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 week 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, an anxious nation 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 surges to the top of the global infection chart with more than 85,000 confirmed cases, more than 1,200 deaths and New York becomes the epicenter of the domestic outbreak, here are 15 highlights from the "data-led" Birx-Fauci powerhouse.
Severity in children is "less": Mortality data from Europe suggest that no child under 15 has succumbed to the virus in that geography. In China, there is the case of a lone 14 year old who died. Severity in children is less and this, Birx says, "should be reassuring to the moms and dads out there."
Less than 1 per cent mortality in under-15 age group Less than 1 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 those with 3 pre-existing conditions: The pre-existing condition still holds in Italy, with the majority of the mortality having "three or more" pre-existing conditions. Much of the learning for the White House task force is coming from South Korea, Italy and Spain data.
New York attack rate 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 a 1,000. This is 8-10 times what the other areas are seeing. Birx said that no country till date has shown an attack rate of more than one in 1000. "The only people who are over really one in 1000 cases are those that have very small populations, like Monaco. When your population is really tiny, one case can put you over one to 1000 or 2 to a 1000."
19 out of 50 states have only 200 cases: Nineteen out of 50 states which means nearly 40 percent of America is reporting "extraordinarily" low numbers of coronavirus infections and the New York area alone is turning up 55 per cent of all new cases. Also, 86 per cent of the tests done on people who present with fever and symptoms are coming back negative.
28 per cent of submitted specimens positive in New York: In the New York area, 28 per cent of submitted specimens are positive from that area, where 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 March 26, 552000 tests have been completed across the United States. By March 24, the US had done 370,000 tests and the lion''s share of those are over 220,000 - in just eight days, which is what South Korea was reportedly able to do in eight weeks.
New York: More than 5 in 10 US cases, more than 3 in 10 US deaths About 55 percent of all cases and all new cases in the United States are coming out of New York metro area. This number has been dropping from the 60 per cent mark in this week itself. New York accounts for 31 percent of people in the US succumbing to COVID19.
Early signs that mitigation strategies working in New York: Early signs emerged March 25 that social distancing norms implemented at 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 time to declare victory 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 12-18 month timeline for vaccine development.
No model that predicts large scale attack rate in US: "There''s no model right now and no ground reality where we can see that 60 to 70 percent of Americans are going to get infected in the next eight to 12 weeks. I just want to be clear about that", Birx said. "So when people start talking about 20 per cent of a population getting infected, it''s very scary, but we don''t have data that matches that based on the experience."
Fauci confident about vaccine development: Fauci struck a cautiously upbeat tone saying he feels "confident" with all the knowledge now available on the virus."We will have some sort of therapy, that gives at least a partial if not a very good protection in preventing progression of disease", he said. Randomized control trials are how the US is planning to get the best drug as quickly and safely as possible to the people.
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