Analysis – 3 July 2020

Today looks the same as yesterday, only German numbers are a little better. 

Brazil: The nightmare continues. Daily cases are at 23 per 100K and rising. This is the second highest daily value and I fear it might be eclipsed soon. Daily death trend is now pointing up.
Outlook: Very Bad

US minus CA,NY,WA: Highest daily case value ever and numbers continue their steep trend upwards, now in the fourth week, currently at 17 per 100K. The daily death numbers are slowly rising too, the trendline is moving up towards being flat. Daily positives grew to 8.5%.
Outlook: Very Bad

California: Daily cases numbers are slightly below 25 per 100K and continue their steep rise since mid May. The deaths remain below 100 but the trendline is pointing up now. Daily positives grew to 6.9%. State scientists see no slowdown of this trend up into August. 
Outlook: Very Bad

New York: Daily case trend moved a little farther away from the nice pre-reopening decline. New cases now at 4 per 100K. Deaths are still declining nicely and daily positives remain at 1%. The latter two numbers look really good but the cases are stubbornly moving towards a plateau of around 3 per 100K. which may or may not be too high (see below).
Outlook: Bad With Hope

Washington
: It is a mixed bag. On one hand, daily positives seem to be staying away from the 5% mark (now at 4.7%), which is good. Death numbers remain relatively low but are in the same range as in Germany, which has 10x the population. I would only be happy if they were consistently below 5 per day. But worst, new cases have now reached 7.5 per 100K and are still trending upwards. Egotism runs so high in Washington that the governor had to make mask wearing mandatory when shopping. In Germany, this was never mandatory. People just do it. Out of respect for others.
Outlook: Bad

Germany: Daily case trend is going up less steeply so and new cases look as if they were to settle on 0.6 per 100K for longer. While this seems to be low enough for rebooting life and economy without severe risk, and suitable for German capacity to deal with clustered outbreaks (see below), a lower number would be obviously desirable. Deaths are very low and so are the daily positive tests (0.7%). But Germany is falling behind on the testing. 
Outlook: Satisfactory With Hope For Good

France: Daily cases have sunk to 1 per 100K but still trending up. France seems to be doing better in the testing-tracing-containing than Germany and could therefore allow itself higher daily case numbers. But I am not too convinced. Deaths are in the double digits for the fourth day. New testing data have not been published yet. 
Outlook: Satisfactory

Tunisia: Daily cases are still below 0.04 per 100K and no new deaths in 15 days. Daily positives have dropped from 0.8% to 0.7%. Tunisia and Germany have now opened travel in both directions and I could have my Tunisian friends visit me, also to escape the scalding heat wave in their country. But I do not feel safe travelling in Germany, yet. And upon their return, they might have to quarantine in their country. So we shall wait what the numbers look like in August. 
Outlook: Excellent

Remarks – On thresholds

When dieting, losing weight is easy but keeping it low is hard. 

In a pandemic, getting over the peak value is relatively straightforward (if you have the economy and the financial means for a lockdown). But keeping the numbers down is hard. For one, it takes much longer. The economy requires rebooting and so does social life. And both carry risks for viral transmission.

It was clear in March already, that the period following a lockdown would be characterised by some kind of up and down of the case numbers, reflecting some kind of trial and error in containment measures.

Germany allows up to 50 new cases per 100 000 inhabitants per week in a county (Kreis) before another lockdown is ordered (this is 7.1 per 100K per day). Compared to the current national number of 0.6 new cases per 100 000, this looks high. If applied to Germany as a whole this threshold would allow for 6000 new daily cases before countermeasures must be taken.

Based on the numbers I have been following, I would place this threshold 10x lower, which translates to around 1 daily case per 100 000 per week.

But what is a good threshold? Can there be a threshold at all?

I do not know the answer.

But we know already one factor that is important: the size of the area to which the threshold applies. When a subregion has high numbers per capita, they are in a small space where administration is closer to the people and lockdown measures can be implemented more swiftly and more accurately than in an entire country.

Other factors are a country's ability to contain a clustered outbreak (testing-tracing-quarantining). Germany is not as good as France (source), which would necessitate a lower threshold. 

Another factor is the strength of a country's health care system, which translates to beds with respirators or availability of certain drugs to help cure the diseased. Not to forget the capacity of the economy to function with social distancing. In a country like India, where millions of people depend on daily wages, a long lockdown is simply not possible.

Maybe New York's daily cases of 3 per 100K is acceptable for them. Maybe France's 0.7 per 100K is too. So perhaps when daily cases stabilise at a certain level and people are still doing fine, that level may be a sort of threshold.

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