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Virus Trending You Can Trust, I Think

Dr. Matteo Bassetti, head of the infectious diseases clinic at Italy's San Martino Hospital told The Telegraph, "The clinical impression I have is that the virus is changing in severity."

The coronavirus is on the rebound in several countries, including the US, but the mortality rate – at least so far – is not.

The US recorded back-to-back days of more than 30,000 new cases on Friday and Saturday, for the first time since April 30 – May 1. The country had seen a trend of declining new case reports, starting at the peak of over 39,000 on April 24, through about June 9. That day marked three consecutive days under 19,060 new cases for the first time since March 27, when the virus was clearly on the rise. But starting June 10, new cases have largely been on an upswing.

The death rate – a morbid but simple and accurate term – has continued it’s downward trajectory. Sunday’s reported deaths were 267, the fewest since March 23. Certainly the rate of deaths lags the rate of new cases, and simple mathematics would indicate it is sure to increase in the coming days. One contra-indicator to that assumption is that the peak number of deaths (2,693 on April 21) preceded the peak infection rate by three days. There are plenty of inconsistencies in the state-by-state reporting, and extreme factors like crowded nursing homes (especially in New York) that undermine any short-term trend one might try to establish. But looking at the longer-term ebbs and flows, you can clearly see that while new cases peaked, then began a slow decline, maybe flatlined for a bit in early June and are now moving upward again, deaths have been on a sharp and steady decline for two months. These graphs from Worldometer illustrate my point:

What to make of it all? Well an Italian infectious disease specialists thinks he may have the answer. Dr. Matteo Bassetti, head of the infectious diseases clinic at Italy’s San Martino Hospital told The Telegraph, “The clinical impression I have is that the virus is changing in severity.”

Bassetti notices a stark difference in the conditions of patients coming into his hospital with the virus now versus a few months ago. “People were coming into the emergency department (in March and April) with a very difficult to manage illness and they needed oxygen and ventilation. Some developed pneumonia.” But he said the patterns have “completely changed” in the last month. “It was like an aggressive tiger in March and April,” Bassetti continued. “But now it’s like a wildcat. Even elderly patients, aged 80 or 90, are now sitting up in bed and they are breathing without help. The same patients would have died in two or three days before.”

Bassetti credits social distancing measures, masks and lockdowns as factors that may have helped to mutate and weaken the virus, saying patients now may have a lower viral load because of these tactics. “We have fewer and fewer people being infected,” Bassetti said – something which is true in Italy. “It could end up with the virus dying out” even before a vaccine is found.

I’m no scientist, but I have a stayed at a Holiday Inn Express more than a few times. I also know how to interpret graphs and can extrapolate simple concepts from the voluminous reading I’ve done about this virus over the last five months. I’m also a bit of an optimist. Anyhow, Dr. Bassetti’s theory makes sense to me.

For one thing, many – certainly not all or even most – but many of the most vulnerable in our population have already had the virus. Some did not survive it. In the US alone, almost 2.4 million have been infected. That’s still less than one percent of the population, but it’s a big number. Those people – for whatever reason – may have been more susceptible to it than others. As a virus moves from host to host, it mutates. Often mutations make viruses stronger, but that’s not always the case. As more and more people build immunity – and studies have been all over the place about how many people may have antibodies – the number of likely victims falls. While that number is still high, it falls every day as new patients contract or recover from the virus. One hypothesis I will float is that most geographic areas will see a rise, a spike, then a reduction. But they won’t all happen at the same time. Take the early “hot spots” in the US for example.

New York State was an absolute hotbed for virus activity, registering more than 10,000 new cases per day on seven different days in April. New York has seen a stunning decline in infections over the last two months, and hasn’t registered more than 2,000 cases in a day since May 22.

New Jersey’s trend mimicked that of the Empire State, although with smaller numbers. Their downward trend has done the same. Between March 30 and April 26, New Jersey had only four days with fewer than 3,000 new cases, and had five days with over 4,000. New Jersey has not registered a day with 1,000 new cases since May 29. The death rates in each state have been consistently below 100 throughout the month of June. Illinois, another early hotspot, has followed a similar path.

Have these states’ numbers improved because of impeccable leadership and excellent public cooperation? That’s debatable, and I’m being generous. A coronavirus tidal wave swept through those states early and has now subsided. Other states got only ripples in March and April, but are now seeing waves of their own. They include Texas, Florida, Arizona, North and South Carolina and others. Worldometer doesn’t graph every state, but they do graph Texas and Florida. Those graphs are almost exact opposites of New York’s with regard to new cases. Interestingly though, deaths are not (at least not yet) following the same path. The death rates in these states have remained flat or even declined as the infection rates have increased in the last two to three weeks. Again, the math would indicate that is likely to change, but even so, any increase in death rate just doesn’t appear like it will match the increase in new cases.

California presents a very solid, but rather unique case for my regional wave theory as well as for Dr. Bassetti’s weakening severity theory. The infection rate there has been steadily increasing since the early days of the US outbreak, though at a slower pace than what New York saw. From early March right up through today, their numbers have grown, but the death rate in California has been on a gradual decline since April 22.

Similar, but less dramatic diversions of new cases versus deaths can be seen in Brazil, the country with the second most cases, behind the US.

One discouraging piece of news is that warm weather doesn’t appear to diminish the virus’s spread. That seemed evident to me early on, as equatorial nations saw outbreaks that were on a per-capita basis as serious as those seen in most of the larger nations. And that is bearing out as many of the states with increasing infections are in the South and seeing consistent temperatures in the eighties and nineties. Guam and the US Virgin Islands are among the areas seeing spikes this month.

If my theory holds, infection rates in these newly spiking states will begin to fade by mid-July. By then, we may be seeing other states spike. West Virginia, the last state in the nation to report its first case, Kentucky and Nevada, for example, may be among the states that begin to spike in the coming weeks. But with the major population centers having already peaked, or likely peaking very soon, the nation’s overall numbers should again start declining by August. Or maybe not. Like I said, I’m no scientist. Check back with me around August 1, if we’re still around.

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