To kick things off, here are my latest graphs for the Washington State COVID-19 positivity rate. The positivity rate is the daily percentage of positive COVID-19 tests. Like the daily new case count, we’re hoping to see a downward trend over time as community mitigation (AKA “social distancing”) slows the effective infectiousness (R_EFF) of SARS-CoV-2.

The first graph is based on data from the Washington State Department of Health (DOH). DOH aggregates data across the entire state. Data for most recent days are incomplete and I have not included partial results in the graph.

The second graph is based on data for the University of Washington (UW) Virology Laboratory. The UW chart is up-to-date because they don’t have the same aggregation and reporting responsibility as DOH. For UW, it’s specimens in, and test results out. The UW results are sent to DOH where they are eventually folded in.

Both graphs show a steady decline. In terms of positivity rate, we’re back to where we were in mid-March. The peak occurred around March 28.

SARS-CoV-2 is still circulating in the community. I think Governor Inslee has made the right decision to go slow on “re-opening.”

The positivity rate is an imperfect indicator of the actual infection rate in the general population. Given the total number of confirmed cases (14,327) and assuming that ten times as many people are actually infected (143,000), that’s an overall infection rate of 2%. Normally, a disease doesn’t slow down until the infection rate is 50% to 60% (so-called herd immunity). Two percent is insignificant and SARS-CoV-2 could easily “burn” through the population if it is left unchecked.

Are we heading toward 1918, again?

The Centers for Disease Control and Prevention (CDC) site has an extensive section about the 1918 influenza pandemic in the United States. The pandemic was caused by an H1N1 virus. The disease was first identified in the United States during the spring of 1918, eventually killing 675,000 people in the U.S. The number of deaths worldwide is estimated at 50 million people.

Due to poor record keeping and other factors, a true accurate tally of infections and deaths is not possible. All figures are estimates.

If you’re at all familar with recent events in the United States, the 1918 pandemic timeline should make your hair stand on end.

• March 1918: Outbreaks of the flu are first detected. This is the beginning of the first wave.
• April 1918: Cases and deaths are reported by public health officials.
• Summer 1918: The first wave crests and declines.
• September 1918: The second wave emerges.
• October 1918: 195,000 Americans are killed by the virus during October alone.
• November 1918: The fatal second wave subsides. America celebrates World War I Armistice (parades, etc.) setting up a third wave of infection.
• December 1919: A third wave begins.
• April 1919: The third wave subsides.

The second wave was the most deadly wave and was responsible for most of the losses in the U.S. The timing is eerily similar to the COVID-19 outbreak in the U.S.

The graph below illustrates the lethality of the three waves (as measured in the United Kingdom).

Barely two months into the COVID-19 pandemic, seventeen states are reopening partially and six states are lifting orders or reopening soon. [The New York Times, May 1, 2020] Some of the states have not satisfied the WhiteHouse/CDC gating criteria for reopening.

I fear that this is too soon to declare victory or to even imagine a return to a normal (pre-pandemic) state of affairs in one or two months. Dr. Anthony Fauci (NIH), Dr. Robert Redfield (CDC) and other health officials have warned about a second wave in Fall 2020. Be assured, SARS-CoV-2 will continue to circulate in the population during the summer months just like the 1918 H1N1 influenza virus. The American populace is just as vulnerable to an COVID-19 outbreak as it was in January 2020.

I genuinely hope and pray that we haven’t set outselves up for an extremely fatal second wave of COVID-19. Are we doomed to repeat history?

Stay the course and stay healthy — P.J. Drongowski