“I’ll take my usual trim and some coronavirus, please”

  

A very telling news story yesterday illustrated a significant problem that hasn’t been resolved, as most of the country rushes prematurely toward opening up. Or course, it’s linked to the bigger unresolved problems that are out there – including (have I mentioned this before?) a lack of adequate testing capacity. It’s problems like these (and the two I discussed in Friday’s post) that are certain to derail any large-scale reopening of the economy.

The story was about a Springfield, MO hairdresser who continued to work, even though she was symptomatic for Covid-19. At work, she exposed 91 other people (mostly customers, but including seven co-workers) to the illness. The local health department said that all 91 of those people would be tested for Covid-19 – and presumably they’ll be isolated if they test positive.

But she had also visited various stores – CVS, Walmart, Dairy Queen (all of these businesses, and the hairdressing establishment, were legally open). The health department announced approximate times when she had been there, and urged people who may have been threre with her to be “on the lookout” for Covid-19 symptoms – but, tellingly, they didn’t say that everybody who might have been in those stores at those times should be tested. This means that people in those stores, who might have become infected but are so far asymptomatic, are going about their normal lives and infecting their family and friends (and maybe their coworkers and customers). If testing were widely available and easy to do, all of those people could be required to get tested themselves. But of course, it isn’t.

Why did this hairdresser continue to work when she suspected she might already have Covid-19? This isn’t addressed in the articles (she hasn’t even been named, let alone interviewed), but let me take a guess at the most likely reason: She doesn’t get paid if she doesn’t work. And, like a large percentage of the US population, she doesn’t have savings to live on if she isn’t working (a large survey a couple years ago found that some number of American families doesn’t have the resources to meet an unexpected $400 expense). And of course unemployment insurance isn’t an option for her, since the business is open.

I remember that, as Congress started discussing the first big tranche of economic relief, it seemed to me it would be a no-brainer to include some provision requiring that workers be given sick pay, if not already provided. And if a business simply can’t afford to do that, the federal government would reimburse them for that. At the time, this seemed to me to be a simple – and relatively inexpensive – measure we could take to prevent incidents exactly like this one.  Of course, this didn’t happen, and who knows how many other symptomatic people are working (often in customer-facing industries) and spreading the virus today, because they have no other option?

P.S. As I’ve been writing this, my wife – who has been helping her family in Vietnam for a while – reported that in the last month there hasn’t been a single new Covid-19 case identified in the whole country (and of course, they still haven’t recorded their first death). This in a country with a per capita income that’s about 1/25 that of the US, which is very densely populated and is next door to China. She also reports that a lot of Vietnamese people in the US would love to return to Vietnam and wait out the pandemic there, but they aren’t allowed to.

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 10%.

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	9,385	1,341
Month of May	45,237	1,459 (=1 death every 59 seconds)	76%
June 6	10,278	1,468
June 13	11,255	1,608
June 20	12,325	1,761
June 27	13,498	1,928
Month of June	52,258	1,742 (= 1 death every 50 seconds)	116%
Total March - June	161,364

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 98,683

Increase in deaths since previous day: 1,036 (vs. 1,415 yesterday)

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

Yesterday’s 7-day rate of increase in total deaths: 10% (This number is used to project deaths in the table above – it was 11% 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: 1,666,829

Increase in reported cases since previous day: 21,930

Percent increase in reported cases since yesterday: 1%

Percent increase in reported cases since 7 days previous: 11%

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

Total Recoveries in US as of yesterday: 382,244

Total Deaths as of yesterday: 98,683

Deaths so far as percentage of closed cases (=deaths + recoveries): 18% (vs. 19% 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