by Brian T. Lynch, MSW
Welcome to the Daily Pandemic Diary for DECEMBER 2020. The purpose here is to provide a global context to how our nation is coping with the pandemic and to supply information about COVID-19 that might be helpful to the readers. This blog continues the daily collection of data begun in the Daily Update blog and the monthly Daily Pandemic Diaries linked below. The raw data comes from the independent, international non-profit data reporting organization called Worldometer.info. Test Positivity data comes from Johns Hopkins University. Data in red are calculated values.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 271 - DECEMBER 31, 2020
All states reported new-case data. Wyoming and Hawaii either had no deaths or reported none.
COMMENTS
Wishing everyone a Healthy and Happy New Year! And again, my condolences to everyone who lost a loved one this year.
Today's new infections and death totals are about where they might be on the daily trend if there had not been a Christmas undercount. I am hopeful that this reflects an actual slowing of the pace of new infections. To explain, we entered the month with new infections doubling every 30 days. If that rate continued we would have about 331,000 infections per day now. The total number of new infections reported yesterday (234,775) is more than 40% fewer than expected. The total is double what it was 56 days ago. All of this could change, of course, but if enough of us do our part to prevent infections we should continue to bend the curve in January. Wear a good quality mask around others at all times! Stay away from everyone if you feel sick! Keep your distance at all times! Avoid crowds and crowded rooms! Stay SAFE! We can get through this and make 2021 a better year.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 270 - DECEMBER 30, 2020
Today's data reflects no new-case or new-death reports from Missouri and no new death reports from Hawaii, Wyoming, Kansas, South Dakota, or Deleware.
COMMENTS
Today is Wednesday. New deaths reported are nearly 3,400 with six states not reporting and an unknown number of backlogged reports from Christmas. COVID-19 testing is down while test positivity continues to rise. To meet our national goal of herd immunity from the vaccines by mid-summer we need about 3.4 million vaccines per day but it was reported yesterday that we are giving about 1 million per week. And so it is hopeful that the new Oxford/AstraZeneca vaccine approved yesterday in the UK is easier to mass-produce and store at refrigerator temperatures. There is no telling yet when we might expect emergency approval here or shipment of any vaccine. Meanwhile, the first proof that the new more infectious strain of the virus was confirmed in Colorado yesterday. The lateness of this discovery, and the specificity of it to one individual, highlights another colossal failure in our inability to detect outbreaks earlier in whole populations using wastewater testing methods used in parts of Europe since the pandemic began. But why should we expect better than we earn when we still have swaths of the population protesting masks?
Below is a pretty good depiction of the progression of competence from the creation of the vaccine to its distribution in America. This was circulating on Twitter today.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 269 - DECEMBER 29, 2020
With all states reporting new-case data, four states are not reporting new-deaths data. They are Hawaii, Alaska, South Dakota, and Iowa. The numbers do not yet appear to reflect the backlog of statistical reporting.
COMMENTS
Nothing definitive can yet be said about the current status of the pandemic in the United States. It has been taking until Thursday or Friday to catch up with the weekend backlog in recent months, but Thursday and Friday of this week are also holidays. An accurate picture of our status may not be possible until the 6th or 7th, of January 2021. What can be said is that the U.S. has slipped from 19th to 20th in the global ranking of COVID tests given per million. Our test positivity rate is climbing back up again. Relative to the U.S. population, the total number of COVID tests given to date would only be enough to give a single test to 75% of our population. Despite the undercount of new cases, the U.S. is pushing towards recording 2 out of every 5 new cases per day in the world. It is projected that, despite the introduction of the vaccines, January will be a worse month for the virus than December has been. With that in mind, I include here instructions about what to do if you become exposed to someone who recently tested positive for COVID-19. This was developed following CDC guidelines and a little bit of common sense. Feel free to print a copy. Also, contact me with any additions or corrections you may have if you have better advice.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 268 - DECEMBER 28, 2020
UNDERCOUNT
COMMENTS
Significant undercounts over the past four days have resulted in artificial declines in the 7-day averages and other indicators. We essentially do not know the status of the pandemic in America. What we can say is that despite the holiday undercount in five states the U.S. still recorded nearly a third of all new cases globally. Despite the undercount of new deaths in 12 states from yesterday we still had 17% of the world's new deaths from COVID-19.
