Tuesday, March 31, 2020

Coronavirus dashboard for March 31: more States finally implement lockdown; testing rate still poor

 - by New Deal democrat

Here is the update through yesterday (March 30) 

It looks like there is near-consensus in the medical community that a “first China, then South Korea”  (or, “Sledgehammer then Scalpel”) approach is the paradigm to tamp down the pandemic. 

Nearly 75% of the US population is now under lockdown, and it may be beginning to break the band of exponential growth. 

Based on South Korea’s experience, a ratio of 15:1 in total tests to results showing infection is the level where there can be some confidence that the infections have been contained. I pointed that out to Bill McBride a week ago, and he is now including that in his daily testing graphs. 

The above three most important metrics are starred (***) below. 

Number and rate of increase of Reported Infections (from Johns Hopkins via arcgis.com)
  • Number: up +21,555 to 164,610 (vs. +18,369 on March 29)
  • ***Rate of increase: day/day: 15% (vs. 34.6% baseline, 20% for the past week, and 15% on March 28)
Here is the Johns Hopkins log scale graph comparing the 7 day rate of growth in new cases vs.  total infections in the US:

This looks like confirmation that the exponential rate of growth is beginning to slow.
Also, Ben Engebreth has started tracking coronvirus infection and testing numbers for each state, with graphs, here.
Number and rate of increase of testing (from COVID Tracking Project)
  • Number: 113,503, up +17,856 vs. 95,647 on March 29 day/day
  • Rate: increase of 19% vs. number of tests previous day
Comparison of rates of increase in documented infections vs. testing  
  • Infections +15% vs. Tests +19% day/day
Result: The rate of testing has been failing to improve (until today) and remains far, far below what is needed, which is probably now at least 250,000/day. Note this target number is also increasing exponentially as we try to chase the number of exponentially increasing infections.

Ratio of tests to positives for infection (from COVID Tracking Project)
  • Number: 113,503 new tests vs. 21,469 new diagnosed infections 
  • ***Ratio: 5.3:1 
In South Korea, where aggressive testing has led to a near-total disappearance of new cases, the inflection point where the number of new daily cases plateaued was reached when the ratio of tests to new cases found reached 15:1. Any ratio less than that suggests that not enough testing is being done. Yesterday’s ratio of 5.3:1 continues to show that testing is falling further and further behind the level of new infections.
Number of States (+DC and Puerto Rico) in total lockdown, business lockdown, and partial restrictions
  • Total lockdown (personal + business): 31 (AK, AZ, CA, CO, CT, DC, DE, HI, ID, IL, IN, KS, LA, MD, MN, MI, MT, NC, NH, NM, NJ, NY, OH, OR, PR, RI, VA, VT, WA, WI, WV)
  • Business lockdown: 6 (KY, MA, ME*, NV, PA*, TN*)
  • Partial restrictions on business (restaurants and bars): 11 (AL, FL*^, GA*, IA, MO*, MS, ND, SC*, TX*^, UT*, WY) 
  • School closure only: 3 (AR, OK**, SD)  
  • No mandatory restrictions: 1 (NE*) 
*some local areas are under lockdowns
**some local areas with partial restrictions
^restrictions on entry into State from some other affected States
Here is the NY Times’ most recent graph of lockdowns:

Number and percent of US population in total lockdown, business lockdown, and partial restrictions
  • ***Total lockdown: 153.2 million, 59.8% 
  • ***Business lockdown: 35.4 million, 10.7%
  • Partial restrictions on business (bars, restaurants): 88.0 million, 26.5% 
  • School closure only: 7.9 million, 2.4% 
  • No mandatory restrictions: 1.9 million, 0.6%
Earlier last week, there was a decisive move towards more restrictive measures across the board. This all but ground to a halt across the southern “red” States. Yesterday did see MD, DC, VA, and AZ go to total lockdown, and TN go to business lockdown.
Summary for March 31
Almost 3/4 of the total US population, including metro areas in some non-lockdown States, is under total lockdown. Unfortunately, we still have to wait 1 to 2 weeks for this to have its full effect. Because no action has been taken to “quarantine” incoming travel, including from the recalcitrant States, especially Florida, travelers from those States will re-seed new outbreaks. 
 It does appear that “social distancing” and lockdowns are bearing some limited fruit. But a deceleration in the exponential rate of increase still means the US as a whole is failing.
Further, the rate of testing, while having increased tremendously, still remains abysmally too low compared with the spread of the virus. In other words, we are still chasing the virus, and we are falling further behind.
It remains the fact that the federal government under Trump will never take the necessary steps - in particular, enforcing a nationwide lockdown or assisting the States in theirs, or ordering emergency production of masks, tests, thermometers or other necessary equipment.  Therefore those States which have gone to lockdowns need to cooperate regionally in effectuating a “Sledgehammer, then Scalpel” solution.