Our slide into the pit continues! But at least we're not diving in...

I always show rates of increase rounded to a whole number, when in fact they’re calculated to a number of decimal points by Excel. Since the projections of deaths are based on the exact number, this means there can be large changes in my projections, even though the rounded 7-day rate of increase in total deaths looks like it didn’t change.

That’s what happened between my projections yesterday vs. those today. The rounded 7-day rate of increase in total deaths remained at 5%, but the projected deaths for the month of August jumped from 35,377 yesterday to 39,535 today. This was just continuation of a trend. On July 11, with the rate at 3%, I projected “just” 21,257 deaths for August.

However, that projection is still far lower than the actual number of deaths for April, which was 59,812. Why is it so much lower, since the total number of cases is more than four times higher now than at the end of April (and by the end of August it will easily be five or even six times higher)? I think the answer is in the last number I track: deaths as a percentage of closed cases – i.e. the percent of cases that end with the person dying.

At the end of April, that number was 29%, whereas it’s 6% today. What accounts for that change? I can think of several reasons. There are undoubtedly others.

1.      Hospitals are less overcrowded in general than they were in April, even though the virus has come back hard in states like Florida, Texas and Arizona.

2.      Techniques for treating infections have obviously improved, and probably widespread use of remdesivir has helped.

3.      People getting infected are on average younger (in part because we seem to have finally figured out that we need to focus lots of resources on nursing homes, as evidently Florida has), and they’re much less likely to die than older people.

If the percentage hadn’t changed (i.e. it had remained at 29%), I would be projecting 965,236 deaths in August. Maybe the 39,535 I’m projecting now isn’t so bad (although it will likely go up, not down), compared to 965,000. That may be so, but on July 11, the projection was 21,000, meaning we’ll probably have at least 20,000 additional deaths in August (and more in subsequent months) - simply because we let the coronavirus spread out of control again, after it seemed to be almost under control in early June.

The point is that this shouldn’t be happening to us. Lots of other countries are also experiencing new “waves” (for example, Vietnam, after going for a couple months with literally zero new cases, found a few new cases in the city of DaNang not more than a week ago, and today has 600 cases – up from about 30 yesterday). But they are in a position to be able to contain outbreaks through testing, contact tracing and isolation (for example, Vietnam will test the entire population of DaNang, which is over a million people, and will isolate anybody who is infected for 14 days – not just tell them to stay at home where they’ll infect their families).

Yet we’re way behind on testing. And even if we had the contact tracers we need, their efforts are fruitless if it takes more than three days to get test results, as Dr. Fauci pointed out recently. Meanwhile, Admiral Giroir, the latest official in charge of making excuses for having inadequate testing (there have been a whole string of those, including the president, Jared Kushner, and Deborah Birx), admitted that the US can’t guarantee a 3-day turnaround for test results now, after recently sounding very rosy on the prospect of finally achieving an adequate level of testing.

So even though we’re doing over 800,000 tests a day now, we would need to be doing at least three or four times that in order to be able to rapidly isolate any new outbreaks. As it has been since early February, the continuing inability of the US to have adequate testing, tracing and isolating capacity is a disgrace. It is literally killing lots of Americans, as well as making us the object of pity for the rest of the world. Somehow, it wasn’t supposed to be this way…

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	26,649	860	111%
August 1	8,069	1,153
August 8	8,503	1,215
August 15	8,961	1,280
August 22	9,444	1,359
August 29	9,952	1,422
Month of August	39,535	1,275	148%
Total March – August	196,306

I. Total deaths

Total US deaths as of yesterday: 157,921

Deaths reported yesterday: 1,149

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% two days ago. 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: 4,765,155

Increase in reported cases since previous day: 57,754

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: 2,363,165

Total Deaths as of yesterday: 157,921

Deaths so far as percentage of closed cases (=deaths + recoveries): 6%

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