COVID-19 Part 4: New York Cases Plateau, Massachusetts Surges, the Rest of the U.S. Is Relatively Flat
Much of the media continues to report absolute number of cases by location, which is misleading because a location's population matters in terms of what's known as local severity.
This is better described as case density, or the number of cases per capita. For example, if 10 out of 50 people were infected on a small grass field, the case density would be 20%. If 25 out of 500 people were infected on a larger grass field, the case density would be 5% even though there are more cases.
Therefore, even though 2.5 times more people were infected on a larger grass field, the case density would be 4 times less, and therefore the local severity would be less critical. The same is true for deaths per capita. With that in mind, here are the updated charts.
Figure 1: On a per 100,000 population basis, the rises for New York City and New York State are quite steep. When plotted with other locations, the plots of the other locations are squashed significantly and misrepresent the actual condition. Therefore, the plots of NYC and NYS have been removed for the sake of clarity. However, for the rates of change chart, NYC and NYS plots remain as they don't obscure the other plots significantly.
On the left of Figure 1, we see that Massachusetts is experiencing the largest surge in cases so far. It is said that Massachusetts may soon become the new epicenter of case growth in the US.
But to maintain perspective, NYS still carries 31% of all cases in the US and 9.9% of all cases in the world. By contrast, Massachusetts carries 5.2% of all cases in the US and 1.7% of all cases in the world. However, case density in Massachusetts has surpassed that of "The Rest of the US" (US-NYS) by more than a factor of 3, but less than half of NYS.
On the right of Figure 1, the number of daily new cases in Italy peaked on March 21st, 12 days after their lockdown with daily cases continuing to fall over the last 33 days. For NYS and NYC, the number of daily new cases peaked on April 9th, 23 days after social distancing began, and has continued to fall over the last 2 weeks.
For the UK, the number of daily new cases peaked on April 11th, 15 days after lockdown but 19 days since increasingly stringent social distancing began. This downward trend has been ongoing over the last 12 days.
For Ireland, the number of new cases peaked on April 11th but is currently escalating again. Belgium's number of new cases peaked on April 16th, but it's too early to tell if it will increase again. It looked as if Belgium was on a downward trajectory in terms of rates of change, but the country experienced a subsequent surge. The same holds true for Northern Ireland.
Sweden, like Massachusetts, is on a surge, but with much less magnitude.
Figure 2 illustrates the relative lag times between the peak of new cases and the peak of daily deaths. The arrows correlate to when the daily peak cases occurred (not the peak of deaths, although they may coincide by chance).
In general, deaths follow cases. One would expect that the peak of daily deaths for any location would arrive after the peak of daily new cases. This is true for Italy, where the peak of daily deaths occurred 7 days after the peak of daily new cases, which in turn occurred 12 days after lockdown. 19 days of lockdown were required to lessen Italy's death rate.
The UK needed 15 days of lockdown to simultaneously reduce both the number of daily new cases and the death rate. This could be because the UK may be under-testing, resulting in a delay of the peak of daily new cases.
It's also conceivable that the peak of new daily cases can arrive after the peak of the daily death rate. Further support for this notion is the fact that Ireland has a higher case density than the UK, yet the UK has a higher number of deaths per capita.
NYS required 24 days of social distancing to reduce the death rate; a reduction which occurred 1 day after the peak of daily new cases. Again, this could be due to the lack of testing. In NYC, deaths are on the rise again but to an unknown extent. The same is true for Massachusetts, Northern Ireland, Belgium, and Sweden. It's too early to tell what will happen in Ireland.
For "The Rest of the US," the death rate peaked 8 days ago, 29 days after social distancing was instigated.
Sources of data: Worldometer.com, Spectrum News NY1, New York State Department of Health, Massachusetts Department of Public Health, HSC Public Health Agency
COVID-19 - Part 3: The Inflection Point
One notices, however, that in Figure 1 for NYC and NYS, a low and flat trajectory is seen from early February and continues until March 16th, when suddenly the trajectory begins to steepen. This is called the inflection point of the curve and will be described in Figure 2.
In Figure 2, locations other than NYC, NYS, and US-NYS (US minus NYS) have been removed. Social distancing began on March 17th. Note that in prior charts, social distancing for the US was lumped with that of the UK. But, after reviewing history, the US actually began social distancing a week earlier. (This has been corrected on subsequent charts.)
Figure 2 presents milestones that show when certain measures were enacted and what the number of cases and deaths were at that time, on a per 100,000 population basis by location. The inflection point represents a small window of opportunity to make a quick decision on mitigation.
Here are the events leading up to and around the inflection point:
2/2/20: Travel ban from China
2/29/20: Travel ban from Iran, Italy, and South Korea
3/11/20: World Health Organization declares COVID-19 a pandemic
3/12/20: Travel ban from Schengen European Countries*
3/14/20: Travel ban from UK and Ireland
3/17/20: Social distancing and restrictions start
3/19/20: Travel restrictions from Japan (not shown in Figure 2)
3/19/20: Increased testing in New York (not shown in Figure 2)
As far as the other locations seen in Figure 1, we can see that Italy continues to decrease in daily new cases, Ireland and Belgium have seen spikes in new cases. Massachusetts and NY continue to see waves of new cases that overall seem to be increasing in magnitude, while the rest of the locations continue on low and flat trajectories.
