COVID-19: Good News, Bad News

As the pages of the internet explode with the rhetoric of a new social distancing culture war, Americans find themselves arguing over whether the unfolding lockdown is a necessary measure to preserve life … or a case of economy-crushing overkill.

Meanwhile, the man who fed one side of the debate for weeks by downplaying the seriousness of the Coronavirus pandemic has changed his tune.

Here’s a tweet from Donald Trump on March 9th:

Eleven days later, as infections approached 20,000, he implemented social distancing guidance and asked Americans to stay home.

A few days ago, as infections reached nearly tenfold that number, he warned Americans that COVID-19 could kill more people than are lost in world wars, and warned of a “very painful” two weeks ahead. Official White House projections now warn of a death toll between 100,000 and 250,000.

Clearly, someone finally convinced Donald Trump to look at the data. A close inspection of the now robust COVID-19 numbers generates a startling response. The news is both good and bad.

The good news is that social distancing is working. Since implementation of the policy, the trailing 7-day average of daily infection growth has reduced from 1.37 to 1.15, a 16.1% improvement.

This represents 67,507 infections that have not occurred since March 20th which theoretically would have had the previous infection curve been maintained the past two weeks. That’s 1,811 deaths prevented at the current fatality rate.

If we then assume, given President Trump’s extension of the lockdown, that the curve continues to flatten at the same rate until reaching a baseline of 1.04 (the best flattening achieved in countries with reliable data and similar policies enacted prior to the US), we can expect 1.625 million confirmed infections by the end of April.

This number could be higher given accelerating testing regimes, and could also be higher given the lack of adherence to social distancing policy in some parts of the country, particularly in Southern states.

1.625 million is about 515,000 fewer infections than would have been projected by the end of April on the prior infection curve.

This implies about 14,000 deaths prevented, between late March and end of April alone, effectuated by people simply staying away from one another in the ways suggested by epidemiological and virological wisdom.

The bad news is that even as the infection curve is flattening, the fatality curve is accelerating. This is undoubtedly why Trump is changing his tune and preparing Americans for the worst.

While the growth in daily deaths is stable and even gently receding as a percentage of the prior day’s fatality count, the rate of fatality as a percentage of infections is skyrocketing, from 1.4% on March 20th to nearly 2.7% two weeks later.

Considering the disease takes a couple of weeks from the onset of serious illness to claim a victim, today’s fatalities were part of the infection pool a couple weeks ago. In the time is took for them to pass away, the number of overall infected has climbed, making the death rate look artificially lower than anecdotes from American hospitals would suggest.

The grim reality is that as time goes on, the fatality rate is likely to be revealed as far higher than the government’s early claims — claims used to deflect early calls for serious action. Assuming the incidence of fatal COVID-19 continues to climb at the same rate it has over the past two weeks, the country will have buried approximately 80,000 victims by the end of this month. This is a fait accompli and direct consequence of allowing the disease to rage for weeks before taking meaningful steps to disrupt it.

Project these calculations forward across the summer with reducing fatality rates (assuming treatments and hospital resources improve now that we are taking this seriously) and we’re still looking at something like 18 million infections and nearly 400,000 deaths by the end of June. This number could explode if Americans choose to prematurely abandon social distancing (or never adhere, as in some parts of the country) and make the infection curve too tall for hospitals to absorb the numbers of simultaneously infected patients.

Remember, the further this spreads into the inner reaches of society, the more vulnerable people will be touched. And as we subject first responders and medical staff to excessive viral loads, they themselves could be systematically impaired, leading to a degradation in the care of victims.

The past few weeks have seen a fascinating framing of COVID-19 policy as a contest between ethical and economic decision making. I don’t see it as that sort of dilemma at all. Given the ample evidence of what this virus has done in other developed nations with robust medical infrastructures, there is only one correct decision here no matter which register you choose to follow, and that is to stick to social distancing and slow the spread of this virus in the name of public safety.

The coming weeks will see a lot of debate about what is right, what is legal, what is constitutional or not, and whether impairing the economy is “worth it.” Arguments in favor of letting people die to preserve our pensions expose a gross callousness lurking in the heart of our society, and reflected in our politics.

The good news is that such arguments will be continually dampened over time until they fall silent. The bad news is that it will be a mounting death toll which does the silencing.

Tony Carr is an American veteran. He writes from Manchester, UK.

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