Zero people in the United States will be welded into their homes.
Exactly. And if it wasn’t clear, by using the word “perfect,” I wasn’t implying endorsement. I just meant that we can’t hope to have compliance like the communists did.
We have other factors going against us here: obesity, and lack of experience with the first SARS. Notice how the people of Asian countries just have experience with the containment and mask wearing. This is all new to most people here.
Another way of looking at it is that most recently it was 3700 in 5 days.
Yes, the peak deaths are delayed from peak cases, but I think there are additional factors that keep it from being quite that far apart. For example, the super unhealthy make up the majority of deaths and probably die more quickly. Also, note that they are expecting the deaths to peak in a couple of weeks. I have my doubts. I expect the peak will be later.
Yeah, we are on a 23% growth rate right now, meaning we are a little bit more than 3 days to double. Of course, the goal of flattening the curve is that the growth rate will go down. So far, however, there is no deviation from 23% growth in deaths for the last 15 days. Again, the death curve should trail the case curve, so if we see flattening of the case curve, the idea is that the death curve will flatten soon thereafter.
The odd thing is that the projection of the peak at 2,214 deaths requires that the growth in deaths start slowing dramatically in a few days or we’re going to be on the high-end trajectory. We’ve not seen a dramatic slowdown in rate of infections. We’ve seen some change, but not a dramatic slowdown.
I doubt that we even have anything like a case curve right now. Or if we do, it’s from a model with a boatload of assumptions built into it. Testing has been so haphazard and non-random and so widely variant from place to place that I don’t think we can even begin to get a bead on what percentage of Americans in a given area have Covid right now. The death curve is not without its problems, but dead people are a lot easier to count than cases at this point.
What I’m hearing from Joseph and from John M. is engineerish graph talk, which obscures the big picture. The Big Picture is that this thing has killed far less than 100,000 people worldwide. at this point. The United States is not China. We are not Italy. We have modern medical facilities and higher standards of sanitation. 100K-240K predicted is fear mongering. It is based on no evidence. It is unreasonable, on its face. Frankly, it’s infuriating that anyone takes this seriously.
Here’s another Big Picture question. If 100K-240K people are going to die anyway, with draconian social distancing regulations in place, then clearly what we’re doing is not working and will not work. So why are we doing it? What’s the justification for it? What’s the cost/benefit? Is it worth it to have an economic depression and 200,000 people dead?
That’s my final comment on this thread.
I hope you are right. I hope we can peak right at 1250 deaths per day [edit: Well, 39 minutes later, that’s clearly a pipe dream.] in the whole country and drop below 500 per day by the end of the month, and 0 by the end of May.
However, with both the number of confirmed cases and the death rate from confirmed cases still rising, I don’t hold out much hope for that.
If you are wrong, and that many do die, I hope you will reconsider whether the same people who made that (correct) prediction might have been right with their prediction of what would have happened without social distancing. Right now in New York, more people are dying from Corona Virus than everything else combined. I would say the purpose of social distancing where I live in Cincinnati is to prevent that from happening here. So far it seems to be mostly working.
Well. Time will tell, won’t it? Looking at politicalcalculations, it looks like deaths went from ~3700 to ~6900 between 3/31 and 4/3, so not quite doubling in three days. If this isn’t going to be a big deal and isn’t going to kill 100,000 people, that curve had better flatten off really fast.
We will probably spend decades arguing about what happened. Whatever the death toll is, and whatever the economic damage is, many will argue that the trade offs were not worth it. I do wish that we’d let the bodies stop piling up before we started the recriminations phase of this, but here we are in 2020 USA. (And I’m not at all accusing you of the recriminations, Ben: more so the people of power and influence in our society.)
What I keep coming back to is that following the current numbers is not useful to me or my family. I’m not in any position to be making policy, so the policy wonks and experts will do whatever they decide to do regardless of how loudly I scream in support or opposition. I’m convinced that we will have no way of knowing whether any of this was necessary for at least six months, but more likely a year or more.
In many respects, the damage of shutting down the economy is already done. The damage of the $2 Trillion stimulus bill is also done, it’s just a matter of who’s going to get the money and when. The likelihood of people actually dying from the economic shutdown is remote, at least in the near-term.
The worst-of-all-case-scenario is that the shutdowns have been necessary, but people disregard them and the virus spreads uncontrolled anyway–so we pay the economic cost of a shutdown without the benefit of slowing the rate of infection.
So I’m going to hunker down, do my work (from home), tend to my family, and turn my thoughts toward gardening.
This is a very healthy attitude, Zak, and I commend it.
