Here we have the data from Wednesday for Covid-19.
Pennsylvania saw continued spread of the virus. Notably, Monroe County in eastern Pennsylvania passed 1000 cases. It was one of the state’s earliest hotspots. That appears to have been because it was advertised as a corona respite for people from New York, not too far to the east and by then in the grips of their own outbreak.
New Jersey grimly passed 5000 deaths Wednesday. And it is on track to pass 100,000 total cases likely Friday or Saturday. Almost 2/3 of these cases are located in North Jersey, with some South Jersey counties still reporting just a few hundred cases and a handful of deaths.
Delaware passed 3000 cases and Kent Co. passed 500. While those don’t read like large numbers, keep in mind the relatively small population of the state.
Virginia has restarted reporting deaths, this time at the county level and not the health district level. What we see is deaths being reported all over the eastern third of the state from DC through Richmond down to Virginia Beach. In the interior counties we are beginning to see the first deaths appear. And in western counties, we still see that the virus has yet to reach some locations, but counties are beginning to report their first cases.
Illinois continues to suffer greatly in the Chicago area, and at levels that dwarf the remainder of the state. However, the downstate counties are beginning to see spikes of their own. Macon and Jefferson Counties each saw increases of 30–40 cases in just 24 hours.
A longer-term look at the states shows how the states diverge in their outbreaks. Pennsylvania looks like it might be forcing the curve downward whereas New Jersey appears to have more plateaued. Earlier I expressed concern about Virginia, which does now appear to have not peaked and continues to see an increasing rate of spread. Then we have Illinois, which may have plateaued, but we need to see if yesterday’s record amount of new cases was a blip or an inflection point. And in Delaware a missing day of records makes it tricker to see what exactly the trend is.
I want to share a small graphic I made yesterday evening. And I am being charitable with the term graphic. Really it is nothing more than a collection of organised factettes. But I have seen the footage of those protesting the lockdowns in various states, including Pennsylvania.
To be clear, people can have different policy prescriptions to solve the pandemic. For example, the governor of Pennsylvania is considering lifting the lockdown piecemeal once the state overall has sufficient testing and tracing capabilities. Look at the state.
He rightly said that Cameron County, one of the little light purple shapes in the upper left, with its one case for the last 25 days is in a different situation than Philadelphia where cases continue to grow, albeit at a slowing rate. And in the future it is possible that Cameron County could open before Philadelphia. That is a different policy prescription than, say, opening the state all at once.
I don’t think most people enjoy lockdown—I haven’t left my building in 38 days and I cannot wait to leave and go do something. But I recognise that spreading outside these walls we have a deadly pandemic for which we have no vaccine. But then I see people protesting—protesting in a manner that contradicts the guidelines put out by the health officials—and claiming that we should open up because this is nothing worse than the flu.
Well, Covid-19 is not the flu. It is much worse.
Now, those numbers will change because the pandemic is ongoing. But, let’s spitball. Let’s assume those numbers hold. The idea of the shutdowns, lockdowns, and quarantines is to prevent the spread of the virus. For the sake of this thought experiment, let’s just assume, however, that it infects 56 million people, the upper end of the range for this most recent influenza season.
Influenza this year killed as many as 62,000 people after infecting 56 million. Hypothetically, with a mortality rate of 5%, Covid-19 would kill 2,800,000 people.
With a 4% rate that drops to 2,240,000
With a 3% rate that drops to 1,680,000
With a 2% rate that drops to 1,120,000
With a a 1% rate that drops to 560,000
With a 0.5% rate that drops to 280,000
And even at 0.5% that is still far greater than the flu. And so that is why it is so important to keep the number of people infected as low as possible. (And I won’t even get into the surge problems overwhelming hospitals that acts as a force multiplier and is the proximate reason for the lockdowns.)
Monday’s Covid-19 data for Pennsylvania, New Jersey, Delaware, Virginia, and Illinois provided a glimmer of good news, most notably in Pennsylvania. That, however, occurred on the same day as a protest in Harrisburg that could set the state back days if not weeks. More on that below.
Pennsylvania saw fewer than 1000 new cases for the first time since 1 April. The curve here may be doing more than flattening, but it might actually be falling. That is to say the infection rate is decreasing rather than stabilising and holding steady, as it appears to be doing in New Jersey. That said, new cases are appearing sporadically in the rural and less dense areas of the state. Problematically, protestors arrived in Harrisburg to let it be known they are unhappy with the quarantine. Because the rest of us are.
