COVID-19 UPDATE: Americans broke their "shelter at home diets" and next 2 weeks will tell us a lot. Most at stake are "social distance victim stocks" = barometer next 2 weeks

COVID-19 remains a global crisis and we realize that many people need to keep up with COVID-19 developments, particularly since we are moving into the more critical stage (“restart economy”), so feel free to share our commentary to anyone who has interest.



There are sources if the US sees “renewed” outbreak in the number and intensity of COVID-19 cases.  We touched upon these yesterday, the first is the 75 cities seeing widespread protests stemming from the senseless death of George Floyd; and the second, is imported cases along the US-Mexico border (as discussed below, in the 23 counties bordering US-Mexico, daily cases +162% in the past month).  From a healthcare perspective, the mass gatherings, laying aside social distance protocol, PPE (for most part) and sanitization, is equivalent to a dieter being 27 days into a 30 day “no carb” diet and suddenly breaking fast.

But I don’t know what will happen in two weeks.  And this is why the path of COVID-19 in the US is dependent on the outcome from these protests.  No doubt, Americans gathering in density is similar to the Champion League events in Northern Italy that resulted in that country’s massive outbreak.  We now have transmission risk in high gear in the US in 75 cities.  This is a fact.  And the outcome could be 1 of several:

– USA cases explode in the next two weeks;
– USA cases remain flat/steady next two weeks, more of the same trend as today;
– USA cases collapse in the next two weeks;

If this last one is what we see, this by far, the biggest development for COVID-19 anywhere in the World.  This suggests the combination of using PPE, and/or better weather (>vitamin D) and/or mutations are making COVID-19 less of a health risk.  And this means no second wave (for now), and no need for future shutdowns.  Very likely, Americans will resist a future effort to shelter-at-home, with Americans breaking their “shelter at home diets,” it is doubtful that genie can be put back in the bottle.

The biggest winners if there is no “second wave” in two weeks:

– theme parks
– cruise lines
– airlines
– casinos
– outdoor events
– sports and stadiums
– concerts
– bars and nightclubs
– theaters

Put another way, the equities of these groups are worth watching.  If they continue rallying, they are telling us the protests are not triggering a second wave.  So far, these groups have been strong over the past week.

– we will see how they do in the next 2 weeks.
– if strongly, then likely no second wave

POINT #1:  Ex-MA, US cases count plunged to a new all-time low of <16,500.  MA “adjustment” includes ~3,000 “probable” cases
The total USA COVID-19 case count came in at 19,959, -2115 from 1D ago and -3977 from 2D ago.  Total tests administered rose to ~414k today vs ~375K 1D ago.  And the total case count would have been even lower as Massachusetts reported a massive +3,840 cases today (+3,176) as it “adjusted” its case counts to reflect past “probable” cases.

https://www.bostonglobe.com/2020/06/01/metro/mass-coronavirus-death-toll-surges-over-7000-cases-surpass-100000-state-begins-including-probable-cases/



2 states see sizable jumps:
Massachusetts     3,840 vs 664 (1D) +3,176
Connecticut             539 vs 179            +360
Total                                                   +3,536

6 states see sizable declines (usual ping-pong):
Texas                 593 vs 1,949 (1D)    -1,356
California        2,423 vs 3,705            -1,282
Arizona              187 vs    681               -494
Michigan            135 vs    513               -378
Illinois                 974 vs 1,343              -369
New Jersey        473 vs   837               -364
Total                                                   -4,243

Source: COVID-19 Tracking Project


NY state cases are now down -91% from the peak (58 days ago)
Look at how much progress NY state has made as its total cases fell below 1,000 and are now down 91% from its peak.  NY state is clearly on the other side of the battle of COVID-19.

Source: COVID-19 Tracking Project



Total tests administrated came in at 414,951, up 11% vs 1D ago…
Total tests administered today increased sizably, up 11% and is hovering around the 400,000 level over the past few weeks.

Source: COVID-19 Tracking Project


And this led to positivity rate falling to 4.8%.  This is not as low as the 3.8% reported a few weeks ago.  But the figure today also reflects a big one-time adjustment from MA.

Source: COVID-19 Tracking Project



POINT #2: USA importing COVID-19 along US-Mexico border counties as daily cases +162% in the past month.  For states open prior to 5/1/2020 (4 weeks now), daily cases -11%

USA seeing imported COVID-19 cases from Mexico along US-Mexico border, cases +162% in the past month…
Yesterday, I was struck by the case data reported by Imperial County, CA, which noted that they saw a surge in cases due to overflow from Mexico.  So tireless Ken, our data scientist, compiled the daily case data for US counties bordering Mexico.  There are 23 counties and the composite is shown below. 

