docs/updates/day23.R

In eeholmes/CoV19: Eli's package for figures and data on CoV-19 epidemic

Update 23. Regional Review

This update is mostly here:
  https://eeholmes.github.io/CoV19/updates/2020-05-04-Patterns.html
This is just a highlight. 

Europe: In my case study area, Lombardia, new cases continue to slowly but steadily decline. New cases per day have been below 1000 for a week. The countries with big outbreaks are all showing a defined peak and steep declines. Across Central and Eastern Europe, especially, the outbreaks are now very low. Sweden and the UK are the big exceptions. Looks like there the outbreak (1st wave at least) will continue well into summer but new cases numbers are not extreme (so not overwhelming the health system at current pace). Projected death rates however are on the high side for Europe.

Washington: In King County, we have been at a steady 100 new cases a day (more or less) for a couple weeks. In Washington as a whole, we are seeing an uptick in cases due to increasing numbers around Yakima and in the tri-cities.

Northeast: The Northeast looks the most like Europe but with high cases and death rate, so like Italy and Belgium and not like Germany. At the current descent rate (meaning assuming lockdown continues), they should get below 100 new daily cases/million people by beginning of June.

Everywhere else: On the good side, the new daily cases/million are low enough that healthcare systems are not getting overwhelmed. On the not so good side, there is no evidence of a peak except in a few states: FL, WA, NorCal, OR, SD, HI, LA, ID, MT. That's about it. That's not to say that it looks like it's headed to 'We cannot handle this' as doubling are quite long (20+ days on the NYT visualizations). 

The one exception is the eastern midwest (MN, IA, NE, MO, ND, SD). Their average new cases per day doubled in the last 7 days and it's at 100 per million now. In MN cases are going up fast and their case fatality rate just went up to 10%, which suggests it's has gotten into some vulnerable populations. In IA and NE, the new cases are going up fast but the case fatality rate is quite low (like 2%), which suggests that the spike in new cases is associated with testing of younger, less vulnerable populations. I'm guessing it's associated with survellance of communities with meat processing plants, but that's just a guess.