SARS-CoV2 infections were originally doubling once every 2.5 days, according to the CDC and the WHO. Over the last 4 days, deaths in different countries have had different doubling rates, but US deaths doubled very close to once in that 4 days.
This is a result of the fact that the places with the highest numbers of deaths also have done the most to slow transmission via shelter-in-place orders and other measures. So even if infections and deaths are doubling much faster in counties and states that haven’t yet been hit hard, the total number of deaths they add from a single doubling might yet be small compared to deaths in, say, New York City, which had over 500 on Friday. (By the way, New York City’s measures haven’t yet been effective at slowing the doubling: their deaths doubled in a mere 3 days.) We are not likely headed for a slowdown of the doubling rate because there are so many places where the virus is just beginning its infectious burn, and while each individual county might be small, there are many counties with many, many people in Texas and Florida and Georgia and other red states.
Since the doubling rate depends on human behavior, it can and will change. But since by the time someone dies of COVID-19 the moment that they were first exposed to the SARS-CoV2 virus is already 2 weeks (or maybe more) in the past, the doubling rate today depends on human behavior 2 weeks ago. All this means that while we can’t know for sure what’s going to happen with COVID-19, there’s no reason for non-experts such as this blog proprietress to think that the doubling rate is going to change much for at least two weeks. Even then, since there are so many exceptions to the shelter-in-place orders in many states (like keeping gun stores open and, I kid you not, a horse show and auction), we can’t possibly see as great a reduction in the growth rate as nations like South Korea. Italy, Spain & France had their deaths double over the last 10, 7, and 6 days, respectively. I doubt we’re going to be better than any of them.
But okay, let’s say that we double our deaths 3 times over the next 12 days before red-state orders begin to have some small effect (remembering that NYC has been trying hard for a while now and still doubled their total deaths over the last 3 days). The next doubling, we can hypothesize, takes 5 days before the next two doublings after that are at a more France-like rate of once every 6 days. In this case, we have 6 doublings over the next 29 days. Given that current deaths in the US from COVID-19 were at 6,593 at the CDC reporting deadline Saturday afternoon, that means that on the afternoon of May 3rd the US should have 2^6 * 6,593 deaths, or 64 * 6,593 deaths. That gives us 421,952 deaths on May 1st. We should actually reach Trumps low-end death total of 100,000 two doublings before that, or 17 days from now when red-state measures are finally beginning to help, but long before we can expect to stop the spread entirely. There really is very little hope at all that deaths will be less than 100k on Earth Day this month. Since we’ll still get more than another doubling by the end of the month if we reach France-like levels of containment on transmission, Trump’s most pessimistic projection of 240,000 deaths from COVID-19 in the USA will be surpassed before sunrise on April 29th.
Of course we knew that Trump has been painting a rosy picture of this pandemic since the beginning and we had every reason to believe that his “pessimistic” projection of 240k deaths was anything but pessimistic. Still, I think it is rather shocking that we have less stringent protective measures in place than France, we have a population at least as willing to disregard government warnings as France given the strong tendency towards science-denialism among Republicans and anti-government sentiment even when they might be tempted to believe the science, and only by making our control measures as effective as those in France as soon as reasonably possible given that red states only just implemented those measures can we delay surpassing Trump’s most pessimistic numbers until after the 23rd of this month. And even then, we only gain a few days.
There is no way to predict human behavior, and we may get progressively better at halting transmission much earlier than I think is likely, based on the experiences of European nations. But right now my best guess looking at the math and thinking about how ready so many are to believe that COVID-19 is a hoax or overblown or a manufactured excuse to implement government control over individual movements, is that we’ll be above 250k cases at the end of this month and that we’ll see at least two more doublings of death after that, even if those doublings take much longer. China’s most recent doubling has taken 49 days, but we can’t entirely eliminate transmission without preventing people from grocery shopping and doing other vital tasks, and even if we don’t hit 420k deaths by May 3rd as seems likely to me, even if we bend the curve downward more steeply than I think the stupid and rebellious among us will allow, we would still hit 250k deaths early in May, and doubling deaths every 50 days (a success rate I don’t think is achievable without a hugely powerful central government such as exists in China), 100 days from May 3rd would be only mid-August, far too soon for us to expect to have engineered and manufactured and distributed an effective vaccine. In the best case it is remotely plausible to imagine (and don’t get me wrong, I think calling it “plausible” is being far more generous than the scenario deserves), we’re should expect one million dead of COVID-19 by mid to late summer.
