On Friday, the first person died in the United States from the effects of an infection by the 2019 novel coronavirus. On Saturday, another case of apparent community spread was identified, this time in Chicago, half a continent away from previous signs that the virus may be circulating in Washington, Oregon, and California. Then came another case in Rhode Island (a traveler to Italy, not community spread).
But the worst news of the day came in a phone call from the CDC on Saturday afternoon. Though it has received little attention in a usually sensationalist media that seems suddenly concerned about saying anything at all that might raise a sensation, what the CDC said during that call indicated that the official number of cases of COVID-19 is likely to double almost overnight — and it’s happening in the worst place imaginable for a disease of this type.
The subject of that CDC press call on Saturday was the Life Care Center, a long term nursing facility near Kirkland, Washington. The cases there have not yet been confirmed by testing, but there are two “presumptive positives”—which, from the call, appear to be quick tests that returned positive values, but are waiting for lab confirmation. One of these positives is a health care worker at Life Care Center. The other is one of the residents there, a woman in her 70s.
But those two aren’t alone. CDC officials and officials from Washington state indicated that another 27 out of the facility’s 108 residents are showing symptoms that may indicate COVID-19. So are 25 members of the staff.
Considering the profile of COVID-19, with deaths and severe illness heavily slanted toward patients over 60 or those with other health issues, this sort of facility would seem to be the very worst case scenario. These are the people at highest risk for a poor outcome … and yes, that’s a euphemism.
And the worst thing out of this worst thing may be that one of the Washington state officials made it clear that, had they been able to test earlier, they might have identified and isolated infections before the situation reached this point. Now there seems little to do but protect those not yet showing any symptoms, wait for test results, and hope that everyone there is just sharing a persistent cold.
So, let’s look at a number that’s actually kind of nice to see.
For the first time, the blue wedge here is actually larger than the orange—that is, the number of cases considered to be “recovered” have exceeded the number of active cases. The reason for this is also right there on the same chart. With a recovery period between 10-17 days, the “fat” part of the graph in terms of the original epicenter in China are now reaching the point where they reach an outcome. In a sense, cases before Valentines Day have now, with few exceptions, either ended in death or recovery. And as far as China goes, the number of cases logged after that date is less than what came before.
However, there’s also a bad sign on this chart. At the very top of the graph, you can see that the overall slope for total cases has stopped flattening out and started to grow more steeply. This is because China is no longer driving the outcome. South Korea alone reported more new cases on Saturday than did all of China. Iran was not far behind. Here’s another look at the top 10 locations outside of China (and cruise ships).
The growth of cases outside of China shows the appearance of those three new epicenters—South Korea, Italy, and Iran, though the order of these new sources is almost certainly not as they appear from the public information. Every indicator is that Iran is not only continuing to vastly under-report the true situation, but was harboring a significant number of infections for days or even weeks before the first case was reported. Iran has reported 54 deaths as of Satuday—more than Italy and South Korea combined.
What may be more interesting on the chart is actually those other countries up near the top: Japan, Hong Kong, and Singapore. In each of these nations, despite proximity and frequent travel to affected regions in China that made them all early locations for cases identified outside of the original epicenter, additional cases have not undergone exponential growth. That’s true in Japan despite dozens of cases of community spread (including a scary number of cab drivers in major cities). After an initial outbreak, Singapore now shows only 32 active cases. Both of these countries show admirable management of the infection that has avoided the mistakes seen elsewhere. Worth studying.
Finally, here’s a warning of a different sort—these daily reports need to change.
The first of these articles on 2019 novel coronavirus appeared on January 23, when the number of cases in China was still in the hundreds, but 17 deaths had made it clear that what was happening near the city of Wuhan demanded attention. Chinese authorities had already instituted travel restrictions within the country, restricting travel in Hubei Province. However, there was something going on at the time—an impeachment—that definitely put the story on the back burner, and back pages, within the U.S. It wasn’t until a week later that the virus, and the disease it caused, got a regular daily post. That first one warned against the rumors and misinformation that was already spreading faster than the infection.
Since then, the series had gone through a lot of topics: Right wing efforts to paint the virus as the another reason for xenophobia, the difference between an epidemic and pandemic, the death of whistle-blowing doctor Li Wenliang, who became an overnight symbol for free speech and government transparency, and the first news that passengers aboard the cruise ship Diamond Princess had been confirmed to be carrying the virus.
Even though most of those events were less than a month ago, they’re already receding into the early history of an event that is turning into something that’s exceedingly rare—a genuinely worldwide event. For the last three weeks, these articles have often been a grim exercise in watching the rising tide of numbers. That may be an interesting exercise in some ways, but hitting everyone with charts and graphs is likely of diminishing value as this becomes more about how 2019 novel coronavirus affects your town, family, and life. Look for some changes to the reporting to match that new focus.
Resources on novel coronavirus
World Health Organization 2019 Coronavirus information site.
World Health Organization 2019 Coronavirus Dashboard.
2019-nCoV Global Cases from Johns Hopkins.
BNO News 2019 Novel Coronavirus tracking site.
Worldometer / Wuhan Coronavirus Outbreak.
CDC Coronavirus-2019 (COVID-19) information site.
European Centre for Disease Prevention and Control.