COVID-19 Results Briefing

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Delaware COVID-19 RESULTS BRIEFING

COVID-19 Results Briefing

Delaware

January 14, 2021

This document contains summary information on the latest projections from the IHME model on COVID-19 in Delaware. The model was run on January 13, 2021 with data through January 11, 2021.

Current situation

• Daily reported cases in the last week increased to 800 per day on average compared to 700 the week before (Figure 1).

• Daily deaths in the last week decreased to 0 per day on average compared to 10 the week before (Figure 2). This makes COVID-19 the number 2 cause of death in Delaware this week (Table 1).

• Effective R, computed using cases, hospitalizations, and deaths, is greater than 1 in 27 states (Figure 3). The Effective R in Delaware on December 31 was 0.93.

• We estimated that 16% of people in Delaware have been infected as of January 11 (Figure 4).

• The daily death rate is greater than 4 per million in 47 states (Figure 6).

Trends in drivers of transmission

• In the last week, new mandates have been imposed in District of Columbia, Kentucky, Massachusetts, Minnesota, New Mexico, Ohio, Washington. Mandates have been lifted in Kentucky, Pennsylvania, Washington, Wyoming (Table 2).

• Mobility last week was 35% lower than the pre-COVID-19 baseline (Figure 8). Mobility was near baseline (within 10%) in no states. Mobility was lower than 30% of baseline in in 26 states.

• As of January 11 we estimated that 81% of people always wore a mask when leaving their home compared to 81% last week (Figure 9). Mask use was lower than 50% in no states.

• There were 249 diagnostic tests per 100,000 people on January 11 (Figure 10).

• In Delaware 57.9% of people say they would accept a vaccine for COVID-19 and 22.7% say they are unsure if they would accept one. The fraction of the population who are open to receiving a COVID-19 vaccine ranges from 66% in Mississippi to 85% in Utah (Figure 12).

• We expect that 593,000 will be vaccinated by May 1 (Figure 13). With faster scale-up, the number vaccinated could reach 593,000.

Projections

• In our reference scenario, which represents what we think is most likely to happen, our model projects 1,000 cumulative deaths on May 1, 2021. This represents 0 additional deaths from January 11 to May 1 (Figure 14). Daily deaths will peak at 0 on January 17, 2021 (Figure 15).

• By May 1, 2021, we project that 100 lives will be saved by the projected vaccine rollout. If rapid rollout of vaccine is achieved, 200 lives will be saved compared to a no vaccine scenario. As compared to a no vaccine scenario, rapid rollout targeting high-risk individuals only could save 200 lives (Figure 14).

• If universal mask coverage (95%) were attained in the next week, our model projects 0 fewer cumulative deaths compared to the reference scenario on May 1, 2021 (Figure 14).

• Under our mandates easing scenario, our model projects 1,000 cumulative deaths on May 1, 2021 (Figure 14).

• We estimate that 41.5% of people will still be susceptible on May 1, 2021 (Figure 17).

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Delaware COVID-19 RESULTS BRIEFING

• Figure 21 compares our reference scenario forecasts to other publicly archived models. Forecasts are widely divergent.

• At some point from January through May 1, 42 states will have high or extreme stress on hospital beds (Figure 22). At some point from January through May 1, 45 states will have high or extreme stress on ICU capacity (Figure 23).

Model updates

Methods have not been changed in this week’s update. Reported data on vaccination scale-up for select countries has led us to revise the expected rates of vaccination. For some countries, the revision has reduced the expected vaccination rates, and for others – such as Israel – the revision has increased expected vaccination rates.

