COVID-19 Updated Data and Developments - 6.1.2020

International case numbers as of June 1, 2020, 10:00 am

• 6,198,167 COVID-19 cases worldwide; 372, 501 deaths; 2,656,789 recovered.¹
• COVID-19 cases in the United States now account for nearly one-third of worldwide cases with 1,790,191 diagnosed cases.
• Brazil now has the second highest number of cases with 514,849 cases, Russia third with 414,878, and the United Kingdom fourth with 276,156.
  • Deaths in multiple countries now exceed reported deaths in China. Deaths due to COVID-19 in 12 countries exceed China’s reported total.
• COVID-19 cases in the United States now account for nearly one-third of worldwide cases with 1,790,191 diagnosed cases.
• Brazil now has the second highest number of cases with 514,849 cases, Russia third with 414,878, and the United Kingdom fourth with 276,156.
  • Deaths in multiple countries now exceed reported deaths in China. Deaths due to COVID-19 in 12 countries exceed China’s reported total.

Epidemic curve of confirmed coronavirus cases worldwide by region (from European Centre for Disease Prevention and Control COVID-19 Situation Update, as of 6/1/2020).

Distribution of coronavirus deaths worldwide by region (from European Centre for Disease Prevention and Control COVID-19 Situation Update, as of 6/1/2020).

US National case numbers as of June 1, 2020, 10:00 am

• 1,790,191 cases of coronavirus confirmed by lab tests, 104,399 deaths, and 444,758 recovered cases. 16,936,891 total tests have been conducted.³
  • New York has the highest number of confirmed cases at 370,770 followed by New Jersey at 160,445 cases and Illinois at 120,260 cases.

Risk in population

● The fatality rate from data already available is 1.3% in people 50-59, 0.4% in people 40-49, and 0.18% in people 30 to 39. Those that are 29 and under face mortality rates 0.09% and under, and children ages 0-9 are estimated to experience mortality at rates below 0.01%. Data from the CDC shows that young adults ages 20-44 face a substantial risk of serious illness and hospitalization from the coronavirus.⁷

Deaths involving COVID-19 reported to National Center for Health Statistics as of May 28, 2020.⁸

• Data from the CDC continue to confirm that individuals with underlying conditions are at greater risk of experiencing severe outcomes as a result of COVID-19. However, the CDC has reiterated that measures should be taken to protect all persons, including those without underlying conditions.⁹

Provisional Death Counts for COVID-19 by Demographic Characteristics (as of May 28)¹⁰

From CDC COVIDView Weekly Surveillance Summary, retrieved 6/1/20. ¹¹

● Elderly: Older adults (those over 60 and particularly those over 80) and those with serious chronic health conditions (including heart disease, diabetes, and lung disease) are at a higher risk of getting very ill due to COVID-19.¹²

● Children: Relatively few children are hospitalized due to COVID-19 but severe outcomes have been reported in children. The CDC advises children to practice social distancing and wear cloth face coverings as well as to follow other everyday preventative behaviors.¹³

New US developments

● The death toll associated with COVID-19 surpassed 100,000 last week in the United States.14

● As cases have continued to decline in the northeastern US, many areas of the country, especially the Midwest, have faced increasing rates of COVID-19. 15

● US jobless claims continue to rise and exceed 40 million even though business are reopening. 16

● Some cities in Arkansas, Texas, and California are seeing daily case growth rates of more than 9%, indicating possible outbreaks. Milledgeville, Arkansas and Roanoke, Virginia have daily death growth rates of more than 10%. As states continue to reopen, these trends will be important indicators of whether some may have reopened prematurely. 17

