Thread by @Bob_Wachter

1/ Covid (@UCSF) Chronicles, Day 195

As a politics junkie, I spend much of each day refreshing the election projections @538politics (tinyurl.com/y4vqs85a; it currently has Biden at a 78% chance of victory).

2/ While @NateSilver538’s model has many variables, I’m guessing it’s missing one of the most important: Covid status in swing states. That’s today’s topic.

I’ll focus on the 8 states that 538 deems the most likely to be tipping points: PA, FL, WI, MI, AZ, NC, OH, and NV.

3/ My thesis: in a close race, whether Covid is front of mind may determine whether persuadable voters base their votes on Trump’s handling of Covid, or on other things.

The fact that the US is likely now starting its 3rd surge (whether in your state or not) should be enough…

4/ … But, as @edyong209 has observed tinyurl.com/y44zhxq3, Covid has brought to light a “failure of empathy” in the U.S. – unless people see the impact of the disease on themselves or loved ones, they don’t seem to take it seriously enough.

5/ The fact that the early wave was in coastal blue states meant that it mostly spared red (and swing) states. But the chart below – of Covid case counts in Clinton vs Trump states through 7/16 tinyurl.com/yxcqwt23 – shows that the virus began surging in red states in June.

6/ Trump remained in denial. “If you take the blue states out,” he said on 9/17, “we’re at a level that I don’t think anybody in the world would be at. We’re really at a very low level.” A statement that manages to be both loathsome and (after July) wrong tinyurl.com/y63m4ee9

7/ Voters give Trump awful marks on his handling of Covid, and deservedly so. In the latest Quinnipiac poll tinyurl.com/yy3b5jbm, by a 16 point margin (55%-39%) voters trust Biden more than Trump to handle the pandemic.

8/ But in our me-oriented culture, attitudes are linked to perceived personal/family risk. In a new @abcnews / @washingtonpost poll, 62% worry that they or a family member might get Covid. Voters who express this concern overwhelmingly favor Biden, 71%-27% tinyurl.com/y2knyyg9

9/ With the election 5 weeks away and the polls giving him a failing grade on Covid, Trump is doing all he can to focus our minds on anything other than the virus – the Supreme Court, racial tensions, mail-in voting, “socialism.” It’s mostly not working, but it’s his only shot.

10/ If the election is a blowout, it may not matter. But if it's close, the Covid situation in a swing state could determine the outcome. So here is the current situation, in a few charts. I’ll sum it up after the data.

It’s not all bad news for Trump, but a few real threats.

11/ Here, from @nytimes, is a map showing where cases are going up, or not (redder is hotter). The picture illustrates that Wisconsin is the hottest (in Covid terms) of the 8 swing states. Some of the other tipping point states are active, but none like WI.

12/ Note that much of the Midwest is heading in the wrong direction, but most of these states (ie, MO, OK, TN) are solidly in Trump's column. This means that their surges probably won’t matter electorally – though the toll in health, death, economics, & schools will be very real.

13/ State trends (below) confirm this impression, w/ WI the only swing state w/ a high caseload getting worse. NV, PA & AZ have relatively low caseloads but are trending up. Here, NC, FL, MI & Ohio look calm, but NC’s graph (showing the last 14d) may be deceptive, as we’ll see.

14/ Transmission rates tell a slightly different story, and they may predict where things go in next 2-3 wks. This chart confirms WI's high transmission rate (Rt 1.12). But NC (1.15) is even higher, & NV (1.08) & MI (1.0) are also ≥ 1.0. We could see surges in these states soon.

15/ Let’s look at case curves over time for the 8 states (Fig on left) – it's a bit hard to read because they’re bunched up. In R Fig, I’ve isolated just WI and NC – the NC bump is now very impressive. We’ll need more data to be sure it’s a real spike and not a reporting error.

16/ I’m guessing it’s real: combo of the NC Rt of 1.15 and this recent spike in cases makes me think North Carolina might be joining WI as another swing state with a big Covid problem. Lots of colleges & universities there; that may be part of the answer tinyurl.com/y48e4v2h

17/ Test positivity rate is another way to get a sense of a state’s current Covid situation. Here, we see more signs of WI heading in the wrong direction, and so is NC. FL also remains dangerously high, though it’s downtrending. Nevada is showing a turn for the worse – worrisome.

18/ If you prefer # ‘s to figures, here are case trends for the 8 states, incl. cases/100K population in past week. We see that FL, while downtrending, is still awfully high. WI is high, as is NV, but the real surprise, again, is NC, where an early surge now seems very real.

19/ Taking it all together, it’s clear that WI is in trouble Covid-wise, and NC isn’t far behind. NV has some worrisome trends. FL is improving but not out of the woods.

In the rest of the states (PA, MI, AZ, OH), it doesn’t look like a local Covid surge will color the voting.

20/ But things can change quickly based on facts on the ground. In Wisconsin, Democratic @GovEvers has enacted a new set of restrictions and implored the citizens to follow the public health recs tinyurl.com/y4pf664c If people take his lead, things could turn around fast.

21/ On other hand, in FL, Repub @GovRonDeSantis is doubling down on opening up tinyurl.com/y25xdbx9, perhaps betting that the Rs will score points for opening before paying a price from Covid, particularly since folks are casting mail ballots now. Too cynical? Don't think so.

22/ To sum up, Biden need win only a few of these states to reach 270. So a Covid surge in any could focus voters' attention on Covid & tip persuadables. Currently @538politics has Biden at 81% chance in WI, 54% in NC.

And the NC senate is 63% Cunningham (D) over Tillis (R).

23/ For example, if Biden wins WI & NC, as well as MN & MI (where he’s now at 88% and 85%, respectively), then he’s up to 262 in the Electoral College. He could hit 270 by winning just one of the following: PA, AZ, GA, FL, or any two of NH, NV, IA, or ME tinyurl.com/yybhhxdd

24/ And, while FL & AZ aren’t currently surging, the memories of the summer – when surges in both Republican-led states led to many thousands of deaths – are still fresh. The handling of Covid is likely to be a factor in these states as well, particularly among older voters.

25/ Given all that’s going on (Trump’s taxes, anyone; or maybe that CA is still on fire, & the Court), it’s far from certain that Covid – at a state level – will be the decider. But given the relatively small # of undecideds still out there, I wouldn’t bet against it either. /end