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Home » Flu vs. COVID-19: worrying about hospital shortages is nothing new

Flu vs. COVID-19: worrying about hospital shortages is nothing new

The New Neo Posted on by

Commenter “Montage” writes:

Covid-19 is not just like the flu, which some want you to believe. In all the years of the flu we didn’t have hospital bed shortages or a worry about the number of ventilators that will be needed.

Here’s the part with which I agree: COVID-19 is not like the flu, at least not exactly. First of all, it’s a coronavirus rather than an influenza virus. That may seem like a nit-picking (or virus-picking) point to make, but it actually matters. The reason is this:

Making vaccines is always challenging. Developing this one is made more difficult because there has never been a vaccine for any type of coronavirus. “We don’t have a production platform, we have no experience in safety, we don’t know if there will be complications. We have to start from scratch, basically,” Krammer says.

It was much easier to make a vaccine for H1N1, known as swine flu, which emerged as a never-before-seen virus in 2009. “There are large vaccine producers in the US and globally for flu,” Krammer says. Manufacturers were able to stop making the vaccine against the seasonal flu and start making a vaccine for this new strain of flu. “They didn’t need clinical trials, they just had to make the vaccine and distribute it,” he says.

We have a lot more experience with the flu in every way. But talking about “flu” as though it’s a single entity is misleading, of course. That’s why there are “bad” flu seasons and “good” ones – that is, strains of flu that become ascendant in a particular year that kill more people or fewer people. The range is fairly wide:

Influenza spreads around the world in yearly outbreaks, resulting in about three to five million cases of severe illness and about 290,000 to 650,000 deaths… Death occurs mostly in high risk groups—the young, the old, and those with other health problems.

In the United States, the range of deaths per year from seasonal flu is between 12,000 and 61,000. Those deaths don’t occur at a rate that’s equal throughout the year, either; they are concentrated in flu season, which doesn’t have a strict calendar beginning and end but tends to be late fall to early spring. Therefore, in a “good” year with 12,000 deaths, I would estimate that during the months of flu season the US death rate from flu is very approximately 2,000 per month, and in a “bad” one it is close to 10,000 per month, with deaths dropping enormously in the other non-flu-season months of the year. Or, the deaths may be more spread out than that, but certainly not evenly distributed among all the months.

That’s a lot of people. That number of people may still be dying of the flu, for all I know, and all the COVID deaths are in addition. But maybe not – perhaps someone here can find some statistics on that.

But those are “regular” flu years. There are pandemic flu years such as 1957, 1968, and 2009:

In the 20th century, three influenza pandemics occurred: Spanish influenza in 1918 ([worldwide] 17–100 million deaths), Asian influenza in 1957 (two million deaths), and Hong Kong influenza in 1968 (one million deaths).

The death tolls from these pandemics in the US were much higher than in ordinary flu years, particularly in 1918. The death toll from 2009’s flu pandemic H1N1 (as estimated by the CDC) ended up being not as bad as originally predicted; it caused the death of between 8868 and 18,306 Americans.

So it actually is highly possible that COVID-19 will end up with a death toll no higher than the toll in a “bad” flu year. Or it could be worse, even much worse. Neither of those possibilities takes in the huge economic toll of the extreme strategies used to combat it, of course. How will we know if they will have been worth it? I suppose some day the number crunchers will analyze the data and come up with an answer, or several competing answers from which you can probably pick and choose. We don’t have a control world to compare it to, where we went on with business as usual.

And now let’s take up the last part of Montage’s statement: “In all the years of the flu we didn’t have hospital bed shortages or a worry about the number of ventilators that will be needed.”

Well, we don’t yet have hospital bed shortages in this country with COVID-19 either, although there’s no shortage of people claiming that we do. But at some point we may indeed have some shortages (as they seem to have in Italy), and we’re planning for that and preparing for that (here’s an example of the preparations).

However, we certainly have worried about hospital bed shortages with the flu in the past. Remember this from October 2009? I didn’t either, but take a look:

If a third of people wind up catching swine flu [H1N1], 15 states could run out of hospital beds around the time the outbreak peaks, a new report warns Thursday.