Current projections from the same model the White House is using (updated), are that the total deaths (assuming continued social distancing through May) will only be 60,415. On Sunday they had dropped the number to around 80k. Now they actually suspect Washington state has passed its peak.
Their writeup for the big drop on Sunday is an interesting read. The update mostly comes down to a few things.
- We had very little data to start with for our initial projection. Only Wuhan had peaked when we made the model on March 26. Now we’ve got more data and we’re updating the model accordingly. (This is obviously what everybody should want to happen. More data is better. The initial criticisms were largely that models and decisions were being made without anywhere near enough data. Now we’ve got enough data to start putting that objection to rest.)
- “The time from implementation of social distancing to the peak of the epidemic in the Italy and Spain location is shorter than what was observed in Wuhan.”
- We started weighting school closures, stay-at-home orders, non-essential business closures, and travel limitations separately, rather than grouping them together under a single data point for a state (are restrictions in place or not?).
- We made a bunch of changes to make the model better fit the data and account for things like differing communities (are they taking into account the density of various populations? I don’t know.), wild swings in numbers of reported cases and deaths (actually this was changed in today’s model update), and places where numbers are very low still.
It is worth noting that this model is being criticized by many for being overly optimistic. There are other models that are still putting total deaths much higher. All in all, I’m actually quite hopeful that the numbers in this model will continue to drop and that they are a decent model, whereas some of the others are fear mongering in my judgment.
There are various ways to translate this double drop in expected deaths. One is to say, “See, I told you it was no big deal.” Another is to say that social distancing works even better than we expected and/or people are doing a better job of it than expected.
I’d like to note a few other things here. First, Mark Levine reports that deaths at home in NYC are up dramatically from 20-25 per day to 200-215. He further claims that these are generally not counted in the Covid death numbers because only those who tested positive are counted, and most of these people presumably were never tested and they don’t have the resources to test them after death. This would imply that the number of reported deaths is pretty dramatically under-counted right now. On the other hand, anybody who dies after testing positive is being counted, which will not always be appropriate. Others are giving anecdotes that people picked up at home are being counted as Covid deaths, even when it isn’t appropriate, thus driving the numbers up artificially. My response is that I don’t think there is any way to know what is and isn’t being counted perfectly, but there is still data that is meaningful.
On an average day, NYC has about 148 deaths. For the last week, NYC has averaged 416 deaths per day attributed to Covid. Even if they were literally attributing every death to Covid, meaning this is all the deaths that happened in the city, the death rate is way way up. So all the non-covid deaths prevented by the shutdown in NYC (stopping the flu, fewer traffic accidents, etc.) don’t even come close to making up for the increased number of deaths in NYC.
Indications out of Italy are that the deaths are being somewhat under-counted, but the spread is much greater than expected. If the latter is true, that is very good news, as it means the disease is less fatal than we expected, even after adding in the uncounted deaths. It is worth noting, however, that it would also mean that the virus is more contagious than we thought, making social distancing more important than we thought, saving more lives than we expected. (ie just how the model was updated) In other words, if you choose to believe this data out of Italy, you have to deal with all the implications.
This is veering OT. But I read scientists at Stanford (I think) want to know why CA has a very low 12 deaths per million population. They believe that the virus was there early. CA has a very large Asian population. Travel to and from China is copious. There were reports of an early flu season. They want to test the thesis that a herd immunity developed which has led to a low death/M.
Several cities in California, then soon followed by the state, shut things down earlier than elsewhere in the United States. SFO banned large gatherings on March 7, five days before NYC did so.
I think Ben is being vindicated on these numbers now.
I don’t think many people in New York would agree with you.
I should be clear that Ben appears to be right that there will not be 100k deaths in the USA by the end of the summer as predicted. I’ve already mentioned the lowered predictions.
What I meant by saying New Yorkers would likely disagree is that his claim that it was simply fear mongering and that the shutdown is unnecessary has not been vindicated by the numbers in New York.
There is always uncertainty in models, and more so because this was a new disease, but we did have examples from Wuhan, Italy, Spain, New York, etc. of what happens without early shutdowns. To call the shutdowns unjustified on the basis of a death count lower than originally forecasted seems like some Ninevites complaining that the command to fast and wear sackcloth was oppressive and the result of fearmongering because the city wasn’t overthrown as prophesied.
I think a healthy skepticism about elevating modeling to canonical status is in order.
An engineer doing a project builds what they call a safety factor into all their projects. I have a CE brother-in-law and an ME son. Both very sharp and accomplished in their fields. They’ve explained to me that all the factors cannot be accounted for. And while cost factors into the mix, projects do get over engineered.
Now the projects they work on are relatively small and deal with physical properties.
