A fall tsunami?

  

Some people might be tempted to take comfort in the fact that the US is taking longer to reach the 100,000 Covid-19 deaths figure than I and many others thought it would take. When we didn’t hit it on Sunday, I thought for sure it would yesterday, but I forgot about one thing: the fact that many of the offices that report deaths are closed over the weekend (and especially yesterday), means that the numbers have been abnormally low the last two days, and will probably continue low the next day or two – although it’s certain we’ll pass the 100,000 mark today.

Of course, as I’ve been noting, the 7-day rate of change (which smooths out the weekly reporting cycle) in total deaths has been declining since late March, yet the daily number of new deaths has been stuck around 1,000 or more. This is mostly because the increase in the absolute base number fights the decrease in the rate of change. As you can see below, even though new deaths this month will be lower than in April, June deaths will be higher than May’s, if the rate of change doesn’t fall further.

But even if the decrease in the rate of change wins out in the short term – and let’s say that means new deaths will be below say 500 a day in August and September – it’s still inevitable that we’ll have a fall wave of new infections, as both Drs. Fauci and Redfield (head of the CDC) have said. And if this pandemic is like the 1918 Spanish flu pandemic, it will be a much larger wave than the one we’re in now.

But even if the fall wave isn’t larger than the current one, the likelihood is we’ll have a lot more deaths anyway, because it will coincide with the normal fall/winter wave of the flu, meaning a lot of hospitals are likely to be overwhelmed. This was what Dr. Redfield said at one of the White House press conferences about a month ago – at which point Trump said he didn’t really mean that (but Redfield stood his ground, for once anyway).

As I’ve pointed out a number of times, even if we got total reported cases in the US back down to the level they were at the beginning of March (about 100), we would still have at least the current number of cases and deaths three months later as we have today – three months later than early March. And since it’s inevitable that we’ll have a much larger number than 100 in say August, it’s also very likely that we’ll have a much larger numbers of cases and deaths as we have today, in October or November.

And remember, most states locked down their population for at least a month, and we still have the numbers below. Yet Trump made it clear recently that there will be no lockdown this fall. So when the new wave hits, all bets are off.

My wife just told me from Vietnam that the Vietnamese government isn’t allowing Vietnamese citizens who have been living in the US to return, because of the risk they pose. This is a good indication that, 6-12 months from now, assuming we don’t have the virus under control, most countries in the world won’t permit anyone who has been in the US – citizen or no – to enter (or at least without a 14-day quarantine near the airport). What a nice situation that will be!

The numbers

These numbers are updated every day, based on reported US Covid-19 deaths the day before (taken from the Worldometers.info site, where I’ve been getting my numbers all along). No other variables go into these numbers – they are all projections based on yesterday’s 7-day rate of increase in total Covid-19 deaths, which was 9%.

Note that the “accuracy” of the projected numbers diminishes greatly after 3-4 weeks. This is because, up until 3-4 weeks, deaths could in theory be predicted very accurately, if one knew the real number of cases. In other words, the people who are going to die in the next 3-4 weeks of Covid-19 are already sick with the disease, even though they may not know it yet. But this means that the trend in deaths should be some indicator of the level of infection 3-4 weeks previous.

However, once we get beyond 3-4 weeks, deaths become more and more dependent on policies and practices that are put in place – or removed, as is more the case nowadays - after today (as well as other factors like the widespread availability of an effective treatment, if not a real “cure”). Yet I still think there’s value in just trending out the current rate of increase in deaths, since it gives some indication of what will happen in the near term if there are no intervening changes.

However, it’s 100% certain that deaths won’t stop at the end of June! They might decline some more this summer, but Drs. Redfield (CDC head) and Fauci both predict there will be a new wave of the virus in the fall, and one noted study said there was a good probability the fall wave would be greater than the one we’re in now, as happened in the 1918 pandemic.

Week ending	Deaths reported during week/month	Avg. deaths per day during week/month	Deaths as percentage of previous month’s
March 7	18	3
March 14	38	5
March 21	244	35
March 28	1,928	275
Month of March	4,058	131
April 4	6,225	889
April 11	12,126	1,732
April 18	18,434	2,633
April 25	15,251	2,179
Month of April	59,812	1,994 (= 1 death every 44 seconds)	1,474%
May 2	13,183	1,883
May 9	12,592	1,799
May 16	10,073	1,439
May 23	8,570	1,224
May 30	8,501	1,214
Month of May	43,983	1,419 (=1 death every 61 seconds)	74%
June 6	9,233	1,319
June 13	10,029	1,433
June 20	10,893	1,556
June 27	11,831	1,690
Month of June	45,751	1,525 (= 1 death every 57 seconds)	104%
Total March - June	153,604

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 99,909

Increase in deaths since previous day: 609 (vs. 617 yesterday)

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

Yesterday’s 7-day rate of increase in total deaths: 9% (This number is used to project deaths in the table above – it was 19% 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: 1,709,388

Increase in reported cases since previous day: 22,952

Percent increase in reported cases since yesterday: 1%

Percent increase in reported cases since 7 days previous: 10%

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

Total Recoveries in US as of yesterday: 465,668

Total Deaths as of yesterday: 99,909

Deaths so far as percentage of closed cases (=deaths + recoveries): 18% (vs. 18% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 18% of them have resulted in death. Compare this with the comparable number from South Korea, which is below 3%. China’s is 6%. The reason this number is so high is that total reported recoveries are so low. I’ve been assuming since March 26, when the recoveries number was first published, that it would rise, so that this percentage (which was 41% on March 26), would be far lower than it is now. It still has to drop a lot, but it currently seems to be making some progress. Hopefully it will be down to at most 6% in the near future.

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