New BA.2.12.1 variant steadily gaining dominance. COVID-19 cases ticking up, but at a "linear" speed

Click HERE to access the FSInsight COVID-19 Chartbook.

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This note only includes the COVID-19 update, as we sent out the strategy section on Thursday morning.

POINT 1: Total COVID-19 cases 435,087 over past 7D (avg 62,155 per day), up +72,676 (+10,382 per day) vs same period 7D ago…

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Current Trends — COVID-19 cases (past 7D vs. 7D prior):
 – Total new cases  435,087 vs 362,411 7D prior, up +72,676
 – Avg daily cases    62,155 vs 51,773 7D prior, up +10,382
 – 7D positivity rate 7.5% vs 7.0% 7D prior
 – Hospitalized patients  15,497, up +15% vs 7D ago
 – 7D Avg daily deaths 330, down -6.0% vs 7D ago
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As the markets focused on the Fed FOMC meeting and the 1Q2022 earnings, COVID-19 cases crept up “quietly.” Over the past 7 days, a total of 435,087 new cases (avg 62,155 per day) were reported in the US, up +72,676 (avg up +10,382 per day) compared to the same period 7 days prior. Almost all US states reported higher weekly cases. Among them, NY, CA, and IL have the most increase in new COVID cases.

Last week, we noted that the daily cases and positivity rates in NYC and NYS appeared to roll over. However, the latest data shows those declines seem to be a head fake. Over the past week, the daily cases in both NYC and NYS resume rising. This, once again, shows how unpredictable COVID is (and has been).

Moreover, we noticed that the rise of US covid cases somehow coincided with the emergence of the new sub-variant of BA.2.12.1, which is a sub-variant of the “stealth” BA.2 and is expected to be 25% more transmissible.

According to CDC Nowcast estimates, over 1/3 of recent cases in the US are caused by the BA2.12.1 variant. And in NY and NJ, this proportion is estimated to be 62%.

The most important question to ask is whether the mutation of BA.2.12.1 has made the virus more or less virulent. We do not know the definitive answer yet, but according to CDC Director Dr. Rochelle Walensky, CDC is not anticipating more severe disease from the variant. Of course, the future is uncertain and the researchers are still studying the new variant.

7D delta in daily cases shows the daily cases are rising at a “stable” speed. Over the past 10 days, 7D delta in daily cases, aka the speed of case rise, has been flat.

• This means the case rise is somewhat linear, rather than parabolic
• If the speed of case rise persists, the average daily new cases could reach 100,000 in 4 weeks, but still just a fraction of the peak level we saw in mid-January.
• Hence, we believe the situation will not be severe enough for people to cancel travel plans during the summer. But as we always say, the future is uncertain.
  

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30 states have shown clear trends of cases rising.
 *** We’ve split the “Parabolic Case Tracker” into 2 tables: one where cases are falling (or about to fall), and the other where cases are rising.
In these tables, we’ve included the vaccine penetration, case peak information, and the current case trend for 50 US states + DC. The table for states where cases are declining is sorted by case % off of their recent peak, while the table for states where cases are rising is sorted by the current daily cases to pre-surge daily cases multiple.

– The states with higher ranks are the states that have seen a more significant decline / rise in daily cases
– We also calculated the number of days during the recent case surge
– The US as a whole, UK, and Israel are also shown at the top as a reference

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Net Hospitalization starts to rise. Daily mortality is still falling. The positivity rate is now above 5%…

Below we show the aggregate number of patients hospitalized due to COVID, daily mortality associated with COVID, and the daily positivity rate for COVID

– Current hospitalization is still within the range of the all-time low since the pandemic. But it has been ticking up recently. But in terms of absolute numbers of hospitalization, the current level is just a fraction of the peak level at ~160,000 in Mid-January.

– Daily Mortality is still falling. As we learned from the previous wave, the mortality trend tends to have a 3-4 week lag compared to the case trend. So, it is worth watching whether the mortality trend will start to reverse. But it seems the BA.2 sub-variant and the new BA.2.12.1 sub-variant do not cause severe illness so far.

