Saturday, August 8, 2020

THE DAILY PANDEMIC DIARY FOR AUGUST 2020

by Brian T. Lynch, MSW

(If you are returning to this site just skip down to today's data table and comments below)

Welcome to the Daily Pandemic Diary for August. This report is divided into four parts, the U.S. daily global share of new cases in the prior 25 hour period, the U.S. daily global share of COVID-19 related deaths in the same 24 hour period, a daily commentary on the trends and related issues, and a graphic of the table from which the raw data is reported.  The raw data all comes from the international Worldometer.info website. The main purpose here is to provide a daily snapshot of how the U.S. is doing relative to the world as a whole. For example, if we have 4.3% of the world's population but 20% of the new cases, that isn't very good. If 18 other countries are testing more of their people per million population than are we, that is an indication that we must do better, etc. The twenty-four-hour lookback is based on Grenich Mean-time. The Total Tests/U.S. Population is the ratio of all COVID-19 tests given relative to the population of only one test was given per person.

This blog continues the daily collection of data begun in the blog mentions below. Daily additions to that blog became cumbersome, therefore future daily diaries with be added to a blog for each month.
U.S. National Health Emergency
Day 170 - August 31, 2020











Comments: Today is day 170 of the National Health Emergency and the last day of the Daily Pandemic Diary for August. So where do things stand? 

Below is a table showing the change in total cases and total deaths from COVID-19 from July 31st to August 31, 2020. The bottom line is that the total number of cases and deaths grew substantially in August the United States and around the world, but the growth rate in the U.S. was not as steep as the global numbers. The number of new infections in August rose about 45% globally and about 33% in the U.S.  The global COVID-19 deaths rose about 26% in August while the deaths in the U.S. rose about 21%. At the same time, the daily U.S. COVID-19 testing average declined slightly from July to August leaving us 18th in the world for the most tests per million people. This is obviously the wrong direction for COVID-19 testing. The daily average number of U.S.deaths from all causes prior to the pandemic was 7,158 per day while the COVID-19 daily average of additional deaths in August was 1,030 per day. That is a 14.4% increase in daily excess deaths due to the virus.







U.S. National Health Emergency
Day 169 - August 30, 2020

Comments: No comments today





U.S. National Health Emergency
Day 168 - August 29, 2020

Comments: The U.S. was second-highest yesterday in the number of new cases and COVID-19 death in the world. California had the highest number of new infections (5,406), followed by Texas, Florida, and Iowa. Texas had the most COVID-19 deaths (168). As we approach September, a look at our overall status so far finds that our case numbers are still way above the levels we were at in the early months of the pandemic (see chart). There are early signs that our downward trend in case numbers is slowing. The data patterns for the United States look nothing like the patterns we see in nations that successfully locked down early and reopened cautiously. A statewide lockdown in California may become necessary and local lockdowns in other states may be needed to bend down the curve and finally get this virus under control. But there are political forces already at work trying to convince us that lockdowns don't work. I've written more extensively on this disinformation campaign to keep the economy open in a separate blog post which I encourage you to read here.






U.S. National Health Emergency
Day 167 - August 28, 2020

No Entry

U.S. National Health Emergency
Day 166 - August 27, 2020


Comment: You will notice today that the 1.7 million daily tests reported yesterday are back down to 8.3k today confirming that yesterday's number contained a correction. The U.S. is second in the number of new infections, globally, and we had the most deaths recorded yesterday of any country. 

My comments are limited today as I am working on a longer article detailing how the American Institute of Economic Research is promoting a batch of misleading and unscientific articles for Republican politicians to reference while trying to convince us that economic lockdowns have no effect in reducing transmission of the Coronavirus. This is clearly not true, but the details are important if we are to innoculate ourselves against these false claims and biased opinions. More tomorrow... 





U.S. National Health Emergency
Day 165 - August 26, 2020


 Comments: The U.S. had the third-highest number of new cases in the world and the most deaths in the past 24 hour period. One in 5 COVID deaths in the world were in the U.S.  There was a jump in daily testing of over a million. This is likely an adjustment figure, we shall see. We are 165 days into the health emergency yet all the tests ever given so far would not be enough to test a quarter of the U.S. population. Looking at the states, Texas, California, Florida, Georgia, Illinois, and Tennessee had the largest number of new infections. Current projections show that if Texas maintains current restrictions by adds a mandate to wear masks, they could flatten the rising curve, but that still would not lower the daily spread of infections. The same goes for Florida, Georgia, and Tennessee. California, on the other hand, will not be able to flatten the curve without both a universal mask mandate and new restrictions.





