State of Affairs: August 23, 2021

Delta continues to burn through the United States like a wildfire. Today, we have an average of 42 daily new cases per 100,000 people. Cases have started to decelerate (second graph), which would normally indicate that our peak is coming soon. Delta hasn’t let up in Israel or the UK, though, so we don’t really know what the future holds.

The South continues to blow case records out of the water. Mississippi (120 per 100K), Florida (109 per 100K), and Alabama (108 per 100K) are state leaders and now have higher cases than ever before. Thankfully, the original Delta leaders (Missouri, Arkansa, Louisiana) have peaked.

Unfortunately, my prediction last week came to fruition and the Northwest is quickly becoming the #2 hotspot. Oregon (49 cases per 100K) and Washington (40 cases per 100K) are gaining speed with higher than 100% case increase in the past two weeks.


Throughout the pandemic, we’ve used test positively rate (TPR) as a reliable indicator of what’s to come. If TPR started to increase, cases would then increase. If TPR started to decrease, cases would soon follow suit. This may just not be the case anymore. TPR has been flat or decreasing since August 2, but cases continue to increase. This is probably due to two things:

  1. Vaccinated are not getting tested, and

  2. Antigen tests are gaining traction. Since July, at home antigen testing has increased exponentially (second graph). While this is fantastic, it will shift our data and the interpretation of that data.


Unvaccinated hospitalizations are just out of control. Seven states (Arkansas, Florida, Hawaii, Louisiana, Mississippi, Oregon and Washington) have hospitalization levels that have exceeded their previously highest peak. Orlando Utilities Commission has even asked residents to conserve water to help hospitals. Oxygen is used to purify water, but right now they need oxygen to treat hospitalized COVID-19 patients.

Projections from the CDC show that hospitalizations, on a national scale, won’t slow down anytime soon. This makes sense because hospital trends lag case trends by 3-4 weeks.


201 million Americans now have at least one dose. There’s a lot of work still to be done among certain groups, though. Republicans are the least vaccinated (54%) followed closely by 18-29 year olds (57%).

Breakthrough cases

As of August 9, 8,054 patients with COVID-19 vaccine breakthrough infection were hospitalized or died.

Because the CDC doesn’t track mild and moderate breakthrough cases, we continue to be dependent on local jurisdictions. In Oregon, unvaccinated cases continue to dominate the count compared to vaccinated.

Interestingly, Israel started a third dose for 60+ year olds on July 30. The impact on breakthrough cases is hopeful. Exactly two weeks after the start of third doses, break through cases among vaccinated started decreasing while cases among unvaccinated continued to increase. It will be interesting to see how the new policies impact United States and the UK case numbers in the coming weeks.

That’s all for now. Stay safe out there, YLE