The good news: There’s bipartisan agreement on what to do! The bad news: Both parties are wrong

I now have two blogs: https://tomalrichblog.blogspot.com/ (devoted to cybersecurity and compliance in the electric power industry) and https://thepandemicblog.blogspot.com/ (devoted to...well, you know what!). While I will continue to put pandemic posts on both blogs in the near future, if you're only concerned with pandemic issues (that's also a limited audience: only human beings) you might want to subscribe to the email feed on this blog, since it will only have pandemic-related posts.

Yesterday’s numbers (as of noon EDT):

Total US confirmed cases (from Worldometer): 43,734

Increase in cases since previous day: 10,168

Percent increase in cases since yesterday: 30%

Percent increase in cases since 7 days previous: 838%

Expected cases 7 days from yesterday (March 29): 366,445 (up about 80,000 from yesterday)

Expected cases 14 days from yesterday (April 5): 3,070,417 (up about 800,000 from yesterday)

Total US deaths: 582

Increase in deaths since yesterday: 124

Percent increase in deaths since yesterday: 27%

Expected US deaths over course of pandemic: 1,312 (assumes no new cases starting today, and case mortality rate of 3%. Based on yesterday’s figures)

Expected US deaths 7 days from yesterday (March 29): 10,993 (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)

Expected US deaths 14 days from yesterday (April 5): 92,113 (ditto, but 14 days ahead. This is up 25,000 from yesterday)

Total closed cases so far (deaths and recoveries): 877

Deaths as percentage of total cases so far: 66

Here are the numbers as of yesterday. I’ve added two more lines at the bottom. Total closed cases is total deaths and total recoveries. As you can see, 66% of closed cases are due to death. Since I’m now using a case mortality rate of 3% (i.e. percent of total cases that result in death), does this mean you have to multiply all of my death numbers by 22? No. There are lots of reasons why closed cases would move along very slowly (Kevin Perry pointed out a few of them to me, such as that declaring a person to be free of coronavirus takes at least two tests a certain amount of time apart). So this percentage will come down over time, and since I’m assuming a 3 percent case mortality rate across the whole pandemic (i.e. we won’t know the true figure until all cases are closed), if I’m right, the 66% figure will ultimately end at 3%.

But the case mortality rate is totally dependent on how overwhelmed the hospital system is, and in that regard, we’re in big trouble – as we’ve all been reading. I imagine New York City will need to start triaging cases next week (in fact, Kevin just pointed out the report of Gov. Cuomo’s press conference this morning, which is heartbreaking for what it means for the residents – although my sister, who lives in Harlem, has been sheltered with her husband for a couple weeks. She needed to go from 127^th St. to Chinatown last week – over 100 blocks – and she walked the whole way, rather than take the subway). Other cities (probably not Seattle) likely still have a few weeks to get ready for the onslaught. Maybe they can fix some of the things that need to be done (and for a great article on what needs to be done across the board in the country as a whole – not just in the health care system – see this terrific piece in the NY Times today).

But nobody should think that any city, and certainly not the US as a whole, can escape the inexorable growth rate of reported cases and later on deaths. That is currently 830% a week, which is what I’m using in my projections. But let’s play a game here: Since I’m currently projecting that the total cases on April 5 will be over 3 million, what happens if the growth rate is half that, or 415% per week? When will the total cases in the US cross the 3 million mark? Take a guess – will it be July 1, September 1, never?

Nope, it will be April 16. So halving the growth rate buys us less than two weeks. How about if we bring the rate down to a quarter of what it is now, or 207% per week? Then the date is May 4, so we buy another couple weeks of time. But the end result is the same: absolutely huge numbers of cases, with corresponding huge numbers of total deaths. But what if we could magically reduce the total cases today to say the level they were three weeks ago, or about 10? Of course, all we’ll do then is just find ourselves in exactly the place we’re in today, except it will be 3 weeks later.

Which brings me to the title of this post. In one way, it’s heartening to see Trump and other Republicans, and Pelosi/Schumer and other Democrats, converging (although not completely) on a solution to save the economy: a) dumping massive amounts of cash (not literal cash, of course!) everywhere to keep businesses from liquidating, etc. Along with b) instituting partial measures that will slow the virus’ spread but not “kill the economy”.

I agree with part a) absolutely. Having studied economics with Milton Friedman (and read his and his wife’s great book, A Monetary History of the United States), I can assure you he would be saying the same thing now: We need to get money out there any way we can. That was his criticism of the Federal Reserve’s performance after the 1929 stock market crash. By letting banks fail and not getting off the gold standard, as some other countries did, they let the money supply plummet (since bank lending accounts for about 9/10 of the money supply, although that figure is perhaps out of date – it was a different world when I took two classes with Friedman, as an economics major at the University of Chicago, although I won’t say when that was. Would you believe the 1990s? I didn’t think so). They should have stepped in and done a lot of things the Fed is doing today (although the Fed had a much more limited view of its powers then, and the idea of the money supply as something more than the stock of gold was totally foreign). But even then, that’s not enough; there need to be fiscal measures, and Congress is stepping up to that plate now.