U.S. National Health Emergency
Day 164 - August 25, 2020


Comments: The number of new cases and new deaths in the US is continuing to be lower than last week, which is good. The amount of testing continues to trend downward, which isn't so good. Georgia has, for the first time, edged out Florida for third place in the high number of new cases it had yesterday.  

I added the national COVID-19 test positivity rate today. As a W.H.O. guideline, any locality or country with a positivity rate of over 5% should be implementing restrictions to prevent the spread of the virus. The U.S. is above that, and some states are considerably above 5%. But the rate of positive tests per 100k population is influenced by many factors. It is a spongy metric at best. Johns Hopkins published an article this month to try and explain how to interpret COVID positivity rates. Here is one confusing quote from that article:
"The percent positive will be high if the number of positive tests is too high, or if the number of total tests is too low."
I believe this is an acknowledgment of two factors influencing positivity, the number of total tests per 100k, and the rate of daily new cases. I came up with a graphic that I think captures the positivity relationship between new cases and the total number of tests given per Johns Hopkins, but I suspect it only holds true to the extent that testing is random.

What happens to positivity rates when tests are mostly given to people are sick and go to the hospital or to people who have already been exposed to a known carrier of the virus. Or, what happens if a state or municipality decided that giving fewer tests should reduce the number of people who test positive and manipulate total test numbers for political purposes. We have a President who has advocated for that openly on many occasions. Here is a small table to help show how a testing triage plan might influence positivity rates. And non-random testing patterns are not the only factors that can influence positivity rates.

The point here is that positivity rates are complex and require consideration of other factors in order to understand what the percentages really mean. I included it here today, for now.










U.S. National Health Emergency
Day 163 - August 24, 2020



Comments: It appears that California, Texas, and Florida are turning the corner on their COVID-19 outbreak, but it is too soon to say for sure. There is always a reporting gap around the weekend, but the numbers look better. For the first time in a very long time the U.S. has dropped below 25% of the global Coronavirus cases. As mentioned yesterday, this may be due in part to the fact that the infection rates are advancing in the world in general. The U.S. drop in COVID-19 deaths to 430 yesterday is substantial and probably due to a reporting gap. We shall see.

In other news: " Cases are circulating widely in parts of the U.S. The FDA announced emergency use for convalescent plasma. And when will we have a spit-on-a-stick COVID-19 test?








U.S. National Health Emergency
Day 162 - August 23, 2020


Comments: As we compare the USA progress in managing the virus relative to other countries, it is important to keep in mind that every country is instituting some variation of the same precautionary measures recommended here by the CDC. Instead of seeing the fantastic success these measures have had in saving lives, there are those who see the lower numbers instead as evidence this virus is no worse than a bad flu season. They fail to see that a million lives have probably been saved by now thanks to the difficult sacrifices people around the world have made, sacrifices that have never been used during the flu season. Still, some global perspective on how the whole world is doing is instructive.

"Coronavirus is continuing its spread across the world, with more than 23 million confirmed cases in 188 countries. About 800,000 people have lost their lives.  Cases of the disease are continuing to surge in many countries, while others that had apparent success in suppressing initial outbreaks are now seeing infections rise again.," according to a BBC article today.

CNN - Aug 22, 2020: "Just weeks after many European countries opened their borders to travelers within the continent, some are closing again, seemingly undermining efforts to salvage the continent's vital summer tourism economy.

So, things are difficult within and outside of the United States. Still, most nations are doing far better than are we.






U.S. National Health Emergency
Day 161 - August 22, 2020









Comments: Things have yet to turn around. It can all be challenging and depressing at times. So, today I wanted to offer up the numbers with uplifting words of hope written in another time when the world was darkness and great upheaval. 


Desiderata

GO PLACIDLY amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story.
Avoid loud and aggressive persons; they are vexatious to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism.
Be yourself. Especially do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment, it is as perennial as the grass.
Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.
By Max Ehrmann © 1927
Original text





U.S. National Health Emergency
Day 160 - August 21, 2020














Comments: To put this country's pandemic performance into an international perspective, consider how the ranking of nations would change if California, Texas, and Florida were their own countries. As of yesterday, subtracting the total new cases from these three states would only drop the U.S. from second-most new infections to third place. At the same time, California would rank 7th, Texas would rank 9th and Florida would rank 12th out of 218 nations. This is really bad. We can and must do better.

As the Summer begins to fade it is time to consider what we have learned about the virus before we shift more of our activity indoors. We know that the principal means of transmission is from what we exhale and inhale and that the biggest threats come from the largest moisture droplets we expel when we breathe, talk, cough, sing or sneeze. Hence the continuing need for masks and social distancing. 

