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
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