Fasten your seat belt – Very high case counts in Europe may set the precendence for the US.

Take a look at the charts below – which highlight since inception the top 3 months for absolute number of covid cases in each of the countries shown. Notably an off the charts rise in cases in some countries – due to Omicron. Likely also due to a much better testing regime. But the data clearly show that we are in an unprecedented surge – and also note – we are not yet at the end of the month (so December data is incomplete).

Here we go:

Where Omicron was first detected – South Africa

Current data in the US isn’t hitting one of the top 3 months of all time yet.

But the European data shows what the US can expect. The number of cases identified in France in December to date is 3x that of November – and higher than any other month in its history!

For Germany the last 2 months have been the highest – by a long margin. Also note the substantially increasing fatalities curve. Fatalities in December are 17 times higher than the low point post vaccination (August 2021).

Let’s take a quick look at the league tables. 6 European countries all have new cases per million per day over 1000

Spain shows a very high month in December – over 5x that of November

Denmark has the same pattern – along with a significant spike in fatalities

Ireland has the huge spike in cases, and a gradually and persistent rise in fatalities

UK appears to have a huge spike in cases but fatalities are relatively the same for the past 4 months. Notice how the UK fatality rate came down very quickly in early 2021 – following a very rapid vaccine rollout (opting to defer issuing the 2nd shot until many people had received the first shot).

But now the importance of getting boosted is getting reflected in the UK data. November fatalities in the UK are 15 times higher than the lowest level of fatalities post vaccination rollout.

While it may be too early to conclude – fatalities in this wave are a lot lower than the previous peaks in Dec 2020 / Jan 2021 – mostly resulting from the availability of vaccinations. But having said that a number of countries are experiencing fatality rates more than 10x the post vaccination lows. That’s going to put stress on the hospital systems of those countries.

How do we model this data for the US?

If the fatality curve of the European countries like Germany and the UK predicts the future for the US – then 10x the post vaccination low in deaths (July 2021) would be about 90,000 deaths per month. That is clearly going to be a stressful level for the hospital system.

Is that too unrealistic to contemplate? Well – lets look at NY.

December cases are already a record high – and almost 3x higher than in November. And current monthly fatalities are rising – and are 9x higher than the post vaccination low of 171.

While NY has a jump start on many states re Omicron – the wave is clearly spreading – from Maine to Colorado and Washington:

Buckle up – this is going to be challenging couple of months ahead.

Over 50 million covid cases in the US

Startling fact: the US has recorded over 50 million cases of COVID since inception. Our total (as of Dec 24th) is around 51 million – and with an average of just over 150,000 new cases per day. Without a doubt, Omicron is now fueling a fresh set of growth – as we can see from the hotspots in the chart below.

An in aggregate the impact on the US is significant:

So far this month, over 3 million new covid cases, and 29,000 deaths have been recorded. Expect close to 40,000 deaths by the end of the month. At this point I can’t help reflect how we were at ‘only’ 9000 deaths in the month of July. The world has moved on; Delta took hold; and now Omicron is spreading rapidly.

Here are the current fatality hot spots – all expressed in per capita numbers:

Note: Tennessee is likely due to a data anomaly – or a catch up recording of deaths that were previously not reported. The New York Times data shows a large spike in deaths on Dec 23rd.

NY cases have risen sharply. Fatalities appear to be stable – but we do not have a full month of data for December yet. Expect fatalities in Dec to be at least 50% higher than the prior 3 month average:

Michigan looks precarious:

Seems to have gotten the Delta wave under control – reflected in the lower case levels recently.

But zoom out to the monthly trend – and this looks like a health care system under pressure. This could well be one of the deadliest months for Michigan.

Global view:

Globally the story is somewhat similar. While the UK, France and Italy have a much higher rate of COVID spread; fatalities are far below the US levels. Likely due to a higher levels of vaccinations.

Here’s a quick look at the league tables for current cases and fatalities before we explore some charts

Germany did have a significant ramp up in cases and fatalities, but enacted restrictions on those who were unvaccinated and fatalities now seem to be levelling off.

South Africa; the country that detected Omicron has relatively few deaths from COVID

Eastern Europe is still suffering heavily from Delta – and likely Omicron as well

There are very high current fatality rates in these countries:

Russia has high fatalities but low case numbers; likely reflecting insufficient testing

The sun contibues to shine in South America:

The Southern hemisphere (excluding South Africa) is doing very well. Maybe we should have taken that trip to Costa Rica after all!

