Nobody knows how bad this coronavirus surge is

Science

More than six months after the first case of the novel coronavirus was diagnosed in the U.S., and more than three months after we shut down large chunks of America’s economy to stop the spread of the disease, cases are surging once again around the country. Areas that were largely spared the worst back in the spring — primarily states in the South, Southwest, and West Coast — are seeing cases surge to record levels. In the case of Florida, daily confirmed case counts nearly match New York’s at the height of the crisis in early April.

And yet, while the rest of the developed world (and big chunks of the commentariat) stares in slack-jawed horror at American stupidity, most Americans aren’t radically changing their behavior. One reason: Daily death counts have barely budged, which has led some observers — and key policymakers like Vice President Mike Pence — to cast doubt on the seriousness of the situation, or even to question whether the rise in cases is real.

But the surge is real, not an artifact of increased testing. We know this because the test positivity rate — the percentage of tests coming back positive — has surged along with an increase in cases. If the rate were falling even as cases rose, as was the case in New York over the course of the spring, that would be a sign that the rise in cases was largely or entirely an artifact of increased testing — casting a wider net was catching more cases even as the spread slowed. Since the opposite is true, we should reach the opposite conclusion: The rise in cases is not only real, but could well be an underestimate, with actual infections rising more rapidly than the testing infrastructure can track.

So why aren’t death counts rising? Possibly it’s just a matter of time. People don’t die the moment they are infected, and over the next few weeks death counts may begin to rise (as they have already begun to do in Arizona). But there’s an arguably more benign possibility, which some have seized on: that it’s a consequence of changing demographics of the epidemic. Close to half the Americans who died from COVID-19 contracted the virus in nursing homes, mostly in the spring. The age profile of the recent surge looks quite different. The median age of those recently infected in Florida has dropped to 36. In California, a majority of those testing positive for the virus were under 50, while a majority of those who died were over 75. Maybe we’re doing a better job of protecting the most vulnerable, even if we’re doing a poor job of stopping the virus from spreading more generally.

But that word — “maybe” — is the problem. To make good policy, we need to know what’s actually happening.

Infections are rising rapidly — but are they really hitting new record highs? Or are we still only partway up a slope that is …read more

Source:: The Week – Science

      

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