DANIEL VAUGHAN: We can only see the past with COVID-19, which is bad for the present

We’ve re-entered the dark shadows of the coronavirus. The initial surge or wave was known for everything we don’t know.

We didn’t realize how deadly the virus was, we didn’t have tests, and the vastness of what we knew with didn’t know, combined with unknowable variables, told us we needed to shut down everything until we could figure out what was transpiring.

We know what’s going on this time. We’re running millions of tests a week, sometimes well over half a million tests a day. Drug therapies are getting released to the market while new ones get investigated, a surplus of ventilators stand at the ready, and pursuit of a vaccine is running at full throttle. We also know that the number of people testing positive is going up precipitously every day.

As a country, Johns Hopkins University estimated that by the end of May or June 1, coronavirus tests’ positivity rate fell to all-time lows of under 5%. The problem is that we’ve dramatically increased testing since then, and even still, the positivity rate has climbed above 7%.

Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute and former head of the FDA, gave an interview on CNBC’s SquawkBox saying that we’re likely only diagnosing 1 out of 10 COVID-19 positive patients. He estimates there could be as many as 200,000 to 300,000 positive cases undiagnosed, either asymptomatic or not.

And in another concerning development, a recent CDC study found that approximately one-third of COVID-19 positive patients reported “they hadn’t returned to baseline health by 14–21 days after testing positive.” That longer recovery time is terrible compared to traditional influenza, which usually only sidelines a person for two weeks.

How did we get here? If you look at the seven-day rolling average of positive cases in Johns Hopkins data, everything looks fine in mid-June. That’s important to note, because testing, hospitalizations, and deaths are all lagging indicators. They don’t tell you what is happening at the moment, but what happened in the past. 

According to the CDC on the incubation period for COVID-19: “The incubation period for COVID-19 is thought to extend to 14 days, with a median time of 4-5 days from exposure to symptoms onset.1-3 One study reported that 97.5% of persons with COVID-19 who develop symptoms will do so within 11.5 days of SARS-CoV-2 infection.”

The most severe cases, those ending up in hospitalizations and death, follow a similar path. The same CDC report found that:

Among patients who developed severe disease, the medium time to dyspnea from the onset of illness or symptoms ranged from 5 to 8 days, the median time to acute respiratory distress syndrome (ARDS) from the onset of illness or symptoms ranged from 8 to 12 days, and the median time to ICU admission from the onset of illness or symptoms ranged from 10 to 12 days.

So when tests come in, they’re telling you what was happening seven to 14 days in the past. If you were to draw a line backward from the middle of June, and the later weeks of June, that means the testing tells you what was happening that first couple of weeks of June.

Almost all 50 states were in the process of reopening by the middle of May. The early states, places like Florida, Texas, Tennessee, and Colorado, had all started opening at the end of April.

If “reckless” or opening “too early” were the reason a surge, you’d expect to see data coming in from those states far early than mid to late-June. You’d expect information on reopening to trickle by the end of May.

The unfortunate fact is that George Floyd was murdered on May 25, with protests starting soon after and growing throughout the first few weeks of June. That’s not to say the protests are the proximate cause of the virus spreading, but they are the intervening event that changed how Americans approached the coronavirus.

You could straight-up blame the protests for causing the spread. More likely, the protests caused Americans to become less strict about following guidelines like wearing masks, washing hands, and social distancing in general. We won’t know sure without some proper contact tracing that examines the causes of the new spread.

We don’t know the exact reason why the virus is spreading again. We do know we have all the tools to arrest the spread if we’re willing to stick to it. And I don’t mean a full-blown shutdown. It would be hard to convince any politician in an election year to crash the economy — again — to prevent the spread of a virus because people refuse to follow necessary hygiene procedures.

We’re back in the shadow of the corona. The only way to know what’s happening is by testing and finding out what happened in the past so we can react in the present. It’s a tall order, but we’ve proven we can slow the virus once. We can do it again. But it will take a renewed effort and social cohesion that appears, unlike our first bout with it, to be gone this time around.