Yesterday’s numbers (from Worldometers, as
of about 7 PM EDT March 29)
Total US confirmed cases: 142,746
Increase in cases since previous day: 18,965
(vs. 19,525 increase yesterday)
Percent increase in cases since yesterday: 15%
(vs. 19% yesterday)
Percent increase in cases since 3 days previous: 37% (vs. 44% yesterday)
Total US deaths as of yesterday: 2,489
Increase in deaths since previous day: 260
(vs. 533 yesterday)
Percent increase in deaths since previous day: 12% (vs. 31% yesterday)
Expected* US deaths over course of
pandemic: 97,133 (based on 4% case
mortality rate)
Expected* US deaths over course of pandemic: 145,699 (based on 6% case mortality rate)
Expected* US deaths over course of
pandemic: 194,266 (based on 8% case
mortality rate)
Projected as of April 5 (7 days from
yesterday):
These numbers assume we wait until
April 5 to impose a total lockdown, and that new cases drop to zero on May 2.
Total cases: 268,079
Total expected* deaths over course of
pandemic: 216,452 (324,678 with 6% mortality rate)
Projected** number of actual deaths on 4/5
alone: 2,838 (i.e.
almost as high as total deaths on 9/11. Of course, this number keeps climbing)
Case mortality rate used to compute total
pandemic death estimates: 4%
Projected as of April 11 (14 days from
yesterday):
These numbers assume we wait until
April 11 to impose a total lockdown, and that total new cases drop to zero on
May 9.
Total expected* cases: 503,157
Total expected* deaths over course of pandemic:
406,258 (609,387 with 6% mortality rate)
Projected** number of deaths on 4/11
alone: 10,463 (equal
to about three times total deaths on 9/11. And this is the reported deaths in a
single day)
* Based on growing total cases by
the 3-day growth rate in cases as of yesterday: 37%. Further assumes that as of
the day in question, a total lockdown is imposed and it’s 100% successful,
meaning new cases are zero 28 days later.
Total
Recoveries in US as of yesterday (3/29): 5,211
Total
Deaths as of yesterday: 2,489
Deaths
so far as percentage of closed cases (=deaths + recoveries): 38% (actually higher than that, because I forgot
to get the Recoveries number this morning, and both deaths are about higher as
I write this)
Date on which 100,000
deaths will be set in stone: March 30 (yes, today!)
Date on which
500,000 deaths will be set in stone: April 14
Date on which 1
million deaths will be set in stone: April 20
These are
based on the assumption that, on that date, a total lockdown will be put in
place. It will be 100% effective (0 new cases) 28 days later.
I decided that I couldn’t live with a very
unrealistic assumption I’ve been making for a week or so: That when a decision
to totally lock down the country (which is what most of the experts are calling
for) is made, it will be in effect just two weeks. At the end of that period,
all infected people will have been identified, so new cases will fall to zero.
The people identified as infected will be quarantined (alone, not with their
families); their contacts will all be traced, and they will be quarantined,
too.
I’ll bet you can see lots of holes in this –
I always could, too, but I thought this would be a good yardstick. Since the
numbers I was reporting were so horrible anyway, I decided it was better to let
people take these numbers with a grain of salt and use them as comparisons (as
I did, in determining the cost of waiting one day to lock down the economy –
which was about 10,000 deaths when I wrote that a couple days ago, but is today
at about 17,000 deaths).
I have now extended the lockdown in my
assumptions to 28 days (and there are proposals for a two-month total lockdown,
which will probably be necessary anyway), keeping the same assumption that it
will be 100% effective and new cases will be zero at the end of the 28 days.
This is much more realistic, but there are
some big holes in this as well. Probably the biggest is, of course, testing.
People are still having a very hard time getting tested, and even then it takes
up to two weeks to get the answer (by which time you’ve either fully recovered
or you’re probably in the hospital, fighting for your life).
You often have to have very clear symptoms
to even get a test. And even if you have clear symptoms, the hospital might
well send you home if they think it’s unlikely you’ll develop serious problems.