● A new study in the Lancet retrospectively analyzed 96,000 patient medical records from December 2019 to investigate the effects of hydroxychloroquine on COVID-19 patients. The 15,000 patients who were treated with the drug had a 34% increase in risk of mortality and a 137% increased risk of serious heart arrhythmia, these risks were even high for those who were also treated with an antibiotic. This study only confirms previous understanding that hydroxychloroquine has no benefit in treating COVID-19 patients and may increase the risk of adverse cardiovascular events. The WHO is halting the hydroxychloroquine portion of its Solidarity Trial, which aims to find new treatments for COVID-19 patients, following the new Lancet study. 18

● All 50 US states are moving towards reopening. The degree to which restrictions are lifted varies greatly from state to state but almost all businesses are allowed to reopen, some with more restrictions than others. Even still, public health officials are concerned about a resurgence of cases. The CDC has released a number of “decision trees” to help businesses safely reopen. On a Senate panel, Dr. Anthony Fauci and CDC director Dr. Robert Redfield, warned that opening the economy too soon could have dire consequences. 19

● Moderna, which tested the first COVID-19 vaccine in humans, stated that their first trial in humans (8 individuals) appears to be safe and was able to stimulate an immune response. The next step will be to test the vaccine in 600 individuals but full scale production of the vaccine could take at least a year. 20

● More US meat plants closed as a result of significant COVID-19 outbreaks are being ordered to reopen by executive order, which is likely to place workers at increased risk of contracting COVID-19. The largest US beef producer, JBS, has revamped their processes in response to COVID-19 but their production has significantly slowed which could reduce the US beef market for months. 21

● There is increasing concern about the accuracy of COVID-19 testing in the US. ID, Abbott Laboratories’ COVID-19 test, is currently used in the White House for rapid testing but reports say it may miss up to 50% of positive cases compared to other tests. 22

● Children in the US are becoming seriously ill due to a new syndrome that appears to be linked to immune responses to COVID-19. Pediatric multisystem inflammatory syndrome can affect children that were previously healthy, though many of the children that have been hospitalized with the syndrome either tested positive for coronavirus or had positive antibody tests, suggesting that they previously had coronavirus. Symptoms can include fever, rash, reddish eyes, swollen lymph nodes, and sharp abdominal pain. 23

● Research from a team lead by Daniel Weinberger at the Yale School of Public Health suggests that deaths in the US may have been significantly underestimated. These data come from analysis of the excess number of deaths, many of which could be directly or indirectly attributed to the COVID-19 pandemic. 24

● The FDA has approved the use of Gilead’s remdesivir for severely ill COVID-19 patients. Although the drug did not significantly reduce mortality rates, it was shown to moderately reduce hospitalization time, from 15 days to 11 days.

● With almost 2,500 long-term care facilities reporting COVID-19 cases, the death toll in these facilities is now more than 2,000 and expected to continue to rise. 25

Known cases in Connecticut (call 211 or text "CTCOVID" to 898211 for information)

Increases in Cases and Deaths in CT with Percent Increase from Previous Reporting Period

Connecticut Summary Statistics by Month for Age, Nursing Home/Assisted Living, and Race/Ethnicity per 100,000

*Data on nursing homes is sparingly updated

• As of June 1, 2020 Yale New Haven Health has 122 (a decrease of 86 from May 25) COVID-19 patients. The number of in-patients has been steadily decreasing.
  • 46 (down 26 from May 25) patients are in the ICU and another 30 (down 18 from May 18) patients are on ventilators.
  • YNHH has seen a 9-12% mortality rate among patients that test positive for COVID-19 since the beginning of the outbreak.
  • Patients not requiring ICU care have, on average, stayed for 6 days in the hospital.
  • 667 frontline health care workers have been tested for COVID-19 across several YNHH hospitals. Of those, 3 were positive and asymptomatic and 3 were positive and mildly symptomatic.
  • Of the 895 Yale employees returning to work tested for COVID-19, none were positive.
  • Yale Health’s health care services are currently seeing about 2 positive COVID-19 cases per day.

