Government COVID-19 Map Looks Great

The COVID-19 news headlines look grim, but the United States might actually be winning the battle against the outbreak, at least for now. Just about all of the national maps and charts in the latest weekly COVIDView report show outbreak intensity indicators moving in the right direction. Public health specialists at the U.S. Centers for Disease Control and Prevention (CDC) create the reports based on data from a wide variety of sources, including state public health agencies, hospitals, primary care clinics and urgent care clinics. To compensate for the well-known problems with COVID-19 testing, they present COVID-19 data alongside data for conditions that look like COVID-19, such as pneumonia and influenza. They also provide data on deaths from all causes, to deal with the possibility that COVID-19 might be causing deaths through mechanisms that look nothing like pneumonia.

Resources

• The CDC's weekly COVID-19 report is available here.
• The CDC's provisional COVID-19 mortality data table is available here.
• Florida's COVID-19 reports are available here.
• Arizona's COVID-19 reports are available here.
• An overview article about the weekly COVID-19 report for the previous week is available here.

One challenge the CDC faces is reporting lags: The new CDC report includes data submitted up through June 12, for the period ending June 6, but many states take two weeks, or longer, to turn in their data, and some forms of data, such as cause-of-death data, takes longer for the CDC to process than other types of data. The CDC's latest mortality chart, for the week ending June 6, shows that the percentage of all deaths caused by COVID-19 and conditions that look like COVID-19, such as influenza and pneumonia, fell to 7.3%. That's close to a stunningly high figure, of about 28%, in mid-April, and close to the ordinary flu epidemic threshold level of 6.2%. The CDC hospitalization rate chart shows that the number of hospitalizations per 100,000 people, for people with laboratory-confirmed cases of COVID-19, is falling. For adults ages 65 and older, for example, the COVID-19 hospitalization rate has fallen to 8.9 per 100,000, from a peak of 32.9 per 100,000 in mid-April. The CDC tries to measure the number of relatively new cases, by looking at data on "influenza-like illness" cases "out in the community." Officials get those figures from the primary clinics, urgent care clinics and hospital emergency rooms. The CDC is now coloring all of the U.S. influenza-like illness activity map a dark, healthy green, meaning that all 50 states and the District of Columbia are reporting minimal levels of cases involving patients who have illnesses that look like flu, or like COVID-19.

The Context

Other organizations that are trying to track the U.S. COVID-19 outbreak appear to be reporting numbers that look similar to the CDC numbers. The COVID Tracking Project, for example, is showing that the number of people currently hospitalized with COVID-19 fallen has fallen to 28,524 as of Friday, from a peak of 59,260 April 15. One reason for the gloomy headlines is that, although total numbers of new cases are falling nationwide, the numbers are still increasing in many states. The Johns Hopkins University Coronavirus Resource Center has a collection of charts that shows that, since June 1, the number of cases has been increasing in many states in the West and South, and especially in Arizona, Arkansas and South Carolina. But, at this point, the number of confirmed new COVID-19 cases per 100,000 residents still appears to be much lower than it was in the hard-hit states, like New York and New Jersey, and the rate of increase appears to be lower than it was when the number of cases was surging in those states. Dynata, an online survey map, has been using its survey tools to generate global COVID-19 symptom maps. The Dynata maps appear to show that the overall incidence of various sets of COVID-19-like symptoms, such a dry cough and loss of the sense of smell or taste, has fallen to a low level in most U.S. states. For the 14-day period ending Friday, for example, the percentage of Dynata survey takers ages 18 through 64 who said they had a dry cough, along with loss of taste or smell, was just 1.2%, down from 2.1% in mid-April. The incidence of COVID-19-related symptom sets continues to be relatively high for people ages 18 through 34, who may be more likely than people of other ages to have essential jobs out in the community. In Wyoming, for example, 3.6% of the Dynata survey takers in that age range say they have been saying they have a dry cough along with a loss of the sense of taste or smell. For agents aiming to sell life and annuity products to high-income prospects, one concern may be that the Dynata figures have consistently shown that survey takers with annual household income of $500,000 and more report much higher rates of symptoms that could be a sign of COVID-19, such as having a fever or a dry cough, than the survey participants in any other income group. That could be due to the nature of the kinds of high-income people who participate in online surveys, or it could be a sign that many high-income people travel frequently, go to conferences, work as health care providers, or have engaged in other activities that have increased their odds of suffering from upper respiratory infections. For public health officials, another concern is the lag between when people are exposed to the virus that causes COVID-19 and when people begin noticing the first symptoms of the disease. The fear is that, because the virus incubation period can last for 10 days or more, waiting until large numbers of people begin suffering from COVID-19 symptoms to impose work-at-home rules or add other protective measures could allow a big surge of cases to flare up. Still another concern is that many of the most prominent U.S. COVID-19 reports are based on weekly state-level data, or, possibly, weekly county-level data. But major surges of COVID-19 cases may occur in neighborhoods, or even on individual city blocks, and those kinds of surges may flare up in the course of a few days. For Florida, for example, Johns Hopkins' summary case number chart for the period from Jan. 22 through June 14, shows that the number of new cases reported every week has held relatively steady for the past few weeks, since COVID-19 testing became readily available. But Florida's three-day new case average spiked to 2,068 Friday, from 1,331 a week earlier. In Dade County, where Miami is located, the number of new cases soared to 571 Friday, from 258 Thursday. The increase could be the result of random fluctuations; efforts to improve testing for various high-risk groups, such as residents of certain nursing homes; or actual increases in the number of Dade County residents who have COVID-19. Addendum: After the original version of this article as posted, some readers have asked about Arizona. Here's a look at the numbers from Arizona... In Arizona, where reports of COVID-19 cases swamping hospital intensive care units have surface, the number of new confirmed cases soared to 1,456 June 8, from an average of about 400 to 500 per day in May. The reported number of new confirmed cases is lower for each later day. The decreases in the reported number of confirmed Arizona COVID-19 cases on days after June 8 could reflect a decrease in the number of new cases, but it could also reflect fluctuations in testing, and delays in data reporting. The increase in the number of new confirmed COVID-19 cases in Arizona could also be related in improvements in patient access to COVID-19 diagnostic tests. Another, broader indicator — the percentage of all hospital emergency room visits resulting from illnesses that look like COVID-19 or influenza — suggests that COVID-19 may be spreading much more slowly in Arizona now than it was in early April. The percentage of Arizona emergency room visits resulting from COVID-19-like illness stood at 5% for the week ending June 7. That indicator was up from 3.8% for the week ending May 17, which was Arizona's best week since mid-March. But the indicator was down, sharply, from what it was from March 8 through March 29: Throughout that three-week period, the percentage of emergency room visits resulting from COVID-19 like illnesses ranged from 7.7% to 7.8%. But patients admitted to hospitals with COVID-19 tend to stay in for weeks, and many deteriorate. Due mainly to COVID-19, the percentage of Arizona hospital intensive care units in use has been rising steadily since mid-April. It reached 82% Sunday. .