by Brian T. Lynch, MSW
Welcome to the Daily Pandemic Diary for January 2021. 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 302 - JANUARY 31, 2021
There is a significant undercount today. The following states provided no statistics from yesterday: Missouri, Alabama, Louisiana, Kansas, Nebraska, Connecticut, and Rhode Island. Additionally, Idaho, Alaska, Wyoming, and Hawaii reported no deaths or death statistics. Based on active cases in those states the death toll is missing about 2,100 deaths. The estimated total deaths from yesterday should be closer to 3,992 and our portion of the world total should be closer to 27%.
COMMENTS
It is the last day of January, so let's review how we did in January compared with the rest of the world:
1. New Cases - The U.S. had 6,210,228 news cases in January, a 30% increase vs a 20.6% global increase in new cases (after subtracting the U.S. cases from the world totals).
2. Deaths - The U.S. had 96,171 deaths in January, a 27.2% increase vs a 21.1% global increase in January (after subtracting the U.S. cases from the world totals).
Looking back at December, the U.S. had 6,297 new cases that month, a 45% rise in total cases. There were also more deaths, 118,552 deaths, which was a 53% rise in total deaths. As it turns out, January was not the worse month for the pandemic in the U.S. as predicted. We did improve our infection-prevention behaviors. Recent polling indicated that Democrats and Republicans alike increased mask-wearing by 13%, thus resulting in a dramatic decline in the rate of community spread over the second half of January. The number of deaths in January was held just below the December total. If it continued to rise at December's rate of 53% it would have taken the lives of an additional 93,000 people. So, WE DID IT!
We are starting a new month with new challenges on the horizon from new variants of the coronavirus that are more infectious and in some cases less responsive to the vaccines. So again, as I wrote about yesterday, our best option to get this pandemic under control is to continue improving our collective prevention behaviors to further limit the spread of the virus.
January 31st data below
January 1st data below
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 301 - JANUARY 30, 2021
Missouri and Nebraska have not posted their COVID data again today. Vermont, Alaska, and Wyoming either had no deaths or didn't post them.
COMMENTS(I had comments posted yesterday but they didn't get saved for some reason.)
Today, the big news is that the virus is mutating into vaccine-resistant variants faster than scientists expected. The reason is clear. According to the LA Times piece, "... the speedy evolution is largely a result of the virus’ unchecked spread."
Whenever any cell or virus replicates, there is a slim chance that a mistake or mutation happens. The faster a virus replicates the more frequently these mistakes happen. Most mistakes do nothing, but every so often, by chance, a mistake makes the virus heartier. This new "variant" is more successful at replication. It eventually out-competes the original strain, becomes the dominant strain, and this mutation process continues.
The number of times a virus replicates in the human body is such that the rate of mutations is low and the likelihood of a beneficial mutation occurring is extremely rare. But, multiply the speed of mutations in an individual by 26 million, which is the number of active COVID-19 cases worldwide, and you greatly speed up the rate at which more robust variants emerge. The more people who are sick with the coronavirus, the quicker the vaccine becomes less effective. The race for an effective vaccine isn't actually over yet.
What can be done to keep new resistant variants from disrupting our progress? Three ideas come to mind. We can try to speed up how quickly scientists can identify more robust variants and modify existing vaccines to counter the variants. We have seen already how slow that process can be. The speed of development for the current vaccines is already record-breaking. We can, and should, greatly pick-up the pace of getting people vaccinated all around the world. This is an enormous task and would require a level of global effort and cooperation that is unparalleled in human history. The third, most practical and effective way to slow the speed of new, more robust variants is to greatly reduce the spread of the infection. So, it all comes back to the basics of prevention.
roperly wear good quality masks and keep yourself six or more feet from everyone who is not in your immediate household. Don't go indoors to bars, restaurants, or any other place where you might have to remove your mask to eat or drink unless they are scrubbing the air in the facility. Stay away from crowds, outdoors or indoors. If you must be in a building where you are around strangers, such as a doctor's office, etc., make sure there are air scrubbers running (medical-grade HEPA air filters) or proper air exchangers operating. Make sure everyone has the ability to stay 6 feet apart.
