Latest in COVIDView: Deaths decline, test positivity increases, concerning trends emerge in states

I wish the CDC would host regular media briefings on the Covid work they’re doing but since they aren’t being allowed to, I will summarize what I see as the most important findings of their latest COVIDView report—the single best source of information on the pandemic.

Decline in deaths

Good news first. Deaths continue to decline, although they’re not at baseline levels yet. But remember: these are trends on the basis of large denominators. Even at baseline there could be hundreds of people killed each day by Covid.

Flu-like activity down to almost zero, as expected

Flu and flu-like activity are just about gone, as expected by now. Flu continues to circulate at low levels over the summer, too low to be picked up by most surveillance systems. We need to track Covid-like illness as an early warning and systems for that need to be built, validated, and disseminated.

Kids are continuing to test positive at elevated rates

For the past month, the proportion of kids testing positive for the virus has been higher than any other age group. More investigation is needed, but the most likely possibility is that this reflects infection of kids in households.

How many communities are offering people with Covid infection alternative, appealing housing? Not enough. Kids getting infected is concerning, but parents and grandparents are at high risk of death if they become infected by a household member.

Test positivity increasing

Now the most concerning trend. For the first time since tracking began, test positivity rates are increasing. This is bad news. In the face of stable or increasing testing, this means spread has been increasing for a least a week. 

"The overall percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly from week 22 (6.0%) to week 23 (6.3%) nationally driven by increases in four regions." -COVIDView

I explained in a Washington Post op-ed why focus on the number of cases, number of tests, or even test positivity is misguided. Anyone can have great epidemiologic insights and analysis, but just as you’d rather have heart surgery by someone with training and experience, I trust the folks who’ve actually analyzed and controlled epidemics before most.

Concerning trends in several states

Covid Exit Strategy is an excellent website to track trends.

Which states meet all of these criteria?

1. Increasing cases, AND
2. Increasing test positivity, AND 
3. Stable or increasing test numbers, AND 
4. Large numbers of cases 

AZ, TX, NC, FL, followed by SC, AK. Continued increases are likely, unfortunately.

Let’s take Arizona (starting alphabetically). Cases and test positivity have more than doubled, test positivity is very high, and numbers of tests have increased. Sixteen days in a row of increases. This is not the kind of streak you want.

Arizona has a good data dashboard, including for the number of positive or suspected Covid patients in hospitals. 

This is not the kind of trend you want to see. This is NOT from more testing, it’s from more spread.

Public health is the road to recovery

If we do great field epidemiology to understand where spread is happening and how to stop it with minimal negative economic and social impact, we can save lives and livelihoods. That requires being guided by and supporting public health. Public health isn’t blocking economic recovery, it IS the road to recovery.