"It has come to this..."

Today’s Times carried a great op-ed by the former director of the National Institutes of Health (where Dr. Fauci works today, of course) and the president of the Rockefeller Foundation entitled “It Has Come to This: Ignore the C.D.C.”

The title refers to the CDC’s puzzling (and that’s the best you can say for it) assertion last week that asymptomatic people should not be tested for Covid-19. For the moment, let’s put aside the fact that the stated reason for this change in policy is that tests need to be reserved for people who are very likely to already be sick, since they have symptoms. Hmm…I guess this means we’re not now testing enough at all, as of course Trump and others in the administration have said repeatedly (My goodness, does this mean they’re misrepresenting facts? Who would have thought this to be possible?).

In fact, Trump has repeatedly said we’re doing too much testing, by which he means we’re doing so much testing that it might cost him re-election. At his Tulsa rally, he said he had ordered testing to be throttled back. Of course, various people in the administration and Congress quickly asserted that he didn’t mean this. Yet here we have the CDC saying exactly that.

As the authors of the op-ed point out, the CDC isn’t a regulatory agency, so this statement can be ignored, and already is being ignored in many areas. And of course there’s lots of precedent for this attitude, since Trump and his administration – like the noble Dr. Deborah Birx, who thankfully isn’t heard from in the press very much nowadays – have repeatedly forced the CDC to tone down its warnings about fairly inconsequential matters like whether children will be safe going back into full classrooms in areas where the novel coronavirus is still spreading (another note: in the last month or two, new infections and deaths among children have increased more quickly than among adults. Of course, I’m sure Trump and Betsy DeVos, having seen this statistic, will immediately cease their efforts to get school districts to reopen before it’s safe. As Trump has said, fighting the virus is his first priority, although it seems inciting political violence is now right up there with it).

The two authors lay out exactly why it’s important to be testing asymptomatic people, especially in certain situations (e.g. they were in close contact with an infected person, or they’re going back to work in almost any workplace). But they also point out that – pending a widely-available and effective vaccine – there is no such thing as too much testing. In fact, they admit that, were it at all possible (which it’s not), testing every American every day would be the best course.

It’s safe to say that this CDC directive will be ignored (and of course, Dr. Redfield, who made his name in the military by underplaying the importance of responding to the AIDS epidemic and now seems to be carrying out that old playbook on a much wider stage, is already trying to walk it back some). But it’s of course really sad that the CDC - which was recognized around the world as the gold standard for public health agencies (as indicated by the number of countries, like China, that have named their agencies the CDC) – is now just another administration voice that we should tune out.

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	7,552	1,079
August 29	6,675	954
Month of August	30,970	999	116%
September 5	6,771	967
September 12	7,016	1,002
September 19	7,270	1,039
September 26	7,534	1,076
Month of Sept.	30,425	1,014	98%
Total March – September	218,166

Red = projected numbers

I. Total deaths

Total US deaths as of yesterday: 187,742

Deaths reported yesterday: 515

Percent increase in total deaths in the last seven days: 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: 6,212,174

Increase in reported cases since previous day: 37,166

Percent increase in reported cases in the last seven days: 5%  

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

Total Recoveries in US as of yesterday: 3,456,859

Total Deaths as of yesterday: 187,742

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: 5.7%

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 (recent rates for New York state: .8%. For Texas: 11.2%. For Florida: 12.3%.  For Arizona: 7.2%).

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