And remember, everyone in a hot zone everywhere on earth needs rapid access to a vaccine and all the PPE necessary to prevent the spread of the virus. A new variant anywhere in the world will make its way everywhere else on earth. We are all in this together, so PPE and vaccines must be readily available in every county for all of us to be safe here at home.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 300 - JANUARY 29, 2021
No Entry
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 299 - JANUARY 28, 2021
COMMENTS
The New York Times and other outlets today are reporting on the drop in new cases over the past few weeks. I took a look at the global trends for comparison and found that the U.S. is following a general global downward trend. By how much the U.S. numbers are driving that trend I cannot say, but the shape of the two trendlines is quite similar. Given all the variables of which I am aware, increased wearing of masks in the U.S. appears to be the only factor robust enough to account for the decline in daily new cases. There is also a decline in super-spreader events (Trump rallies, for example) since the election that may contribute to the decline as well.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 297 - JANUARY 26, 2021
Missouri, Kansas, and (again) Nebraska have not reported their COVID-19 statistics from yesterday. Vermont and South Dakota either had no deaths or didn't report them.
COMMENTS: Here is a thought experiment for anyone who questions the utility of wearing a mask to control the pandemic. Imagine that you walked into a room with a person that has a cold that can only be transmitted by breathing the virus. The person is wearing a respirator that is 100% effective at not shedding any virus. Also, everything in the room was 100% disinfected before you entered. During your time in the room, this person never removes their mask. What are the odds of you catching the virus? Probably close to zero, right?
Next, imagine the same set-up but with a respirator that is only 95% effective. What would be your chances of catching the virus? And if but both of you are wearing respirators that are 95% effective, and both of you never get less than 6 feet from each other? Wouldn't the odds of you catching the virus be very small?
Finally, imagine every single person in the world consistently wearing respirators that are 955 effective while in the vicinity of anyone else, staying 6 feet away from everyone they see, washing their hands every time they have contact with anything anyone else might have touched in a world where there were no crowds of people anywhere on the planet. If everyone on earth could do this for a month (or the time that COVID-19 remains infectious in the human body), the result would be something close to the eradication of the virus.
This is only a "theoretical" thought experiment because it is unrealistic that every person on earth would comply, but you should have no doubt that an N95 mask (which is 95% effective at keeping the virus from spreading) and social distancing is just as effective as a vaccine if everyone did comply.
The latest polling indicates that the number of American adults who always wear masks in public is at an all-time high of 72%. Most of us still wear cloth masks which are 40% to 60% effective. Cloth masks have uneven pore sizes and they don't seal tightly against the face, so they leak). So, if it seems like masks are not working to you, it is because 93 million Americans are not wearing them all the time, many more are wearing them below their nose (which isn't wearing them at all), and at least twice as many people are only wearing masks cloth masks that are 1/2 as effective as they should be.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 296 - JANUARY 25, 2021
Again Nebraska has not reported new cases or new COVID death data. Seven other states have reported no deaths or not reported death statistics. They are North Dakota, South Dakota, Alaska, Hawaii, Montana, Wyoming. and Iowa. The estimate today for the number of unreported deaths from these states is 226 deaths.
COMMENTS
Despite recent successes in slowing the spread of the virus in the U.S. one of every three new cases in the world happens here. Our testing levels are still inadequate and today the test positivity rate went up instead of down as it has been doing every day for a few weeks. Three states have over 10,000 new cases every day, although in each of these the daily new case totals are leveling off or declining recently.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 295 - JANUARY 24, 2021
COMMENTS
ON VACCINE IMMUNITY: People are starting to get vaccinated, and that's a very good thing. The numbers still too are small to curb community spread of the virus, but the vaccines do give a measure of individual immunity for most people. (1 out of 20 might become at least mildly infected if exposed to the virus). The CDC recommends that everyone still use the same precautions after getting vaccinated, wearing masks, avoiding crowds, social distancing, etc. There are a number of reasons for this recommendation. First, personal immunity takes time to develop after the shots are given. The initial vaccine conveys about 80% immunity at the point when the second shot is due. It takes another few weeks to develop full immunity after the second shot. Secondly, no one knows for sure how long this immunity lasts or who quickly declines. There is also the question of whether a person can be immune and yet contagious to others. While it would be highly rare for a vaccinated person to still be able to infect a non-vaccinated person, the research doesn't exist yet to say this is true for this virus. And the final reason is that new variants of the virus are cropping up quickly. The more widespread the infection in the population, the quicker it mutates. The vaccines may not work with some of the new variants. Once the community spread is greatly reduced, the speed of new variants will be reduced and the research needed to assess and adjust the efficacy of the vaccine can keep pace with new strains. It is possible, if not likely, it may be safe to open up our social bubble in the future to others who are otherwise maintaining safe behaviors in public, but we can't count on that yet, so we must continue taking all prevention measures for the time being.
