Written by Steven Hansen
The U.S. new cases 7-day rolling average is 27.4 % HIGHER than the 7-day rolling average one week ago. U.S. deaths due to coronavirus are now 41.9 % HIGHER than the rolling average one week ago. U.S. hospitalizations due to COVID-19 are now 7.6 % HIGHER than the rolling average one week ago. Today’s posts include:
- U.S. Coronavirus New Cases are at a near-record 221,267
- U.S. Coronavirus deaths are at a record 3,124
- U.S. Coronavirus hospitalizations are at a record 106,688
- The 7-day rolling average rate of growth of the pandemic shows new cases was little changed, hospitalizations again improved, and deaths improved
- Which Hospitals Are Dangerously Full. Is Yours?
- Pfizer says it looked for the safest vaccine possible while researching candidates
- FDA Authorizes First Direct-to-Consumer COVID-19 Test System
- Don’t Vaccinate Healthcare Workers First
- South Korea study shows coronavirus’ spread indoors is 20 feet
- DOD Unveils Its Coronavirus Vaccine Distribution Plan
- Tensions rise over masks as virus grips smaller US cities
- A slowdown in US population growth worsened by COVID-19
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The recent worsening of the trendlines for new cases should be attributed to going back to college/university, cooler weather causing more indoor activities, possible mutation of the virus, fatigue from wearing masks / social distancing, holiday activities, political rallies / voting, and continued loosening of regulations designed to slow the coronavirus spread.
My continuing advice is to continue to wash your hands (especially after using the toilet as COVID first sheds in your stool), putting down the toilet seat (as flushing the toilet releases a plume), wear masks, avoid crowds, and maintain social distancing. No handwashing, mask, or social distancing will guarantee you do not get infected – but it sure as hell lowers the risk in all situations – and the evidence to-date shows a lower severity of COVID-19. In addition, certain activities are believed to carry higher risk – like being inside in air conditioning and removing your mask (such as restaurants, around your children/grandchildren, bars, and gyms). It is all about viral load – and outdoor activities are generally safe if you can maintain social distance.
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Hospitalizations (grey line) and Mortality (green line)
source: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
The Impact of Thanksgiving
The 4 day Thanksgiving holiday period put a wobble in the trends. Over weekends and holidays, the number of new cases and deaths decline. Over weekends, this is not a problem for week-over-week rolling averages as weekends are compared against the previous weekend. But when a holiday falls within a working week, a non-working day is compared to a working day which causes havok in the trends. However, hospitalizations historically appear to be little affected by weekends or holidays – the daily counts do not vary significantly from day-to-day [although they are now in record territory and the raw numbers grow every day].
The hospitalization growth rate so far is little changed over the past week which is not good news as it means the number of beds needed is growing around 8 % every week.
The above graph demonstrates in the last week hospitalization rate of growth has been steady. But what we do NOT know right now is the size of the impact of commingling and travel over the Thanksgiving holiday period – although it has slowed the decline in the rate of growth that we were seeing before . The CDC says it will have caused a significant growth in new cases, hospitalizations, and deaths. Historically, hospitalization growth follows new case growth by one to two weeks. That means this week we will be able to measure the impact of Thanksgiving on the spread of COVID-19.
As an analyst, I use rate of growth to determine the trend. But, the size of the pandemic is growing in terms of real numbers – and if the rate of growth does not become negative – the pandemic will overwhelm all resources.
The graph below shows the rate of growth relative to the growth a week earlier updated through today [note that negative numbers mean the rolling averages are LOWER than the rolling averages one week ago]. As one can see, the rate of growth for new cases peaked over one month ago and the rate of growth has been decelerating.
This graph is currently demonstrating that the recent actions to contain the pandemic were beginning to bite – but have now been impacted by Thanksgiving. In the scheme of things, new cases decline first, followed by hospitalizations, and then deaths.
It is up to each of our readers to protect themselves and others by washing your hands, wearing a mask, avoiding crowds, and maintaining social distancing.