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Delaware CURRENT SITUATION

Current situation

Figure 1. Reported daily COVID-19 cases

0 250 500 750 1,000

Apr 20 May 20 Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21 Month

Count

Daily cases

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Delaware CURRENT SITUATION

Table 1. Ranking of COVID-19 among the leading causes of mortality this week, assuming uniform deaths of non-COVID causes throughout the year

Cause name Weekly deaths Ranking

Ischemic heart disease 36 1

COVID-19 34 2

Tracheal, bronchus, and lung cancer 15 3

Chronic obstructive pulmonary disease 12 4

Stroke 11 5

Alzheimer’s disease and other dementias 8 6

Chronic kidney disease 7 7

Colon and rectum cancer 5 8

Diabetes mellitus 5 9

Drug use disorders 5 10

Figure 2a. Reported daily COVID-19 deaths

0 5 10 15 20

Apr 20 May 20 Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21

Daily deaths

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Delaware CURRENT SITUATION Figure 2b. Estimated cumulative deaths by age group

0 5 10 15

<5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 99

Age group

Share of cumulative deaths, %

Figure 3. Mean effective R on December 31, 2020. The estimate of effective R is based on the combined analysis of deaths, case reporting, and hospitalizations where available. Current reported cases reflect infections 11-13 days prior, so estimates of effective R can only be made for the recent past. Effective R less than 1 means that transmission should decline, all other things being held the same.

<0.93 0.93−0.93 0.94−0.95 0.96−0.97 0.98−0.99 1−1.01 1.02−1.03 1.04−1.05 1.06−1.06

>=1.07

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Delaware CURRENT SITUATION Figure 4. Estimated percent of the population infected with COVID-19 on January 11, 2021

<5 5−9.9 10−14.9 15−19.9 20−24.9 25−29.9 30−34.9

>=35

Figure 5. Percent of COVID-19 infections detected. This is estimated as the ratio of reported daily COVID-19 cases to estimated daily COVID-19 infections based on the SEIR disease transmission model.

10 20 30 40

Apr 20 May 20 Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21

Percent of infections detected

California Delaware Florida New York Texas

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Delaware CURRENT SITUATION Figure 6. Daily COVID-19 death rate per 1 million on January 11, 2021

<1 1 to 1.9 2 to 2.9 3 to 3.9 4 to 4.9 5 to 5.9 6 to 6.9 7 to 7.9

>=8

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Delaware CRITICAL DRIVERS

Critical drivers

Table 2. Current mandate implementation

Primary school closure Secondary school closure Higher school closure Borders closed to any non−resident Borders closed to all non−residents Individual movements restricted Curfew for businesses Individual curfew Gathering limit: 6 indoor, 10 outdoor Gathering limit: 10 indoor, 25 outdoor Gathering limit: 25 indoor, 50 outdoor Gathering limit: 50 indoor, 100 outdoor Gathering limit: 100 indoor, 250 outdoor Restaurants closed Bars closed Restaurants / bars closed Restaurants / bars curbside only Gyms, pools, other leisure closed Non−essential retail closed Non−essential retail curbside only Non−essential workplaces closed Stay home order Stay home fine Mask mandate Mask mandate fine

Wyoming Wisconsin West VirginiaWashingtonTennesseeVermontVirginiaTexasUtah South Dakota South CarolinaNorth CarolinaNorth DakotaRhode IslandPennsylvaniaNew MexicoNew JerseyOklahomaNew YorkOregonOhio New HampshireMassachusettsMississippiMinnesotaNebraskaLouisianaMarylandKentuckyMichiganMontanaMissouriGeorgiaNevadaKansasIndianaFloridaHawaiiMaineIllinoisIdahoIowa District of ColumbiaConnecticutDelawareCaliforniaArkansasColoradoAlabamaArizonaAlaska

Mandate in place

Mandate in place (implemented this week) Mandate in place (update from previous reporting)

No mandate

No mandate (lifted this week)

No mandate (update from previous reporting)

*Not all locations are measured at the subnational level.

