State of Affairs: August 9, 2021

Well, things continue to worsen in the United States. Cases are exponentially increasing and we are now averaging more than 100,000 new cases per day.

Unfortunately, on a global scale, countries that seemed to peaked with Delta are increasing again. What this means for the United States is unclear.

Every state has increasing trends, but the South continues to differentiate itself from the rest of the country. Louisiana has the highest case per capita in the world (99 cases per 100,000).

Thankfully, we may be coming to a peak for some early leaders. Acceleration is getting slower and slower in places like Louisiana and Missouri. Nevada even plateaued. (notice below is the log graph- so this shows how quickly cases are changing, not raw number of cases).


All states have “substantial” (orange) or “high” (red) transmission in the community. We no longer have any states with moderate or low transmission. 73% of counties are in “high” transmission. Everyone needs to be wearing a mask indoors.


And we just aren’t testing enough. As a nation, our test positivity rate hit above 10% last Wednesday which means far too many people don’t know they’re positive. Interestingly, TPR plateaued before the weekend, so this may be an early sign that wave 4 will peak soon. TPR has consistently been an early sign of what’s to come. But, and importantly, this assumes consistent behavior. Schools open in Texas today, and across the country soon, which will change the game.


Hospitalizations in the 4th wave are higher than Wave 1 and 2 peaks. It’s incredibly clear that the national average is differentially influenced by states. States with low vaccination rates continue to have the highest hospitalization rates. Notably, Florida has a hospitalization rate higher than any previous wave.

Kids are getting swept up in this wave

Child hospitalizations are the highest they’ve been during the whole pandemic. And increasing fast. In the hardest hit area (HHS Region 4- which includes Florida and most of the South), pediatric admissions continue to be lower than other age groups, but the sharp uptick of 500% in July is notable (second graph).


I was very curious to see how deaths would be impacted given that 80.4% of 65+ years are fully vaccinated. Unfortunately, deaths are starting to rise (yellow line) but certainly not at the rate it did in Waves 1-3 in relation to new cases (blue bars). This means the vaccines are largely protecting the most vulnerable from mortality, which is fantastic news.

Breakthrough infections

As of August 3, 7,525 breakthrough cases have been hospitalized or died. We continue to have no idea how many mild and moderate breakthrough cases there are. On a local data, like San Diego, things continue to look great. Like Dr. Eric Topol stated, “I’ll take the 1:10 odds for vaccinated : not vaccinated”.

That’s it for now.

Have a safe week, YLE