The Growth of COVID-19 in the U.S., Organized by State Peak Date
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Visualizing the Growth of COVID-19 in the U.S., Organized by State Peak Date

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The exponential nature of viral spread means that pandemics are fast-moving and dynamic.

Combine this with the high interconnectedness of modern life—even when social distancing and lockdowns are applied—and pandemics can evolve quickly. In just a few weeks, previous hotspots can cool down, while new high risk areas can crop up seemingly out of nowhere.

In the United States, like many other places in the world, the virus is hitting regions differently, and this landscape is constantly changing over time.

COVID-19 Growth, by State

Today’s first visualization comes to us from Reddit user bgregory98, and it uses data from the New York Times to plot confirmed active COVID-19 cases by state.

States are organized by the date that weekly average cases peaked, from top to bottom. Data is normalized and is current until June 16th, and states are colored based on regional definitions (i.e. Northeast, Midwest, West, South) as defined by the U.S. Census Bureau.

Visualizing the Growth of COVID-19 in the U.S., Organized by State Peak Date

As you can see, when looking purely at active cases, the situation has evolved considerably from a geographical perspective.

Early on, COVID-19 cases were more concentrated in coastal population centers, especially in the Northeast. New York, New Jersey, and Massachusetts, the three hardest hit states per capita so far, saw cases peak in April.

However, a look at the bottom half of the visualization shows that generally, states in the South and West are starting to heat up with cases. Recent daily numbers confirm this, with California, Texas, Florida, Arizona, and North Carolina all gaining more than 1,000 new cases on June 17th.

Growth by State, Part Deux

The following visualization by Reddit user jawsem17 is designed using a similar concept, and is current as of June 17th.

This version uses the same data set from the New York Times. However, it also includes deaths as a metric, showing a comparison of peak deaths to peak cases for each state.

Visualizing the Growth of COVID-19 by Peak Cases and Peak Deaths

Although one would expect peak deaths to follow peak cases, this is not always the case.

Peak deaths in Nevada, for example, occurred on April 24th, but peak cases have been in the last week. This same peculiar pattern can be seen in a variety of states, from California to Oklahoma.

Mapped: The Evolution of COVID-19 in the U.S.

As the pandemic spreads and the situation has evolved, the mean center of weekly COVID-19 cases has been moving in a southwest direction.

The following map, which also comes from Reddit user bgregory98, averages the center coordinates of all counties weighted by how many new confirmed cases they have had over the past week:

Mean Cases Map

Originating in Ohio, the mean center of cases was initially heavily skewed by cases in the New York metro area. Since then, the mean center of cases has shifted and has now journeyed slightly past the mean center of U.S. population, located in Missouri.

This is partially a regression to the mean, but it is also driven by growing case counts in aforementioned states in the southern and western parts of the country.

Mapped: Peak County Totals

Finally, the progression of COVID-19 within the U.S. can be mapped in another useful way, revealing a geographical perspective to the virus’ spread.

These maps from Winston Saunders show places where current disease levels are below their previous peaks (blue), and where current COVID-19 cases are at highs (red) as of June 18:

Cases Below Previous Peaks

Cases at Peak Levels

This again shows the shift from the Northeast and Midwest parts of the country towards the West and South regions.

As always, the path of the virus’ spread will continue to change and evolve, and the picture could again look quite different in just a few weeks time.

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Explainer: What to Know About Monkeypox

What is monkeypox, and what risk does it pose to the public? This infographic breaks down the symptoms, transmission, and more.

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Explainer: What to Know About Monkeypox

The COVID-19 pandemic is still fresh in the minds of the people around the world, so it comes as no surprise that recent outbreaks of another virus are grabbing headlines.

Monkeypox outbreaks have now been reported in multiple countries, and it has scientists paying close attention. For everyone else, numerous questions come to the surface:

  • How serious is this virus?
  • How contagious is it?
  • Could monkeypox develop into a new pandemic?

Below, we answer these questions and more.

What is Monkeypox?

Monkeypox is a virus in the Orthopoxvirus genus which also includes the variola virus (which causes smallpox) and the cowpox virus. The primary symptoms include fever, swollen lymph nodes, and a distinctive bumpy rash.

There are two major strains of the virus that pose very different risks:

  • Congo Basin strain: 1 in 10 people infected with this strain have died
  • West African strain: Approximately 1 in 100 people infected with this strain died

At the moment, health authorities in the UK have indicated they’re seeing the milder strain in patients there.

Where did Monkeypox Originate From?

The virus was originally discovered in the Democratic Republic of Congo in monkeys kept for research purposes (hence the name). Eventually, the virus made the jump to humans more than a decade after its discovery in 1958.

It is widely assumed that vaccination against another similar virus, smallpox, helped keep monkeypox outbreaks from occurring in human populations. Ironically, the successful eradication of smallpox, and eventual winding down of that vaccine program, has opened the door to a new viral threat. There is now a growing population of people who no longer have immunity against the virus.

Now that travel restrictions are lifting in many parts of the world, viruses are now able to hop between nations again. As of the publishing of this article, a handful of cases have now been reported in the U.S., Canada, the UK, and a number of European countries.

On the upside, contact tracing has helped authorities piece together the transmission of the virus. While cases are rare in Europe and North America, it is considered endemic in parts of West Africa. For example, the World Health Organization reports that Nigeria has experienced over 550 reported monkeypox cases from 2017 to today. The current UK outbreak originated from an individual who returned from a trip to Nigeria.

