COVID-19 "Second Wave" Forecast - Monthly Think Tank - Wednesday, July 15, 2020 - Home Care 100

Monthly Think Tank

COVID-19
"Second Wave“
Forecast
Wednesday, July 15, 2020

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JULY 15, 2020

COVID-19 “Second Wave” Forecast

                David Ellis (Moderator)
                President & Founder
                Lincoln Healthcare Leadership

Vin Gupta, MD          James Lawler, MD           Jeff Schlegelmilch            Eric Toner, MD
 Affiliate Assistant   Director, International   Director, National Center        Senior Scholar,
      Professor        Programs & Innovation,          for Disaster               Senior Scientist,
 of Health Metrics        Global Center for           Preparedness,          Johns Hopkins Bloomberg
      Sciences,           Health Security,            Earth Institute,         School of Public Health
Institute for Health   University of Nebraska      Columbia University
       Metrics             Medical Center
& Evaluation (IHME)

Where We Are (as of July 15, 2020)

Second Wave Is Upon Us
• 60K new daily cases (double first wave peak)

• 39 states growing cases

• Average age is much younger

• ICU beds near capacity in Phoenix, Houston, Miami

• Deaths just starting to rise

Public Policy: Decentralized,
Inconsistent, Politicized, Misguided
• Europe – suppression (flattened the curve). US – mitigation
  (by default, not design)

• Weak federal leadership – up to the states

• False choice: economy or safety – should be economy and safety

• Some states opened too fast, now retreating

• Does each state actually need to learn on their own?

Public Policy: Decentralized,
Inconsistent, Politicized, Misguided
• Masking – needs full (and apolitical) endorsement

• Testing – 39/50 states still not at recommended minimum #,
  Delays.

• Contact tracing – ?

• PPE – ?

• Scapegoats: China, WHO, prior Administration, CDC, Dr. Fauci

Science and Healthcare: Promising
• Treatments
    • Convalescent plasma
    • Remdesivir
    • Dexamethasone (steroid)
    • Monoclonal antibody therapy
    • Blood thinners
    • Proning

• Vaccines
   • 140 candidate vaccines now tracked by WHO
      • 17 in phase one
      • 9 in phase two
      • 3 in phase three

Going Forward
• We are stumbling towards Sweden

• Is this bad, or, possibly, okay?

• Case counts high, hospitalizations medium, deaths low (?)

• Decoupling of cases and deaths: testing, youth, treatment,
  sequestering of elderly (?)

• Is herd immunity achieved at 20%, not 60%?

The Proportion of New Cases is Shifting from Countries in
Europe, to North America, Latin America, and Asian Countries

Hot Spots in U.S.

                    SOURCES: State and local
                    health agencies and hospitals.

Daily New Cases and Deaths in the U.S.
            (Cases Delayed One Week)

Patients Currently Hospitalized with CV-19 in U.S.

Daily New Coronavirus Deaths in the U.S.

Case Fatality Rate in the U.S.
        (Cases Delayed One Week)

Weekly Median Age of People Who Tested
        Positive for Coronavirus in Florida

SOURCE: Twitter: @ScottGottliebMD https://twitter.com/scottgottliebmd/status/1275074495464607751.

Daily New Cases in Sweden

SOURCE: Worldometer https://www.worldometers.info/coronavirus/country/sweden/.

Daily Deaths in Sweden

SOURCE: Worldometer https://www.worldometers.info/coronavirus/country/sweden/.

U.S. COVID-19 Forecast – 4 Options

                          4,000
U.S. # COVID Deaths/Day

                          3,000
                                                                             D

                          2,000                                              C

                                                                                 B
                          1,000

                                                                                 A

                                    May    August   December   June   December
                                    2020    2020      2020     2021     2021

U.S. Forecast: Infections and Deaths
                                (April 2020 – July 2021)

        Real Daily          # Days                            Lethality
                                            # Infected                          # Deaths
       Infections*       (16 Months)                            Rate

 A          50K               480           24 Million           0.6%              144K

 B         125K               480           60 Million           0.6%              360K

 C         280K               480           120 Million          0.6%              720K

 D         370K               480           180 Million          0.6%             1,080K

*Real daily infections on 7/15/20: 60K infections reported* 5x (including unreported) = 300K

U.S. State COVID-19 Risk (Aug. 2020 – Dec. 2021)

  What are the chances your state
  develops severe* community spread?
   *Hospitals reach near to full ICU capacity

                                  A   < 30%

                                  B   30-50%

                                  C   50-70%

                                  D   > 70%