There’s no doubt about Brazil’s progress month over month:

Or that of Peru:

Oh well Costa Rica – maybe we’ll visit next year:

Europe tops the league tables for COVID cases

Europe is having a major upswing in COVID cases and deaths. As you can see from the tables above. Here’s how some of the top country charts are looking:

Only Germany, Netherlands and Belgium seem to have bent the curve – but, as we head into holiday season, its too early to tell. Poland has an extremely high level of average daily fatalities per capita. Germany is #15 in highest levels of average daily fatalities

US Cases Sharply Rising Again Dec 12 2021

US cases are undeniably on the rise again – no doubt due to the colder weather and holiday driven socializing.

The US is currently recording approximately 120,000 new cases and 1,255 fatalities per day – and I don’t see that coming down significantly over this holiday period.

It basically the same story in the UK (albeit with lower levels of fatalities)

Germany is also on a major upswing – driven by its closer proximity to the Eastern Europe spread we noted in earlier blogs

By contrast Southern Hemisphere countries are mostly doing well

What’s driving the US?

Its likely mainly Delta – and not Omicron yet. Here’s the highest areas of new cases per capita. Florida – I’ll be there for Xmas! Notice both Maine and NY have very high levels of cases.

Fatalities are mostly in line with this trend. Oregon has likely peaked (on Delta) given the rate of new cases.

Lets deep dive into Michigan – which shows a very high case rate and double digit fatality rate. Basically gradual and persistent rises since August.

New York is having a faster increase in cases and fatalities – rightly prompting the governor to take action.

Florida is doing the reverse. Their most recent peak was in mid-September – which we’d assume would be a wake up call for many to get vaccinated.

Kentucky unfortunately had record setting tornados to contend with on top of a troubling set of COVID results. Currently about the same level of per capital fatalities as Michigan.

COVID Global Outlook: Germany puts the brakes on – and for good reason. Eastern Europe still dealing with Delta.

See the following news headline from this week:

Germany announced severe restrictions on unvaccinated people, banning them from nonessential stores, recreational venues, and more.

Merkel announced the measures after a meeting with federal and state leaders, as the nation again topped 70,000 newly confirmed cases in a 24-hour period. She said the steps were necessary to address concerns that hospitals could become overloaded with patients suffering from COVID-19 infections, which are much more likely to be serious in people who have not been vaccinated.

Note that throught this crisis, managing to hospital capacity has always been a challenge. With the new variant potentially having greater transmissibility this puts any population of people who are unvaccinated at greater risk. That in turn has a potential impact on hospital capacity.

Here’s the German COVID curve (per capita) over the past 4 months. No doubt about it – this looks closely like an exponential curve to me.

Fatalities in November were higher than any month since May 2021. Basically the highest in 6 months and more than double the prior month

South Africa:

So far at least South Africa results are relatively low per capita … but hard to say whether there is complete and accurate data here:

However – looking at the World Health Organization data – the largest growth in cases week over week is mainly in African countries or those with strong affiliations. Clearly there are some small populations in many of these countries – so small changes in data can have a big percentage impact – but it pays to keep an eye on the longer term trends.

In the case of French Polynesia (population 280,000) the WHO database recorded 683 new cases on Nov 30th – wherease typically 1 or 2. Looks like they are catching up on a backlog of testing or administration.

Current global fatality rates

Delta is still driving the majority of cases and fatalities with Eastern Europe most affected. Hungary continues in #1 spot recording its 4th highest monthly total of deaths in November since COVID began.

Monthly totals for COVID (December 2021 is thru Dec 3rd). November 2021 is the 4th highest on record.

Bulgaria appears to be coming out of the current crisis albeit with currently very high fatality rates

Outlook:

Global cases are again on an upswing. Notice the rising number of cases in the chart below. At about 4m new cases per week – that’s more than 40% greater than week begining October 11th

Omicron Concerns; even while Delta is still stongly impacting the world

The financial market indices signalled concerns about COVID – the Omicron variant from South Africa on Friday. The Dow was down 2.53%; FTSE100 down 3.64%; NASDAQ down 2.23%; S&P500 down 2.27%

Here’s the core problem: The US (and the world) still isn’t done with Delta. Take a look at monthly cases and deaths. So far in November – approximately 30,000 deaths – on 2.2 million new cases. Average daily deaths are 3x higher than 1st August – about 1,500 per day. We are certainly not yet back to normal – even though we are increasingly acting as normal.

