It took seven days for the novel coronavirus to infect another million people in the United States, with cases growing from 10 million on Nov. 6 to 11 million on Nov. 13. At the current rate of spread – and unless state and local governments insist on social-distancing practices – the RSM model shows a million new cases being contracted every five days.
That would result in a cumulative 14 million infections by the end of November.
The intensification of the pandemic poses a downside risk on our growth forecast for gross domestic product.
This data is juxtaposed against the recent Pfizer and Moderna news on a potential vaccine. It implies that there needs to be timely coordination on a regional and national basis to mitigate the further spread of the disease and a public discussion around a plan to produce the vaccine and distribute it equitably.
While this is being worked out, it is clear that the intensification of the pandemic poses a downside risk on our growth forecast for gross domestic product of 2.75% in the fourth quarter and 2.2% in the first quarter next year. Time is of the essence, and it is in the national interest that the coordination and national conversation on vaccine production and distribution begin immediately.
Records are being broken at an alarming rate, with the number of newly reported cases averaging 152,000 per day. That’s magnitudes higher than the initial peak of 32,600 in April and twice as high as the second peak of 69,000 reached in mid-summer.
There have been a quarter million deaths in the United States attributed to COVID-19 since its outbreak in March. Deaths are now occurring at a rate of more than 1,100 per day, higher than the August peak, but significantly lower than 2,200 in the initial April peak.
The number of people who are currently infected with COVID-19 has rushed past four million. And hospitalizations have nearly doubled in recent weeks, according to the COVID Tracking Program, which notes that “health care systems are reaching capacity in many areas where cases have spiked.”
Countdown to a vaccine
Despite the growing numbers, there is light at the end of the tunnel. Two synthetic vaccines – one developed by a joint venture between Pfizer and BioNTech, and the other by a collaboration between Moderna and the National Institutes of Health – are tweaking messenger RNA to attack the coronavirus. Both have announced results of greater than 90% efficacy in late-stage trials.
But those are two of many efforts around the globe to find a vaccine. A recent article in National Geographic listed the global efforts to combat the coronavirus, a summary of which follows:
- U.S. and Germany: Pfizer and BioNTech – “The project is aiming to apply for emergency authorization from the FDA after the third week in November. Pfizer has signed a nearly $2 billion contract with the U.S. government to provide 100 million doses by December 2020—an agreement that goes into effect when and if the drug is approved and delivered—and hopes to supply 1.3 billion doses by the end of 2021.”
- Russia: Gamaleya National Center of Epidemiology and Microbiology – The center “reported that an interim analysis of its Phase 3 trial found 92% efficacy of the Sputnik vaccine,” based on 20 cases.
- India: Bharat Biotech – Preliminary results from this Indian biotech company’s vaccine have not yet been peer-reviewed, but found “more than 90% of human participants developed antibodies.”
- Maryland: Novavax – A Phase 3 trial is being conducted in the United Kingdom.
- New Jersey: Johnson & Johnson – On Oct. 23, the company announced it would resume trials.
- Massachusetts: Moderna with National Institutes of Health – In the third phase of its clinical trials, Moderna “says it remains on track to deliver at least 500 million doses per year,” but it is “unlikely the vaccine would be widely available in the first half of 2021.”
- England: University of Oxford with AstraZeneca – Now conducting Phase 3 clinical trials, “AstraZeneca and Oxford plan to produce a billion doses of vaccine that they’ve agreed to sell at cost.”
- China: Sinovac with Brazilian research center Butantan – Brazil’s regulatory agency granted this vaccine candidate approval to move ahead to Phase 3 as it continues to monitor the results of the Phase 2 clinical trials.
- China: Sinopharm – This company is using “an inactivated SARS-CoV-2 vaccine that it hopes will reach the public by the end of 2020.”
- Australia: Murdoch Children’s Research Institute with University of Melbourne – As of April 12, “the World Health Organization says there is no evidence that the (Bacillus Calmette-Guerin) vaccine protects people against infection with the coronavirus.” The BCG vaccine has long been used to prevent tuberculosis.
- China: CanSino Biologics – “Preliminary results from Phase 2 trials, published in The Lancet, have shown that the vaccine produces ‘significant immune responses in the majority of recipients after a single immunization’” and there were “no serious adverse reactions documented.” The vaccine is reported to have already been distributed.
Where things stand
Before the latest Pfizer announcement, Anna Durbin, a vaccine researcher at Johns Hopkins Bloomberg School of Public Health, was reported as saying ”that even when an [emergency use authorization] is issued, we’re not going to have enough vaccine for everybody” immediately.
So where does that leave us? Estimates of a rollout need to be tempered by the time it takes to release and review the Phase 3 test data, the manufacturing of the vaccine and equipment, the means for refrigerating and transporting the vaccine around the country, and the challenge of administering the vaccine to hundreds of millions of individuals.
Estimates of a general vaccine rollout now center on the spring of 2021, which implies at least another six months of what we are going through now. There were more than 52,000 COVID-19 deaths in the past two months. If conditions were to remain the same, that implies another 150,000 deaths before the end of May.
Finally, there are still two months before the presidential inauguration on Jan. 20, and the beginning of what appears will be a concerted federal effort. In the meantime, it will be up to state and local governments to take action, the saving grace of a federalist system.
You can click here to see what your state is doing to stop the spread. Local leaders have been grappling with a rising caseload. Mark Gordon, the Republican governor of Wyoming, expressed exasperation at a recent news conference: “It’s time that Wyoming woke up and got serious about what it’s doing,” he said. “We’ve relied on people to be responsible, and they’re being irresponsible. They think somehow this is all nonsense.”
State-by-state analysis
The first figure below shows the spread of the infections among the six states with major metropolitan areas (Massachusetts, New York, New Jersey, Pennsylvania, Illinois and California) where the initial outbreak peaked in April. The recent increase in cases in those states is attributed to increased social interaction, as people let down their guard while enjoying family gatherings and attending colleges, schools and other institutions.
The second chart shows the spread of the virus across all the other states, where infections peaked across the South and Southwest in the weeks after the July 4 weekend. That spread has since moved into the Midwest and across the Northern tier, with new cases in those states surpassing their summer peak.
Infections in the six states with major metropolitan centers are rising at an alarming rate of more than 35,900 new cases per day as of Nov. 15, which far exceeds the 20,000 per day in the initial outbreak. Infections in all other states are rising at a rate of 114,000 per day.
Deaths attributed to the coronavirus are averaging 235 per day in the six major metropolitan states as of Nov. 15, and 960 deaths per day in all other states.
Average weekly growth rate
In the following table, we show the state-by-state weekly growth rate of infections since Sept. 12, which was the low point for infections in the days after the Labor Day weekend and which signaled the unofficial start of indoor activity and social interaction.
Note that because of the inconsistency of reporting by states and the haphazard spread of the virus, we are looking at the average rate of infection in the several weeks since the onset of cooler weather.
The blue highlights indicate the six states with major metropolitan areas that were initially affected by the virus. After much progress over the summer, each of those states is reporting increasing numbers of cases since Labor Day.
Hawaii is the only state reporting lower levels of the infection since Labor Day. Wyoming was averaging 44 cases per day in the week after Labor Day and is now averaging 755 per day, an average weekly increase of 36.5% over the past nine weeks.
For more information on how the coronavirus is affecting midsize businesses, please visit the RSM Coronavirus Resource Center.
