COVID DIARIES, 23 AUGUST 2020

Fading Away, Yet Still Very Much Here

The June coronavirus surge is in decline, and yet the disease is still very much with us.

For the week ending this past Friday, 313,455 more Americans tested positive. That’s a 14% drop from previous week. Testing over the past two weeks also declined 6%.

Key coronavirus metrics all declined this week nationwide, coming off the very high levels of the surge in June and July.

Better yet, positivity is down among the test samples we do have. For the previous week (ending Aug. 15, the most recent data available), the CDC reports positivity dropped from 7.1% to 6.6% in public health labs. In clinical labs, positivity fell from 5.9% to 5.7%. And commercial labs saw positivity drop from 7.0% to 6.3%.

Cumulatively, the US now has had nearly 5.7 million cases since January, by far the highest in the world. The next most infectious country, Brazil, has had about 3.6 million cases.

As of last Friday, 40,951 Americans were hospitalized with confirmed virus cases, and there were 8,349 confirmed COVID-19 patients in the ICU. These are respectively 11% and 10% decreases over week-ago totals.

Also in the week ending Friday, 7,117 more Americans died of confirmed COVID-19 cases. That’s a 3% drop from the previous week.

US coronavirus deaths have averaged more than 1,000 per day since July 14, and remained there this week. For reference, that’s roughly two 9/11-scale events every week for each of the past six weeks.

Cumulatively, more than 175,000 Americans have died so far as a direct result of the virus. That number is underreported, and does not include “excess deaths” that are indirectly attributable to COVID-19. Total deaths are likely 10%-40% higher than the directly attributed number.

With all the major metrics down, it’s clear the surge that began in June continues to taper off. What’s less clear is that the virus is still largely out of control in many hotspots around the country. Nationwide, the virus is still spreading; not as fast, perhaps, but it’s still spreading.

Infection rates remain high in many parts of the nation, even in places with declining new-case rates. Kansas this week claimed the “honor” of being the most infectious state per capita.

The rate of new cases increased in 12 US states and territories, mostly in the Upper Midwest; remained about the same in 19 more; and decreased in 23 more. While new cases have dropped significantly since late July, case numbers are remain persistently high across most of the country, even in areas with declining case rates.

We also got several high-profile reminders this week that reopening too soon is a bad idea. UNC and Notre Dame moved all undergraduate classes online after dozens of students tested positive.

At least two dozen positive cases so far resulted from close contact at the annual motorcycle rally in Sturgis, SD. And baseball, which unlike other sports did not opt for a “bubble” approach, has had 37 games postponed in its season’s first month due to positive cases.

The virus is still expanding in California, but at a significantly slower rate than before. Hospitalizations and deaths are also down, though the death rate in Ventura County is holding steady at about 1.4 per day.

In California, the rate of new cases over the past week has consistently fallen below the recent trendline. For the week ending this past Friday, there were 49,261 new confirmed cases in the Golden State. That’s nominally a 21% drop compared with the week-ago total while testing expanded by 3%.

However, the 21% drop is not a meaningful comparison. Last week the state reported out much of the case backlog stemming from system failures in July. As a result, cases nominally grew 40% last week — but that number likely includes older cases. Ventura County now says the state has cleared out the backlog, so future comparisons should be valid.

Computational biologist Mike Bass ran a 30-day regression of state new-case data. Recent reports show cases are growing at a rate slower than the trendline would have predicted.

Even with the public-health reporting hiccups, daily new-case reports in Ventura County and statewide are on the decline. Computational biologist Mike Bass reports the numbers daily in his Twitter feed. Mike’s reports from the past few days show state reports below the 30-day trendline.

However, Mike’s statistical model also shows the virus is still growing, just slower than before. Each day, Mike predicts the next day’s value using a regression based on recent results. If the actual value is higher than the prediction, the virus is winning. If not, we’re beating the virus.

Unfortunately, the virus has won for the past several days. While the rate of increase is declining in Ventura County, we’re not yet at the point where we’ve got the virus under control. We’re getting closer, though.

Computational biologist Mike Bass used a 14-day rolling average to compute doubling times. In Ventura County, cases now double every 65.0 days; statewide, it’s every 53.2 days. Both numbers are rising, which is a good sign.

Mike also reports case doubling times are rising, and that’s a good thing. Using a 14-day rolling average, doubling times are now 65.0 days in Ventura County and 53.2 days statewide.

Also as of this past Friday, California had 6,039 hospitalizations and 1,706 ICU patients with confirmed COVID-19 cases. Those are respectively 5% and 8% declines from week-ago levels. Locally, Mike reports Ventura County hospitalization and ICU numbers are holding steady.

California reported 825 COVID-19 deaths this week, a 16% drop over the previous week. Averaged over 14 days, death rates have held steady at around 1.4 deaths/day in Ventura County and 132 deaths/day statewide.

While a declining death rate is welcome news, 1.4 deaths/day locally is still very high. Ventura County already has had 102 COVID-19 deaths so far this year. For reference, the sheriff reported five homicides countywide in 2019.

Closing out with a bit of good news: An intriguing study found that three people with neutralizing antibodies didn’t get infected on a fishing ship when almost everyone else did. That suggests some level of infection can lead to some protection.

The study hasn’t yet been peer-reviewed, and there are still many questions yet unanswered: How long does immunity last? How complete is it? What percentage of infected people are protected? But, with a vaccine still months (or longer) in the future, it’s a start.

While the findings are definitely not an argument for a herd-immunity approach (which requires far higher exposure), they do suggest we can take a more nuanced view of immunity rather than viewing it as an on/off switch. If the findings hold up it could mean more people with protective antibodies will slow the spread of the virus.

Until a proven vaccine is in widespread use, this may be the best outcome we can hope for.

UPDATE 1: I neglect to mention that a study released this week found virus transmission via aerosolized fomites is possible. This makes getting outdoors and ensuring adequate ventilation indoors all the more important.

UPDATE 2: I also neglected to mention that this week Dr. Anthony Fauci underwent surgery for vocal cord surgery, and that physician and US Sen. Bill Cassidy (R-LA) tested positive for the virus. I wish them both full and speedy recoveries.

Photographer, editor, recovering engineer.