WHO reports close to 260 million cases of covid since inception and almost 5.2 million deaths. The global picture shows no significant sustained reduction of cases or fatalities. (Although note a lage drop off in cases and fatalities as vaccine began rollouts from April 2021 to June 2021). Still much work to be done.

South Africa

Hard to tell how accurate the data is; or how effective the testing is, but here’s the the data (source WHO). 62 cases per million per day. But using recent data – the fatality rate is 7% of those infected (prior month lag) – which points to likely a very significant level of cases that are undetected (lack of sufficient testing).

But the week over week comparisons show a more alarming story in Africa – sharply rising cases and fatalities:

And we also see fatalities on the rise, week over week as follows:

In all of the WHO global data – Africa has a very low percentage of cases. In my view that is most likely a sign of insufficient levels of testing. In the data below – Africa is about 1% of all cases. Seems unlikely given that Africa is about 16% of world population.

European countries with sharply rising cases:

All expressed per capita – as cases & fatalities per million of population per day. Notice the higher cases are translating into significantly increased fatalities.

The Netherlands spike is best viewed in comparison to longer time range data:

Here’s the longer term Germany chart. Easy to see why German authorities are getting concerned. The fatality curve from August to Date looks almost exponential.

Russia & Eastern Europe

Russia and Eastern Europe are still leading the league tables for highest per capita level of fatalities. These are very high levels of average daily fatalities per million of population. By contrast the US is @ 4.5 fatalities per million per day; UK is 1.9

Russia is still experiencing very high fatality levels – even though cases have started to reduce:

Ukraine has an even higher fatality rate:

Hungary has an even higher current level of fatalities

Bulgaria has the highest levels of per capital fatalities, but down over the course of November:

South America Success:

Hard to know the reasons for success – but South America in general is having very low rates of COVID. Is it the shift to the summer season? Brazil, Peru and Argentina continue to trend down:

Conclusion:

The VIRUS is again showing its ability to mutate – even while Delta is still impacting the world.

Success in the South – but Northern US getting hit hard. It ain’t over yet.

A surprising picture emerges from the data today: Notice how most of the Southern states have low levels of new covid cases.

And compare this with the same view from end August 2021.

The deep red of the south we see at end August has been completely eliminated today. Take a look at the dramatic reduction for Florida. From almost 1000 new cases per million per day at the end of August to just 64 new cases per million per day today.

Fatalities

Fatalities today have started to shift away from Southern States. Missouri, Kentucky and Montanta are experiencing the highest per capita levels of fatalities.

Here’s the same picture from end August:

Again notice the concentration in the Southern States. Florida substantially improved.

Overall US Trend

The impact of cases away from the south did result in some reduction of cases and fatalities through late October. However there has been a noticeable uptick since December of both cases and fatalities.

Results by State – League Tables

Michigan, Minnesotta and New Hampshire are recordng very high levels of new cases.

Missouri:

The data for Missouri looks like a sharp spike typically due to a correction in the data (in this an upward revision in the fatality numbers)

Kentucky has a serious high fatality rate – and I would be concerned about hospital capacity if I lived there. This is a terrible position to be in during the holiday period.

Tennessee seems to have pulled the case numbers down significantly – but overall fatalities are still high at 3.7 per million per day.

Michigan is in a state of concern with a persistent upward trend in both cases and fatalities

Pennsylvania shows a similar, concerning, trend

What can you say about North Dakota…. very small population so hard to compare directly with other states – but a very different position since August this year. Basically within a 2 month period – what looked like a controlled position – has changed into high levels of cases and fatalities.

Conclusion

With many northern states showing a severe uptick in cases and fatalities on the early start to the holiday season this does not present a positive picture for the next 2 months.

The rapid uptick in many states – from being well controlled in early August to the current levels shows not only how quickly COVID can return to high levels – but must surely be correlated with return to school.

As corporations plan for return to office – they will need to think carefully about their potential impact on the COVID – which can of course be mitigated by vaccination policies.