We have also learned that the virus can be present in the much smaller aerosol form. The virus load of these microscopic moisture particles is small. Short exposures to low concentrations of aerosols are unlikely to cause infections, but extended breathing by an infected person is a smaller space with little ventilation that will concentrate the aerosol virus load to infectious levels. 

N95 masks have small enough pores to filter out most aerosols, but they are not effective in stopping aerosol transmission because where masks contact our skin there are always gaps that let in these aerosols. These gaps also allow aerosols to escape. So as we migrate indoors, how do we keep the air safe when people gather to socialize. 

Vox News just published an article on this subject. In summary, there are three basic ways to keep indoor air as safe as possible. First is to limit the size and length of time for indoor gatherings, especially in smaller rooms, and to wear masks when non-household members are visiting. 

The second is to have as much fresh-air exchange as possible. So, window fans or heating systems that have air exchangers might be examples. Leaving the bathroom vent fans running during and immediately after visits, might be a good idea, as long as the bathroom windows are closed. This creates a negative pressure that prevents the air in the bathroom from entering the rest of the living space. Air-exchange is always possible and is never simple. You don't want the flow of air in a home or business to carry a virus in the air from an infected person past the uninfected people, for example. 

The third way to make indoor air safer is to filter the air using a properly equipt portable HEPA filter. HEPA filters have the same pore size and filtering capacity as an N95 mask. A properly sized air filter can exchange the volume of air in a room multiple times per hour. When you are entertaining guests and they are wearing masks (while not eating or drinking), a HEPA filter in the room will slow or reduce the build-up of virus-carrying aerosols making the room safer for all.







U.S. National Health Emergency
Day 159 - August 20, 2020


Comments: One out of four COVID-19 infections around the world have happened here in the United States and new infection rates are still four times higher than expected given our population. Testing is still lagging behind given our case numbers, especially in the states of Florida, Texas where more testing is badly needed. As mentioned a few days ago, testing rates have declined by about 13% in the past two weeks prompting some reporting that suggests fewer tests is a way to suppress the reporting of daily new cases for political reasons in some states. If this is happening we should see a decline in both testing and cases with positive test rate either stable or trending upward, not downward (unless people with symptoms are not being tested while those without symptoms are being tested in greater numbers.) 

A visual review of available data on testing and new case reporting suggests that this might be happening in some states, but it isn't conclusive. A more sophisticated statistical analysis would be needed. Some of the visual data I looked at is included below. (continue viewing at Data-Driven Viewpoints blog)




These are the states that suggest a relationship between testing and new case reporting. There are other states where the data gives a mixed result, so, absent a more refined statistical analysis, this visual inspection of the data appears to inconclusive.








U.S. National Health Emergency
Day 158 - August 19, 2020
















COMMENTS:  [no comments today]






U.S. National Health Emergency
Day 157 - August 18, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.2%  ............... U.S. POPULATION
25.5% ...............  TOTAL COVID-19 CASES
22.4% ..............   TOTAL COVID-19 DEATHS 
20.5% ...............  NEW COVID-19 CASES   (24hr) 
13.7%. ..............  NEW COVID-19 DEATHS (24hr) 
17th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
40,612   ............  NEW INFECTIONS (24 hr.) 
  522      ............. NEW DEATHS (24 r.) 
727,151 ............. COVID-19  TESTS GIVEN (24 hr.) 
216,412*  ............. TESTS PER MILLION POPULATION
21.6%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 We rose a rank, to 17th, in tests per million but we are still far short of any reasonable goal for daily testing. Other nations that have the their numbers under control require less daily testing than countries that have very high infection rates. USA Today reports that "As testing has slowed, positive rates increased over the past week in 35 states as of Friday, according to Johns Hopkins University's Coronavirus Resource Center.  On Sunday the New York Times also reported on the declining trend in testing and reiterated the point that the number of tests given per day in the United States should be in the millions to effectively fight the spread of the disease. Business Insider reported that the decline in testing over the past two weeks amounts to a 13% reduction. And CBS News has pointed out that the decline in testing calls the accuracy of COVID-19 data into question. As testing declines, so do the number of reported positive cases. At the same time, less testing means that only symptomatic people are getting tested, which raises the positivity rates. High positivity rates and dropping numbers of new cases appears to be evident in a number of states. The fear, of course, is that the testing decline may be a harbinger of political manipulations to justify political goals.