The nonprofit Trust for America’s Health estimates the number of people hospitalized could range from a high of 168,000 in California to just under 2,500 in Wyoming.

The public health advocacy group used government flu computer models to study how quickly hospitals would fill up during a mild pandemic, like the kind the swine flu — what doctors prefer to call the 2009 H1N1 strain — is shaping up to be.

It based its estimates on the mild 1968 pandemic, suggesting up to 35 percent of the population could fall ill.

Even though only a fraction would be sick enough to be hospitalized, health officials are bracing: When H1N1 first appeared in the spring, more than 44,000 people visited emergency rooms in hard-hit New York City, the report noted. Just sorting out which patients are sick enough to be admitted from the vast majority who need to go home is a big job. And hospital capacity varies widely.

By the outbreak’s peak, the new report suggests Delaware and Connecticut hospitals would fill up soonest. Also on that list: Arizona, California, Hawaii, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia and Washington.

I found a host of articles like that one from 2009. But it never came to pass.

And what of a “regular” flu year? This is from January of 2018, entitled “A severe flu season is stretching hospitals thin. That is a very bad omen”:

A tsunami of sick people has swamped hospitals in many parts of the country in recent weeks as a severe flu season has taken hold. In Rhode Island, hospitals diverted ambulances for a period because they were overcome with patients. In San Diego, a hospital erected a tent outside its emergency room to manage an influx of people with flu symptoms.

Wait times at scores of hospitals have gotten longer.

But if something as foreseeable as a flu season — albeit one that is pretty severe — is stretching health care to its limits, what does that tell us about the ability of hospitals to handle the next flu pandemic?

Good question, eh?

More:

That question worries experts in the field of emergency preparedness, who warn that funding cuts for programs that help hospitals and public health departments plan for outbreaks and other large-scale events have eroded the very infrastructure society will need to help it weather these types of crises…

A dozen years ago or so, government officials placed pandemic influenza preparedness efforts on the front burner because of fears that a dangerous bird flu strain — spreading quickly across Asia at the time — might trigger a catastrophic pandemic…

Then in 2009, the first flu pandemic in four decades did hit. But instead of bird flu, it was a swine flu virus called H1N1. There were not mass casualties…

Pandemic influenza lost its big, bad bogeyman status. And in the years since, budgets for preparedness work have suffered…

Hospital and public health preparedness programs have sustained cuts in the order of about 30 percent in recent years, said Dr. Oscar Alleyne, a senior adviser with the National Association of County and City Health Officials, adding: “The level of funding is a concern to us.”

…A modeling program called FluSurge developed by the Centers for Disease Control and Prevention to help hospitals plan generates some pretty sobering scenarios, he noted. In a bad pandemic, hospitals might have four times more people in need of a ventilator than they have ventilators, and far too few intensive care beds for the seriously ill.

“So there would be a big mismatch between demand for care, lifesaving care, and the ability to provide it,” Inglesby said. “We would have a huge problem in this country.”

…Getting help from elsewhere — as a community will often do in the case of a major medical disaster — isn’t really an option during flu epidemics, because other places are either dealing with their own or steeling themselves for a wave that’s about to hit.

Please read the whole thing.

Comments

Flu vs. COVID-19: worrying about hospital shortages is nothing new — 45 Comments

  1. Epidemiologists in some ways resemble economists. Their forecastings are often wrong. As Neo’s quotes show.
    There is a saying that if you laid all economists end-to-end, they would not reach a conclusion.
    In the case of epidemiologists, the same is true, except they set our hairs on fire: Death is coming to someone near you!
    Epidemiologists are chronic worriers.
    They also pout when money is not showered upon them.

  5. It behooves medical places to fill up beds and run out and beggar the state for more funding, which when things go away, are available for raises to management (regular workers rarely get raises even over decades).

    been watching that play for over 15 years before i was put on the street for being anti diversity by existing… now i think maybe i should join the 80% that go bye bye… after all… my existence harms everyone now..