The last 14 days or so in the U.S. graph (right side) show the recent bending of the curve and represents a slowing of the spread of the virus. The UK graph shows a very sharp spike in new cases as the countries of the UK were overwhelmed with the new COVID variant that is so much more contagious. But then you see a reversal and rapid decline in numbers, greater than our own, that followed when the UK imposed a stringent lockdown. The table below summarizes the lockdown measures they imposed to achieve this impressive turn-a-round.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 294 - JANUARY 23, 2021
UNDERCOUNT
Four states have not recorded their news cases or deaths today. They are Louisiana, Connecticut, Rhode Island, and Wyoming. Based on the total active case in the states not reporting, the estimated undercount of people who died yesterday is 62 deaths. COMMENTS
As reported yesterday here, the increased wearing of masks in the U.S. appears to be bending the curve in new infections. To put our progress in a global context I compared our national trend with the progression of COVID in the next four countries with the highest number of new cases. The total new cases reported in the four other countries are far lower than the U.S. total. For scale, the combined populations of Brazil, the U.K., France, and Mexico is 45% higher than the U.S. population, yet the new cases reported yesterday in the U.S. are 34,000 cases more than those reported in the other four countries combined. What we need to focus on in the following graphs are the shapes of the trends and the national contexts from which they emerge.
France has been diligent in increasing prevention efforts since the new variant arrived there and in contrast to the UK, which was taken by surprise, you can see that Frances's efforts have paid off.
Brazil's inconsistent and even feckless efforts have most mirrored the efforts here in the U.S. that have resulted in our outstanding failure to control the spread of the virus. Not surprisingly, the shape of their trendline most closely mirrors our own as a result.
Mexico has managed to do a better job than the U.S. in controlling the virus until they elected a new President. They had high hopes, but so far they are disappointed all the way around. The new leadership has shown little proclivity in managing the pandemic in Mexico and their number of new infections is spiking out of control. Here is an article and an excerpt on the political situation in Mexico.
UNDERCOUNT
No statistics were reported by Missouri or Nebraska. Nebraska has not reported any statistics for the past four days. What is going on in that state? Also, no deaths were reported in Alaska and no death statistics were reported from Delaware.
COMMENTS
Good News! Daily new infections of COVID-19 has declined for the past week from a peak of over 248,000 on January 16th to 186,862 yesterday. The trailing indicator, COVID deaths, continued to grow and the 7-day running average is still creeping up. The U.S. test positivity rate has also steadily declined over the past two weeks from a high of 13.98% on January 9th to today's 9.46%. This is good news testing rates have not changed much in this period. These trends appear robust and are not a product of the persistent undercounts. It is too soon to see any impact yet from vaccinations, so the apparent reduction in the community spread is likely the result of the increased mask-wearing, as documented in a recent poll (previously referenced):
"More than nine in 10 U.S. adults (93%) said they sometimes, often or always wear a mask or face covering when they leave their home and are unable to socially distance, including more than seven in 10 (72%) who said they always do so, the poll revealed."
"The percentage who reported always wearing a mask in October has increased for all political persuasions since August: Democrat (82% versus 69%), Republican (66% versus 53%) and Independent (69% versus 64%)."
Great Job, America. Keep up the good work!!!
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
Day 293 - January 22, 2021
UNDERCOUNT
Nebraska failed to report its statistics for the third day in a row. All other states reported new cases from yesterday and new deaths except Wyoming which may not have had any deaths yesterday.
COMMENTS
No Comments today.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 292 - JANUARY 21, 2021
UNDERCOUNT Nebraska is the only state not reporting out new cases or deaths in today's data. There are either no deaths to report or no death reports from South Dakota, Wyoming, and Idaho. Based on active cases in these four state the undercount of COVID-19 deaths is approximately 27 people. COMMENTS
While today is day 292 of our Nationa Health Emergency, it feels like day one. On day two in his term as President, Biden will push Congress to advance the strategy his team of scientific advisors developed, starting with 10 executive orders and directives he will sign today.
