The COVID statistics for the US for CDC Week 29 (ending July 18) got moderately worse as some parts of country fought worsening outbreaks and the conditions in other regions ameliorated.  There were also some encouraging news and emerging trends.

Cases

Total positive tests results in the US were up from 393,000 to 461,000, a 17% increase.  While previous claims that the increase in new cases was the result of increased testing have largely been inaccurate, that was the case last week.  Testing jumped 5.4 million from 4.7 million, a 15% increase.  The week’s positivity rate of 8.52% was up slightly from 8.36% last week.

The testing data is becoming harder to interpret as time goes on.  There are growing reports of false positive and negative results and long delays in getting results.  If tests results are a week or more older, it does not give much idea of what is happening in real time.

There is also the problem that a growing number of people are being tested multiple times.  A friend of mine who had a mild but persistent case of COVID was tested four times before he cleared the virus.  So, that one person accounted for three positive tests and one negative.  The COVID Tracking Project has been attempting to quantify the actual number of people tested, but the data from the states is so incomplete that we really do not know how significant this issue is.

Fatalities

Fatalities for the week rose from 4,737 to 5,194, a 10% increase.  However last week’s death toll was still more than 60% below the all-time high in mid-April.

For some historical perspective, 51,615 people died during CDC Week 29 in 2019.  In mid-April, the CDC’s excess death analysis suggested that fatalities were about 40% above normal (2020-78,480 v 2019-55,469).  By the end of May, the rate had fallen to around 10% (2020-57,009 v 2019-52,692).

There is a growing divergence between the number of infections and the number of fatalities.  Some of this can be attributed to the lag time in reporting fatalities, but there is also a significant improvement in patient outcomes.  I will be writing in more detail about this soon.

Hospitalizations

The COVID Tracking Project (CTP) shows that hospitalizations for the week were up by about 10% for the week (52,578 v. 57,562) and by the end of the week were near the all-time highs in April.  However, many states, including Florida, have only begun reporting hospitalizations in last few weeks.  As a result, longer-term comparisons may be skewed.

Of more critical importance is the ICU bed capacity.  The CTP includes that metric in their data, and it shows ICU bed usage has roughly held steady since late May.  But the data is only reported for about half the states, with some very notable exceptions like Texas and Florida.  (BTW, I have no idea why CTP is not reporting ICU usage for Texas, because the State reports that data every day.)

The CTP data also shows that the ratio of hospitalization to confirmed infections has been continuously dropping and now stands at just half what it was in early April.

It is important to recognize that the COVID hospitalizations still represent a small portion of the nation’s total hospital bed capacity.  In a 2018 survey, the American Hospital Association reported that the US has just under one million staff hospital beds, putting current COVID usage at around 6%.  However, that does not mean that a particular region cannot be overwhelmed, as we saw in New York.  If you are dealing with an outbreak in Houston, an empty bed in Montana does not do you much good.  But the notion that hospitals all over the country are filling up with COVID patients is not accurate.

Vaccines

There is growing confidence in the research community that a COVID vaccine might be available this year.  Moderna announced a robust immune response from its small-scale trial last week, which will allow it to move to a 30,000-participant Phase 3 trial this week.  In a 1000-person study just released this morning found the Oxford/AstraZeneca vaccine produced an immune response after 91% of recipients after a single dose and 100% after follow-up dose. The lead Oxford/AstraZeneca researcher told the British parliament recently that their vaccine will be available in September. Even the normally dour Fauci recently said he was “cautiously optimistic” a vaccine would be available by the end of the year.

There has been an undercurrent narrative on social media and to a lesser extent in the mainstream media that humans may not be able to develop immunity to COVID and that the development of a vaccine is, therefore, impossible.  This speculation has mostly been fueled by anecdotal reports of individuals being infected twice with COVID.  But this discussion is outside the scientific community’s consensus and I seriously over 200 pharma companies would be investing billions to develop a vaccine if there was even a remote chance the task is impossible.

Also, many of the reports of re-infections are quite suspicious and even if true are not inconsistent with the belief that the vaccines will be effective for a large majority of people and, thus allow us to accelerate reaching herd immunity.

I heard one epidemiologist recently say,  “In the end, always bet on the human immune system.”  Two hundred thousand years of human history suggest he is right.