COVID-19 projections for reopening Connecticut³⁵

• With all US states beginning to reopen, there is increasing concern that infection rates will again. Professor Forrest Crawford, Dr. Zehang Richard Li, and Dr. Olga Morozova at Yale created models for infection, hospitalization, and death depending on the amount of interpersonal contact following reopening. Critically, should a “fast reopening” occur, Connecticut will see a surge of hospitalizations and deaths by August. It is unknown exactly what type of reopening will occur but it is likely to fall between a slow and fast reopening.

Graphs from Connecticut COVID-19 Update³⁴

• As of June 1, 2020 Yale New Haven Health has 122 (a decrease of 86 from May 25) COVID-19 patients. The number of in-patients has been steadily decreasing.
  • 46 (down 26 from May 25) patients are in the ICU and another 30 (down 18 from May 18) patients are on ventilators.
  • YNHH has seen a 9-12% mortality rate among patients that test positive for COVID-19 since the beginning of the outbreak.
  • Patients not requiring ICU care have, on average, stayed for 6 days in the hospital.
  • 667 frontline health care workers have been tested for COVID-19 across several YNHH hospitals. Of those, 3 were positive and asymptomatic and 3 were positive and mildly symptomatic.
  • Of the 895 Yale employees returning to work tested for COVID-19, none were positive.
  • Yale Health’s health care services are currently seeing about 2 positive COVID-19 cases per day.

COVID-19 projections for reopening Connecticut³⁵

• With all US states beginning to reopen, there is increasing concern that infection rates will again. Professor Forrest Crawford, Dr. Zehang Richard Li, and Dr. Olga Morozova at Yale created models for infection, hospitalization, and death depending on the amount of interpersonal contact following reopening. Critically, should a “fast reopening” occur, Connecticut will see a surge of hospitalizations and deaths by August. It is unknown exactly what type of reopening will occur but it is likely to fall between a slow and fast reopening.

“Slow reopening” scenario

“Fast reopening” scenario

Connecticut developments

• Governor Lamont eased restrictions on gatherings so that indoor social gatherings of up to 10 people and outdoor gatherings of up to 25 are now permitted.³⁶
• Tribal casinos in Connecticut are reopening on June 1 with capacity restrictions, mandatory face mask rules, and temperature checks of patrons when they enter.³⁷
• The number of people hospitalized in Connecticut has continued to decline since the peak in April. However, experts warn that residents should continue social distancing measures in order to ensure the decline in COVID-19 infections.³⁸
• New rules have been announced for Connecticut’s first phase of business reopenings on May 20. The revised list of businesses that will be allowed to reopen include restaurants for outdoor dining only, museums, retail stores (including malls), and office buildings. In addition to these openings, social gatherings will continue to be limited to no more than 5 people. Those that are over age 65 and/or have preexisting health conditions are encouraged to continue to self-quarantine at home.⁴⁹
• Connecticut’s lab capacity to process COVID-19 tests is currently around 3,000 kits per week. Processing capacity is set to ramp up to 40,000 per week over the coming month and is projected to be at 140,000 tests processed per week by the end of June.⁴⁰
• Governor Lamont is joining fellow governors from New York, New Jersey, Rhode Island, Massachusetts, Pennsylvania, and Delaware to develop a regional supply chain for personal protective equipment, other medical equipment, and COVID-19 tests. The plan aims to identify the region’s needs, reduce cost, and stabilize the supply chain for these products.⁴¹
• Governor Lamont signed an executive order requiring the use of face masks or coverings in public where close contact is unavoidable.⁴²
• Though the period for rent relief has lapsed, no evictions can occur until July 1 unless due to a safety concern.⁴³

Known cases in Rhode Island (call 401-222-8022 for information)

• As of May 31, 2020⁴⁴
  • 14,991 confirmed cumulative cases (+926 from 5/24/20)
  • 156,835 total tests conducted
  • 195 patients currently hospitalized
  • 46 patients currently in ICU
  • 720 deaths in the state

