1/11 Weekly epi review. Just when you thought it couldn’t get worse….But stay tuned for news Tuesday about a better way to get a nation-wide approach despite lack of national leadership. The folks at exit strategy added “bruised red” to their map. The bruise is spreading.

2/11 Overall test positivity increased slightly, tho positivity in commercial labs decreased slightly. Something odd is going on with the commercial lab data -- the number of tests reported is way down and we’ll have to wait until next week to know if their trends are reliable.

3/11 Look carefully at public health lab results. Lines are positivity rates, on the Y axis. Note yellow - young adults- increasing for more than a month. Older adults, blue and green lines, increased sharply last week. Not good. First cases increase then 2-3 weeks later, deaths.

4/11 Test positivity trends are revealing, but don’t be fooled by test numbers. Tests that take more than 2-3 days to come back are of little or no value. We should know testing rates for each race/ethnic group, limited to tests that come back within 48 hours.

5/11 ILI and CLI are continuing to increase in much of the country. Syndromic is an important early warning system and alarmed in Arizona in late May….

6/11 Death rates declined to near baseline. Rosling got it right: we have a hard time with the concept: Better, but still very bad. Dramatic increase in use of Remdesivir, steady increase in plasma treatment in hospitalized patients with Covid. Promising tho unproven treatments.

7/11 States with high rates, high and rising test positivity: FL, TX, GA, LA, SC, AL, NV, ID. AZ stabilized at high rate. CA, UT and many others intermediate; CA population means large numbers. Reassuring so far but at risk: Northeast, WY, SD. HI and AK low with small increases.

8/11 Where does the epidemic go from here? This modeling site has performed better than most, using solely deaths and machine learning. Nationally, @youyanggu estimates 4.8 million people with Covid today - 1 of every 70 people.
https://covid19-projections.com 

9/11 The same site projects 211,500 deaths in the US by the end of October. Leaving Belgium, which may count deaths differently, aside, that could possibly put the US death rate ahead of those of France, Sweden, Italy, and Spain and about tied with the UK for worst in the world.

10/11 It’s not about opening schools, it’s about opening them and keeping them open. We know what to do: 3W’s - wear a mask, wash your hands, watch your distance (e.g., close restaurants and bars), and box the virus in with strategic testing, isolation, tracing, quarantine.

11/11 Better care, newer treatment can decrease death rates (maybe: plasma and remdesivir early, steroids for some patients late). Even with a vaccine, the virus is likely here to stay. We need a comprehensive response to minimize deaths and get to the new normal soon and safely.