Coronavirus in D.C.: What the first month tells us about its spread

The next 30 days could show if the District will be in the next wave of hot spots or if social distancing measures have been effective at “flattening the curve”

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On March 7, D.C. Mayor Muriel E. Bowser (D) announced the first known coronavirus case in the nation’s capital. As of April 6 — one month after the first diagnosis — the city had more than 1,200 cases and more than 20 fatalities.

With more infections reported each day, the District is one of many urban centers bracing for the possibility of becoming the next covid-19 hot spot. Over the past week, the city has been reporting about 100 cases every day, with a spike of more than 200 cases Wednesday alone.

30 days after first covid-19 diagnosis, D.C. had more than 1,000 known cases

By April 6, the District had 318 recoveries, 874 active cases, and 23 deaths.

1,200 known cases

April 6 1,215 total known cases

Total known cases

March 23 D.C. begins releasing recovery data

March 7 First covid-19 diagnosis in D.C.

March 7

April 6

March 20 First covid-19 death in D.C.

Note: D.C. initially reported new cases, recoveries, and deaths on the day they occurred. On April 1, D.C. began reporting changes the day after they occurred. The data on this page reflects the dates of diagnoses, recoveries, and deaths, rather than the day they were announced.

April 6 1,215 total known cases

1,200 cases

Total known cases

March 23 D.C. begins releasing recovery data

March 7 First covid-19 diagnosis in D.C.

March 20 First covid-19 fatality in D.C.

0

March 7

April 6

Note: D.C. initially reported new cases, recoveries, and deaths on the day they occurred. On April 1, D.C. began reporting changes the day after they occurred. The data on this page reflects the dates of diagnoses, recoveries, and deaths, rather than the day they were announced.

In the coming weeks, the city will discover whether social distancing measures — including school closures and a stay-at-home order — will pay off in “flattening the curve,” or if the city’s pessimistic projection that the peak will not come until early summer will prove true.

The next 30 days could point to whether the D.C. metro area’s death count will continue rising exponentially, like New York’s, or if the pace will slow, like in San Francisco.

Deaths in the D.C. area remain far below other hot spots, but show no sign of slowing

This chart uses a logarithmic scale: The angle of each line shows how quickly deaths double in each metropolitan area. Counts are for each city and the metropolitan areas that surround them.

New York City

5,120 total covid-19 deaths

2,560

1,280

Detroit

640

New Orleans

Seattle

320

160

Miami

Dallas

80

D.C.

San Francisco

40

20

10

5

2

1

Day of first death

10 days since first death

20 days since first death

30 days since first death

New York City

5,120 total covid-19 deaths in metropolitan area

2,560

1,280

640

Detroit

New Orleans

320

Seattle

160

Miami

D.C.

80

Dallas

San Francisco

40

20

10

5

2

1

30 days since

first covid-19 death

Day of first

covid-19 death

10 days since

first covid-19 death

20 days since

first covid-19 death

New York City

5,120 total covid-19 deaths

2,560

1,280

Detroit

640

New Orleans

Seattle

320

160

Miami

Dallas

80

D.C.

San Francisco

40

20

10

5

2

1

Day of first death

10 days since first death

20 days since first death

30 days since first death

The rising number of covid-19 cases in The District has coincided with a rise in testing, as local hospitals launched their own testing sites and the city’s public health lab increased its workload.

[Coronavirus projections suggest coming toll; Bowser says 1 in 7 could be infected in D.C.]

But experts caution that official tallies show only a partial picture of the virus’s toll. Tests are often limited to those showing symptoms, and commercial lab results can come more than a week after the sample was taken.

The District has seen between 12 and 16 percent of test results come back positive in recent days, a high rate that reflects more stringent testing criteria.

Despite increased testing, the proportion of positive tests remains high

D.C. has tested nearly 8,000 people...

7,823 people tested

8,000 total covid-19 tests

No data for March 20

0

March 13

April 6

...but the percentage of positive tests is high, reflecting stringent testing criteria

25% positive test rate (cumulative)

15% of all D.C. covid-19 tests

are positive

South Korea, which tested widely for covid-19, had a 7.5% positive test rate

at the peak of the virus’s spread.

0

March 13

April 6

D.C. has tested nearly 8,000 people...

7,823 people tested

8,000 total covid-19 tests

No data for March 20

0

March 13

April 6

...but the percentage of positive tests is high, indicating stringent testing criteria

25% positive test rate (cumulative)

15% of all D.C. covid-19 tests were positive

South Korea, which tested widely for covid-19, had a 7.5% positive test rate at the peak of the virus’s spread.

0

March 13

April 6

D.C. has tested nearly 8,000 people...

7,823 people tested

8,000 total covid-19 tests

No data for March 20

0

March 13

April 6

...but the percentage of positive tests is high, reflecting stringent testing criteria

25% positive test rate (cumulative)

15% of all D.C. covid-19 tests

are positive

South Korea, which tested widely for covid-19, had a 7.5% positive test rate

at the peak of the virus’s spread.

0

March 13

April 6

“The positivity rate continues to increase in the District and that could be a function of a number of things,” said LaQuandra Nesbitt, the director of the D.C. Health department.

“What we may be observing is ... our health care providers, the doctors who decide who gets tested, them being more focused on those priority groups: People who are hospitalized, our health care workers, first responders, individuals over the age of 65, people who have underlying health conditions, and focusing on individuals who have symptoms being tested.”

As a result, testing data has its limits.

“Testing only symptomatic people isn’t even telling you the complete story,” said Lucy Wilson, an infectious disease specialist and faculty member at the University of Maryland at Baltimore County. “If you look at the testing data, it can be useful for a snapshot of the overall prevalence of disease in a population … but it’s not a complete picture of the disease.”