U.S. National Health Emergency
Day 156  -  Monday, August 17, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.2%  ............... U.S. POPULATION
25.5% ...............  TOTAL COVID-19 CASES
22.4% ..............   TOTAL COVID-19 DEATHS 
17.3% ...............  NEW COVID-19 CASES   (24hr) 
11.5%. ..............  NEW COVID-19 DEATHS (24hr) 
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
36,843   ............  NEW INFECTIONS (24 hr.) 
  522      ............. NEW DEATHS (24 r.) 
862,664 ............. COVID-19  TESTS GIVEN (24 hr.) 
214,220*  ............. TESTS PER MILLION POPULATION
21.2%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The United States remains second in new infections over the past 24 hours despite a large drop in cases, which might be due to the usual weekend reporting lag. Close attention must be paid to the reports of the number as we approach the election because the potential for manipulation has grown substantially.

For decades, and up until June 20th, the CDC got all their health statistics directly from the hospitals and other medical centers. These statistics were also sent out by health care providers to the states' Departments of Health.

Now President Trump has created something called the "HHS Project" and diverted all COVID-19 statistical reporting to his own cabinet agency. Hospitals and health organizations no longer submit their data directly to the CDC.

But the HHS Project does not get the daily data directly from hospitals either. The Trump administration gave a 10 million dollar, no-bid, six-month contract to TeleTracking Technologies to create an interface website program to which hospitals must report their daily statistics. From there, the information is transmitted to another private vendor, Palantir Technologies, for data processing services. Palantir is a privately held, Republican-friendly company that is going public in what is expected to be the biggest IPO this year. Business Insider Magazine described Palantir this way in a July 7th article:

"Palantir, a secretive tech company started by members of the 'PayPal mafia' with close ties to the Trump administration, could be one of the biggest tech IPOs ever. Take a closer look at how it makes money"

After Palantir is done with the data, it then goes to HHS to be channeled back to the CDC and every other scientific enterprise that is a consumer of the data.

I feel less confident with the numbers going forward now that they go directly to two private vendors before landing in HHS under our President's direct control. I don't care who the President is, this isn't right. It increases the temptation to alter the data for political effect.






U.S. National Health Emergency
Day 155  -  Sunday, August 16, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.2%  ............... U.S. POPULATION
25.6% ...............  TOTAL COVID-19 CASES
22.5% ..............   TOTAL COVID-19 DEATHS 
20.6% ...............  NEW COVID-19 CASES   (24hr) 
19.8%. ..............  NEW COVID-19 DEATHS (24hr) 
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
53,523   ............  NEW INFECTIONS (24 hr.) 
1,071      ............. NEW DEATHS (24 r.) 
735,975 ............. COVID-19  TESTS GIVEN (24 hr.) 
212,002*  ............. TESTS PER MILLION POPULATION
21.2%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The United States had the second-highest number of new infections yesterday behind India, and we were first in the number of COVID deaths. But how is the most powerful country in human history doing internationally on other pandemic measures?  As reported above, we are 18th in the number of COVID-19 tests per million. How are we ranked on deaths per million population, for example?

The U.S. has one of the top-rated healthcare systems in the world (even though it cannot be accessed by everyone), so you would expect us to do better than most other countries. You would be wrong. We are ranked:

  • 10th from the bottom in the highest number of deaths per million out of 215 countries 
  • 8th from the bottom in cases per million
  • Dead last with the high number of critically ill COVID-19 patients  (over 17 thousand), and with just 4.2% of the world's population (yes it dropped 0.1% recently)
  • We are ranked dead last with the highest number of currently active cases (2.9 million are sick) 
For comparison sake, India with a billion more people has about 9k critically ill patients and 700k active cases while Brazil has 8k patients who are critically ill and 800k active cases as of today.

The point here, in fact, the point of this whole diary, is to make explicit the abject failure of national leadership in the United States relative to every other country in the world. Our great nation can't seem to punch its way out of the global pandemic. We can't even convince everyone that this virus is real.





U.S. National Health Emergency
Day 154  -  Saturday, August 15, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
25.7% ...............  TOTAL COVID-19 CASES
22.5% ..............   TOTAL COVID-19 DEATHS 
21.2% ...............  NEW COVID-19 CASES   (24hr) 
18.8%. ..............  NEW COVID-19 DEATHS (24hr) 
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
60,600   ............  NEW INFECTIONS (24 hr.) 
1,120      ............. NEW DEATHS (24 r.) 
837,407 ............. COVID-19  TESTS GIVEN (24 hr.) 
209,401*  ............. TESTS PER MILLION POPULATION
20.9%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. was the second hottest hot-spot for new infections yesterday as California, Florida, and Texas still struggles to control their outbreaks.  Here is some other tidbits of news for today:

