Today brings more of the same as we scurry about to re-open the economy. For the second consecutive day I had to drive to west Knoxville for an appointment. Yesterday, the traffic was noticeably heavier than it has been in the last month. Today was very heavy, coming and going. America is on the move again, for better or for worse.
International News:
As of mid-day, there are 3,767,662 confirmed cases of COVID-19 reported world-wide and 253,713 deaths. I mis-typed an important digit yesterday, saying there were 3,596,717 cases when, in fact, there were 3,696,717. With that correction, today’s totals represent overnight increases of 70,945 case and 4,191 deaths. A week ago, the overnight increases were very similar, though higher, at 75,975 and 4,990. New cases and deaths have bounced in the same range for the last month.
The UK continues to struggle, adding nearly 5,000 new cases yesterday. It now has the fourth highest number of total cases in the world and the third highest total deaths in the world. It is on pace to move up in both categories. It has tested less than 2% of its population.
Russia continues to be in peril, with overnight infection rates running from 6 to 10% daily. They now rank seventh in the world in total infections and are second only to the United States in new daily cases. Their current total death count is significantly lower, but likely only because they started their upward trend later than many other countries.
Other countries in trouble include Brazil and, perhaps most alarming is India which given its crowding, poverty rates and massive population (1.3+ Billion – over 4X the population of the U.S.), could set up the worst situation in the pandemic. Their current world rank in total cases is 15th, but that could very quickly and tragically change if their rate of increase continues or escalates. Yesterday, their overnight increase was 8.5%.
National News:
As of mid-day there are 1,218,638 total cases and 70,727 deaths in the U.S. Overnight there was an additional 25,557 cases and 1,749 deaths. For the last month new cases have plateaued one side or the other of 30,000, while deaths have plateaued one side or the other of 2,000 per day. We haven’t been below 20,000 cases or 1,000 deaths in a single day since March.
Despite the fact that we are re-opening our economy, there is little data to suggest that we are moving in the right direction. Very few, if any of the states outside of a very small group, have met the White House Task Force or the CDC guidelines for a fourteen day decline in new cases. We appear to be shifting to a Swedish model in which we’ll social distance, but get back to work and life with adjustments. The difference is that we already have massive numbers of cases.
Given the above, estimates of cases and deaths predicted by the various models are being revised dramatically upward. The most alarming reports coming out yesterday afternoon revealed a CDC/Johns Hopkins report circulating in the White House projects 200,000 new cases a day and 3,000 deaths a day by the end of May. The Institute for Health Metrics and Evaluation at the University of Washington (which has been used by the White House Task Force) has increased its estimate (based on the re-openings) of deaths by the beginning of August to 135,000. This is more than double what it projected less than three weeks ago.
If the Johns Hopkins numbers are correct, we would have about 140,000 deaths by the end of this month. That would raise several questions: Can we maintain an economic re-opening with millions of Americans (at once) sick and at home or in the hospital? Will the alarming rate reduce the resistance to the measures being taken for our protection? What will June’s death rate look like if we enter that month adding 200,000 new cases a day? Since the increases are anticipated in more rural parts of the country, will their small hospitals and clinics be ready?
Perhaps the John’s Hopkins Model is incorrect. The more conservative Health Metrics model suggests 135,000 dead by August. Even with those conservative numbers, some continue a bitter resistance to simple things like wearing a mask when you can’t social distance, even though medical professionals say it will save lives. Yet, we have a security guard murdered in Michigan for insisting that patrons wear a mask, while a park ranger was shoved into the water while explaining the social distancing rules to a group. Groups in North Carolina continued to rally even as one of their leaders was diagnosed with COVID-19. After initially implying otherwise, she stayed away from the rallies.
It should be noted that those most outspoken constitute a minority. In a recent poll (conducted by NPR/PBS Newshour/Marist six days ago) about 80% of respondents said they supported continuing social distancing and did not want to see restaurants and schools opening or large sporting events until there is more testing.
State and Local News:
There are 13,571 cases and 219 deaths being reported in the state of Tennessee. These numbers represent overnight increases of 394 and 9 respectively. About half have recovered and half are still ill. 211,443 have been tested, which includes 6,836 since yesterday. Assuming no one was tested twice, this would about 3% of our total population has been tested from the beginning of the crisis.
Locally, the Knox County Health Department is reporting 252 cases and 5 deaths. This is an increase of 6 cases over yesterday and is consistent with the increases we’ve seen for the last month. There are 38 currently active cases and 2 are hospitalized.
Today’s Health Department Briefing:
Dr. Buchanan chaired the briefing and began by thanking those in the parade thanking Health Department workers this past Friday. She confirmed the above numbers. She gave a special emphasis to wearing masks, saying it is important to public health. She said she wears a mask any place where social distancing can’t be maintained. She noted that the briefings are largely virtual.
- To reports of crowds over the weekend, she said the plan relies on people following the plan. She says those who disregard the guidelines are risking the health of others and of the progress our community has made. She said it could prevent us from opening further or even require that we step back. She pleaded for cooperation with distancing, masks, hand washing, cleaning surfaces and staying home if you are sick.
- What is the target number of tests for Knox County? We don’t have one. We’ve chosen to look at whether our testing capacity is increasing and the answer to that is yes. She said reporting is getting better from private testing.
- What number of contact tracers do we need? We have 30 right now and that is fine. Recommendations for our population would be just over 60 and we can quickly exceed that if needed.
- How many people have recovered after being on a ventilator? We don’t know, but we are focused on ventilator availability and it is good.
- How much testing has been done in nursing homes? We test if there is a case, but many of them are testing on their own. We have plans to do targeted testing.
- Should people invite people into their homes? Maintain social distance and it is ok. No more than 10 people.
- What would be considered a “surge” on hospital capacity? We don’t have a number, but we are prepared to go much higher if needed.
- Two (37919, 37923) zipcodes have the highest numbers of cases. Are there hotspots? No, we don’t have hotspots, but community-wide spread.
- The Nashville Metro Health Department has clear numbers as metrics in new cases, etc. Why haven’t we done that? We may move toward that if we have more cases. They have more cases and we don’t have enough data, yet.
- When will antibody tests be available? Good question. We only want one when we are able to be sure it is accurate. Additionally, we are not sure how long any immunity would last after having COVID-19.