1/14 COVID Epidemiology thread for the week, bottom line up front:

The tide is turning but is still very high.

Decreasing positivity rates in many areas, but still very high. Will we relax control measures too soon again, before we have the virus on the run and can corner it?

2/14 Positivity down (8.7 to 7.8%, decreases all lab types, 9 of 10 regions) but still high in many places. Surprisingly high in 5-17-year-olds: >10%, highest of any age group. Any place above 5% has LOTS of Covid, probably too much to be able to open schools and keep them open.

3/14 It's not just about having enough tests, it's about having fewer cases. Unless we decrease spread, we'll never have enough tests. And when we decrease spread, we need to use tests to quickly isolate infectious people and warn contacts before they infect others.

4/14 A test alone does NOTHING to control Covid. Only useful with rapid isolation of infectious people and rapid warning and quarantine of contacts. Don’t pay for tests if they take more than 72 hours to come back. A healthy incentive for companies. Report TAT for every state.

5/14 One approach re-calibrates the number of tests needed to keep positivity below 3%. By that measure the US, which last week averaged 740K tests per day with 7.4% positivity, would need more than twice as many tests to be doing anywhere near enough.

6/14 If we stick with the 3Ws (including indoor closures) to drive cases down by 80% or more, many fewer tests would be needed.

7/14 Big decreases in the number of tests reported from Texas, Florida, Washington, Minnesota, Puerto Rico. What’s happening? Average daily tests decreased by more than 40,000 last week, including increases in some areas and total decrease of nearly 60,000 in the above 5 places.

8/14 Positivity tracks disease rates reasonably well, not only in the US but also globally. We’re a long way from where we need to be in the US. Latin America continues to get hit hard, as do parts of Africa and Asia and the Middle East.

9/14 Another important indicator is flu- and covid-like illness visits to emergency departments, which continue at low and stable levels in all regions of the US. This is an important indicator to watch and to tune to for Covid symptoms as we learn more.

10/14 In most years, flu doesn’t hit hard until January. With less global travel and more physical distancing, flu season could be much milder. But by all means, get a flu shot this fall. We don’t know what flu season will be like this year, but every season is COVID season.

11/14 It’s not just that the US has more deaths than any other country, with among the highest death rates in world. It’s that countries in Europe and elsewhere have a handle on their epidemic and a tiny fraction of the deaths per day we are having now. https://nyti.ms/33Q3wWv 

12/ US will have >650 deaths/day through end of August. We must not lose sight of the horror of these numbers. These deaths are unacceptable, preventable tragedies. Will Covid be new example of American exceptionalism or will we join together, physically distanced, to stop Covid?

13/14 In Africa and elsewhere, interrupted vaccinations and treatment of AIDS, TB and malaria could mean more deaths from Covid disruption than from Covid infection. We must protect health workers and health care.

14/14 Encouraging start by CDC on science-based approach to vaccination, respecting communities. Vaccination is the most important tool to fight Covid, but won't end spread of the virus, which is here to stay. Our response must improve continuously. http://bit.ly/3fvrKHr