The Best-Case Scenario For Coronavirus? It's Super Infectous
Over the past few days, some glimmers of relative hope have flickered down the end of what had seemed until recently a possibly endless tunnel. The COVID-19 news since the weekend isn’t all good; in a pandemic it rarely is, and yesterday marked the highest number of new deaths in the United States reported yet: 1,941, almost 50 percent higher than the previous peak, which came just on Saturday. In New York, the epicenter, 800 patients died yesterday of COVID-19, twice as many as on any day before, and now, in addition to those deaths registered by hospitals, 200 New Yorkers are dying at home each day, uncounted in the official statistics, perhaps ten times as many as died during a typical day before the pandemic arrived.
But also over the past few days, the number of new hospitalizations in New York has probably begun to flatten. San Francisco has started to think about what follows shelter in place. And, in perhaps the most significant development, revisions to the pandemic model developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington suggested that the country would ultimately need fewer beds, fewer ICU beds, fewer ventilators and doctors and nurses and PPE — in short, fewer hospital resources of all kinds than was expected. More strikingly, it revised its most recent estimates for the ultimate coronavirus death toll downward by 11,765, or roughly 15 percent: from 93,531 to 81,766. A couple of days later, it revised them even more dramatically, from 81,766 to 60,415, or roughly 25 percent more.
These revisions may be eye-opening, in addition to being encouraging, because as recently as a week or two ago, the projections discussed by most public-health officials were much, much higher. When Donald Trump unveiled his “flatten the curve” chart, months after public-health experts began advocating that approach to the disease, he was working off the IMHE model, and suggesting that between 100,000 and 240,000 Americans would die. A model developed by the CDC projected a range between 200,000 and 1.7 million. The Imperial College model famously predicted 2.2 million deaths in the U.S. in a do-nothing scenario, and more than 1 million even if quite aggressive mitigation measures were adopted. As of April 2, a survey of public-health officials summarized by FiveThirtyEight found a median projection of around 263,000 deaths. The new IHME model suggests an ultimate toll less than one-quarter that number, about one-20th the figure projected in the Imperial College’s “mitigation” scenario, and less than one-30th what was projected in their “do nothing” scenario.
As Zeynep Tufekci has brilliantly written for the Atlantic, models like these are not meant to be crystal balls, producing projections we can all take to the bank, but a survey of possible futures that depend on what choices are made and what policies are engineered and implemented in response to the pandemic threat. Nevertheless, the gap between what experts projected a few weeks ago and what they are projecting now is absolutely astounding, and it is primarily a reflection of just how much has been done, and how quickly, to defend against and respond to the coronavirus. In many cases, we have achieved so much more than modelers even imagined possible that the range of outcomes we are now looking at did not even appear at the very low end of initial forecasts. The models weren’t “wrong,” exactly, they seemingly just underestimated how widespread, thorough, and steadily maintained social-distancing measures could be. How could they not? It can be easy to forget, a few weeks into something like a hemisphere-wide lockdown, just how absolutely unprecedented this public-health mobilization truly is: nearly every American in every state embracing punishing, restrictive quarantine-like isolation for the sake of the country as a whole. We are doing so willingly, with hardly any meaningful resistance to shelter-in-place guidance, even though the statistical profile of the disease, while brutal, would allow most Americans to think it was a much more significant threat to others (the case fatality rate here now estimated between 2 and 3 percent). This is solidarity I simply didn’t believe was possible in this country anymore and under any circumstances, and it has arrived in the space of just weeks, in the midst of national political chaos with tribal partisanship still boiling at a feverish peak. It is breathtaking.
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https://nymag.com/intelligencer/2020/04/best-case-scenario-for-coronavirus.html
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