A bit of good news

As I did yesterday, I’m dispensing with the projections of deaths, since they once again have changed very little – because the 7-day growth rate is virtually unchanged. However, I do have my usual summary of yesterday’s numbers at the bottom of this post.

Below is the same table I showed in yesterday’s post. In that post, I focused on the last column, the ratio of deaths to closed cases. Now I’d like to focus on another thing I noticed in the table: The US ratio of deaths to total cases (in the fourth column) is right in the middle of the other countries. Our ratio is less than three times South Korea’s.

Why is this striking? Because there has been agreement for a long time that lack of testing capacity was severely constraining the case numbers. If we only test people who have symptoms of Covid-19, we miss the larger number who are infected but don’t have symptoms at all, or who have mild symptoms but decide that getting a test is too much of a hassle. At first, I projected case numbers, and used an assumed case fatality rate to project total US deaths over the course of the pandemic.

But I stopped doing that when I felt the case numbers just reflected testing capacity – if we doubled tests the next day, we’d probably come close to doubling cases. Early estimates by epidemiologists were that actual cases in the US were five to ten times reported ones. But since South Korea is definitely the gold standard for dealing with the pandemic, it’s likely our actual cases are less than three times reported ones.  So we’re moving in the right direction on testing. Maybe it won’t be too long before total cases number is a fairly accurate representation of actual cases.

But there’s another milestone we need to reach on testing, which is much farther away: It’s when we’re testing enough people to safely reopen all workplaces. People aren’t going to want to go back to work in an office or factory if they think there’s a good chance they’ll get infected. There will need to be at least weekly testing of all workers for that to happen. And some workers might not feel safe until there’s daily testing – which is being done in one workplace now, the White House.

There is a good article in the Washington Post today about Storm Lake, Iowa. They have a huge Tyson’s pork processing plant there, yet it was only last week that any testing was done on the workers – and no test results have been released yet. So people in the town have every reason to believe that their neighbors might be infected. Even though the plant is open, and restaurants are allowed to be open, few of them have actually opened. Nobody wants to take the chance that they’ll be served Covid-19 along with their pork chop.

Only when there’s widespread testing, with isolation and contact tracing for people who are found to be infected, will towns like Storm Lake be able to really open up. Again, to fix the economy, you first have to fix the virus. 

Country	Total Covid Cases	Total Covid Deaths	Ratio of Deaths to Total Cases	Recoveries	Ratio of Deaths to Closed Cases*
S. Korea	11,441	269	2.35%	10,398	3%
China	82,999	4,634	5.58%	78,302	6%
Italy	232,248	32,999	14.21%	152,844	18%
France	186,835	28,714	15.37%	67,803	30%
Spain	285,644	27,121	9.49%	196,958	12%
Iran	148,950	7,734	5.19%	116,827	6%
US	1,794,153	104,550	5.83%	519,611	17%

* *Total closed cases = total deaths + total recoveries

5/31: My friend Kevin Perry wrote in to say why he doesn't trust the recoveries numbers. This doesn't affect the subject of today's post, but it does affect yesterday's. In either case, what he says is interesting, and it shows I may be too optimistic about this:

It has become clear that many states are just not counting and reporting recoveries.  And the means for determining recovery is inconsistent.  Do you declare recovery by two consecutive negative tests, at least 24 hours apart?  Do you do, like Arkansas, simply assume recovery if the COVID-19 patient is not hospitalized 14 days after onset of symptoms?  How do you count the significant number of infected people who were either asymptomatic or whose illness was so mild that they never sought medical attention?

Testing for infection and testing for post-infection anti-bodies is also problematic.  There are instances where the nasal swab produced a negative result because the virus was centered in the lungs, not the nasal cavities.  And the anti-body test is now appearing to have as much as a 50 percent failure rate.

The “recovered” statistics are, in my mind, no longer meaningful.  Just as we have no idea how many people have been infected, we have no idea how many infected people have really recovered.

I. Total deaths

Total US deaths as of yesterday: 105,557

Increase in deaths since previous day: 1,010 (vs. 1,203 yesterday)

Percent increase in deaths since previous day: 1% (this number was 1% yesterday)

Yesterday’s 7-day rate of increase in total deaths: 7% (This number is used to project deaths in the table above – it was 7% yesterday. There is a 7-day cycle in deaths, caused by lack of reporting over the weekends from closed state offices. So this is the only reliable indicator of a trend in deaths, not the one-day percent increase I used to focus on).

II. Total reported cases

I no longer pay any attention to the reported case number. It is a huge underestimate of actual cases, which is at least 5-10 times what’s reported. This is because of the huge shortage of testing capacity. For reported cases to be anywhere near actual cases, we would need to be doing millions of tests a day. I believe the US has done fewer than 7 million tests since the start of the pandemic.

Total US reported cases: 1,816,897

Increase in reported cases since previous day: 23,244

Percent increase in reported cases since yesterday: 1%

Percent increase in reported cases since 7 days previous: 9%

III. Deaths as a percentage of closed cases so far in the US:

Total Recoveries in US as of yesterday: 535,238

Total Deaths as of yesterday: 105,557

Deaths so far as percentage of closed cases (=deaths + recoveries): 16% (vs. 17% yesterday) For a discussion of what this number means – and it’s very important, see this post.

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com