I am less than 36 hours from a move to another state, and am going to have to keep this post short this week and also skip the visualizations I usually produce. I'll catch up next week, but from looking at the data earlier today I think the trends I've been noticing the last few weeks are basically unchanged. I did note that South Africa is now 6th in the world in terms of number of diagnosed cases, which is sobering. The U.S., of course, is still number 1. Daily death counts in the U.S. are still less than a thousand, so we still haven't seen the surge in new cases about a month ago result in a large increase in deaths. I thought we would see an increase in deaths by now, which means that either treatment has gotten better, recently infected people are more likely to be young and not die of covid-19, or that there is a spike in deaths coming but it's just not here yet (or some combination of these). I tend to think the major explanation is just that we haven't seen a spike in deaths YET, but time will tell and in the meantime it's good news that death counts are staying under 1000 per day (compared to the more than 2000 per day we were seeing in April). In the meantime Brazil, which has 210 million people to the U.S.'s 328 million, IS seeing daily death counts higher than 1000 per day, which I believe is the highest death toll in the world right now.
I talked to a friend in New Zealand today, who goes to restaurants and places for fun, and whose child is in primary school with no masks and no social distancing. (Raise your hand if you want to live in NZ right now. Me too.) According to the Ministry of Health, the country had ONE new case of covid-19 today. (I think they actually mean one case of someone testing positive for SARS-CoV-2, not necessarily that the person was showing clinical symptoms of covid-19.) ONE. The case came from outside of the country; it's been 77 days since there was a locally-acquired case. The infected person is in isolation at a hotel, and there is no one in NZ with covid-19 requiring hospital care.
Obviously NZ has some natural advantages, such as being an island nation, wealthy, and with a small population. Yet hearing that NZ has crushed their epidemic and people are returning to normal life is a stark reminder to me that there is nothing inevitable about the path the epidemic is taking. We are collectively making choices that determine our future. I have a lot more sympathy for South Africa at this juncture than I do the U.S., because South Africans and the South African government are operating under so many more constraints. So many South Africans live in crowded informal housing in which social distancing is impossible, and have no savings or social safety net to provide for their families if they don't go to work, even if the workplace (or getting to work) is risky. I read Ramaphosa's speech from earlier this week and truly believe he is trying to navigate the best possible course among bad options, but SA can't magically triple their number of hospital beds or send thousand dollar checks to every citizen.
In the U.S., on the other hand, we have vast resources, plus many good examples from similar countries that are successfully controlling their epidemics, and yet we are utterly failing to control the virus' spread. I realize that is a national view rather than a state-level or more local view, but I think there are very few states that are doing well right now. Every corner of the U.S. seems to be consumed with the question of whether schools should re-open with in-person instruction in August/September, but the reality is that most states are in a worse position than when schools closed in March (schools closed in 48 of 50 states, if memory serves). I still believe that schools need to re-open, as much in person as possible (especially for kids under 10), but we have utterly squandered the opportunity to make it safe(r) to re-open schools. I don't think it's possible to turn things around in the U.S. in the next 6 weeks or so before schools should re-open.
I'm reading dire reports about hospitals in the U.S. and South Africa being overwhelmed. This harrowing tale of a 50-something South African who died from covid-19 (a few days after spending all night in an ambulance trying to get a hospital bed) was a warning about the fragile state of the health care system, and that it's not only the very old who have a high risk of dying. Another very sobering part of the story was how quickly she went from being at home for a week and not seriously ill, to critically and then fatally ill.
I feel that many of us (at least in the U.S.) are starting to take the pandemic less seriously exactly when we should be taking it MORE seriously. This isn't over. People are dying. And we all have an imperative to do what we can to lower risks for ourselves, our families, and our communities. Masks and social distancing are good (and mandated, in many places), but staying home as much as possible is better.
Sometimes a picture is worth a thousand words, so take a look at these pictures of a person's exhalations with and without a mask. These images are from an awesome video that makes a very convincing case for mask wearing in only 8 minutes, as well as being a great explainer on the epidemiology of the pandemic and the scientific process generally.
I already hugely respected Anthony Fauci, but my esteem for him only grew in reading this profile in the Washington Post. He's been showing remarkable leadership for decades, spearheading brilliant research, and skillfully navigating politics so that politics won't stand in the way of good science. I'm deeply disturbed and dismayed to see how he is being undermined and sidelined by the Trump administration. If the U.S. produces a vaccine anytime in the next year it will be in large part because of Fauci's relentless effort and brilliant leadership. The man is a national treasure, and I dare you to read that profile and not come away with the same conclusion.
Finally, I recently did an interview with an institute at Wheaton College (my current employer), with thoughts more theological than epidemiological. While written from a Christian perspective, it may be useful to people of any faith who are trying to decide when to resume in-person religious services, or what our faiths require of us in this time.