Could Monkeypox become a new pandemic?

Monkeypox, which primarily spreads through animal-to-human interaction, is not known to spread easily between humans. Most individuals infected with monkeypox pass the virus to between zero and one person, so outbreaks typically fizzle out. For this reason, the fact that outbreaks are occurring in several countries simultaneously is concerning for health authorities and organizations that monitor viral transmission. Experts are entertaining the possibility that the virus’ rate of transmission has increased.

Images of people covered in monkeypox lesions are shocking, and people are understandably concerned by this virus, but the good news is that members of the general public have little to fear at this stage.

I think the risk to the general public at this point, from the information we have, is very, very low.
–Tom Inglesby, Director, Johns Hopkins Center for Health Security

» For up-to-date information on monkeypox cases, check out Global.Health’s tracking spreadsheet

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Healthcare

Visualizing How COVID-19 Antiviral Pills and Vaccines Work at the Cellular Level

Despite tackling the same disease, vaccines and antiviral pills work differently to combat COVID-19. We visualize how they work in the body.

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Current Strategies to Tackle COVID-19

Since the pandemic started in 2020, a number of therapies have been developed to combat COVID-19.

The leading options for preventing infection include social distancing, mask-wearing, and vaccination. They are still recommended during the upsurge of the coronavirus’s latest mutation, the Omicron variant.

But in December 2021, The United States Food and Drug Administration (USDA) granted Emergency Use Authorization to two experimental pills for the treatment of new COVID-19 cases.

These medications, one made by Pfizer and the other by Merck & Co., hope to contribute to the fight against the coronavirus and its variants. Alongside vaccinations, they may help to curb extreme cases of COVID-19 by reducing the need for hospitalization.

Despite tackling the same disease, vaccines and pills work differently:

VaccinesPills
Taken by injectionTaken by mouth
Used for prevention Used for treatment only
Create an enhanced immune system by stimulating antibody productionDisrupt the assembly of new viral particles

How a Vaccine Helps Prevent COVID-19

The main purpose of a vaccine is to prewarn the body of a potential COVID-19 infection by creating antibodies that target and destroy the coronavirus.

In order to do this, the immune system needs an antigen.

It’s difficult to do this risk-free since all antigens exist directly on a virus. Luckily, vaccines safely expose antigens to our immune systems without the dangerous parts of the virus.

In the case of COVID-19, the coronavirus’s antigen is the spike protein that covers its outer surface. Vaccines inject antigen-building instructions* and use our own cellular machinery to build the coronavirus antigen from scratch.

When exposed to the spike protein, the immune system begins to assemble antigen-specific antibodies. These antibodies wait for the opportunity to attack the real spike protein when a coronavirus enters the body. Since antibodies decrease over time, booster immunizations help to maintain a strong line of defense.

*While different vaccine technologies exist, they all do a similar thing: introduce an antigen and build a stronger immune system.

How COVID Antiviral Pills Work

Antiviral pills, unlike vaccines, are not a preventative strategy. Instead, they treat an infected individual experiencing symptoms from the virus.

Two drugs are now entering the market. Merck & Co.’s Lagevrio®, composed of one molecule, and Pfizer’s Paxlovid®, composed of two.

These medications disrupt specific processes in the viral assembly line to choke the virus’s ability to replicate.

The Mechanism of Molnupiravir

RNA-dependent RNA Polymerase (RdRp) is a cellular component that works similar to a photocopying machine for the virus’s genetic instructions. An infected host cell is forced to produce RdRp, which starts generating more copies of the virus’s RNA.

Molnupiravir, developed by Merck & Co., is a polymerase inhibitor. It inserts itself into the viral instructions that RdRp is copying, jumbling the contents. The RdRp then produces junk.

The Mechanism of Nirmatrelvir + Ritonavir

A replicating virus makes proteins necessary for its survival in a large, clumped mass called a polyprotein. A cellular component called a protease cuts a virus’s polyprotein into smaller, workable pieces.

Pfizer’s antiviral medication is a protease inhibitor made of two pills:

  1. The first pill, nirmatrelvir, stops protease from cutting viral products into smaller pieces.
  2. The second pill, ritonavir, protects nirmatrelvir from destruction by the body and allows it to keep working.

With a faulty polymerase or a large, unusable polyprotein, antiviral medications make it difficult for the coronavirus to replicate. If treated early enough, they can lessen the virus’s impact on the body.

The Future of COVID Antiviral Pills and Medications

Antiviral medications seem to have a bright future ahead of them.

COVID-19 antivirals are based on early research done on coronaviruses from the 2002-04 SARS-CoV and the 2012 MERS-CoV outbreaks. Current breakthroughs in this technology may pave the way for better pharmaceuticals in the future.

One half of Pfizer’s medication, ritonavir, currently treats many other viruses including HIV/AIDS.

Gilead Science is currently developing oral derivatives of remdesivir, another polymerase inhibitor currently only offered to inpatients in the United States.

More coronavirus antivirals are currently in the pipeline, offering a glimpse of control on the looming presence of COVID-19.

Author’s Note: The medical information in this article is an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please talk to your doctor before undergoing any treatment for COVID-19. If you become sick and believe you may have symptoms of COVID-19, please follow the CDC guidelines.

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