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Delaware CRITICAL DRIVERS Figure 7. Total number of social distancing mandates (including mask use)

Wyoming Wisconsin West VirginiaWashingtonTennesseeVermontVirginiaTexasUtah South Dakota South CarolinaNorth CarolinaRhode IslandNorth DakotaPennsylvaniaNew MexicoNew JerseyOklahomaNew YorkOregonOhio New HampshireMassachusettsMississippiMinnesotaNebraskaLouisianaMarylandKentuckyMichiganMontanaMissouriGeorgiaNevadaKansasIndianaFloridaHawaiiIllinoisMaineIdahoIowa District of ColumbiaConnecticutDelawareCaliforniaArkansasColoradoAlabamaArizonaAlaska

Mar 20 Apr 20 May 20

Jun 20 Jul 20

Aug 20 Sep 20 Oct 20 Nov 20

Dec 20 Jan 21

# of mandates 0 1−5 6−10 11−15 16−20 20−25

Mandate imposition timing

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Delaware CRITICAL DRIVERS Figure 8a. Trend in mobility as measured through smartphone app use compared to January 2020 baseline

−50

−25 0

Jan 20 Feb 20 Mar 20 Apr 20 May 20 Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21

Percent reduction from average mobility

Figure 8b. Mobility level as measured through smartphone app use compared to January 2020 baseline (percent) on January 11, 2021

=<−50

−49 to −45

−44 to −40

−39 to −35

−34 to −30

−29 to −25

−24 to −20

−19 to −15

−14 to −10

>−10

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Delaware CRITICAL DRIVERS Figure 8c. Trend in visits to restaurants as measured through cell phone data compared to 2019 average

WYWI WVWAOROKOHNDNCUTTNSDSCNYVAVTTXPARI NMNHMTNVNENJ MOMS MNMAMI MDMEGADCCOKYKSDECTCAARAKLAAZALFLIAINIDHIIL

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan

% of 2019 mean

1.2+

(1,1.2]

(0.8,1]

(0.6,0.8]

(0.4,0.6]

(0.2,0.4]

(0,0.2]

Figure 8d. Trend in visits to bars as measured through cell phone data compared to 2019 average

% of 2019 mean

1.2+

(1,1.2]

(0.8,1]

(0.6,0.8]

(0.4,0.6]

(0.2,0.4]

(0,0.2]

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Figure 8e. Trend in visits to elementary & secondary schools as measured through cell phone data compared to 2019 average

% of 2019 mean

1.2+

(1,1.2]

(0.8,1]

(0.6,0.8]

(0.4,0.6]

(0.2,0.4]

(0,0.2]

Figure 8f. Trend in visits to department stores as measured through cell phone data compared to 2019 average

% of 2019 mean

1.2+

(1,1.2]

(0.8,1]

(0.6,0.8]

(0.4,0.6]

(0.2,0.4]

(0,0.2]

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Delaware CRITICAL DRIVERS Figure 9a. Trend in the proportion of the population reporting always wearing a mask when leaving home

0 20 40 60 80

Percent of population

Figure 9b. Proportion of the population reporting always wearing a mask when leaving home on January 11, 2021

<50%

50 to 54%

55 to 59%

60 to 64%

65 to 69%

70 to 74%

75 to 79%

80 to 84%

85 to 89%

>=90%

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Delaware CRITICAL DRIVERS Figure 10a. Trend in COVID-19 diagnostic tests per 100,000 people

0 250 500 750 1000

Test per 100,000 population

Figure 10b. COVID-19 diagnostic tests per 100,000 people on December 31, 2020

<5 5 to 9.9 10 to 24.9 25 to 49 50 to 149 150 to 249 250 to 349 350 to 449 450 to 499

>=500

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Delaware CRITICAL DRIVERS Figure 11. Increase in the risk of death due to pneumonia on February 1 2020 compared to August 1 2020

<−80%

−80 to −61%

−60 to −41%

−40 to −21%

−20 to −1%

0 to 19%

20 to 39%

40 to 59%

60 to 79%

>=80%

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Figure 12. This figure shows the estimated proportion of the adult (18+) population that is open to receiving a COVID-19 vaccine based on Facebook survey responses (yes and unsure).

<50%

50−59%

60−69%

70−74%

75−79%

80−84%

>85%

Figure 13. The number of people who receive any vaccine and those who are immune, accounting for efficacy, loss to follow up for two-dose vaccines, partial immunity after one dose, and immunity after two doses.

