COVID-19 Update 5.18.2020

Quick Summary

United States
• For the most part cases in the US continue to decline with a majority of states improving. The 7 day moving average of cases in the US declined to 22,861 yesterday, the lowest level since April 1st. But the rate of decline has remained very slow.
• Deaths are also falling more quickly than cases. The case fatality rate (CFR%) looks like it has peaked and may begin to decline.
• Comparing yesterday’s 7 day moving average to the 7-day moving average from a week ago, there are 12 states and territories where cases are climbing, 14 where cases are falling, and 25 where cases have been roughly flat. (An average of +30 cases was considered climbing, -30 falling). This might suggest that cases are flat. However, we are also testing far more people today and capturing what is likely a much larger share of the infected population.
• Only 5% of those tested yesterday were positive yesterday. The 7 day average is 6.4% down from 8.9% a week ago. At the present run rate we may soon run out of people to test and as the positive rate on tests continues to fall then the number of cases may begin to fall in line with the decline in deaths. At the current rate of improvement this may happen starting in another 1-2 weeks and at that time I do think we will see cases in more states begin to fall again.
• The increased testing is likely masking the rate of the improvement.

United States Forecast Summary
• The total case count forecast range in the US has increased slightly from a week ago with the ranges increasing by 100,000 to between 1,700,000-2,000,000 by mid-June. The forecast for total deaths by mid-June remains between 110,000 and 120,000.
• Projected number of deaths for August 1 remains between 130,000 and 200,000.
• The case fatality rate (CFR%) forecast has now decreased to 5.8% as the forecast now has a peak followed by a slow slight decline. So while the forecasted number of cases has increased slightly the projected number of deaths has moved to the low end of the range. They are simply capturing more cases as testing continues to climb.

International
• Global case count has remained range bound in the 66,000-100,000 range. Russia, Brazil, India, UK, Peru, and Mexico have been experiencing high case counts with Brazil hitting over 15,000 cases in a day recently. Bangladesh, Peru and other poorer and more densely populated countries have not been able to contain the virus spread and may continue to see an increase in cases. Much of South America and a fair amount of the Middle East has experienced steadily climbing case counts. South America is at more risk especially as they head into their winter. However they have kept case growth below 10% daily so their policies are having an impact on slowing the spread. But these policies are increasingly being lifted mostly as a result of their negative economic impact.
• Most developed countries have been able to cap the virus spread and ultimately reduce it. Sweden, whose economy has remained open, continues to keep cases in the 500-800 range daily.
• Hong Kong, Thailand, Taiwan, Vietnam, have nearly eliminated cases. Australia , Norway, Switzerland, South Korea, Austria, and even Denmark have reduced cases to no more than several dozen daily.
• Most developed countries which have reopened have done well with cases mostly continuing to fall. So far case growth in Austria, Czechia, Denmark, and Norway have remained low and even continued to trend lower.
• China has recently locked down over 100M people again even though their official cases have remained below 10 daily.
• A few countries are experiencing early signs of a second period of increase including Iran, but these are rare. Even Iran is not really a second wave yet, but their numbers are increasing again.
• Given the early successes so far of Sweden, Austria, Czechia, Denmark, and Norway there is increasing evidence that may be able to re-open the economy responsibly by following the frameworks demonstrated by these and other European countries. This does not suggest a total return to normalcy but instead that responsible and calculated openings can be effective.

Forecast

Very widespread improvement with most countries below 0% now. However, most countries are only marginally below 0% suggesting the improvement remains slow.  There is increased risk in Days 70+ that case growth will accelerate with all of the opening in the US. For now the base case forecast assumes ongoing moderation based on responsible individual behavior regardless of state economies opening.

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