  6. [they are importing another 80k workers which prevents older men and now even students from work to pay off their college]]

    How a handful of Democratic activists created alarming, but bogus data sets to scare local and state officials into making rash, economy-killing mandates
    https://thefederalist.com/2020/03/25/inaccurate-virus-models-are-panicking-officials-into-ill-advised-lockdowns/

    As U.S. state and local officials halt the economy and quarantine their communities over the Wuhan virus crisis, one would hope our leaders were making such major decisions based on well-sourced data and statistical analysis. That is not the case.

    A scan of statements made by media, state governors, local leaders, county judges, and more show many relying on the same source, an online mapping tool called COVID Act Now. The website says it is “built to enable political leaders to quickly make decisions in their Coronavirus response informed by best available data and modeling.”

    An interactive map provides users a catastrophic forecast for each state, should they wait to implement COVID Act Now’s suggested strict measures to “flatten the curve.” But a closer look at how many of COVID Act Now’s predictions have already fallen short, and how they became a ubiquitous resource across the country overnight, suggests something more sinister.

    The models are being shared across social media, news reports, and finding their way into officials’ daily decisions, which is concerning because COVID Act Now’s predictions have already been proven to be wildly wrong.

    COVID Act Now predicted that by March 19 the state of Tennessee could expect 190 hospitalizations of patients with confirmed Wuhan virus. By March 19, they only had 15 patients hospitalized.

    In New York, Covid Act Now claimed nearly 5,400 New Yorkers would’ve been hospitalized by March 19. The actual number of hospitalizations is around 750. The site also claimed nearly 13,000 New York hospitalizations by March 23. The actual number was around 2,500.

    Jessica Hamzelou at New Scientist notes the systematic errors researchers and scientists have found with the modeling COVID Act Now relies on:

    Chen Shen at the New England Complex Systems Institute, a research group in Cambridge, Massachusetts, and his colleagues argue that the Imperial team’s model is flawed, and contains ‘incorrect assumptions’. They point out that the Imperial team’s model doesn’t account for the availability of tests, or the possibility of ‘super-spreader events’ at gatherings, and has other issues.

    Among other issues, COVID Act Now lists the “Known Limitations” of their model. Here are a few that seem especially alarming, considering they generate a model for each individual state:

    Many of the inputs into this model (hospitalization rate, hospitalization rate) are based on early estimates that are likely to be wrong.

    Demographics, populations, and hospital bed counts are outdated. Demographics for the USA as a whole are used, rather than specific to each state.

    The model does not adjust for the population density, culturally-determined interaction frequency and closeness, humidity, temperature, etc in calculating R0.

    Founders of the site include Democratic Rep. Jonathan Kreiss-Tomkins and three Silicon Valley tech workers and Democratic activists — Zachary Rosen, Max Henderson, and Igor Kofman — who are all also donors to various Democratic campaigns and political organizations since 2016. Henderson and Kofman donated to the Hillary Clinton campaign in 2016, while Rosen donated to the Democratic National Committee, recently resigned Democratic Rep. Katie Hill, and other Democratic candidates. Prior to building the COVID Act Now website, Kofman created an online game designed to raise $1 million for the eventual 2020 Democratic candidate and defeat President Trump. The game’s website is now defunct.

    Perhaps the goal of COVID Act Now was never to provide accurate information, but to scare citizens and government officials into to implementing rash and draconian measures. The creators even admit as much with the caveat that “this model is designed to drive fast action, not predict the future.”

    They generated this model under the guise of protecting communities from overrun hospitals, a trend that is not on track to happen as they predicted. Not only is the data false, and looking more incorrect with each passing day, but the website is optimized for a disinformation campaign.

  7. I at one time knew a fair amount about respirators (ventilators). as I worked in a surgical ICU and my best friend was a respiratory therapist. How many breaths-per-minute, the sigh, and so on. The patients then would be monitored by ABGs (arterial blood gas), the blood being painfully drawn out of the artery (rather than a vein), put in ice, then taken to the lab.

    I still remember the numbers we were looking for.

