The US may have crested this COVID wave, but still has a very long way to go

Things may be looking up for now. Seems that the US current levels of new cases at 358 per million per day are about 63% of the recent peak of 569 per million per day earlier this month.

Its too early to call success on fatalities however. Below is the same chart – but with whole numbers – rather than per million figures. Close to an average of 2,000 deaths per day – having been as low as 195 on 8th July.

Case numbers are falling significantly in Florida, Georgia, Texas – take a look at the right hand side of this table showing the change in the average daily number of cases week over week.

Tennessee looks to have broken the curve… from country number 1 in late August. However over 600 cases per million per day is no cause for celebration. Fatalities are way too high.

Applying that to the rest of the US, generally more than 300 new cases per million per day is still very bad:

Here’s the same data visually. Tennessee still wants to feature in the league tables

Most states are struggling with very high fatality rates right now. As an example TN has just 6% ICU capacity – just 127 available beds for a population of 7 million:

TN has recorded over 1,500 deaths from COVID this month alone, the 4th highest in this states pandemic history:

September to date is the 3rd deadliest month in our COVID record:

Close to 50,000 deaths. US deaths from this pandemic at over 680,000 have now eclipsed that of the 1918 flu pandemic (known as Spanish Flu) – albeit the 1918 population was obviously a lot smaller.

COVID Country Comparisons: How the US compares to other countries

Many countries are delivering better results on COVID than the US. What can we learn from that? Clearly we are doing something wrong!

Lets start with the big picture on the US. We see average daily deaths at 10.5 per million per day in Dec/Jan period – and currently on a significant upswing.

Here’s the more recent period in close up. We’re at the highest levels of daily deaths since March 1st this year.

Europe – significantly improving:

Average daily fatalities are 1/12th that of the US. Cases are less than one quarter.

France: a very similar story to Germany.


UK – similar case levels to the US; fewer (but rising) fatalities

South America is significantly improving

Its time for a long hard look at how we are handling this in the US. Compared to many countries we are doing a poor job. In August and September (to date) over 50,000 people died in the US from COVID. Its time for more action not less.

Here are thumbnails for the top 30 countries by total number of deaths from COVID. This is a bit of an experiment to find the best way of visualizing these dashboards.

States setting new peak COVID deaths

Mississippi; Florida and Louisiana have all set record peak daily death numbers so far this month

MS had 124 on Sept 6th; Florida has 1,338 on Sept 2nd; and Louisiana had 223 on 1st Sept. Lets pull up the charts

MS – currently 14 deaths per million per day

Florida – 15.8 deaths per million per day

Louisiana 10.1 deaths per million per day


Not positive. The following states have all set record new daily case numbers this month (September).

Oklahoma, Kentucky, Tennessee, Indiana, North Carolina, Alaska, Washington, Oregon, Idaho, Georgia, South Carolina

Its no surprise that the US fatality rate has risen sharply over the past 6 weeks. From less than 1 per million per day – to more than 4. In plain numbers thats almost 1,500 deaths per day currently.

To pick my home state example – across all of TN ICU capacity is now at 5% – or 107 beds available for a state of 7 million people.

Peru – the worst impacted country in the world for COVID – shows sustained improvement

Some good news for Peru

Peru leads the world in reported deaths per capita. As you can see from the table below – almost 2x the number of the second country in the table. Thats a total of almost 200,000 deaths on a population of 32 million people

Improving trend

Current fatalities are now just 1.2 per million per day. The best result in many months.

A similar story for Brazil

Improvement – but 3 fatalities per million per day is still too high

The Driver: Vaccinations

The chart below shows steady progress in a rollout of vaccinations commencing around May 2021. Levels are still relatively low: as of Sept 4th 26% of the population are fully vaccinated. Seems like the case curve started to fall sustainably in June – which fits the profile of the vaccination curve with 1 month lag – as we would expect.

Is herd immunity a driver? Unlikely. Almost 2m people have been diagnosed and presumed recovered from COVID – which is 6% of the population. Assume that’s 2 to 5x underreported – that still shows this population is no way near the level of exposure to generate herd immunity.

Well done Peru in clearly targetting potential vulnerable populations with your vaccine rollout.

Rural Tennessee: Carter County

Carter County Courthouse in Elizabethton

How does a county of just 54,000 people manage to amass 184 covid deaths? That’s over 3,000 deaths per million – one of the highest in the country

From the chart below – we can see peak deaths occurred in January at 46. Zero deaths in April and very few in May and June. The we see the rise of COVID Delta. 4 deaths in July (perhaps no too alarming); but then 18 deaths in the month of August.

Here’s the wikipedia link to Carter County A few selected data points:

97% white; median age 38; median family income $33k; per capita income $15k. 17% of the population is below the poverty line.

Carter County has about 32% of its population fully vaccinated.

Delta is different… its not too late to get the vax

TN COVID: Its a rural problem driven by low vaccination rates

What’s behind Tennessee’s rise to the number 1 COVID hotspot in the country? The data might surprise you, it surprised me. I had thought the rise was consistent across the state. The answer is rural populations. Counties with populations greater than 200,000 have, so far, fared better than those with smaller populations.

Marion county has the highest rate of new case creation expressed per capita – and its population is close to 30,000. It also has one of the lowest fully vaccinated rates in the country – just 34%. (However even the best counties are only 54% fully vaccinated.)

To put that in context – Davidson County – population 700,000 has one third the rate of Marion County.

Not surprisingly counties adjacent to hotspots fare worse.

Higher cases lead to higher fatalities. Here are those counties with an average of more than 10 fatalities per million per day

Notice the incredibly low vaccination levels in these counties:

Here’s a link to the NY Times stats for TN – they do a great job

Time to bunker down…. the current rate of case increase in these areas with extremely low vaccination rates is adding stress to an already heavily stressed hospital system.

Undoubtedly this is going to get worse in Tennessee in the near term

Covid lessons from Southern School openings

Excellent reporting from wsj

“In Mississippi, 13,715 students have tested positive for Covid-19 since most schools inaugurated the new academic year in early August, sending more than 20,000 students into quarantine for each of the past three weeks, as of Aug. 31, according to the state health department. In New Mexico, nearly 10% of the state’s 317,000 students have spent time in quarantine, state data show. And in Georgia, more than half of the state’s outbreaks for the week ended Aug. 27 were linked to schools, according to the state health department.”