  • A pregnancy study published in Open Forum Infectious Diseases on August 13, 2020, reviewed 11,308 cases of SARS-CoV-2 infections and/or COVID-19 disease when pregnant showed that health outcomes were generally favorable for both the mothers and newborns. Maternal and neonatal survival was reassuring, (98%) and (99%), respectively. 
  • The U.S CDC updated their coronavirus guidance on August 3, 2020, suggesting that people who have recovered from COVID-19 related infections can reduce their social-distancing efforts for the next 3-months, because of limited immunity.
  • As of August 12, 2020, the U.S. FDA says the food supply is safe and there is no evidence the coronavirus is transmitted through food, food containers, or food 
  • To expand the number of blood plasma donations, LabCorp announced on August 11, 2020, details of a no-charge antibody testing program. For the next 3-months, LabCorp will perform the high-affinity coronavirus antibody test at no-charge to patients, insurance companies, or the government.  
If you think this sort of summary of coronavirus news is helpful, you can find these stories and more at the Corona Virus Today website.






U.S. National Health Emergency
Day 153  -  Friday, August 14, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
25.7% ...............  TOTAL COVID-19 CASES
22.5% ..............   TOTAL COVID-19 DEATHS 
19.5% ...............  NEW COVID-19 CASES   (24hr) 
19.3%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
55,364    ............  NEW INFECTIONS (24 hr.) 
1,301      ............. NEW DEATHS (24 r.) 
973,441 ............. COVID-19  TESTS GIVEN (24 hr.) 
206,876*  ............. TESTS PER MILLION POPULATION
20.7%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 While the U.S. is still third in total new cases over the past 24 hours, over 1 in 4 new cases globally are here in America. California, Texas, and Florida are still the top hot-spots. John Hopkins publishes daily testing trends by state. It shows that Texas has the highest rate of positive results at 23.7%. (I don't trust today's numbers because you would have to believe that daily testing jumped up from 17k per day to 124k yesterday, dropping the 7-day running average 7% in a single day. The prior record testing day was less than 90k tests). Florida's positive testing rate is 17.7%, South Carolina's is 14.3%, Georgia's is 10.9%, California's is 6.7% and North Carolina's is 6%.  In contrast in New Jersey, where the virus is under better control, the positive test rate is 1.7%. The other surprising feature about Texas is how spread out the outbreaks are given the sparse population in large areas of state (see map).  Nationally, the seven-day average positive COVID-19 test ratio is 7.2% and starting to trend downward.











U.S. National Health Emergency
Day 152  -  Thursday, August 13, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.0% ...............  TOTAL COVID-19 CASES
22.7% ..............   TOTAL COVID-19 DEATHS 
19.0% ...............  NEW COVID-19 CASES   (24hr) 
20.3%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
54,345    ............  NEW INFECTIONS (24 hr.) 
1,386      ............. NEW DEATHS (24 r.) 
608,804 ............. COVID-19  TESTS GIVEN (24 hr.) 
203,940*  ............. TESTS PER MILLION POPULATION
20%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. had the third-highest number of new infections in the world again yesterday behind India and Brazil, and again had the most COVID-19 deaths in the world yesterday. Texas had more COVID-19 deaths yesterday. But instead of focusing on our troubles today, it might be interesting to focus instead on Ireland, a county that has been far more successful in managing the pandemic.

The graph below elegantly shows how successful Ireland has been in getting control of the virus versus the United States. As it happens, this blogger has close family connections there who have provided ongoing commentary on the Irish pandemic experience.

The Irish government recognized the pandemic threat early and acted more quickly and decisively than did we to bring it under control. In fairness, Ireland is about the size of Indiana. The first case of COVID-19 occurred on February 29th in the Republic of Ireland. Twelves days later the public schools were shut down. The pubs shut their doors that weekend and haven’t opened since. Tens of thousands of citizens were already put out of work due to the restriction by March 12th, and by March 16th the government established the pandemic unemployment payment of €203 a week. This later rose to €350 (about $415, but no one lost medical coverage which is free for everyone). 


By the end of March, almost 400,000 people had applied for the payment. A full account of their Irish response can be found at this hyperlink.

Early on Irish authorities recognized that the elderly were at greater risk from the virus and established tighter restrictions on everyone over 65 years old. This population was not allowed to leave their residential properties or travel on the roads or go shopping. If their shopping needs and other personal needs could not be arranged through family, friends, or neighbors, the government sent workers to every shut-in to bring them groceries, medicines, and other essentials. To enforce this restriction check-points were set up on the roads to check the ager of the occupants in their vehicles. Rather than railing against this restriction, the elderly saw it as their contribution to the health of their neighbors and called it "cocooning." 


