By now we know that to get the best view of the COVID data we have to identify the specific locations that are creating the excess number of cases that together are keeping the overall US case count too high.
This post focuses on the 35 worst counties in America – those with populations of over 100,000 – and with a current new case daily average in excess of 100 cases per million of population. The reason for only looking at counties greater than 100,000 population is that anything smaller can be skewed very easily. Data as of June 18th.
With those criteria in mind, here are the worst counties for current levels of fatalities and current rate of case creation.
Lets go through some of the numbers. First daily new cases. The US average case to fatality rate is about 3.5% – so any county today experiencing 100 new cases per day – could likely experience about 3.5 deaths in a few weeks. See my earlier post for the case to fatality rate in the US. That seems far too high to be acceptable (and is higher than the US average today of 2 fatalities per million per day.
I’ve taken the view that the only long term acceptable fatality rate is about 1 person per million per day (that’s broadly equivalent to seasonal flu over a 6 month period) – so if COVID stays at these levels for a whole year – that’s about double the seasonal flu level.
Secondly, daily fatalies. I’ve filtered this data set on those counties currently exceeding 3 fatalities per million per day. So that’s 3x what I would expect to be acceptable in the long term.
The combination of some of these stats gives some very dire projections. Take Yuma Arizona, currently 18 fatalities per million per day – and daily new cases of 861 per million per day. That means future fatalities (taking the 3.5% trend above) in this county could be closer to 30 fatalities per million per day. See my earlier post on Arizona – and the potential link between poverty and those counties with high caseloads.
Now – I’ll be the first to admit that Yuma only has a population of about 214,000 so – in real numbers (not per million) – the results will appear smaller. But expressing data per million of population is the only fair way of comparing very uneven data sets.
Many of these counties tend to have a picture like the one below. Basically at no point was COVID successfully brought under control. Now with the ending of restrictions in many states – we see an upsurge in cases and fatalities.
I welcome thoughts, comments on this article as well as suggestions for future analysis.