By our way of counting, this is Day 120 of the COVID-19 pandemic. Our first USA case was identified in Washington State on Day 21 of the pandemic. In those next 99 days (14 weeks) the United States as of 2:05 P.M. on 4/28/20 had 1,004,908 known COVID-19 PCR positive infected patients and 57,812 deaths giving us a still rising death rate of 5.75%. We have 772,780 more COVID-19 positive infected patients than any other country in the world. The total number of COVID-19 positive infected patients in Spain, Italy, France, Germany and the United Kingdom is 921,450 or 83,458 fewer infected patients then the United States. By our modeling, we should reach 2,000,000 COVID-19 positive infected patients in 34.5 days (828 hours or 5 weeks).
As of 4/28/20:
USA World
57,812 deaths 215,461 deaths
1,004,908 infections 3,094,829 infections
Death rate: 5.75% Death Rate: 6.96%
One thing that concerns us is that the University of Washington’s Institute of Health Metrics said last week that we would have 67,641 deaths from COVID-19. This was updated today to a nice round number of 74,000 deaths by August. Their prediction is that we will have this number of total deaths in 93 days.
We think we have a more accurate prediction. We used two simple methods to predict the number of deaths and came up with two numbers: in 34.5 days (828 hours or 5 weeks) we should have either 56,166 additional deaths or 57,004 additional deaths from COVID-19. Therefore, I would predict that 5 weeks from today (April 28, 2020), the total number of deaths in the United States will be either 112,641 deaths or 113,479 deaths. Let’s review this in 5 weeks.
Again I’m going to leave it up to each of you to decide whether we’ve done a good job in this pandemic. Please think globally and act locally.
By our way of counting, this is Day 116 of the COVID-19 pandemic. Our first USA case was identified in Washington State on Day 21 of the pandemic. In those next 95 days (13 weeks), the United States as of 10:30 A.M. on 4/24/20 had 883,826 known COVID-19 PCR positive infected patients and 50,373 deaths giving us a still rising death rate of 5.69%. We have 664,062 more COVID-19 positive infected patients than any other country in the world. The total number of COVID-19 positive infected patients in Spain, Italy, France, Germany and the United Kingdom is 870,996 or 12,830 fewer infected patients than the United States. At our current rate of testing and rate of positive PCR tests, I would predict in the United States that we will have 1,000,000 infected patients in 103 hours (4.3 days). We could reach 2,000,000 COVID-19 positive infected patients in 41.3 days (6 weeks). Again, I’m going to leave it up to each of you to decide whether we’ve done a good job in this pandemic.
Death rate:7.67% Death rate: 6.03% Death rate: 5.69% Death Rate: 7.02%
In New York State, 695,920 PCR assays have been performed, and 271,590 tests were positive (39.02%). Only 4 countries have more infections than New York City. No other country has more infections than New York State.
As previously stated, every state, to include New York and Georgia, needs to perform more tests. Homeless shelters need to be screened and positive folks quarantined. Nursing homes and extended care facilities need to have all staff and patients screened. All hospitals should test every one of their employees. Additionally, it would be nice to give everyone an antibody test for COVID-19.
In our county we should screen and sample at least our nursing homes, extended care facilities, hospital employees, first responders (police, fire and ambulance staff), jails and prisons to identify problems before it’s too late. We should also screen our agricultural employees to include folks in our agricultural processing plants.
COVID-19 is a disease of hot spots with lots of asymptomatic transmission. A study of infections in Italy in April 2020 showed that 41% of their infections occurred in nursing homes (staff and patients), 24.7% from spread within families, 10.8% from hospitals, and 4.2% at work.
Speaking of hot spots and asymptomatic transmission of COVID-19, California Public Health officials released the following data on California skilled nursing facilities for the last two weeks:
The first week of reporting, 258 of 1224 skilled nursing facilities had one or more staff and patients with COVID-19 infections, 1290 staff were infected, and 1740 patients were infected. A little simple math shows that 33 of the 258 sites had 716 of the infected workers (average 21 workers per facility). The other 225 facilities only had 574 infected workers (average of 2 per facility). Data a week later revealed 2,099 infected staff (62% increase in one week) and 3141 infected patients (80% increase in one week). 486 infected patients have died (15.4%). No data on deaths of staff has been provided. Either incomplete data was provided by facilities the first week, or in the second week of reporting there has been a remarkable increase of infected staff and patients in skilled nursing facilities in California. The state has agreed to attempt to update the report weekly.
The scope of our problem locally is that skilled nursing facilities in our region include 52 in Santa Clara County, 16 in Monterey County, 8 in Santa Cruz County and 1 in San Benito County. Only one skilled nursing facility in Monterey County reported any infections in the first weekly report. Data is incomplete or not entered in the state report from this week.
A new hot spot of interest is one of the nuclear power plants in Georgia. The Vogtle and Hatch Nuclear Power plants in southeastern Georgia provide approximately 20% of the electrical power in Georgia. The Vogtle power plant has two functioning reactors and two new reactors under construction. 9,000 workers were on the site until April 17th when 2,000 workers were laid off due a COVID-19 outbreak. The Vogtle plant is in Burke County, Georgia on the banks of the Savannah River. Adjacent counties on the Georgia side of the river are Richmond and Columbia Counties. Across the river in South Carolina are Aiken and Edgefield Counties. Georgia has 22,147 COVID-19 positive patients and 892 deaths. South Carolina has 4,917 COVID-19 infected patients with 150 deaths. The five counties listed above have a total of 642 COVID-19 infected patients and 24 deaths. Burke County has only reported 64 COVID-19 infections and three deaths. There are at least 130 infections listed just at the Vogtle plant in Burke County below:
At the Vogtle plant, 28.0% of the tested workers are COVID-19 PCR positive. To date only 5.1% of the work force has been tested. The Vogtle nuclear power plant in Burke County appears to be an epicenter of an outbreak in five counties in two states.
Power plants and our power grid are key components of our infrastructure, and protecting their workers should also be a priority in each state, county and city. Has anyone offered testing to the workers at the power plant in Moss Landing, California?
Locally, are we squandering an opportunity to get ahead of an approaching storm?
Please think globally and act locally. As usual, please feel free to share this post.
David C. Wright, M.D. 
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