It is still and more than ever to our national shames that Federal Public Health authorities are essentially playing with half a deck on this most serious infectious disease outbreak in more than a decade. Their retreat from compiling definitively all the available public health data and testing results is shocking and deeply troubling. In any normal season heads would already have rolled at the highest administrative levels. Here of course, the problem is that most of the failure has been ordered top down in service of Trump.45’s ego and profound scientific illiteracy and ignorance.
Slight Detour, Folks
Actually in the last 24-hours the situation has gotten worse, as the President lied again from the Oval Office last night and this morning about testing, the Vice-President ducked and covered on TV a few hours ago, and the Surgeon General (Bless his Heart) in Louisiana this morning at a press conference with the Governor spouted nonsense about where the US cases originated. He was wrong on the facts, but he wasn’t instantly corrected because of the Federal “Hide the Salami” Covid-19 virus public information reporting fiasco.
To be clear, kudos to the Surgeon General who was here on the ground in my state where we have 13 new cases this week. He showed up and most of his medical advice was sound, until he got around to trying to explain (justify) the President’s latest plotz of barring Europeans from entering the US for 30 days except England, Ireland, Scotland, and Wales, and banning Euro cargo except no never mind. Defending Trump.45’s verbal eruptions is more of a job than any one man can handle, especially if he is trying to convey public health competence.
The Surgeon General also made an unfortunate and laughable assertion that “this is not our First Rodeo.” Well, the Surgeon General might have been around, but he’s not in charge. As for Head Honcho Cowboy Trump.45 it is most definitely and assuredly His First Rodeo. And the Bull tossed him unceremoniously to the ground right out the gate. He never made anywhere near 8 seconds for the ride. Trump.45 has made a straight up No Score performance.
Still, we were glad to see US Surgeon General Jerome Michael Adams here in person doing his best, and Louisiana thanks him. Respect for the office. As for the man, it turns out he is a Pence Crew Member from Indiana and served as the Health Commissioner there during the 2015 AIDS needle exchange cock-up by state authorities (on moral grounds says he).
From Wikipedia:
During the COVID-19 outbreak, Adams asserted on CNN’s State of the Union with Jake Tapper that he’d seen no indication that people who want to be tested for the virus cannot be.
Maybe his recent Covid-19 related travels will smarten him up. Let’s hope so.
So, the critical data transparency has fallen to private sources. God Bless the JHU Covid-19 Tracker and the New York Times database for multiple daily updates from all 50 stats as well as the anemic Federal contributions. Else we would be even more kneecapped at tracking the wildfire that is this pandemic than we re.
In any event, as of March 11, there are enough US reported cases and deaths by state to begin to make cautious suggestions about the state of affairs in our country. There are stull the usual problems inherent with smallish numbers and the extremely rapid accumulation of cases, coupled with the unforgiveable damage lack of adequate testing capacity superimposes.
Still, the best we can do for now.
Back to the Main Scene
As of 6 PM on March 12, 2020 based on the cases reported in the New York Times, there were 1,504 diagnosed cases in the entire country (310 new ones since yesterday), and 39 deaths in six states: Washington (30), California (4), Florida (2), New Jersey (1), South Dakota (1), and the latest entry Georgia (1), an increase nationwide of two deaths in the last 24 hours.
Here are the pertinent numbers, presented with state populations, and the critical case rate calculations for comparison sake for both days.
Quick Analytic Take: So What’s New?
Nationwide in the US based on 1,504 diagnosed cases there have been 39 deaths. This is a %case fatality rate among infected patients of 2.59%. Not 1.4%, as in the Chinese study published in the New England Journal of Medicine. This represent a small decline from the day before from 3.11%. Not worse is better for us.
Now the US number will likely (but not certainly) continue to moderate as more tests become available to test less severely ill patients or as normal epidemiolocal surveillance testing is finally performed on a reasonable scale (up from nothing). But how much that fatality rate will drop is unknown. It would be foolish to project with any confidence. What we can say is, here is the rate on March 12. Check back as more data hits the system.
We have a hint about the state by state variance in the reported case rates of infection per million population here. The US case rate has now increased to 4.5 per million from just 0.26 observed 11 days ago. The initial number is undoubtedly artificially low, caused by the testing fiasco. What is more interesting is the 6-state range for variability. California and Washington have the highest observed rates, not unexpected since the West Coast seems to have been the primary and earliest entry point for the Covid-19 virus invading our shores. Washington state, sadly probably was the epicenter of US infection, beginning as early as January 10. Their state-based case rate per million is 48.35 and continues to rise. This rate is competitive with the worst of the European high hazard areas (France, Germany, and Spain) except for Italy.
A case rate of 50 nationwide would mean there are more than 16,500 acute cases on offer in the relatively near future. And the Washington epidemic is still growing, not slowing.
We can do one more set of state by states early comparisons. We can compare the 6 states in which deaths have occurred to see the range of actual rates in five different places.
The % case fatality rates in the six states varies from 1.93% on the low end to 12.5% at the top. In Florida and Washington, both populous states with good medical care and public health infrastructure, the %case fatality rate as of March 11 is 7-8%. We can certainly hope this early observed rate declines with more data, larger case numbers, and better testing, but an 8% fatality rate in a combined US population of 30 million (10% of the entire country) is bad news.
If these numbers are anything close to accurate, in the early stages the Covid-19 virus in the US is 70-80 times more lethal than the normal seasonal flu. On the other hand, if California and Georgia are our better epidemiological angels, the true rate might be 2-3%.
South Dakota appears to be an outlier (on the high side) not generally representative. This is likely to be related to the fact that South Dakota is a small population state widely dispersed. It is 47th in population size in our country, with a population density of only 12 people per square mile, compared to hundreds per square mile for the other five states. Room to breathe and fill their own separate space for these hardy residents. Of course, that also entails issues with access to medical care, especially tertiary care, so that circumstance may pose extra risks for the unfortunate residents who fall ill in South Dakota from Covid-19 infection.
Treat Covid-19 and the seasonal flu as equals at your own peril.
We do all hope the rates cool as the pandemic matures. Pandemic maturity is likely 3-6 months away , at a minimum.
In other words America, Buckle up. Or as Dr. Fauci said in perfectly straight forward and plainspoken English. It will certainly get worse before it gets better.
Anyway, these are the best numbers available, for folks who care about real life information and not political production values.
