COVID-19 UPDATE: TX and FL do some useful 'course correcting' on their opening. Median age of FL case is 37.5 vs 66.5 in March, explaining fewer hospitalizations

Equity markets traded sloppy on Wednesday, opening higher but ultimately selling off into the close, potentially due to messy allegations raised in former White House National Security Advisor John Bolton's forthcoming memo ('The Room Where It Happened'), given the potential implications for 2020 elections.

In addition, both Texas and Florida took steps to address the rise in COVID-19 cases seen in their state.  Texas Gov. Greg Abbott is doing some 'course correcting' issuing a directive to bars/restaurants to comply with their state guidelines on 'Open Texas' --this is to address the sustained rise in recent days (total 3,129 vs distorted 4,098 yesterday) and is discussed more fully below.  Similarly, Florida Gov. Rick DeSantis provided some detailed specific case and demographic information on its recent surge in cases (discussed more fully below).

The common thread is that both states are noting the majority of the increase in cases is from younger adults (vs seniors or nursing home residents) and in many cases, asymptomatic.  And instead of rushing to reverse the easing of restrictions, both states want to move forward but want to adjust their plans to reflect the rise in cases.  In the case of Texas, even mayors are requesting the right to require masks (currently encouraged by the state but not required).

In our review of cases, we now see 6 states (+1 Florida) with sustained rises in cases plus the risk of increased hospitalizations which are: Arkansas and Utah (for some time, but Arkansas looks like it peaked, actually), 3 border states: TX, CA and AZ and now Florida (which was on the cusp). 

The economy opening is not the only known factor accounting for the rise across states.   If we were to list the factors contributing to the rise in cases:

- nationwide protests involving tens of thousands of Americans (Wednesday is Day 19, so timeline fits well);
- greater mobility as restrictions eased;
- lack of 'herd immunity' in most states except for NY tristate area and some other hard-hit areas.
- CA, TX and AZ see imported cases from Mexico (Washington Post article May 27th)

We have noticed a number of clients querying us about this latter point, since it does not seem to be widely discussed in the media.  But there is now discussion, even at the White House. 


https://apnews.com/129cbe9e6320cd16ce3e845f29de0cac


Is herd immunity keeping NY/NJ from seeing any protest-related surge?
NY/NJ has a confirmed case count of 19,798/18,881 cases per 1mm residents  (~2% of the state) vs CA at 3,974, TX at 3,332, FL at 3,851.  See the difference?  COVID-19 has run through NY/NJ and potentially, given seroprevalence tests, the residents of those two states have herd immunity.  In other words, NY/NJ may be the safest places in the US and the citizens might be immune.  This similar collapse in cases is seen in Italy, France and Spain, so what we are seeing in these 6 states could remind us that the respective curves are simply flatter.

Is this all a major setback to the economy re-opening?  If indeed FL and TX are seeing cases rise among younger residents, and many with fewer or no symptoms, then it is not entirely clear why shelter at home is the right step.  Clearly, mitigation steps and course correction are required and it looks like both states are doing this.  But this only further highlights the importance of a healthcare solution -- either a cure or a vaccine.

Hospitalization and death trends are considerably better than case data at the moment...
Nationwide, the trend in "gross hospitalizations" (33 states report this) and daily deaths is clearly down.  So even as daily reported cases are rising, we are seeing a divergence with hospitalizations and daily deaths.  Again, this raises a few questions:

- is the disease becoming weaker? 
- Or is it infecting a healthier and younger patient now?

Either way, this divergence is a good thing and if it continues, it really helps mitigate our fears about a relapse.

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