By: Kyle Freese, PhD, MPH

Daily summary 3/18/2020

This is the first of the daily updates that will be provided to keep track of updates in the COVID-19 fight. I will share interesting charts from various sources and provide some insight into what the data might mean for us.

The U.S. has nearly 4,400 confirmed cases of and 79 deaths. As shown in the figure to the right, Washington is still the hardest hit state, even after adjusting for population.

Credit: WHO Situation dashboard

Today also marks when all 50 states have reported cases, an expected development as the pandemic continues.

However, as reported by the New York Times yesterday, the U.S. lags in coronavirus testing (25,000 specimens tested compared with 134,000 in Italy and 274,000 in South Korea). See @Epi_DrFreese Twitter feed for a figure showing the relationship between number of tests given and confirmed cases for these countries. Expansive testing is the only way to understand the true magnitude of the problem.

Shown in this graph is the most recent, worldwide epidemic curve from the World Health Organization COVID-19 Dashboard. Ignoring the artificial peak that occurred on 12-Feb (the date when China changed their diagnostic criteria for identifying cases overnight), we are in the second wave of the pandemic, though it is unclear if we are declining from the peak or still in the growth phase.

Will the U.S. learn from Italy?

Italy confirmed 3,500 new cases of COVID-19 yesterday, bringing the total confirmed cases to over 31.500. To put that in perspective, on March 1st, they had 561 new cases.

The graphic below shows the total positive cases for Italy and the U.S., both in crude totals as well as adjusted for population. The figures show, side-by-side, the two populations with 11- and 17-day lags, respectively. If aggressive isolation measures are not successful, we can expect the U.S. to experience a similar trend.

We also should consider potential strain on our healthcare systems. For example, though the age distribution between Italy and the U.S. is different (i.e. Italy skews older), Italy has 3.4 hospital beds per 1,000 people, whereas the U.S. has only 2.9 per 1,000. This might act to amplify potential negative effects experienced as the healthcare system struggles to treat new COVID-19 patients.

Epidemic curve from the WHO Novel Coronavirus (COVID-19) Situation Dashboard.
Known COVID cases per million residents.
Comparison chart of 2020 Coronavirus pandemic, Italy vs. USA.

For additional references, resources, or questions, please email Dr. Kyle Freese at