The Grim Numbers

Today’s numbers (as of noon EDT):

Total US confirmed cases (from Worldometer): 38,757

Increase in cases since yesterday: approx. 14,539

Percent increase in cases since yesterday: approx. 60%

Total US deaths: 400

Increase in deaths since yesterday: 98

Percent increase in deaths since yesterday: 32%

Expected US deaths over course of pandemic: 1,163 (assumes no new cases, and case mortality rate of 3%)

Note from Tom at 3 PM ET: I just checked the Worldometer site, and the confirmed cases have jumped by over 8,000 since when I last checked, which was about 4 hours ago. I updated the numbers above, but I haven't updated them in any of the discussion below. So just say that any number you see down there will be maybe 20% worse - this includes all of the death figures (with exponential growth, any change in the base number gets reflected exponentially in the later numbers). For some perspective, this means that about 20% of the entire Coronavirus cases in the US to date have occurred in the last four hours. I kid you not.

As you can see from the above, I’m preparing for the long haul now. I expect to be writing about the pandemic for a while (if I can stand it. It’s going to get harder and harder as the actual and expected deaths mount. It’s already hard), so I want every1,163body (including me) to see what I consider to be the most important numbers at a glance.

And for now, it seems to me the last one is the most important. I can promise you: that number will become more and more important as time goes on. Remember, it will grow exponentially along with the number of cases. Barring some big change in the growth rate of cases soon, expected deaths will be over one million before the end of April (and perhaps hugely over – like 2 million or more. I don’t even want to think about what the number will be in May, if we don’t get this thing under control. Maybe you thought I was exaggerating when I said that April will be hell on Earth, and May will be worse?).

And folks, if that doesn’t make you spit out your coffee in horror, I don’t know what will. This is really, really, really, REALLY bad!

Oh, and that’s not the worst of it. Worldometer has now added a “Closed Cases” box. A closed case is one in which the person has either recovered or died (note that the total cases number includes people who have recovered, since this is the most important comparison figure. There is also a box for “Active Cases”, which does subtract closed cases). Today, closed cases in the US total 527, meaning 178 have recovered. That is terrible news, since if taken at face value it means 66% of people who have contracted Covid-19 so far in the US have died!

I’m sure that number is true, but I did some comparisons. Spain (very hard hit by the virus, although also very recently) has a 45% rate, while Italy is 44%. On the other hand, I looked at the comparable figures worldwide from the Johns Hopkins site, and that shows a 12% percentage. Yet the figure for Hubei Province in China, where of course Wuhan is located, is only 1.6 percent.

I don’t have time to compare other countries, but I imagine the reason that the US, Italy and Spain are so high is that Covid-19 deaths are concentrated up front, while recovery (or at least, declaring the victim completely recovered) takes a lot longer. The epidemic is over in Hubei, as well as probably in China as a whole. So our rate won’t be anywhere near 66% when the epidemic has ended and nobody is still recovering.

However, don’t take too much comfort in this statement. It means that very soon – probably 2-3 weeks, maybe even next week – our hospitals will be overwhelmed with coronavirus patients, so our case mortality rate (which can only be determined when the epidemic is over, as it is in Hubei) will be much higher than Hubei’s.

Why will it be so much higher? Hubei was initially overwhelmed, but there was a huge national effort in China to help them, which seems to have saved a lot of lives. The big difference with the US is, when our surge hits (again, 2-3 weeks, maybe next week), it is going to hit hardest in more than one place in the US simultaneously. Of course, Hubei was the first place in China and the world, to be hit by the coronavirus.

Definitely Washington state and New York City will be hit by a surge in hospital demand soon, but maybe a few others as well. And even then, demands on hospitals will be high – or about to get high – in many if not most areas of the country. The thing about exponential growth is that, even if it starts at different times in different places, the end result is the same. So if say Wichita, KS is behind the rest of the country in identified cases now (and I don’t know whether they are or not), it definitely has a number of unidentified cases, and they will grow very quickly (since, of course, the people don’t realize they’re infected yet). Wichita’s peak will be maybe 3-4 weeks behind New York’s; maybe even more than that.

This means that – to be brutally honest – it may be very hard to share resources among US states, since any state that isn’t in crisis mode will probably be so within a few weeks. And it’s abundantly clear that the Federal government won’t be anywhere near ready to provide the help that’s really needed for the hospital systems.

I just moved my estimate of the US case mortality rate from 2 to 3 percent (and rewrote the beginning of this post, which is why you don’t see a 2% number there). But that may not be the end of it; I may need to push it up again. I will try to follow this, to the best that my amateur status – with no resources to devote full-time to epidemiology – will allow. Remember, every time I push up the mortality rate, the death rates go up as a percentage of the previous number. So by moving it from 2 to 3 percent, this effectively means I multiplied all of my death figures by 1.5.

If anything is clear, it’s that there’s no way anybody should even be questioning the need for immediate and complete social distancing nationwide, right away - both on a nationwide and state-wide level, as well as on the level of your family. And I hate to say it, but if some of your family members just got the gospel of staying inside in the last few days – or even today – you may need to consider separating family members, or at least having everybody wear a mask in the house and stay in one room. If any one of the family is sick without knowing it, you’ll have just one sick person who needs to be helped, rather than all of them including yourself). And, of course, this is why we need to get leaders who see what needs to be done right now.

I heard the head of the FDA being interviewed on NPR a couple days ago. He was in full defensive mode, not wanting to admit that they and the CDC were well behind the 8-ball (especially in the matter of tests) in the crucial month of February, when other countries like South Korea, Singapore and even China (once Hubei was locked down) were successfully beating the virus back. At one point he said that the American people should appreciate that they (the FDA) had learned quickly and were moving on the right course now.

There’s one little fact he left out: that the FDA’s wonderful learning experience probably cost over a million US citizens their lives. I guess we’re supposed to forget all of that, since it’s water under the bridge. He is a disgrace and he should be fired, but a number of other people in Washington should be fired as well, starting with the guy at the top. It’s one thing to make some mistakes early on, but admit how wrong you were and make a concerted effort to change the situation quickly.

It’s a completely different thing to not admit that you did anything wrong, and to claim that you did exactly what anyone else would have done with the same knowledge at the same time. What you’re saying is that you’ll keep making big mistakes over and over, and blaming them on the fact that you didn’t have perfect knowledge of all facts, present and future. These clowns are leading us further and further into a black hole. Who’s going to rescue us?

And by the way, I don’t want to hear any more encomiums for Dr. Anthony Fauci. Sure he’s a good guy, and he’s known all along that big mistakes were being made, and he’s done what was within his power to do (which was very little), etc. etc. The fact is, he didn’t go into the Oval Office, pound on Trump’s desk, and demand that he take the coronavirus seriously. Of course, he would have been fired, but it would have been a lot clearer to the rest of the country that things were headed south. He still could do that today, and it could still make a huge difference (in fact, an even bigger one, since most of the voices saying that the virus was all a Democratic hoax have fallen silent – although certainly not all). As it is, all his gentle admonitions and tinkering around the edges are going to end up not saving any deaths, just delaying some by maybe a day or two. Exponential growth is a very cruel adversary.

Let’s try to hold total deaths under a million, anyway. That’s probably the best we can hope for at this point.