Dr. Fauci (although I’d prefer to call you Saint Anthony, if that’s
OK), you once again didn’t follow my advice
to resign yesterday. To be fair, I said you should do that because Trump was
about to fire you, whereas yesterday Trump stated flatly that he wasn’t going
to fire you.
So far, so good. But you didn’t let it stand like that. You felt
compelled (perhaps were compelled is better wording – it really doesn’t matter
at this point) to take back what you had said on Sunday that got Trump and his
far right friends so mad – that (to quote ABC News) the administration "could
have saved lives" had firm social distancing guidelines been enforced
earlier, but there was "pushback about shutting things down." Of
course, the truth of what you said on Sunday was no more deniable than a
statement that the sun might not rise tomorrow, but you managed to deny it
anyway! So once again, you’ve given Trump a clean bill of health for all of the
mistakes (a few due to malevolence, but most due to pure incompetence, which
has been the one unifying trait of his administration from the start of his
presidency) he’s made so far during the crisis.
At this point, my big concern isn’t assigning blame for the mess we’re
in – there’s plenty of time later to do that. But I am concerned about
finally putting a stop to the daily “mistakes” in the White House that are
making things worse. And the biggest of these is that Trump continues to
believe he’ll be able to open up the economy very soon, even if the governors
don’t want to do that (and the majority of them don’t. But there are a few who
wouldn’t object at all, like the wacky governor of South Dakota. She refuses to
lock down her state, but instead intends to “do something” about the
coronavirus by instituting a statewide test of hydroxychloroquine, the miracle
drug Trump has been touting as the cure for Covid-19. She’s doing this even
though a test
of choloquine – closely related to it – on 89 Covid-19 patients in Brazil was
halted because a number of them developed irregular heart rhythms and 11
of them died by the sixth day of their treatment. I’m sure the people of South
Dakota will be very pleased to sacrifice one eighth of their number to help
prove their governor’s loyalty to Trump).
Of course, Trump won’t be able to open the country up. The Constitution
clearly gives these powers to the states, and as late as Sunday, Trump was saying
the governors were responsible for the coronavirus response in their own
states. Clearly he wouldn’t have any leg to stand on if he even tried to do
this. Even the current Supreme Court majority will without a doubt confirm
that, if it even comes to them to decide (which it won’t).
But here’s another reason why Trump won’t be able to “open up” the
economy whenever he wants: Even in states where the governor hasn’t implemented
a near-total lockdown, the people are locking themselves down! They’re not
going to malls, restaurants, movie theaters (if any of those are still open in
the US today. Probably not), etc. And businesses are trying to have their
employees work from home as much as possible. People and businesses in these
states have decided that their own lives are perhaps more important than trying
to make Trump look good, so that he can continue to assert that life can go on
as normal in the face of an existential threat. It can’t. Period.
Yet Trump is wasting valuable time on pushing for a reopening, when the
tasks he should be accomplishing are being neglected:
- Testing is still woefully short of what
is required to begin to restart the economy. I read yesterday that people –
who are clearly sick with the virus – are getting in line in the middle of
the night for “drive through” testing in New Jersey, on the hope they’ll
be tested the next day before the supplies run out (which they do every
day). Testing kits are more available now, but they rely on supplies that
aren’t readily available at all. Had there been…you know…planning
in February and March, when it became clear that the coronavirus was here
and spreading quickly, the government could have figured out other sources
for these supplies (the reagents and the prepared cotton swabs), and if
there were none readily available, used the Defense Production Act to
compel them to be produced. Until everyone in the US can be tested say at
least once a week if they want to (since companies will need to do that
for everybody who comes in to work, if for no other reason than to protect
themselves against lawsuits if people die), the economy can never
be opened up.
- There needs to be a whole industry for
contract tracing set up, since for every person who tests positive, all of
their recent close contacts need to be identified and quarantined. In
Wuhan alone, the Chinese deployed 1,800 teams of five people to trace
contacts. Given the much larger scope of our problem, we probably need
500,000 or more people just doing contract tracing. This would be a great
way to create work for people who are laid off. Are we doing anything
about this now? If so, I haven’t heard of it. But again, there’s no way we
can possibly open up the economy until the workforce for contract tracing
is trained and in place.
