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Making Sense of the (Happy) Mystery of the Declining COVID Death Toll

One of the true mysteries of this stage of the COVID Crisis in the United States is why the death toll from the disease continues to fall, albeit slowly, even after months of plateaued cases and weeks of rapid case growth in most of the country. The White House has glommed on to this disjuncture in a highly dishonest and opportunistic way. But that doesn’t mean we shouldn’t try to understand what’s happening on its own terms.

It is helpful to distinguish between two issues.

The first is the range of potential reasons why fewer people may be dying of COVID or becoming severely ill even though more people are getting it – even taking into account more testing. I want to devote another post to making sense of potential reasons for this. They are a variety of factors including the age profile of people getting infected, an improved standard of care, perhaps even people becoming infected with less intensive exposure.

Again, we’ll come back to those in another post.

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Where Things Stand: An Endless Quest For Leakers
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The pattern has become pretty predictable.

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On the Schools #1

From TPM Reader JS on the whether the schools should reopen in the Fall …

I’m a high school teacher. I teach math in a rural, Title I school. I have very conflicted feelings about the re-opening, but I can tell you there is a very vocal portion of my colleagues that feel like being sent back this fall is being treated like cannon fodder (check out /r/teachers for example). I disagree with that and I think between masking and the mounting evidence that children are weaker vectors, makes the situation more manageable. I’m also a parent I know that my kids need to do something soon or they are going to be damaged for life, not just due to lost learning (something in my household that isn’t as big of a problem) but due to the isolation.

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School Reopening and Magical Thinking

We’re now down to little more than two months before school starts in most of the country and a great many districts, if not necessarily most, are yet to announce definitive plans for how they are going to conduct school in the Fall semester. Indeed, the entire subject of school closures and openings is another example of a country trapped in magical thinking, yet another permutation of the “reopening” debate.

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Where Things Stand: Maybe He’s Sort Of Listening
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As we flagged earlier this morning, attendees at President Trump’s upcoming rally in New Hampshire will be “strongly encouraged” to wear masks even though President Trump has thus far refused to wear one in public.

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Watch Out, New York

After being the center of the cataclysm, New York State and New York City have become a great COVID success story, showing what’s possible with an aware public, aggressive mitigation and robust testing. But we may be seeing the first hints that the national trends are catching up with this.

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Curbside Only, Folks

One of the many ancillary insights or interesting developments during the epidemic is the creative use of anonymized big data to learn to things about the outbreak. Mobility data tied to cell phone and mapping apps is one example. Not too long after the outbreak began they started surfacing some of their trove of mobility data for people and public officials making public health decisions. (If you haven’t seen it, check it out here.) Credit card use is another. JPMorgan Chase just released a report based on their own credit cards which suggests a strong correlation between “card present” restaurant purchases and new outbreaks.

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Where Things Stand: Keep An Eye On Azar’s Travel
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Even though the White House has cut off its coronavirus task force briefings in order to pump up President Trump’s political aspirations, most Americans are acutely aware of which states are experiencing massive COVID-19 spikes.

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Explosive and Out of Control

The COVID infection numbers from yesterday and indeed since early June are ominous and harrowing. As we note here yesterday was another big record. They are best absorbed visually. Here are the case counts from early March with the original epicenter of New York separated out from the rest of the country.

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Stop Talking About “Reopening”
TAMPA, FL - JUNE 26: Zack Vermes a bartender at  Carmine’s Ybor Italian restaurant wipes off the bar while awaiting patrons on June 26, 2020 in Tampa, Florida. Florida has suspended the consumption of alcohol at bars amid a surge in the positive coronavirus cases according to a tweet by Halsey Beshears, the secretary of the state Department of Business and Professional Regulation on Friday.  (Photo by Octavio Jones/Getty Images)

From the start of the COVID epidemic we’ve been talking about “reopening”, when it would happen, whether it is safe. The President started demanding it about two weeks into the crisis – the churches needed to be full on Easter, the 12th of April. Now we talk about which states have reopened and which haven’t. It’a all wrong. From the start this metaphor has saddled us with distorting language and a distorted concept which has enabled and driven bad policy. It suggests a binary choice when one doesn’t exist. The impact goes beyond semantics.