"One of the orders will direct agencies to use the Defense Production Act to address critical shortfalls in 12 categories of items needed for testing, treating and vaccinating people for COVID-19: vaccines, N95 masks, gowns, gloves, test supplies and kits, lab analysis machines, therapeutic drugs and other supplies — and will work to spur production of the items in America." - NPR
It is like someone flipped a switch. A national pandemic response is at last one the way.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 291 - JANUARY 20, 2021
Daily new infections and death reports are missing from Kansas and Nebraska. Death reports are missing from South Dakota and Montana, and no deaths were reported in Vermont.
COMMENTS
Good News: Underselling the Vaccine - from the New York Times.Bad News: New Jersey (112%) and Vermont (75%) lead the nation in the percentage of increase in the number of cases over the past two weeks.
Scary news: Another New Covid-19 Variant Discovered In L.A. Might Be Vaccine Resistant, Researcher Says; Strain First Identified In Denmark.
"Days after the Los Angeles Public Health Department announced that the much-talked-about UK variant of Covid-19, known as B.1.1.7, had been identified in the region, the California Department of Public Health revealed that another lesser-known strain had been circulating in the county as well. Known as L452R, the newly announced arrival was first identified in Denmark in March. It showed up in California as early as May."
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 290 - JANUARY 19, 2021
New infections and new deaths data from three states are missing today from North Carolina, Idaho, and Rhode Island. Death reports are definitely missing from Delaware, New Hampshire, Arizona, and North Dakota, and no deaths were reported or recorded in Hawaii, Alaska, Vermont, and Wyoming.
The number of deaths yesterday missing from today's statistics can be estimated from the total number of active COVID-19 cases in those states multiplied by the national average of daily deaths per active cases. This calculation estimates an additional 1,400 deaths not reported today, bringing today's adjusted death toll to 2,825 deaths. That would push the global death toll yesterday to 10,642 and our global share of deaths to 26.5%. Such is the impact of these weekend reporting failures from a relatively small number of states.
COMMENTS
Here is another statistic worth pondering. If the vaccines were not yet developed, and if more of us wore masks and took other precautions so that we stopped the rise in cases, at the current average daily fatality rate we would lose 1.2 million Americans per year.
So why is it that 10% of us still think this pandemic is under control? Political disinformation plays a role. "About 1 in 5 Republicans say they think the pandemic is at least mostly under control," while 5% regarding it as completely controlled, a new survey finds. A new HealthDay/Harris Poll shows that more Americans are wearing masks. According to the poll:
"More than nine in 10 U.S. adults (93%) said they sometimes, often or always wear a mask or face covering when they leave their home and are unable to socially distance, including more than seven in 10 (72%) who said they always do so, the poll revealed."
While improvements in mask usage have grown, political differences remain a key obstacle to controlling the virus.
"The percentage who reported always wearing a mask in October has increased for all political persuasions since August: Democrat (82% versus 69%), Republican (66% versus 53%) and Independent (69% versus 64%)."
The reason we cannot flatten the curve on community spread is that mask-wearing has become a symbol of fidelity to a political party that can no longer justify its policy goals through conventional persuasion. Until Republican policies are realigned with empirically verifiable data, the pandemic will continue to take an excessive toll while we await herd immunity through the vaccination programs.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 289 - JANUARY 18, 2021
Data from five states are missing today. They are Michigan, Missouri, Kansas, Connecticut, and Rhode Island. Additionally, death totals were not reported in Delaware, Nebraska, or Washington. Vermont, Alaska, and Wyoming either had no deaths or didn't make a report.
COMMENTS
Into the wind I ask, why aren't we testing to locate the new Coronavirus variant hotspots? With no systematic means to identify local spikes in new cases that resemble the known new variant spike patterns in the United Kingdom, I somewhat randomly check new case numbers in various states for evidence of any anomalies. I may have found one in Harris County Texas. Harris County includes the Huston area, and the total new cases there yesterday appeared significantly higher than in the next highest county. A look at the county's local COVID dashboard turned up a frightening rise in new cases of late. Notice the similar shape of the rising case data in both Harris County, Texas, and Great Britain in the charts below. Texas officials may be testing to locate and isolate new variant hot spots, I don't know. If we had a national pandemic response plan we would already be directing our resources to help the people who live in the greater Huston area.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 288 - JANUARY 17, 2021
No reporting today from Missouri, Louisiana, Kansas, Connecticut, Nebraska, Oregon, or Rhode Island. Alaska, Vermont, and Wyoming may not have had any deaths to report.
