(2/28/21) Over 500,000 Americans have died due to Covid-19, but there is a real chance we do not ever hit 600,000. Still new variants are lurking and accelerating so watch out for another small rebound.
Snapshot
I’ll continue with the usual format, but I have added to the end a Q&A on important issues that I haven’t seen properly or correctly addressed by our officials or the media so have a look at that too.
The Tables below give a dashboard view of per capita cumulative deaths and weekly death rates as indicators of total magnitude and current severity, respectively, of the epidemic in various populations ranging from local to international. The 4th column shows the direction and magnitude of changes in Covid-19 severity relative to the previous reporting period (5 weeks ago).
What a difference in just 5 weeks. In the last posting the world was on fire with essentially every part of the world rising on the third wave with alarming speed. Today we are definitely over the peak and riding down the tail at a reassuring rate. The U.S. is lagging a bit on the rate of decline, but the movement is in the right direction and appears sustainable. In harder hit places of the world and in the U.S. best estimates now indicate that 15-30% of these populations were infected and are now immune and removed from the susceptible population. With vaccination rates continuing to increase (about 15% of Americans by 2/26/21) we will approach (but may never reach – more later) herd immunity by late summer in the more aggressive countries and that includes the U.S. We must still continue masking and social distancing so that new strains don’t accelerate during the time we are knocking down the epidemic and undo the good work.
Here are the latest death rate plots for the U.S. and CA. I have also added the US daily case rates.
We briefly note here that the U.S. and CA are on a clear downward trend. We show for the first time the daily U.S. case rate as there appears to be a plateauing to a still very high level over the last week or two, which is worrisome if it is due to growth of more resilient SARS-CoV-2 strains.
The Local Scene
I wrote another Leader Board back page commentary in the Orange County Business Journal about the local OC and LAC scene (link here). How quickly things change. Just a month ago we were peaking in death rates, but the leading indicators, cases and hospitalizations, were declining at a healthy clip. Happy to say the death rate plot is following dutifully at an expected 2-week delay. The plots below summarize this recovery.
The main observations are:
- There is a substantial decline in new cases and down to October levels.
- It is important that the rate of infections declines significantly further and not hit a plateau from which a rebound infection could occur.
- CA is not recovering any faster than the rest of the country as evidenced by the plot below showing continuing high percentage of U.S. daily deaths that occur in CA.
The Nation
Below are death rate plots for the same representative U.S. states we have shown before in case anyone is comparing.
Key observations are:
- The situation around the U.S. is looking pretty good.
- AZ continues to be the most infectious state in the nation, but it is declining in step with the U.S. in general. Still, it maintains its lead for highest daily deaths per capita (table above), but CA and TX are nipping at its heals.
- There are no surprises or states to be called out; the worst are recovering. My opinion is that the states with the most lax social guidance resulting in ungodly heights of illness and death have reached close to 50% infection and immunity so well on their way to herd immunity. Glad they sacrificed for us!
My last four monthly updates have reported the U.S. Covid-19 death 250,000 (11/20/20) to 330,000 (12/25/20) to 420,000 deaths (1/22/21). We are now at 510,000 deaths 5 weeks later, uncannily close to the Covid-19 forecasting model from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, which forecasted 5 weeks ago 517,000 deaths by March 1.
Next, we update the grim statistics representing number of deaths in terms that we all can relate to. If there ever was an argument against complacency, notice that we have greatly reduced the death rate due to Covid-19 to just the equivalent of 11 plane crashes a day or more than a Pearl Harbor or 9-11 in a single day. We still have a long way to go.
International
The situation overseas has recovered almost more than could be hoped for. The most unexpected change is the dramatic drop in the death rate in the U.K., home to one of the new variants sweeping the world (or at least western EU as shown below). The U.K. was heading down a death spiral, but PM Boris Johnson, epiphany complete, drove a government and social response that has uncharacteristically lead to a national unity movement supporting vaccination and isolation. Results are showing. Hear hear!
Other Main observations:
- You can see a bifurcation in the death rate plots for the third wave in Europe. We will call these waves 3A and 3B. I hope the epidemiologists are looking at this data, because it has not made it into the usual specialized news feeds. Here is how I read this.
