Relentless

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Yesterday’s numbers (as of about 6 PM EDT March 26)

Total US confirmed cases (from Worldometers): 85,749

Increase in cases since previous day: 17,155 (vs. 13,653 increase yesterday)

Percent increase in cases since yesterday: 25%

Percent increase in cases since 7 days previous: 522%

Minimum expected cases 7 days from yesterday (April 3): 639,146 (up about 128,000 from yesterday)

Minimum expected cases 14 days from yesterday (April 10): 4,763,991 (up about 1,000,000 from yesterday)

Total US deaths as of yesterday: 1,304

Increase in deaths since previous day: 268

Percent increase in deaths since yesterday: 26%

Minimum expected US deaths over course of pandemic: 2,572 (assumes no new cases starting today, and case mortality rate of 3%. Based on yesterday’s figures)

Minimum expected US deaths 7 days from yesterday (April 2): 32,306 (same number as above, but calculated 7 days ahead. Note this means the number of total US pandemic deaths anticipated 7 days from now, using the same assumptions as above. Note it isn’t the number of deaths I expect to see reported 7 days from now – I can’t estimate that through purely mathematical means) This is up about 3,000 since yesterday.

Minimum expected US deaths 14 days from yesterday (April 9): 240,399 (ditto, but 14 days ahead) This is up 98,000 from yesterday.

Just to be clear: The point of both of the above numbers is that, if we wait either 7 or 14 days to totally lock down the US, the cost in additional US deaths over the course of the pandemic will be about 32,306 or 240,399 respectively, vs. if we had acted today.

Total Recoveries in US: 1,868

Total Deaths: 1,304

Deaths as percentage of closed cases (=deaths + recoveries): 41%

Case mortality rate used to compute death estimates: 3%

These numbers pretty much tell the whole story. For those who don’t know, yesterday the US surpassed both Italy and China to become the country with the largest number of coronavirus cases. And if you look at the 25% growth rate in new cases (identical to the last two days), you’ll agree there’s no way any other country could catch up to us, absent a total lockdown in the US by say 5PM today – and even then it will be hard, because the cases will keep growing at their normal rate for two weeks.

Only after two weeks of lockdown will we even have a reasonable idea of total cases, and then we can lock down all of them – of course, that assumes there will be a) enough testing capacity and b) some place to lock these people down individually, since one of the lessons learned from Wuhan (one of many completely ignored by the White House) is that you can’t just rely on locking down families – you need to separate the family members as much as possible. If you don’t, then you’ll very possibly have an entire infected family.

Since the number of cases in the US two weeks from now will be in the millions, we’ll need say five to ten million individual rooms available. I’m sure the Trump administration will figure out how to do that in two weeks, just like they’ve figured out how to deal with the respirator problem: Put on hold a commitment by GM and Ventec (a ventilator company) to build 80,000, because it would cost about $1 billion. While it’s very possible we’ll need 1 million ventilators at the peak of the crisis (which unfortunately may come even before GM/Ventec can produce the 80,000, even if they’d been given the goahead yesterday).

Of course, the administration’s big problem – which was mentioned in comments by somebody at the White House yesterday – is that these ventilators might just be needed for a week. Then the crisis would pass, and there would be all these expensive ventilators sitting in a warehouse. What a tragedy. I agree completely with the WH in this regard: It’s much better to have a million or two more people die because those 80,000 ventilators weren’t available when they needed them (which could easily happen), than it is to have “wasted” $1 billion building up our strategic stockpile for the next time a virus like this hits. You just have to have your priorities in place, and this administration is making theirs abundantly clear.

Meanwhile, the new $2T recovery bill includes $17 billion for Boeing with no US equity position (even though that’s being done with the airlines), even though Boeing’s CEO stated last week that they didn’t need the money. It’s all about priorities…

I added two new numbers. One is total recoveries in the US (which had been published for a few days by Worldometers, then dropped). If you add that to total actual deaths, you get total closed cases so far. Dividing today’s total deaths figure yields deaths as a percentage of closed cases. Currently the number is 41%, but it was even higher when Worldometers first published it.

Compare this with the estimate of case mortality rate that I’m using for all of my deaths estimates, which is 3%. People have been telling me that number is way too high, although there will be no way to calculate it exactly until the pandemic is finished in the US. They often point to Wuhan (where it started, and is now close to finished, although they still haven’t ended the lockdown), where it seems the case mortality rate was 1.4%.

In reply, I say, “That’s a great example, because China beat the coronavirus in Wuhan by completely locking down Hubei province – and people are only now being allowed to leave there. The US needs to do the same thing but for the whole country, since the virus is literally popping up in just about every city now. If we were to do that, maybe we would end up with a 1.4% rate, too. But I certainly can’t assume that now.”

In fact, I’m wondering about the 3 percent number. China as a whole is now pretty stable, with about 82,000 cases and 3,200 deaths, which leads to a 3.9% rate. And they did a great job, after the initial miscues in Wuhan (and I’m not minimizing those, since the right steps at the right time there would have ended the whole epidemic – and even then, they could have grounded external flights so that their citizens didn’t infect the rest of the world. The novel coronavirus would just be something you’d find in some obscure academic journal entry. China has a lot to account for to the rest of the world. At the minimum, they need to explain how they won’t let this happen again). Given the problems we’re likely to have in hospitals across the US (and all ICU beds in NYC will be filled as of today), it might be hard to keep the rate at even 4%.

Finally, take a look at the last three numbers I highlighted in red and the sentence in red at the bottom. Were we to make the decision today to lock down the country (and were it to be perfectly successful, so that in 14 days there would be virtually no new cases), there will be 4,334 total deaths (using the average 7-day growth rate in total cases from the last 7 days. That is going to be my growth yardstick from now on, or at least until I think I've found a better one). If we wait a week to do this, there will be ­32,306 deaths. If we wait two weeks (to April 10), there will be 240,799 deaths. And beyond that, we're into the millions.

A couple people have told me we just need to give Trump more time on this. If I were sure that he’s a) learned his lessons from his complete inaction starting in late January, when many other world leaders did start preparing for the onslaught they knew was coming – while he has golfed every weekend until two weeks ago – and b) brought in someone who both knows exactly what needs to be done and won’t undercut him or her with his own contrary messages and actions (which he’s continued to do through yesterday and probably today, since I don’t do Twitter), I would give him the time. And of course, that person (Deborah Birx?) needs to implement a total lockdown starting tomorrow morning at the latest. If all this happened, I agree that changing horses at this point wouldn’t help.

But let’s say Trump wastes two weeks on his plan to have the whole country up and running by Easter (April 12) – omitting the fine detail that he’d have to force most of the workers to go to work at gunpoint, since they would literally be risking their lives to do so at that point – and on April 10 has a complete Road to Damascus conversion. He immediately implements a total national lockdown with grounding of all nonessential travel (and the lockdown, again, is 100% successful). That two weeks will have cost us 236,465 lives in the long run. I guess that’s not such a big price to pay. After all, Trump needed some time!

As I said, relentless.

11:30AM: You may have noticed that I implicitly wondered whether Deborah Bix might be the person to lead us from Egypt's land (where the plague runs rampant) to the Land of Canaan. However, I dropped that idea when I heard just now that she stated she knew of no shortage of ventilators. Unfortunately, nobody who works for Donald Trump can be trusted at this point. He needs to completely step aside, and someone from outside needs to be given complete control of the response. Preferably today, but tomorrow at the latest. If you don't understand why I said that, you haven't read this post.