I’ve never been so happy to be proven wrong

in this post on May 24, I told the story of a hairdresser in Springfield, MO who knew she had Covid-19, but continued to work and exposed 91 customers and co-workers to the disease (she also exposed people at stores where she went shopping). She did this because she didn’t have other resources to sustain her if she stayed home, since of course she wouldn’t get unemployment insurance payments because her employer was still open (and she probably didn’t get sick pay, either).

I speculated that it was inevitable that some (perhaps a lot) of the people she exposed to the disease would get sick – and as usually happens, some wouldn’t know they were sick and would expose still other people as they went about their normal lives.

Why did I say this was inevitable? Because of the general lack of testing and contact tracing capacity nationwide. I assumed that there would be minimal effort to contact all 91 co-workers and customers and get them tested, and there wouldn’t be much more than public service announcements to reach out to the people who could have been in the stores that she’d visited while sick (she’d only gone to a couple, for necessities like food and medicine).

However, it seems I was wrong. Yesterday, Kevin Perry (who had initially clued me in about the original story) sent me a link to a follow up story on this incident. At first, the story looked like it might be even more dire, since it seems there was another hairdresser who was also infected at the same salon. Between the two of them, they exposed 147 people to the virus at the salon, not just 91.

However, the story is very different – it seems there have been zero cases among those 147 people. And how is that fact even known? Because it seems both Great Clips, the chain this salon was part of, and the local authorities did the right things both before and after the infections were known (well, the problem might not have happened at all if the two hairdressers had paid sick leave). Here are some details:

1. The salon owner had taken good precautions when she first reopened the business. She required all staff to wear masks at all times, physically spaced customers and required staggered appointments. She also kept meticulous records of all customers, which proved very valuable when the infections were discovered.
2. 46 of the customers and co-workers were immediately tested, all with a negative result. The 101 others were all quarantined for 14 days (although there’s no explanation for why they weren’t tested as well). None of them developed cases during that time.
3. The quarantined people received calls twice a day from health officials asking if they had any of the usual Covid-19 symptoms.

The main question I have about this story is why the 101 people who were quarantined weren’t tested. I know they weren’t tested, since their results would either have been negative, or they would have been inconclusive – but if they were inconclusive, why weren’t they tested again? I don’t really think most people would prefer to be quarantined for 14 days, rather than take a test, no matter how intrusive it is. I see two possible reasons for this:

1. They didn’t want to be tested. I think most people would prefer to be tested, rather than spend 2 weeks in quarantine, but maybe they had sick leave anyway and don't enjoy doing their jobs – so they were glad to have some extra PTO.
2. They wanted to get tested, but there weren't enough tests. That would point to the shortage of tests not being anywhere near remediated.

However, I’m not going to let this question spoil my feel-good story (God knows I haven’t had many of those!). If the problem is tests are still in short supply, this can’t be blamed on the local authorities, but rather on failures at the national level.

So what does this mean? All of the measures I described are clearly needed – in spades – if the US is going to come anywhere close to full reopening. Yet the administration is pushing states to reopen in violation of the White House’s own guidelines. States and local governments need the resources to test, contact trace and quarantine (preferably in isolation, although that’s not mentioned in the story, so it probably wasn’t done) every case, just like they did with the two hairdressers.

Where the Feds can help in this is supply the funds that states and localities need to implement these measures – many states and municipalities are really strapped by the outbreak as it is, and are getting ready to lay people off, not take on a bunch of new employees. Yet the official line in the Senate is that there won’t be any aid for them in this next stimulus bill. Doesn’t fill you with hope, does it?

I guess this wasn’t such a feel-good story after 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 the projected numbers – they are all projections based on yesterday’s 7-day rate of increase in total Covid-19 deaths, which was 5%.

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 significant 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	6,544	935
June 13	5,942	849
June 20	6,479	926
June 27	6,834	976
Month of June	27,773	926 (= 1 death every 93 seconds)	66%
Total March - June	133,970

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 116,052

Increase in deaths since previous day: 912 (vs. 981 yesterday)

Percent increase in deaths since previous day: 1% (this number was 1% yesterday)

Yesterday’s 7-day rate of increase in total deaths: 5% (This number is used to project deaths in the table above – it was 5% 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 three-day percent increase I used to focus on, and certainly not the one-day percent increase, which mainly reflects where we are in the 7-day cycle).

II. Total reported cases

Total US reported cases: 2,090,115

Increase in reported cases since previous day: 23,504

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: 816,457

Total Deaths as of yesterday: 116,052

Deaths so far as percentage of closed cases (=deaths + recoveries): 12% (vs. 12% yesterday)

For a discussion of what this number means – and why it’s so important – 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