Time to wave the white flag?

  

In a column in the Washington Post two days ago, public health expert Leanna Wen essentially surrendered to the coronavirus, saying (and I’m going a little beyond her argument here, since she was obviously pretty limited in space):

1. If we had done the right things early on in the pandemic – lots of testing, contract tracing, isolating infected people and their contacts – we could have the novel coronavirus under control now, as other countries like South Korea and Taiwan do.
2. We could still do that, but it would require a lot more of all three of those items than we’re doing now (yet the country has done hard things before, like winning two World Wars and going to the moon).
3. With a smaller investment in testing and contact tracing, but at the cost of a total lockdown (perhaps one month) of the economy (with a complete end to nonessential transportation, I might add), we could also get the virus under control.
4. However, the country doesn’t seem to have the will to pursue either of those options. No state meets the White House guidelines for reopening, yet 40 states are pursuing it anyway, to greater and lesser degrees.
5. This means we need to admit we’re no longer trying to beat the virus, but instead we’re pursuing a strategy of harm reduction. We need to admit that businesses and schools will reopen; we have to focus on helping them do it as safely as possible.

However, I see a few problems with her argument:

a)      Unfortunately the current administration doesn’t even want to try to help businesses and schools reopen safely. This was made very evident by the fact that they suppressed what was reportedly a very good, detailed guide that the CDC had prepared to help different types of businesses (and churches) reopen safely. Why would they do this, given that the alternative is to require each state and municipality to have the expertise onboard to draw up these guidelines for their own businesses – which they don’t, of course?

b)      The answer is clear: The administration considers any sort of advice on living with the virus to be an implicit admission that it’s not going to magically go away in a month or two – which would mean there’s no reason to take any substantial safety measures now. Just let all businesses reopen, and they can sort this out for themselves. This is a great idea if you’re 100% certain that the coronavirus will disappear very soon. But I know of only one person in the federal government now that really believes that – unfortunately for us all, that’s the guy at the top.

c)       But Ms. Wen’s argument seems to assume we’ll drift along in the range of daily deaths we’re currently in – about 1,000 to 2,500 a day. Yet all the experts say we will have a second wave in the fall (barring a huge change from our current course), which will very possibly be much higher than the current wave - as was the case in the 1918 flu pandemic. My guess is that wave will finally put to rest the idea that there’s another good alternative other than beating the virus, period. But of course, many more people will die if we wait until then to do what’s needed, rather than do it now.

d)      And Ms. Wen doesn’t consider at all the question, “What will the country look like, if no vaccine appears in a year or two (which is very possible. 40 years after AIDS appeared, we still don’t have a vaccine for that scourge) and we continue to bump along at a level of even 1,000 deaths a day? I can think of a few things:

a.       Even though current large businesses can mostly survive, they certainly won’t thrive. Given the non-negligible chance of dying if you do almost anything outside your home, most people are going to hunker down. They’ll buy the basics they need to live, but they certainly won’t travel much; they won’t attend concerts or sporting events, they’ll be reluctant even to eat in a restaurant, etc. Why take the chance?

b.      People will be very reluctant to start new businesses. If the US population has lost the will to try new things, explore new places, etc. this means there isn’t much room for new businesses to find a niche.

c.       We’re likely to be literally isolated from the rest of the world. My wife is currently sitting in Vietnam, a country – next door to China, mind you – that has 312 cases and zero deaths so far. Every day she asks me how many have died in the US the previous day; she’s not likely to come back at all until the number of deaths is much lower than it is now. And as far as Americans traveling to the rest of the world is concerned, forget it. Most countries will at a minimum require Americans to quarantine for 14 days when they arrive, if they allow them in at all. Kind of puts the kibosh on the two-week family vacation to Europe, doesn’t it? And of course, nobody is going to want to come here from Europe or Asia (say to attend a conference or to travel), if they know they won’t be allowed back into their home country unless they do a 14-day quarantine there.

e)      Probably the biggest problem I see with the idea of just surrendering now is that it assumes this won’t have much impact on kids. On the contrary, it will have a profound impact, far beyond the question of how many will end up dying. Can you imagine growing up in a country like the one I just described? I can’t either, but if we surrender to the virus, we’re going to find out.

  

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 13%.

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	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	10,388	1,484
May 23	11,736	1,677
May 30	13,259	1,894
Month of May	52,629	1,698 (= 1 death every 51 seconds)	88%
June 6	14,980	2,140
June 13	16,924	2,418
June 20	19,121	2,732
June 27	21,602	3,086
Month of June	79,503	2,650 (= 1 death every 33 seconds)	151%
Total March - June	196,002

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 86,912

Increase in deaths since previous day: 1,715 (vs. 1,772 yesterday)

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

Yesterday’s 7-day rate of increase in total deaths: 13% (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: 1,430,348

Increase in reported cases since previous day: 21,712

Percent increase in reported cases since yesterday: 2%

Percent increase in reported cases since 7 days previous: 13%

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

Total Recoveries in US as of yesterday: 318,027

Total Deaths as of yesterday: 86,912

Deaths so far as percentage of closed cases (=deaths + recoveries): 21% (vs. 22% yesterday) Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 21% 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. But it still has to drop a long way, in order for the US to have anything less than millions of death over the course of the pandemic – since we seem to have given up on controlling total cases in any meaningful way.

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