COVID-19 Part 4: New York Cases Plateau, Massachusetts Surges, the Rest of the U.S. Is Relatively Flat
COVID-19 updates from a Harvard physician.
By Anthony Lee, MD
Faculty, Harvard Medical School
As we make our way through this pandemic, the large number of cases in the United States has caught our attention and prompted much discussion. In Part 4 of this series, we examine the latest trends in cases and deaths in the 10 locations we've been following.
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
The very small window of opportunity to close down the country
By Anthony Lee, MD
Faculty, Harvard Medical School
As we make our way through this pandemic, the large number of cases in the United States has caught our attention and prompted much discussion. In Part 3 of this series, we will delineate the events that have thus far unfolded for the United States.
In Parts 1 and 2 of this series, we plotted cases and deaths on a per 100,000 population basis. In Part 2 we added "The rest of the US" as a location, represented by "US-NYS" to illustrate that outside of New York State, the US is doing relatively well compared to NYS and other parts of the world.
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.
Block Renovation's got you covered.
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.
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:
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.
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.
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.
From Cardi B to Hamilton to Queen Bey herself, here are ten songs that have inspired and soundtracked the ascensions of female politicians and powerful women of the modern world.
If it wasn't clear from Alexandria Ocasio-Cortez's recent Twitter battle with Cardi B and Tomi Lahren, we're living in an era where politicians and musicians have the ability to influence each other on huge scales.
But music has long been a source of inspiration and power, especially for women or other people whose voices have been subjugated or silenced.
In honor of the newest class of women in Congress, and in celebration of women in politics in general, here's a list of ten songs that we think would make the perfect soundtrack to their ascensions, and might even inspire you to follow suit.
1. Cardi B – Best Life
Cardi B - Best Life feat. Chance The Rapper [Official Audio] www.youtube.com
The song's lyrics seem to align with Ocasio-Cortez's approach to communicating with her supporters, which has been radically honest and personal, as she frequently shares developments at work and at home via her Instagram stories. Though she was met with backlash from users who told her to "write intelligibly," Ocasio-Cortez's supporters cheered the reference.
Unabashedly outspoken and proud of their stratospheric rise to the top of their respective fields, Ocasio-Cortez and Cardi B are two women who seem to be on unstoppable paths—while determined to keep it real all the while.
2. Anaïs Mitchell – Why We Build the Wall
Anaïs Mitchell ft. Greg Brown - Why We Build the Wall www.youtube.com
When folk singer Anaïs Mitchell penned "Why We Build the Wall" in 2006 for her concept album Hadestown, she never imagined that its lyrics—which retell the story of the Greek god of death Hades and his quasi-American capitalist hellscape—would become so relevant.
The song is a call-and-response narrative between Hades and his citizens, who work ceaselessly on a wall in exchange for the economic security that living in Hadestown provides. It contains lyrics like, "The wall keeps out the enemy / and the enemy is poverty / and we build the wall to keep us free / that's why we build the wall." Hadestown, which also tells the story of Orpheus and Eurydice, is coming to Broadway in the spring of 2019.
This song seems like it would make the perfect satirical rallying cry for Nancy Pelosi, who denounced Donald Trump's request for $5.7 billion to build his wall between the U.S. and Mexico after his speech on January 8th, two weeks in to what would become the longest government shutdown ever.
3. Aretha Franklin – Respect
Aretha Franklin - Respect  (Original Version) www.youtube.com
Aretha Franklin passed away in August of 2018, but her legacy lives on within every woman who ever wanted to be treated with honor and—as perhaps her most iconic song repeats—R - E - S - P - E - C - T. (Hint: that's all of us).
Aretha's unforgettable voice soars above the song's infectious musical backdrop, coalescing to form a track that is alternatingly prideful and enraged, hopeful and world-weary. This song's message seems too vast to be contained to one politician or time period. It's a timeless sentiment that could change the world, if we'd only listen.
4. Ms. Lauryn Hill – Everything is Everything
Lauryn Hill - Everything Is Everything www.youtube.com
In June, recently-announced 2020 presidential candidate Kamala Harris posted a Spotify playlist as a homage to important black musicians of the 20th century. The third song on the playlist, "Everything is Everything" from the iconic The Miseducation of Ms. Lauryn Hill, echoes sentiments that Harris has proclaimed in her own speeches.
Its powerful lyrics, "Sometimes it seems / We'll touch that dream. But things come slow or not at all / And the ones on top, won't make it stop / So convinced that they might fall," seem like they could be a rallying cry for Harris, a politician campaigning on promises of "American values" and "not putting people in boxes."
Hill's message of everything is everything is a beautiful sentiment about the way that all people and all issues are interconnected and cannot be addressed independently, and she has long been a powerful voice for women of color.
Kamala Harris's work as a prosecutor is under scrutiny from leftists everywhere, but judging by her playlist, at least her music taste is up to par.
