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U.S. Tops 2k COVID-19 Deaths In 24 Hours: Johns Hopkins

Clinical Assistant Professor in Emergency Medicine at the University of Arizona College of Medicine in Phoenix, Dr. Murtaza Akhter, joins Yahoo Finance’s Zack Guzman to discuss how the U.S. surpassed 2,000 deaths in 24 hours for the first time in three months, according to Johns Hopkins data.

Video Transcript

ZACK GUZMAN: All that we've seen play out over the last few months has been tied directly to what we've seen play out on the health front. Of course, we've been watching cases here in the US, and unfortunately, as the lag time generally happens here when we think about cases, they've been moving in the right direction shortly. But that lag between the case spike that we saw a couple weeks ago now playing out in the death count as US deaths from the coronavirus pandemic exceeded 160,000 today.

Nearly a quarter of the world's total, according to a tally from Reuters, and of course, this is ongoing as we've been keeping a close watch on some of those worrying states that kind of triggered this in Florida, California, Arizona, and Texas. Things in Arizona, though, seem to be improving. The rolling seven day average there for newly reported cases was just above 1,800 on Thursday. That was the lowest we've seen since June 18, according to the AP.

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So joining us now for more on that is one of our favorite doctors to discuss all this, Dr. Murtaza Akhter, a clinical assistant professor in emergency medicine at the University of Arizona College of Medicine Phoenix joins us now. And Dr. Akhter, I mean, when we're talking about this, it seems like things are improving in Arizona just based off that. You also have the same metric here for average daily deaths moving in the right direction as well. We're seeing that count falls, so how does it seem to be shaking out there and the way that you guys are handling this in the state of Arizona?

MURTAZA AKHTER: Yeah, Zack, I think you said it correctly that the trends are going in the right directions. So that means not just fewer cases. We still have quite a few, but they're trending in the right direction. But also, the positivity is going down. Because remember, you can just do fewer tests to get fewer cases.

And actually, we are doing fewer tests, but even the percent of them that come back positive has been trending downwards. It's not at a good spot. It is still far too high above the threshold to say that we are in the clear. We won't be in the clear for a long time, but we're not even been close to it. But it does feel on the ground like it's getting better too.

The kinds of patients I'm seeing are moving. You know, we still have plenty of patients come in with COVID like symptoms. But it seems to be more of the bread and butter that we were used to before the pandemic, while also having those COVID patients.

Now, the challenge is, you know, do we sort of reassign some of the beds in the hospital? Or do we keep them as COVID units, because there might be another spike? But at the very least in terms of the volume coming in the ER, it's becoming a little bit more in terms of the diversity of cases, a little bit more like what we're used to, though, not quite there yet. We've still got a ways to go.

ZACK GUZMAN: Yeah, I'm glad you mentioned that kind of-- first of all, when we're talking a lot about positivity rates in this segment. But I'm glad you mentioned kind of that false start, because that's something we saw in Arizona, too, in terms of lifting the lockdown and seeing a spike in cases come after it. A lot of people right now are raising that might be what's going on in the Midwest when we think about how they were quick to kind of come back here, have people go out and attend some of these businesses that might be problematic.

When you look at the overall testing, as you noted in Arizona coming down, testing overall here in the country decreased by nearly 13% compared to the week prior, which could be muddying what's even going on in the Midwest. And we're seeing some other states as well. You talked about positivity rate in Arkansas. Its positivity rate over the last few weeks as it's testing has decreased by 34%, so I mean, it happens. If you're testing less, it could mess all these numbers up. So what's your take right now on how some of these other states might be going through exactly what you guys went through just a few weeks ago?

MURTAZA AKHTER: Yeah, that's exactly right. Actually, one of the concerns that I had, I was looking at South Dakota's numbers. And you know, there are a couple of states that actually never went on lockdown, and maybe it seemed OK at the time. Because they had so few cases and such a little density.

But if you have very few cases, because you're not testing people, it doesn't really give you a good idea of how widespread it is. And if you look at the positivity numbers in some of these states, you mentioned the Midwest, but I'll also talk about rate. I'm a midwesterner, so I guess I consider some of the Great Plains states outside the Midwest. But the numbers of cases in terms of the percent that are positive is looking actually like it's going definitely in the wrong direction, and some of them are actually seeing the caseloads increase per capita, you know?

Again, if you have few people, you're only going to have so many cases. But if you look at the case per capita, some of these states are looking concerning, so that's one of the metrics we've looked at. And you've mentioned multiple times before, Zack, is the percent positive, because it's sort of controls. Not perfectly, but it sort of controls for how many tests you're doing.

And my fear is that it went from the Northeast and then came down towards the sunbelt. Is it now moving up to the Midwest? Some of the Midwest states already had issues, but is it moving to the Midwest and the Great Plains states? And are they going to have issues, because they thought they were OK? Clearly, the virus doesn't most state borders, right?

You know, seatbelt laws can change from state to state, but the virus doesn't care. It'll spread. If people go to other states, the virus will go to other states too, and we've got a close eye on that, including in our own state by the way. Because remember, it can go up in your own state, too, as some people have seen. For example, New Orleans or Louisiana has been seeing second waves already. So we have to be very vigilant.

ZACK GUZMAN: I think that's also why we've seen states, like New York, also be pretty bad, even though their case-- we talk about positivity rates. It's held at about 1% here, but still not allowing indoor dining here in New York City, being very cautious about what could happen in a second wave. But we did get the update in terms of schools here in the state of New York with Governor Cuomo announcing that schools will be allowed to decide on their own if they're in a region where the average positivity rate is below 5%.

That's the threshold that we've heard recommended from the WHO to begin reopening here. Most of the state, though, as I said, has been around a 1% positivity rate, including New York City. So I mean, what's your take on that kind of guideline, again, kind of shifting responsibility to the local school districts, but sticking with a certain scientific metric here to say, look, 5% and below is safe?

MURTAZA AKHTER: Yeah, I think this is a very complicated question actually, and I don't say that just as a cop out. There are certain things that have clear rights and wrongs, like distancing, washing your hands, or wearing masks. And even those have become debatable, which is really crazy.

The reason I say this one is complicated is because there really are multiple metrics to look at. I think the 5% positivity threshold is a great one, and it's been used by the WHO, as well as other health organizations. And if you want to give a simple answer, because you're passing the buck to superintendents and principals, then that probably isn't a bad metric.

But there are multiple things to look at, including how densely populated is your county, how densely populated are your schools. Because remember, if you're in a private school, and you have lots of school buses, and your kids can distance, and everybody lives in a mansion, like in Westchester County or something-- not to stereotype. But if you live in one of those particularly wealthy districts, you're more likely to be OK than if, say, you're in the Bronx and are living in-- you know, I shouldn't call them tenement housing. But you know, close quarters, multiple generations of family members, many of whom have asthma and other comorbidities.

If that kid is going to school, even if he or she might be OK, he or she can bring that but back to home in close quarters with immunocompromised people. And that isn't accounted for in, for example, the 5% metric. So I would say somebody who is living with two healthy accountant parents who stay at home in a mansion is probably OK to go to school, even if the positivity rate is 6%. But if the positivity rate is 4% and that child lives with siblings, or immunocompromised, or elderly grandparents in a small home, that would be concerning. So it's not just numbers, but looking at the overall picture, which is why this becomes so complicated.