Graphs from Rhode Island Department of Health COVID-19 Disease Data dashboard as of 5/31/2020.⁴⁵

Rhode Island developments⁴⁶

• Rhode Island is moving into Phase 2 of its reopening plan. Starting June 1, gyms, restaurants, barber shops, and hairdressers can reopen under new guidelines that include mandatory face masks, deep cleaning procedures, and capacity limits in facilities.⁴⁷ Houses of worship can reopen on Sunday, June 7 at 25 percent capacity.⁴⁸
• Rhode Island is the first state in the northeast to reopen nonessential businesses. Businesses that choose to reopen must limit the number of customers allowed inside, based on their square footage, face coverings are required in all public spaces, and meetings of more than 5 people are still prohibited.⁴⁹
• Governor Raimondo issued an executive order requiring all employees to wear masks while at their place of business. Additionally, Governor Raimondo has ordered that all people must wear cloth face coverings while in public.⁵⁰

Key international developments

• The United States has announced its intentions to leave the World Health Organization over concerns related to COVID-19 following a temporary pause of funding in April. Many world leaders have called for the country to remain.⁵¹
• The World Food Programme estimates that 14 million people in Latin America and the Caribbean are at risk of extreme food insecurity due to COVID-19.⁵²
• New Zealand now has only 1 active case of COVID-19 and has not had any new cases in seven days.⁵³
• Despite increasing rates of COVID-19 in the country, some areas of Brazil are easing restrictions meant to curb the spread of coronavirus.⁵⁴
• Countries around the world are reopening as infection rates and deaths slow.⁵⁵
• China has repeatedly pushed back against international calls for an independent investigation into the origins of the COVID-19 pandemic.⁵⁶
• Wuhan, the epicenter for the pandemic, is in the process of testing all 11 million residents.⁵⁷
• Oxford University has begun human testing of their COVID-19 vaccine and hopes to have it widely available by September if the vaccine demonstrates efficacy by June.⁵⁸
• As the pandemic continues, developing countries around the world are facing a global food crisis. Lockdowns and social distancing are preventing people from working and disrupting agriculture production and supply routes. More than 265 million people could be facing acute hunger, increasing from the already 135 million people who already face food shortages.⁵⁹

COVID-19 numbers sources

The New York Times may be the best source of COVID-19-related because of its interactive US map and overview of trends in states. The New York Times also includes probable COVID-19 cases. Other news sources include:

1. New York Times
   1. State and local health agencies and hospitals.
      1. Now including cases and deaths that have been identified by public health officials as probable coronavirus patients
   2. Great US map interactive
      1. Detailed state information; identifying states that are increasing/decreasing
   3. Regular updates
2. CNN
   1. Data from Johns Hopkins
   2. Great visuals of the US cases
   3. Okay timeline charts by state
      1. Y axis not standardized, may be misleading on first look
   4. Regular updates
3. NPR
   1. Data from Johns Hopkins
   2. Okay US case visualization
   3. Great timeline visualization of cases by state (heat map)
      1. Easy comparison between states
   4. Regular updates
4. John Hopkins
   1. Data from Johns Hopkins, Red Cross, Census American Community Survey, Bureau of Labor and Statistics.
   2. Very comprehensive data
   3. Visualizations are okay (overwhelming)
   4. Includes recovered
   5. Updated daily
5. WorldOMeter
   1. Official Websites of Ministries of Health or other Government Institutions and Government authorities' social media accounts
   2. Includes recovered
   3. Very comprehensive data
   4. Simple visualizations
   5. Daily
6. CDC
   1. Cases and deaths reported by U.S. states, the District of Columbia, and other U.S.-affiliated jurisdictions
   2. Not very interactive
   3. Updated daily

What is coronavirus?

