Have we reached a plateau?

For the eighth day in a row, yesterday total deaths grew by 1% day-to-day and 7% on a 7-day basis. As I pointed out recently, the number of deaths per day peaked at 2,633 the week of April 18 and has been falling since then. The last week of May, that number was 982. Is it likely to continue falling, at least on a weekly basis? For it to fall farther, we will need the 7-day rate to start declining again, but as I said it’s been stuck at the current 7% level for eight days.

This has been the longest period at the same level since I’ve been following the deaths numbers – but of course that doesn’t mean it won’t decline again. Of course, previous deaths don’t cause new deaths – they’re driven by the number of cases in previous weeks. The 7-day growth rate in cases has been declining for a while, but it – no doubt coincidentally – has also been stuck at the same level for eight days: 9%. This makes it less likely that weekly deaths will continue to decline, at least in the near future.

If you’ve been reading my posts recently, you’ll know I gave up a while ago on trying to use the reported cases number in any meaningful way. My reasoning was that, due to the severe shortage of testing capacity, it seemed the case numbers were reflecting nothing but the availability of tests – make tests more available, and cases would keep going up and up.

However, while testing capacity is still far short of what’s needed to support anything near a total reopening of the economy (and an army of contact tracers is still needed, as well as lots of hotels to isolate new cases), we seem to have caught up with the need a lot recently. I suspected this when I wrote this post last week. In that post, I noted that our ratio of deaths to total cases is in the middle of the pack of other countries, as opposed to being an outlier on the high side, as before.

This means that actual cases may no longer be 5-10 times reported cases, as I previously guessed (and some epidemiologists were saying that), but may be 2-3 times reported cases now. In any case, this means the reported cases number might actually have useful information in it. So the fact that it isn’t declining now leads me to believe that new deaths don’t have much further to decline either.

The upshot is that it’s likely we’ll be bumping around the 800-1,000 deaths per day range for a while, whereas there are a number of countries, maybe 1/5 to 1/3 our size, that haven’t passed 100 deaths during the entire pandemic. The question then arises: Is this an acceptable number? Or in other words, is it true that we can’t do anything to bring this down to a lower level? In my opinion, no and no.

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.

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	7,013	1,002
June 13	7,479	1,068
June 20	7,976	1,139
June 27	8,506	1,215
Month of June	33,600	1,120 (= 1 death every 77 seconds)	79%
Total March - June	139,797

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 110,210

Increase in deaths since previous day: 1,051

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 no longer pay too much attention to the reported case number. It is an underestimate of actual cases, which is at least 2-3 times what’s reported. This is because of the shortage of testing capacity. For reported cases to be anywhere near actual cases, we would need to be doing millions of tests a day.

Total US reported cases: 1,924,591

Increase in reported cases since previous day: 21,812

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: 712,436

Total Deaths as of yesterday: 110,210

Deaths so far as percentage of closed cases (=deaths + recoveries): 13% (vs. 14% yesterday) 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 14% 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