COVID-19 DIARIES, WEEK OF 9 OCTOBER 2020

Shelter From the Storm

California enjoys coronavirus calm as cases spike nationwide

In 1348, as a plague killed thousands in Florence, a lucky few escaped to the Tuscan hills, enjoying themselves with the stories memorialized in Boccacio’s The Decameron.

That’s been the situation this past week here in California: We live in comparative calm, while new cases and hospitalizations rose rapidly around the rest of the country.

Locally, computational biologist Mike Bass’ analysis of state data shows the number of new cases per day is far lower now than it was two months ago. New cases dropped low enough for the county to move out of the state’s most infectious tier.

According to this analysis of state data from computational biologist Mike Bass, there are far fewer cases per day now than during the summer surge, both in Ventura County and statewide. However, the decline in new cases has stagnated over the past few days. Essentially, Mike writes, we’re at a point where the virus and the humans are tied.

In Ventura County, if case levels remain low for another two weeks, public schools can reopen. That’s not only a relief for parents but also a very good thing for kids. Fears that schools would be superspreader locations now appear to be overstated, provided schools implement adequate safety protocols. More local businesses also reopened, but with relatively low occupancy requirements still in place.

Mike’s analysis also shows numbers of hospital and ICU patients are flat in Ventura County and down statewide. Death rates also are down.

Despite the recent stagnation of new case growth in the past few days, California remains in much better shape than much of the rest of the US. New cases/day fell 8% compared with last week. Hospitalizations grew slightly, although the numbers of ICU patients and deaths both fell.

For all the good local news, however, there is a sign of concern: In the past three or four days, cases rose in Ventura County and statewide. The county increase isn’t statistically significant so far, but the state increase is.

Even prior to the recent uptick, we’d reached a kind of plateau. Mike likes to compare each day’s new case number to a 14-day rolling average, and declare that either the humans or the virus has won that day. For the past few days, it’s essentially been a tie — and case numbers are on the upswing again.

Nationally, the picture is far more dire. Cases rose 11% this week, with testing up just 1%. Hospitalizations and ICU patients rose 13% and 10% respectively. Deaths fell 1%, but that’s a trailing indicator and may well rise again given the spike in new cases.

Nationally, cases rose sharply in the past week, up 11% over the previous week. Testing rose too, but only by 1%, not enough to explain the spike in new cases. There’s more virus around.

New cases per day have risen steadily over the past month. The 7-day average trend line smooths out the increase somewhat, but the 57,000 new cases per day reported Friday are the highest in two months.

There were 57,500 new cases reported Friday, a level of infection we haven’t seen since the peak of the summer surge in early August.

Further, although states in the Upper Midwest remained the most infectious, there’s evidence new cases are growing in many areas throughout the county. New York and New Jersey, which struggled with heavy caseloads early on, again are at risk after months of relative calm.

This chart (from the NY Times, via former CDC director Tom Frieden, MD) shows cases are steady or increasing in most of the country. Dr. Frieden anticipates 230,000 COVID-19 deaths by Nov. 3.

The virus continues to be widely distributed, with Midwestern and Southern states experiencing the most infection per capita. South Dakota was this week’s the most infectious state, but new cases per million rose in many other states as well. (Arkansas and New Hampshire did not file reports on Friday; their numbers are not 0.)

Hospitalizations also rose 11% nationwide compared with the previous week. There is every indication that we are at the beginning of a third cycle of cases, following those that occurred early in the year and again this summer.

Looking at case growth over time, this chart (from the Financial Times, via Eric Topol, MD, of the Scripps Institute) shows we’re beginning a third cycle of new cases just as cold weather and flu season begins.

Nationally, deaths declined by 1%. While this is encouraging news, it’s important to remember that deaths are a trailing indicator. What we’re seeing now may be the last throes of the summer surge, it’s not necessarily a sign that the virus is becoming less lethal.

It remains to be seen whether new therapeutics (including the experimental ones the president received) will lessen the effects of the current wave of infections.

Not surprisingly, the widespread resurgence of coronavirus cases has public-health experts worried, especially as it comes with the onset of cooler weather and flu season.

“We’re looking at a pretty tough fall and winter. We’ve got to get ready and do everything we can to protect people and get through this time period,” says Ashish Jha, MD, dean of public health at Brown University.

That doesn’t mean more lockdowns, Jha says, who views closures as a last resort. We have much better tools, he says, such as mask wearing and avoidance of indoors gatherings.

We know how to defeat the virus. We just need to employ these means, and hopefully create more safe shelters from the storm, just as we’ve done in Ventura County.

Here are this week’s coronavirus stats, all sourced from covidtracking.com.

US stats for the week ending Friday, October 9 (with % change from previous week):

Total tests (positive, negative, pending): 6,715,239 (+1%)
New cases: 329,619 (+11%)
Cumulative US cases: 7,623,648
Confirmed COVID-19 hospitalizations: 34,839 (+13%)
Confirmed COVID-19 ICU: 6,713 (+10%)
Deaths: 4,859 (-1%)
Cumulative US deaths: 205,470

CA stats for the week ending Friday, October 9 (with % change from previous week):

Total tests (positive, negative, pending): 868,066 (+6%)
New cases: 21,329 (-8%)
Cumulative CA cases: 838,606
Confirmed COVID-19 hospitalizations: 3,186 (+1%)
Confirmed COVID-19 ICU: 742 (-7%)
Deaths: 442 (-25%)
Cumulative CA deaths: 16,428