There is no opening or closing and there won’t be until we have a vaccine or a very effective cure for COVID. There are various mitigation strategies. Does the state push or mandate widespread masking? Does it permit indoor dining? Are bars open? Has it scaled sufficient testing capacity and a robust contact tracing program? The devil and the death toll are all in this particulars. The ‘reopening’ metaphor obscures all of this.

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Where Things Stand: Here Are The Admin Officials Who Don’t Want To Give You Daily COVID Info
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White House chief of staff Mark Meadows, senior adviser Jared Kushner, White House press secretary Kayleigh McEnany and counselor to the president Hope Hicks, for starters.

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Where Things Stand: The GOP’s Embarrassing Mask Prodding
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At this point, multiple Republicans and Trump allies have done their damnedest to quietly nudge President Trump on masks — all without actually calling him out for it.

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Reading John Roberts

TPM Reader JO, a lawyer, reacts to this morning’s Supreme Court decision on stare decisis (and abortion, of course!):
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Shoeless In St. Louis

TPM Reader BL writes in to offer a clarification on the gun-toting couple in St. Louis. It’s potentially important context in a legal sense, but in the larger context I’m not so sure that armed residents of a Gilded Age knockoff of an Italian Renaissance palazzo defending their own private street patrolled by private security guards changes the essential meaning we can draw from this cartoonish encounter:

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Where Things Stand: We Should’ve Known A While Ago That Kavanaugh Can’t Be Trusted
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Back in the days of now-Justice Brett Kavanaugh’s contentious Senate confirmation, the Washington Post killed a story that could’ve exposed a striking example of Kavanaugh’s public disingenuousness.

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New Data Source

Here is a new source of COVID data I want to share with you: outbreak.info. There are a lot of these sites and I try to dig into just who is running them and what standards they’re using for their data. This one appears to be the work of a team headed up by Andrew Su at the Scripps Research Center Institute in La Jolla. A lot of the data is what you find at other great sites like The COVID Tracking Project, the Johns Hopkins data site, etc. But this is a team specializing in bioinformatics. So they’ve worked on creating uniform formats for COVID data so the data can be efficiently and accurately meshed together – so the data can talk to each other.

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Bonnie And Clyde
Armed homeowners standing in front of their house along Portland Place confront protesters as they march to Mayor Lyda Krewson's house on Sunday, June 28, 2020, in the Central West End in St. Louis. (Laurie Skrivan/St. Louis Post-Dispatch/TNS)

TPM Reader MD writes in with his personal account of the St. Louis protest that featured the gun-waving Bonnie and Clyde in front of their “Midwestern palazzo”:

Trump just re-tweeted images of the gun-toting St. Louis couple, so this seems destined to become a national obsession. Might as well send you my two cents.

I was in St. Louis last night. In fact, I attended the protest. Let me give you a play-by-play.

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Clean AF

We interrupt our regular programming for an unsolicited testimonial from TPM Reader JD:

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Mystery Solved?

One of the most persistent mysteries of the COVID-19 pandemic in the U.S. is why cases have largely plateaued (until the last couple weeks) while mortality figures have fallen substantially. As we’ve discussed, there’s been an ongoing debate about disentangling the evolving case counts from the ongoing rise in the number of tests being conducted every day. But particularly as cases started to rise in June it is clear that cases are growing well in excess of what can be explained by more testing. So why have the daily mortality numbers dropped? Why the disjuncture between the two numbers, even taking into account a two- or three-week lag between spikes in new cases and people succumbing to the disease?

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Where Things Stand: TFW You Were Wrong
This is your TPM afternoon briefing.
Texas Governor Greg Abbott announces the reopening of more Texas businesses during the COVID-19 pandemic at a press conference at the Texas State Capitol in Austin on Monday, May 18, 2020. Abbott said that childcare facilities, youth camps, some professional sports, and bars may now begin to fully or partially reopen their facilities as outlined by regulations listed on the Open Texas website. (Lynda M. Gonzalez/The Dallas Morning News Pool)

Gov. Abbott is doing some self-reflection.

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This Didn’t Have to Happen
DALLAS, March 22, 2020 . Staff work at a drive-through COVID-19 testing site in Dallas, Texas, the United States, March 21, 2020. The number of COVID-19 cases in the United States topped 20,000 as of 1:30 p.m. Eastern Standard Time on Saturday ,1730 GMT, according to the Center for Systems Science and Engineering ,CSSE, at Johns Hopkins University. (Photo by Dan Tian/Xinhua via Getty)

Let’s start with one chart that tells one part of the story.

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