Those restrictions have recently been lifted and the country is in a phased reopening, similar to what is currently in place in states like New Jersey. The measures taken in Ireland were tough but the results have been worth the sacrifice. The attitudes of the Irish people in facing down the pandemic are in sharp contrast to the politicized and polarized reaction here in the U.S. The Irish philosophy towards wearing masks perhaps typifies their more community-minded approach to this pandemic.  We could learn a lot from the Irish.










U.S. National Health Emergency
Day 151  -  Wednesday, August 12, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.0% ...............  TOTAL COVID-19 CASES
22.5% ..............   TOTAL COVID-19 DEATHS 
20.5% ...............  NEW COVID-19 CASES   (24hr) 
22.9%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
54,519    ............  NEW INFECTIONS (24 hr.) 
1,504      ............. NEW DEATHS (24 r.) 
763,742 ............. COVID-19  TESTS GIVEN (24 hr.) 
202,106*  ............. TESTS PER MILLION POPULATION
20%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. had the third-highest number of new infections in the world behind India and Brazil, but had the most COVID-19 deaths in the world yesterday. Testing numbers are still not climbing upward as they should be. California had the highest number of new cases yesterday and Florida had the highest number of deaths. California, Texas, Florida, and Georgia accounted for 54% of all new U.S. infections yesterday.




U.S. National Health Emergency
Day 150  -  Tuesday, August 11, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.0% ...............  TOTAL COVID-19 CASES
22.5% ..............   TOTAL COVID-19 DEATHS 
23.0% ...............  NEW COVID-19 CASES   (24hr) 
12.4%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
49,800    ............  NEW INFECTIONS (24 hr.) 
569         ............. NEW DEATHS (24 r.) 
745,364   ............. COVID-19  TESTS GIVEN (24 hr.) 
199,803*  ............. TESTS PER MILLION POPULATION
20%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. is second again behind India in the number of new infections. Deaths are still trending downs relative to the rest of the world. Testing in the U.S. has plateaued and may be trending downward (we shall see). We are 150 days into this National Health Emergency and still, only enough COVID-19 tests have been given to date to test just 1 out of 5 Americans if each person was given only one test.

Interestingly, a look back at the peaks and valleys of daily reporting over time, both the daily new cases and COVID deaths, reveals that there is a weekly reporting cycle where the peaks mostly happen mid-week and the valleys occur around the weekends. The line graph of reported deaths for a three-day daily average (below) shows the regularity of this weekly reporting pattern. When looking at these daily statistical totals, the day of the week should be factored in. Note that there are 18 peaks in the graph below which correspond to the 18 weeks between April 3rd, and August 7th.







U.S. National Health Emergency
Day 149  -  Monday, August 10, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.0% ...............  TOTAL COVID-19 CASES
22.6% ..............   TOTAL COVID-19 DEATHS 
21.4% ...............  NEW COVID-19 CASES   (24hr) 
11.1%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
47,979     ............  NEW INFECTIONS (24 hr.) 
534          ............. NEW DEATHS (24 r.) 
6543.3   ............. COVID-19  TESTS GIVEN (24 hr.) 
197,553*  ............. TESTS PER MILLION POPULATION
19.8%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. is second behind a surging India virus transmission rate. Again, India has a 1.1 billion more people. California had the most new cases yesterday and Texas had the most new deaths. New Jersey still has the most deaths per million population while California, Florida, and Texas now have more total cases than New York.





U.S. National Health Emergency
     Day 148  -  August 9, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.0% ...............  TOTAL COVID-19 CASES
22.7% ..............   TOTAL COVID-19 DEATHS 
20.6% ...............  NEW COVID-19 CASES   (24hr) 
17.4%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
54,199     ............  NEW INFECTIONS (24 hr.) 
976          ............. NEW DEATHS (24 r.) 
822,628   ............. COVID-19  TESTS GIVEN (24 hr.) 
195,075*  ............. TESTS PER MILLION POPULATION
19.5%      ............. TOTAL TESTS / US POPULATION
* For context, daily testing rates should be between one and three million per day.

COMMENTS:
 The U.S. is back to number two in daily new cases behind India, which has over a billion more people. The spread of infections is still concentrated in Florida, California, and, Texas which together account for about 41% of the daily new infections. Lousiana, Arizona, and Florida still have the most cases per one-million population. Our daily testing numbers are starting to plateau.