Coronavirus News You May Have Missed
Tensions rise over masks as virus grips smaller US cities – AP
Arguments over mask requirements and other restrictions have turned ugly in recent days as the deadly coronavirus surge across the U.S. engulfs small and medium-size cities that once seemed safely removed from the outbreak.
In Boise, Idaho, public health officials about to vote on a four-county mask mandate abruptly ended a meeting Tuesday evening because of fears for their safety amid anti-mask protests outside the building and at some of their homes.
One health board member tearfully announced she had to rush home to be with her child because of the protesters, who were seen on video banging on buckets, blaring air horns and sirens, and blasting a sound clip of gunfire from the violence-drenched movie “Scarface” outside her front door.
Boise police said three arrest warrants were issued in connection with the demonstrations at board members’ homes.
In South Dakota, the mayor of Rapid City said City Council members were harassed and threatened over a proposed citywide mask mandate that failed this week even as intensive care units across the state filled with COVID-19 patients.
Another economic blow: A slowdown in US population growth worsened by COVID-19 – USA Today
The COVID-19 pandemic has upended the U.S. economy by forcing restaurants and stores to close and keeping Americans stuck at home. But the crisis is also taking a less visible toll on activity.
It’s further slowing the nation’s population growth.
The number of U.S. residents is likely to increase by just 700,000, or 0.2%, this year, the slowest pace since 1918, when the Spanish Flu and World War I combined to shrink America’s population, according to estimates by Moody’s Analytics.
A solidly growing population is a major economic engine, creating more consumers – whose spending makes up 70% of the economy – and a larger labor force to churn out more goods and services.
By contrast, sluggish population gains “make the economy less dynamic,” says Mark Zandi, Moody’s chief economist. “Fewer people means fewer homes (purchased), fewer cars, fewer vacations.”
FDA Authorizes First Direct-to-Consumer COVID-19 Test System – FDA
The U.S. Food and Drug Administration authorized LabCorp’s Pixel COVID-19 Test Home Collection Kit for use by any individual 18 years and older without a prescription. This product, which is authorized as the first COVID-19 direct-to-consumer (non-prescription) test system, allows an individual to self-collect a nasal swab sample at home and then send that sample for testing to LabCorp. Positive or invalid test results are then delivered to the user by phone call from a health care provider. Negative test results are delivered via email or online portal.
This home sample collection kit can be purchased online or in a store without a prescription. It is intended to enable users to access information about their COVID-19 infection status that could aid with determining if self-isolation (quarantine) is appropriate and to assist with health care decisions after discussion with a health care professional.
“This is the first kit for consumers to self-collect a nasal sample for COVID-19 in their home that does not require a prescription,” said Jeff Shuren, M.D., J.D., director of FDA’s Center for Devices and Radiological Health. “While many home collection kits can be prescribed with a simple online questionnaire, this newly authorized direct-to-consumer collection kit removes that step from the process, allowing anyone to collect their sample and send it to the lab for processing.”
Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors – Los Angeles Times
Dr. Lee Ju-hyung has largely avoided restaurants in recent months, but on the few occasions he’s dined out, he’s developed a strange, if sensible, habit: whipping out a small anemometer to check the airflow.
It’s a precaution he has been taking since a June experiment in which he and colleagues re-created the conditions at a restaurant in Jeonju, a city in southwestern South Korea, where diners contracted the coronavirus from an out-of-town visitor. Among them was a high school student who became infected after five minutes of exposure from more than 20 feet away.
The results of the study, for which Lee and other epidemiologists enlisted the help of an engineer who specializes in aerodynamics, were published last week in the Journal of Korean Medical Science. The conclusions raised concerns that the widely accepted standard of six feet of social distance may not be far enough to keep people safe.
The study – adding to a growing body of evidence on airborne transmission of the virus – highlighted how South Korea’s meticulous and often invasive contact tracing regime has enabled researchers to closely track how the virus moves through populations.