The problem is that it appears a significant percentage of those infected with the virus are asymptomatic carrier, i.e. they are sick, but do not show any symptoms like fever, coughing, difficulty breathing. Critically, they may not appear sick, but they can spread the sickness. And so a gathering of several hundred people in close quarters? Not ideal.
Compare that to a Christian cultish church in Daegu, South Korea. There, an infected parishioner did not heed government calls to isolate and instead attended a church service. The average infected person spreads this virus to two or three people. This congregant? They infected 43 people who then went on to infect other people.
It is quite possible that someone in that Harrisburg protest was an asymptomatic carrier. And given the lack of social distancing, the lack of masks, and the general reckless behaviour, it is quite possible that the rally could be a super-spreading event. But we won’t know for 5–10 days, the apparent incubation period of the virus. Hopefully we dodge the proverbial bullet. But it is quite easy to see how these kinds of protests could lead to surges in infections. And those surges would then force the government to extend its quarantine by weeks thereby defeating the entire point of the protestors.
We get it. Quarantine sucks. But we all have to suck it up.
Moving on to New Jersey, where we see continuing evidence of the plateauing of cases. The bulk of the cases remain in the north in the New York suburban counties with the fewest numbers in the counties in South Jersey. However, averages of nearly 3500 new cases daily remains quite high and the death toll of 4377 is likely to continue to climb higher, even if Monday’s 175 new deaths was lower than most days in recent weeks.
Delaware is back to reporting its figures. And in that release, we had Sussex County in the south climb above 1000 total cases. The levels or curves chart at the end will also show how the state might be flattening and stabilising its infection rate, but we will need several days of uninterrupted reporting to make that determination.
Virginia might be worrying. Or it might not be. Cases continue to increase in the big metropolitan counties like Fairfax and Henrico. But, there are still several counties out in the west that remain unaffected. And the curves chart at the end shows how there has not yet been any sort of even a near-exponential growth curve. Instead we just see a steady, slow increase in the number of cases. That in its own way makes it more difficult to see when the curve flattens, because it was already a relatively flat curve.
Illinois continues to be the tale of two states: Chicago vs. everywhere else. The combined Chicago and Cook County have over 20,000 total cases and the surrounding counties add a few thousand more, which gets you over 2/3 of the state’s 31,000 cases. That said, new cases and new fatalities are beginning to pop up in downstate counties.
Lastly a look at the curves. As I noted above when talking about Pennsylvania, you can clearly see the downward slope of the state’s new cases curve. Compare that to the plateau-like shape of New Jersey. Delaware and Illinois might be approaching a New Jersey-like curves. But I would want to see more data and in Delaware less volatility. But like I said, Virginia is a tricky one to read.
Here is a look at the data from Sunday’s releases on the COVID-19 outbreak in Pennsylvania, New Jersey, Virginia, and Illinois. I’ve omitted Delaware because they paused reporting on Sunday to move to a noontime release instead of their previous end-of-day.
I’m not exactly certain what that means for the data on Delaware and reporting time series. But, my guess is that will be more like a hole in the time series. I need to spend some time looking at that. But, anyways, on to the states for which we did have data on Sunday.
Pennsylvania continues to see growth in cases, but as we’ll get to with the levels, that appears to at least be stabilising. But in the spread of the outbreak, we are beginning to see the T of the state, that more rural and less densely populated area, beginning to fill in with cases. These are of course the areas of concern, the areas with shuttered rural hospitals, lack of comparatively developed infrastructure, where the impacts could be proportionately more severe than in the bigger cities. In terms of deaths, they have now spread almost across the state from east to west. I am still waiting until two adjacent counties connect before I make that final pronouncement.
For New Jersey, I have removed the orange outlines around each county. The initial idea was to show where deaths had occurred. But now that they have been reported in every county, they don’t seem to be as helpful as the small number I provide in the graphic. Regardless, 4200 deaths is a lot. But the approximately 200 new deaths is the lowest number reported in several days.
Virginia is a weird state. When we see the levels chart below, you will see how its uptick has been far more gradual, and to this point it does not yet appear to have peaked or begun to stabilise. Most of the reported cases continue to be in and around the state’s big cities, notably the DC metro area, but also Richmond.
Illinois has now seen cases from north at the Wisconsin border all the way south to Cairo. Most cases remain, however, concentrated in the Chicago metropolitan area, with lesser scale outbreaks occurring in the Quad Cities area and the suburban counties of Illinois this side of the Mississippi. Deaths continue to rise, and while most area again in the Chicago area, they are appearing increasingly at low levels in downstate counties.
