Editor’s Note: I am getting you this thrice weekly update on COVID-19’s spread a little late as New York State’s daily report was not released until well into cocktail hour – which started unusually early, I noticed. I have also revised the data so it is now reported on Core Based Statistical Area code to allow a more granular view of areas like the Bay Area/Silicon Valley. Connecting the data to the CBSA code also allows us to analyze prevalence of the disease per 100,000 people and compare case counts to available hospital beds as reported by CMS. If you, or anyone at your firm would like to get daily updates of the data, please email Will McMahon at
Finally, we have begun hosting a 10 min call each Monday, Wednesday and Friday which is open to all clients. On that call we will update the data, call out important trends and generally give you a clear view of how COVID-19 is progressing in the US. The link to Monday’s webcast is here. We won’t be sending out multiple invites as it our practice but we will alert you earlier in the morning so you can tune in. We will also offer a replay.
The Curious Case of New York.
Last night, the US cumulative case COVID-19 case count approached 20,000. Translated into case per 100,000, that amounts to about 6.25. For context, China’s reported prevalence is about 5.8. Italy’s is staggering 77.7 cases per 100,000 while Germany, whose health care system is more similar to the US than the others, has a prevalence of 24.35. Lyme Disease has a prevalence of about 13 cases per 100,000 and for measles it is a miniscule 0.04.
However, if you look at the prevalence of COVID-19 by MSA, a high degree of variability emerges. The New York City-Newark-Jersey City MSA has a population of about 19 million people. The prevalence rate is roughly 30 cases per 100,000. However, other major Metro areas have adhered more closely to national trends with Los Angeles an outlier to the downside with about half the cases per 100,000 population.
NYC Metro represents 30% of all US COVID-19 cases. Yesterday, while total US Metro areas experienced a 21% increase in cases DoD, NYC clocked in at 33%. Seattle, the original hotspot, grew at 13% DoD.
For that subset of the NYC Metro area that is New York City proper, the cases are more or less evenly distributed in the major boroughs.
On a per 100,000 population, Manhattan is taking a greater share of the cases, followed by Brooklyn and Queens.
To better forecast the growth of COVID-19 in the New York community, we have been watching closely since late February the ER visits attributable to what the CDC calls Influenza-like Illness. ILI is characterized by a fever and a cough and cannot be diagnosed as one of the seasonal flu types. COVID-19 has similar symptoms so we have theorized that NYC’s nearly real-time record of ER visits for ILI may tell us when spread of the disease slows. This data is additionally attractive because it is not fraught with the shortages and delays now associated with COVID-19 testing and reporting.
We know thus far into the COVID-19 outbreak, that subgroups emerge in a dramatic fashion. In South Korea, the COVID-19 outbreak is strongly associated with religious observation of a particular sect. In Boston, about half of confirmed cases are associated with the BioGen Conference. In Seattle, nursing home populations played a key role.
We do not have enough demographic data to identify any subgroups that might be contributing to the explosive growth in New York area COVID-19 caseloads, but the NYC Health Department’s ILI data suggests some geographical hotspots.
As helpful as the data is on NYC, it will be difficult to apply it to the rest of the US. COVID-19 appears to be running wide-open in New York much like it is in Italy. This outcome is difficult to explain as the Mayor and Governor of New York have imposed extreme social distance requirements. SImilar restrictions appear to be paying off in Seattle and Northern California. It is a curious situation to be certain.
Call with questions and please join us Monday when we will go through regional and state impacts in greater detail.
Emily Evans
Managing Director – Health Policy
Twitter
LinkedIn