- The third wave 3A in Europe accelerated at the onset of October.
- You can then see a second wave 3B at the beginning of the new year. Given that these data are death rates it indicates a new wave of infections on top of an already fast rising rebound in early/mid December.
- The U.K. showed the greatest 3B wave suggesting that it was ground zero for a new infectious strain. This is now old news, but where did it go?
- From the above plots one might surmise that it traveled to Spain, France and Italy in approximately that order judging by the relative intensity of the 3B vs. 3A waves.
- This bifurcated third wave seen in western Europe doesn’t show elsewhere.
- Brazil is Brazil and the government just doesn’t care. Despite cancelling Carnival, Brazil is almost hopeless. This may be the population that achieves herd immunity naturally.
- Great news is that the worldwide (WW) death rate is coming down significantly. For too long, as you can see from the above plot, the WW death rate (per day) just kept climbing. There would be great improvement in some of the hard-hit countries and U.S. states, but despite any of these good trends, somewhere else in the world was going bad and the world continued to get worse. Hopefully, we are seeing a sustained recovery for everyone!
Special Q&A Section
How apropos that as I start this section I should be listening to the Pet Shop Boys playing their song “I Want to Wake Up.” So please wake up here. The following topics interest me particularly since they are difficult and not really reported accurately or meaningfully by our officials or the media.
Can we just give one dose?
My opinion is that we are better off as a total population vs. individual benefit by vaccinating as many people as possible once and coming back when supplies increase for the second booster shot. Before seeing new data supporting this view, my notion is that every injection leads to a large build-up of antibodies followed by a slow decay. The purpose of the booster shot is to build the level up high enough so that the long-term levels are sufficient. However, a single shot should give at least a few months of immunity. The new data shows that the Pfizer and Moderna vaccines give over 80% effectiveness from one shot vs. 95% for two shots. So, giving one shot to two people is equivalent to 160% effectiveness and the overall population becomes more immune. Dr. Anthony Fauci argued against this premise but that is understandable since he must abide by strict FDA regulations and two shots is how the clinical trials were run. But strictly from consideration of the fastest approach to herd immunity I disagree with him.
If vaccinated can one still infect someone?
Again, I run counter to prevailing views, but the data is now showing that if you are vaccinated you may not be immune to infecting someone else, but the probability is very low vs. a person who is infected without prior immunity. It is possible that the coronavirus can be inhaled and remain transmissive until one’s body’s immunity destroys it, generally within a day.
What percentage of populations are infectious?
During the peak of the 3rd wave the percentage of the population in many hot spot states, e.g., the Dakotas, AZ, CA, etc. was as high as a few percent meaning that in the hottest spots one in every 25-100 or so people were infectious. If you come in close contact with even one person a day that says that within a month you could be in close contact with an infectious person. That is how easy it is to catch COVID-19. Fortunately, we are well past this huge surge of infections.
Are we reaching herd immunity?
We don’t have to reach herd immunity to dramatically reduce cases if we practice even a modicum of isolation and protection. However, here is another way to look at herd immunity. Consider that our population is divided by those who abide by masking and social guidance and those who don’t. Currently about a third of all Americans have had Covid-19. However, probably about half of those in the second category of being Covid-19 deniers have been infected. So, in the subpopulation that chooses to be most exposed they might have herd immunity (including vaccination numbers) and the careful population will not but because they are probably attenuating exposure by at least 50% by masking and socially isolating they will not amplify infections either. So, we are making great progress by the combination of natural immunity, vaccination, continued masking and isolating, and letting the idiots carry the susceptibility burden.
Is the vaccine safe?
Absolutely. Anyone who spews fear that some people may get sick from the vaccine, then consider that those very people are probably the ones who would get seriously ill and die from the coronavirus. Pick your poison.
What happens if 20% refuse the vaccine?
At some point vaccine supply will exceed demand and there will be a sizeable fraction of the population that will refuse the vaccine thereby compromising our approach to herd immunity. Well OK, they will then be the remaining susceptible population and most likely will catch the virus and become immune. Sad that this will stretch out the infectiousness, illness and deaths, but at least it will be concentrated on those who choose to be foolish.