disease Control did not accept a diagnosis of COVID-19 without substantiation by a positive test. Thus, many deaths were not reported because tests for COVID-19 were largely unavailable to nursing homes. Now, officials are going back to see if many deaths can be categorized as probable COVID-19 based upon the medical presentation and history of exposure. As of May 28, New York reported the lowest proportion of COVID-19 deaths in LTCFs at 21 percent, yet the rate is three-four times higher in other Northeastern states. “Once we get accurate counts of the COVID-19 deaths in all states, we will likely see a big increase in the total number of deaths in the United States,” says Thomas Perls, MD, professor of medicine at BUSM and a study co-author.
Coronavirus ‘Contact Tracer’ is One of the Most In-Demand Jobs Right Now. Here’s How to Get Hired – Money
States across the country are hiring tens of thousands of contact tracers to stop the spread of COVID-19.
It’s important work: Contact tracers help infected Americans recall the names of everyone they’ve recently come into contact with, and then track those individuals down to avert the disease’s path of infection.
Emily Gurley, a Johns Hopkins epidemiologist and the lead instructor of a free online course on the fundamentals of contact tracing, calls the people who fill these roles “part detective, part therapist, and part social worker.”
From Immediate Responses to Planning for the Reimagined Workplace: Human Capital Responses to COVID-19 – The Conference Board
We expect that COVID-19 will have many lasting impacts on the world of work and human capital processes, and we wanted to capture what human capital professionals are thinking today as they look to the future. To gauge how organizations are reacting to the changing business environment in the context of their workforces, we conducted an online survey in April 2020 with more than 150 human capital executives, mostly in large companies. Our accompanying chartbook shares the survey findings about remote work and the cost-reduction actions that have already been taken, as well as HR priorities for the recovery phase. [click here to view the executive summary]
ZeroHedge’s Summary of Coronavirus News
- Brazil passes Italy to claim world’s third-worst death toll
- Architect of Sweden’s no-lockdown strategy says he has no regrets, and doesn’t plan to change approach
- NY to allow drive-in, drive thru graduations
- Italy sees more good numbers
- Pakistan reports record jump
- NYC won’t allow outdoor dining until next month
- Florida reports most new cases since April for 2nd straight day
- Global cases top 6.5 mil
- Deaths top 485k
- Hong Kong sees another alarming cluster
- China allows foreign airlines to apply to return to service
- Russia, Mexico, Brazil all see alarming jump in cases, deaths
- Experts say Russia likely underestimating deaths in St. Petersburg by considerable margin
- Backlash to the hydroxychloroquine backlash intensifies
Budgetary Effects of the 2020 Coronavirus Pandemic – CBO
Effects of Tax Deferrals on Revenues
First, Senator Scott asked about federal revenues that will be lost because of tax deferrals. As Senator Scott noted, revenues collected since late March have been much weaker than those collected during the same period last year and also much weaker than CBO projected earlier this year. The lower revenues result in part from the economic disruption caused by the pandemic, which has reduced wages and other taxable income, and in part from the government’s actions to address that disruption.
The federal government’s response included a variety of changes to tax rules. Some of them reduce the amount of taxes that businesses and individuals owe; others just allow taxpayers to defer paying taxes. CBO anticipates that most of the revenues affected by those deferrals will be collected in July, some will be collected in later years, and some will be permanently lost. CBO does not have an estimate of the amounts that fall in each of those categories.
Payroll Taxes. The Coronavirus Aid, Relief, and Economic Security (CARES) Act allows employers to delay their payments of payroll taxes— until 2021 and 2022—on wages paid from March 27, 2020, through December 31, 2020. That delay provides additional liquidity to businesses that may be facing reduced revenues or increased costs as a result of the pandemic. In effect, those firms have been provided an interest-free loan that equals a fraction of their payroll. The firms are obligated to pay half of the deferred payroll taxes on December 31, 2021, and the remainder on December 31, 2022.
The staff of the Joint Committee on Taxation (JCT) has estimated that the delay will reduce tax revenues in 2020 by over $200 billion. But by JCT’s estimate, most of the payroll taxes deferred under the CARES Act will be paid in future fiscal years, so the net loss from the delay will be $12 billion. The reason for that loss is that some of the affected firms will cease operations before they can make their payments, so some of the deferred taxes will not be paid.
Effect of Business Losses on Tax Liability. The CARES Act also temporarily modified the rules governing the use of business losses in determining tax liability. One change allows losses to result in the refund of income taxes paid for earlier years, not just for the following year, and another allows losses to reduce tax liability more than would have otherwise been the case. By allowing losses to be applied now rather than against future taxes, the changes give businesses liquidity now and increase the income taxes that they will pay in the future. As with other types of deferral of tax liability, if a business ceases to exist, its deferred taxes may not be paid.