    This was 40 years ago. I wonder how much things have changed.

  8. I don’t think patients enjoyed being on ventilators, so far as I could tell. I believe they were sedated.

    It looked horrifying to me.

  10. Chuck:

    Are you the Delphic Oracle?

    You might at least put up a link.

    Now, I have no doubt there are plenty to choose from. And people predicting that might be correct. But if you’re going to make a pronouncement like that, back it up.

    One thing I think people are ignoring is that there are (as I put in my post) conversions of some large spaces into temporary hospitals to take up the slack.

    What I see are tons of articles saying “NY could run out of beds” etc. etc.. I always want to know on what figures and models this is based, as well as hearing from those who disagree and what their reasoning is.

  12. miklos:

    I’ve known three people who were put on ventilators (not for COVID, although one was for H1N1 and one for something that might have been pneumonia). All were put in artificially-induced comas for the duration.

  13. I got the number of beds for the state and simply extended the exponential increase in hospitalizations for a few days. Now I do expect more temporary beds to be made available in an emergency, so I am only talking about current hospital beds. The rate of increase of total hospitalizations is a pretty straight line on a semilog plot and extrapolating a straight line for a couple of days is not particularly risky. Of course, folks are also leaving the hospital and I don’t have data on that, but the growth is sufficiently fast that if it doesn’t happen in two days it will almost certainly happen in four. Note that I don’t claim any oracular precision, just pointing out where it looks like things are going in the short term.

    Beds available : ~13,000
    Hospitalizations : 8,526 (Last in 7 days of data)

    I’m sure better data is available, but I don’t see the use in tracking it down. I expect plenty of better informed people are looking at the numbers.

  14. miklos:
    being placed on a ventilator requires first placing a tube in the windpipe (medically, endotracheal tube) which cannot be tolerated by any conscious human due to overwhelming violent cough reflex, so induced comas are essential and unavoidable.

  15. I wonder if a possible part of opening up society again is going to be some sort of requirement that masks be worn in businesses or something like that for a period of time. They need to be producing those things by the millions.

  16. I expect NY will run out of trained personnel before it runs out of overflow beds.

  17. Chuck:

    Why don’t you put some links up? What is the rate of increase you are using for hospitalizations? Or the beds available? Where are you finding the information?

  19. As for the rate of hospitalizations in NY, they are increasing by roughly 30%/day. There is no point in being overly precise here, but next week in NY is going to be rough.

  20. Montage gets his ‘news’ from the mainstream media and like a good little troll/useful idiot he parrots it back at us. Regardless of how many times his claims are factually rebutted it just passes through without permanently registering. He believes what he wishes to believe and facts that can be easily confirmed are of complete disinterest. And that’s intentional because his fragile ego can’t face that he’s being played for a fool.

  21. Message to Artfldgr – please don’t be so pessimistic. Your existence harms no one and enriches many, including us – but especially your family. You are a valued member of this community; if we are sometimes a bit gruff, that’s just how friends are. Keep giving us your insights and information, which you have so much of to share.

    This is such a great song to lift your spirits.
    Men of the Tabernacle Choir singing “You Raise Me Up”
    https://www.youtube.com/watch?v=DSb3m9bNWkA

  22. Chuck:

    Looking at some of those links, I find there is no way to tell if the forecasts are correct because the range of possible figures given is HUGE. The ones they stick with are just averages of the range, as far as I can see, and the range goes from “not overwhelmed” to “very very overwhelmed.”

    So I don’t know about the forecasts, but I’m even having trouble getting good data for the present. In NYC, it seems to me that, from a bunch of sites I went to, 20% of all diagnosed cases at the moment are going to the hospital. Why is that particular rate so high in NYC right now? I’m not talking absolute numbers here – I know that the numbers of infected people in NY are high – but why such a high rate? Is it that the infection is extremely widespread in NY already, and so they’re only testing (and confirming) the more serious cases? I’ve not seen anything that deals with that question, despite all the verbiage about “epicenter” and “overwhelmed.”

