Summary:
- 9 states see COVID hospitalizations hit record highs
- National guardsmen deployed in Washington DC test positive
- AP weighs in on WHO’s latest flip-flop
- Gottlieb warns Texas on the brink of losing control of the outbreak
- Greater New York area continues to bend the curve
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Update (0750ET): In this morning’s “AP Morning Wire” letter, the wire service shared a piece addressing the WHO’s latest flip flop, which cast doubt on its previous guidance on mask wearing (also the product of a flip-flop on Friday that came long after most countries had already made masks mandatory), when a top researcher claimed that examples of asymptomatic spread are much less common than researchers had initially expected.
For those who are just learning about this now, the WHO’s technical lead on COVID-19 was asked about transmission rates during a press conference earlier this week when she claimed that “it appears to be rare that asymptomatic individuals can actually transmit onward.” Following an international uproar over the claim, which, if true, would seemingly have major repercussions for coronavirus-related policy.
On Tuesday, Dr. Van Kerkhove said she was referring to a few studies, not the complete picture, while other scientists vehemently disagreed with Dr. Van Kerkhove’s characterization.
“I was surprised by the conviction of that statement because there have clearly been people who have transmitted the infection before they go on to develop symptoms,” said Keith Neal, an infectious diseases expert at the University of Nottingham who has advised the British government.
As the AP notes, exactly how the virus is transmitted from person to person is still not well understood, and the WHO has claimed for months that the vast majority of infections are from people with symptoms like a fever or cough. Coughing and sneezing aerosolizes the virus, helping it spread.
At a hastily arranged pres briefing on Tuesday to try to clear up confusion,the WHO’s Dr. Michael Ryan claimed that “both symptomatic and asymptomatic individuals are part of the transmission cycle”. In a section of its report subtitled “Why Can’t The Scientists Agree?”, the AP explained that there’s a genuine debate in the scientific community.
Although numerous studies have suggested people can spread the virus before they show symptoms, WHO has largely dismissed those as anecdotal or pointed out that they were based on modelling.
Babak Javid, an infectious diseases doctor at Cambridge University Hospital, says many scientists are persuaded by the studies published so far and think WHO should publish the data it is citing to explain why it believes transmission of the disease in people without symptoms is “rare.”
“If you’re going to make a really important statement like that, it would be good to back it up,” Javid said. “I think WHO is an important organization, but they’ve made a lot of statements that have been misleading.”
WHO’s Ryan said the agency was committed to being honest and transparent and welcomed the scientific debate it has prompted.
Which scientist do you believe?
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Even as US stocks tumbled on Tuesday for the first time in a week following reports that a dozen states, including Puerto Rico, had reported record numbers of new COVID-19 infections (nearly half of US states have reported a troubling resurgence in the weeks since MDW), most market analysts attributed the move to a healthy “pause” in the blistering 10-week rally that returned the Nasdaq to its ATH. But that still-sunny outlook has apparently changed overnight, following reports, which we noted last night, that Texas has seen COVID-19-related hospitalizations bounce back to their highest levels since the outbreak began.
While the Greater New York area has seen cases, deaths and hospitalizations continue to fall, the rebound in other parts of the US has kept the number of new cases reported each day from falling more sharply.
On Wednesday morning, the Washington Post reported that hospitalizations in at least nine states are on the rise. Some readers might remember that at the outset of the lockdowns back in March, Dr. Fauci and others insisted that the goal of the American response to the outbreak was to “flatten” the curve enough to prevent hospitals from being totally overwhelmed. Here’s more from WaPo:
In Texas, North and South Carolina, California, Oregon, Arkansas, Mississippi, Utah and Arizona, there are an increasing number of patients under supervised care since the holiday weekend because of coronavirus infections. The spikes generally began in the past couple weeks and in most states are trending higher.
Data from states that are now reporting some of their highest seven-day averages of new cases is disproving the notion that the country is seeing such a spike in cases solely because of the continued increase in testing, according to data tracked by The Washington Post.
The sheer number of states that have reported rebounds suggests that the increase in new cases can’t be attributed (at least, not entirely) to an expansion of testing. Anybody who has been paying attention to the numbers out of Texas probably notice that the state has reported several record daily totals of new cases. Texas has reported 75,616 cases since the pandemic began, but during 10 of the past 15 days, the state’s 7-day average (a metric that’s preferred to the un-smoothed daily data) reached new highs.
One reason that the jump in hospitalizations may have been overlooked by the market up until now is because those numbers are difficult to track, since not all states release the numbers, and reporting criteria vary from state to state.
That this is happening in Texas is important, since the state embraced an aggressive reopening timeline, just like Georgia did, and for a time, it looked like these decisions might pan out. Now, journalists and ‘experts’ are apparently revisiting that view.
North Carolina has reported the second-largest spike in hospitalizations (behind Texas) since Memorial Day, though NC’s trend began before the holiday weekend. On May 26, the state reported 621 hospitalizations, but two weeks later, that number had climbed to 774.
In South Carolina, hospitalizations have increased sharply since the start of the week. In the span of just a day, there have been 30 new hospitalizations, a 6% jump in total capacity, according to the state’s health department. In Utah, new cases are on the rise, and so are hospitalizations. Like other states, Utah has seen newly reported cases climb since MDW, with the average number of new cases increasing in 12 of the past 15 days. Over that two-week span, Utah has reported a 42% jump in hospitalizations, with 230 patients hospitalized with the condition as of Tuesday afternoon.
During an interview on CNBC’s “Squawk Box”, former FDA Commissioner Scott Gottlieb, who has been warning about the uptick in new cases and hospitalizations for at least the past week, warned that Texas is going to need to devise a new intervention plan if it wants to avoid another round of lockdowns.
“Texas is going to have to figure out how to target interventions…remember they’re in phase 3 of reopening and they’re reopening everything…but the state has already been open a while…they’re going to have to figure out where the spread is occurring and take more mitigation steps,” Dr. Gottlieb said.
Whatever it decides, Texas – particularly the area around Houston where the outbreak is most severe – needs to get its arms around this thing soon, or it could lose control.
“When you look at hotspot regions like Arizona and Texas, they have to be concerned, particularly areas around Houston right now. they could lose control of this very quickly,” says @ScottGottliebMD on balancing re-opening with public health. pic.twitter.com/XcfoGbsjMp
— Squawk Box (@SquawkCNBC) June 10, 2020
Gottlieb also warned that the “seasonal effect” which may have helped lower the number of new cases in some areas has likely already run its course.
“Certainly in the tri-state area we’re in much better shape than the rest of the country…but in more rural areas they need to be concerned,” he added, citing Arizona as another example.
“We might not get more seasonal effect as we get into July and August so this might be it.”
Dr. Fauci meanwhile sat for another interview with CNN Wednesday morning where he largely repeated comments from his interview with the NYT published last night, including his colorful comment about COVID-19 being “my nightmare” and his belief that a vaccine could be secured by the beginning of next year.
Before we go, readers would be well-served to remember one more thing: although some national guard members – first in Minnesota, and then in Washington DC – have tested positive for the virus, most experts say that any spike in new cases associated with the protests likely won’t manifest until later this week.
