What Second Wave? The US is not Done with the First Wave

We pointed out earlier that if one looks at the US outside of New York (NY) and New Jersey (NJ) (or more precisely outside of Metro-NYC), the country’s COVID-19 pandemic has not peaked but rather has plateaued since mid-April.  Some states outside of NY and NJ appear to have also peaked but the 3 biggest states in the US, California, Texas, and Florida - containing 25% of the country’s population, has not really peaked and are experiencing continued increases in daily confirmed cases.  The figure below shows the daily case count for these 3 states:

California (CA - blue diamonds in figure above with 7-day rolling average), after plateauing in early April, has seen rising case count since mid-April.  Part of this rise has been due to increased testing but while testing has definitely improved it cannot account for all the increases in infections.  Some of it has been due to a series of politically motivated miscalculations undertaken to reopen the state since early May and testing and contact tracing missteps.  In addition, since Memorial Day, the massive crowds at the beaches and at the demonstrations against racial injustice and police brutality have just begun to feed into higher infection rates this month and into Summer.   

Texas (TX - red squares) after initial infection plateaued in mid-April has experienced waves of additional infections ever since Phase 1 reopening began on May 1st.  Governor Abbott just widened the reopening to Phase 3 on June 3 with little regard for the alarming trends in infections.  Texas has just reported its highest rate of hospitalization rates since the Coronavirus began spreading but officials have no plans to slow reopening.  Yesterday, 2166 COVID-19 patients were hospitalized and Texas ICUs are reportedly at 88% capacity.  So while its Deaths per million population and Case Fatality Rate (CFR in table below) has been relatively benign due to its relatively young population (median age of 34.8 yrs), it should not want to see its ICU flooded with more cases.

Florida (FL - green triangles) showed some evidence of peaking in case count in early April that led to halving of infections by early May.  However, as soon as the state reopened on May 2nd the case counts leveled off and by the end of May begin to rise again for a wide variety of reasons.  More recently the rise has begun to look exponential with an effective reproduction rate of R=1.18 and a doubling time of 13 days (see table below).  This does not bode well for the GOP convention now scheduled for August in Jacksonville.  If they do not enforce testing, masking, and social distancing it could spell disaster for the GOP, city, state, and country. 

State
Infections
Infections
Deaths
Deaths
Fatality
% test
Median
R
Doubling

/million

/million
(CFR)
Positive
Age
time(days)
CA
   147,132
       3,724
  4,988
        126
3.4%
5.5%
36.8
1.08
33
TX
     85,641
       2,954
  1,966
          68
2.3%
6.8%
34.8
1.14
20
FL
     70,971
       3,332
  2,877
        135
4.1%
5.4%
42.2
1.18
13

While CA, TX and FL had the 3 highest single day totals yesterday, North Carolina, Arizona, and Arkansas also saw large increases (~0.02% of population) recently.  Other states such as Oregon and Utah have prudently paused reopening plans as they investigate recent surges.  Those who are not pausing are inviting disaster because the slower one reacts, the more drastic the measures one needs to apply to stop any outbreak. 

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