Hedgeye - COVID-19 Update - U.S. Continuing To Spike As More Tests Come Online (3/23/20)

Editor's Note: This is a complimentary research note published by Director of Research Daryl Jones on March 18th. CLICK HERE to get daily COVID-19 analysis and alerts from our research team and access our related webcasts.

“Wisdom comes to us when it can no longer do any good."
-Gabriel García Márquez, Love in the Time of Cholera

KEY TAKEAWAYS

As more testing comes online, U.S. cases continues to grow exponentially and currently sit at 35,241 and are up ~34% in less than 24 hours (Update: now at 39,389 since we started writing)
Total global cases are at 351,731, which is up about 11% from yesterday. The reported death toll on reported cases is north of 15,000
We saw a small uptick in China, Korea, and Japan cases, but that doesn’t seem to be sustaining. China has also disclosed, more below, that they understated numbers (obviously we are all shocked!)
As of yet, no discernable trend in slowing in cases in Europe, but our expectation would be to see that soon in countries that locked down early (Italy)

U.S. Situation

Quick note: when we say we are projecting it goes without saying that we aren’t virologists and the data itself is inconsistent, we are merely reporting that data as it exists and looking at the rate of change
The U.S. count continues the path we outlined a few days ago growing at 36%+ day-over-day and should eclipse Chinese “reported” numbers later this week. The table below looks at cases grown at 36% from March 21^st through March 28^th:

As of yesterday at 4pm EDT, the U.S. had completes 227,365 tests, which was up 44,560 day-over-day. The table below looks at new tests by day, new positives by day, and trending positive rate. Obviously as tests ramp, so too should COVID-19 positives

New York State continues to be the hardest hit in the U.S. as cases surged 38% day-over-day to 20,875. NYC is the epicenter and accounts for 12,305 of the cases in the state. New York has done approximately 61,000 tests as of yesterday and a positive test rate is north of 25% (highest in the country)

Global Situation

Overall global growth rates continue to grow at 10%+ day-over-day as more and more nations continue to grow off larger bases. Below we look at the chart of global cases and daily growth since March 1^st. The data fluctuates from day-to-day, but the trend for now is relatively consistent and has averaged 10.1% for the last ten days

We are watching Europe closely for some slowing of growth rates in terms of daily infection growth. While we have heard some anecdotes, we aren’t seeing much of trend yet in the numbers. The table below looks at the key hot spots in Europe going back ten days:

On the positive ledger, the head of Germany’s public health institute said the following:

“We are seeing signs that the exponential growth curve is flattening off slightly,” said Lothar Wieler, head of the Robert Koch Institute. “But I will only be able to confirm this trend definitively on Wednesday.” Full Article Here

Most of the emerging hot spots in Europe continue to grow at 20%+ day-on-day.

COVID-19 is now in 194 countries, up 6 from yesterday

Japan, Korea, China, Malaysia Situation

After a slight uptick, which seems likely to be more timing of reporting, cases in China, Korea, and Japan maintained their low levels of new daily adds:

China 81,498 total, 82 new
Korea 8,897 total, 98 new
Japan 1,081 total, 50 new
Malaysia is at 1,183 and has 153 new cases, so continues to grow at 10% per day

As it relates to China, we see more evidence the numbers are likely not overly reliable. According to reports:

*As much as a third of coronavirus cases may be asymptomatic - SCMP

Citing classified data, the SCMP reports that more than 43,000 people in China had tested positive for Covid-19 by the end of February but were asymptomatic. They were placed in quarantine and monitored but were not included in the official tally of confirmed cases, which stood at about 80,000 at the time.

The story notes scientists have been unable to agree on what role asymptomatic transmission plays in spreading the disease. Moreover, countries differ in the way they count confirmed cases. WHO classifies all people who test positive -- symptomatic or not. South Korea also does this. But the Chinese government changed its classification guidelines on 7-Feb, counting only those patients with symptoms as confirmed cases. The United States, Britain and Italy simply do not test people without symptoms, apart from medical workers who have prolonged exposure to the virus.

A growing number of studies are now questioning the WHO's earlier statement that asymptomatic transmission was "extremely rare". A report by the WHO's international mission after a trip to China estimated that asymptomatic infections accounted for 1-3% of cases, according to a European Union paper.”