ON IMMUNITY›
Just a few thoughts here on vaccines and immunity before the public discussions become too corrupted with politics and disinformation. Vaccines and natural immunity don't prevent us from getting infected with a virus. Rather, they prime the body to fight the virus and eliminate it before it can replicate and overwhelm our natural defenses. Most vaccines in the past were made from live, dead, or actual fragments of a virus. The vaccines currently in use for COVID-19 are different. They are made from messenger RNA (mRNA), the stuff inside our cells that creates proteins by combining various molecules, sometimes using our DNA as a blueprint. Research on mRNA-based vaccines has been ongoing for a decade. The basic construct is no new. The current COVID-19 vaccines allow our cells to make a specific protein that binds to a spike-like projection on the coronavirus, a spike that it uses to attach to our cell walls. If the virus can't attach, it can't infect a cell.
Natural immunity comes when a person recovers from a COVID-19 infection. A growing body of research suggests that the amount and duration of natural immunity are proportional to the severity of illness a person experiences. A person with mild or no symptoms has fewer antibodies and may become reinfected in as little as a few weeks to a few months after clearing their initial infection. People who are very sick with the virus have both stronger and longer immunity.
On the other hand, modern vaccines have other immune-enhancing properties. Research in the past decade has discovered "adjuvant" systems, which are combinations of immunostimulatory molecules designed to allow vaccines to provide better and broader protection. The combination of how the mRNA vaccination functions, in combination with the adjuvant systems, make the vaccine more predictably effective than natural immunity. In short, the vaccines are more robust than natural immunity.
So, even people who have been mildly ill with COVID-19 this year should consider getting the vaccine. In fact, if COVID-19 acts like other common strains of coronavirus, immunity may only be seasonal. Annual COVID vaccines could be in the future. We just don't know yet for sure.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 267 - DECEMBER 27, 2020
It is clear that there will continue to be a significant undercount throughout the holidays. There are no new case, or death data from Missouri, Louisiana, Rhode Island, Kansas, Connecticut, or Maine. There are no deaths reported from Hawaii, Nebraska, Iowa, Wyoming, or Oregon.
COMMENTS
The accurate status of the pandemic will be unknown until Thursday or Friday of the coming week due to a lack of reporting during Christmas.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 266 - DECEMBER 26, 2020
With about half the states no reporting any statistics for Christmas Day and two states (HI & NE) not reporting deaths, the data today is severely undercounted affecting not only the totals but the averages as well. The states with no reporting are: FL, OH, TN, MI, NC. MN, MD, MA, LA, SC, OK, UT, KY, KS, CT, ID, SD, ND, RI, MT, AK, WY, NH, DC, and VT.
COMMENTS
Based on today's undercount you can just about double the new cases and death totals. Look to see if tomorrow's totals are 50% higher than normal, which it needs to be to make up today's undercount. There is not much else to say except to point out that even with half the states not reporting the U.S. has three times as many new cases as the UK.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 265- DECEMBER 25, 2020
No reporting from Michigan, North Carolina, Kentucky, Rhode Island, or Wyoming. No deaths reported from Kansas.
COMMENTS
It is tragic and sad that perhaps 3,000 people died yesterday from the virus on the eve of Christmas Day. And yet, in the spirit of hope and Christmas miracles, this is an excellent day to focus on the 117,257 people who recovered from COVID-19 yesterday. This number is in no small part due to the heroic efforts of our fantastic frontline healthcare workers who sacrifice and risk their lives every day for us. Since the pandemic began, 11.2 million people have gotten ill and recovered from the virus. Many of these survivors were snatched from the jaws of death by the dedicated work of doctors, nurses, technicians, and all the support staff that surrounds the very ill. This is not just true here in America but all around the whole world. This Christmas Day we are grateful for the gifts and talents of these extraordinary citizens. Shalom!
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 264- DECEMBER 24, 2020
With all states reporting out their new cases for yesterday, only Delaware (and maybe Wyoming) reported no death total.