  23. I only used the first site for the number of beds available in NY, the second site for the history of hospitalization. Here

    In [1]: from numpy.polynomial import Polynomial as P

    In [2]: beds = array([8526,6844,3805,3234,2636,1975,1603], float)[::-1]

    In [3]: days = arange(len(beds))

    In [4]: P.fit(days, log10(beds), 1).convert().coef
    Out[4]: array([3.17362117, 0.1220118 ])

    In [5]: 10**0.1220118
    Out[5]: 1.324377518710616

  24. AesopFan, i wish that was true…
    surely do
    but its not, and i do not wish to live on the street again
    my family doesnt bother with me much, my son, very little
    i do not have friends like other people, spend most of my time alone studying
    i design and invent solutions that no one will join or work on..
    some pretty damn good… but without paper, or associates, or capital or reputation or family or friends… im just a ghost… been most of that way most of my life… even my wife is not all that close and can easily spend a day ignoring i exist… now with no way to earn a living, i just drag everything down…

    have a chip design that cango through data faster than anything they have now
    it was designed to search for single nucleotide polymorphism, but shadt of illumina crushed me in favor of his xilinx 3% increase… my partner put it off for a long time, and it affected my job so didnt help… at the end we submitted a paper to plos one

    i do AI stuff… but its for nothing… I solved the french flag problem, no one will hear the answer… dozens of great products and things, no one will ever see… really beautiful artwork, that no one will see or buy…

    nope… sadly some of us dont have those normal things..
    but thanks for being so nice… its appreciated…

    well see what happens… wont we..

  25. The media is up to its usual tricks. Dante’s Inferno is going to need some new levels soon.
    https://pjmedia.com/trending/what-the-media-isnt-telling-you-about-the-united-states-coronavirus-case-numbers/

    What the Media Isn’t Telling You About the United States’ Coronavirus Case Numbers
    BY MATT MARGOLIS MARCH 27, 2020

    When President Trump said this week that the United States had done more testing than South Korea, USA Today was quick to fact-check his claim by pointing out, “The United States population is more than six times the size of South Korea’s. On a per-capita basis, South Korea is testing far more of its citizens than the U.S.” In this case, the media attempted to use a per capita comparison against Trump. CNN and MSNBC each made similar fact-checks.

    On Thursday, the New York Times made a big fuss over the fact that more than 81,321 Americans have been infected with the coronavirus, which is “more cases than China, Italy or any other country has seen.”

    According to their report, the United States, following “a series of missteps,” is now “the epicenter of the pandemic.”

    But, is it really?
    …
    In a visual presentation titled “Where the U.S. Stands Now on Coronavirus Testing” the New York Times even used whole numbers for confirmed cases in one slide, and then in the next slide used per capita numbers for testing, in order to paint the United States in the worst light.
    …
    So, why weren’t the case numbers adjusted to show them on a per capita basis, the same way testing was?

    Well, let’s take a look and see why.

    Betcha can’t guess the reason.

  27. Dem Gov admits there’s thousands of unused ventilators in NY
    https://byberry.com/dem-gov-unused-ventilators-ny/

    New York’s Democrat Governor Andrew Cuomo has now admitted that his state has a “stockpile of unused ventilators” – all after he previously complained that the American government was not providing enough. This comes after President Donald Trump stated, on Twitter, that there was plenty of ventilators in New York not even being used.

    Unsure of where Trump got his info from, but he said, “Thousand of Federal Government (delivered) Ventilators found in New York storage. N.Y. must distribute NOW!”

    Cuomo responded, according to Breitbart, saying, “Yes, they’re in a stockpile because that’s where they are supposed to be, because we don’t need them yet… We need them for the apex, the apex isn’t here, so we’re gathering them in a stockpile.”

    Cuomo continued, saying “we don’t need them today, because we’re not at capacity today, that’s why they’re not deployed because they’re not needed.”

  29. Dr. Deborah Birx, a member of the White House coronavirus task force, is pleading with the media to stop frightening people worldwide with incorrect stories about supply shortages and hospitals enforcing universal “Do Not Resuscitate” orders.

