State of the Nation

Because testing numbers are still on the rise, I’m taking a new approach to my weekly attempt to understand the whole ‘rona situation. I still have rankings but I’ve decided to talk about states in geographic regions based on latitude and longitude. The decisions still require some assignment since some states don’t fall neatly into a particular category. Once we get out west, the states get bigger leading to smaller groups. I may combine later.

Let’s start with the overall numbers for the week that ended on October 17th. Once again, we hit a new high in tests with 7.3 million reported. This is the fifth week in a row where tests have hit a new high. The number of newly reported positive results was 386,192 which is the highest number since the week that ended on August 1.

But we need to put that into perspective. The percentage of positive results last week was 5.3%. If I look at the week ending on August 8th, there were 369,959 positive results recorded which is close to last week but the percentage of positive results was 6.9%. If we were still at that rate, we would have observed 506,016 positive results which would have been the highest number for a week. Again, looking just at positives without considering total number of tests does not give you all the information you need.

Having said that, the percentage of positive results had been below 5% for the last five weeks in a row and not really showing any type of trend. So this is a jump upwards which was matched by the number of hospitalizations but it is still on the low side. If we were going to see a real third wave, then this figure should start to increase – if we see something over 6% next week, then it is something to be concerned about. Until then, we call it a cautionary sign.

We will start in the Northeast which includes Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York, New Jersey and Pennsylvania. In my categories, Maine, Massachusetts, New Jersey and New York would be in group 1. Connecticut, New Hampshire and Vermont in group 2 and Rhode Island and Pennsylvania in group 3.

Last week, we saw peaks in Connecticut, Massachusetts, New Hampshire, New Jersey, New York and Pennsylvania. A peak meaning a new recent high in percentage of positive results. However, except for Pennsylvania, all of these states had less than 3% positive so these peaks are driven by increased testing.

Out of this group, the only one to be concerned about is Pennsylvania. The percentage of positive results jumped to 9.2% last week. It has been at 7.8% and 7.9% the last two weeks and in the 6.5% range for the five weeks before that. Give them a yellow light while the rest are green.

Moving down but staying on the east coast, the next group has DC (1), Delaware (2), Maryland (2), Virginia (3) and North Carolina (3). In case it wasn’t clear, the group assignment is shown after the state. DC and Maryland were under 3% in terms of percent positives while the other three were between 5.7% and 6.4%. Both Virginia and North Carolina hit new peaks but don’t show any sign of a trend. I honestly can’t figure out what is going on in North Carolina. They’ve basically been in the 5-7% positive range since May. Since all of these places are not showing a true increase in percentage of positive results, I’d consider them all green.

Going back north and west, we get to the big Midwestern states: Illinois (4), Indiana (4), Michigan (3), Ohio (3) and Wisconsin (5). All but Wisconsin set new highs last week and Wisconsin would have except they didn’t report data over the weekend. Some, but not all of what we see in Michigan, Ohio and Illinois is driven by testing as the percentage of positive results in those places was 3.7%, 4.7% and 5.4%. But all three did see a small increase in the last week. Indiana had a big spike but was trending that way while Wisconsin has seen a real trend. For now, I’ll call Michigan and Ohio green, give Illinois a yellow and put Indiana and Wisconsin in the red.

Coming south, we get to West Virginia (3), Kentucky (4) and Tennessee(4). West Virginia had a new high last week but the percentage of positive results was 4.2% but there is no trend in the results so I’d consider them green. Kentucky is an example of why you can’t overreact to a single value. Two weeks ago, they jumped from 3.8% to 7.6% positive results but fell back to 5.3% this week. Without clear evidence of a trend, I’d probably still go yellow just because they are still over 5%. Tennessee was at 8.3% which is the highest there since early August. Tennessee is similar to North Carolina without any clear trends in their data but I’ll give the a yellow just until we see that they aren’t going to go higher than the 8.3%.

Now we get to the deep south with Alabama (3), Florida (1), Georgia (2), Mississippi (3) and South Carolina (2). None of these states hit new highs. They have higher rates of positive results than a lot of places but the trends are flat to down. Based on where they were earlier this summer, I’ll call Florida, Georgia and South Carolina green and keep Alabama and Mississippi as yellow just due to the high number of positive results.