COMMENTS
As of Wednesday of Christmas week, 12,591 people have died so far from the coronavirus. Anyone who has lost a loved one over the holidays knows how especially painful it can be. We offer our heartfelt condolences today, and every day.
The death rate, which is a trailing indicator that follows about a month behind new cases, has doubled in just 21 days. If there is a glimmer of good news on Christmas Eve, it is that the doubling rate of new cases appears to have declined to 43 days versus the 30-day doubling rate on the 5th of December. We who wear masks in public and forgoing unsafe gatherings are starting to bend the curve downward, a reward for our sacrifice. And if we continue to be the example and encourage others to do the same, we will save thousands of lives over the next few months. Note the bend in the curve in the past week or so.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 263- DECEMBER 23, 2020
COMMENTS
The U.S. has 7.4 million people with active COVID-19 infections. That is 34.4% of the global total. If our active cases were on the same scale as our population size, we would only have about 900,000 active cases. That means we have 6.5 million people with currently active illness who might not be sick if the U.S. were as diligent at prevention as are most other nations. And here below is some news about the new virus strain and some new research.
The U.S. has 7.4 million people with active COVID-19 infections. That is 34.4% of the global total. If our active cases were on the same scale as our population size, we would only have about 900,000 active cases. That means we have 6.5 million people with currently active illness who might not be sick if the U.S. were as diligent at prevention as are most other nations. And here below is some news about the new virus strain and some new research.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 262- DECEMBER 22, 2020
All states are reporting new case numbers in today's data. Seven states have no death statistics reported. When a state has no deaths reported it can mean there were no deaths or that no death reports were published. In fairness to states with low rates of active cases (and so fewer deaths), I came up with a method to estimate daily deaths and will only report missing state statistics when it is unlikely that there were no deaths. Based on the national ratio of daily death totals to active cases (.02%), Alabama( estimated to have about 27 deaths/day) is unlikely to have had no deaths to report.
[none]
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 261- DECEMBER 21, 2020
Today's report is missing new case and death statistics from Michigan, Missouri, Kansas, Connecticut, and Rhode Island. Additional death statistics are missing from Wyoming, Alaska, Maine (may not have had any), and Alabama.
UNDERCOUNT
UNDERCOUNT
UNDERCOUNT
COMMENTS
[none]
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 260- DECEMBER 20, 2020
New daily cases and daily death total reports are absent from Tennessee, Louisiana, Connecticut, and Rhode Island. The COVID death totals are absent from Wyoming, Kansas, and Idaho.
COMMENTS
There is a new genetic variant of the COVID-19 virus identified in the UK that has everyone worried. It isn't more virulent, and the good news is it may respond to the current vaccines. The bad news is it is far more infections.
On BBC news today it was explained that the new variant adds about .4 to the Rt value of the original. (The Rt value is the rate of community spread). So, if your community spread rate after the extreme mandatory lockdowns in April was .8 (meaning we were bending down the curve), it would be 1.2 now with the same extreme measures to control the spread... meaning that the infections would still grow exponentially. So this isn't good news. It also means that the percentage of people who would have to be inoculated to achieve herd immunity is greatly increased as well. And while countries in Europe have either issues a travel ban with the UK, or are considering it, a case or two of the new coronavirus variant has already been identified in Italy and Australia [a correction]. The cat may be out of the bag. And some scientists say this variant may have been spreading since September.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 259- DECEMBER 19, 2020
With all states reporting their new case counts, Alaska, Wyoming and Iowa have not reported their death totals.
COMMENTS
The United States had more new infections yesterday than did Brazil, Germany, Russia, Great Britain, India, Turkey, Italy, France, Colombia, and Ukraine combined. We dropped to 19th in the world for the amount of testing per million population and rose to over 12% in test positivity rates. The World Health Organization correctly interprets test positivity rates as a measure of the adequacy of the amount of testing. A test positivity rate of 3% would be a general benchmark of adequate testing to identify all the cases. According to Our World in Data, a scientific online publication of researchers out of Oxford University, "Countries that do very few tests per confirmed case are unlikely to be testing widely enough to find all cases."
