Continuing good trends in the numbers

                                                                                                                

The table below tells a good tale about total US Covid-19 deaths: That number rose on a weekly basis through the week of April 18 and has declined steadily since then. In fact, this past week was the first week that daily deaths averaged less than 1,000 since the week of April 4. My projections assume that the current 7-day rate of increase in total deaths won’t change through the end of June, but of course if that rate declines further, then total deaths will be lower than what’s projected in red below.

What are the chances that new deaths will decline much more than they are now? Here it helps to look at the state-by-state data. Of course, both the runup to the April peak and the decline since then have been driven in large part by trends in two states: New York and New Jersey. They’ve both come a long way down from their April peaks, but they both had increases in total deaths and total cases yesterday. They’re clearly not down to zero growth in either cases or deaths, and they probably never will be.

So what about the other states? Yesterday, every state but Idaho had an increase in total cases, and all but 15 states had new deaths. Here are the top ten states for new cases (in order of magnitude): California, Texas, Illinois, Virginia, North Carolina, New York, New Jersey, Maryland, Florida and Georgia. And here are the top ten states for new deaths: New York, Massachusetts, New Jersey, Illinois, Georgia, Connecticut, Michigan, California, Maryland, Pennsylvania.

It seems the “usual suspects” for high deaths are still at the top of new deaths – which is of course due to the fact that they still have so many more cases than other states – but they’re not at the top in new cases. This certainly leads to the suspicion that deaths aren’t going to decline much more than they have, since the usual suspects still have high rates of death and other states seem to be competing to take their place at the top.

Of course, it may well be true that the warmer weather means deaths will continue to decline through the summer. But that’s cold comfort (no pun intended. Well, only slightly intended). The only thing that will signal a real turnaround in the fight against the novel coronavirus is if total cases start to decline; and right now, they continue to grow at a nice clip. In fact, since the number of reported cases is still just a fraction of actual cases (due to the continuing inadequacy of testing), reported cases will continue to increase for a long time, even if actual cases start to decline.

Is it possible that acutal cases are declining now? No. Every state in the country is opening up now – the only difference is some are doing it recklessly, others more responsibly. And the fact that we still don’t have adequate testing, contact tracing, and isolation of infected people means it’s inevitable that new cases will continue to increase throughout the summer. Bottom line: It’s very unlikely new deaths will fall much more, until we can have a rigorous testing/contact tracing/isolation program in place in every state and every locality in every state.

This of course also points out why it’s still possible the fall wave (which almost all epidemiologists are predicting) will be worse than the current one. If we haven’t controlled the virus by the fall, then – in the absence of a new national lockdown, which seems unlikely – any of the thousands of places where cases remain could easily become new hotspots. Remember, at the beginning of March we had around 100 reported cases and only a few deaths. Today we have 1.8 million cases, and that number is growing by around 20,000 every day. In say the beginning of September we’ll clearly still have at least a million cases, meaning deaths could balloon to a much higher peak than we saw in April.

There are three things that could prevent this from happening:

1. Development, approval and widespread distribution of a vaccine. There’s clearly zero chance that will happen by September.
2. A huge new lockdown, covering every state this time, and grounding of all interstate travel. Again, little chance of this – and if it happens, it will mean people have been so spooked by the return of massive increases in deaths that they’re willing to do this. Meaning the battle will have in one sense already been lost.
3. A massive program of testing, contact tracing and isolation. This could be done, but of course there’s no impetus for this on the national level. Even though some states are moving toward having this capability in place, their efforts will be largely for naught if neighboring states don’t do the same. If we really don’t have a national effort in place by the fall, I predict that individual states – with good programs in place - will start to try to ban travel from other states. And that won’t be pretty at all.

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	6,874	982
Month of May	42,327	1,365 (=1 death every 63 seconds)	71%
June 6	7,333	1,048
June 13	7,842	1,120
June 20	8,387	1,198
June 27	8,969	1,281
Month of June	34,582	1,153 (= 1 death every 75 seconds)	82%
Total March - June	140,779

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 106,198

Increase in deaths since previous day: 641 (vs. 1,010 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 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

Total US reported cases: 1,837,578

Increase in reported cases since previous day: 20,681

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: 599,875

Total Deaths as of yesterday: 106,198

Deaths so far as percentage of closed cases (=deaths + recoveries): 15% (vs. 16% yesterday) 

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