0 200,000 400,000 600,000

0 20 40 60

Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21

People Percent of adult population

Reference rollout Rapid rollout

Solid lines represent the total vaccine doses, dashed lines represent effective vaccination

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Delaware PROJECTIONS AND SCENARIOS

Projections and scenarios

We produce six scenarios when projecting COVID-19. The reference scenario is our forecast of what we think is most likely to happen. We assume that if the daily mortality rate from COVID-19 reaches 8 per million, social distancing (SD) mandates will be re-imposed. The mandate easing scenario is what would happen if governments continue to ease social distancing mandates with no re-imposition. The universal mask mandate scenario is what would happen if mask use increased immediately to 95% and social distancing mandates were re-imposed at 8 deaths per million. These three scenarios assume our reference vaccine delivery scale up where vaccine delivery will scale to full capacity over 90 days.

The rapid vaccine rollout scenario assumes that vaccine distribution will scale up to full delivery capacity in half the time as the reference delivery scenario and that the maximum doses that can be delivered per day is twice as much as the reference delivery scenario. The rapid vaccine rollout to high-risk populations scenario is the same but high-risk populations are vaccinated before essential workers or other adults. The no vaccine scenario is the same as our reference scenario but with no vaccine use.

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Delaware PROJECTIONS AND SCENARIOS Figure 14. Cumulative COVID-19 deaths until May 01, 2021 for six scenarios

0 500 1,000 1,500

0 50 100 150

Oct 20 Nov 20 Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21

Cumulative deaths Cumulative deaths per 100,000

Reference scenario Universal mask use

Continued SD mandate easing

Rapid rollout

Rapid rollout to high−risk No vaccine

Figure 15. Daily COVID-19 deaths until May 01, 2021 for six scenarios

0 3 6 9 12

0.0 0.3 0.6 0.9 1.2

Feb 20 Apr 20 Jun 20 Aug 20 Oct 20 Dec 20 Feb 21 Apr 21

Daily deaths Daily deaths per 100,000

Rapid rollout

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Delaware PROJECTIONS AND SCENARIOS Figure 16. Daily COVID-19 infections until May 01, 2021 for six scenarios

0 500 1,000 1,500

0 50 100 150

Feb 20 Apr 20 Jun 20 Aug 20 Oct 20 Dec 20 Feb 21 Apr 21

Daily infections Daily infections per 100,000

Rapid rollout

Figure 17. Susceptible population, accounting for infections and people immune through vaccination

0 250,000 500,000 750,000 1,000,000

0 25 50 75 100

Oct 20 Nov 20 Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21

People susceptible Percent susceptible

Rapid rollout

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Figure 18. Month of assumed mandate re-implementation. (Month when daily death rate passes 8 per million, when reference scenario model assumes mandates will be re-imposed.)

January 2021 February 2021 March 2021 April 2021 No mandates before May 1 2021

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Delaware PROJECTIONS AND SCENARIOS Figure 19. Forecasted percent infected with COVID-19 on May 01, 2021

<5 5−9.9 10−14.9 15−19.9 20−24.9 25−29.9 30−34.9 35−39.9 40−44.9

>=45

Figure 20. Daily COVID-19 deaths per million forecasted on May 01, 2021 in the reference scenario

<1 1 to 1.9 2 to 2.9 3 to 3.9 4 to 4.9 5 to 5.9 6 to 6.9 7 to 7.9

>=8

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Figure 21. Comparison of reference model projections with other COVID modeling groups. For this comparison, we are including projections of daily COVID-19 deaths from other modeling groups when available:

Delphi from the Massachussets Institute of Technology (Delphi; https://www.covidanalytics.io/home), Imperial College London (Imperial;https://www.covidsim.org), The Los Alamos National Laboratory (LANL;

https://covid-19.bsvgateway.org/), and the SI-KJalpha model from the University of Southern California (SIKJalpha;https://github.com/scc-usc/ReCOVER-COVID-19). Daily deaths from other modeling groups are smoothed to remove inconsistencies with rounding. Regional values are aggregates from availble locations in that region.

