In this week’s review of the COVID-19 infection statistics in the United States we see an interesting phenomenon. While the infections have been dropping over the past month, they appear to be stabilizing at a higher level than in the pre-Memorial Day trough.
The reasons that these numbers have stopped falling may be that multiple. Individuals had hypothesized that there would be an increase in infections after Labor Day similar to the increase seen after Memorial Day in June. It will be important to determine if this is a stabilization in new infections or if a new peak is developing.
Several other reasons have been suggested for a possible increase at this time. Many have hypothesized an increase in infections this winter as people spend more time inside. While it would seem early for this phenomenon, it could be happening as summer outdoor activities wane. Also, the return to school (especially to colleges) has triggered a number of outbreaks throughout the country. This may be important at this point in time since it’s roughly a week or two after most schools reconvened.
In accordance with the end of summer decrease in infections, there has been a general increase in the R0 values in many states over the numbers of a month ago. As seen below, 11 states now have R0 values greater than 1.1, and the number of states with R0 values below 1.0 is less than half (22). This also seems to indicate that overall there is greater infectivity in the population than has been seen over the last six weeks.
We need to watch these numbers carefully. While individual states such as AZ have decreased their infection rates without lockdowns, if the number of infections start to increase, we may require more aggressive enforcement of mask ordinances and other measures to ensure health care facilities are not overwhelmed as happened in the early spring.
One bright spot — deaths continue to remain low compared to infections. At this time this finding really does suggest we are providing better care for COVID-19 patients.
Pandemic Pondering 
Your commentary continues to be high quality work with rigorous objective insight. I am curious regarding the point about improving means of treating infections. I talked to a friend who is a general surgeon at a rural South Carolina hospital. He noted another observation : the cases presenting at his small hospital seem to be reducing in severity . Can you be on the lookout for similar observations and comment in a future post?
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Potentially younger and less debilitated patients. Also appear to be getting care sooner due to better screening. Let me know what he/she thinks.
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