US COVID cases continue to rise sharply. Testing has also risen, but an increase to 10% positive test rates show that this is not simply about more testing. While there’s been a slow down in the percentage growth of confirmed positives that could be a leading indicator of a peak in daily new cases, Thursday’s numbers put a wrench in what had been a promising trend. A peak for daily new cases in the wake of Thanksgiving is still possible, but in the meantime millions of new cases will emerge. At a lag, hospitalizations will follow. Adjusted for the population of states reporting hospitalizations, hospitalization rates have reached new records. Like clockwork, deaths are following. Almost 2,000 Americans died yesterday, and at a lag to cases and then hospitalizations, the trend is accelerating. We update these charts and the analysis that goes with them every morning in our pre-market report The Morning Lineup.  Click here to start a free trial to Bespoke Institutional and receive our daily Morning Lineup for the next two weeks, featuring more commentary and data on macro markets.

Switching to a granular look at states, below we show a table of state deaths, cases, tests, and positive test rate. We adjust for population on the right side of the table to make comparisons across states like-for-like. One note on positive test rates and test counts: some states under-report the actual number of tests run, so not all of these numbers can be taken at strictly face value. This table is still quite useful in seeing where testing, cases, positive test rate, and deaths sit across the country for the period ending on November 19th.

Another way to look at state performance is to compare tests over time. In the table below we show state 7 day average daily positive tests indexed to their peak (which in most cases is the current level). This allows a view of where the pandemic is currently worst versus the last six months. This helps to illustrate the national breadth of this massive increase in new cases currently underway.

We have a similar chart for hospitalization rates. Hospitalization rates are not subject to vagaries of test counts, and while they tend to lag new positive tests as an indicator of COVID’s spread, they are closer to real-time than deaths, which lag hospitalization rates. As shown, a number of states have over 400 people hospitalized per million population, and in all but a very few cases, hospitalization is rising, mostly quite quickly. Anything under a few hundred hospitalizations per million population isn’t a sign of stress on health care systems, but above 300-400 hospitalizations per million, states generally start running out of beds. Surging resources can help, but there are practical limits on how many people can be hospitalized at once. With new cases continuing to accelerate, this is a bad sign, because hospitalizations tend to lag new case counts.

Below we show charts of new cases relative to population for a variety of regions and countries across the world at large. European cases spiked just ahead of the US. That includes Sweden, which introduced restrictions for the first time this fall amidst rising hospitalizations. We update these charts and the analysis that goes with them every morning in our pre-market report The Morning Lineup.  Click here to start a free trial to Bespoke Institutional and receive our daily Morning Lineup for the next two weeks, featuring more commentary and data on macro markets.

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