COVID-19 Results Briefing · 2021. 2. 20. · Figure 11....

covid19.healthdata.org 1 Institute for Health Metrics and Evaluation

COVID-19 Results Briefing

The United States of America

February 20, 2021 This document contains summary information on the latest projections from the IHME model on COVID-19 in the United States of America. The model was run on February 20, 2021, with data through February 16, 2021.

Infections, hospitalizations, and deaths are steadily declining in the US. The main driver of this decline is seasonality, aided by expanding levels of vaccination. Counteracting the combined effect of seasonality and vaccination is the spread of the B.1.1.7 variant, which likely accounts for less than 20% of infections today but will increase to 80% by late April. The most uncertain driver of the trajectory of the epidemic over the next four months is how individuals will respond to steady declines in daily cases and deaths. If most individuals remain careful, maintaining mask-wearing through until April or longer, we expect that there will be a further 103,000 deaths from now until June 1, leading to a cumulative death total of 589,000. More rapid increases in mobility or reductions in mask use can easily lead to increasing cases and deaths in many states in April. So far, reported mask use remains high at 77%, but mobility has started to increase. Managing the epidemic in the next four months depends critically on scaling up vaccination, trying to increase the fraction of adults willing to be vaccinated above three-quarters, and strongly encouraging continued mask use and avoiding situations where transmission is likely, such as indoor dining, going to bars, or indoor gatherings with individuals outside the household. Despite the favorable trends in the epidemic, we do not expect to reach herd immunity prior to next winter.

Current situation • Daily reported cases in the last week decreased to 92,500 per day on average compared to

118,900 the week before (Figure 1).

• Daily deaths in the last week decreased to 2,300 per day on average compared to 2,690 the week before (Figure 2). This makes COVID-19 the number 1 cause of death in the United States of America this week (Table 1).

• The daily death rate is greater than 4 per million in 30 states (Figure 3).

• We estimated that 18% of people in the US have been infected as of February 16 (Figure 4).

• Effective R, computed using cases, hospitalizations, and deaths, is less than 1 in all states (Figure 5).

• The infection-detection rate remains around 55% over the last week.


Trends in drivers of transmission • New mandates on gyms were introduced in Massachusetts and Michigan, and on restaurants

in Texas. Mandates were lifted in Colorado, Idaho, Illinois, and Rhode Island.

• Mobility last week was 28% lower than the pre-COVID-19 baseline (Figure 7). Mobility was near baseline (within 10%) in Wyoming. Mobility was lower than 30% of baseline in 16 states.

• As of February 16, we estimated that 77% of people always wore a mask when leaving their home, the same as last week (Figure 9). Lowest mask use was in Wyoming.

• There were 396 diagnostic tests per 100,000 people on February 16 (Figure 11).

• In the US, 74% of people say they would accept or would probably accept a vaccine for COVID-19. The fraction of the population who are open to receiving a COVID-19 vaccine ranges from 59% in Wyoming to 85% in Massachusetts (Figure 14).

• In our current reference scenario, we expect that 156.06 million will be vaccinated by June 1 (Figure 15).

Projections • In our reference scenario, which represents what we think is most likely to happen, our

model projects 589,000 cumulative deaths on June 1, 2021. This represents 103,000 additional deaths from February 16 to June 1 (Figure 16). Daily deaths have peaked and are expected to steadily decline, reaching below 500 a day prior to June 1 (Figure 17).

• By June 1, 2021, we project that 117,200 lives will be saved by the projected vaccine rollout.

• If universal mask coverage (95%) were attained in the next week, our model projects 17,000 fewer cumulative deaths compared to the reference scenario on June 1, 2021 (Figure 16).

• Under our worse scenario, our model projects 616,000 cumulative deaths on June 1, 2021 (Figure 16). This represents 27,000 more deaths than in the reference scenario. Daily deaths remain near 1,000 a day on June 1 in the worse scenario.

• Daily infections in the reference scenario are expected to decline from now until June 1, although the spread of variants, especially B.1.1.7, will lead to slower declines in the number of infections in March. In the worse scenario, with more rapid spread of B.1.351, daily infections could increase in March and early April.

• Figure 19 compares our reference scenario forecasts to other publicly archived models. All models forecast steady declines in daily deaths with the exception of the Los Alamos National Labs model, which has increases in late March.

• At some point from February through June 1, 18 states will have high or extreme stress on hospital beds (Figure 20). At some point from February through June 1, 18 states will have high or extreme stress on ICU capacity (Figure 21).