And all this would be true assuming that we are as good at fighting this disease over the next month as France has this past month, and as good at fighting it for 3 months after that as China has for the last month and a half. With Trump in charge, that seems optimistic to the point of self-delusion. It seems to me that we’re more likely to reach 3 million deaths than to stop short of 250 thousand, and more likely to reach 2 million than to stop short of 500 thousand. Our best hope is not that the federal government or even the states will proactively halt the spread of SARS-CoV2, but that those currently inclined to ignore its risks literally panic as the numbers of deaths climb past a quarter million. Our best hope is that this panic changes their behaviors drastically, enough to slow down the spread in a way that appeals by scientists and governors have not yet managed.
In other words, we can no longer trust our leaders to manage this crisis. We can only now trust our idiots to act from fearful cowardice.
The thing that makes the US death rate so frightening is that you are still at least a week, if not two “behind” those European countries that have been affected the worst.
I absolutely agree that death rates are the result of infections that happened 2-3 weeks ago (I think the average is 18.5 days after contracting the virus) and I also think that death rates are also the only ones that are giving a halfway accurate image. “Confirmed cases” depend heavily on how much you’re testing, which partly explains Germany’s low death rate: we’re testing a lot and have been increasing testing capacities ever since as well as analytic capacities.
This gives you an inaccurate picture. For one thing, wide spread testing will give you many positives and detect many mild cases that don’t require much treatment. Secondly, until this week results took up to a week, so you had a backlog of “mild cases” that suddenly increased the number of cases at a point where people thought that numbers should increase more slowly. So even within a single country the numbers are complicated and when you then try to compare them across countries, or in the USA states, it becomes a really big fat mess. One thing I think they should publish alongside the confirmed cases is the number of tests that have been run.
When talking about leadership, it’d truly frightening. This pandemic comes at a point where many densely populated western countries have fascist (leaning) narcissist leaders who don’t believe in science and who don’t give a fuck about their people. I sit here in Germany where our governments sure have many mistakes and where our health care system is in a bad state after years and years of profit increasing and cost cutting and also see that we’re being praised internationally for our good leadership and solid health care and that really drives home how bad it must be elsewhere.
My predictions early on were Black Plague type numbers, and nothing I see dissuades me from it. The US will be lucky if its death toll is only seven digits. Worldwide, the total deaths reached 2^16 as I write, and I’m expecting it to reach anywhere from 2^24 to 2^28.
We’re on the starting slope of a badly maintained roller coaster, and all we can do now is hang on and hope our own carts aren’t the ones to fall off. Because this isn’t just comparable to the Spanish Flu or Plague. Multiply it by the 1815 Tambora earthquake when you consider farming and food production.
And then there’s the aftermash. Will those responsible (e.g. Xi, Cheetolini) be held responsible, or will they try to blame nurses, doctors and scientists for not doing enough (re: seismologists blamed for Italy’s earthquake in 2009)? Will we see corrupt regimes fall because of their actions, or dictatorships and police states worldwide (vis-a-vis Hungary’s president and his power grab)?
*aftermath. How did that happen?
I’m somewhat concerned about domestic terrorism as well. The various rightwing nutjob pundits are going on about conspiracy theories and what not, and apparently a non-zero amount of rightwingers are taking that bullshit seriously. There was that guy who tried to derail a train in an attempt to damage a Navy Hospital ship, gun stores have been doing record levels of business, and supposedly people have been damaging communication towers.
I’m just worried that this sort of reaction is going to become more common as this progresses.
Giliell @ # 1 makes excellent points about the terrible inaccuracy of the available numbers: quite possibly the margin of error exceeds 100%, rendering the estimates of our esteemed host and of the most sophisticated epidemiologists … well, not at all meaningless, but awesomely imprecise.
Possibly, if we collect blood samples from everybody, an after-the-fact analysis could sort out usable figures – but that would require an extensive and expensive effort by competent authorities – conditions we can tell already will not be met.
Speculating rather far ahead, one thing I wonder about here in France is what will happen once there is a Covid-19 vaccine available. France is notoriously anti-vaccine, Why does France have the lowest levels of trust in vaccines globally? (video, English, Sept 2019): “It might seem paradoxical, but France, the home of Louis Pasteur’s pioneering discoveries in immunology, is also one of the most sceptical countries in the world when it comes to vaccines. Where does this vaccine hesitancy come from? And what are public health officials doing about it?”
Whilst not specifically about France, Orac points out the anti-vax genocidal manics are already planting massively destructive seeds, No, the flu vaccine does not increase your chance of getting coronavirus by 36% due to viral interference.
