Number of COVID infections is high, rising.

What should we expect between now and December 1?

How many more infections?

Looking at the last 6 weeks gives us some clues

But bottom line?

We will likely have 250K to 300K new daily infections by December 1

Thread
All data from @COVID19Tracking and 7-day moving avgs

Oct 1 to Oct 15

42K new cases --> 53K new cases

This was an increase of 24% off base of 42K cases

Oct 16 to Oct 31

53K --> 78K; Increased 46% off base of 53K

Nov 1 to Nov 16

78K-->150K; Increased 88% off base of 78K

2/4
So infections accelerating off of a higher and higher baseline

If things continue without intervention, expect around 300K or more new cases on December 1

And the implications for hospitalizations and deaths is awful

But a few things can alter this:

3/4
So what can change the trajectory?

1. Restrictions like what Michigan, others doing to bend the curve

2. Personal behavior: people pull back as they see their local hospitals full

These would be good

But a third possibility is strained testing capacity and its not good

4/6
We already see testing failing to keep up with infections

That's why test + rates doubled in last month

As infections rise, if testing can't increase, will see slowing growth of cases

But this is not good: will mean infections are rising but we are missing more of them

5/6
Bottom line?

We are on track to hit 300K new infections daily by 12/1

We may not if testing starts to falter. But that won't be good

We can actually turn it around by policy interventions, personal behavioral change

But the time to act is now

Fin

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More from @ashishkjha

20 Nov
Today was a very, very odd day

I testified before @SenateHomeland

They held a hearing on hydroxychloroquine.

Yup, HCQ

In the middle of the worst surge of pandemic

HCQ

It was clear how our information architecture shapes questions of science and medicine of COVID

A thread
There were 4 witnesses.

3 who strongly supported HCQ

They believed thousands of Americans were dying from lack of HCQ

And then, there was me

This split was not a reflection of evidence or the consensus in medicine

It reflected ability of the majority to seat more witnesses
The hearing was a testament to how politicized science has become

I shared evidence of studies that have failed to find benefit of HCQ

3 other witnesses shared personal experiences

And suggested my testimony was reckless because it would deny people access to lifesaving HCQ
Read 9 tweets
15 Nov
With cases spiking across the U.S. and national leadership nowhere to be found, states are taking the lead

Watching @GovWhitmer announcement. Feels like kind of science-based, nuanced policy intervention we need right now

What is Michigan doing?

A good amount

Thread
Michigan is doing a 3-week pause on:

indoor dining

bowling alleys and other indoor recreation

high schools

group fitness

And limiting informal indoor gatherings substantially

What are they NOT pausing?
Michigan is NOT pausing:

outdoor gatherings

essential work places

And most critically:

They are not pausing K-8 in-person schools

And they've ramped up testing to one of the higher levels in the country
Read 4 tweets
13 Nov
Things are obviously horrible re COVID

Our 7-day moving avg # of infections now 130K, 11.2% positivity, 60k hospitalizations 1050 deaths

But two of our largest states are still keeping things under control

NY and CA

And if they lose control, things will get much worse

Thread
NY and California combined represent 58 Million People

18% of US population

But they are doing 26% of all tests and rising

Have only 8% of all cases

8% of all hospitalizations

and 6% of all deaths

How are they doing it?
They have similar approaches

On per capita basis, they are, combined, doing about 60% more testing than rest of nation

Both states use data to drive local actions:

When cases rise, they curtail activities locally

Not perfect (hello NYC indoor dining??) but largely works

3/4
Read 4 tweets
10 Nov
Biden team won't have formal power to manage COVID until January 20

71 days

Between now and then, we may see additional 100,00 deaths from COVID

Its a horribly high number

Why do I say that? Heres the math

Right now, 1000 people dying every day

That number will rise

Thread
The 1,000 deaths represents infections that happened 4-5 weeks ago

So how many infections happened 4-5 weeks ago?

On October 7, we had about 45,000 cases with 5% positivity rate

Yesterday, we had 110,000 cases with 10% positive rate

These are 7-d moving averages

2/6
So number of identified infections 2.5X

And % positive doubled.....meaning we are missing MANY more cases today than on Oct 7

We're missing so many cases today b/c of our wholly inadequate testing

So I suspect true number of infections at least 3-5X what it was on Oct 7

3/4
Read 6 tweets
8 Nov
Through their votes, the American people have decided they want a new approach to the pandemic

But we have 73 days until new President takes office

73 hard days

Without action, additional 100,000 Americans will die by inauguration day. At least

So we can't wait to act

Thread
The key is that we are not likely to get much action from the Trump Administration

So we need to look for leadership elsewhere

But first, a little data on how we got here

Let’s talk about this moment.

All data from @covid19tracking using 7-d moving avgs

2/n
First, the current surge started soon after labor day.

We went into labor day with about 35K new cases/day

And now, we are at about 100,000 per day New infections in the US from September 11 through November
Read 12 tweets
27 Oct
President keeps saying we have more cases because we are testing more

This is not true

But wait, how do we know?

Doesn't more testing lead to identifying more cases?

Actually, it does

So we look at other data to know if its just about testing or underlying infections

Thread
Easiest is to wait 2-4 weeks

If underlying infections stable but you test more, hospitalizations and deaths will remain stable

But what if you don't want to wait?

Look at test positivity

As testing increases, becomes harder to find the next case

So test positivity drops
Best example is NY, which tests more than 100K people daily, test + of about 1.3%

So now, let's look at where we are as a nation vs 2 weeks ago

All data from @COVID19Tracking using 7d moving avg

Yesterday, did 960K tests
2 weeks ago, 898K tests

So testing is going up

3/n
Read 6 tweets

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