Much of the feedback from my recent blogs involves asking me what I believe will happen with the pandemic in the U.S. There are a number of websites and news organizations claiming that there is “uncontrolled spread” of the virus in most states. When I look at the data, the most reasonable conclusion is no one can really say that.
The overall CDC data, which I have been posting for the last couple of days, reflect an increase in infections without consistency across all states and counties. Again, this may be due to differences in reporting.
I heard Scott Gottlieb this morning on Face the Nation and he’s fairly confident that there is an overall increase in infections. He showed data from the American Enterprise Institute (AEI, where he works). It does seem to show a slight increase in hospitalizations across the country although it is muted compared to infections. It also appears that certain counties, especially rural counties, are having new outbreaks for the first time.
When you examine the AEI data by state and examine the county by county risk factors, however, they are remarkably variable. Looking simply at my own state of Michigan, the risk factors for infection in different counties appear to be variable because they are based on great differences in the number of people tested and infected. Most other states have similar variability.
Therefore, there is a concern that cases are increasing across the country with an increase in hospitalizations in some areas; but this is not seen uniformly. There also has not been an increase in deaths as of yet, although this may be delayed. None of this tells us anything about the potential size or severity of a potential “third peak.”
This phenomenon is not new. Everyone should remember that the “summer peak” was mainly localized to a few states and local areas within these states.
All of this certainly does not mean that people don’t need to wear masks and be very careful. Please avoid large, dense crowds and events that could cause significant spreading of the infection. Do these things regardless of any current trend in infections.
My recommendation to my friends and colleagues who are concerned: continue to take care as you go about your daily activities, but don’t be consumed by the fear that there is about to be some incredible COVID-19 outbreak in your neighborhood.
Pandemic Pondering 
Would you speak about families gathering at Thanksgiving? — I know Fauci said his kids won’t come, but they’d be traveling from out of state. What about small families who live in the same community? We’ve been able to gather outside during the summer, but Thanksgiving outside in Michigan doesn’t seem likely.
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Depends on credibility of family members. If the college students hit the bars the nights before thanksgiving, a traditional event in some places, it would be concerning. If your family is careful and the background testing positive rate is low (currently 3% in Ann Arbor) should be ok. Might distance at dinner or keep windows opened for ventilation if concerned. We bought patio heaters and may eat on the deck if we invite outsiders.
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