Three lost weeks in February

I have been reading the Wall Street Journal most of my adult life, and my experience until this year was quite consistent: While I disagreed substantially with a lot of the content on the editorial pages, I found the news content to be unbiased, relevant and always well written. However, since the onset of the pandemic, I have found myself reading very few of the news stories, since they seemed to be mostly ignoring what’s without a doubt the most important story so far in the 21^st century: the pandemic, and this country’s disastrous response to it. Since the editorial page has from the beginning downplayed the pandemic’s importance as well as the importance of doing anything about it, it seemed the message had reached the reporters: They should find other things to write about.

So I was pleasantly surprised when they ran a story yesterday called “Three Lost Weeks Stalled Virus Testing” (the link is here, although it’s probably behind a paywall. If you’d like to read it and you’re not a subscriber, you could sign up for the free trial). The story describes the 21 days between Feb. 8, when the CDC realized there was a problem with the test they’d developed and shipped to labs across the country, and Feb. 29, when they offered a broad solution that didn’t require shipping out new test kits – just using the original kit in a different way (a solution they could have offered right from the start, but for some reason were reluctant to do). During that time, all testing swabs had to be sent to the CDC in Atlanta to be processed, which greatly limited the number of tests that could be performed per day.

Meanwhile, the US could have easily bought any quantity it wanted of the German test that was endorsed by the WHO, and which was used in lots of other countries quite successfully. But it seems nobody even thought of that.

Why was this delay important? The story points out that the virus probably started spreading person-to-person in the US in January. Since during the entire month of February tests were severely limited (and they remain limited to this day, of course, relative to the size of the epidemic in the US), they had to be limited to people who had traveled recently to China. Anybody who didn’t meet that criterion couldn’t be tested, period. So the message was loud and clear: The only people who have to worry about the novel coronavirus are those who’ve been in China. After all, 100% of the cases we’ve identified so far are people who had traveled to China! Nobody else needs to worry.

So people felt free to travel freely and gather in large groups in February, when they should have been warned to stop those activities (as other countries had done. Remember, Italy had banned all travel within and without the country). And the article notes that probably the biggest superspreader event of February was Mardi Gras in New Orleans, where a million people gathered to celebrate. Of course, Louisiana paid the price big time, but this probably seeded outbreaks in other states as well.

Also, had testing been freely available in February, New York City might have recognized what a serious problem it faced. The NYC infection was seeded by travelers from Europe, perhaps even before travelers from China seeded outbreaks in Seattle and the Bay Area – but of course travelers from Europe weren’t tested. And other states, wanting to avoid New York’s dilemma, might have banned travel from that city, just as NYC is now requiring quarantines of travelers from almost all other states (and there’s a good reason for that. NYC’s test positivity rate is now around .25%, vs. 6.3% nationally and 15.5% in Texas).

Of course, the people responsible for bungling testing at the CDC were trying to do a good job. But there was nobody pounding on the table in early February, saying to the CDC “Look this is really serious! Buy the WHO test now! If you fix the problem with your test tomorrow, maybe we’ll have wasted some money. But the stakes are way too high not to do something.” Who could have done this? Lots of people, including Dr. Fauci (who only reluctantly admitted in late February that “perhaps” this could have been handled differently), Alex Azar or President Trump himself. But none of them did anything, because Trump was making it very clear that he would allow no talk about an epidemic in the US. He had solved the problem with his total ban on travelers from China (which was great except for the 40,000 people who entered the US from China after the ban).

Had this been done, and had Trump just handed the pandemic response over to the experts in March rather than trying to play Donnie, Boy Epidemiologist, we would probably be like Germany or even France now – struggling to suppress new outbreaks, but with the novel coronavirus under control on a national scale, rather than just in a few places like New York City.

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 4%.

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	7,153	1,022
August 15	7,556	1,079
August 22	7,107	1,015
August 29	7,399	1,057
Month of August	31,602	1,019	119%
September 5	7,704	1,101
September 12	8,021	1,146
September 19	8,351	1,193
September 26	8,695	1,242
Month of Sept.	34,861	1,162	110%
Total March – September	223,235

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 177,438

Deaths reported yesterday: 1,073

Yesterday’s 7-day rate of increase in total deaths: 4% (This number is used to project deaths in the table above; it was 4% 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: 5,746,534

Increase in reported cases since previous day: 45,144

Percent increase in reported cases since 7 days previous: 6%  

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

Total Recoveries in US as of yesterday: 3,095,910

Total Deaths as of yesterday: 177,438

Deaths so far as percentage of closed cases (=deaths + recoveries): 5%

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.

IV. 7-day average of test positive rate for US: 6.3%

For comparison, the recent peak for this rate was 27% in late July, although the peak in late March was 75%. This is published by Johns Hopkins.

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