Where are we with the COVID-19 Pandemic? The Good and the Bad as of This Week

(This blog was originally shared on my LinkedIn account: https://www.linkedin.com/pulse/where-we-covid-19-pandemic-good-bad-week-tom-frieden/?trackingId=GnuqPnY5Q26fXQu2W8YIWg%3D%3D)

Another momentous and painful week. With it, another CDC COVID-View report. Below is a quick summary of the key findings.

One big thing to note is what’s not reported: case numbers, which are largely irrelevant. We actually find only about 1 in 10 cases, and the numbers are highly dependent on testing intensity and the testing approaches used.

First, the good news on COVID-10 epidemiology. The percentage of positive tests continues to decrease, as do trends for the proportion of outpatient visits for ILI and CLI (influenza-like illness and COVID-like illness). These proportions can be misleading because when people do not go to healthcare facilities or seek treatment to avoid exposure to COVID-19, the proportions can increase even if infections are decreasing. It’s important to track both the proportion and numbers of ILI/CLI.

Now, two pieces of not-so-good news:

First, in 4 regions, the southeast, southcentral, west coast, and pacific northwest, test positivity has increased.

Second, the positivity rate in kids continued to stay stable or increase.

The leading hypothesis is that adults are bringing infection home to their kids. To remedy this, we should offer housing for the infectious period for all with COVID-19. This is what the best programs around the world are doing. This limits spread and protects families. This should, of course, be voluntary and provide appealing, temporary housing.

Race/ethnicity inequalities continue to persist, with Native and Black people having 5x hospitalization rates and Hispanic/Latinx people having 4x the hospitalization rates of white people. This disproportionate burden requires a disproportionate response. We must focus on protection, prevention, engagement, and support.

Now, for the most encouraging trend. Deaths continue to plummet. Within a week or two, death rates may be at or near the baseline IF trends continue. Note, the below chart shows the percent of death from pneumonia, influenza, and COVID-19. We use percent, not number, because this is the most reliable indicator.

But, even with this trend, there could still be hundreds of deaths from COVID-19 each day. It’s preventable. It’s tragic. And it represents continued spread and risk of the virus. However, Europe, which is weeks ahead of us epidemiologically, appears to be reopening without rekindling -- yet. 

So, we will wait and see. What should you do? What you have been doing. Wear a mask. Wash your hands. Watch your distance from others. Box the virus in: test, isolate, contact trace, and quarantine. Continue to track the pandemic and our response to it. Importantly, protect nursing homes, the homeless, jails, factories, and anywhere where large numbers of people congregate. Hope for the best, plan for the worst.