But what about those curves? Excepting Delaware, which hasn’t reported new data, we can see that some states like Virginia continue to see increasing rates of infection. Others like New Jersey and Pennsylvania clearly have flattened and have entered a new phase. In New Jersey’s case it appears to be more of a stabilised plateau. In Pennsylvania, there was some evidence it was entering a declining rate phase, but that may now have begun to become more of a steady rate of infection like in New Jersey. Illinois is tough to read because of the variability of its data. It might be more of a pause in the rate of increase, or it may have begun to stabilise. We need more data.
The data from Monday provided yet more evidence that the outbreak is flattening in several states. However, in some, the outbreak continues to pick up steam. Does this runs contrary to the idea that as a country is flattening? Not necessarily, but it is important to remember that a country that spans a continent and holds 330 million people will experience the pandemic differently at different times. So some states like Washington will be first, and others will be last.
Our five states cover the range of worsening to stabilising. We hope that those stabilising states soon enter the improving phase. Though to beat the dead horse, I would add that just because a state is improving doesn’t mean we can all go back to life like we knew it two months ago. That would likely result in us being right back here shortly thereafter.
Pennsylvania continues to be a state where the pandemic is spreading within the denser metropolitan areas of Philadelphia and Pittsburgh, leaving the central T to see fewer cases that spread more slowly.
Delaware might be approaching an inflection point, given that its most populous county, New Castle, is about to reach 1000 cases. (By the end of today it likely will if its new case trend holds.) We know that deaths lag new cases, and so the worry is that the number of deaths will begin to increase rapidly. The hope is that the slow initial growth of the outbreak will have left hospitals able to better cope over the longer time frame than if everyone had gotten sick all at once.
Virginia is a state that we will contrast to New Jersey, which I will write about last. Because Virginia is a state where it appears the outbreak is beginning to pick up steam and accelerate, rather than flatten. There was the significant drop in cases on Sunday, but that was due to the state’s enhancement of reporting data. (Their website now includes many new statistics.) But just like that the Monday data showed over 450 new cases on Monday. The question will be whether or not over the remainder of the week those new case numbers fall from over 450 to less than 400 to show that the state can flatten the curve before the outbreak becomes especially severe.
Illinois has shown a lot of variability in its day-to-day numbers, hence the advantage of the rolling average. But even that has appeared a wee bit jagged. It’s tough to see the curve flattening just yet, but if we receive updates today and over the next few days that cases are consistently lower, than we might just be able to say the curve is flattening.
And of course in New Jersey we have a state where the curve really and truly has flattened. We have yet to see sustained evidence of a decline in the number of new daily cases. As I said before, this might be more a situation where the outbreak has stabilised and roughly the same number of new cases is being reported daily. Of course the hope is that whatever that rate is falls below the excess capacity threshold of the state’s hospitals.
But I also want to take a look at the state of New Jersey with a degree of granularity. Because, as I noted with Virginia above, not all states are at the same point in their outbreak. And the same can hold true within states. We know that the outbreak in New Jersey began in the north and was very late in reaching some parts of South Jersey. So the same metrics we run for the state, we can run for the counties—though the data I have been collecting from the states only goes back as far as St. Patrick’s Day.
The northern counties, where the state has been hardest hit, have clearly begun to see the curve bend. But in the south the story is a bit more mixed. Some, like Burlington and Ocean, have seen the curve noticeably flatten. But in Camden and Mercer Counties, home to Camden and Trenton, respectively, the evidence is not quite there. Instead, in these populous counties there exists the very real possibility that the outbreak will continue accelerating for hopefully a very short while.
Another day, more cases of coronavirus and Covid-19. So let’s take a look at Sunday’s data as there were some interesting things going on.
First, let’s dispense with Virginia. The state is enhancing its reporting structure, and so they admit the data is likely an underestimate of the present situation in Virginia. So here’s Virginia, nothing really changed.
Moving on, we have Pennsylvania. Here we are beginning to truly see the disparity between the cities in the southeast and southwest, namely Philadelphia and Pittsburgh, and the T that describes what sometimes is used to describe Pennsyltucky. (Though it also includes cities like Harrisburg, the state capital.) The point is that the T of Pennsylvania has yet to suffer greatly from the outbreak. Of course, it’s also the part of the state least equipped to deal with a pandemic.
New Jersey is just bad. One can make the argument that South Jersey is hanging on. (Though I will touch on that later with an idea for today’s afterwork work.) Bergen County in the northeast is likely to surpass 10,000 cases on its own today. And that will put it above most states.
Delaware is tough because it sits as a small state next to several much larger ones. But, the numbers seem to indicate the outbreak is still worsening. Though in terms of geographic spread, there’s little to say other than that New Castle County, home to Wilmington, in the north is the heart of the state’s outbreak.