COMMENTS
I changed my mind. Instead, I want to revisit a topic I have written about many times in the past. MASKS. Here is a link and reference to an article published in the Atlantic:
Why Aren’t We Wearing Better Masks?
Cloth masks are better than nothing, but they were supposed to be a stopgap measure.
ZEYNEP TUFEKCI AND JEREMY HOWARD
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 287 - JANUARY 16, 2021
All states are reporting daily new cases from yesterday. Louisiana and D.C. reported no deaths. Hawaii and Wyoming also reported no death and may not have had any.
COMMENTS
PERSPECTIVE: We remain the world leader in the spread of COVID-19 and COVID deaths. We had more new infections yesterday than the next 8 countries combined, countries with a combined population 2.5 times higher than our own.
While the rate of increase appears to be slowing, the CDC is warning that the new and more infectious variant will become the dominant strain by March. The variant has been detected in 72 cases and 12 states so far but the U.S. is not systematically testing for the new strain. The U.S. is also not testing wastewater sources which would give easy, accurate, and early indications of where the new strain is taking hold. Evidence of the new strain will show up as spiking increases in new cases. I checked the daily new case increases in all 50 states and D.C. and found that only New York has a potentially suspicious rise.
Against this background, we learned yesterday that the Trump administration lied about having a national stockpile of vaccine and its promise to distribute it to the states was canceled, leaving states in the lurch. But on the positive side, President-elect Biden releases his $1.9 trillion COVID and economic relief plan that promises to take many specific actions to speed up the rate of inoculations in the next 100 days.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 286 - JANUARY 15, 2021
Missouri and Kansas have not reported new cases or deaths from yesterday.
COMMENTS
Sometime tomorrow the U.S. will record its 400,000th death from the coronavirus.
Let's make February 6, 2021, a national day of mourning to recognize all the loved ones lost in this pandemic. Write to President Biden, your Governor, your Congress members, and Senators. Ask them to set aside this date for a national day of mourning. Share this on social media.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 285 - JANUARY 14, 2021
All states are likely reporting their statistics today. Wyoming and Vermont likely had no deaths yesterday.
COMMENTS
With a little over 4% of the global population, and with all states reporting, the U.S. has nearly a third of all new cases of COVID-19 in the world and 25% of all the deaths.
Good News! There is evidence that the rate of increase in community spread is slowing. The 7-day average for new cases on December 13th was 52% higher than it was on November 13th, while the average 7-day average on January 13th was only 14% higher than on December 13th. The test positivity rate is also trending down recently. An outbreak of the new variant could quickly reverse this trend, but baring that, we are close to flattening the curve.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 284 - JANUARY 13, 2021
Missouri is the only state today not reporting new cases or deaths. Hawaii, South Dakota, and Kansas have reported no deaths.
COMMENTS
A record number of people died of COVID yesterday, over 4,000. RIP. If you smooth out the trend line, the 7-day average of 3,300 deaths per day appears to be accurate. It also appears to be steadily climbing by about 35% per month. If we don't lower this rate there will be 4,600 people dying per day by this time next month. This brings me to a follow-up from yesterday's comments.
February 6th will be the one-year anniversary of the first COVID death in America. As a nation, we have not yet mourned or honored these dead. We have not acknowledged the grief and great loss experienced by so many of our citizens. It's time we did. Let's make February 6, 2021, a national day of mourning to recognize all the loved ones lost in this pandemic. Write to your Governor, your Congress members, and Senators. As them to set aside this day for a national day of mourning. 