- As everyone knows, our ultimate salvation
will be a vaccine. And as everyone except Trump knows, this will probably
take 18 months to be developed and tested. But even when that happens, it’s
going to need to be manufactured in enough quantity that literally every
person in the US will receive it. That’s going to take a lot of factory
capacity, and since no drug company builds a manufacturing facility just
on the off chance that it might be needed some day, the government will
have to either place firm orders for certain factories to be ready to
produce the vaccine when it’s approved, or they will need to arrange for
new ones to be built. Is any of this going on now? If it isn’t and that’s
not corrected soon, we’ll be in the same position for the vaccine as we
are for the virus itself – scrambling around to put in place facilities
that we should have (and other countries did) put in place as soon as the
gravity of the situation became clear a couple months ago.
There are more things he should be doing, of course. But the point is
that Trump is wasting time on planning something that will never happen until
he does the stuff he’s not currently doing. This would be comical were it not
that the American people will pay a huge toll in deaths for every day that
Trump delays doing these things.
And what is that daily toll? My “set in stone” numbers are a projection
of total US deaths over the course of the pandemic, based on the day’s total
reported cases. They’re based on the idea that a total lockdown will be put in
place as of the day the calculation is made (you can read the full set of
assumptions below). Obviously, no total lockdown will be put in place anytime
soon, so these numbers are a projection of minimum deaths over the
course of the pandemic.
As shown below, the set in stone number for today is 179,000. The same
number for tomorrow is 9,000 higher, and of course the difference itself keeps
growing day by day (remember, exponential growth). But let’s use the 9,000
figure. This is the minimum number of additional deaths, over the course of the
pandemic, that are caused each day that Trump delays doing the right
thing. So the cost of a one-week delay? 63,000 deaths at a minimum.
And this is the real problem, Dr. Fauci. By giving Trump cover not to
do what needs to be done, and to waste his time advocating and planning for
something that will never be done as he intends, you are costing the US 9,000
deaths each day.
But I’m not even advocating you resign, Dr. Fauci. Just go back to your
National Institute of Allergy and Infectious Diseases, and make sure all of the
workers there are properly protected. Don’t make any more statements of any
kind, and don’t even visit president Trump anymore. You have a great excuse for
this – social distancing!
Now, the
Numbers
All numbers below are based on yesterday’s reported figures of total
confirmed cases, total deaths and total recoveries, published on
Worldometers.info. I’m happy to send my spreadsheet that calculates all of
these to anyone who wants to check the calculations, although they follow the
assumptions described below.
Note on
April 14: This is the first day that I’ve used my new estimate of the case
mortality rate: 7%, vs. the 4% estimate I was using. I did this as a result of
a little spreadsheet “experiment”
I did on Sunday, which seemed to show that 7% was a much better estimate. But
if you think that’s too high, I’ll just point you to the actual case mortality
rate we have so far (discussed at the end of this post): It’s 39% as of today.
So if you think 7% is unrealistic (and it probably is), then it would be best
to go with 39%. That will require multiplying all of my “set in stone” estimates
of deaths (not the other death projections) by 5 ½ times! I hope that makes you
feel better.
Date on which the number of new deaths
on that day will probably exceed the toll of Sept. 11: April 20
Actual number of deaths during week ending
April 11 (Saturday): 12,126
Projected* number of deaths during
week ending April 18 (Saturday): 14,541 (i.e. >2,000
per day)
Projected* number of deaths during
week ending April 25 (Saturday): 24,503 (i.e. >3,000
per day)
Projected* number of deaths during
week ending May 2 (Saturday): 44,218 (i.e. >6,000
per day)
Projected* number of deaths
during month of April: 83,440
Number of new deaths on May
1 alone: 6,118
* Projected
deaths for each day equals the previous day’s deaths, grown by yesterday’s
3-day percentage growth rate in new deaths, which as of today is 39%. The
weekly number is the sum of the projected deaths for the 7-day period. Note
that my estimated case mortality rate doesn’t affect these projections at all.
