Thursday, April 2, 2020

Paging Dr. Fauci!


Thanks for getting back so quickly, Dr. Fauci. Please wait a moment while I go over today’s numbers with the readers. In fact, why don’t you pay attention to these numbers, too? In the presentation you gave on Tuesday, it was quite clear that you’re working from a completely different set of figures. Unfortunately, if you agree with the simple projection methodology described below (at least in the first two weeks), you’ll need to get up today and give a completely different presentation. And if you don’t agree with the methodology, please let me know where I’m wrong!

Yesterday’s numbers (from Worldometers, as of about 7 AM EDT April 2)
Total US confirmed cases: 215,357
Increase in cases since previous day: 26,710 (vs. 24,212 increase yesterday)
Percent increase in cases since yesterday: 14% (vs. 15% yesterday)
Percent increase in cases since 3 days previous: 31% (vs. 32% yesterday)

Total US deaths as of yesterday: 5,113
Increase in deaths since previous day: 1,054 (vs. 884 yesterday) The first day above 1,000. Unfortunately, we’ll soon be looking back at this number nostalgically. See below.
Percent increase in deaths since previous day: 26% (vs. 28% yesterday)
“Set in stone” US deaths* over course of pandemic:  105,632 (based on 4% case mortality rate) Remember the range you gave on Tuesday for total pandemic deaths, Dr. Fauci? It was 100,000-240,000, although you said it could be a lot more if we don’t all practice social distancing. Well, the coronavirus decided not to wait for your timeline. It’s now certain that there will be over 100,000 deaths over the pandemic, and no amount of social distancing could change that.

*This number assumes a) Total cases grow by 31% into the future (= yesterday’s 3-day growth rate in cases); b) New cases drop to zero on April 30, because of the lockdown; and c) case mortality rate = 4%. To consider a 6% mortality rate, multiply each projection by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 11.75%.

Projected as of April 9 (7 days from today):
Total expected* cases: 433,882
Total deaths set in stone** over course of pandemic: 241,049
Projected*** number of actual deaths on 4/9 alone: 7,616
*Expected cases assumes a) Total cases grow by 31% into the future (= yesterday’s 3-day growth rate in cases); b) we wait until this day to impose a total lockdown; c) New cases drop to zero 28 days later, because of the lockdown.
** Deaths set in stone = expected cases X case mortality rate of 4%. To consider a 6% mortality rate, multiply the figure by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 11%.
*** Projected deaths = previous day’s death number, grown by that day’s 3-day percentage growth rate. Note this is calculated completely differently from the deaths set in stone.

Projected as of April 16 (14 days from today):
Total expected* cases: 755,996
Total deaths set in stone** over course of pandemic: 554,406
Projected*** number of actual deaths on 4/16 alone: 38,160 (HOLY S___!)
*Expected cases assumes a) Total cases grow by 31% into the future (= yesterday’s 3-day growth rate in cases); b) we wait until this day to impose a total lockdown; c) New cases drop to zero 28 days later, because of the lockdown.
** Deaths set in stone = expected cases X case mortality rate of 4%. To consider a 6% mortality rate, multiply the figure by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 11%.
*** Projected deaths = previous day’s death number, grown by that day’s 3-day percentage growth rate. Note this is calculated completely differently from the deaths set in stone.

Reported case mortality rate so far in the pandemic in the US:
Total Recoveries in US as of yesterday (4/1): 8,878
Total Deaths as of yesterday: 5,113
Deaths so far as percentage of closed cases (=deaths + recoveries): 37% Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 37% of them have resulted in death. Compare that to the 4% mortality rate I’ve been using to calculate total pandemic deaths, based on cases. Of course, this number will come down as time goes on and more cases are closed in which the victim recovered. But it’s only come down by about 4 percentage points since Worldometers started publishing the recovery rate on March 26, and about half the days (like yesterday), it’s gone up. I’d say it’s much more likely my 4% mortality rate will turn out to be too low, after the pandemic’s over and all of the bodies have been counted, than it will be too high.

Date on which 200,000 deaths will be set in stone: April 8
Date on which 500,000 deaths will be set in stone: April 18
Date on which 1 million deaths will be set in stone: April 26
“Set in stone” means that on that date, a total lockdown will be put in place. It will be 100% effective (0 new cases) 28 days later.

Thanks for waiting, Dr. Fauci. Here’s the situation: You have become known as the technical expert Trump is most likely to pay at least some attention to on the coronavirus, in part because of your long, distinguished career fighting epidemics, since HIV/AIDS. The whole country feels comforted, knowing that you have Trump’s ear, and he’s probably going to listen to you more than anybody else. The country trusts the numbers you give out, especially in Tuesday’s briefing. While they don’t like to hear that there might be 240,000 deaths in the US over the pandemic, they take comfort in their belief that you can be trusted to give them the real story.

