Baseball paves the way!

NPR broadcast a short piece this morning quoting the noted epidemiologist Dr. Michael Osterholm of the University of Minnesota – as well as others – saying that the “test, contact trace, isolate” approach to fighting the coronavirus (used by every other country that has been successful in fighting it) is no longer sufficient, given the huge lead the virus has gained on us (in the US) in the last month and a half. We not only aren’t making any progress in containing the virus, we’ve slipped way behind, as evidenced by the fact that a huge portion of the tests that are being done currently are meaningless, since the positive result is often only available long after the infected person (with minimal or no symptoms) has had ample opportunity to infect other people – and of course they’ll in turn have ample opportunity to infect even more people since they won’t be able to get a quick test result either, etc. etc.

Our problem literally from day one of the pandemic in the US (sometime in January) is that there hasn’t been adequate and timely testing available. And the administration has made only sporadic attempts to change this situation, since the guy in charge was convinced that more testing meant that people would get more alarmed by the results, and less inclined to vote for him in November – the problem with that approach being that when the bodies start piling up in the morgues, people will be alarmed anyway, unless of course they happen to be the former inhabitant of one of the bodies.

And that attitude continues today, since Trump initially wanted zero additional funding for testing, contact tracing or the CDC in the new relief package (it seems he was talked out of that position, though, although the GOP bill introduced yesterday includes a consolation prize for him: a new FBI headquarters building across from Trump’s hotel on Pennsylvania Avenue, to replace the suburban location that the agency wanted but Trump vetoed, of course because it would hurt business for his hotel. It’s gratifying to see that Trump is consistent in pushing for what’s really important to him, although it would be better if what’s really important were the health of the American people rather than his own bank balance).

But at this point we’re never going to be able to ramp up testing and tracing (and begin isolation, since it’s been tried only in a couple places like New York City so far) enough to control the virus, no matter how hard we try. And of course, an adequate effort would require strong direction from the White House, which clearly isn’t going to happen before January 20, barring a sudden change of heart on the part of GOP Senators and Mitch McConnell in particular.

The Washington Post published a good editorial this morning on how the US could possibly fully reopen by sometime in October – even including gatherings like major league football – if we adopted a hybrid strategy of universal mask wearing (which needs to be made mandatory and needs to be enforced), beefing up testing/tracing/isolation as much as possible, closing all bars and further restricting indoor restaurants and all gatherings above say 50 people (including churches, of course), banning all interstate travel, keeping most schools closed, and locking down nonessential businesses (although I would exempt businesses like auto plants that have been able to control the virus through following the CDC guidelines rigorously. I would also exempt other businesses that pledge to follow those guidelines and submit to regular inspections by OSHA, if they even still have inspectors nowadays. And some areas without much virus might not need to lock down at all, although as someone pointed out on the NPR broadcast, there probably aren’t a lot of those areas).

There’s only one good way to fix this problem: take the painful steps needed to control the virus now, so that total infections get down to a level where we can adequately test, trace and isolate any new cases that come up. The editorial points out that this could easily be October, if we have the national discipline – and national direction, of course, which as always is the number one problem here – needed for this. If we don’t have the discipline to maintain these measures until the virus is under control, we’ll try to reopen again in October, and end up really shutting down in say February, when an administration that can actually face facts and do what’s necessary will be in place. But in that case we’ll go through another four months of misery that we otherwise won’t have to endure.

You might say this sounds impossible, especially shutting down interstate travel. But guess what? Interstate travel is rapidly getting shut down anyway. For example, Illinois has required travelers coming from a list of states that have growing infection rates to quarantine for 14 days, and yesterday added Wisconsin to the list – which, with Indiana (who might not be far behind), is by far the largest source of cross-border traffic. Of course, this order isn’t enforced now (as a similar order is in New York state, to some degree anyway), so it’s questionable how many people are doing it. But the point is that the idea of shutting down interstate travel is hardly far out now, as it would have been when much of the country shut down in March and April (and I was advocating it in this blog, along with a true nationwide shutdown).

The other thing that probably sounds impossible is shutting down a lot of businesses that are finally reopening. But here again, the facts are leading the way. Major League Baseball’s “season” is off to a bad start, as the Marlins had to postpone their first three home games after eleven (!) of their players tested positive after playing the Phillies in Philadelphia. And the Phillies had to postpone a game with the Yankees because they all need to be tested now (plus the Yankees were going to have to use the same locker room the Marlins had used). This event alone isn’t going to shut down the season. But I’ll bet two or three more will do it – everyone will agree it’s not worth trying to go on like this.

That’s exactly what will happen if schools or businesses reopen in areas where the virus isn’t under control – one or two incidents won’t shut them down, but a string of incidents will. So our choice isn’t between locking down and not locking down, but just between doing it in a disciplined way, designed to achieve the goal of getting the virus under control once and for all, and doing it in the chaotic, undisciplined way that’s the hallmark of everything else the Trump administration does.

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.

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	1,474%
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	71%
June 6	6,544	935
June 13	5,427	775
June 20	4,457	637
June 27	6,167	881
Month of June	23,925	798	57%
July 4	4,166	595
July 11	5,087	727
July 18	5,476	782
July 25	6,971	996
Month of July	26,743	863	112%
August 1	7,489	1,070
August 8	7,863	1,123
August 15	8,256	1,179
August 22	8,669	1,238
August 29	9,102	1,300
Month of August	35,899	1,158	134%
Total March – August	192,764

 Projected numbers in red.

I. Total deaths

Total US deaths as of yesterday: 150,450

Deaths reported yesterday: 598

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 the reported deaths numbers, 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: 4,433,532

Increase in reported cases since previous day: 61,540

Percent increase in reported cases since 7 days previous: 14%  

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

Total Recoveries in US as of yesterday: 2,137,187

Total Deaths as of yesterday: 150,450

Deaths so far as percentage of closed cases (=deaths + recoveries): 7%

For a discussion of what this number means – and why it’s so important – see this post. Short answer: If this percentage declines, that’s good. It’s been steadily declining since a high of 41% at the end of March. But a good number would be 2%, like South Korea’s. An OK number would be 4%, like China’s.

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