If you live here in the US and use any type of social media, you’ve been bombarded with pleas to go vote tomorrow. I have no plans to discuss that subject except to say it will probably keep the media occupied so the ‘rona will likely be pushed to the sidelines until we figure out what the heck happened in the election.
Want to touch briefly on the worldwide situation. A couple of weeks ago, I said India was on track to pass the US in total case. Yeah, that’s not going to happen. We exploded into a third wave while case count there has actually started to drop. The big issue is now Europe where cases are soaring. France, Spain and the UK now rank in the top ten in total number of cases.
Just to give an impression on how fast this happened, back on October 6th, Europe had 1,150,833 fewer cases than SE Asia (Mostly India). Again, I’m using the regions as defined by the WHO which is a little flaky but I’m sure they have their reasons. By October 23, Europe had passed SE Asia and, as of yesterday now has 1,810,927 more cases. Its tough to contain and can look very scary when the numbers are going up exponentially.
The only bit of good news is that deaths are not rising at the same rate. In Europe, for the month of October, cases were up 86% but deaths were only up by 20%. But deaths do typically lag cases so it wouldn’t be a shock to see more deaths in the near future.
In the US, we remain in the third wave. There are many places where cases are up – even above the false positive rate and I’ll focus on a few later. It still looks like a much slower wave than the first two.
For the week ending on Halloween, the US recorded 8.6 million tests which is again a record number. There were 555,271 newly reported positive results which is also a new record high, but the percentage of positive results was 6.5% which is not a record. We have seen the percentage of positive results rise over the last five weeks from 4.1% to 6.5% which is evidence of the third wave as new cases are being found over and above the noise from false positives.
Going back to the second wave for reference, I would put the start of that wave on June 7th. If we look at a five week span, that rate rose from 4.4% to 7.6% in the first week in July. It peaked the next week at 7.8% and then started to drop. We saw a similar increase in testing so actual cases didn’t peak until the week of July 19th or seven weeks after the presumed start of the wave. If this follows a similar trend, then the next three weeks are likely going to have what look like scary numbers of cases given our significant increase in testing.
With hospitalizations, during the second wave, that started to trend upward around June 19th which was the week when the percentage of positive results got above 6% for the first time. There was a very steady increase which peaked on July 17th where the number of people hospitalized was twice what it was on June 19th. The start of the third wave is harder to pin down since things started to turn upward on September 24th but the daily trend has shown some ups and downs. On October 5th, there were 31,299 people hospitalized and that represents a new high and another possible starting point. As of yesterday, there were 47,502 people hospitalized so that figure is climbing at a slower rate than during the second wave. A similar pattern holds for ICUs although we are closer to the second wave peak than we are with hospitalizations. But for both, the second wave started to decline 45 to 55 days after the start so we still don’t know if that pattern will hold.
Yes, we are seeing record numbers of cases. We are also seeing record numbers of tests so we are finding more than we have before. Hospitalizations and ICU usage, which are measures of severity, are up but not as fast as we saw in the second wave. I’m going to hold off discussing deaths until the CDC site is able to fill in more recent data. But the general increase in cases and testing makes my earlier ratings kind of useless.
We can take quick looks at a few states where things look the worst.
Wyoming – They did not participate in the first wave and saw a slight increase in the second so this is really the first time they’ve seen cases grow like this. From the website, it is interesting to note that almost half the cases are in people under 30. Wyoming doesn’t seem to consistently count negative tests so no trending is really possible. Things appear to have plateaued though so we just wait to see how long they remain at peak.
South Dakota – saw a small peak during the first wave but the number of cases last week was 10x the peak back in April. Deaths have also picked up in the last two weeks (62 and 52). Deaths are always something to be taken with caution if you don’t know if the state is reporting actual date of death. To soon to say things have flattened. They don’t have hospitalization trend data on their website but they currently show roughly 35% of hospital and ICU beds available and most of the beds in use are non COVID patients.