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 283 - JANUARY 12, 2021
All states reported new cases from yesterday. New Jersey, Hawaii, and six other states didn't report any deaths. (NH, WY, SD, AK, ND, and VT)
COMMENTS
The first confirmed death from COVID-19 in the U.S. happened on February 6, 2020. That is 25 days from now. If conditions don't get worse between now and then an additional 82,500 people will die before then. That would mean a total of 468,000 COVID-19 deaths by the one-year anniversary of the first death in the United States. There is not much we can do now to lower that total since 25 days is about the lag time between catching the virus and dying from it. Because the infection rate is still trending upward, the final one-year could climb to half a million souls. How many of them could we have spared?
UNDERCOUNT
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 282 - JANUARY 11, 2021
Based on the 7-day average of new cases in the six states not reporting any statistics today there are likely 10k more new infections from yesterday. The states not reporting any statistics are Michigan, Missouri, Kansas, Connecticut, Rhode Island, and New Jersey (a first for that state). States reporting new cases but not new COVID deaths are Wyoming, North Dakota, Vermont, Alaska, and Maine.
COMMENTS
It is interesting to look back and see how the U.S. was doing exactly six months ago. Here below are the statistics that were being kept in this Diary back then.
Notice first that our ratio of cases and deaths globally were higher than today. The United States was hit very early and very hard in the initial months of the pandemic. Yet, by June 10th our efforts to "bend the curve" through lockdowns and mask-wearing brought our global total down to 16% of the world's total. Today, our share of the global spread of the virus is 35% of the total worldwide. More shockingly, the daily new-case average is 10 times worse now than it was 6 months ago. The largest "mega-spreader" event (or perhaps a MAGA-spreader event) in history just took place on January 6th in Washington D.C. when over 10,000 shoutings, maskless marauders stormed the Capitol. They came from all over the country and returned to far-flung places. Their assault has already lead to 5 deaths. It will surely result in many more deaths over the next 30 to 45 days. Their congregate catastrophe may also hasten the spread of the new, more contagious variant in other states.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 281 - JANUARY 10, 2021
Missouri, Kansas, Louisiana, Connecticut, Nebraska, and Rhode Island did not provide new case data or death toll data for today's report. Wyoming, North Dakota, and Vermont may not have had any deaths to report based on their active cases.
COMMENTS
Based on the 7-day averages of new Coronavirus cases from the six states not reporting yesterday's number, 14,874 new cases are missing from today's tally. Adding in the estimated new cases from the states not reporting would bring the total number of new cases yesterday to 264,393. That would be the nation's fourth-highest day total. Half of that total would bring us back to the 7-day average on November 11th. The doubling time for the virus is now about 60 days. That is twice as long as it was in late November and early December. The rate of increased numbers is slowing but not yet declining. Good news!
UNDERCOUNT
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 280 - JANUARY 9, 2021
All states reported their new cases. Nebraska did not report new deaths from yesterday.
COMMENTS
About a quarter of a million people are now catching the virus and testing positive each day on average. On average, over 3,000 people are dying each day now. About 14% of each COVID test comes back positive. Globally, the U.S. is part of an escalating rise in new cases and new deaths. Within the global context, we are leaders in those escalating numbers, outpacing most other countries. The slight bending of the curve that looked so promising back in late December does not appear to be holding now. It is difficult to tell because of the pattern of undercounts over the holidays. The focus of the nation hasn't been on the pandemic since the assault on our democracy. That is understandable, but with 175 million people catching the virus and 21,000 people dying from it each week, our attention will be drawn back to it soon. Even with the vaccines being administered we are on track for losing half a million lives in the first year of this National Health Emergency.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 279 - JANUARY 7, 2021
There is no report today from Kansas, and Hawaii may have no deaths to report.
COMMENTS:
The most single-day total of new cases globally happened yesterday, and the second-highest number of new deaths as well. The U.S. had more new cases reported yesterday than the next 8 countries combined. The total new cases and deaths reported in the U.S. from yesterday are both record-high numbers, as are the 7-day moving averages for new cases and new deaths. The national test positivity rate is the highest since I started recording it here, while the total number of COVID-19 diagnostic tests are still fewer than our population after 279 days of the health emergency.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 278 - JANUARY 7, 2021
All states reported their new cases from yesterday and two states reported no deaths, Wyoming and Delaware (which may not have had any).