New York State continues to be the epicenter of the world, with 33% of all US cases and 10% of all cases globally.
Sources of data: Worldometer.com, Spectrum News NY1, Massachusetts Department of Public Health, HSC Public Health Agency
*The Schengen Area is composed of 26 European states that have officially abolished passports and all other types of border control at their mutual borders.
The Trick To Renovating Your Bathroom In No Time
Home renovations can be a nightmare - Having to find and coordinate meetings with designers and contractors, sourcing and scheduling materials, not to mention having to sacrifice your home for weeks.
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The stress and expense of it all makes you wonder if it's even worth it. Plus, we've all heard the inflated costs that continue to increase throughout the project.
Thankfully, Block Renovation makes the process so seamless with their technology, network of contractors, and sourcing of material that you can plan your whole renovation virtually from the comfort of your couch.
With Block, you get the whole package of at home consultations (in-person or with video), architect-grade designs & drawings, materials sourcing, and a ready-to-build contractor. Their process is 3 times faster than average.
Here are 3 reasons Block Renovation is the place to go for bathroom and kitchen renovations:
Convenient
With Block, the whole process is technology based, you enter details that generates a quote online and a Block Project Planner will quickly get in touch to schedule a video consultation to see your space and hear about your objectives.Block then refines the proposal and sends it within 24 hours.
After a design session either in person or over video, your designer follows up with a package containing everything you need to get your renovation project going - design renders, building approval documents, a build manual, and a construction timeline.
Block orders and schedules the delivery for all materials needed so you don't have to source them yourself or deal with backorders like you would with most renovation projects. The contractors are all vetted and briefed on your project with an up-front timeline.
Fast
Block Renovation is 3 times faster than the national average when it comes to renovation. Their average build time for a bathroom is 4 weeks! Compared to the national average of 16 weeks, which is due to its convenient, seamless process. You can literally apply online in a few minutes, and once you send your videos and photos, they get back to you in 24 hours.
With other renovations, the estimated date of completion can change as complications arise.
Affordable
With most renovation companies, it's likely that the price given upfront is only an estimate. With lots of competition, other companies bid with optimistic numbers that can change along the way.
Block Renovation is completely clear and realistic with price. They are more accurate and reasonable with pricing because they have pre-negotiated rates with their roster of contractor partners.
Block Renovation supports you and your assigned builder from start to finish, ensuring there are no delays. This can save you more than 60 hours of personal time trying to manage and organize the whole project.
There really is no better option than Block Renovation when it comes to high-end bathroom and kitchen renovations.
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Male, Female, or X? New York City Will Add A Third Option to Birth Certificates
Along with California, Washington, New Jersey, and Oregon, NYC is moving away from pre-determined gender identification at birth by adding an "X" option to birth certificates along with "male" and "female." This is a huge step towards greater equality and dignity, not only for transgender and nonconforming New Yorkers, but for the next generation, who will now have the ability to start their lives without a label to live up to. As The Source explains, "The option could be used by parents of intersex children or by parents who want their child to be able to choose a gender at a later date," as well.
As per NBC News, "The New York City Council and Board of Health voted on Wednesday (9-12-18) to include a third gender category, 'X,' on birth certificates starting Jan. 1, 2019. Furthermore, the legislation will discontinue the need for a doctor's note or health care provider's affidavit to change one's gender marker." The bill was adopted by a 41-6 vote. This means people can also update their existing birth certificate to reflect their identity retroactively.
The proposal for this change was presented in June 2018 by Mayor Bill de Blasio and City Council Speaker Corey Johnson. Johnson stated, "This groundbreaking legislation will make New York birth certificates more inclusive for all and will send a powerful signal to the world that New York City government works for everyone."
Health Commissioner Dr. Mary T. Bassett added, "By allowing self-attestation and 'X,' the Health Department and City Council are reaffirming our commitment to the self-determination of the transgender and gender nonconforming community. We know that being able to live your authentic gender and gender expression is critical to physical and mental health. Now more than ever, we must ensure that all people can live their best and healthiest lives."
Along with California, Washington, New Jersey, and Oregon who are already on board with the "X" option for birth certificates, additional states are making strides in this direction too. As NBC News reports, "Maine, Oregon, and Washington, D.C., currently enable residents to opt for a nonbinary gender marker on their driver's license, and California will join them starting in January." Other states have gender-change laws in place, most only for male-to-female (and vice versa) updates. For a state-by-state listing, see the Intersex & Genderqueer Recognition Project's report.
"Today is a historic day for New York in its role as a worldwide champion for inclusivity and equality," City Council Speaker Corey Johnson told NBC News. Will the remainder of the country follow in the Big Apple's footsteps? From the looks of things thus far, change is contagious.
