Wednesday, November 25, 2020

Are COVID-19 Infections Peaking? Report for the Week Ending November 21st.

Martin Hill Ortiz 7:53 AM 1 comment

Last week, all but one state had a week-to-week increase in COVID-19 cases. This week six states showed decreases, including those with the most cases: North and South Dakota (1st and 2nd in most new cases per population last week), Iowa (3rd), Wisconsin (5th), and Alaska (14th).

While having only six states with declining counts does not signal an overall fall, there were many states with modest increases and graphs that showed signs of peaking.

The following states, all with increases over the past week, had eerily similar graphs. (Graphs from the state reports at The COVID Tracking Project.)

Colorado

Idaho

Indiana

Massachusetts

Michigan

Minnesota

Missouri

Montana

Nebraska

Tennessee

I'm not saying that the recent downturns for these ten states are dramatic. I'm pointing out the weeks of growth have stopped and there seems to be a peak.

So then, why aren't the overall cases going down? High population states such as California (with a 51% growth, last week to this week), Florida (27% growth), and Pennsylvania (30%) more than make up for the decreases and stabilizations in lower population states.

The Week Ending November 21

North Dakota continues to lead the nation with the highest rate of new infections per million population for the week ending November 21st. Their new cases dipped and they broke their string of 21 straight weeks with increasing numbers. South Dakota had been in second place for 10 straight weeks behind North Dakota. This week it fell to third, with Wyoming taking second place. New Mexico experienced the most dramatic increase, their case rate growing by 71.3%.

As I mentioned last week, I began this week-by-week survey of data on June 20th. Comparing the new case rates per population for the week ending June 20 to the one ending November 21st we see the following.

Number of states with new case rates per million population that fall within the categories. Cumulatively, June 20th had 3 states with rates over 1000 per million. November 21st showed 50.

New Cases Per Million Population for the Week Ending November 21

Do I Have COVID-19?

The test results came back negative. I probably had a cold and did not have a mild case of COVID-19.

Martin Hill Ortiz is a Professor of Pharmacology at Ponce Health Sciences University and has researched HIV for over thirty years.

https://mdhillortiz.com/

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Thursday, November 19, 2020

The Coronavirus Pandemic Continues to Spread

Martin Hill Ortiz 12:23 PM No comments

I have been writing weekly reports for 22 weeks, since June 20th. Back then the nation experienced a lull in cases. Three states had weekly new case rates of over 1000 per million population with Arizona recently assuming first place with 2107. For the week ending November 14, 37 states have higher rates than Arizona's number. Arizona itself, after demonstrating a marked decrease with their case rate going down to 359 in September, is up to 2222.

North and South Dakota continue to lead the nation in reported new cases with 12454 (six times that of Arizona on June 20th) and 11279, respectively, per million population. Iowa is not far behind with 10142.

In reality, these numbers do not reflect the new cases in those states. For this past week, the positivity rates, that is, the percentage of the tests that are positive, were 67% for North Dakota and 57% for South Dakota. North Dakota was 33rd in the rate of testing per million and South Dakota 30th. With this high of a positivity rate, these states should be doubling their tests or more.

If North Dakota doubled their testing and the positivity rate for those new tests dropped to 40%, they would be showing 19885 new cases per million this past week. (I suspect that this number is an underestimate.)

A total of 25 states had an increase of at least 40% in their case numbers this past week.

Vermont tripled their cases and lost their status as having the lowest case rate, an honor which they've held since the week ending July 4th. Hawaii is now in first place with Vermont second. Hawaii was the only state to have fewer cases this past week over the previous one, although Virginia came close, increasing from 9783 to 9785 cases.

The daily number of new cases is more than double its pre-October peak. This situation could get worse. Currently, the most populous states are among those with the lowest rates of new cases. The four most populous states and their ranks for new cases per million: California (45th), Texas (36th), Florida (40th), and New York (42nd). Florida keeps their case numbers down in part by ranking the worst in tests per population (that is, this past week 51st place with the District of Columbia included in the count).

When Did this Recent Wave Start?

The week ending October 3rd had a decrease in cases from the previous week. Since then the cases nationwide have had a steepening increase each week.

Percent increase in cases over the previous week

Rate of New Cases Per Million Population

Do I Have COVID-19?

My family has had a run of cold-like symptoms, which could also be a mild COVID-19 infection. We are quarantining. I am scheduled to have a COVID-19 molecular test tomorrow, results pending several days. It could well be that we had the common cold.

Martin Hill Ortiz is a Professor of Pharmacology at Ponce Health Sciences University and has researched HIV for over thirty years.

https://mdhillortiz.com/

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Sunday, November 15, 2020

The Coronavirus Death March: State Hospitalization Data

Martin Hill Ortiz 1:16 PM No comments

The current wave of COVID-19 cases in the United States greatly exceeds that of the summer peak. Arizona foretold the July wave. Its rate of new cases grew to be 3486 per week per million population, exceeding that of New York state in the early days of the pandemic.

The numbers from the first week in November had 17 states surpassing Arizona at its height. The second week statistics will be much worse. (The reports from some states on the past week's statistics are not available until Monday evening.)

Perhaps the best statistic that illuminates the toll of coronavirus infections is that of hospitalizations for the disease. In several states the number of cases cannot be accurately counted: positivity rates are too high. Even then, case numbers don't reflect the face that a portion of the cases are mild: approximately 20% are asymptomatic. On the other extreme, deaths have occurred in 2.2% of those with a diagnosis of COVID. (Worldometer COVID counts, United States, total deaths divided by total diagnoses.)

As for having a case serious enough for hospitalization, this statistic takes into account the acute morbidity of the disease short of mortality. This statistic connects to the challenges that can overwhelm the hospital system. Coronavirus does not need to kill to produce tragedy. The patient without insurance pays an average of over $73,000 for hospitalization due to COVID-19. Hospitals will lose 323 billion this year due to the pandemic (same source).

The COVID Tracking Project includes graphs for the current COVID-19 hospitalizations for each state. These data are imperfect. One of the great tragedies of the United States response to COVID is that there is still no uniform reporting method.

Below, thanks to the COVID Tracking Project, are graphs depicting COVID-19 hospitalizations over time. I have set them in the order of those with the highest rate of cases as of last week. The graphs come from snapshots gathered November 15, 2020, morning and early afternoon.

The solid line is the seven-day running average. The individual bars are the daily counts. With the exception of two or three states where the numbers are near flat or merely hint at rising, there is no good news. Some of the states which have the currently the lowest infection rates are showing dramatic increases.