Another important recovery step

  

For yesterday, Worldometers.info showed the lowest number of US Covid-19 deaths since March 30: 787 (yes, I didn’t leave off a digit! This was the first 3-digit deaths number since April 2). This will undoubtedly go back up in the next couple of days, if for no other reason than the fact that deaths are lowest every Monday and Tuesday - most likely because the local and state government offices that report deaths have much lower staffing levels on weekends (as my new friend Royce Howland pointed out to me this weekend).

This still may augur a lower number of deaths this week than last, although that would require the 7-day growth rate in total deaths to keep declining this week – as it has more or less steadily since March 28. But even if we do end up with lower new deaths this week than last, that doesn’t mean we’re on our way to zero new deaths (which of course would be the best possible indication that we have the virus under control. Of course, the best indication would be if new cases were zero, but because of the severe lack of testing so far, the reported case numbers are certainly some small percentage – maybe 10 to 20% - of the actual figure, so there’s no way to know for certain whether total cases are declining or not, although given that we added 20,000 new reported cases yesterday, it would be very hard to say it isn’t increasing).

To get to zero deaths, the growth rate in deaths would have to decline faster than the total number of deaths increases. For example, if the 2% daily rate of increase holds true tomorrow, there will be 15 more deaths than today, since tomorrow’s deaths will be 102% of today’s – that’s what exponential growth means. Of course, it’s very hard to see how we’ll ever get to zero deaths, without increasing, rather than decreasing, social distancing measures.

However, if we were down to say 10-20 new deaths a day, that would be victory to a lot of people, and I would be glad to see that. But real victory is only possible when we literally know every person who has the virus in the country and they’ve been quarantined – along with all of their close contacts, which means there is massive contract tracing. This literally means testing almost everybody in the country every week or two. And if we don’t do that, then we have to go with a total lockdown of the country for at least a month, with prohibition of all non-essential travel over say more than five miles. There simply is no other way to get the virus under control – and even when that happens, there are certain to be various hot spots popping up now and then, as happened just this week in China and South Korea.

One other thing about lockdowns: In a good article in the Washington Post today – which pointed out flaws in the arguments for reopening now – there’s the factoid that 66% of newly hospitalized Covid-19 patients in NYC had been sheltering at home. Of course, this means people in lockdown are infecting their families. This was observed early on in Wuhan, and the government there turned to putting infected people in empty hotels to complete their quarantines. This needs to be done here as well, along with massive testing and contract tracing. Of course, there are lots of empty hotels now!

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 18%.

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 if there are no intervening changes.

Week ending	Deaths reported during week/month	Avg. deaths per day during week/month	Pct. Change from previous month
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	14,207	2,030
May 23	16,729	2,390
May 30	19,698	2,814
Month of May	68,022	2,194 (= 1 death every 39 seconds)	114%
June 6	23,194	3,313
June 13	27,311	3,902
June 20	32,159	4,594
June 27	37,867	5,410
Month of June	135,190	4,506 (= 1 death every 19 seconds)	199%
Total March - June	267,083

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 80,787

Increase in deaths since previous day: 747 (vs. 1,418 yesterday)

Percent increase in deaths since previous day: 1% (vs. 2% yesterday)

Yesterday’s 7-day rate of increase in total deaths: 18% (This number is used to project deaths in the table above)

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: 1,367,963

Increase in reported cases since previous day: 20,645

Percent increase in reported cases since yesterday: 2%

Percent increase in reported cases since 7 days previous: 15%

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

Total Recoveries in US as of yesterday: 256,336

Total Deaths as of yesterday: 80,040

Deaths so far as percentage of closed cases (=deaths + recoveries): 24% (vs. 25% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 24% of them have resulted in death. Compare this with the comparable number from South Korea, which is below 3%. 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. This number is very high, comparable with Italy and France (China’s is 6%).

My guess is the fact that this number is still so high is just another indication of the ongoing shortage of tests, since if a person has clearly recovered, the hospital is unlikely to want to “waste” a test on them. But if it stays close to the current level even as testing capacity increases, this will be an indication of a deeper problem.

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