Illinois is a fascinating state, because of how dissimilar it is compared to Pennsylvania, a state which has a similar number of people.
The map shows that geographic spread still has a little way to go before reaching every county in the state. But the outbreak has been there longer than in Pennsylvania. And most of the darker purples are concentrated in the northeast, in Chicago and its collar counties. Compare that to Pennsylvania above where you will see dark purple scattered across the cities of its eastern third, e.g. Allentown and Scranton, and in the western parts near Pittsburgh. This too could be worth exploring in depth in the future.
Lastly I want to get to the cases curves charts. Here we look at the daily new cases in each state.
And unfortunately Sunday’s numbers will impact the Virginia curve, but it overall looks as if the state is worsening. I would argue that Illinois, which appears to be bending towards a steadying condition is likely in a weird weekly pattern where it appears to stabilise on weekends and then resumes reported infections come Monday. Pennsylvania might well be flattening its curve. I would want to see a few more days’ worth of data before stating that more definitively. Let’s give it to Wednesday or Thursday.
And then in New Jersey we have a fascinating trend. The curve of increasing number of cases has clearly broken. But it also is not shrinking. Instead, it seems to be more of a plateau. And in that case, the outbreak in New Jersey is not getting worse, but it’s also not getting any better. At least not numerically. However, the goal of flattening the curve is to create a slower, more steady increase in case numbers to help hospitals cope with surge volumes. So good news?
As I said yesterday, since people are finding these updates helpful on the social media, I am going to repost the previous evening’s graphics I make on the Coronavirus Covid-19 outbreak here on Coffeespoons as well. So while today is Thursday, these are the numbers states provided yesterday, so it’s more of a Wednesday update.
But here I can start with the flatter curves graphic. The New Jersey numbers in particular look good—I mean they’re still bad. Of course we are just a few big breaches of quarantine and lapses in social distancing from reversing that progress.
State-wise, Pennsylvania continues to worsen. However, a close look at the slope of the line in the previous chart indicates that the steepness of the growth may be lessening. Deaths passed 300 and cases are now firmly entrenched on both sides of the state with the rural, less densely populated areas in the Ridge and Valley portion of the state seemingly hit not as hard.
Despite the potential flattening, New Jersey is just in a rough spot. The final bastions of low case numbers in South Jersey are slowly filling up as Cape May County passed the 100-case threshold.
Delaware continues to accelerate and is now past 1000 cases.
Virginia continues to see cases spreading in the eastern, more populous portions of the state. And at 75 deaths, it’s nearing the 100-death threshold.
Illinois is seeing deaths occur away from Chicago, in the St. Louis suburban counties and in and around Springfield and Champaign and Bloomington areas.
Here are the Tuesday figures for Pennsylvania, New Jersey, Delaware, Virginia, and Illinois. At the end is an updated version of the flattening curves chart as well. Given the value of these graphics that people have been texting, emailing, and DMing me on social media, I might consider making these a regular staple here on my blog as well. I would probably slowly write about other graphics covering the outbreak as well.
Any feedback is welcome on how to make the graphics more useful to you, the public.
Pennsylvania has finally reached the point where the virus has infected at least one person in every county. Now, if we shift our attention a wee bit to the deaths, we can see those are still largely confined to the eastern third of the state.
New Jersey continues to suffer greatly. But a sharp increase in new cases could be a blip, or it could mean the curve isn’t flattening. We need more data to see a longer trend. Regardless, over 3000 more people were reported infected and over 200 more died.
Delaware worsened significantly. As a small state, it has a lower captive population. But it is rapidly approaching 1000 cases. In fact, I would not be surprised if that is the headline from Wednesday.
Virginia also saw a significant uptick in cases. And most counties and independent cities in eastern Virginia now report cases. But the rural, mountainous counties in the west and southwest are not uniformly infected. At least not yet.
Illinois saw some geographic spread, but again, compared to a state like Pennsylvania, the worst in Illinois is disproportionately concentrated in the Chicago metropolitan area.
Lastly, the curves are not flattening in all the states but maybe New Jersey. But as I noted above, the higher daily cases there might be a blip.
Yesterday I mentioned that there was some data to suggest that at least in New Jersey the curve was flattening. Monday we received additional data and so I wanted to share what that data showed.
I used a set of bar charts to show the new daily cases yesterday for Pennsylvania, New Jersey, Delaware, Virginia, and Illinois. But as I mentioned, a single day can be a blip. Noise. We want to find the pattern or the signal within that data set. Consequently I applied a simple 7-day rolling average to the new daily cases data set.