Which Hospitals Are Dangerously Full. Is Yours? – NPR
Using an analysis from the University of Minnesota’s COVID-19 Hospitalization Tracking Project, NPR has created a tool that allows you to see how your local hospital and your county overall are faring. (Jump to look-up tool.)
It focuses on one important metric – how many beds are filled with COVID-19 patients – and shows this for each hospital and on average for each county.
The ratio of COVID-19 hospitalizations to total beds gives a picture of how much strain a hospital is under. Though there’s not a clear threshold, it’s concerning when that rate rises above 10%, hospital capacity experts told NPR.
Anything above 20% represents “extreme stress” for the hospital, according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington.
If that figure gets to near 50% or above, the stress on staff is immense. “It means the hospital is overloaded. It means other services in that hospital are being delayed. The hospital becomes a nightmare,” IHME’s Ali Mokdad told NPR.
[click on image below to go to interactive map]
Don’t Vaccinate Healthcare Workers First – MedPage
The best way to reduce mortality is to staunch the flood of hospital admissions. If the hospital had fewer COVID admissions, this would accomplish two things. First, it would ease the burden on the healthcare workers. I speak from experience as an ICU doctor working this from the beginning. So much of what we do is COVID and we have had to expand services in a way that has stretched us very thin. We just want less of this. If we had less, we could manage much better. The patient is making us sick, not the other way around.
Second, if we target the high-risk group for serious COVID-19 morbidity and mortality, we will begin to also reduce morbidity and mortality overall. Every single death is the loss of an individual person. Every single death averted is a life saved.
The idea behind vaccinating healthcare workers is to avoid a crippling level of healthcare worker absenteeism. This sounds reasonable. In my experience, yes, healthcare workers have gotten sick with COVID-19, but on the whole, this group has actually done well in protecting itself and is not the population at the crest of the wave of mortality. Until we target the highest risk groups, we will continue to lose lives to COVID-19. Those of us in healthcare demand that this stops.
DOD Unveils Its Coronavirus Vaccine Distribution Plan – NPR
The Department of Defense aims to administer just under 44,000 doses of Pfizer’s coronavirus vaccine within 24 to 48 hours of authorization for emergency use. U.S. Food and Drug Administration officials have said they will make a decision soon after they hear from an advisory committee which meets Thursday.
The vaccine will be distributed through 16 DOD installations, 13 in the U.S and three overseas. The facilities selected are in California, Florida, Indiana, Maryland, New York, North Carolina, Texas, Virginia and Washington, director of the Defense Health Agency Army Lt. Gen. Ronald Place said in a news conference Wednesday.
Each location was selected to be part of the DOD’s control pilot program for vaccine distribution. The installations selected have sizable populations to receive the vaccine, ample medical staff and the cold storage capabilities required, Place explained. Health care workers and high-risk people at these locations will be inoculated first.
Assistant Secretary of Defense for Health Affairs Thomas McCaffery said some senior leaders will also receive the vaccine “as one way of helping to message the safety and efficacy, and underscore that we are encouraging all those eligible personnel to take the vaccine.”
The emergency use authorization would prohibit the vaccine from being administered to anyone who doesn’t want to take it. But DOD officials are optimistic that their 11 million personnel will have faith in the FDA.
COVID-linked Illness MIS-C Kills First Child in L.A., More Cases Likely – Newsweek
A child in Los Angeles County died this week from a COVID-related syndrome called MIS-C, health officials in California have confirmed.
The patient died from complications relating to multisystem inflammatory syndrome in children (MIS-C) while being treated at Children’s Hospital Los Angeles. They suffered from a “complex, preexisting cardiac condition,” a hospital spokesperson said.
The case is believed to mark the first COVID-related death of a child in the county, the Los Angeles Times reported. The hospital public relations team said no further details could be made public at this time due to rules surrounding patient privacy.
Scientists do not know what causes MIS-C but it seems children with the syndrome had the virus that causes COVID, or were in contact with someone with the disease.