– As of Monday April 4th, HHS is no longer requiring testing sites to report negative antigen test results. Therefore, the number of tests reported is distorted to some degree. We modified our positivity rate calculation slightly and now only included states that report the number of tests (negative and positive, or as a total). Based on the data we could obtain, the trend of the positivity rate is also ticking up. But the current level is still below 10% (in other words, still manageable).

Regarding the COVID-19 situation globally, all regions have seen a falling or stable case trend except North America.

• Europe and Asia have seen steady declines in daily cases
• Cases in LatAm and Africa have risen slightly. But the magnitude was too small to see in the chart below.

The improvements in China and Korea are the primary reason for the cases in Asia to fall.

• As shown below, both China and Korea have seen cases fall significantly from recent highs
• The 7D average daily cases in China and Korea have fallen 66% and 88%, respectively.
• As we noted previously, Shanghai (the epicenter of the recent COVID wave in China) has gradually lifted its lockdown district by district. The lockdown-related supply chain problems might start to show signs of alleviation.

POINT 2: VACCINE: vaccination pace has been up recently…

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Current Trends — Vaccinations: 
– avg 0.4 million this past week vs 0.5 million last week
– overall, 30.8% received booster doses, 66.0% fully vaccinated, 77.3% 1-dose+ received
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Vaccination frontier update –> all states now above 100% combined penetration (vaccines + infections)
*** We’ve updated the total detected infections multiplier from 4.0x to 2.5x. The CDC changed the estimate multiplier because testing has become much better and more prevalent. 

Below we sorted the states by the combined penetration (vaccinations + infections). The assumption is that a state with higher combined penetration is likely to be closer to herd immunity, and therefore, less likely to see a parabolic surge in daily cases and deaths. Please note that this “combined penetration” metric can be over 100%, as infected people could also be vaccinated (actually recommended by CDC). 

– Currently, all states are above 100% combined penetration 
– Again, this metric can be over 100%, as infected people could also be vaccinated, but 100% combined penetration does not mean that the entire population within each state is either infected or vaccinated

There were a total of 366,631 doses administered, as reported on Wednesday. The vaccination pace has started to level off after a brief pickup in mid-March. Today, the FDA placed restrictions on the Johnson and Johnson single-shot vaccine. Only those in a situation where they cannot receive the Pfizer or Moderna vaccines or those who would not get vaccinated unless they were receiving the J&J vaccine will be eligible for it.

This is the state by state data below, showing information for individuals with one dose, two doses, and booster dose.

In total, 577 million vaccine doses have been administered across the country. Specifically, 257 million Americans (78% of US population) have received at least 1 dose of the vaccine. 219 million Americans (66% of US population) are fully vaccinated. And 102 million Americans (31% of US population) received their booster shot.

POINT 3: Tracking the seasonality of COVID-19

***We’ve updated the seasonality tracker to show figures from the last 9 months, from this calendar day, in each of the last two years***

As evident by trends in 2020 and 2021, seasonality appears to play an important role in the daily cases, hospitalization, and deaths trends. Therefore, we think there might be a strong argument that COVID-19 is poised to become a seasonal virus. The possible explanations for the seasonality we observed are:- Outdoor Temperature: increasing indoor activities in the South vs increasing outdoor activities in the northeast during the Summer- “Air Conditioning” Season: similar to “outdoor temperature”, more “AC” usage might facilitate the spread of the virus indoors- Opposite effects hold true in the winter

During the Summer, outdoor activities are generally increased in the northern states as the weather becomes nicer. In southern states, on the other hand, it becomes too hot and indoor activities are increased. As such, northern state cases didn’t spike much during Summer 2020 while southern state cases did. Currently, southern states are not showing as much of a spike as other states. This could be attributed to spring weather in the south encouraging more outdoor activities.

CASES
Current hospitalizations appear to be similar or less than Summer 2020 rates in most states. This is likely due to increased vaccination rates and the vaccine’s ability to reduce the severity of the virus. Current death rates appear to be scattered compared to 2020 rates. This is likely due to varying vaccination rates in each state. States with higher vaccination rates seem to have lower death rates given the vaccine’s ability to reduce the severity of the virus; states with lower vaccination rates seem to have higher death rates.

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HOSPITALIZATION

DEATHS

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