Everything we are seeing right now indicates that the coming five weeks or so are going to be brutal. You can quibble with this projection or that projection, because all of them are trying to account for a million little variables that aren’t easily seen: How strong are the immune systems of those currently infected? How well will the hydroxychloroquine and azithromycin treatments work? How well are health authorities keeping the virus out of nursing homes and retirement communities? How much are people practicing social distancing? We’re hoping the worst projections are wrong — and perhaps they’re so scary, they spur people to take additional steps to stop the spread and prevent the bad outcomes that they project.
But here’s what we know: For the last week, the number of new cases is increasing by anywhere from 10,000 to 20,000 each day. Yes, some of that increase reflects more widespread testing. Yes, many of those people will recover without needing hospitalization… Hang on, hang tough, try to stay out of a hospital if you don’t need emergency treatment.
If we can get through the next five weeks, the worst will probably be behind us.
We are now four weeks and two days into that five-week period. In that time, the number of confirmed cases in the United States has increased from 168,177 to nearly 1.1 million; the number of deaths has increased from 4,066 to more than 64,000.
Yes, you can argue the official death count is likely an over-count because it counts cases that are suspected to be driven by the virus, but not confirmed. You can also argue the official death count is likely an under-count because the overall death rate in the United States skyrocketed after the virus reached our shores.
The number of daily new cases nationwide seems to have peaked on April 24 with nearly 39,000 cases — although after a drop, the number has steadily crept back up in the past few days. The number of daily new deaths nationwide appeared to peak April 21 with 2,683 deaths . . . but we’ve lost between 2,470 and 2,200 people for the past three days.
Some parts of the country are on the downside of the curve — particularly the ones that were hit the hardest in late March and throughout April. Other parts of the country are still on the incline.
We are likely through the worst. Thankfully, only a small percentage of hospitals received more patients than they could handle. Most hospitals ended up starved for patients. Treatment options are expanding, remdesivir looks particularly promising, and manufacturers are producing large quantities of potential vaccines on spec — making them and hoping that ongoing unfinished testing proves they work. With precautions such as widespread use of masks, continued social distancing, and avoiding crowds, our society and economy should be able to open up in a measured, careful way that mitigates the risk of further infections but recognizes that human interaction inevitably will lead to new cases.
The worst is over, but the months to come are not going to be “good” but merely “less bad.” All in all, we’re probably living with this virus affecting our lives for one to two years, unless there is a breakthrough and really speedy production and distribution of a vaccine.
The CEO of Gilead, the company that makes remdesivir, says his company can make “140,000 treatment courses plus between now and July.” By the end of the year, they think they can ramp it up to 1.5 million doses. (Remember, remdesivir is a treatment, not a vaccine. It’s given intravenously for several days, and that increases the chance of recovery and shortens the recovery time.) This is terrific news for those who are currently having a serious infection and those who will have one in the weeks and months to come. But 1.5 million doses aren’t going to protect a country of 253 million adults, even if a million have already caught the virus and fought it off, and say, 20 million to a generous 60 million are asymptomatic and already caught it and fought it off.
The Center for Infectious Disease Research and Policy at the University of Minnesota concludes “60 percent to 70 percent of the population may need to be immune to reach a critical threshold of herd immunity to halt the pandemic.” (That’s lower than the Los Alamos National Labs estimate of 82 percent.) On the lowest end, that’s about 152 million American adults. If this virus has a one-tenth-of-one-percent fatality rate over that sum of adults, we’re looking at roughly 150,000 deaths. If you think it is more likely that this virus has an overall four-tenths-of-one-percent fatality rate, we’re looking at roughly 600,000 deaths. On the higher end, it’s 177 million American adults — with a one-tenth-of-one-percent fatality rate calculating out to a little under 180,000 deaths, and a four-tenths-of-one-percent fatality rate calculating out to a bit more than 700,000 deaths.
While there are several different ways the “waves” of infection could progress, the University of Minnesota report concludes “whichever scenario the pandemic follows (assuming at least some level of ongoing mitigation measures), we must be prepared for at least another 18 to 24 months of significant COVID-19 activity, with hot spots popping up periodically in diverse geographic areas.”
We will survive, we will endure, and we will ultimately triumph over this virus. But we will pay a terrible price along the way.
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