This reinforces what I have been reporting here from day one. Testing in the United States has been wholly inadequate relative to the scale of our community outbreak. The lack of testing has suppressed accurate data about community spread. It has prevented us from identifying and remediating hotspots as they developed. Suppression of data has given credence to the Trump Administrations's disinformation campaign designed to conceal its gross incompetence and its disinterest in governing. It is likely that millions of infected persons have gone uncounted and as many as 100,000 deaths may have gone unreported by now. The scale of our epidemic is a man-made disaster and the majority of deaths were preventable. The magnitude of the Trump Administrations' failure to manage the pandemic in the United States cannot be overstated. The full extent of the preventable illnesses and deaths will take years to uncover.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 258- DECEMBER 18, 2020
Missouri's and Kansa's new case and death statistics are missing from today's reports.
COMMENTS
If the ratio of the avg. U.S. COVID deaths to the averagenumber of daily new cases (1.18%) matched the global ratio of 1.76%, the number of deaths reported today would be around 5,100 people. This may be a positive indication of how well we are treating the sick here compared with the rest of the world. It might also reflect some of the undercount in daily statics in the U.S. A better indication of the trend in community spread is the doubling rate of the infections. Based on today's 7-day average of new cases reported, the doubling time was 39 days. The doubling rate was 30 days back on December 5th. This is a sign that the rate of community spread nationally may be slowing its advance. It could be a reflection of the restriction that have been imposed recently in a number of states, and perhaps a more careful adherence to personal safety measures, like mask wearing. We will have to wait and watch as the test positivity rate shows no sign of declining and the actual average number of new cases is still rising. Also, the national hospitalization rate (see below) is still topping the all-time high every day.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 257- DECEMBER 17, 2020
All states reported their new case numbers. Wyoming and D.C. did not report their death totals.
COMMENTS
A new record high of 3,538 people died yesterday. There was also a new revelation about the Trump Administration working at cross purposes to the American people to keep us all safe from this pandemic. On July 4, 2020, Dr. Alexander, a CDC overseer especially appointed by the President himself, stated in a memo:
“Infants, kids, teens, young people, young adults, middle-aged with no conditions etc. have zero to little risk….so we use them to develop herd [immunity]…we want them infected…”
For many months millions of Americans, including me, have bucked the contrary messaging on wearing masks, social distancing, hand hygiene and restricting our contacts with loved ones and friends to keep each other safe. We have done this for the common good to keep as may people alive and well as possible while we waited science to create a vaccine. If this pernisious policy goal, to infect children and the young to keep older adults safe, appauls and disturbs you as much as me, then lets channel our outrage into an all out effort to do the opposite and get everyone to wear masks and social distance. We have about five months between now and the time vaccines begin to turn the page on this pandemic. Let's spend that time keeping as many people alive as humanly possible. We can do this.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 256- DECEMBER 16, 2020
All states have reported their new-case numbers. Two states have not reported their death statistics from yesterday, New Hampshire and Kansas.
COMMENTS
America stands alone in the severity of our outbreak, says David Leonhardt of the NY Times. I'll let his article state what is behind today's numbers, adding only that if California were a country, its 35,384 new infections yesterday rank it 3rd in the world behind the U.S. (minus California numbers) and Brazil.
There is good news. A new in-home COVID-19 PCR (the definitive laboratory test) will soon be available for around $30.00. This will put it in reach of about three-quarters of all U.S. households. It should also shame Congress into including a provision in a relief package to supply free, in-home PCR test kits to anyone on public assistance who requests them. Then there is the Maderna vaccine that will likely receive an emergency use license this week, adding another 30 million vaccines (15 million people) over the next three months. If anyone reading this knows of any other good news, please share it. We all need to hear it.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 255- DECEMBER 15, 2020
Montana had no new-case or death reports from yesterday. The following states had no deaths reported in these statistics: HI, SD, WY, AL, DE, and AK.