Coronavirus is a family of viruses that have been known to infect humans. Viruses in the family are known to cause the common cold, SARS, and MERS. The virus that causes COVID-19 infects people and is easily spread person-to-person but is far less virulent than SARS. Cases have been detected in most countries worldwide, including the United States, and has officially been declared a pandemic, or a global disease outbreak. COVID-19 causes a respiratory disease that may be identifiable by dry coughing, breathing difficulties, and fever. Those that suspect they are infected with coronavirus should call their health provider first and should not go to a health care facility unless directed to do so.

Nomenclature

The novel (new) coronavirus, formally named “SARS-CoV-2,” and the disease it causes has been named “coronavirus disease 2019” (abbreviated as COVID-19) by the World Health Organization.

Is there a vaccine?

Moderna, who tested the first COVID-19 vaccine in humans, stated that their first trial in humans (8 individuals) appears to be safe and was able to stimulate an immune response. The next step will be to test the vaccine in 600 individuals but full scale production of the vaccine could take at least a year.⁶⁰

Vaccines must go through at least 3 clinical phases to ensure their efficacy and safety before they can be approved and used in the general population.⁶¹ Even with an expedited process it will be at least a year before a COVID-19 vaccine is fully developed and made available to the public.⁶² Johnson and Johnson will start human testing of their COVID-19 vaccine in September, to be ready for emergency use by early 2021. The vaccine would be sold on a not-for-profit basis.⁶³

What is a vaccine?

Vaccines are one of the most effective ways to prevent diseases. Vaccines are made out of killed or weakened parts of the virus or bacteria of interest. Once inside the body, the vaccine is able to stimulate the immune system to develop antibodies and thus immunity to the disease, all without the person getting the disease.⁶⁴

The vaccine currently being developed by Moderna uses genetic information, messenger RNA (mRNA), to deliver the vaccine. mRNA vaccines are an emerging platform and as of now no mRNA vaccine has reached the market. Compared to some forms of traditional vaccines (DNA-based, live/killed attenuated viruses), mRNA vaccines are thought to be safer because they are non-infectious and have no risk of potentially mutating inside the human body. Through chemical modifications mRNA is stabilized and readily enters into cells. Lastly, mRNA vaccine production is inexpensive, fast, and scalable.⁶⁵

Information highlights from CDC website⁶⁶

• Symptoms
  • Symptoms may appear 2-14 days after exposure.
    • Fever
    • Cough
    • Shortness of breath
• Mounting anecdotal evidence suggests that a loss of smell and taste are significant symptoms associated with COVID-19.⁶⁷
• Strange lesions on the toe (termed the “Covid toe”) or swollen and reddish toes may be an indication of a COVID-19 infection. This phenomenon may be an indication of a mild or asymptomatic infection or may develop several weeks after an acute COVID-19 infection.⁶⁸
• Testing⁶⁹
  • As of March 15, all 50 states, the District of Columbia, and Guam have successfully verified COVID-19 diagnostic tests in state and local public health laboratories.
  • Many states have opened “drive-through” coronavirus testing stations with more to come.⁷⁰
  • The number of tests still lags far behind need. The governors of many states have complained that the federal government’s response in making tests available has been inadequate.⁷¹

How is coronavirus spread?⁷²

• Person-to-person

Guidelines from the CDC to Minimize Chances of Infection⁷³

• Clean your hands often
• Avoid close contact
  • Avoid close contact with people who are sick
  • Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
• Take steps to protect others
  • Stay home if you’re sick
    • Stay home if you are sick, except to get medical care. If you think you may have contracted the virus call your doctor first.
  • Cover coughs and sneezes
    • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
    • Throw used tissues in the trash.
    • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
  • Wear a facemask
    • If you are sick: You should wear a facemask when you are around other people, when you go out in public, and before you enter a healthcare provider’s office. People who are caring for you should wear a facemask if they enter your room.
    • If you are NOT sick: The CDC recommends that all people who are not sick wear a cloth face covering in public settings where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies. Wearing a cloth face covering in public is especially important in areas with significant community-based transmission.
  • Clean and disinfect
    • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
    • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

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