Time to Prepare!

The 7-day average rate of increase in total COVID-19 deaths looks like it’s fallen 2-3 percentage points since last week. This means that daily deaths for this week will be close to 1,000 for the first time since the week of April 4. It also means the daily deaths number has continued its decline since it peaked at 2,633 for the week of April 18. This of course has once again lowered my projected deaths for May and June, since they’re computed by projecting out yesterday’s seven-day growth rate in total deaths.

Will daily deaths in fact continue to decline? That’s simply not too likely. Most of the drop recently has been because the New York and New Jersey numbers have come way down from their peaks. But meanwhile, at least half of the states have rising case numbers, as they’ve eased off on lockdowns. For example, in Wisconsin, where the state Supreme Court invalidated the governor’s stay at home order two weeks ago, the number of cases hit its highest level so far yesterday.

At least some of the pressure is off our medical system, meaning people are less likely to die because of hospital overcrowding – but that’s a local phenomenon, so it could be easily reversed as outbreaks flare up in smaller cities and rural areas (as happened in Montgomery, Alabama, where hospitals reached their capacity last week).

But we’re hardly all the way home. With over 1.7 million active cases now, the coronavirus isn’t in any way beaten. Since we’ve decided we’re not going to do what’s necessary to beat it now, we have to be prepared for the fall wave, which is inevitable. It might be much larger than the wave we’re in now (as happened in the 1918 pandemic), but even if it’s the same size, there will be a big hospital overcrowding problem, since the fall Covid-19 wave will coincide with the annual seasonal flu wave (the CDC says there were 24,000 to 64,000 deaths in the 2019-2020 flu season, which officially ended on April 4).

So what needs to be done to prepare? Of course, the most important is to greatly ramp up testing, since what we have is still woefully inadequate (and hindered by the fact that the CDC has been inexplicably counting antibody tests with virus tests, even though the latter are the important ones. We need to be able to find out if people are sick now, not if they have ever had COVID-19 and presumably recovered). Contact tracing seems to be ramping up in many areas, but another thing that’s important is isolation of confirmed cases. If people quarantine with their families (as they’re doing now), they will end up infecting family members. In Wuhan, the Chinese took over hotels and used them to isolate sick people.

Of course, all this costs money. The Trump administration has made it clear it’s up to the states to arrange all of these things (even though this is much less efficient and very costly), yet at the same time they don’t want to “bail out” states, as if they had brought the current crisis on themselves. It’s inevitable they will get more money to he states, but it’s criminal that they’re not moving faster to do that.                                                                                                                

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 7%.

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	7,149	1,021
Month of May	42,623	1,375 (=1 death every 63 seconds)	71%
June 6	7,667	1,095
June 13	8,222	1,175
June 20	8,818	1,260
June 27	9,457	1,351
Month of June	36,258	1,209 (= 1 death every 71 seconds)	85%
Total March - June	142,750

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 103,344

Increase in deaths since previous day: 1,095 (vs. 1,624 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 8% 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: 1,768,608

Increase in reported cases since previous day: 22,805

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: 498,762

Total Deaths as of yesterday: 103,344

Deaths so far as percentage of closed cases (=deaths + recoveries): 17% (vs. 17% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 17% 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