Pfizer says it looked for safest vaccine possible while researching candidates – CNN
Pfizer was looking for the safest vaccine it could when sorting through various candidates for a coronavirus vaccine, the senior vice president and head of vaccine research and development at Pfizer said Thursday.
“Given the enormity of our mission, clinical data were important to us in deciding on the right candidate for a Covid-19 vaccine,” Pfizer’s Kathrin Jansen told the FDA’s Vaccines and Related Biological Products Advisory Committee.
“We evaluated not just one, but four different candidates in Phase 1 to be able to make real time scientific decisions to select the best candidate,” Jansen added.
“With regard to safety, we were looking for the most favorable safety and tolerability profile in both younger and older adults. With regard to immunogenicity, we were looking for the broadest antiviral immune responses, most likely associated with efficacy. And with regard to a rapid pandemic response we were looking for the candidate that could be developed and produced most efficiently,” she said.
Jansen said when it comes to mRNA vaccines, “we have a deep scientific understanding of how such vaccines work.”
She said that mRNA vaccines “can be developed and scaled up quickly,” offering “a clear advantage,” over other types of vaccines.
The following are foreign headlines with hyperlinks to the posts
Proprietary information on the Pfizer/BioNTech vaccine may have been stolen during a cyberattack on an European Medicines Agency database.
U.S. Ranks Behind EU, Australia, U.K. in Vaccine Buys But Says It Will Meet Goal
Canada is the latest country to authorize the Pfizer/BioNTech vaccine. But the country is now coming under fire for overbuying COVID vaccines, leaving poorer countries out in the cold.
Saudi Arabia approves Pfizer coronavirus vaccine
Chinese Flight Attendants Advised to Wear Diapers to Lower COVID Risk
ICUs in Stockholm reach 99 percent capacity: report
France will delay easing some virus restrictions.
The European Central Bank expanded its massive monetary stimulus program by another 500 billion euros ($605 billion), taking its total value to 1.85 trillion euros and extending the time horizon for asset purchases until March 2022.
North Korea tells WHO it has tested more than 9,000 people and found no virus cases
UK travelers could be banned from EU after January 1 under Covid rules
India seeks more data for emergency AstraZeneca shot approval
Mexico to buy 35 million doses of China’s CanSino COVID-19 vaccine
South Korea builds ‘container wards’, speeds up testing in fight against third wave of Covid-19
The following additional national and state headlines with hyperlinks to the posts
US Military Starts Vaccinating Troops, Behind Russia and China
Pfizer’s COVID-19 vaccine, which was co-developed with Germany’s BioNTech, faces one final and critical hurdle before an expected decision to greenlight the shot for use in millions of Americans. Food and Drug Administration advisers meet today to scrutinize the company’s data for any red flags or oversights.
U.S. Vaccine Poll: A new survey from The AP-NORC Center for Public Affairs Research has found only about half of Americans are ready to roll up their sleeves for COVID-19 vaccines even as states frantically prepare to begin months of vaccinations that could end the pandemic.
Not all health care workers want to be first in line to receive the vaccine. Only one-third of a panel of 13,000 nurses said they would voluntarily take a vaccine, another third said they wouldn’t and the rest said they were unsure, according to a late October survey by the American Nurses Association.
The number of people applying for unemployment aid jumped last week to 853,000, the most since September, evidence that companies are cutting more jobs as new virus cases spiral higher.
The U.S. reported 3,124 COVID-19 deaths Wednesday, a single-day toll worse than 9/11. Over the past seven days, the U.S. has reported 15,927 deaths – equivalent to 95 per hour, or one death every 38 seconds – breaking a record set in April. At the current pace, the U.S. death toll from the entire pandemic could reach 300,000 in just a few days.
Ellen DeGeneres tests positive for COVID-19
NFL updates: Bears close facility after positive test
The Gates Foundation adds $250M gift to fight COVID-19 worldwide
GAO report finds the government is falling short of PPE stockpile goals and still lacks a centralized database of PPE for health workers.
