The Current State of Covid in the US (12/13/20)

By Charlie Bilello

13 Dec 2020

Let’s run through some questions and answers to parse out where we are with the virus and where we may be headed…

1) Is the prevalence of the virus rising or falling?

In the US as a whole, it is rising.

New cases continue to hit new highs, averaging 209,951 per day over the past week.

Regionally, new cases are at new highs in the Northeast, South, and West while the Midwest is showing some signs of improvement (peak on Nov 19).


2) Are new cases rising only because we are testing more?

No. They are rising because more people are getting the virus.

We know this this is true because the percentage of positive tests is rising, currently at 11.4%. If more testing was the sole reason for more cases we would see the percentage of positive tests stay flat or move down with more testing.

Instead, 11.4% is the highest percentage positive we’ve seen in the US since May 4.

3) What impact is increased covid spread having on hospitalizations and deaths?

In General:

Increased Spread -> Rising Cases -> Rising Hospitalizations -> Rising Deaths. There is a lag between each of these occurrences, ranging from days to weeks.

Hospitalizations in the US continue to hit new highs (108,487), up 7% in the past week and 61% in the past month.

Looking at the breakdown by region, we see the South and West at new hospitalization highs and the Northeast moving sharply higher. The Midwest peaked on December 1 and has started moving lower over the last 2 weeks.


More states (16) are seeing rising hospitalizations over the last week than falling (6), but a good sign is that many states are starting to see a stabilization (29).


Here are the hospitalization trends in the most populous US States…

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Deaths in the US average 2,379 per day in the last week, a new high and now above the April peak (2,067).

Deaths are rising in all US regions with the Midwest, South, and West currently seeing the highest number of daily deaths since the start of the pandemic.


4) Are there any signs of a slowdown in the spread?

Thankfully, yes.

The rate of increase (month-over-month) is slowing in both new cases and hospitalizations, a good sign.

Whether this continues in the coming weeks will depend in large part on upcoming holiday gatherings and their impact on the spread. It is widely expected that spread will increase from these gatherings, but how much is unknown.

5) Are states imposing restrictions?


Most states currently have a mandatory mask requirement.


Business closures vary by state, but with more restrictions being put in place in recent weeks, particularly on bars and restaurants (ex: NYC ban on indoor dining, LA county ban on outdoor dining).


Only a few states have issued stay-at-home orders or curfews, with California being the most restrictive


6) What impact will the vaccines have on the virus?

With the Pfizer and Moderna vaccines showing around 95% effectiveness, they will have an enormous impact, hopefully bringing an end to the virus at some point in 2021.

But it will take some time for the vaccines to be approved and distributed.

In a big first step, the FDA approved Pfizer’s covid-19 emergency use authorization on December 11 for people 16 and older. And Today (12/13), the first shipments were sent out to all 50 states…

This coming week (Dec 17) the FDA will meet to discuss the Moderna vaccine’s application for emergency use.

The chief scientific advisor for Operation Warp Speed (Moncef Slauoui) believes that “about 20 million people” in the US could be immunized in the month of December.

The vaccines require 2 doses (3 weeks apart for Pfizer, 4 weeks apart for Moderna) to be fully effective.

7) Who will receive the vaccine first?

The CDC is recommending the following prioritization for distribution in phase 1:

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Source: CDC

The very first to get the vaccine will be the groups most at risk, including heath care personnel and Long-Term care facility residents.

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Source: CDC

The sooner we vaccinate those in long-term care facilities, the more lives we will save, as 40% of the recorded deaths in the US have come from these facilities.

Children will be the last group to be vaccinated as we need more studies on kids and they have the lowest risk of serious illness or death.

8) When will herd immunity be achieved?

That will depend on many factors, including the speed of manufacturing, distribution, and the willingness of Americans to take a vaccine.

But Slaoui estimates that 70% of the population could be immunized somewhere in the month of May 2021.

A few months ago, that projection would have seemed impossible. But through human grit and ingenuity, we have witnessed a modern-day miracle.

There’s finally a light at the end of the tunnel, and it’s a bright at that. But the virus is not over yet (as the charts above illustrate) and we must all do our best to protect the most vulnerable in the coming weeks and months as we approach herd immunity.

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