I. Numbers
based on total cases, actual and projected
Total US confirmed cases: 587,173
Increase in cases since previous day: 26,740 (vs. 29,938 increase two
days ago)
Percent increase in cases since yesterday: 5% (vs. 7% two days ago)
Percent increase in cases since 3 days previous: 17% (vs. 23% two days
ago)
“Set in
stone” US deaths* over course of pandemic: 179,381 (based
on 7% case mortality rate)
*This number
assumes a) Reported cases are a fairly accurate estimate of total cases; b) Total
cases grow by 17% into the future (= yesterday’s 3-day growth rate in cases);
c) We impose a massive lockdown, with prohibition of all non-essential travel, today;
d) New cases drop to zero in 28 days, because of the lockdown, but they
continue to grow at the current projected rate up to the 28th day; e)
testing and contract tracing are widely available by the 28-day mark; and f) the
case mortality rate = 7%.
Projected
as of April 21 (7 days from today):
These
numbers answer the question: What would happen if we wait seven days to totally
lock down the US, based on the assumptions below (which frankly are themselves
wildly optimistic).
Total expected
cases*: 897,597 (vs. 936,345 expected two days ago)
Total expected
deaths set in stone** over course of pandemic: 270,455 (vs. 255,707
expected two days ago, using 4% case mortality rate)
* The
expected cases number assumes that total cases grow by 17% every three days, for
the next 7 days (= yesterday’s 3-day growth rate in cases).
**This
number assumes a) Reported cases are a fairly accurate estimate of total cases;
b) Total cases grow by 17% into the future (= yesterday’s 3-day growth rate in
cases); c) We impose a massive lockdown, with prohibition of all non-essential
travel, on April 21; d) New cases drop to zero in 28 days because of the
lockdown, but they continue to grow at the current projected rate up to the 28th
day; e) testing and contract tracing are widely available by the 28-day mark;
and f) the case mortality rate = 7%.
Projected
as of April 28 (14 days from today):
These
numbers answer the question: What would happen if we wait 14 days to totally
lock down the US, based on the assumptions below (which frankly are themselves very
optimistic)?
Total
expected cases*: 1,287,346 (vs. 1,500,882 projected two days ago)
Total deaths
set in stone** over course of pandemic: 393,285 (vs. 418,516
projected two days ago, using 4% case mortality rate)
* The
expected cases number assumes that total cases grow by 23% for the next 7 days
(= yesterday’s 3-day growth rate in cases).
**This
number assumes a) Reported cases are a fairly accurate estimate of total cases;
b) Total cases grow by 23% into the future (= yesterday’s 3-day growth rate in
cases); c) We impose a massive lockdown, with prohibition of all non-essential
travel, on April 18; d) New cases drop to zero in 28 days, because of the
lockdown, but they continue to grow at the current projected rate up to the 28th
day; e) testing and contract tracing are widely available by the 28-day mark;
and f) the case mortality rate = 7%.
Date
on which 500,000 total pandemic deaths will be set in stone: May 3
Date
on which 1 million total pandemic deaths will be set in stone: May 16
Number
of deaths set in stone on April 30: 433,164
II. Numbers
based on total deaths, reported and projected
(All of the
numbers below are based on reported deaths, not reported cases and an assumed
case mortality rate of 7%. The reported cases number is the basis for the set
in stone deaths numbers above; however, there’s general agreement that reported
cases are some fraction of actual cases. So the projections below are going to
be much more accurate estimates of deaths than the ones above, at least in the
shorter term)
Total US
deaths as of yesterday: 23,644
Increase in
deaths since previous day: 1,529 (vs. 1,819 two
days ago)
Percent
increase in deaths since previous day: 7% (vs. 10% two days ago)
Yesterday’s
3-day rate of increase in total deaths: 26% (vs. 39% reported yesterday)
III. Reported case mortality rate so far in
the pandemic in the US:
These numbers are also unaffected by the
increase in assumed case mortality rate to 7%.
Total Recoveries in US as of yesterday: 36,948
Total Deaths as of yesterday: 23,644
Deaths so far as percentage of closed cases
(=deaths + recoveries): 39% (vs. 40% two days
ago) Let’s be
clear. This means that, of all the coronavirus cases that have been closed so
far in the US, 39% of them have resulted in death (compare that to the 7%
mortality rate I’ve now using to calculate the “set in stone” total pandemic
deaths numbers). Of course, this number will come down as time goes on and more
cases are closed in which the victim recovered. But this number has gone down
and up since Worldometers started publishing the recovery rate on March 26
(when it was 41%), and on about half the days, it’s gone up; there is still no
sign of a downward trend. I’d say it’s more likely my 7% 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.
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