Covid Epi Weekly Thread: Worser and Worser, Every Week

Cases increasing exponentially in most of US; current epicenter including increasing hospitalizations, deaths is in midwest. Likely half million new infections/day. In Dakotas, an estimated 1 in 11 people have Covid.

Test positivity increased 10.8%→11.9%. @youyanggu nowcasting 3.3 infections/diagnosed case. Tho not all people estimated to have illness are infectious (max. infectivity before and 5-7 days into illness), nationally ~1 in 100 people infectious today. 2/10
Highest hospitalizations ever in US. Deaths increasing. Further increases inevitable - but continued increases are not (more on this later). Midwest is a crescendo. Northeast increasing. South never decreased a lot, now increasing. West increasing. 3/10
Hospitalizations are increasing steadily. Already many hospitals stretched; likely we’ll see another 30,000+ increase in coming weeks. Scarcest resource: trained healthcare staff. PPE remains insufficient. Nursing home cases are increasing. And all of this will get worse. 4/10
If our plans don’t change, Thanksgiving will be Super Bowl of super spreader events, accelerating an epidemic already out of control. Good guidance from @CDCgov. Better a Zoom Thanksgiving than an ICU Christmas. Read my latest: 5/10
Very encouraging news on vaccines! Still to be seen: supply, immunity duration, protection of frail, safety when millions vaccinated. For distribution: fast, fair, transparent. Nursing home staff, residents should get first. States need $$$ to prepare. Congress must act. 6/10
Much better control needed for many more months. WOW! Great graphics show how much policy matters here: And tale of 2 states: VT is 6x more densely populated than SD, but has 10x fewer deaths. Following the science saves lives. 7/10
Hong Kong and Singapore created a travel bubble. More than 5 unlinked infections/day, they will stop travel. Yesterday ~500,000 unlinked infections in US. With a new approach based on science, organized response and honest communication, together we can make steady progress. 8/10
Masks and mask mandates work!! Important report from @CDCMMWR. Impressive graphics: line graph worth careful study. Mandating masks --> decreasing cases.

Freedom includes freedom from disease. Is that complicated?

Next weekly epi thread in 2 weeks. 9/10

Have a happy, socially connected, physically distanced Thanksgiving!

“Wear gratitude like a cloak and it will feed every corner of your life."
― Rumi

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More from @DrTomFrieden

14 Nov
Covid Epi (and Research) Weekly: New Highs, New Lows

More cases in more places than ever. More hospitalizations. Sadly, as much division as ever. Encouraging news on vaccines, immunity but many hard months ahead. Together we can reduce spread, save lives, protect jobs. 1/thread
Stunning increase in cases, dangerous increase in hospitalizations, tragic increase in deaths. On March 10 @cyrushapar and I estimated deaths with .5% fatality rate. Sadly, our projections are on track. Act now or half million people could die. 2/
Simple, depressing math. Test positivity increased from 8.4% to 10.5% in a week. Cases are increasing exponentially. Hospitalizations lag cases by 1-2 weeks. Hospitalizations will pass 100,000 within a month. Deaths will reach 2,000 a day by the end of the year. 3/
Read 29 tweets
7 Nov
Covid Epi Weekly: Death Won’t Take a Holiday this Holiday Season

Divided government. Divided country. Just when we most need unity to stop the pandemic. Covid skyrocketing. 100-fold difference between S Dakota and Vermont, and 10x between northeast and upper midwest. 1/thread
How bad is the increase? Bad. Doubling, tripling of cases or more in many communities and states. Much of the country is in the exponential increase phase. Every day of delay cost lives. Basic concept: 1-2 punch. 1: Knock virus down, minimizing social harm. 2: Keep it down. 2/14
First, the numbers. Bad almost everywhere. CDC understatement: “Percent positivity increased [7.2% to 8.2%] among all age groups ... in all regions.” Horrifying. National tsunami. Hospitalizations up 14%, deaths up 8%. Deaths follow hospitalizations by a week or two. 3/14
Read 14 tweets
30 Oct
Covid Epi Weekly: Scariest. Halloween. Ever.

Hard to imagine a worse confluence. Cases surging in much of US. People are tired of limitations the virus is imposing. Economic harm is real, painful, and persistent. White House communications continue to mislead, divide, deny. 1/
Bottom line (almost) up front: there IS one thing that can stop Covid. For months I’ve said there isn’t, but there is one thing. Not masks. Not travel limitations. Not staying home. Not testing. Not contact tracing. Not isolation. Not quarantine. Not even vaccine.

Around the world, the best predictor of controlling Covid is social cohesion. The understanding that we’re all in this together. We’re all safer when we all mask up, support tracing, and, eventually, get vaccinated. No group can get infection without endangering others. 3/
Read 21 tweets
24 Oct
Covid Epi Weekly: Turning the Corner on Covid in the US ... Into an Oncoming Tsunami of Cases, Hospitalizations, and Death

You know who’s NOT tired of winning? Covid, that's who. Unless we up our game, it will keep winning, keep spreading, keep killing Americans preventably.

Test positivity increasing in ALL age groups. Positivity in >65s increased 44%, from 3.6% 5 weeks ago to 5.2%; 5 weeks ago rate in young adults was 50% higher than in over 65s; last week 20% higher. What started in the young didn’t stay in the young. 2/
Cumulative hospitalizations people >65 in US
1 in 300 Caucasians
1 in 120 American Indian/AN
1 in 110 Latinx
1 in 87 (!) Black people

Covid+ failure to protect essential workers, many Black/Latinx+ baseline less access to healthcare = exacerbated racial injustice in health. 3/
Read 14 tweets
16 Oct
Covid Epi Weekly: Immunizing Against Herd Stupidity

Bad week for fight against Covid. Reopening without sufficient care. Failure to isolate. Failure to communicate. Dangerously misguided theory on immunity. Cases increasing, hospitalizations following, more deaths to come. 1/15
Test positivity increased for first time in a month (to 5.4%), but positivity difficult to interpret. Antigen tests, lack of consistent definitions. Hospitalization data concerning tho in the crazy world of US health economics supply creates demand. 2/15
In the past 2 weeks, 21 states had their highest reported rates ever, including most of the midwest, much of the west. As predicted, we have surpassed 50,000 cases/day. White House cluster up to 40 known cases, hundreds not untested. Maine and Vermont still encouraging. 3/15
Read 14 tweets
9 Oct
Covid Epi Weekly: The First Cluster

Cluster at White House is symptom and symbol of the failure of Federal response. Overconfidence in testing. Lack of basic safety precautions in crowded indoor places. Delayed isolation. Incomplete contact tracing. Failure to quarantine. 1/13
Testing only useful as part of a comprehensive strategy; it doesn’t replace safety measures. There are false negatives, and even if accurately negative in morning someone can be highly infectious hours later. Also need 3W’s: wear a mask, watch your distance, wash your hands. 2/13
Masks are important. Worth reading science review by the wonderful @CyrusShahpar. I learned from it. In addition to protecting others & yourself, masks may reduce inoculum and make it more likely that if you do get infected you won’t get severely ill. 3/13
Read 13 tweets

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