We are 148 days into our National Health Emergency yet if only one COVID-19 test was given per person in the United State to date, fewer than 1 in 5 people would have been tested. There has never been a universal agreement as to how much testing is needed in the United States in part because estimates are based on differing goals and strategies to control the virus. But there is universal agreement that our current testing numbers are inadequate. Ramping up testing to meet the current national need cannot be accomplished without federal intervention and the invoking of the National Defense Procurement Act by the President. Back in April, when there were about 25,000 new cases a day, the estimated number of COVID-19 tests needed for various strategies to bring the spread of infection under control was published in a table by the Kaiser Family Foundation. The minimum number of daily tests among the models at that time was 3 million tests per day. (see KFF table below)




  <- Total tests, tests/million, U.S. population


U.S. National Health Emergency
     Day 147  -  August 8, 2020 

 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.1% ...............  TOTAL COVID-19 CASES
22.7% ..............   TOTAL COVID-19 DEATHS 
26.6% ...............  NEW COVID-19 CASES   (24hr) 
20.0%. ..............  NEW COVID-19 DEATHS (24hr) 
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
63,246     ............  NEW INFECTIONS (24 hr.) 
1,290        ............. NEW DEATHS (24 r.) 
758,346    ............. COVID-19  TESTS GIVEN (24 hr.) 
192,992*  ............. TESTS PER MILLION POPULATION
19.3%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS:
 The recent slow down in daily virus testing has pushed us back to 19th place in national tests per million. Both the number of new infections and deaths in the past 24 hours has risen,  making the US number one in both. (Beginning today the daily tables will appear at the top of this blog instead of having to scroll to the bottom.)


<- Total tests, tests/million, U.S. population


U.S. National Health Emergency

     Day 146  -  August 7, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.2% ...............  TOTAL COVID-19 CASES
22.7% ..............   TOTAL COVID-19 DEATHS 
20.9% ...............  NEW COVID-19 CASES   (24hr)
18.6%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
58,611     ............  NEW INFECTIONS (24 hr.)
1,203        ............. NEW DEATHS (24 r.)
756,852  ........... COVID-19  TESTS GIVEN (24 hr.)
190,640* ............. TESTS PER MILLION POPULATION
19.1%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS:
 [No Comments]






U.S. National Health Emergency
     Day 145  -  August 6, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.2% ...............  TOTAL COVID-19 CASES
22.8% ..............   TOTAL COVID-19 DEATHS 
20.3% ...............  NEW COVID-19 CASES   (24hr)
19.2%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
56,148      ............  NEW INFECTIONS (24 hr.)
1,311        ............. NEW DEATHS (24 r.)
762,258  ........... COVID-19  TESTS GIVEN (24 hr.)
188,353* ............. TESTS PER MILLION POPULATION
18.8%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS:
 The U.S. had the second most new cases yesterday. A word about childhood transmission of the virus, following this comment yesterday from our President:

"... children are almost — and I would almost say definitely — but almost immune from this disease."

It has long been observed that children are less likely to show symptoms of COVID-19, but it has never been suggested that this means they are immune. Children have been getting sick and dying from the virus all along.  A recent study shows that children who do have symptoms are just as likely as adults to spread it to others: 
6/30/2020 - Researchers have discovered that children younger than 5 years with mild to moderate COVID-19 have much higher levels of genetic material for the virus in the nose compared to older children and adults. The findings point to the possibility that the youngest children transmit the virus as much as other age groups.
A scientific study to learn about the incidents of COVID-19 infection rates in children was launched in May.
"A study to help determine the rate of novel coronavirus infection in children and their family members in the United States has begun enrolling participants. The study, called Human Epidemiology and Response to SARS-CoV-2 (HEROS), also will help determine what percentage of children infected with SARS-CoV-2, the virus that causes COVID-19, develop symptoms of the disease."

The study has yet to be completed, so a definitive answer as to the incident rate of the virus in children isn't known yet, but it certainly isn't zero, as the President is claiming.






U.S. National Health Emergency
     Day 144  -  August 5, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.3% ...............  TOTAL COVID-19 CASES
22.8% ..............   TOTAL COVID-19 DEATHS 
21.3% ...............  NEW COVID-19 CASES   (24hr)
13.0%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
54,540      ............  NEW INFECTIONS (24 hr.)
1,362        ............. NEW DEATHS (24 r.)
681,496  ........... COVID-19  TESTS GIVEN (24 hr.)
186,055* ............. TESTS PER MILLION POPULATION
18.6%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS:
 We are 144 days into our national health emergency and still have over 20% of the world's new cases despite being only 4.3% of the global population. Over 1,300 people died of the disease yesterday (R.I.P), a number that is within statistical expectations given the peak number of new cases it reflects. (It is not a statistical correction). Texas, Florida, and California still have the largest outbreaks.






