We finally have some semi-decent numbers to address significant Covid-19 epidemic questions within our own US borders. We already know the Federal informatics response is just pitiful: laggard, out of date, incomplete. A truly half-hearted effort run by a group claiming petal to the metal 20-hour workdays. Rubbish.
Thank God for many interested private groups and media organizations who really are chasing this 24/7 to the lasting benefit of all Americans. Here is one thread of the comprehensive New York Times Covid-19 tracking database teased out with some analysis.
For days now, the official rap is that the major cause of the most recent crop of US cases of infection is the result of foreign travel. And so, that justifies the increasingly stringent travel restrictions put in place, now including all of Europe and the UK.
The policy is one of several useful general mitigation strategies which may be used to blunt the slope of the curve, reducing the peak, and avoiding a health care crash in the US because of our regrettably slow start. It is one good public health practice, along with serious social mitigation procedures now in place: elder self-isolation, closing events attracting large crowds like professional sports events, school closures where needed, limiting casual public outings, etc.
But the proffered justification for the Government’s delayed action is not supported by the evidence.
Here’s the Who Done It Category Analysis
The New York Times has compiled reports of investigations into the most likely original exposure pathway for each US case. See their website, updated several times each day, including weekends.
I have combined the Times’ specific entries into five consistent analytic categories to make summary comparisons simpler. These categories are:
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- 01 Community Transmission
- 02 Foreign Travel (All Countries)
- 03 Medical Facilities Spread
- 04 On Board Cruise Ship Origin
- 05 Not Yet Determined
Here are the first three days of results.
These are early days, and the value will increase as time passes, but these numbers are at least real data based on more than 2,000 actual cases, not Governmental justification palaver sans data reference.
The most important take-away at noon on Sunday, March 15, 2020 is that foreign travel either to Europe, China, the Middle East or anywhere else is NOT the predominate driving factor now in the US case spread. All travel accounts for just 27% of the total of 639 cases for which an origin has been determined.
In contrast 50% of all US cases are US based community transmission. This only reinforces the public health imperative for everyone to Slow Down, Close It Down as much as possible for the next few weeks to try and tamp down the coming wave. Public Health mitigation efforts will be more effective and should be focused on interior US measures more than any travel ban.
Starting right now. We are already behind. The virus has already spread to every corner of the country: North to South, East to West, Coast to Coast, and Sea to Shining Sea. Yes, West Virginia has not officially recorded a case. That is due to their lack of testing and public health surveillance, not because the virus gave them a pass. They will catch up reporting and diagnosis-wise in a couple days
The other flashing light from this 3-day snapshot is that 10% of US cases are coming from patient to patient and provider spread within medical and nursing facilities already. This is very bad news for the elderly and sick, and for our stressed health care providers. It doubly amplifies the warning about temporarily halting contact nursing home and hospital visits. This is America, Folks. Break out the Face Time and Skype devices. Lend or Donate spares, and let hospital staff teach Grandpa how to digital for the next 2 months. You can love them over the ether with video.
The cruise ship contribution is dropping and should phase out if the stoppage agreements hold for 60 days.
Another initial observation is that we are completely stressing out the epidemiological investigation and contact tracing surveillance system in short order. Each day the number of new cases undetermined dwarfs the new cases determined category by a ratio of 10:1. Pretty soon there will be no way to catch up. Easy to predict with chronic underfunding and staffing shortages, CDC will start to triage and give up the ghost of past best public health practices. It’s a shame.
One final note. These are early collections and data views. The situation is changing so rapidly that even a few hours difference in time can alter the picture. As this effort has just started the collection times were 4 PM on March 13, 9 PM on March 14, and 10 AM today. I will try and regularize the snapshot collection times to help stabilize inter-day to day changes. None of this appears to have affected the relative bottom line estimates in the data.
Travel related cases are not the major hazard or driving force in generating new US Covid-19 cases. The predominant factor is clearly community transmission. Community spread is alive and well and driving this epidemic train, as of right now. Health facility spread today accounts for 10% of all US cases. Take it to the Bank.
Tell the Government spokespeople to stop the defensive, outdated explanation. The travel restrictions are a good move, but not for the reason offered. We can handle it. We need truth, not mush.
Here is the raw data used for the March 15 entry in the chart above. Note Bene: the raw data is adapted from the New York Times Covid-19 database. They have produced a superlative resource which only gets better each day. None of the summary analysis could be done a single person without the underlying data they provide to the General Public for the General Good. I subscribe to the digital paper, so I contribute my 2centss worth. Maybe you should to.
The synthetic categories are ones I have created (not the New York Times). I think they make good attribution sense. Interested readers may disagree. Make a better set if you wish. Run the numbers yourself. Be skeptical.