These current virus models are trying to take into account vast amounts of variables and are dealing with biological, social, political and many other factors on a global scale. The first models which came out and scared people to deathly panic and stampeded governments into the draconian measures they’ve taken sounded like the trumpet of the four horsemen of the apocalypse had sounded.
Please note this is not a comment on the seriousness of the disease.
I was listening to Governor Cuomo’s live news conference this morning and he said,
“The number [of deaths] is down because we brought that number down. God did not do that. Fate did not do that. Destiny did not do that.”
So foolish. I would not want to be a resident of New York at this time. It reminded me of @jtbayly’s comment:
It is now apparent that our initial information was incomplete. The pandemic is not what we all thought it was going to be. This is understandable. It was new. We all thought it was a dire threat and we all responded to protect the lives of our citizens, and our congregants, as we should have.
This is all true.
It is now clear that the stated rationale for these temporary, emergency actions, “to flatten the curve”, has been achieved,
This is true in most places in the US.
and that these temporary measures are no longer necessary.
This might be true in some places, but is certainly not a given. Certainly some of the measures are unnecessary at this point in time in some of the places.
If we continue on the current course of action of extreme mitigation, things may get much worse, as we fear they most certainly will.
While Covid-19 is among us and members of our churches have been harmed by the disease, the much larger damage to our members has been done by cutting off the means of supporting the lives of their families. In our churches, we have few Coronavirus cases, hospitalizations or deaths.
This is precisely because the social distancing worked to prevent the disease from doing what it would have otherwise. I know I’m in the minority, but I don’t think it’s nearly as straightforward as this letter implies and most here seem to believe: that we just need to let things return to normal.
Normal means letting the disease run its course until we have herd immunity and it’s not a problem anymore. About 70% of the population must get it before that happens. The big question is what percent of people who get it will die. The original estimate was 0.9% Infection Fatality Rate (IFR).
330,000,000 * 70% * 0.9% = 2,079,000 dead in the US.
Thankfully, it seems the 0.9% IFR estimate was too high. The latest two estimates I’ve seen are 0.66% and 0.37%. That’s wide range, but let’s look at the lowest current estimate: 0.37%. What would that mean in terms of deaths?
330,000,000 * 70% * 0.37% = 854,700 dead in the US.
It’s true that the majority of those deaths would be people over the age of 60. It’s also true that even with the lockdown we’ve been unable to keep it completely out of our nursing and assisted living homes. However, the lockdown has kept the deaths extremely low compared to what they would be otherwise, even in nursing homes. I don’t believe that returning to normal right now we are ready to protect the elderly in nursing homes, much less the millions of people above 60 that don’t live in assisted living or nursing homes.
But let’s give this a bit more perspective. New York has only suffered 11,500 deaths so far. They would be looking at about 39,000 more deaths before they hit 0.37% IFR. In other words, they are less than a quarter of the way there. In New York. Where they are burying people in mass graves by the hundreds. Most other places in our country have hardly even gotten started.
Another way to look at it is simply to ask yourself what would it look like if the percent of people who have already died in NY state died in the rest of the country. We would be at 196,000 deaths total instead of 27,641. Or go even more local. Take Cincinnati, where I live. The greater metropolitan area has 2.1 million people. So far there have been only 59 deaths in the metro area attributed to Covid-19. On its face, shutting down the city when there have been so few deaths seems absurd, yes. But if we had people dying at the rate the NY state does, we’d have already seen 1,273 deaths, with more happening every day. The hospitals, morgues, and funeral homes are just as unable to handle that here as they are in NY.
I think this is something to be thankful for. I think that we are much better off having taken this course of action.
Do I have proof that it is the shutdown that has prevented all of those deaths? No, but I have a lot more evidence than those who assume that opening the economy back up would not lead to those results.
Yes, we probably know enough now and have done enough work preparing (producing more personal protective gear, for example) that we can start to make changes, and some of the rules in some of the states have been just plain dumb. Some of the rules (as always) have been abused, and a few of the rules have undoubtedly been wicked (such as allowing abortions to continue).
But a simple appeal to “open” the economy is foolhardy in my judgment. What I’d like to see is any evidence that the IFR is actually much lower than the current estimates. Failing that, we could decide that those numbers of deaths are acceptable and necessary to prevent worse problems. However, even then I’d like evidence that we know how (without a lockdown) to slow it down so that what is happening in NY doesn’t happen in the rest of the country. It’s bad enough having one state going through it that quickly. It would truly be terrifying if it was happening in 20 or 30 states at once.
I’m hoping that the powers that be can rollout large-scale antibody testing. Not only will it help determine what the true IFR is but it will allow us to know who has already been exposed and could therefore who could more safely be allowed to return to work.