Other Taxes. Deadlines for filing returns and paying taxes have been delayed for many other taxes. The Administration delayed the tax filing and payment deadlines for individual and corporate income taxes from April 15 to July 15, and it also delayed the due dates for estimated payments during that period. For excise taxes on wine, beer, distilled spirits, tobacco products, firearms, and ammunition that were originally due during the period from March 1, 2020, through July 1, 2020, the Administration delayed due dates by 90 days. And the Administration is allowing customs duties on some imports to be deferred for 90 days for businesses facing significant financial hardship.
CBO expects that most of the revenues that would have otherwise been paid when taxes were originally due will be paid by the new deadlines. In particular, CBO expects that most of the income tax revenues that would otherwise have been collected in the period from April through June, when taxpayers would ordinarily have filed their 2019 returns and made estimated payments of taxes for 2020, will be paid in July of this year. However, because some individuals or businesses may become insolvent and fail to make those payments, the government may not collect all of the deferred taxes.
Projected Federal Deficits for 2020 and 2021
Senator Scott also asked how large CBO anticipates the federal deficit will be in fiscal year 2020. In late April, CBO provided preliminary projections of federal deficits in fiscal years 2020 and 2021, which took into account recent events and the enactment of pandemic-related legislation. According to those projections, if laws currently in place governing spending and revenues generally remained unchanged and no significant additional emergency funding was provided, the federal deficit would be roughly $3.7 trillion in fiscal year 2020 and $2.1 trillion next year. (In CBO’s March baseline projections, deficits were just over $1 trillion in each of those years.)
Those projected deficits are significantly larger than the budget shortfall in 2019 because of sharply lower revenues and substantially higher noninterest spending. Even though federal borrowing grows in those projections, declines in interest rates mean that net interest outlays are lower in both years than in 2019.
CBO will scrutinize its projections of federal revenues and spending over the next several months, and the budget outlook in the updated baseline projections that the agency plans to release in early September of this year may be significantly different from the estimates described here.
Budgetary Effects of Pandemic-Related Legislation
Finally, Senator Scott asked what provisions enacted into law to respond to the pandemic were having the largest effects on the federal deficit. CBO has provided cost estimates for each of the four pandemic-related bills that were enacted through the end of May. The budgetary effects of those bills over the 2020-2030 period are as follows.
- The Coronavirus Preparedness and Response Supplemental Appropriations Act (Public Law 116-123, enacted March 6, 2020) is estimated to increase deficits by $8 billion.
- The Families First Coronavirus Response Act (P.L. 116-127, enacted March 18, 2020) is estimated to increase deficits by $192 billion.
- The CARES Act (P.L. 116-136, enacted March 27, 2020) is estimated to increase deficits by $1.721 trillion.
- The Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139, enacted April 24, 2020) is estimated to increase deficits by $483 billion.
Those laws would have the biggest impact on the budget in fiscal year 2020. The policies in those laws with the largest projected effects on deficits over the 2020-2030 period are as follows.
- The Paycheck Protection Program (PPP) provides funding to guarantee loans, which may be forgiven, to small businesses and other eligible entities to cover payroll and other eligible costs over eight weeks. The CARES Act provided a direct appropriation of $349 billion for the subsidy cost of guaranteeing and delivering PPP loans in 2020, and the Paycheck Protection Program and Health Care Enhancement Act increased the subsidy appropriation for PPP by $321 billion in 2020, increasing deficits in that year by a total of $670 billion.
- Recovery Rebates for Individuals, which were provided by the CARES Act, consist of a refundable tax credit of $1,200 per person (or $2,400 for joint filers) plus $500 per dependent child under the age of 17. The credit phases out for taxpayers whose adjusted gross income is over $75,000 (or $150,000 for joint filers, or $112,000 for taxpayers filing as heads of households). JCT estimates that the credits will increase deficits by $292 billion over the 2020-2021 period.
- Changes to unemployment insurance, which were included in the CARES Act, expand eligibility for unemployment compensation benefits and increase the weekly benefit amount and the number of weeks when beneficiaries can claim benefits. Major changes include creating the Pandemic Unemployment Assistance program to provide weekly benefits to unemployed people affected by the pandemic who would otherwise be ineligible for unemployment compensation benefits; temporarily adding $600 to the weekly benefit amount in unemployment programs; providing an additional 13 weeks of unemployment compensation benefits through the Pandemic Emergency Unemployment Compensation program to people who have exhausted regular benefits; and federally funding various other unemployment compensation benefits, as well as states’ administrative expenses. Overall, CBO estimates that the changes to unemployment insurance will increase deficits by a total of $267 billion in 2020 and 2021.
