By Nikhila Natarajan
Two renowned doctors on the White House coronavirus task force are headlining their guidance for Americans, based primarily on three data sets: mortality data from Europe and data from the 8-10 weeks curves of China and South Korea which have moved off their infection peaks.
When Dr. Deborah Birx and Dr. Anthony Fauci step up to the podium in the James Brady press briefing room nearly every evening at around 6 pm, the US tunes into what has now become must-see television. Fueled by an endless supply of caffeine, data, pizza and donuts over long working hours in the windowless Situation Room, Dr. Fauci and Dr. Birx deliver gut punches and insights on the COVID-19 pandemic straight to the American public, often in sharp contrast to the US president’s rosy outlook.
As the US caseload passes the 69,000 mark, death toll tops 1,000 and New York becomes the epicenter of the outbreak, here are 12 takeaways from the “data-led” Birx-Fauci powerhouse.
Less severity amongst children
Mortality data from Europe suggest that no child under 15 has succumbed to the virus in that geography. In China, there is a single case of a 14 year old dying of this deadly disease. Severity in children is less and this, Birx says, “should be reassuring to the moms and dads out there.”
Less than one percent mortality under-15 age group
Less than one percent of all the mortality is less than 50. So, 99 percent of all the mortality coming out of Europe, in general, is over 50, along with pre-existing conditions. Yet, nobody is immune, Birx has warned repeatedly and stressed the difference between physical and physiological age as a tipping point.
Maximum mortality in people having three pre-existing conditions
The pre-existing condition still holds in Italy, with the majority of the mortality having “three or more” pre-existing conditions.
New York attack rate is 1 in 1000
The New York metro area of New Jersey, New York City, and parts of Long Island have an attack rate close to 1 in 1000. This is 8-10 times more then what the other areas are seeing.
28 percent of submitted specimens positive in New York
In the New York area, 28 percent of submitted specimens are positive from that area, where as it’s less than 8 percent in the rest of the country. Clearly the virus had been circulating there for a number of weeks to have this level of penetrance into the general community.
Why is the New York rate so high?
Birx and Fauci say part of it is the density of population in New York and part of the reason is surface transmission from a robust and packed public transport system. It could also be because of people who came back after Christmas, from Asia, that didn’t get caught up in border closures on either side.
How many tests have been done?
By 24 March, the US had done 3,70,000 tests and the lion’s share of those — over 2,20,000 — in just eight days, which is what South Korea was able to do in eight weeks.
New York: More than 5 in 10 US cases, more than 3 in 10 US deaths
About 56 percent of all cases in the United States are coming out of New York metro area. Nearly 60 percent of all the new cases are coming out of the metro New York area. New York accounts for 31 percent of people in the US succumbing to COVID19.
Early signs signifying the success of mitigation strategies in New York
Early signs emerged on 25 March that social distancing norms implemented at big scale are beginning to slow the hospitalisation rate in the highest cluster area in the US. Last Sunday, New York hospitalisations were doubling every two days, by Monday that rate slowed to every 3.4 days and by Wednesday, it came down to every 4.7 days.
Don’t declare victory too soon
It is not the right time to declare victory against this deadly disease, when the number of new cases begins to flatten out, cautions Fauci. It’s just a sign that you are headed where you want to go. Mitigation strategies will flatten the spread, Fauci says with confidence. “The curve will flatten, and we will know when that happens.”
“Imported” cases when rules are relaxed
Citing new information coming in from Chinese counterparts, Fauci said that as China begins to relax restrictions, they have begun to report “imported” cases. “They wanted to warn us that when we get successful, make sure you very carefully examine how you’re going to release the constraints on input”, Fauci said, speaking to rising public concerns over recent comments by US president Trump that he would like to open up the economy as soon as possible.
Coronavirus could become seasonal
Fauci cautions that coronavirus could very well become a “seasonal, cyclical” infection, based on the patterns it is exhibiting through its spread in the southern hemisphere. There, cases are appearing as winter sets in. If there is a “substantial” outbreak, then the world absolutely needs the vaccine by the time the cycle comes around the second time. Fauci has pegged a 12–18month timeline for vaccine development.