And that’s the problem. You’re not giving them the real story at all. Just look at the numbers above (and let me know if you don’t agree with the simple projection methodologies I used), and compare them to what you said on Tuesday:

  1. The range of total pandemic deaths in the US will be 100,000 to 240,000. Guess what, Dr. Fauci? There are 105,000 deaths set in stone already. 241,000 deaths will be set in stone on April 9, and they’re only set in stone if we implement a total lockdown and grounding of all non-essential travel by all modes on that day. Do you really think we’ll get the total lockdown by April 9? More importantly, are you pounding on Trump’s desk every day, demanding he do this, since 135,000 of the 241,000 guaranteed pandemic deaths on the 9th will be simply because you didn’t do that today – or yesterday, as I said you should do in my post?
  2. You said that there could be up to 2.2 million deaths if we don’t do any social distancing. I assume that means social distancing on top of what’s already been done, right? What are the chances of that? Yes, Trump convinced Florida’s governor to lockdown yesterday as well as Georgia’s governor, and the latter said he did it because he’d just received information that the virus can be transmitted by asymptomatic people! And I’m sure he’s absolutely right. Georgia’s government is probably a lot like the Federal government, where the guy at the top only watches one news source that doesn’t provide information that will upset him, and where the subordinates are too cowed to do that, either.
  3. You’ve been a partial exception to that norm (being afraid to speak truth to power), but not much. For example, you surely knew in early February that every day’s delay in getting a massive rollout of testing would be a huge tragedy, because the virus was already here on our shores, and was already spreading at the same astronomical pace at which it spread in Wuhan. Yet you didn’t bring this up to the public until the end of February, and only then at a Congressional hearing at which you said, well, we kind of dropped the ball on testing – or something like that. And of course, you waited to be questioned on it. If you had clearly moved beyond that fearfulness, I would say the public’s faith in you is well placed. But you demonstrated on Tuesday that you’ve made no progress at all on that front.
  4. The big problem with the University of Washington study that you touted on Tuesday is that it’s based on the assumption that we’re going to put a lot more social distancing in place than is the case now. I don’t know whether it spells out exactly what that means, but I imagine it’s something close to the standard set that all the experts are advocating: total lockdown of the citizenry and cutting off all travel (with essential and emergency exceptions in both cases, of course). But how is this going to happen, since you didn’t call on Tuesday for anything except more cooperation by the population? Those who are scared now have presumably already locked themselves down, and those that aren’t scared aren’t going to do that until they are ordered to. A lot of people have been ordered to, and the 3-day growth rate in new cases that I track has come down from 100+% two weeks ago to 31% yesterday. Yet I’m using the 31% figure for my projections today, and I still get total pandemic deaths growing at the rates shown above. Do you think the growth rate in new cases will come down drastically, without much more social distancing than is in place now?
  5. And here’s the big problem with the study: It’s there to scare people into doing the right thing, isn’t that the case? But the numbers it’s predicting assume they will do the right thing. These numbers are comforting because people focus on the upper bound as “the worst it can get”, and make their plans accordingly – they don’t think that their particular or collective actions might bring total deaths way above the upper bound. Of course, this goes in spades for the Federal government, which now knows it can allow 240,000 deaths without incurring the ire of the Big Man (and Trump also said that his action in blocking travel from China in early February probably saved us from having total deaths go above 2.2 million, meaning he’s reserving the right to say later – when actual deaths reach say one million – that it’s not his fault because he prevented deaths from being much higher than that. It’s nice to see that he’s spending his time figuring out how to deflect the blame for an astronomical number of deaths, rather than to prevent those deaths from happening in the first place).

Dr. Fauci, just last week I was intending to write a post saying that you should quit now and bring the facts to the American people, so they can appreciate the real seriousness of the situation. For instance, you could get up and mention a few of the items you see in my numbers above. For example:

  • We went over 1,000 actual deaths in one day for the first time yesterday.
  • Just three days ago, total deaths so far in the pandemic exceeded total deaths on 9/11. But on April 6 alone, we’ll probably have about 3,700 deaths – i.e. hundreds more than we had on 9/11.
  • On April 9, we’ll have around 7,600 deaths in one day. On April 16, we’ll have about 38,000 deaths in one day. And don’t say anything about new social distancing – even if you were advocating it – helping to lower that number. Daily deaths are a function of cases 2-6 weeks ago, not cases today. Even if massive distancing is put in place next week, the earliest that could have an impact on actual deaths would be at the end of April, when we could be at over 1 million deaths every day.
  • This last sentence might sound outlandish, given that I’m saying we’ll only have about 3 million reported cases on that day, but this is a reflection of the fact that the actual cases are probably ten times reported cases, mostly due to the fact that we didn’t have the testing capability (and the willpower on the part of the Federal government, to be frank) to bring the virus under control in early February, when we could have. If that’s true, then it’s very likely that we’ll have more than 30 million real cases on April 30, so the 1 million deaths on that day isn’t beyond belief.

Of course, one million deaths a day is certainly unthinkable, and something will inevitably be done before then. I totally agree with that statement. I think within two weeks, and maybe one, a tsunami of public disgust will roll over the current administration, and someone will be brought in (like Bill Gates) to run the response – even if Trump and Pence remain in their current posts. But every day we waste before that happens will cost literally tens of thousands of lives.

So somebody needs to stand up today to demand that Trump impose a total lockdown starting tomorrow. I’ll give you until midnight to do that. But if you don’t by tomorrow, you should resign and we’ll have to find someone who can do it. Of course, I’m fine if you continue on your current day job. But Dr. Fauci, I’m afraid you’re a perfect example of the Peter Principle: someone who does his previous jobs well, but gets put into a position for which his temperament and skills are totally unsuited. You could have played a big part in preventing lots of lives from being lost, and you didn’t do that.

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