Watching New Cases Fall – the US and NY

I pay too much attention to numbers. That’s me. I did it when I was a little boy. The sports section!  What six year old runs to the box scores? At ten I was scouring the almanac for old election results and weather history. That was me.

I limit myself, somewhat, today. But in this pandemic I am at times drawn to look at the numbers. To understand what is happening I have settled on three categories: current case rates, new cases, and deaths.

Deaths, while up substantially during this (fading) third wave, are down substantially as a proportion of people who get sick, and as a proportion of people who get hospitalized. That is, if you got sick a year ago, you had a decent chance of dying. If you get sick today, that chance is much, much lower. Also, if you got sent to the hospital a year ago, you had a substantial risk of not coming out. If you get hospitalized today that risk is much lower. The number of daily new cases at the peak of this wave was 8 times greater than in the spring – but the number of daily deaths at the peak of the third wave was 1.5 times greater than in the spring.

Current Case Rates I have been plotting every day or every few days since November. Here is a 3 month overview. Here is the most recent trend.

New Cases in the US

New Cases. That’s what I want to look at today. Let’s start with the chart for the US as a whole:

This is the number of new cases per day (averaged over the course of a week to smooth things out – better for looking at the big picture) for the entire United States, starting last February.

There are three waves – but that may not be obvious.

The first wave was nightmarish scary – where it hit. But it was largely limited to the west Coast, and the NYC metropolitan area, with some additional pockets. Also, many fewer people were being tested; there were likely many more undiagnosed cases. But that little rise to a little plateau in April? Felt like Armageddon to New Yorkers. We were the global epicenter of the global pandemic. The sirens. The news. The wondering who would die next. Were there enough hospital beds? Enough ventilators?

The second wave is there – see that lump that rises through July with its hump at the end of the month? – New Yorkers might be scratching their heads. The second wave was not felt much or at all in the places that experienced the first wave. But for those places whose first encounter with large numbers of COVID cases was the summer, that second wave was very real.

The third wave is interesting

• Start – look not where the rise begins modestly (late September), but where it zooms – which part looks most, if you let it rotate, like the bottom of the bowl? (second derivative). That’s the last week in October.
• First hump – there was a huge spike in the northern plains and upper midwest before the third wave engulfed the entire country. Because it was only one region, it appears like a hump, not a spike. Peak November 24. It is absent from the graphs in states outside of that region, including New York.
• Middle hump – Thanksgiving surge. December 6 – December 24, with a flatter top, but peaks at December 18.
• Dip between the holidays – December 27 – December 31
• Christmas/New Years peak – January 9 – January 13
  • Detail: The Christmas/New Years peak was 14% higher than the Thanksgiving Peak.
• The wave recedes – January 13 – today
  • Detail 1: The numbers today are near the numbers from October 31
  • Detail 2: The numbers today are 32% as high as the top of the Christmas/New Years peak

New York

In New York the first wave looks very large (it was hard to see on the US graph), though not as high as the US as a whole. The second wave, expectedly, is absent.

New York’s 3rd Wave Looks Different

• Start – New York did not participate in the October surge (that was Iowa and Wyoming) so the start is a bit later. I mark November 7, approximately.
• Thanksgiving surge – this is different from the national graph. December 1 – December 7 there is a very sharp increase.
• Middle rise – This is also different from the nation as a whole. Where the number of cases in the US was plateauing, in NY the number of cases continued to go up. From December 9 to December 24 there is not as much of an increase as right afterThanksgiving, but there is still increase.
• Dip between the holidays – Not in New York! This appears to be the only place in the country where new cases rose from Thanksgiving through Christmas and New Years without a break.
• Christmas/New Years peak – January 9 – January 13
  • Detail: The Christmas/New Years peak was 57% than the Thanksgiving Peak.
• The wave recedes – January 13 – today
  • Detail 1: The numbers today are near the numbers from December 2
  • Detail 2: The numbers today are 45% as high as the top of the Christmas/New Years peak

The 3rd wave was tougher in New York than the rest of the country. It started a month later than in some other states, but cases rose more steeply, and cases continued to rise between the holidays – which was not the case anywhere else, including New York’s immediate neighbors.

As the wave recedes, it recedes more slowly in New York than in any other state (with some recent indication that the numbers are not falling).

What is Going On?

Clearly something is wrong, but it is beyond me to do more than offer some ideas.

New variants? Yes, the British variant is here. And yes, it may in the very near future cause us much suffering. But for today the numbers are too low for it to be driving New York’s numbers.

Bad leadership? Yes, we have a serious problem here, but no, Cuomo did not take measures that were appreciably worse than what other governors did. He earned a positive reputation in the spring for holding sane press conferences. But holding a sane press conference is a very low bar, set and not met by former president Donald Trump. He told people to wear masks, and some listened. But there are plenty of governors who did the same. His color zones were arbitrary and inconsistent. So I don’t give him credit for much, but I don’t blame him for the 3rd wave or New York’s delayed recovery.

Different travel patterns? Do more out of towners, both domestic and foreign, find their way to New York than to any other large city? Do more New Yorkers travel to more places around the country and around the world, then people from other cities? Do more New Yorkers travel to more corners of our own state…?

Unique urban concentrations of poverty, overcrowded housing, maskless Trump voters, and Hasidim? Der ferter ferd? Nah. Each one of these is a problem, but something unique is happening in New York, and having things in NY that are the same as elsewhere, but a little bit more, that wouldn’t do it.

This is becoming urgent. This is a city of 8 1/2 million. A state of almost 20 million. This is not an orange microcluster. We need real epidemiologists looking, trying to find out what is going wrong in New York.