Experts say the key data points to watch are not necessarily the number of known cases, but the use of health-care resources.

“One of the important things to monitor is if the health-care system is overwhelmed. Are hospitals full? Are the ICU beds full? Are there enough ventilators?” Wilson said. “The indicator of whether our social distancing is working is whether we can take care of the people who are most severely affected by covid-19.”

Ventilator usage in the District

On March 25, D.C. hospitals had 405 total ventilators and about 36 percent were in use. By April 6, capacity had increased to 432 ventilators, with about 41 percent in use.

300 ventilators

available

258

255

Available ventilators

March 25

April 6

0

Ventilators in use

147

177

300 ventilators

in use

300 ventilators

available

258

255

Available ventilators

March 25

April 6

0

Ventilators in use

147

177

300 ventilators

in use

300 ventilators

available

258

255

Available ventilators

March 25

April 6

0

Ventilators in use

147

177

300 ventilators

in use

The District has, so far, been one of a handful of localities to release detailed demographic data on who is contracting coronavirus and dying from it.

Men are slightly overrepresented in infections and deaths, making up 13 of the 23 fatalities. Racial data released this week shows black residents, who are 46 percent of the District’s population, account for nearly 6 in 10 deaths and a similar proportion of the reported cases where officials know the person’s race.

More than half of the known cases in the District involve people over the age of 40, which is higher than the median age of 34 in the general population. Globally, seniors are most likely to die, and the average age of the dead in D.C. is 66.

Ages of reported coronavirus cases and deaths in D.C.

Known cases

Known deaths

296

219

205

188

170

79

30

24

10

4

1

1

0

5

2

0

19-30

31-40

41-50

51-60

61-70

71-80

81+

0-18

The youngest

known patient was

The oldest known patient was 98 years old.

diagnosed at 8 weeks old.

0

100

Median age of deceased patients: 66

Median age of residents: 34

Median age of known patients: 46

Known cases

Known deaths

296

219

205

188

The youngest

The oldest known patient was 98 years old.

170

known patient was diagnosed at 8 weeks old.

79

30

24

10

5

1

4

1

2

0

0

0-18

51-60

19-30

31-40

41-50

61-70

71-80

81+

0

100

Median age of known patients: 46

Median age of deceased patients: 66

Median age of residents: 34

Known cases

Known deaths

296

219

205

188

170

79

30

24

10

4

1

1

0

5

2

0

0

31-40

41-50

51-60

61-70

71-80

81+

0-18

19-30

The youngest

known patient was

The oldest known patient was 98 years old.

diagnosed at 8 weeks old.

0

100

Median age of deceased patients: 66

Median age of residents: 34

Median age of known patients: 46

Washington has many more cases per 100,000 residents than the surrounding metro area, according to county-level data from Johns Hopkins University. The District is followed by Prince George’s and Montgomery counties in Maryland, and Arlington County in Virginia.

Total reported deaths by county in the D.C. area

Covid-19 deaths per 100,000 residents

0

1

2

3

MD.

W.V.

VA.

D.C.

Covid-19 deaths per 100,000 residents

FREDERICK

0

1

2

3

JEFF.

MONTGOMERY

W.V.

MD.

Loudoun

D.C.

CLARKE

VA.

ARL.

PRINCE

GEORGE’S

FAIRFAX

WARREN

FAUQUIER

CALVERT

PRINCE WILLIAM

CHARLES

STAFFORD

SPOTSYLVANIA

Covid-19 deaths per 100,000 residents

0

1

2

3

MD.

W.V.

VA.

D.C.

Compared with other metropolitan areas, the D.C. metro area has roughly 1 death per 100,000 residents. That’s nowhere near the rate of hard-hit urban areas like New Orleans (29) and New York City-Newark-Jersey City (26).

Covid-19 deaths per 100,000 residents in selected metropolitan areas

29.0

New Orleans

26.0

New York

14.7

Detroit

7.4

Seattle

2.2

Philadelphia

2.1

Miami

1.4

Baltimore

1.3

D.C.

1.0

San Francisco

0.6

Phoenix

0.6

Dallas

0.6

Minneapolis

0

5

10

15

20

25

30

New Orleans

29.0

New York

26.0

Detroit

14.7

Seattle

7.4

2.2

Philadelphia

Miami

2.1

Baltimore

1.4

D.C.

1.3

1.0

San Francisco

0.6

Phoenix

0.6

Dallas

0.6

Minneapolis

29.0

New Orleans

26.0

New York

14.7

Detroit

7.4

Seattle

2.2

Philadelphia

2.1

Miami

1.4

Baltimore

1.3

D.C.

1.0

San Francisco

0.6

Phoenix

0.6

Dallas

0.6

Minneapolis

One thing that is certain from the first 30 days is that the pandemic’s grip on the District is far from over.

“We are concerned that the next wave, if you will, if you consider New York City the first wave and other cities that we heard about,” Bowser said this week. “D.C. could be in the second wave.”

About this story

Sources: D.C. Department of Health, Johns Hopkins University.

D.C. initially reported new cases, recoveries, and deaths on the day they occurred. On April 1, D.C. began reporting changes the day after they occurred. The data on this page reflects the dates of diagnoses, recoveries, and deaths, rather than the day they were announced.

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Alyssa Fowers is a graphics reporter for The Washington Post.FollowFollow
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Fenit Nirappil covers D.C. government and politics. Before he joined The Washington Post in 2015, he covered the California statehouse for the Associated Press and suburban government outside Portland, Ore., for the Oregonian.FollowFollow