POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..”

“One of the first states to receive rapid, low-cost coronavirus tests from the U.S. government is cautioning against their use in asymptomatic people, a group that were hoped to benefit most from the technology.”

How Johns Hopkins tracks Coronavirus cases: “ systems engineering, a modernized approach to civil engineering for the complex, interconnected world.”

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“The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began, bursting past a grim threshold even as the wave of infections engulfing the country shows no sign of receding.

The total count of new infections on Wednesday was more than 107,800, according to a New York Times database. Twenty-three states have recorded more cases in the past week than in any other seven-day stretch.

Five states — Maine, Minnesota, Indiana, Nebraska and Colorado — set single-day case records. Cases were also mounting in the Mountain West and even in the Northeast, which over the summer seemed to be getting the virus under control.

North and South Dakota and Wisconsin have led the country for weeks in the number of new cases relative to their population. But other states have seen steep recent increases in the last 14 days.

Daily case reports in Minnesota, on average, have increased 102 percent over that time, while those in Indiana have risen 73 percent. For months, Maine had among the lowest levels of transmission anywhere in the country, but new cases there have more than tripled. In Wyoming, new cases are up 73 percent, while in Iowa they have more than doubled.

Deaths related to the coronavirus, which lag behind case reports, have increased 21 percent across the country in the last two weeks.

Hospitals in some areas are feeling the strain of surging caseloads. More than 50,000 people are currently hospitalized with Covid-19 across the country, according to the Covid Tracking Project, an increase of roughly 64 percent since the beginning of October.” (A)

“One of the first states to receive rapid, low-cost coronavirus tests from the U.S. government is cautioning against their use in asymptomatic people, a group that were hoped to benefit most from the technology.

Antigen tests like one from Abbott Laboratories that look for telltale viral proteins may miss some infections that can be picked up by costlier gold-standard assays, and can incorrectly return positive results. The rapid tests aren’t recommended for people without symptoms who haven’t been exposed to a Covid-19 patient, and those who undergo one should be informed of the limitations, the Louisiana Department of Health said in guidance issued last week.

The recommendations highlight issues with tests like Abbott’s $5 BinaxNOW that the U.S. Department of Health and Human Services is spending $750 million on and were used in the White House. State health officials are increasingly concerned that people without symptoms should be screened with more costly but more reliable polymerase chain reaction assays because of worries about the rapid tests’ performance, according to Jeff Engel, a senior adviser at the Council of State and Territorial Epidemiologists.

HHS “made this purchase without any studies on the novel use in which they’re deploying these tests,” Engel said. “I think that’s careless.”

HHS is providing antigen tests for use in symptomatic and asymptomatic people, said Mia Heck, an agency spokeswoman, in an email. Widespread, affordable rapid antigen testing helps slow the virus’s spread, and tests like BinaxNOW, when used as intended, can detect those most likely to be infectious, Abbott said in an email. Its shares gained 3.6% at 12:51 p.m. in New York.

The U.S. Food and Drug Administration also issued an alert on antigen tests, warning on Tuesday that they can produce incorrect positive results. Problems are more likely in populations with low virus prevalence, or when the test is improperly performed, the FDA said in a statement.” (B)

“Less than a month into 2020, Ensheng Dong heard the news. A new viral contagion, SARS-CoV-2, had begun to spread in Wuhan, the capital of China’s Hubei Province. Dong, a graduate student at Johns Hopkins University in Baltimore, was thousands of miles away from the outbreak’s epicenter, but he had studied epidemics and knew how fast they can spread.

Taiyuan, another provincial capital and Dong’s hometown, is 600 miles from Wuhan. That’s not exactly next door—it’s the same distance that separates New York City and Detroit—but Dong felt concerned for his family’s safety.

On January 20, the first case of COVID-19 in the United States was confirmed in Washington state. Suddenly, the coronavirus—for Dong—seemed that much closer.

The following day, Dong met with his faculty adviser, Lauren Gardner, co-director of the school’s Center for Systems Science and Engineering. They discussed the emerging epidemic and decided it was worth a closer look.

Gardner suggested that Dong use a geographic information system (GIS) to construct an online dashboard, a visualization tool that uses maps and data to monitor unfolding events.

Dong nodded. “That’s my plan.”

Dong, 30, studies systems engineering, a modernized approach to civil engineering for the complex, interconnected world.”

“The emphasis is on civilization engineering,” Dong said. “It’s basically about the interaction of people with the built environment.” For Dong, the discipline allows him to explore ways to combine the objectivity of numeric data with the subjectivity of data visualization.” (C)

• A.U.S. Records 100,000 Cases in a Day for the First Time, https://www.nytimes.com/live/2020/11/04/world/covid-19-coronavirus-updates?referringSource=articleShare
• B.Caution Arises on Rapid Covid Tests in Asymptomatic People, By Emma Court, https://www.bloomberg.com/news/articles/2020-11-04/caution-arises-on-rapid-covid-tests-in-asymptomatic-people
• C.COVID-19: Inside Look at the Johns Hopkins Dashboard, Keeping Tabs on the Virus, by Greg Milner, https://www.esri.com/about/newsroom/blog/how-researchers-built-johns-hopkins-dashboard/

Contemporaneous Case Study methodology

Jonathan M. Metsch, Dr.P.H.