– it is clear the cases have been rising sharply in these 23 counties over the past few weeks.  
– in the past month, daily cases +162% from 249 to 653.

So these border counties are seeing a surge in cases, by contrast with the rest of the USA.

Source: State Health depts for CA and TX, Johns Hopkins CSSE


We have listed the daily case data for the 23 counties below (sorted by total cases in past 10D).  There are case surges across CA, TX, NM and AZ.

– Imperial County saw a massive surge
– Yuma, AZ went virtually zero a month ago to 100/day

 

Source: State Health depts for CA, AZ and TX


By contrast, states open prior to 5/1/2020 are seeing no surge in cases and daily deaths now down -23% since 5/1
We have updated our daily case composites, to show trends for states open, based on date of opening.  The surge in yellow is MA.  So, it may be worth giving that one a mulligan.

– states open prior to 5/1 have seen daily cases of 3,106, down 11% from 5/1.  
– it has been >4 weeks and yet daily cases have been muted

Source: COVID-19 Tracking Project

Similarly, daily deaths in the 13 states (open prior to 5/1/2020) down 22%
Similarly, daily deaths have been falling in these 13states and are now down 22% from 5/1.  This is all fairly positive news, as it suggests these states, which have seen relaxed restrictions >4 weeks, are not experiencing a surge in cases.

Source: COVID-19 Tracking Project


The 13 states are listed below.  Despite all the commentary prognosticating doom, none of the 13 states seems to be having any renewed outbreak.  Not even Georgia.

Source: COVID-19 Tracking Project



POINT #3: The weekend protests across the US is 1,000X super spreader events all in one day
The protests that erupted across the US reflect a nation that is rallying behind a cause, a cause that compelled Americans to break quarantine and even disregard the social distance measures prescribed by health experts.  In other words, the biggest development in COVID-19 over the past week are the widespread protests across the US.  Thousands of Americans left their homes to gather in large groups, with “recommended” social distance measures not being maintained (6 feet) and without proper sanitation and likely insufficient PPE (protective equipment).

And the reason health experts are concerned, is these large gatherings are the source for widespread transmission.  Recall,  the concerns about the Memorial Day gatherings in the Lake of the Ozarks, Missouri.  The dense crowds are not that different than the density seen over this past weekend across the US.

Italy’s initial outbreak is attributed to a football (American = soccer) Champions League match in Atalanta-Valencia… 
And moving back in time, the initial outbreak in Italy and Spain is considered to be tied to a soccer match that attracted 40,000 fans.  That was 40,000 fans in one match, and we got two nations with COVID-19 spreading rapidly.  Granted, more people wear face masks, so this should be helpful.

And as we mentioned above, this is a real-time test.  If COVID-19 cases do not surge across the US in the next few weeks, then the country can even accelerate the pace of re-opening.

https://www.wsj.com/articles/the-soccer-match-that-kicked-off-italys-coronavirus-disaster-11585752012


A recent study by Meher K Prakash did a meta-analysis of the known COVID-19 super spreader events…

https://www.medrxiv.org/content/10.1101/2020.05.22.20110726v1

This study, published on 5/22/2020 looked at 16 documented events which involved a known superspreader.  The biggest outbreak studied is a cruise ship, where one passenger infected 2,817 (of 10,000 passengers) over 3-4 weeks. 

– None of the studies looked at spread after an outdoor activity, such as the widespread US protests.
– But some superspreader events happened after only 2-3 hours of exposure.  53 from a choir.  52 from a birthday party in CT. 94 from a nightclub.  All listed below and fully explained in the paper.

https://www.medrxiv.org/content/10.1101/2020.05.22.20110726v1


These events took place mostly without the updated guidelines of masks, distance and sanitation.  So, these protests are not comparable.  But some of the information is useful anyways.  Take a look at the spread that took place in an office space (below) which involved 1 person infecting 89 people — and this took place over a few days.

https://wwwnc.cdc.gov/eid/article/26/8/20-1274-f2




STRATEGY: If the protests do not trigger a massive new outbreak, this would be the most positive possible outcome as it definitely answers whether it is safe to go outside…
If the hundreds of protests and the multiple thousands of participants over multiple days do not trigger an outbreak, then COVID-19 is largely fading from the US.  And this makes even “social distance” victim businesses safer. The following industries, if this happened, would be considered safer than perceived.

The biggest winners if there is no “second wave” in two weeks:

– theme parks
– cruise lines
– airlines
– casinos
– outdoor events
– sports and stadiums
– concerts
– bars and nightclubs
– theaters

Put another way, the equities of these groups are worth watching.  If they continue rallying, they are telling us the protests are not triggering a second wave.