Making our way across the country, we get to the Northern Plains which includes Iowa (4), Minnesota (4), Nebraska (5), North Dakota (5) and South Dakota (5). All five states hit new highs last week and Minnesota, at 6.2%, was the lowest in terms of positive results and I’ll go with yellow for them until we know that isn’t an isolated case. Iowa and Nebraska don’t really show a trend but they have a high number of positive results so I’ll go yellow for them. North Dakota and South Dakota are seeing upward trends although it isn’t really following an exponential pattern just yet. Still, I’ll go red for them.

Coming down, we get to Arkansas (4), Kansas (4), Missouri (4) and Oklahoma (5). Arkansas, Kansas and Missouri all hit new highs last week but none of them really have evidence of an increasing trend. Missouri is odd just due to some reporting things while the other three have been flat at relatively high rates (8% for Oklahoma, 9% for Arkansas and 15% for Kansas. The high rate could also reflect different testing strategies. If you focus more on symptomatic patients rather than casting a wide net, you’ll likely see the percentage of positive results be higher. Given they are all flat and not declining, I’ll call all of them yellow.

Now the groups start to get smaller since we only have Louisiana (1) and Texas (2) in the next group. Neither set a new high and both are flat in terms of percentage of results. Louisiana was at 4.1% last week while Texas was at 7.1%. Texas is a little high but, given where it was, I’ll call both of these states green.

Going back north and into the Rockies, we start with Montana (5) and Wyoming (5). OK, I said I might combine and I’ll just do that now and toss Idaho (5) into this group. All three set new highs last week. Montana had 10.1% positive results while Wyoming had 20.2% and Idaho had 29.6%. Again, without understanding the testing strategy of each place, it is hard to really compare across states. But all three are seeing an upward trend in results (Montana may be near a peak though) and, for that reason, I’ll call them all red.

I’m going to make another combination and go with central and southern Rockies for Colorado (3), New Mexico (4) and Utah (5). All three did hit new highs last week. With Colorado, most of it is driven by testing but the percentage of positive results was 5.3% last week which is the highest since July. Consider them yellow until we see whether that was a real increase. Utah was at 15.4% last week but they’ve been above 14% for most of September. The trend is flat but higher than they’ve been so I’ll call them yellow as well. Lastly, we have New Mexico which was at 5% two weeks ago and 6.3% last week. That is the highest two weeks since April. Because the percentage is still low, I’ll call them yellow for now.

My next group has Arizona (1) and Nevada (3). If I was just going on location, Nevada would be like Utah but most of the people in Nevada live in Las Vegas which is desert and closer to Phoenix so I’m grouping these two together for now. Neither had a new high or real evidence of a trend. For now, they can be called green.

In the Pacific Northwest, we have Washington (2) and Oregon (3). Washington’s number of positive results was the highest since July but the percentage of positive results was 3.4% which is lower than the 5.2% they had in July so that increase is driven by testing and we can call them green. Oregon is similar. They’ve been over 2200 positives the last two weeks which is the highest since late July. But the percentage of positive results was 5.2% last week and basically the same as it was in July. Oregon has really been flat since June with a rate of about 6%. For now, I’ll call them green as well.

The last three are California (1), Alaska (5) and Hawaii (1). Last week, California has 2.5% positive results and the number of positive tests was about a third of what is was back in August with roughly the same amount of tests. They could be called green. Hawaii was at 3% last week and also way down from where they were in August and are also green. Alaska hit a new high last week with 1330 positive results. They’ve been above 4% now for three of the last four weeks – in the summer they were usually less than 2%. Given that the percentage of positive results is still low and looks to be more flat than increasing, I’ll call them yellow for now.

Looking back over this, it looks like I’ve put Indiana, Wisconsin, North Dakota, South Dakota, Montana, Wyoming and Idaho in the red. Probably could argue about some of the others but I think that highlights where there is clear evidence of an increasing number of cases not driven by increased testing. I guess we wait and see what the rest of fall and winter brings.