Post #1376: COVID-19 trend to 12/30/2021 – still vertical.

Posted on December 31, 2021

The U.S. is now averaging over 100 new COVID-19 cases per 100K population per day.  Still no sign of a slowdown for the country as a whole.

Data source for this and other graphs of new case counts:  Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 12/31/2021, from https://github.com/nytimes/covid-19-data.”  The NY Times U.S. tracking page may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html.

The only little light I see on the U.S. horizon, at the moment, is that maybe DC and Maryland have begun to plateau.  Those were two of the earliest-hit and hardest-hit areas in the Omicron wave.  DC seems to be topping out at more than 300 new cases / 100K / day, and Maryland around 150.  (The Maryland data look wonky because they had some sort of reporting glitch for a couple of weeks running.  Separately, I can’t discount the possibility that DC has simply run out of testing capacity, given the high rate of new cases.  But at face value, both of these leaders appear to be topping out.).

I place the start of the period of rapid growth in both states somewhere around 12/13/2021.  And if this is the peak there, then the end of it dates to roughly 12/29/2021.  Or just over two weeks from start of rapid growth to peak.

That said, you have to balance this little ray of hope against what’s happening elsewhere.  I’m still goggling over the U.S. South Central region, where the graph looks like they rang a bell the day after Christmas and everybody got Omicron.  Those lines go from practically flat to practically vertical, in one day.  Their trends seem to have turned on a dime.  That makes no sense, but it is what it is.  I’d like to think that’s some sort of reporting artifact, but it’s not stopping, and if those lines don’t turn back down, then that trend is real.

Anyway, most of the states look more like that, than like DC and Maryland.  So we have a ways to go yet.


An anecdote to illustrate how fast this is moving.

The new cases numbers are growing so fast that I have to keep extending the vertical scale of my charts.  Apparently I’m not the only one having trouble keeping up with that.

Here’s the chart that Google provides you today if you search for COVID Great Britain.

Source:  Googled:  COVID Great Britain

Good news, right?  Looks like Britain has firmly plateaued. 

Look again.  That’s just a bit too neat to be real, isn’t it?.  And I didn’t catch it when the first post-Christmas bar was published.  I only caught it when I went back to look and saw three in a row.  What you’re seeing is the fact that Google didn’t increase the scale on the vertical axis, and so truncated the tops of those bars.

Only if you roll your mouse over the bars can you see the figures for the actual data.  Sketching that in, the true un-truncated chart actually looks like this:

So, no, Britain hasn’t plateaued yet.  Or, at least, not in the way that the original as-published graph suggests.  The bottom line is that Google (or their data source) failed to increase the vertical scale of the chart to keep up with the growth in new cases.

That story, does, however, have a happy ending.  Although the new case numbers are off-the-charts in Great Britain, the hospitalization numbers are steady.

Source:  Googled COVID Great Britain, on 12/31/2021.

I guess that’s the best we can hope for at this point, in the U.S.  We can hope that we don’t overrun our hospital capacity despite new case counts that are large by historical standards.

So let me end with that.  Things are moving so fast that it’s hard to know exactly how to compare the new-case counts and new hospitalizations.  Taking the most recent data from the CDC COVID data tracker, if I compare hospitalizations in the past two days, to cases in the past two days, I get a case hospitalization rate of about 2.2%.  Which is about one-third of what we saw under Delta.  And which is what I would expect to be seeing if we’ve now reached the point where Omicron accounts for almost all new cases.

And so, if we plot the U.S. data that is most similar to the British data above — persons in the hospital with COVID — the results are not dissimilar to Great Britain above.  At present, we have a modest uptick in the count of persons in the hospital with COVID, compared to a vast increase in the number of new cases.

Source: CDC COVID data tracker, accessed 12/31/2021

That’s not to imply that there are no stressed hospitals.

In my area, a handful of Maryland hospitals have shifted to “crisis standards of care”, per this reporting.  But if you read the details, it’s evident that the Maryland definition of that is not the “let them die” version that we have seen in other states.  (That is, this does not provide license for physicians to triage admissions based on likelihood of survival, rather than need for care.)  Instead, assuming the reporting is right, it just allows hospitals greater freedom in (e.g.) rescheduling surgeries, deploying staff, and the like.

The other thing to watch is the mortality rate.  The U.S. is now almost two weeks into the Omicron wave.  If there were going to be a surge in deaths to match the surge in cases, that ought to start showing up about now.  And  it’s not.  Yet.  Like so:

Source:  CDC COVID data tracker accessed 12/31/2021

Not even in New York City, which, along with Washington DC was an area that was hit early and hard by the Omicron wave.  Now, more than two weeks after the start of rapid case growth, there’s only the slightest uptick in deaths.  And, just over two weeks after the start of the surge, maybe they are seeing new cases plateau, similar to DC and Maryland.

Source:  CDC COVID data tracker accessed 12/31/2021


Conclusion

Things look pretty awful at the moment, but only if you focus narrowly on the new case count.  Sure, those high numbers of cases are disruptive.  They are certainly causing some labor shortages, shutdowns of some types of retail and other business.  And certainly should give you pause regarding spending time in any type of indoor public space.

But don’t lose sight of a few things.

South Africa reached its peak case rate under Omicron in just three-and-a-half weeks.  That was from first observed case to peak.

It doesn’t look like we’re going to be quite so lucky here in the U.S., or in Great Britain, or maybe Canada.  We’re already three-and-a-half weeks past out first cases, and we haven’t seen a peak yet, as a country.

But maybe there are some early signs that the early leaders of the U.S. wave — DC, Maryland, and possibly New York City — are finally topping out in terms of daily new case counts.  That will be well worth watching.  In the past, these waves have tended to have roughly the same length in every U.S. state.  If it’s true that we’re finally starting to see some tops in the leading states, that will put a limit on how long we can expect the current wave to continue for the U.S. as a whole.

But, overwhelmingly, the thing we should be most thankful for is that rumors that Omicron was much less virulent than Delta are now pretty clearly confirmed.  Despite the huge new case counts, we’re not seeing hospitals being swamped in large numbers.  And we’re not seeing anything like a commensurate increase in deaths, to match the rise in new cases.

As I look at the case counts, I like to think to myself that one Delta case is worth three Omicron cases, in terms of average severity of illness.  (And aren’t we just damned lucky that’s true.)  So as Omicron gradually pushes out Delta, you have to start discounting the number of new cases.  Think of it as a severity-adjusted case count.  While the raw count it going way up, the severity-adjusted case count is still well below the peak of the Delta wave.