    “Please, for the reassurance of people across the world … there is no situation in the United States right now that warrants that kind of discussion right now,” Birx said during the task force’s daily White House briefing Thursday.

    “To make the implication that when they need a hospital bed, it’s not going to be there, or when they need that ventilator, it’s not going to be there, we don’t have any evidence of that right now. It’s our collective job to make sure that doesn’t happen,” Birx also said.

  30. I had commented on another blog, and thought adding the US states with the most fatalities to the list of EU countries comparing the deaths/1 million population was interesting. These states are on par with Europe.
    If distance = protection, then living in a high density city or country puts you at higher risk. The most dense population countries in Europe are Spain, Netherlands, Italy, and Belgium. England is fairly dense.
    Now look at their deaths per 1 million population
    Italy 165.2
    Spain 128
    Netherlands 37
    New York state 37
    France 34.5 (no doubt because of Paris)
    Switzerland 31
    Belgium 31
    Louisiana 29
    Washington state 25
    New Jersey 16
    UK 15
    Michigan 11
    Denmark 11
    Sweden 10
    Austria 6
    USA 6
    Germany 5
    California 2.5
    I added the US states with deaths <100
    Pretty obvious it sucks to live in a major city right now. Living in flyover country is starting to look pretty good. Now that I've gotten that snark out of my system, my sympathies are to New York.
    Germany is definitely an outlier. It's population density is similar to Switzerland.

  31. From Iceland

    Early results from deCode Genetics indicate that a low proportion of the general population has contracted the virus and that about half of those who tested positive are non-symptomatic,” said [Iceland’s chief epidemiologist Thorolfur] Guðnason. “The other half displays very moderate cold-like symptoms.”

  32. Why is that particular rate so high in NYC right now?

    I think NY is being picky about who they test due to insufficient testing capacity, they can’t test everyone who thinks they may be infected. In Utah the rate is about 5%. Just talked to my stepsister in Brooklyn, one of the families she knows all come down with the virus. The mother spent about 4 days in the hospital, so not too bad. So that is one data point for length of stay in the hospital.

  34. America’s Superb, Unappreciated President
    A close look at what Trump has done to combat the current pandemic — amid constant Democrat assaults
    https://www.frontpagemag.com/fpm/2020/03/americas-superb-unappreciated-president-john-perazzo/?utm_campaign=1109877&utm_content=1555501

    PETER HITCHENS: There’s powerful evidence this Great Panic is foolish, yet our freedom is still broken and our economy crippled
    https://www.dailymail.co.uk/debate/article-8163587/PETER-HITCHENS-Great-Panic-foolish-freedom-broken-economy-crippled.html

    Section 45 C (3) (c) of the Public Health (Control of Disease) Act 1984 (appropriately enough) is the bit that does it. Once the Health Secretary believes there is a threat to public health, he has – or claims to have – limitless powers to do what he likes, ‘imposing or enabling the imposition of restrictions or requirements on or in relation to persons, things or premises in the event of, or in response to, a threat to public health’.

    The former Supreme Court Judge Lord Sumption doubts that the Act can be used in this way and warns: ‘There is a difference between law and official instructions. It is the difference between a democracy and a police state. Liberty and the rule of law are surely worth something, even in the face of a pandemic.’

    [snip]

    After last week, can we rule anything out? This new Stasi society has a horrifying level of support. Humberside police are already advertising a ‘portal’ for citizens to inform on their neighbours for breaking the ‘social distancing’ rules.

    If you think they won’t get any takers, think again. Northamptonshire police have revealed that their control room has had ‘dozens and dozens’ of calls about people ignoring the order.

    They said: ‘We are getting calls from people who say, “I think my neighbour is going out on a second run – I want you to come and arrest them.” ’

    Most people will, by now, have viewed the online film of Metropolitan police officers bellowing officiously at sunbathers on Shepherd’s Bush Green in London, energetically stamping out the foul crime of lying on the grass (would they have paid so much attention, two weeks ago, to a gaggle of louts making an unpleasant noise, or to marijuana smokers?).