United States of America COVID-19 RESULTS BRIEFING

Model updatesWe have updated our model that predicts the spread of the new variants, which is used in the referencescenario in two ways. First, the speed of scale-up of the new variants is now based on data from more than15 locations, whereas previously we only had data from London. Second, we now use observed data on thepresence of new variants (B.1.1.7, B.1.351, or P1) in all locations with reported community transmission andmore than five cases of those variants sequenced.



Figure 1. Reported daily COVID-19 cases

0

100,000

200,000

300,000

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

Cou

nt

Daily cases

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

Cause name Weekly deaths RankingCOVID-19 16,078 1Ischemic heart disease 10,724 2Tracheal, bronchus, and lung cancer 3,965 3Chronic obstructive pulmonary disease 3,766 4Stroke 3,643 5Alzheimer’s disease and other dementias 2,768 6Chronic kidney disease 2,057 7Colon and rectum cancer 1,616 8Lower respiratory infections 1,575 9Diabetes mellitus 1,495 10



Figure 2. Reported daily COVID-19 deaths

0

1,000

2,000

3,000

4,000

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 Feb 21 Mar 21

Dai

ly d

eath

s



Figure 3. Daily COVID-19 death rate per 1 million on February 16, 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

Figure 4. Estimated percent of the population infected with COVID-19 on February 16, 2021

<5

5−9.9

10−14.9

15−19.9

20−24.9

25−29.9

>=30



Figure 5. Mean effective R on February 05, 2021. The estimate of effective R is based on the combinedanalysis of deaths, case reporting, and hospitalizations where available. Current reported cases reflectinfections 11-13 days prior, so estimates of effective R can only be made for the recent past. Effective R lessthan 1 means that transmission should decline, all other things being held the same.

<0.78

0.78−0.82

0.83−0.88

0.89−0.93

0.94−0.99

1−1.05

1.06−1.1

1.11−1.16

1.17−1.21

>=1.22



Figure 6. Percent of COVID-19 infections detected. This is estimated as the ratio of reported dailyCOVID-19 cases to estimated daily COVID-19 infections based on the SEIR disease transmission model.

0%

25%

50%

75%

100%

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

Per

cent

of i

nfec

tions

det

ecte

d

France

Italy

Sweden

United Kingdom

Canada

United States of America

*Due to measurement errors in cases and testing rates, the infection to detection rate (IDR) can exceed 100% at particular points in time.


United States of America CRITICAL DRIVERS

Critical driversTable 2. Current mandate implementation

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WyomingWisconsin

West VirginiaWashington

VirginiaVermont

UtahTexas

TennesseeSouth Dakota

South CarolinaRhode IslandPennsylvania

OregonOklahoma

OhioNorth Dakota

North CarolinaNew York

New MexicoNew Jersey

New HampshireNevada

NebraskaMontanaMissouri

MississippiMinnesota

MichiganMassachusetts

MarylandMaine

LouisianaKentucky

KansasIowa

IndianaIllinoisIdaho

HawaiiGeorgiaFlorida

District of ColumbiaDelaware

ConnecticutColoradoCaliforniaArkansas

ArizonaAlaska

Alabama

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.



Figure 7. Trend in mobility as measured through smartphone app use compared to January 2020 baseline

−80

−60

−40

−20

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 Feb 21Mar 21

Per

cent

red

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n fr

om a

vera

ge m

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ty

France

Italy

Sweden

United Kingdom

Canada


Figure 8. Mobility level as measured through smartphone app use compared to January 2020 baseline(percent) on February 16, 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



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

0

25

50

75


Per

cent

of p

opul

atio

n

France

Italy

Sweden

United Kingdom

Canada


Figure 10. Proportion of the population reporting always wearing a mask when leaving home on February16, 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%



Figure 11. Trend in COVID-19 diagnostic tests per 100,000 people

0

250

500

750


Test

per

100

,000

pop

ulat

ion

France

Italy

Sweden

United Kingdom

Canada


Figure 12. COVID-19 diagnostic tests per 100,000 people on February 08, 2021

<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



Figure 13. 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%



Figure 14. This figure shows the estimated proportion of the adult (18+) population that is open toreceiving 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 15. The number of people who receive any vaccine and those who are effectively vaccinated andprotected against disease, accounting for efficacy, loss to follow up for two-dose vaccines, partial immunityafter one dose, and immunity after two doses.