COMMENTS
For a sense of global scale, the United States had nearly as many new coronavirus cases yesterday as did the combined 2.5 billion people living in 14 countries with the next highest totals. We started December on a Tuesday with 32.4% of the world's daily total of new cases, and on this Tuesday, midway through the month, we are up to 37.4% of the global total per day. We began the month with 14.9% of the global death total, and today we have 18.9% of yesterday's total deaths from COVID-19. The current 7-day average of new-cases is double what it was 36 days ago. That represents a modest improvement possibly reflective of the new state mandates imposed over the past few weeks. This will be a measure to watch, as the slowing of our doubling rate is a direct measure of the effectiveness of our mediation efforts.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 254- DECEMBER 14, 2020
UNDERCOUNT
New deaths reported today are substantially undercounted. Ten states did not provide their death statistics (although Vermont may not have had any). They are Michigan, Connecticut, Rhode Island, Kansas, Vermont, North Dakota, Maine, Wyoming, Alaska, and Alabama. Additionally, Michigan, Connecticut, and Rhode Island have not reported new case numbers.
COMMENTS
The U.S. dropped back to 18th in the world for the number of coronavirus tests per million people. Today the total number of tests given to date would just be enough to cover two-thirds of our people with a single test. The 7-day average of new coronavirus cases per day is now over 3 times higher than it was at the initial peak back in April. The test positivity rate is double what it was this summer. So, what are we doing about it?
MASK MANDATES - Twelve state still have no mask mandates. Wyoming just issued a mask mandate last Monday, while Mississippi rescinded its mandate. I created the table below to sumerize the COVID status of these no-mask-mandate states and ranked them according to today's test positivity rates. With the possible exception of Alaska, all of these states should be mandating masks given their situations.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 253- DECEMBER 13, 2020
UNDERCOUNT
New case numbers and death statistics are missing from LA, CT, RI. Death statistics are also missing from KS and WY.
COMMENTS
No special comments today except to say there are no signs of the virus slowing its rate of community spread. Also, the total number of COVID tests given to date is nearly equal to 2/3s of our total population after 253 days of the National Health Emergency. On a local positive note, the Morris County Community College in New Jersey has started offering free saliva COVID tests to all residents of the county and any healthcare workers or first responders who work in the county. I wonder how widespread this is throughout the country and in poor urban areas?
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 252- DECEMBER 12, 2020
UNDERCOUNT
All state reporting data today.
COMMENTS
We had close to a third of all new cases reported worldwide yesterday and nearly a quarter of all reported deaths. We are averaging around two-million COVID tests per day, well below the six-million target set back in May. We continue to rank 17th in the world for the number of tests per million. Test positivity rates remain over 11%. The running 7-day average for both COVID-19 deaths and new infections (cases) doubled in 34 days. We had more new cases recorded yesterday than did the next 12 countries on earth combined and more COVID deaths than the next 5 countries combined. If more of us are taking better precautions to suppress the virus, the evidence isn't showing up yet in the data.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 251- DECEMBER 11, 2020
UNDERCOUNT
This is a first. Mid-week and five states have not published all of their statistics. There are no new case numbers or death totals from MO, KS, NE, and no death totals from WY or ME.
COMMENTARY
It is hard to put America's death toll into a global perspective, but if you add up all the people who died Wednesday in the 15 most populated countries other than the United States, we lost more people to COVID-19 yesterday than did the 4.8 billion people in those 15 countries. And, that is without county any deaths in five states.
It did not have to get this way. A competent, compassionate government as wealthy as ours could give each of us our daily surgical masks and our three in-home COVID-19 screening test for the week (which operate like pregnancy tests). As discussed last month, these self-administered screening tests would allow people to self-quarantine as soon as they become infectious to others. A compassionate national financial aid scheme would allow all workers to stay home without losing any pay (a federally funded paid sick leave for all who test positive or become sick with the virus!) and allow everyone with a positive screening test to get a PCR laboratory test at no cost.
If masks, screening tests, or any other item needed to fight the virus is in short supply (despite the e implementation of the Defense Production Act), our state and National Waste Water Surveillance systems could spot a week in advance the hotspots of community spread and distribute masks, screening tests, medical supplies, contract tracers, and other resources to those specific communities. Wastewater surveillance can be as specific as testing sewage water for COVID in specific grade schools, college campuses, or dormitories to keep our students safely in school. This is what the Netherlands has been doing since the start of the Pandemic. A coherent and compassionate National Health Emergency policy would do all of this and more, in addition to providing everyone with clear, consistent, scientifically sound information and rational, regional mitigations planning to minimize community spread. These are just a few key elements that might be part of a national strategy if we had good leadership.