2 3 4 5 6

Feb 21 Mar 21 Apr 21 May 21

Date

Daily deaths

Models

IHME Delphi LANL SIKJalpha

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Figure 22. The estimated inpatient hospital usage is shown over time. The percent of hospital beds occupied by COVID-19 patients is color coded based on observed quantiles of the maximum proportion of beds occupied by COVID-19 patients. Less than 5% is considered low stress, 5-9% is considered moderate stress, 10-19% is considered high stress, and greater than 20% is considered extreme stress.

Wyoming Wisconsin West Virginia Washington, DC Washington Virginia Vermont Utah Texas Tennessee South Dakota South Carolina Rhode Island Pennsylvania Oregon Oklahoma Ohio North Dakota North Carolina New York New Mexico New Jersey New Hampshire Nevada Nebraska Montana Missouri Mississippi Minnesota Michigan Massachusetts Maryland Maine Louisiana Kentucky Kansas Iowa Indiana Illinois Idaho Hawaii Georgia Florida Delaware Connecticut Colorado California Arkansas Arizona Alaska Alabama

Stress level

Low Moderate High Extreme

All hospital beds

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Figure 23. The estimated intensive care unit (ICU) usage is shown over time. The percent of ICU beds occupied by COVID-19 patients is color coded based on observed quantiles of the maximum proportion of ICU beds occupied by COVID-19 patients. Less than 10% is considered low stress, 10-29% is considered moderate stress, 30-59% is considered high stress, and greater than 60% is considered extreme stress.

Wyoming Wisconsin West Virginia Washington, DC Washington Virginia Vermont Utah Texas Tennessee South Dakota South Carolina Rhode Island Pennsylvania Oregon Oklahoma Ohio North Dakota North Carolina New York New Mexico New Jersey New Hampshire Nevada Nebraska Montana Missouri Mississippi Minnesota Michigan Massachusetts Maryland Maine Louisiana Kentucky Kansas Iowa Indiana Illinois Idaho Hawaii Georgia Florida Delaware Connecticut Colorado California Arkansas Arizona Alaska Alabama

Apr 20 Jun 20 Aug 20 Oct 20 Dec 20 Feb 21 Apr 21

Stress level

Low Moderate High Extreme

Intensive care unit beds

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Table 3. Ranking of COVID-19 among the leading causes of mortality in the full year 2020. Deaths from COVID-19 are projections of cumulative deaths on Jan 1, 2021 from the reference scenario. Deaths from other causes are from the Global Burden of Disease study 2019 (rounded to the nearest 100).

Cause name Annual deaths Ranking

Ischemic heart disease 1,900 1

COVID-19 927 2

Tracheal, bronchus, and lung cancer 800 3

Chronic obstructive pulmonary disease 600 4

Stroke 600 5

Alzheimer’s disease and other dementias 400 6

Chronic kidney disease 300 7

Colon and rectum cancer 300 8

Diabetes mellitus 300 9

Drug use disorders 200 10

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Delaware MORE INFORMATION

More information

Data sources:

Mask use data sources include PREMISE; Facebook Global symptom survey (This research is based on survey results from University of Maryland Social Data Science Center) and the Facebook United States symptom survey (in collaboration with Carnegie Mellon University); Kaiser Family Foundation; YouGov COVID-19 Behaviour Tracker survey.

Vaccine hesitancy data are from the COVID-19 Beliefs, Behaviors, and Norms Study, a survey conducted on Facebook by the Massachusetts Institute of Technology (https://covidsurvey.mit.edu/).

Data on vaccine candidates, stages of development, manufacturing capacity, and pre-purchasing agreements are primarily from Linksbridge and supplemented by Duke University.

A note of thanks:

We wish to warmly acknowledge the support of theseand others who have made our covid-19 estimation efforts possible.

More information:

For all COVID-19 resources at IHME, visithttp://www.healthdata.org/covid.

Questions? Requests? Feedback? Please contact us athttps://www.healthdata.org/covid/contact-us.