Speaking of France’s preparations, one thing I like to point out (sorry if I’m repeating myself), are the rolling high-speed TGV intensive care hospital train(s?) now being used to transport non Covid-19 intensive care patients from highly-impacted areas to less-impacted areas (to free up ICU beds &tc in those high-impact areas). This is a pre-planned contingency plan that was tested last year for serious emergencies, including (but not limited to) pandemics. The TGV is faster, with greater capacity and much more room for the medical staff to work, than ambulances and helicopters (and most aeroplanes, which France is also using).
Having read this article and the comments, I think I shall resume my usual news-avoiding ways for a while.
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This is bad ass and makes so much sense.
Luckily Canada is not so bad, but almost all my family are still in the US. I don’t know if the French level of skepticism is worse than that found in the US, but the two countries have got to be at least siblings in this. I worry for my parents & step-parents, especially, but everyone in the US more generally. This shit is scary.
@Intransitive:
As I understand it, the virus isn’t capable of producing deaths per capita equal to the Black Plague, but in terms of total deaths, the Black Death-event of Black Plague infection (the specific plague pandemic in Europe between 1345 and 1355) killed about 100 million people or a bit more. With a mortality rate of 3.4%, infecting every living person in the world would generate about double that, so to kill 100 million would require infecting about 50% of humanity. That’s certainly possible; this virus is much more transmissible than other diseases that have worried the professionals. On the other hand, it’s also possible that we develop a vaccine and get it into mass manufacture by Dec 31st of this year. If we can start getting the first doses into the bloodstreams of our population by then, and if we keep growth arithmetic rather than geometric for the rest of this year, then we’re not going to come close to a 50% infection rate.
As of right now, my guess is that we’re going to see a lot fewer than 100 million deaths, but 10 million is easily possible and 20 million seems a(n intellectually) reasonable guess, though that represents a completely UNreasonable tragedy. I think other countries will learn from the USA and that worldwide casualties will be anywhere from 5m to 25m, but what do I know? Guesses involving the behavior of the virus can be backed up with some data. guesses involving the behavior of governments and individual human beings? I could be fucking wildly off the mark.
@Giliell:
Thank you so much for your comment. I really value your input.
This is actually a very important criticism. If the US had been more competent in testing, the CDC statistics of confirmed cases and deaths on Sat, Apr 4 wouldn’t have yielded a 2.38% fatality rate. It would have been a smaller rate because there would be more confirmed cases in the denominator. Of course, as you say that wouldn’t be the final rate, since we have to wait 3 weeks after the last infection to total the last death, and so long as the disease is spreading geometrically like it is in the USA comparing today’s deaths to the number of infections 2-3 weeks ago would be the more accurate ratio. But since the US has utterly failed to adequately test, no one is going to be able to just look up the number of infections from a couple weeks back and plug that into the denominator. We really won’t know how bad this is going to be until there’s nowhere left on the planet with geometric infectious spread.
Sounds like it.
That sounds like a really good idea. I wouldn’t have thought of that, thank you.
Yeah. I’m not sure to be more scared because fascism followed disaster and a desperate desire for security 100 years ago or if I should be less scared since the fascists got into power ahead of the disaster and might now be (appropriately) blamed for their failures?
Even if this virus were to suddenly be inactivated across the globe the moment I press “Post Comment” on this, we desperately need good investigation and analysis after this is all over to determine exactly what was working in the public health systems of countries around the world and what wasn’t. It’s not worth the price, but to lose all the people we’re losing and then deliberately choose not to learn lessons from the tragedy would be to compound the horror.
uh… yeah. We’ve been struggling in Canada as well. Leadership in BC has been bad, but it’s not even mostly the BC system I’m worried about, at least not in the larger cities. It’s the prairies and the maritimes and the isolated towns.
Then there’s the USA with its own special hell of its own creation. I wonder if US voters are smart enough to come out of this with increase support of medicare for all?
On my part, I’ve been wondering about the accuracy of official death count, particularly in US.
When experts estimated that 200,000 deaths in US might be a realistic good outcome, they presumably spoke in terms of total death count. Thus far, everyone else seems to be speaking in terms of officially confirmed deaths,
I understand, if the hospital system is badly overwhelmed, it won’t be practically possible to confirm even most of the COVID-19 deaths in real time. You could only make estimates based on indirect evidence.
And then there’s politics. I’ve already heard rumors from US healthcare workers that deaths are being undercounted by whatever accounting tricks. And naturally, rightwingers are already expressing suspicion that the official death count is overblown, just because politics. This fits in the larger context of politicizing the question on whether there’s a major disaster.