U.S. National Health Emergency
     Day 143  -  August 4, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.4% ...............  TOTAL COVID-19 CASES
22.8% ..............   TOTAL COVID-19 DEATHS 
24.3% ...............  NEW COVID-19 CASES   (24hr)
13.0%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
48,646      ............  NEW INFECTIONS (24 hr.)
  567         ............. NEW DEATHS (24 r.)
1,002,033  ........... COVID-19  TESTS GIVEN (24 hr.)
184,000* ............. TESTS PER MILLION POPULATION
18.4%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS:
 It looks like we have turned a corner. Both new cases and new COVID-19 deaths are down... but wait? Aren't COVID deaths a trailing indicator? Doesn't it take 10 to 20 days for the number dying of COVID-19 to become reflected? Yesterday the death toll was 2 times less than the day before, now today it is only slightly over yesterday's number. What happened 10 to 20 days ago? Was there a drop in cases?

No! In fact, the average number of new infections in that 10 day period was at an all-time peak. The 10 day average during the peek was 63,451 new cases per day, while the average number of deaths in the past two days is 517 per day. That means a very low mortality ratio of 0.8%. It was about 2% on the prior days. Either we have achieved a remarkable drop in mortality rates or the numbers are off and we should see a correction over the next few days.

PS: Our global percentage of COVID-19 deaths continues to decline, also, despite our global rise in new cases relative to the world.





U.S. National Health Emergency
     Day 142  -  August 3, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.4% ...............  TOTAL COVID-19 CASES
22.9% ..............   TOTAL COVID-19 DEATHS 
22.2% ...............  NEW COVID-19 CASES   (24hr)
10.5%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
52,783      ............  NEW INFECTIONS (24 hr.)
  467         ............. NEW DEATHS (24 r.)
708,599    ............ COVID-19  TESTS GIVEN (24 hr.)
178,841* ............. TESTS PER MILLION POPULATION
18.1%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS: 
The U.S. had the second largest number of new infections yesterday, thanks to rising numbers in India (which has a billion more people). COVID-19 deaths recorded yesterday was 2 times less than the past 4-day average. I suspect we will see a correction, yesterday being a Sunday.




U.S. National Health Emergency
     Day 141  -  August 2, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.5% ...............  TOTAL COVID-19 CASES
22.9% ..............   TOTAL COVID-19 DEATHS 
25.9% ...............  NEW COVID-19 CASES   (24hr)
20.0%. ..............  NEW COVID-19 DEATHS (24hr)
18th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
58,429      ............  NEW INFECTIONS (24 hr.)
  1,123      ............. NEW DEATHS (24 r.)
635,857    ............ COVID-19  TESTS GIVEN (24 hr.)
178,841* ............. TESTS PER MILLION POPULATION
17.9%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS: [no comments]









U.S. National Health Emergency
     Day 140  -  August 1, 2020 
 UNITED STATES SHARE OF THE GLOBAL TOTALS
04.3%  ............... U.S. POPULATION
26.6% ...............  TOTAL COVID-19 CASES
23.0% ..............   TOTAL COVID-19 DEATHS 
24.5% ...............  NEW COVID-19 CASES   (24hr)
22.7%. ..............  NEW COVID-19 DEATHS (24hr)
19th    ..............   GLOBAL RANK IN TESTS PER MILLION

UNITED STATES DAILY PANDEMIC STATISTICS
70,904      ............  NEW INFECTIONS (24 hr.)
  1,462      ............. NEW DEATHS (24 r.)
1,069,908    ............ COVID-19  TESTS GIVEN (24 hr.)
176,923 * ............. TESTS PER MILLION POPULATION
17.7%      ............. TOTAL TESTS / US POPULATION
* For context, this number should be over one-million.

COMMENTS: 
It's 140 days since Donald Trump declared a National Health Emergency. We have less than 5% of the world's population and yesterday we had nearly 25% of all new infections in the world. We are among the 10 worst countries in terms of both COVID cases and deaths since the pandemic began. We are 19th in tests given per million despite our need for testing being more critical than in most other countries right now. Despite this, testing isn't "ramping up" but barely crawling scaling up at all. I updated the seven-day average of daily testing in the U.S. (below) and added a graphic from a NY Times article today debunking the President's claim that our high case numbers are due to our high testing numbers. This isn't true. And testing doesn't "cause" infections!







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