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DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 250- DECEMBER 10, 2020
UNDERCOUNT
With all states reporting new case numbers only Delaware's death report is missing.COMMENTS
Yesterday was the deadliest day in America's tragic response to the pandemic with 3,260 people dying. These were mostly avoidable deaths. We are about to pay a huge price over the next 60 days for our poor choice of political leaders and our tolerance of the right-wing disinformation media networks that have set us against each other. As the spread of the virus and deaths skyrocket let's remember that this great country had the knowledge, wisdom, resources, and infrastructure to lead the world in smashing down the impact of this global pandemic.
Today is day 250 of our "National Health Emergency." This daily diary began on April 30th, which was day 48 of our National Health Emergency. On that day, 35% of the world's daily new cases were here, 28,429 infections from the 29th of April. Also reported were 2,390 deaths from COVID-19. What prompted me to start this blog was the huge contrast between how the United States was handling the crisis versus the rest of the world. On April 30th, the U.S. had a third of the world's total cases and deaths. My hope was that highlighting this contrast might prompt citizens and our leaders to do better. Here is my first commentary from that day.
These comparisons clearly show that COVID-19 infection rates and deaths make the United States a huge outlier in the world. We are not doing nearly as well as most other countries. And keep in mind that every nation still only has social distancing as the primary means to control the spread of infections. Testing, isolation, and contact tracing are part of the mix, but keeping infected people away from healthy people is all we've got at this point until we have a vaccine or effective treatments available. We are all in the same boat.
These data, by the way, are continuously updated from the Worldometer.info website, a non-government, non-affiliated international effort to provide global statistics in an easy to access formate.
So, the question has been asked, why are we doing so poorly compared with other countries?
The answer is clear and inconvenient for many Americans. We have a lack of political leadership from the top.
The wealthiest, most inventive, and industrious country in the history of the planet should, by now, have the capacity of testing 10 million citizens per day for the virus. Millions of people who are now unemployed should be hired, by now, to conduct testing, contract tracing, and welfare checks the millions who test positive for the disease and placed under quarantined. We should have in place a national stay at home order the same as every other country. We should have exceptions for stay at home order for essential workers, but we should have massive testing and mandatory guidelines, with aggressive enforcement, for those workers. We should not only have all the PPE we need by now, but we should also be exporting vast quantities of PPE to other nations that don't have our manufacturing capacity.
This is a picture of the nation we should be, the great country we once were. Nations of the world should be looking to us for guidance and help. Instead, we are inching our way back towards another round of disaster and death.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 249- DECEMBER 9, 2020
UNDERCOUNT
The above table is missing reports from New Mexico. Reported death tallies are missing for Kansas, New Hampshire, Wyoming, D.C., Alaska, and possibly Hawaii.
COMMENTS
With at least six states not reporting deaths from yesterday, the total number of people who died is a record high of 2,960. This week will likely see a high of over 300,000 infections in a single day. The 7-Day Average death toll from the virus has doubled in 21 days, more quickly than the doubling rate of the infections. My hope is that this is a statistical feature and not an indication of overload healthcare systems. The test positivity rate also jumped up today.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 248- DECEMBER 8 2020
UNDERCOUNT
With all states reporting new case data, the following states are not reporting death totals for yesterday. They are Arizona, Mississippi, Delaware, South Dakota, Maine, and Hawaii.
COMMENTS
A 90-year-old woman in Great Britain yesterday became the first person to receive a fully tested COVID-19 inoculation. This marks the beginning of the end of this global pandemic, although the road ahead will be some of the worst we have to travel. According to media reports, some sort of bureaucratic snafu within the federal government has resulted in the U.S.'s expected doses of the Pfizer vaccine this year to drop from 300 million to 35-40 million.