I seem to recall there’s still something like 50-fold disagreement between experts and Trump admin on how many people died in Puerto Rico after hurricane whatsername. I fear that, with this pandemic, reality will become a matter of partisan division like it’s never been before. Possibly even after Trump regime is gone, COVID-19 denial will be like a new version of Holocaust denial – or perhaps more appropriately, a new version of Holodomor denial.
lumipuna@9, Here is France there is a known — and acknowledged — glitch in, at least, the Covid-19 death rate: Deaths related to Covid-19 in elderly / retirement care homes are not being counted. From memory, this is due to officialdom being dumb, something like only hospital-diagnosed(?) deaths are counted for “reasons” I don’t recall. They™ are working on fixing this, so I anticipate a restating / correction to the French death rate sometime. I do not know if the number of tests being done is being reported (here in France).
Crip Dyke@8, “This [TGV hospital train] is bad ass and makes so much sense.” Yes! My opinion exactly. In an interview I saw somewhere (probably France24), the doctor in charge pointed out the system could be deployed throughout Europe, albeit as far as I know, it’s currently only being used in France. Having said that, Germany has taken several French patients (like the TGV hospitals, I think the patients were non Covid-19 intensive care), some transported by helicopter.
Updating myself@10, Apparently the anticipated correction in France’s death total has now happened (from the Grauniad’s current live pandemic blog):
The difference with the Black Plague to is that it headed generally in one direction, east to west, along the Silk Road. Today, we have multidirectional intercontinental travel. This will affect every continent, dozens of countries, especially those with the least developed health care systems and highest population densities (e.g. India, Bangladesh, Indonesia, etc.). And in 1917, there were 1.9 billion people and more than half lived in rural areas. There are 7.7 billion today, and more than half live in dense urban areas.
This is a light warmup for climate change, and we are not dealing with it well. By 2050 any surviving governments will spend 90% of their time doing disaster response.
In some ways, sure. I don’t think that we’re likely to see repeated pandemics anything like this one on a time scale more frequently than once every 50 years, and I don’t think we’re even at the unlikely-but-could-really-happen place for pandemics like this every 20 years.
However pandemics aren’t remotely the only threat to human society in a warming world. Hurricanes will be more severe and possibly a little more frequent, so a much larger percentage of tropical storms will be Patricias and Willas and Marias and Sandys and Harveys and Dorians. Of course, these affect large areas, but aren’t big enough to affect the entire US at one time. They can function like COVID-19 for, say, the Bahamas or Taiwan or for a state like Florida or Texas.
The worst things that I’ve heard predicted, however, are the problems with crop failures. As climates change, it’s not just a matter of getting warmer or colder. Moisture levels in the air can increase (hotter weather means more evaporation after all) or decrease. Winds can change direction, etc. A mix of crops that grew well in a nation for the last hundred years might be the wrong mix for the next 20, and if things continue to get bad, you might only have 20 years to get used to a crop mix before that one fails.
Human starvation, combined with mass migration from poor, starving areas to a combination of wealthier areas (that can at least temporarily increase available food through money) or simply neighboring areas with more favorable agricultural conditions means gargantuan refugee crises happening almost continually for a long, long time. Crises like this can easily lead to war as people in a country doing well enough but still worried about their own futures can resent and attack refugees, or starving people can attack others for food. Or, more likely, both. Violent political leaders will exploit these situations.
There is no reason to believe that we won’t have ongoing border crises for decades at a time, given the way that our leaders have performed from 1945 to 2020. Maybe, maybe we’ll get better information and better voters and better leaders. Maybe certain technologies will help ease things some. And maybe this is all a failure of my imagination, but look at our real life humans, the kind who in the US alternate between Bushes and Clintons, the kind who tolerate drone-murders on a mass scale by the very best of US presidents, the kind who elected Mitch McConnell and Susan Collins and Donald Trump. I can’t see how our real life humans won’t fuck this up, won’t vote for violence and repression, won’t encourage their fears instead of their hopes.
This shit is going to be bad. How bad? That requires predicting the behavior of humans, a highly unpredictable group, so I can’t be sure. But it’s going to be bad.
Something I don’t understand: why is it that when people calculate the death rate, they use the number of deaths and the total cases? Why not the number of deaths and the total number of resolved cases?
As I write, Worldometer claims that there have been 10,871 deaths and 19,671 recoveries in the US. That means that out of 30,542 cases in which the outcome is known, 35.6% of the people have died.
Out of the other 300,000+ cases currently unresovled in the US, the calculators must think the vast majority of them are going to live to claim that the death rate is 3% or less.
Worldwide, there have been 74,697 deaths and 278,695 recoveries, but that’s still a death rate of 21.1%, and not the 5.5% that using the total cases figure would get.
What gives?