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Does More Cases Mean More Deaths?

On Saturday over 83,000 new cases were reported in the U.S. That’s a new record, more than 6,000 cases higher than the previous peak on July 17. Here is the daily new case count:

Where is this happening, and what does it mean? Let’s start by looking at geography. There were 13 states that each had more than 2,000 new cases. These 13 states made up 57% of all new cases. Here they are:

Texas and California are at the top, then Illinois and Wisconsin. Since these states are where the current volume is, I’ve added the 6 states here that I didn’t follow to my model starting today (IL, WI, AL, TN, OH, IN). Of course, the more important thing to look at is the active case curve, which I show for 21 states below. Texas and California are our 2 highest population states, so even if case counts were evenly distributed, these two states would show the highest new cases. However, the media reports new cases (and occasionally daily deaths when they are high), so I’m leading with this.

Of more interest to me is the high water mark for each state with respect to known active cases. Again and again, we’ve seen the pattern where a geographical area reaches a certain threshold as a percentage of the population, and then declines rapidly. This threshold is in the range of 1/3 of one percent. Let’s look at the high water marks for the 21 states I’m following now:

The brown horizontal bar is set at the 1/3 of one percent threshold. Many of these states have already reached definitive peaks, and some are setting high water marks now. It is the states on the right side of this chart that worry me. Wisconsin surprises me with a new population percentage record at 0.51%, and at this level I fully expect it will begin its decline shortly. With state to state mobility at very low levels, we are a collection of individual state patterns. In April we saw the Northeastern states with the most volume, then in July the sunbelt, and now the middle of the country. I’ll keep modeling these 21 states to see where each stands on the curve.

In other news, the folks at IHME updated their model on October 22nd, and again decreased their daily death projection. The October 15th revision projected 2,149 daily deaths by year end, and the October 22nd revision now projects 2,042. They’ve had a long string of downward revisions, so not sure what to make of this. The surveys on mask use that they model from show current mask use at 68%, which is an all-time high in the U.S. I believe that mask use is a key independent variable in their model.

Let’s look at the known active case curve. We’re now at about 465,000 active cases, just a hair less than the Wave 2 peak of 468,000. If Wave 3 behaves like 1 and 2, I suspect it will peak in the next couple of weeks, and then begin the march downward.

Part of the rise in daily cases is driven by the rise in asymptomatic testing. We’re now solidly in the 1 to 1.2 million per day band. Just 3 weeks ago testing was in the 800K to 1 million range. As I said in my last report, the increase in testing would explain about a 10,000 per day increase in reported cases, but that’s only a part of the increase we’ve seen lately.

As predicted, we’re seeing the first signs of an increase in daily deaths. We had our first 4 figure daily death report for the month of October on Thursday. I expect we’ll see a 3 week swell in the daily death rate, then begin the slow march downward again.

A more effective measure of mortality is the daily deaths per active case. I expect an increase in this metric as well, primarily because deaths lag cases by 2-3 weeks. So we’ll see deaths continue to rise even when cases begin falling again which pushes this metric up.

Shane Chalke Interviews

https://www.fredericksburg.com/opinion/editorial-unlock-demographically-not-geographically/article_a62e6e70-dccd-51cf-b7b2-16d77a90fd9c.html

Website

Groom Ventures has agreed to host a website that will archive my daily reports, and supplement with other commentary. John Groom worked at one of my companies back in the day, and is an excellent writer. The website is: www.howmuchrisk.com For those of you that post my daily report on Facebook, let me suggest you link to this site, as the direct Facebook posts don’t seem to copy the graphs.

Individual States

Here is Arizona. They changed their reporting protocol on September 17 to add the results of antigen testing. Part of the upward drift since then is a result of this definitional change. Arizona continues with a fraction of the COVID they had in July.

 

SC has been relatively flat for over 2 months. Note that South Carolina double counts cases, as they treat each positive test as a new case (per The Covid Tracking Project).

Here is Florida – down dramatically from the top, and drifting upwards for 12 days now. Note that Miami is no longer the key driver of the state’s results.

California has increased over the last 5 days. CA peaked at a low 0.17% of the population, so we won’t be surprised if this continues to increase. As always, I need to report that California is one of the states that counts tests rather than people, so there is some overcounting here.

Georgia is still doing pretty well. Relatively stable for the past 3 weeks. Georgia hit a high of 0.25% of the population. Note here again, the case numbers are exaggerated. Georgia counts each positive test as a case (according to The COVID Tracking Project).

Texas reported nearly 22,000 historical cases around September 23rd, and that caused the big bump at the end of the September. Texas is rising again, and peaked at 0.235% of the population (a little low), so it wouldn’t surprise me if we some more growth here. Note that Texas also reports positive tests as cases, so is doing some level of double counting (per The COVID Tracking Project).

NC and VA have tended to track each other, but NC reported an additional 4,563 “probable” cases on September 25th, and subsequent to that is growing faster than Virginia. NC has started to flatten out over the past week, but only ever hit 0.137% of the population, which worries me.

Here is the daily death report for NC, flat for 3 months now.

Washington has had so many reporting protocol changes it’s difficult to interpret this graph, but even through all the data fog I’d say it’s clearly increasing. Washington peaked at only 0.073% of the population, so I think there is more to come.

Here are NY and NJ – Significant percentage increases in both NY and NJ, albeit from small numbers. New York has leveled off over the past 17 days, while NJ continues to grow.

Here is Massachusetts. Like NY, they have a significant percentage increase in active cases, but again, on top of a small base. Growth is slow here, but has accelerated over the past 3 days.

…And here is Michigan, clearly growing fast. They sit now at 0.145% of the population, still nowhere near the ceiling.

PA is also growing, as expected. The peak was very low (0.091% of the population), so I believe there is more to come.

And finally, here is Colorado, at a new peak. It’s still only 0.143% of the population, so more to come I’m afraid.

Here is our first look at Illinois. The very definition of the word “spike”. Still at only 0.23% of the population, but getting closer to the ceiling.

Here is Wisconsin. Again, growing very fast, and already at 0.51% of the population. I believe this state will hit the ceiling very soon.

Here is Alabama. Fairly flat until yesterday. I’m guessing this is a data anomaly, but haven’t researched it yet. Every time we’ve seen one of these one day dramatic increases, it’s been a historical data dump or a case redefinition.

Our first look at Tennessee… growing fast, and now at 0.26% of the population. Should be near the top soon.

Ohio is also growing fast, and sits at just 0.13% of the population, so I’m sadly expecting more growth here.

And finally, here is Indiana. Once again, growing fast, and still not terribly close to the ceiling. They stand at just 0.215% of the population.

So that’s it for today. I’ll report again in a week or so (longer if absolutely nothing changes, shorter if we see developments).

–Shane Chalke, FSA

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