This COVID thing is almost hitting 2 years – and it aint over yet

Does Peloton’s stock performance mark the end of COVID? Maybe there’s a market in Eastern Europe.

Peloton stock took a massive hit this week, continuing a downward trend over the last 3 months. People want to get back to regular gyms it seems. Notice the current level of $55 versus 52 week high of $171.

Why the good news on covid?

Answer – the next COVID pill – for treating patients shortly after detecting COVID symptoms is looking very promising. See below from today’s Morning Brew:

Pfizer released clinical trial data for its Covid-19 pill, and it was a report card any helicopter parent would be proud of: The treatment reduced hospitalizations and deaths in the most vulnerable patients by 89%, a result so good Pfizer halted clinical trials early.

Antiviral pills like Pfizer’s and Merck’s (which was just granted authorization in the UK) are crucial tools in the fight to turn Covid-19 from a pandemic to an endemic virus. When taken at home within days of discovering Covid symptoms, these pills are much more accessible than current treatments, which require a visit to a medical office.

Why it matters: We know you’ve been hearing this for a while, but this time it really is true…the end is in sight. With booster shots flowing and effective pills on their way to authorization, by January 4—the vaccination mandate deadline for large US employers—“this pandemic may well be over” in the US, former FDA Commissioner Scott Gottlieb said yesterday.—NF

All data in this analysis is to end October 2021. Per capita we can see cases have fallen significant – but not fatalities

The US still had a very large number of deaths in October – 45,000. Only 5 other months since the inception of the crisis have recorded higher death counts. More to come on that below.

Eastern Europe is still very badly hit

A view in table form – shows the top countries for new cases:

And a similar story for level of current fatalities

Many of these counties have small populations – Latvia for example is 2 million; Lithuania 3m; Georgia 5m. Lets take a look at Russia – population 146m

Russia just recorded its highest level of monthly COVID deaths since the crisis began – 31,000 deaths:

The same story plays out in the Ukraine

United Kingdom

The UK has a sharply rising case rate; but has managed to keep a lid on fatalities. Cases in October were almost exactly those in January 2021 – but look how much lower fatalities are. Jan 2021 noted 33,000 deaths; but in October – just 4,000.

While the UK performance is good – I’ll be the first to state that there is no cause for complacency. The growth of cases in the UK; and across Eastern Europe creates the opportunity for additional COVID variants to take hold.

The UK must now think very seriously about the rollout of vaccine boosters.

Success stories of the month:

Israel managed to bring down cases and fatalities – and had aggressively rolled out vaccine boosters. Deaths in October were less than half those of September.

Costa Rica also did a nice job!

Our neighbour to the north, Canada, is doing a wonderful job. How?

This is in stark contrast to our Northern most states. Alaska had its highest level of COVID deaths ever this month; Maine had its third highest.

The best of the US:

The 3 best states (or equivalent) in the US – are Washington DC; Massachusetts; Connecticut. Basically the bunch below – are doing a very good job keeping cases and fatalities down.

It won’t be the first time for the stock market to declare victory on COVID too soon – and as we have seen – there’s still much work to be done across the US; Eastern Europe; and the UK.

At this point – with new antivirals coming to the market however we finally seem to have the tool kit to address the worst effects of COVID

But we can all do a little more to stop the spread in the meantime

Northern States with rising cases

Spot the difference – a very similar pattern emerges in the northern states. Notice the sharply rising fatality rate (red line) in most cases. Idaho is currently on 12.4 COVID deaths per million per day.

Fortunately a declinining trend in some southern states – especially the blue line (cases)

The net result is that the US has definitely bent the curve for new cases; but fatalities are not falling much. Average deaths are 1600 per day.

Total deaths for October looks set to have a similar level of deaths as September

Russia gets serious on covid – lockdowns and low vaccination rates

Russia is now at a very high level of fatalities from COVID. Over 7 fatalities per million per day. Approximately 34,000 new cases are recorded per day.

The attached WSj article informs that vaccination rates are in the low 50%. Lock downs are in effect.

Russia Orders People Not to Go to Work as Covid-19 Deaths Mount

As reported recently Eastern Europe has very high levels of new cases. Romania, Bulgaria, Latvia all continue to record extremely high levels of cases and fatalities.