In the meantime, our daily new cases continue climbing out of control and still doubling every 31 days. Unless we all take greater safety precautions we will have an average of over 400,000 new infections per day by this time in mid-January. behavior
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 247 - DECEMBER 7 2020
UNDERCOUNT
Eleven states either had no deaths or didn't report them. Four states also didn't report new infections. Michigan, Kansas, Connecticut, and Rhode Island reported neither new cases nor deaths. Wyoming, Alaska, Washington, Utah, and Colorado didn't report their death totals. Maine and Vermont had no death totals also but their infections are low enough that they may not have had any deaths.
COMMENTS
The U.S. remains the country with the most community spread of the virus in the world. The 7-day average number of deaths as of yesterday broke the U.S. record of 2,259 that was set back on April 21st. Still, the numbers are undercounted from over the weekend. The question is, do the higher counts on Thursdays and Fridays make up the full accounting for the days when states aren't reporting any numbers at all? Where is the transparency? I checked with the CDC website. The numbers do come directly from the states that they use, and they have a confirmation process in place to assure that their reporting is accurate. New case numbers are defined by the CDC as cases confirmed cases by laboratory tests or probable cases defined by a clinical diagnosis in combination with other criteria without a confirming laboratory test in most jurisdictions. 
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 246 - DECEMBER 6, 2020
UNDERCOUNT
Nine states are missing death reports from yesterday. Four of them, LA, NE, CT, and RI are also missing new case data. The other states with no death reporting are WY, DE, KS, ID, and WA.
COMMENTS
The 7-day average number of Americans losing their lives to the Coronavirus will soon surpass the peak back in April. It should be over that number already but for chronically late and missing reports of COVID deaths by certain states. The death toll has doubled in just 23 days. In terms of the rate of community spread, exactly 1 of 3 new cases in the world were recorded in the U.S. yesterday, despite no reporting from four states. Testing numbers are not keeping up with infection rates. Test positivity rose again today. Leadership is missing. It is up to each of us to put politics aside and wear masks around other people.
MIT studied the build-up of aerosols under various conditions in different settings. This gives us the first good picture of just how effective mask use can be, and an understanding of the risks we face as we head towards the holidays. They used this information to create a risk assessment tool to help us assess safety in different situations. For example, they found that:
"If people social distance and [properly] wear a [surgical] mask in any room, groups of people can hang out indefinitely — but that is nearly impossible for most situations."
The types of masks being worn indoors make a huge difference, as do a number of other factors that I have written about in this Pandemic Diary blog. I suggest everyone read the full article in the link provided above. And keep in mind, large breath particles contain more viruses and behave differently than aerosols. The green colors above are larger droplets subject to gravity and the red colors are aerosols that behave more like smoke. The point being, if you aren't properly wearing your mask and not social distancing at the same time, your risk of catching the virus from an infected person is imminent.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 245 - DECEMBER 5, 2020
UNDERCOUNT
Still, no reporting from Nebraska reflected here and no death report from Wyoming.
COMMENT
Here is a table of the ten states with the highest ICU bed occupancy as of December 2nd. With new infections and deaths projected to double again in 30 days the pressures on our healthcare systems, especially in these 10 states, will be enormous.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 244 - DECEMBER 4, 2020
UNDERCOUNT
With all states reporting daily new cases yesterday, neither Kansas nor Delaware reported their death statistics.
COMMENTS
For a global comparison, the U.S. had more new cases yesterday than the next 7 countries combined and more deaths than nearly the next 4 countries combined. We have 5.6 million people with active infections and over 100,000 hospitalized. Hospitals in the U.S. are about 70% full, but in many regional areas hospital capacities are already overtopped. All we can do to be helpful now is hunker down, stay home, wear masks, wash our hands, and wait for the vaccine.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 243 - DECEMBER 3, 2020
UNDERCOUNT
Nebraska data is absent for new cases and deaths again today. Not death reports were provided for Alaska or Wyoming, and possibly Hawaii (which may not have had any).
