I am tired. We all are. This pandemic is a pain.
But I am also tired of some of some of the analysis out there (claiming that COVID19 is no longer deadly, and that fatalities will stay low/minimal, based on aggregate data).
But I am also tired of some of some of the analysis out there (claiming that COVID19 is no longer deadly, and that fatalities will stay low/minimal, based on aggregate data).
Today, we had a low count of new deaths in the US. 327 to be specific. But this does not mean that deaths will stay low. 
First, deaths are always low on Monday's. It is pretty obvious in the chart. Deaths were already heading higher last week. It is pretty clear from the 7-day moving average.
Second, deaths at the national level is the sum of deaths in NY+NJ and the rest (that is a definition). Deaths in NY have now declined to zero (good!). But they cannot decline further. From here, dynamics will be driven by 'the rest' (NY will be stable).
Third, deaths are reaching new highs (on 7-day moving average basis) in AZ, FL, CA, TX. It is pretty clear (you can click and zoom on these charts). This is part of the 'rest' and it shows rising death trends.
Fourth, if we zoom in on counties, the countries (12 shown here) with most cases per capita are NOT showing declining fatality rates. Hence, we should expect fatalities to kick in with the usual lag in these places, unfortunately.
If you look further down the list, counties with less extreme case counts, you find more with declining fatality rates. But there are enough where this is not the case to drive fatality numbers in coming weeks.
The point is, you have to look at disaggregated data to understand the fatality trends. The aggregated picture is very misleading, since improving trends in NY get lumped together with deteriorating trends in the rest of the country.
The 2nd wave (or whatever you want to call it) is not the same as the 1st one. It will not be as extreme a situation as NY in April. Behavior is already changing (self-policing if you will) and case growth will likely moderate in key states in coming weeks.
But we also generated a big fresh outbreak in the US over the last 5-6 weeks (based on case growth and higher positivity rates), and the lagged effect of that will show up in more fatalities, even if we manage to get case growth down from here.
Hospitalization trends suggests that deaths will be heading above 1000/day in coming weeks (from a recent low on a 7-day average basis of around 500), with contribution from many states as opposed to April when it was mostly a concentrated NY/NJ issue.
Arizona and Texas have seen growth in hospitalizations moderate. Hence, there is perhaps hope that we do not have to extrapolate at the same elevated rate for many weeks. But that will not help the fatality numbers in the very near-term (1-2 weeks ahead).
The politics have changed, and there is not a great deal of appetite or 2nd round lock-downs. Governors will take targeted steps, as we are already seeing. And it is not clear what specific fatality numbers will generate a very dramatic binary shift in policy.
We will see how policy makers respond to rising fatalities in coming weeks; it may depend on whether it happens with our without increasing case growth also, although each state is different.
I will leave it at that. I am tired of death. END.
