I think COVID-19 plateaued in NYC two weeks ago and is now in decline; One hospital set up last week; Another hospital to set up this week

By Whitney Tilson

Monday, April 6, 2020
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1) New York City is now ground zero of the global coronavirus pandemic, so my analysts and I follow the data here closely – because if we can win the war against the virus here, it’s incredible news for the rest of our country… and the world.

This article in Saturday’s New York Times, Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid, painted a dire picture of the grim state we’re in. However, the article did hold out a glimmer of hope, noting that [emphasis added]:

In the 24 hours through 12 a.m. on Friday… 1,427 newly sickened patients poured into the hospitals – another one-day high – although the rate of increase in hospitalizations seemed to stabilize, suggesting that the extreme social-distancing measures put in place last month may have started working.

I want to go a step further and make the argument that, even though the total count of COVID-19 cases ticked up to a record 6,582 on Friday, the number of new cases (people who test positive for the virus) in NYC peaked several days ago!

This is major news that hasn’t been fully reported anywhere.


As background, every day, the New York City Department of Health (NYC Health) used to report its COVID-19 data on pages like this one. Using this prior data, my team and I created this chart, which shows the number of new cases each day. These are very scary trends, to say the least…

However, five days ago, NYC Health began releasing new data here, which yield a very different (and much more hopeful) chart:

So what’s going on? Are new cases – a critical leading indicator of whether we’re winning the fight to halt the spread of this terrible scourge – spiking to new highs, or are they dropping to zero?

The answer is neither, but the truth is closer to the latter. Allow me to explain…

Five days ago, NYC Health improved the way it tracks cases, hospitalizations, and deaths. To see the differences, let’s look at a hypothetical timeline for a COVID-19 patient who, unfortunately, passed away two weeks ago:

Importantly, because test results can take eight days to come back, this patient actually died before there was a conclusive diagnosis.

Under the old methodology, when NYC Health received confirmation that the patient tested positive for COVID-19, all the data were entered on the day of the result. Thus, as this timeline shows, for our hypothetical patient, the data would show one case, one hospitalization, and one death – all on March 23, which is obviously incorrect:

Under the new, improved methodology, NYC Health now tracks the actual dates of positive tests, hospitalizations, and deaths. This timeline shows how it now tracks our hypothetical patient:

As a result of NYC Health’s changes, we can now see much more accurately how cases in NYC are developing in real-time.

However, there’s one big flaw in this method: the data for the most recent few days are nearly worthless, as it can take several days for tests to get processed. This is why we see the big drop-off in the second chart above (highlighted by the red circle) – most of the tests for the most recent days haven’t yet been processed.

Over time, more data come in and the information becomes more accurate. The data from two weeks ago are correct, but the most recent data on April 5, showing almost no new cases, are preliminary and will change a lot.

Our analysis shows that it takes four days for the data to come in and, therefore, be stable going forward (i.e., the April 2 data will show little change a day later… but the data from the most recent three days (April 3, April 4, and April 5) will likely show big changes.

In summary, therefore, we can track the data accurately using NYC Health’s new methodology, but only up to four days ago.

Thus, this is the latest chart for new cases by day:

To me, it looks like we got off the exponential growth curve two weeks ago on March 19, have been in a range since then, and maybe – just maybe – be starting to decline (though I want to see more than three days of data points)…

Further supporting this thesis, the drop in emergency department visits for respiratory issues and influenza-like illnesses seem to confirm this:


Let’s step back and look at the big picture in NYC…

Here’s a chart I sent out on Friday to my coronavirus e-mail list (you can join it by sending a blank e-mail to [email protected]) about the development of COVID-19 in China:

Here’s the identical chart for NYC, using NYC Health’s new data, going through April 2, the last day in which we have confidence that the data is nearly final:

The big takeaway here is that NYC’s data look somewhat like China’s right as China was plateauing and beginning to decline (though our plateau is longer, likely due to the extreme lockdown measures China took – which we haven’t matched).

If this continues – if we show the same steep, rapid decline as China experienced after the plateau, this would be incredible!

(Also note that while deaths are hitting new highs every day, this is to be expected (tragically) because this is at least a two-week lagging indicator, since those who die were often hospitalized weeks earlier and infected weeks before that.)


In conclusion, based on this data and analysis, I think that NYC stopped the rapid spread of the virus around March 19, and just in the past few days has brought the replication rate below 1 – meaning the virus is now in decline.

Let us all hope and pray that this is what’s indeed happening!

2) If you’ve been reading my e-mails over the past week, you know that I’ve been spending 12 hours a day volunteering to set up an emergency field hospital in Central Park, across the street from my apartment building, to treat critically ill COVID-19 patients.

It’s been one of the most exhausting, emotional, and energizing experiences of my life.

I’m happy to report that the hospital is now fully operational, already at nearly its 68-bed capacity, and saving lives. Click here to watch a three and a half minute video about it (I appear at 2:21). And click here to watch a video of me thanking everyone at the organization running the hospital, Samaritan’s Purse, for helping my fellow New Yorkers during our time of desperate need.

Everyone there has been so appreciative, which prompted me to send them this e-mail on Saturday:

Stop thanking me – you’re getting in the way of ME thanking YOU!

Seriously, here’s the scoop: we need you to focus on treating and healing and saving lives, so my fellow New Yorkers and I will gladly and gratefully lay mulch, haul trash, provide you with any boots and clothing you need and, most importantly, provide you with food and drinks.

Deal?

Anything you want, just let me know and consider it done. Money is no object.

It brings me and my fellow New Yorkers joy to provide for you – so please tell me what we can do – even a little thing like a special type of soap, shampoo, snack, or drink.

3) Yesterday was the last day Samaritan’s Purse needed volunteers – a group of us hauled (using the sleds I used to take my daughters sledding as children!) and raked two tons (literally) of mulch, laying out walkways through the grass and mud. Here are some pictures of me with my oldest and youngest daughters (my middle one is waiting out the crisis in her off-campus college apartment in North Carolina), three friends (that’s an ambulance behind us bringing in another patient), and the finished job last night (look at that smooth mulch with sharp edges!):

4) Now that the hospital has no more need for volunteers, I was looking forward to being able to ease up a little bit and maybe get one good night’s sleep… but no…

It turns out that my work has only just begun, because other hospitals still desperately need volunteers. And I’ve shown over the past week that I have a lot of friends and readers who I can organize to show up and work hard.

So the real estate person at Samaritan’s Purse yesterday put me in touch with her counterpart at Mt. Sinai Beth Israel Hospital… and guess what? They’re reopening an old hospital that they’d mothballed – and need lots of volunteers to assemble beds. So that’s what my friends (and their friends, and their friends…) and I are going to be doing all day every day this week…

I’ll tell you more about it in tomorrow’s e-mail…

Best regards,

Whitney

Whitney Tilson

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About Whitney Tilson

Prior to creating Empire Financial Research, Whitney Tilson founded and ran Kase Capital Management, which managed three value-oriented hedge funds and two mutual funds. Starting out of his bedroom with only $1 million, Tilson grew assets under management to nearly $200 million.

Tilson graduated magna cum laude from Harvard College with a bachelor’s degree in government in 1989. After college, he helped Wendy Kopp launch Teach for America and then spent two years as a consultant at the Boston Consulting Group. He earned his MBA from Harvard Business School in 1994, where he graduated in the top 5% of his class and was named a Baker Scholar.

Click here for the full bio.