Montana – They had a small number of cases during the first wave and more in the second so they are being hit harder in this third wave. While the number of new cases continues to go up, the rate of increase has slowed. Number of newly reported deaths has gone from 31 to 56 to 79 the last three weeks but deaths have typically been a lagging indicator. They don’t have a lot of good information on hospitalizations on their website. Like the other two they seem to be closer to a peak than in the still increasing phase but it is too early to say that for sure.
Alaska – Another place that didn’t participate in the first wave and really not even the second. They hit 3.8% positive results the week of September 7th and have seen things go up from there -last week it was 6%. Over that time, cases have gone from 537 to 2641. But the daily totals have been kind of flat for the past week or so. They reported 15 deaths last week which is actually the highest total for a week this year. Their website shows an increase in hospital usage but still shows capacity in green which I take to be good.
North Dakota – Had a very small increase in the first wave and really didn’t participate in the second. The percentage of positive results went above 5% in late August and is now at 13%. They’ve reported over 1000 new cases for the last four days and that’s a new high but the short term trend is flat. For the last four weeks, they’ve reported 55, 44, 67 and 43 deaths so that trend is also flat. The website shows hospitalizations on the rise and it doesn’t appear the peak has been reached. They don’t really discuss capacity though so I can’t put the 215 currently hospitalized into perspective.
Wisconsin – The number of cases dropped a bit last week even with more testing. They had a small bump in the first wave but nothing like they are seeing now. Reported deaths the last week have gone from 113 to 225 to 297. So we still haven’t seen a peak in deaths but cases may be flattening.
Colorado – Colorado is the first state on this list where the increase is partially driven by testing. Colorado did see a spike in the first wave and had over 130 deaths from April through the first week in May with a peak of 261. The number of cases is four times higher now but the number of tests is 16 times as large. Last week, the percentage of positive results was 7.5% which is the highest since mid May (in April , they topped out at 22.4%) but they only recorded 29 deaths last week – far below what was happening in April. Cases are rising fast here but it doesn’t look to be as severe as the states listed above.
I won’t go into too much more detail. Among the other states where cases increased by more than 10%, you have Minnesota, Michigan, Indiana, Illinois and Ohio. All have shown real increases part of which is driven by testing. In terms of deaths or percentage of positive results, they aren’t yet close to where they were in the spring (arguable exception of Minnesota). No evidence of cases peaking even when accounting for the increase in testing.
A few other states saw cases increase by more than 10% last week.
Idaho – they saw an increase back at the end of July. They have hit new highs in cases with similar testing numbers but the increase isn’t as dramatic as Montana and deaths are currently where they were in July and August.
Iowa – they did have a spike in April and seem to be having a second one. Cases jumped last week but deaths dropped. Not really sure what to make of it yet.
Kansas – similar to Iowa, they had an increase in April and have seen things pick up again. Last week was a high for cases but deaths dropped.
Kentucky – they’ve never reported more than 12% positives in a week. Cases have increased the last two weeks with similar testing numbers. Could be the early stage of something.
Nebraska – They had 23% positives in April compared to 10% last week. While last week represented a high in new cases and positive results, the rate of increase isn’t like the other states. Deaths have been up the last two weeks. Like some of the ones above, it could be the start of a new spike but that’s not yet clear.
New Mexico – Has not really seen a big spike. They had a week in April with 7.9% positives and they currently sit at 8.6%. That positive figure has gone up four weeks in a row and cases have climbed but they’ve also cranked up testing. If it is a wave there, it is a small one.
Utah – Untouched by the first wave and had a small spike in the second. They’ve been above 10% positive since mid September and currently sit at 17%. Most of the perceived increase over that time was due to increases in testing but that doesn’t explain all of the last two weeks. But they look to be closer to the middle of a wave.
West Virginia – Pretty much untouched by either wave. They had a small increase in deaths back in April. They got to 4.8% positives the last week in August and have basically been at or below that level since then. The perceived increase here is due to testing. Last week, they recorded about 64000 tests which is double what was being done in early September. Doesn’t appear to be a wave there.
That clears the list of places where cases rose by more than 10% last week. There are certainly other places where things have picked up but these seem to be the worst. I’ll make no predictions about where we are heading. I’ll just say that this wave does not yet appear to be as bad as the one this summer despite the record number of cases.