Even more importantly, many times the hospital won’t even administer a test
even if they’re pretty sure you have Covid-19, because they don’t want to waste
valuable tests (this has been happening in New York City, ground zero nowadays,
although it’s getting competition from New Orleans, Detroit and soon Chicago).
This, of course, means these cases won’t even show up in the tested totals
count.
So the lack of testing, far from being a
problem of the past, is even more acute now, since it’s almost ensuring that
the virus will continue to spread far beyond the people infected as of today. And,
if not solved by the time a national lockdown is listed, it will mean there are
a huge number of holes that will enable the virus to bounce right back (keep in
mind that as of March 1, there were about 100 confirmed cases in the US;
yesterday there were 143,000 and two weeks from now there will be 689,000. So
in a city of a million people that isn’t locked down today and has 100 cases
total, it’s very possible that about two thirds of the city will be infected in
one month. Do that for five or ten cities, and you begin to see how serious
this is.
The other unrealistic assumption I was
making was about the case mortality rate – i.e. for every 100 people infected,
how many will end up dying? I’ve been using 3%, and some people argued that was
too low. But China is at 4%, and their numbers have been steady – no new cases –
for the past couple of weeks (there are some serious questions about whether
this is in fact true, but since the questions relate to underreporting of both
cases and deaths, there’s no way to say now whether this might end up raising
or lowering the 4% rate).
For comparison, Italy is now at 11%. Spain
is 8.6%. Iran is 6.6%. France is 6.4%. And South Korea (who got hit faster and harder
than we did) is at 1.6%. So if anything I’d say 4% is too low for the US,
especially since the one thing that drives it higher is an overburdened health
care system. Since NYC ran out of intensive care beds on Friday, and there were
even last week some heartbreaking stories of care rationing there (the worst I
heard is that the rationing decisions aren’t being made at the hospital. They’re
being made by the EMTs, who have to take a look at the patient and decide – not
being doctors, of course - if it’s even worthwhile taking them to the hospital.
The last thing you want to have happen is to bring them in, take a bed that
someone with a better chance of survival could take, and have them die within
hours), I’d say it’s close to certain the system will be significantly
overburdened (and it’s made much worse by the lack of masks for staff members.
They’re literally asking whether they should keep working at all, since there’s
such a big risk they’ll get sick, and many will die. We can applaud their dedication
all we want, but if we can’t get them masks, the applause rings hollow indeed).
For comparison, I’ve put projections with 6%
mortality rate in the above, and in one case I did 8%. While I’m probably going
to continue with the 4% rate, I might decide it should be higher, especially if
the stories of overcrowding keep growing (although I won’t be able to bear
reading them at some point).
There’s one piece of good news today, which
is that for the eighth day in a row, the total case rate has declined. To
capture this a little better, I switched to basing my projections on the 3-day
average of the 3-day growth rate, vs. a 7-day average of the 7-day rate as
before. What’s causing this decline? Probably the mandatory shutdowns in a
number of states, although the national please-limit-your-gatherings-to-ten-or-fewer-people-not-that-we-want-to-cause-anybody-any-bother-or-anything-like-that
rule from the Federal government probably helps a little. Since many of the
state shutdowns have been in effect for more than a week, it’s likely that a
lot of their effect has already shown up in the case numbers. But I’ll continue
to monitor this trend.
But speaking of shutdowns, it’s good news
that Trump decided yesterday, after what must have been an interesting meeting
with Dr. Fauci, to extend his whatever-it-is another month. That will somewhat
help, but keep in mind that, with an exponentially growing threat like the
coronavirus, any partial mitigation just has the effect of buying a little more
time so the country can get better prepared – it doesn’t change the ultimate
course of the pandemic. And since in this case I’ve made my other assumptions
more realistic, nothing has really changed that much.
For example, if we institute a total
lockdown two weeks from yesterday (i.e. April 12), there will be 468,502
deaths, vs. 97,133 deaths if we’d done it yesterday. And these are both with a
4% mortality rate. If you want to see what 8% looks like (which would still be
3% less than Italy’s rate today), double them.
It seems to me that somebody might want to
do something about this urgently. But what do I know?
Comments
and questions are welcome. You can reach me at tom@tomalrich.com.
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