COMMENTS
Yesterday we had the second most new COVID-19 infections since the pandemic began. Nearly 1 in 3 cases around the world were recorded here, and we are still undercounting cases in multiple ways. Tomorrow we will top that number and set a new world record. Test positivity rates are rising quickly as well, from 9.57% six days ago to 10.27% today. These high new case numbers still may not reflect the substantia reporting backlogs over the past 10 days. As for the 2,833 souls who lost their life yesterday, this number is even more suppressed by both a lack of direct reporting and the failure of states to follow CDC guidelines in establishing COVID-19 as an underlying cause of death. Irrational politics is helping to drive up these pandemic numbers. Yesterday in Staten Island there was a large, noisy protest by a thick crowd of maskless men in response to the forced closing of a bar. The owner refused to stop serving meals indoors in violation of local public health restrictions. If the same bar had been closed by the health department for any other reason there would not be a peep from anyone. It has been reported that fewer than 70% of Americans are wearing a mask in public and people dying of COVID-19 won't believe they even have it.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 242 - DECEMBER 2, 2020
UNDERCOUNT
Nebraska data is absent for new cases and deaths. Kansas data on COVID-19 deaths is absent as well.
Wednesday, day 242 of our declared national health emergency and the good news is that the Phizer vaccine won approval in the U.K yesterday, the first in the Western world. It will likely be approved here soon as well where it will first go to healthcare workers and vulnerable people in institutions. The epic battle of science to create a safe and effective vaccine in so short a time will be legendary and a milestone in human history. The bad news, of course, is the numbers we will see this month. How we are going to respond and stay safe between now and inoculation day. We all have to hunker down, disentangle ourselves from politics with respect to COVID, and do all the things we already know how to do to keep ourselves and others safe.
When you do have extended contacts with others, take the same precautions you would take if you or they were positive for COVID-19. I will share the personal precautions I take when with visitors. (Not a good idea, I know, but it can't always be avoided):
- Start wearing your mask one half-hour before your company arrives to begin reducing aerosol production and droplet deposits in your home.
- Either air out your house ahead of time or start your HEPA air filters an hour before visitors arrive to remove aerosol particles that may have built up in your home. Constant air exchange with the outside is best when temperatures permit.
- Check your indoor humidity. If it isn't above 40%, start your humidified and try to keep humidity levels between 45%-55%. It is a fact that lower humidity levels cause us to produce more aerosol emissions.
- With your mask on, clean or disinfect all the surfaces your guests are likely to touch before they arrive to help protect them from you. Cleaning tabletops and counters and other surfaces without a mask mean you are spreading breath droplets and infecting those surfaces as you clean.
- Turn on the bathroom air vents a half-hour before the company arrives, keep it on during their entire visit, and for a half-hour after they leave.
- Ask your company to properly wear their mask at all times before entering your home. For the best protection, they should wear an N95 mask. Offer them an upgrade if they have an inadequate cloth mask.
- Have your company remove their shoes and outerwear at the entranceway. They may not have been wearing a mask while driving, which means breath droplets have been collecting on their coats and shoes.
- Ask them to either wash their hands or use hand sanitizer first thing after they are inside, and to keep their masks on at all times.
- Maintain social distances at all times, especially when eating or drinking requires temporary mask removal.
- Visits should take place in the largest or airiest rooms in your house with furniture arranged to maintain social distances. Keep visits as short as possible.
- Don't touch their coats, cell phones, or other belonging without washing your hands or using sanitizer immediately after.
- After they leave, continue wearing your mask and ventilating your home for at least a half-hour and disinfect the surfaces that your guests may have touched after they leave.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 241 - DECEMBER 1, 2020
UNDERCOUNT
All states reporting New Case data. The following states are not reporting deaths: NE, WY, NH, AK, DC, and HI.
COMMENTS
Welcome to December. We start the month with significant under-reporting of new case data and death reports from multiple states over the Thanksgiving day weekend. The 162,736 new cases reported from yesterday do not capture the backlog. The 1,517 new deaths not only don't include most of the backlog, but it also doesn't include death totals from six states. This is in addition to the significant undercount from 24 states that are refusing to count probable COVID cases. With that said, almost 1 in 3 people who were infected with the virus in the world, yesterday, live in the United States. If California were a county it would rank 6th in the world for the most number of new infections in a single day behind Brazil with 5 times more people. Texas would rank 8th behind Germany, and even with those two states gone, the U.S. would still have by far the most number of new cases on any country in the World yesterday. This is the state of things as we head into the "wave upon a wave," as Dr. Anthony Fauci calls it.
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