Nearly 35,000 Americans Died While FDA Ponders Vax Data
Giuliani Leaves Hospital After COVID-19 Treatment
New Baltimore mayor closing restaurants for indoor and outdoor dining
Patients With Lung and Blood Cancers Most Vulnerable to COVID-19
Gavin Newsom’s Companies Received Nearly $3 Million in COVID Relief Loans
White House Will Be Thoroughly Disinfected in the Hours After Trump’s Exit
Airlines are preparing to distribute vaccines, and make up for lost business.
Renters are returning to Manhattan after an early-pandemic mass exodus, driving new leases up 30% year over year in November
Walmart prepares to administer Covid vaccines at stores across the U.S.
Rising unemployment claims could be foreboding for the economy
Moderna Begins Trials of Coronavirus Vaccine in Adolescents
Health officials project San Francisco will run out of ICU beds in 17 days
A Reno hospital turned their parking garage into a new wing to treat coronavirus patients
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
Warning to Readers
The amount of politically biased articles on the internet continues to increase. And studies and opinions of the experts continue to contradict other studies and expert opinions. Honestly, it is difficult to believe anything anymore. A study usually cannot establish cause and effect – but only correlation. Be very careful what you believe about this pandemic.
I assemble this coronavirus update daily – sifting through the posts on the internet. I try to avoid politically slanted posts (mostly from CNN, New York Times, and the Washington Post) and can usually find unslanted posts on that subject from other sources on the internet. I wait to publish posts on subjects that I cannot validate across several sources. But after all this extra work, I do not know if I have conveyed the REAL facts. It is my job to provide information so that you have the facts necessary – and then it is up to readers to draw conclusions.
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 although there is now a discussion of whether T-Cells play a part in immunity [which means one might have immunity without antibodies]
- 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.
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 as many do not show symptoms?
- Masks do work.
- Do we develop lasting immunity to the coronavirus? Another coronavirus – the simple cold – does not develop long term immunity.
- To what degree do people who never develop symptoms contribute to transmission? Research early in the pandemic suggested that the rate of asymptomatic infections could be as high as 81%. But a meta-analysis, which included 13 studies involving 21,708 people, calculated the rate of asymptomatic presentation to be 17%.
- The accuracy of rapid testing is questioned – and the more accurate test results are not being given in a timely manner.
- Can children widely spread coronavirus? [current thinking is that they are a minor source of the pandemic spread]
- Why have some places avoided big coronavirus outbreaks – and others hit hard?
- Air conditioning contributes to the pandemic spread.
- Outdoor activities seem to be a lower risk than indoor activities.
- It seems a vaccine will be available before the end of the year – the question is how effective it will be in the general population AND how long immunity will last.
- Will other medical treatments for Covid-19 ease symptoms and reduce deaths? So far only two drugs (remdesivir and Regeneron) are approved for treatment.
- A current scientific understanding of the way the coronavirus works can be found [here].
Heavy breakouts of coronavirus have hit farm workers. Farmworkers are essential to the food supply. They cannot shelter at home. Consider:
- they have high rates of respiratory disease [occupational hazard]
- they travel on crowded buses chartered by their employers
- few have health insurance
- they cannot social distance and live two to four to a room – and they eat together
- some reports say half are undocumented
- they are low paid and cannot afford not to work – so they will go to work sick
- they do not have access to sanitation when working
- a coronavirus outbreak among farmworkers can potentially shutter entire farm
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 4 % [the 4% is the average of overall statistics – however in the last few months it has been hovering around 1.0%] – which makes it between 10 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.
Resources:
- Get the latest public health information from CDC: https://www.coronavirus.gov .
- Get the latest research from NIH: https://www.nih.gov/coronavirus.
- Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/.
- List of studies: https://icite.od.nih.gov/covid19/search/#search:searchId=5ee124ed70bb967c49672dad
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