5. Lin-Manuel Miranda – Satisfied
Female characters take the backseat to the titular protagonist of Lin-Manuel Miranda's Hamilton, but Angelica Schuyler's Satisfied is a show-stopper in a class of its own. Sung by the sister of Eliza, Alexander Hamilton's wife, it is a flashback to the night that they all met, when Angelica developed feelings for Alexander but decided she needed to set her sights on marrying someone richer.
Angelica, played by Renée Elise Goldsberry in the musical, spits some of the show's fastest bars and hits some of its highest notes in this virtuosic performance, which reveals the extent of her brilliance as well as the extent of her regret at not taking a chance on love.
It might be easy to dedicate this song to Hillary Clinton, whose tenacious determination to win the presidency and refusal to be satisfied with a mere first-ladyship (or Secretary of State position) does belie a similar ambition to Angelica's.
But Angelica, with her razor-sharp wit and social sensibilities, seems similar to some of Congress's outspoken freshmen members, such Ayanna Pressley, who has been an outspoken critic of Trump and many of his policies from her first moments on the House floor, running on the message "Change can't wait" with an urgency evocative of Angelica's intense drive.
6. Taylor Swift – Bad Blood
Taylor Swift - Bad Blood ft. Kendrick Lamar www.youtube.com
Taylor Swift has had her fair share of beef with other artists, but until 2018 remained staunchly apolitical. But after Swift announced in an Instagram post that she "could not support Marsha Blackburn," the politician lashed out—provoking serious flashbacks to the time that Taylor Swift allegedly attacked Katy Perry over a feud involving backup dancers through her video, Bad Blood.
The stakes were slightly higher in this situation, and Blackburn still snagged the Senate seat in spite of the star's opposition.
"Of course I support women and I want violence to end against women," said Blackburn in response to Swift, who had also written that the politician's "voting record in Congress appalls and terrifies" her. Blackburn has been a supporter of Trump's border wall as well as his efforts to end Obamacare.
7. Questlove's Entire Michelle Obama Playlist
Michelle Obama's Musiaqualogy Vol 1 1964-1979 by Questlove
Michelle Obama's Musiaqualogy Vol 2. 1980-1997 by Questlove
Michelle Obama's Musiaqualogy Vol 3. 1997-2018 by Questlove
The musician Questlove of the band The Roots has created three 100-song playlists for Michelle Obama's Becoming book tour, and every song is worth putting on repeat. Entitled The Michelle Obama Musiaquology, it is a journey through time (and occasionally, space) filled with mournful, fierce, and empowering tracks—much like the biography it was designed to soundtrack.
Obama's Becoming is more about hope and unity than it is about politics and division, and so are most of the songs in this playlist. An exuberant melding of jazz, pop, and the occasional stylistic outlier, Questlove's compilation elevates voices of joy, pride, black power, and solidarity in an era in desperate need of them. Featuring icons ranging from Ella Fitzgerald to Kendrick Lamar, it's a survey of music throughout history that has given hope to those who need it most.
8. MILCK – I Can't Keep Quiet
MILCK - Quiet www.youtube.com
Newcomer MILCK's powerful composition became the anthem of the first Women's March, and since then, the artist has continued to release waves of meaningful music while maintaining a confessional and motivational social media presence.
The vulnerable and passionate song that made her famous could be an anthem for kids like Emma Gonzalez, speaking out against gun violence, and for all the other women who have spoken and will continue to reach out and fight for their beliefs.
9. Against Me! — True Trans Soul Rebel
Against Me! - True Trans Soul Rebel [ALBUM VERSION] www.youtube.com
In the shadows of the Trump administration's ban against transgender people in the military, this song is a reminder that trans people not only exist but will continue to fight.
Transgender politician Christine Hallquist did not win in the general Vermont elections for governor, but she did secure a spot in the 2018 Democratic primaries, the first time a transgender person has been nominated by a major party. And more transgender and LGBTQ people ran and won races in November 2018 than ever before, signaling an upswing of pride in spite of the Trump administration's anti-trans policies.
Against Me!'s True Trans Soul Rebel has long been an anthem for the transgender community, an outcry of pain against a world that constantly threatens them with erasure.
10. Beyoncé – Who Run the World (Girls)
Beyoncé - Run the World (Girls) (Video - Main Version) www.youtube.com
No list of songs for female politicians would be complete without Queen Bey's presence. This song is one of the crown jewels of feminist anthems, with its infectious beat pounding underneath Beyonce's velvety vocals and its iconic refrain. This one goes out to all the future female politicians, including the hopefully soon-to-be first female commander-in-chief.
With that, we welcome the 42 new female congresswomen, celebrate the women who came before them, and encourage all the women and trans people coming after to rise up and sing out. Listen to these songs enough and internalize their messages, and it could be you in those seats someday.
Eden Arielle Gordon is a writer and musician from New York City.
Come Jan. 1, 2019, the non-binary marker will become a NYC milestone
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.
Earlier today, seven members of the NYPD were arrested, one of whom is a retired vice detective. The vice detective, who is married to a prostitute, teamed up with his wife to start two brothels, one in Sunset Park, Brooklyn and one on Roosevelt Avenue in Queens. As a result, there are 30 other officers currently under investigation by the Department of Internal Affairs.