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As we head into fall, worth reflecting on the past 3 months, and what it portends for next few

While things are clearly better since summer peak, serious warning signs ahead

The biggest one?

We go into Labor day with much more infection than we did Memorial Day

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So a walk down memory lane

We opened up Memorial Day with 20,000 daily cases, 5.4% test positivity rate

We peaked around July 22, we had about 75,000 daily cases, nearly 9% positivity rate

As we enter Labor Day, we are at about 40,000 new cases, 6.3% positivity rate

2/5
Compared to the peak, we are clearly better

But few things should worry us

1. We're going into fall with a lot more disease than we entered summer

2. Our test positivity rate higher now than June 1: means we are missing more cases

3. Our testing is DOWN over past month
I know we have been promised more testing this fall -- but not here yet

The bigger problem is that we are seeing a real divergence in states

First – southern states

Blazing hot all summer, now cooler

Still generating nearly 20K cases / day

And largely flat to bit down

4/6
Group of Midwest/Western states where things are getting seriously worse:

N/S Dakota
Iowa
Missouiri
Kansas
others

And a group of states that continue to hum along: low case rates, low % positives – scattered across northeast (NY, MA, CT, etc) and midwest (MI, OH)

5/7
Problem is that as kids come back to school, colleges re-open, business re-open – in many places, cases will rise

And we are at a very high baseline to begin with

And as cases begin to rise again, we’ll have larger outbreaks harder to manage.

So what to do?

6/8
In places where cases are high or rising:

1. would NOT yet open schools, colleges
2. would close bars/all indoor dining

Drive cases lower through distancing, masks, testing

In places where cases low, focus on getting kids back to school safely, colleges opening safely

7/8
We must lower infection burden

We all know what happens in fall

weather cools
people spend more time indoors
flu arrives

Huge challenge to control the virus

Starting at a baseline of 40K daily cases a bit of a disaster

And no, vaccine on October 22 won't bail us out

Fin
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Keep Current with Ashish K. Jha

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