But I definitely disagree with b). Some other countries have not totally locked down but have come out very well, including South Korea, Singapore, Hong Kong and China outside of Hubei province (which remains locked down) – although the latter two seem to not have the virus as under control as everybody believed just a few days ago, according to reports I read yesterday.

But there’s a big difference between them and the US. Can you guess? Of course, it’s testing. They early on had the ability to test every person who might be infected, so they could be sure of having almost all infected people under quarantine.

The US, on the other hand, totally failed in the testing department, and for a very well-written (and heartbreaking, when you think of where we would be today if people in government had done things differently in early February) story on that, see this piece in the Atlantic (and if you don’t subscribe to that magazine, you should. They have the best writers in the US. This was Laurene Powell’s - Steve Jobs’ widow - intention when she bought the magazine a few years ago. She’s absolutely succeeded, showing she learned some things from her late husband).

Because of that failure, we probably know of no more than ten percent of the total cases out there. This seems to be the consensus figure of the epidemiologists, although I need to point out that the only numbers I’m tracking and projecting are confirmed cases, not the presumed ones. If you want to account for all of those presumed cases, just multiple all of the numbers at the top by 10 (not the growth rates, of course). I keep saying something or other is the scariest part about the situation the US is in right now, but I have to say I can’t think of anything scarier than what I just said.

This means that it’s totally impossible to get control of the virus without locking down the whole country and grounding all flights, with some important exceptions of course. If we do that today, in 14 days, we’ll know much more about what we have and what we don’t have. We can quarantine whoever is infected and also trace contacts (although if the lockdown has been 100% effective, there will be very few contacts for most people, other than their immediate family members), and then gradually start to lift the lockdown. In fact, my total pandemic deaths numbers (based on today’s cases, also cases 7 days from now and also cases 14 days from now) are based on exactly that assumption. To the extent that this assumption isn’t good (and you can be sure it won’t be), the outcome will be worse.

What’s another assumption I’m making? That there will be universal testing by the time the 14 days is over. If there isn’t, then any case that’s been missed can grow to become its own epidemic. Remember, drastically reducing the number of cases or their growth rate only buys us some time, usually in weeks not months – it makes no difference for the final result, unless other things have changed in the extra weeks it bought us. The total death rates aren’t going to change, unless we at the same time alleviate the hospital shortages (like – ahem! – ventilators), so that there isn’t the oversaturation that is now inevitable.

But let’s say we find a way to manufacture ventilators out of sand and ramp up to producing more ventilators than we currently have installed in the US every week, along with solving all of our other problems in health care. Then we could make a very significant dent in the expected mortality rate, and maybe even 1% is too high for the case mortality rate. Maybe it will be .25 percent, like in a couple Asian countries. If that happens, I agree we could then treat Covid-19 as no greater a threat than the flu, car accidents, or whatever else Trump can think of as a reason to continue his current disastrous course.

I’ll let you figure this one out. If a) we locked down the whole country today and kept it that way for 14 days; b) the lockdown is close to 100% successful, and very few cases remain undetected at the end of 14 days; c) universal testing is available by then, so that all the people who weren’t totally locked down can be tested; and d) we solved all of our healthcare delivery problems in 1-2 weeks, so that the system could easily absorb all new cases – then yes, I’d say we might be able to avoid numbers of deaths like I’m talking about, and the total deaths would be no more than the number of 1,312 above.

And if we wait a week to lock down the country but still do the other three things starting now, we’ll end up with 10,993 total deaths. And if we wait another week, there will be 92,113 deaths. But remember, the CDC itself now projects 200,000 to 1.7 million deaths.

If we do anything less than this now and rely on the various half measures we have in place now, all we’ll be doing is giving a million or two people another 3 or 4 weeks to live (see the first part of this post). I sure hope we can do better than that. And if we do away with those half measures as Trump wants to do in two weeks, we will ensure that deaths are more than they already will be.

If anyone would like to have my spreadsheet, so you can a) see if I’ve made some sort of massive mistake in how I set it up (and I’ve stated in this blog all of the assumptions I’ve used for the formulas – but I’d be very happy if someone could show me a big mistake!); and b) play around on your own (as I did earlier), let me know and I’ll be glad to send it to you. I’ll also love to hear anybody’s comments on where I’m wrong, etc. Believe me, I’ll respond to all of them, as long as you’re not going to hit me with a bunch of conspiracy theories or assertions that this is all going to magically blow away in X days. Trump is doing a great job in both of those areas; he doesn’t need any more help.