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BREAKING June 14 COVID Update: The first verdict in the May state openings is in. It paints an abundantly clear picture & it’s not good.

Thanks to Nephron’s health care research team and Josh Raskin. Follow here if interested in the results.
On the last day in April, as states began to unwind their social distancing measures, most without proper precautions, I wrote a thread captured by Medium, called 30 days of Bliss.

It was about how we won’t know what’s happening for 6 weeks. 2/…
States began lifting stay at home orders April 24 with 14 lifted by May 4th, another 13 by May 22, another 12 by June 6, and another 12 after that.

Let’s call those four groups the Rabbits, the Cheetahs, the Rhinos, and the Tortoises. 3/
Let’s look at how fast cases grew in June so far for each of them.

Rabbits: up 26%
Cheetahs: up 7%
Rhinos: down 31%
Tortoises: down 9%

Overall, cases were flat (down 0.6% actually) during thst period. Half the states grew & have declined.
For the Rabbits, 9/14 are seeing case growth. Texas, Florida, South Carolina, and Alabama lead the way.

Colorado and Indiana stand as exceptions with case declines. 4/
For the Cheetah states, 6 are up, 6 are down & 1 is even.

Arizona, California, and North Carolina are seeing high growth.

Offsetting somewhat are Maryland, Minnesota, CT, and MA who have seen a decline. 5/
The Rhinos are down 30%. 7 are down, 5 are up.

New York is counted here because upstate opened at the end of May, tho NYC didn’t open until last week. Overall NY is down 39%. But Illinois is also down 47%.

Many of these states are recovering but some are beginning to grow. 6/
The tortoises have seen a 9% decline led by Virginia and NJ, which still hasn’t opened up. Here’s a table where you can find your state per Nephron. 7/
More coming....8/
As a reminder there are a number of lags we see. People get infected, many don’t get symptoms for a few days, some become infectious, some go out into the world, some infect others, and the cycle continues.

Eventually some become hospitalized, some need ICU care, and some die.9/
Testing has increased in many states, meaning some of the cases being captured are on a further lag. Growth rates could be lower than indicated, but there are also likely more untested cases.

States where % positive rates increase like AZ, UT, TX, SC, NC & WA are of concern.10/
This is why this analysis by Nephron is important. It takes a look at what happens when states open and what the differences are. 11/
At first after opening, the R0 barely changes. People are uneasy & express concern about getting infected. But as more things open, the R0 increases.

Bars and indoor restaurants, churches, jails, nursing homes and plants represent some of the places where growth occurs.12/
Depending where these infections occur and the age & health status, hospitalizations & deaths could be better or worse.

As of now deaths are still flat to slightly declining. So even though way too many people are dying every day, it’s too early to know about the new cases.13/
Hospitalizations are at record levels in AZ, MS, NC, SC, TX and UT so there could be some reason to worry. AL and AS are also concerning. 14/
We can still remain very hopeful that there will be a lower death rate than in earlier states. The new states are more rural, but also have more than their share of older & sick people.

If those folks continue to protect themselves, there will be better results. 15/
But as @kumailn articulated here, there is a deep deep cost, unfairness & impracticality of isolating people like he and his wife when the virus spreads. So even if death rates fall, this is still of concern. He’s quite funny too. 16/…
The other side of thst news is that post-peak states like NY, NJ, MA, CT and MI are seeing real declines. Their population may remain more cautious given the trauma they lived brought. 18/
All things considered, this is what we didn’t want to happen, what many will be quick to label “predictable.”

It is a warning signal that if the WH & govs ignore this reality, we should still take it seriously. Masks & distance while getting back to things will help./end
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