The human toll of the novel coronavirus continued to mount in the week after Thanksgiving, with no signs of slowing down. A record 237,000 new U.S. cases were reported on Dec. 4 and a record 2,921 people died from the COVID-19 disease on Dec. 3, according to the Worldometers database.
New infections are now averaging approximately 200,000 per day.
New infections in the United States are now averaging approximately 200,000 per day. Through the first five days of December, there were more than a million new infections reported throughout the United States as its people and economy prepared to absorb a shock unlike any other in modern history.
As of Dec. 6, there have already been 15.2 million cases of COVID-19 in the U.S. At the current rate of spread and unless the public quickly adopts social-distancing practices, our model indicates that the cumulative number of newly reported cases could reach 16 million in just four days and then 17 million four days after that. This is unprecedented and has created conditions in which the economy will certainly slow into the first quarter of 2021, with the risk of a double-dip recession rising.
There have been more than 288,900 U.S. COVID-19 deaths in total, now averaging about 2,300 a day. The spike in cases has left 6 million people currently infected, which implies that 1.8% of the population is likely to be fighting the myriad respiratory, liver, heart and cognitive effects of the disease.
According to the COVID Tracking Program, current COVID-19 hospitalizations have pushed past 101,000. That leaves scant capacity for treating patients who do not have the virus.
Allocation of scarce resources
The prospect of more hospitalizations raises the issue of the rationing of scarce resources during a public health crisis. An editorial posted in the Journal of the American Medical Association Network asks, “How Will Patients With Cancer Fare During COVID-19?” The authors report “declines in mammography of up to 90% and delays in elective (i.e., scheduled) surgeries.” The authors surmise that it “will likely be years before credible estimates are available about whether COVID-19-related cancer treatment delays led to increased mortality.”
The authors also report that “states with National Cancer Institute-designated Comprehensive Cancer Centers are less likely to exclude patients with cancer.”
So perhaps one obvious solution to the scarcity issue is for each state to have sufficient health care systems in place. Yet even the sprawling New York City hospital systems were overwhelmed by COVID-19 patients during the initial outbreak, and there is no shortage of empathy for the more rural states now attempting to treat their overflow of infected people.
There are too many ethical issues attached to deciding who receives treatment, or who does not, in a triage situation. During the pandemic, should treatment of patients with limited life expectancy be pushed to the end of the line? These are the difficult questions that health care professionals are having to address.
In terms of public policy, would building hospital systems capable of handling a once-in-a-century pandemic be an efficient use of public funds? That probably depends on whether you think COVID-19 is the last epidemic coming our way, or if you can put a value on someone’s life and compare that to the price of providing adequate health care to all parts of the country. One would suspect that this will be part of the post-pandemic policy narrative around national health care policy.
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 rise in cases in those states more than doubles the initial outbreak and is attributed to increased social interaction as people let down their guard.
The recent rise in cases in states with major population centers more than doubles the initial outbreak.
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 far exceeding their summer peak.
Using state-by-state data from the Johns Hopkins/Bloomberg database, infections in the six states with major metropolitan centers are rising at a rate of more than 58,800 per day as of Dec. 6. Infections in all other states are rising at a rate of more than 136,800 per day.
Deaths attributed to the coronavirus have increased to 570 per day in the six states with major metropolitan areas, and nearly 1,620 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 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.
Cases in Vermont have increased by an average of 32% in each of the 12 weeks since Sept. 12. Hawaii is the only state reporting fewer cases now than in the first weeks of September.
For more information on how the coronavirus is affecting midsize businesses, please visit the RSM Coronavirus Resource Center.
