American exceptionalism




Once again, the 7-day rate of increase in total Covid-19 deaths stayed at 7% yesterday, meaning the projected numbers hardly changed at all. So once again I left the normal projections table out, since it’s hardly changed from yesterday. I did update all the actual numbers below.

The big item yesterday was that new reported cases doubled yesterday to 45,000, from the level of around 21-23,000 it’s been at for weeks. This is the highest one day increase so far. Some of this is undoubtedly because more testing capacity is available. But testing capacity has been growing all along, and it’s hard to believe some huge amount became available yesterday. Another possibility is that someone noticed some data that had been overlooked previously and added it, which is very possible.

But the other thing that I’m sure is going on is cases are increasing in the states that have pushed opening up the most aggressively. Yesterday, Florida led the nation with 1,270 new cases, while Virginia was close behind with 865 and Maryland with 712. Other leaders lately are California, Texas, North Carolina and Tennessee. Meanwhile, the states that used to be the leaders are now among those at the bottom – e.g. New York had 45 new cases yesterday.

Speaking of cases, it’s clear we’ll pass two million cases either today or tomorrow. Just for perspective, total cases worldwide are 6.7 million now. So we account for almost one third of cases worldwide, whereas we’re about four percent of the world’s population; not too coincidentally, we also account for almost a third of deaths worldwide. Is this what people mean when they talk about “American exceptionalism”?

As I pointed out yesterday, it looks like we’re now on a plateau where we can expect 800-1,200 deaths per day for a while (I said 800-1000 yesterday, but I forgot to take into account the entire 7-day cycle of reported deaths). As I did yesterday, I now ask: Is this “tolerable”?


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 new 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.

I. Total deaths
Total US deaths as of yesterday: 111,394
New deaths yesterday: 1,184
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 7% 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 don’t try to project cases anymore, but I think they’re worth looking at, since the huge gap in testing seems to be narrowing somewhat (although, because the CDC has screwed up their testing numbers so much, they can’t be relied on, any more than reported cases)
Total US reported cases: 1,969,406
Increase in reported cases since previous day: 44,815
Percent increase in reported cases since yesterday: 2%
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: 738,729
Total Deaths as of yesterday: 111,394
Deaths so far as percentage of closed cases (=deaths + recoveries): 13% (vs. 13% the previous day) Kevin Perry and Royce Howland have pointed out that the recoveries number is inherently flawed, meaning the ratio above doesn’t have much meaning as an absolute number. However, I think it has value as a relative number. For example, the fact that the ratio has fallen from 41% in late March to 13% yesterday, which is much faster than in countries like Italy and France, indicates the US is doing something right – perhaps having to do with hospitals being much better equipped to handle Covid-19 patients than they were in March. For further discussion of this issue, see this post.


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

Comments

Post a Comment

Popular posts from this blog

The tragedy in India

For a great account of what’s going on in India, read this WaPo article. And read this Atlantic article for a good commentary on how India’s wealthier class ignored the lessons of the 1984 Bhopal disaster and let the health care system stagnate, leaving the country unable to handle this sudden surge in the virus. Although it's wrong to say the system stagnated. For the wealthy, it became (and remains) world-class. Does this remind you of another health care system that, at least in the early days of the pandemic, was overwhelmed?  Both articles call attention to the Modi government’s failures, but they both try to spread the blame around. Yes, others are responsible, but the fact that – after a terrible response to the first wave of the virus – the government got lulled into thinking they’d beaten it, so they could open up completely (including holding big political rallies and allowing the annual Kumbh Mela to take place – this year in Haridwar, which I’ve visited and can ...
Read more

The Indian variant

The numbers keep improving every week. Both new cases and deaths grew at the same 0.7% rate in the past week, vs. 0.9% for both cases and deaths the previous week. And average daily deaths in the past week were 573. For perspective, the last time deaths were this low was March 31, 2020. But given that daily deaths hadn’t gone above 10 until March 15, the fact that they’d accelerated to 468 on March 31 was a bad sign (at the time, my big concern was that total deaths would end up in the low tens of thousands. In fact, they passed 600,000 last week). This morning, WaPo ran a story on the new Indian variant’s arrival in Britain, where it passed 2,000 cases recently. It seems to be at least 50% more transmissible than what we used to call the UK variant, but which is now the dominant variant in both the US and Britain. And that variant in turn easily displaced what had been the previous dominant variant in both countries, since the beginning of the pandemic (in fact, I remember a lot o...
Read more

More than ever, we’re on our own

Leana Wen, a physician and former public health commissioner for Baltimore, wrote another great op-ed piece for the Post today entitled “We’ve reached 200,000 deaths. Our response has gotten even worse than it was at 100,000.” It makes the stark point: By the most important measures of public health, we’re doing worse on a national scale than we were in late May, when the US passed 100,000 Covid deaths. Here are some of her points: “In late May, we had about 20,000 new infections per day. Now we are at double that, with  around 40,000  new daily infections. This is a high baseline to have entering the fall and winter, when the combination of quarantine fatigue and cold weather could drive people to congregate indoors and substantially increase transmission.” “In addition, restrictions keep getting lifted, even in states with surging infections. The nearly 2  million  students returning for in-person instruction will surely lead to more outbreaks, as some colleg...
Read more