The following are foreign headlines with hyperlinks to the posts
Rare turtle lays eggs on tourist-free Thai beach
UK vaccine summit calls for freely available virus vaccine
Hydroxychloroquine: UK halts trial of coronavirus drug touted by Trump after no benefit found
Saudi Arabia reimposes curfew in Jeddah for 15 days
The following are additional national and state headlines with hyperlinks to the posts
‘A Duty to Help’: Battling COVID-19 in NYC
Here’s what Bill Gates has to say about those Covid-19 vaccine conspiracy theories he’s pegged to
Universal reopens live updates: A place where the masks come off
Coronavirus Statistics For 05 June 2020 |
| U.S. Only | Global | U.S Percentage of Total | ||||
| Today | Cumulative | Today | Cumulative | Today | Cumulative | |
| New Cases | 21,140 | 1,870,000 | 127,351 | 6,600,000 | 16.6% | 28.3% |
| Deaths | 1,036 | 108,211 | 5,188 | 391,732 | 20.0% | 27.6% |
| Mortality Rate | 4.9% | 5.8% | 4.1% | 5.9% | ||
| total COVID-19 Tests per 1,000 people | 1.3* | 59.85* | ||||
* as of 04 June 2020
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
April 2020 Headline Consumer Credit Contracts Significantly
May 2020 BLS Jobs Situation – Employment Grew 2,509,000 But Still Down 17,665,000 Year-over-Year
Rail Week Ending 30 May 2020 – Rail May Totals Down 20.2% Year-over-Year
Has Sweden’s COVID-19 Strategy Backfired?
Explaining The Better Than Average Returns
Coronavirus INTERACTIVE Charts
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Analyst Opinion of Coronavirus Data
There are several takeaways that need to be understood when viewing coronavirus statistical data:
- The global counts are suspect for a variety of reasons including political. Even the U.S. count has issues as it is possible that as much as half the population has had coronavirus and was asymptomatic. It would be a far better metric using a random sampling of the population weekly. In short, we do not understand the size of the error in the tracking numbers.
- Just because some of the methodology used in aggregating the data in the U.S. is flawed – as long as the flaw is uniformly applied – you establish a baseline. This is why it is dangerous to compare two countries as they likely use different methodologies to determine who has (and who died) from coronavirus.
- COVID-19 and the flu are different but can have similar symptoms. For sure, COVID-19 so far is much more deadly than the flu. [click here to compare symptoms]
- From an industrial engineering point of view, one can argue that it is best to flatten the curve only to the point that the health care system is barely able to cope. This solution only works if-and-only-if one can catch this coronavirus once and develops immunity. In the case of COVID-19, herd immunity may need to be in the 80% to 85% range. WHO warns that few have developed antibodies to COVID-19. At this point, herd immunity does not look like an option.
- Older population countries will have a higher death rate.
- There are at least 8 strains of the coronavirus. New York may have a deadlier strain imported from Europe, compared to less deadly viruses elsewhere in the United States.
- Each publication uses different cutoff times for its coronavirus statistics. Our data uses 11:00 am London time. Also, there is an unexplained variation in the total numbers both globally and in the U.S.
- The real question remains if the U.S. is over-reacting to this virus. The following graphic from the CDC puts the annual flu burden in perspective [click on image to enlarge].
What we do not know about the coronavirus [actually there is little scientifically proven information]. Most of our knowledge is anecdotal, from studies with limited subjects, or from studies without peer review.
- How many people have been infected?
- Can the US really scale up coronavirus testing and tracing?
- What forms of social distancing work best?
- Can children widely spread coronavirus?
- Why have some places avoided big coronavirus outbreaks?
- What effect will the weather have?
- Can we reopen parks and beaches? [we will find out soon as many beaches and parks have reopened]
- Do we develop lasting immunity to the coronavirus?
- Can the world really push out a vaccine in 12 to 18 months?
- Will we get other medical treatments for Covid-19?
- Do we need all these ventilators?
The bottom line is that COVID-19 so far has been shown to be much more deadly than the data on the flu. Using CDC data, the flu has a mortality rate between 0.06 % and 0.11 % Vs. the coronavirus which to date has a mortality rate of over 5 % – which makes it between 45 and 80 times more deadly. The reason for ranges:
Because influenza surveillance does not capture all cases of flu that occur in the U.S., CDC provides these estimated ranges to better reflect the larger burden of influenza.
There will be a commission set up after this pandemic ends to find fault [it is easy to find fault when a once-in-a-lifetime event occurs] and to produce recommendations for the next time a pandemic happens. Those that hate President Trump will conclude the virus is his fault. The most important issue will be an analysis of whether the federal government took a strong enough lead in dealing with the pandemic – and that includes every single politician!
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