0

50,000,000

100,000,000

150,000,000

0

20

40

60

Dec 2

0

Jan

21

Feb

21

Mar

21

Apr 2

1

May

21

Jun

21

Peo

ple

Percent of adult population

Reference rollout Rapid rollout

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


United States of America PROJECTIONS AND SCENARIOS

Projections and scenariosWe produce three scenarios when projecting COVID-19. The reference scenario is our forecast of what wethink is most likely to happen:

• Vaccines are distributed at the expected pace.• Governments adapt their response by re-imposing social distancing mandates for 6 weeks whenever

daily deaths reach 8 per million, unless a location has already spent at least 7 of the last 14 dayswith daily deaths above this rate and not yet re-imposed social distancing mandates. In this case, thescenario assumes that mandates are re-imposed when daily deaths reach 15 per million.

• Variants B.1.1.7 (first identified in the UK), B.1.351 (first identified in South Africa), and P1 (firstidentified in Brazil) continue to spread from locations with (a) more than 5 sequenced variants, and(b) reports of community transmission, to adjacent locations following the speed of variant scale-upobserved in the regions of the UK.

• In one-quarter of those vaccinated, mobility increases toward pre-COVID-19 levels.

The worse scenario modifies the reference scenario assumptions in two ways:

• First, it assumes that variants B.1.351 or P1 begin to spread within 2 weeks in all locations that do notalready have B.1.351 or P1 community transmission.

• Second, it also assumes that all those vaccinated increase their mobility toward pre-COVID-19 levels.

The universal masks scenario makes all the same assumptions as the reference scenario but also assumes95% of the population wear masks in public in every location.



Figure 16. Cumulative COVID-19 deaths until June 01, 2021 for three scenarios

0

200,000

400,000

600,000

0

50

100

150

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

Cum

ulat

ive

deat

hsC

umulative deaths per 100,000

Reference scenario

Universal mask use

Worse

Figure 17. Daily COVID-19 deaths until June 01, 2021 for three scenarios

0

1,000

2,000

3,000

0.00

0.25

0.50

0.75

1.00

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

Dai

ly d

eath

sD

aily deaths per 100,000

Reference scenario

Universal mask use

Worse



Figure 18. Daily COVID-19 infections until June 01, 2021 for three scenarios

0

100,000

200,000

300,000

0

25

50

75

100

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

Dai

ly in

fect

ions

Daily infections per 100,000

Reference scenario

Universal mask use

Worse



Figure 19. Comparison of reference model projections with other COVID modeling groups. For thiscomparison, 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 groupsare smoothed to remove inconsistencies with rounding. Regional values are aggregates from availble locationsin that region.

0

500

1,000

1,500

2,000

Mar 21 Apr 21 May 21 Jun 21Date

Dai

ly d

eath

s

Models

IHME

Delphi

Imperial

LANL

SIKJalpha


https://www.covidanalytics.io/home

https://www.covidsim.org

https://covid-19.bsvgateway.org/

https://github.com/scc-usc/ReCOVER-COVID-19


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

WyomingWisconsin

West VirginiaWashington, DC

WashingtonVirginia

VermontUtah

TexasTennessee

South DakotaSouth Carolina

Rhode IslandPennsylvania

OregonOklahoma

OhioNorth Dakota



New HampshireNevada




MarylandMaine

LouisianaKentucky

KansasIowa



DelawareConnecticut

ColoradoCaliforniaArkansas

ArizonaAlaska

Alabama

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

Stress level

Low

Moderate

High

Extreme

All hospital beds



Figure 21. The estimated intensive care unit (ICU) usage is shown over time. The percent of ICU bedsoccupied by COVID-19 patients is color coded based on observed quantiles of the maximum proportion ofICU beds occupied by COVID-19 patients. Less than 10% is considered low stress, 10-29% is consideredmoderate stress, 30-59% is considered high stress, and greater than 60% is considered extreme stress.

WyomingWisconsin

West VirginiaWashington, DC

WashingtonVirginia

VermontUtah

TexasTennessee

South DakotaSouth Carolina

Rhode IslandPennsylvania

OregonOklahoma

OhioNorth Dakota



New HampshireNevada




MarylandMaine

LouisianaKentucky

KansasIowa



DelawareConnecticut

ColoradoCaliforniaArkansas

ArizonaAlaska

Alabama

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

Stress level

Low

Moderate

High

Extreme

Intensive care unit beds


United States of America MORE INFORMATION

More informationData sources:

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

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

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

A note of thanks:

We wish to warmly acknowledge the support of these and others who have made our COVID-19 estimationefforts possible.

More information:

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

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


https://covidsurvey.mit.edu/

https://www.healthdata.org/covid/acknowledgements

http://www.healthdata.org/covid

https://www.healthdata.org/covid/contact-us

COVID-19 Results Briefing · 2021. 2. 20. · Figure 11....

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