Quantitative analyses on the global coronavirus pandemic

Month: October 2020

The Beginnings of a Third Wave

Last month we were concerned that the leveling off of new daily cases in Florida and the USA was only temporary.  Over the last four weeks of steadily increasing daily case counts (see red squares in the figure below), we are increasingly concerned that we are seeing the beginnings of the third wave as temperatures cool and indoor activities resume in northern USA (Wisconsin is especially bad now).  We are also concerned that the pressures to reopen schools for in-person learning, reopen the economy before Election Day, and the increasing numbers of maskless, crowded rallies are exacerbating the normal seasonal rise in cases. 

Some of the increasing cases could be due to improved testing.  After stalling for 2 months testing has improved as schools and businesses reopen and want to keep ahead of increased infections by increasing testing.  This has again picked up an increasing number of asymptomatic and mildly symptomatic cases.  If this were the only reason for the recent increase in cases hospitalizations and death counts would not increase. 

In fact, after bottoming in mid-September, the number of currently hospitalized with COVID-19 in the USA has been rising for the last two weeks (see blue diamonds in the figure below).  As we had pointed out before this is a leading indicator of a future rise in death counts. 

Death counts are currently stuck near 750 per day (blue diamonds in the first figure above) but will rise again right near Election Day – lagging rising cases by 2 to 4 weeks.  This is not a good harbinger for President Trump’s re-election chances.  We had suggested that he ease off on maskless, crowded rallies in September to improve his chances of reducing the death count by November but he had chosen to forge ahead with large risky superspeader events such as the Rose Garden announcement for Amy Barrett in defiance of scientific advice.  Impatience bought him a second wave in June; impatience will have now bought him a third wave. 

President Trump’s COVID-19

President Trump announced that he tested positive for COVDI-19 on October 1st.  Since then at least seven other attendees of a Rose Garden ceremony for Amy Barrett on September 26th have tested positive for the virus.  We wish them all speedy and full recoveries.  However, the prognosis for each of them varies widely depending on their age, gender, and general health. 

The exponential age and gender behavior of COVID-19 patients has remained roughly the same since we first published our version of the graphic below 6 months ago.  Improved testing and identification of asymptomatic and mildly symptomatic cases mostly among younger adults have improved the overall case fatality rate (CFR = deaths/cases), but have not changed the strong exponential age dependence.  Better healthcare treatments in terms of logistics (avoiding bed, equipment, and supply shortages that plagued Italy early on) and the introduction of newer therapeutics such as Remdesivirsteroids, and clonal antibodies have prolonged patient lives and improved survival rates modestly. 

For example, a 50-yrs old female with average health, like the First Lady, would have a CFR of 0.7%.  On the other hand a 74-yrs old male with average health would have a CFR of 13%.  The President, being somewhat overweight with moderately high cholesterol and blood pressure issues would have a worse CFR – perhaps 30 times worse than for his wife.  For a 31-yrs old female of average health like Hope Hicks, her CFR is less than 0.1% similar to that for seasonal flu.  So the range of possible outcomes is extremely wide. 

Hospitalization is a leading indicator of the severity of the disease.  In Florida about a third of all hospitalized COVID-19 patients eventually die.  The risk of hospitalization for the very obese nearly triples that for a person with normal weight.  Currently the President and Chris Christy (with asthma and obesity) are both hospitalized.  

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