COMMENTS
Yesterday was a sad day, from the events in D.C. to the pandemic's strengthening grip on our nation. The highest recorded daily number of new infections, the highest daily recorded number of deaths, the highest 7-day average of new cases per day, and the second-highest 7-day average of new deaths per day, which will certainly be the highest by this time tomorrow.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 277 - JANUARY 6, 2021
Missouri's and Nebraska's new-case and death reports are missing from today's data. Hawaii, Alaska, South Dakota, and Kansas are missing death reports from yesterday.
COMMENTS
A third of the world's new COVID-19 cases and a quarter of the deaths are generated here in the United States. Despite us being a global hotspot outlier, 19 other countries do more testing per million population than we do. Test positivity rates exceed 13%.
The United States obtained 40 million doses of vaccine to innoculate 20 million people before the new year. Most of that vaccine is still in storage and some of it has gone bad and had to be tossed out. This is a story that highlights where the absence of national leadership is so evident. The Trump administration has had almost a year to work out a way to quickly distribute the vaccines once they were available. Such a plan could have included a federal effort to create a well-designed and rigorously tested software program for the states to adopt allowing them to instantly be ready to identify and schedule vaccinations. It could have included specific guidelines about who should get the vaccines first yet been flexible enough to leave some decision making up to the states. It could have asked the states to identify and pre-hire (if needed) healthcare staff to administer the delivery process and give the shots. This could have included recruiting retired healthcare workers or training programs. Working with the state, the entire infrastructure for in-arm delivery of the vaccine could have been in place before the first drop of vaccine arrived. That's what American's should expect and deserve. This lazy and incompetent administration did exactly nothing like that.
Instead, all responsibility for creating a distribution system fell to the states, and in some states, the Governors pushed that responsibility even further down the chain of command to local officials. Each governmental entity then had to create its own infrastructure starting from scratch, on a short timeframe, and without knowing how many vaccines it would receive or by when it would arrive. Each state had to build an infrastructure to register citizens and dispense the injection without any model or plans to guide it. All the while, state governments are hobbled by work-at-home plans, dwindling revenues, skyrocketing social needs, high unemployment and high demands for intense public health management needs to keep their citizens safe during this pandemic.
The lack of infrastructure and planning has resulted in only about 10% of the targeted vaccinations being given in 2020. An NPR report has found that the barriers to vaccinations begins with the lack of state and local planning and inadequate website programing and resources to identify and schedule those who are to get the vaccine first. The states cannot find enough qualified people to give the vaccines and man the with the length of time each vaccine take leading to a shortage of medical personnel to give the injections or staffing for the site location. This will all eventually get worked out, but in the meantime some of the vaccines in storage are going bad. It didn't have to be this way.
DAILY PANDEMIC DIARY 
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We must try harder to bend the curve and slow the spread of the virus quickly before the new variant takes over in the U.S. In a NY Times piece, today entitled "The Virus Is Still Winning" there is a graphic showing how the variant is impacting new cases in the UK and South Africa were it has taken hold. The piece goes on to say, "The B.1.1.7 variant appears to be between 10 percent and 60 percent more transmissible than the original version. One possible reason: It may increase the amount of the virus that infected people carry in their noses and throats, which in turn would raise the likelihood that they infect others through breathing, talking, sneezing, coughing, and so on.* a corrected number
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NATIONAL HEALTH EMERGENCY
DAY 276 - JANUARY 5, 2021
With all states reporting new cases from yesterday, only three states reported no death COVID deaths, Hawaii, Wyoming, and South Dakota. Nevertheless, there is still a significant backlog of statistics with which to catch up during the week. For one example, Arizona has 473,000 active cases and had 5,158 new cases reported yesterday but only 3 reported deaths.
COMMENTS
None so far today.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 275 - JANUARY 4, 2021
Fourteen states failed to submit statistics on COVID deaths yesterday and six states also failed to submit data on new cases. Michigan, Missouri, Kansas, Connecticut, Nebraska, and Rhode Island submitted no COVID statistics. Hawaii, North Dakota, Alaska, Wyoming, Idaho, Delaware, Iowa, and Arizona failed to report COVID deaths from yesterday.
COMMENTS
With a substantial backlog of new-case reports over the past three days, the 7-day average for new infections is still approaching the all-time high of 224,273*.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 274 - JANUARY 3, 2021
The data reported here today are missing both new case numbers and death totals from Missouri, Louisiana, Kansas, Nebraska, and Rhode Island. Also missing is the death totals from Deleware and Alabama. (Wyoming and Hawaii may or may not have had any deaths.)