I chose seven days for two reasons. The first was that the onset of the symptoms is 5–10 days after infection. Picking a mid-point in that range assures us that people who are infected are beginning to appear in the data. Secondly, a cursory check of the data suggests that reported numbers dip lower on weekends. And so making a week-long average covers any possibility of lower values at week’s end.
That preface out of the way, what do we see? Well, there is some evidence that the curve is flattening in New Jersey. The lines below represent that rolling average. And if you look at the very top of the New Jersey curve, you can see it beginning to flatten.
Unfortunately that does not mean New Jersey is out of the woods. Not by a long shot. Instead, that means tens of thousands of people will still be infected. And hundreds more will die. But, the rate at which those two things happen will be lower. Hopefully hospitals will not be as overwhelmed as they presently are. And that might make for a lower total death count.
The data does not support, however, the notion that the curve is flattening in the other states. Consider that the United States spans a continent and contains over 330 million people. The outbreak will look different in different states. Compare Pennsylvania and Illinois, which have similar case numbers. But in Pennsylvania we have more cases in smaller cities and rural areas and fewer in the largest cities. Plus, of course, we have the different measures taken by different states to contain and mitigate the pandemic within their borders.
But, we do have some data to suggest that at least in New Jersey the curve is flattening. I’ll take good news where I can find it. (Even if it comes from Jersey.)
This past weekend I continued looking at the spread of COVID-19 across the United States. But in addition to my usual maps of Pennsylvania, New Jersey, Delaware, Virginia, and Illinois, I also looked at the number of cases across the United States adjusted for population. I then looked at the five aforementioned states in terms of new cases to see if the curve is flattening. Finally, I looked at the number of hospital beds per 1000 people vs the number of cases per 1000 people.
The latter in particular I wanted to be an examination of hospitalisation rates vs ICU beds, which are a small fraction of total hospital beds. But as I could not find that data, I made do with overall cases and overall beds.
So first let’s look at the cases across the U.S. What you can see is that whilst New York and New Jersey do have some of the worst of the impact, Washington is still not great and Louisiana and Michigan are also suffering.
And then when we look at the states by their cases per 1000 people and their hospital beds per 1000 people, we see that the states often claimed to be overwhelmed, New York, New Jersey, and Washington are all well over the blue line, which indicates an equal number of beds and cases per 1000 people, or near it. Because it is important to remember that not all beds are the type needed for COVID-19 victims, who often require the more fully kitted out ICU beds. Additionally, not all cases are severe enough to warrant hospitalisation.
Then from the broader national view, we can look at the states of interest. Here, those of you who have been following my social media posts, you can see fewer dark purples in these maps. That’s because I have adopted a new palette that has sacrificed granularity at the lower end of the scale and added it at the top, a particular need in New Jersey and the Philadelphia and Chicago metro areas. And finally we look at the daily new cases to see if that curve is flattening.
Pennsylvania now has almost every county infected. But unlike Illinois, which has a similar infection rate but more unaffected counties, Pennsylvania has fewer cases in its big city, Philadelphia, and has more cases in the smaller cities and towns.
New Jersey is just a disaster. Deaths are now reported in every county—so I can probably remove those orange outlines. The only potential good news is that new cases for the second day in a row were fewer than the day before. It could be a blip. But it could also be a signal that the peak of infection has or is nearing. That said, hospitalisations and deaths are lagging indicators and could take two weeks to follow the positive test results. So in the best case scenario that this is a peak, New Jersey is far from out of the woods.
Delaware is the smallest state I look at—and one of the smallest in the union overall—but its cases are worryingly increasing rapidly, although like every state I examine in detail it had fewer new cases Sunday than Saturday.
Virginia is in a better spot overall than the other four states. You can see that in the national map above. And most of Virginia’s cases are concentrated in the DC and Richmond areas as well as the cities along the peninsulas jutting into the Chesapeake.
Illinois is, as noted above, similar to Pennsylvania in terms of infections. In terms of deaths, however, it is doubling Pennsylvania’s numbers. And most of its cases are located in and around Chicago. Big chunks of downstate Illinois are unaffected or lightly affected compared to the Commonwealth.
Finally, as I noted in New Jersey, could these lower numbers Sunday than Saturday be meaningful? Possibly. But in all five states? Highly unlikely. Regardless, we can look at the number of daily new cases and see if that curve of infection is flattening. We should wait several days before beginning to make that assessment. But one can hope.
All of this is to say that things are bad and likely will continue to get worse. But I will keep looking at the data daily and presenting it to the public to keep them informed.