COMMENTS
Two items jumped out of the data today. First, despite missing new-case numbers from five states, the U.S. still had 42% of the world's new cases yesterday. That is higher than it has been since the start of this pandemic. The other surprising jump is in the U.S. test positivity rate from 11.7% to 13.3%. That is the highest it has been since I started tracking it here. These are not good developments, but it remains to be seen if they are significant as the week unfolds.
Dr. Deepti Gurdasani from the UK recently tweeted out an excellent summary of concerns from the newly published Imperial Report regarding the new COVID-19 virus variant. I copied them into a guest blog post and want to share that link here for any who haven't read it yet. Her tweets are reproduced here in their entirety with attribution to its author. She wrote a far better summary than I could on the topic and has my gratitude.
DAILY PANDEMIC DIARY
NATIONAL HEALTH EMERGENCY
DAY 273 - JANUARY 2, 2021
Almost half the states submitted no statistical reports from New Year's day, making today's daily pandemic report almost meaningless. The states that did not provide any data on new infections or deaths were FL, OH, TN, NC, MI, NM, MA, LA, SD, OK, UT, KY, CN, ID, SD, ND, RI, MT, AK, WY, NH, ME, and VT.
COMMENTS
With about half the country not reporting new cases or deaths from yesterday, the U.S. still made up nearly 30% of the global total of new cases and 22% of the global deaths. As discussed last week, a clear picture of the pandemic in the United States will have to wait until Friday of next week at the earliest.
In the meantime, I wanted to know how equitably the federal government was allocating vaccine doses to the states. A New York Times article from December 11, 2020, tried to find the answer to that question. What they found is that there was no publically available data on vaccine distribution to the states. They queried every state's Health Department to find some states forthcoming and other states declining to comment.
A subsequent article on this topic came out in the Washington Post on December 31, 2020, after the actual distributions of vaccine had either been allocated or promised for delivery within the first week of January. Based on that data, my analysis is that only one state, Alaska, received a disproportionate allocation of the vaccine. They received enough to cover 15.7% of the state's population. But if you ignore that outlier, the rest of the states received an average of doses to innoculate 5.7% of their populations, plus or minus 0.2%. That is a remarkable equitable distribution of the vaccines.
And each state was required to submit a plan to the federal government as to how the vaccine was to be distributed in the state. If you are interested in reviewing the plan in your state, USA Today published an article with hyperlinks to every state's vaccine distribution plan.
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DAILY PANDEMIC DIARY 
UNDERCOUNT
NATIONAL HEALTH EMERGENCY
DAY 272 - JANUARY 1, 2021
Four states have not reported new cases or deaths from yesterday. They are Michigan, Missouri, Kentucky, and Rhode Island.
COMMENTS
A new month. A new year. A quick review. First, we must acknowledge the tragic loss of more than 1% of the U.S. population to the Coronavirus last year. The first COVID-19 death in the United States is now confirmed to have happened on February 6, 2020. So, the one-year death toll is still 36 days away. In the past year 20,445,654 people in the U.S. became infected, 12,125,806 people recovered and 7,965,633 people are still infected. Almost 30,000 people remain in critical condition today.
From a global perspective, we have 4.2% of the world's population but 24.4% of total cases and 19.4% of the global death toll. This is up from 21.9% of cases and 18.6% of global deaths at the start of last month. This means we are getting worse, not better relative to everyone else. We also slipped from 18th to 20th in the world for COVID tests given per million. The United States is by far the world's all-time worst example of mishandling a pandemic. We are on track to be the last to get everyone vaccinated and the last to bring the pandemic under control.
We have our work cut out for us in 2021. We have to do much more than radically improve our government's response to the pandemic under the Biden administration, and more than take personal responsibility for mask-wearing and social distancing. We have to become better social agents to dispel malicious myths and conspiracies about the disease and vaccines. We have to keep ourselves better informed and use that knowledge to challenge those who spread falsehoods they read on the internet.
How is it that everyone takes steps to protect themselves from malicious software written to screw up their computers but won’t lift a finger to protect themselves from malicious conspiracies written to screw up their thinking? We have to accept the fact that the internet is being intentionally infected with malicious fallacies to sow division and discontentment among us. This year we must fight back.
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