    Others will have seen the films, taken by Derbyshire police drones, of lonely walkers on the remote, empty hills, publicly pillorying them for not obeying the regulations. It is genuinely hard to see what damage these walkers have done.

    But as a former resident of the USSR, I can tell you that this sort of endless meddling by petty authority in the details of life, reinforced by narks, is normal in unfree societies – such as we have now become for an indefinite period. It is, by the way, also a seedbed for corruption.

  35. I’m drawn to comparisons between Italy’s healthcare system and our own. Which is more nimble? Were we “wasting” resources when we made sure we had 3x the ICU beds per capita that Italy has? Can we treat ICU beds as a just-in-time sort of inventory and be confident that we can ramp up ICU capacity for any emergency, not knowing what the next emergency will look like and what kind of specialized care it will require? I think the best we can do is stay prosperous and ready to turn on a dime: lots of spare resources and enough flexibility to re-purpose them if things go to pot in a hurry.–And get rid of “certificates of need.” They are an abomination. Deprive them of public funding if you must, but get out of their way.

  36. The projections for beds/ICU/ventilators needed by state that Chuck linked is from a model from the U of Washington that predicts 82,000 deaths in the US by the end of July.
    As Neo said, the range is pretty large.

    “With those inputs, the computer models project a total of 81,114 deaths in the U.S. over the next four months. Most of those deaths are expected to occur during April, peaking at more than 2,300 deaths per day. That rate is projected to drop below 10 deaths per day sometime between May 31 and June 6.
    “If the forecast proves correct, that suggests a dramatic upswing in the U.S. outbreak.”
    “The UW team’s predictions are couched in statistical caveats. For example, the death toll projection of 81,114 has a 95% confidence interval of 7,977 to 251,059 deaths.”

    The projections are very specific, so it will be easy to validate over the next week or two how accurate the modeling is.

    https://covid19.healthdata.org/projections

  37. Brian E

    I thought those projections looked overly pessimistic for NY in light of the current data so I didn’t use them. OTOH, they may just be just be ahead of schedule. We will see.

  38. Neo, thanks for your post. I appreciate the links. Time will tell where this is going but my main point was that Covid-19 is out-of-the ordinary as compared to the typical yearly flu, which usually has many deaths over a longer period. More importantly, we have flu vaccines and – other than the awful years [1918] – it gets contained and we prepare. This one hit us hard and fast and we have no vaccine yet or a way to contain it – short of Martial Law.

    My main argument is that I do think the social distancing and the closing of most crowd gathering businesses and spots is not wrong. I don’t think it’s overreacting. Although it sucks – our economy is taking a hit. But I think we’re doing the right thing. I really don’t believe the country will be ready to open businesses by Easter. If it was like the flu we probably would be ready to re-open again. Let’s see where we are in a month.

  39. Montage:

    I certainly don’t know, either, whether these measures were worth it. I’m not sure we’ll ever know, unfortunately.

    But as far as the flu causing many deaths over a longer period goes – in a bad flu year I’m not even sure that’s true (and I don’t mean just in a pandemic year). Flu is seasonal, which means it tends to strike in certain months, although the exact months can vary somewhat. Some flu seasons are longer than others. October or November through some time in the spring would be typical, and most of the cases and most of the deaths would occur then.

    So let’s say there’s a year in which 30K people die of the flu in the US. To get the number of deaths per month in flu season you can’t just divide by 12 and get 2500. It might be better to divide by 6 and get 5000. It’s hard to find exact figures of the distribution of deaths throughout the year – at least I haven’t found them yet.

    However, let’s look at the 2017-2018 season, which was a bad flu year in which there were apparently 61,000 flu deaths in the US:

    The United States Centers for Disease Control and Prevention (CDC) began counting the 2017–2018 “flu season” as October 2017, and by early February 2018, the epidemic was still widespread and increasing overall. By February 2018, the CDC said that the circulating virus strains included both B strains (Yamagata and Victoria), H1N1 and H3N2. On 10 February 2018, Fortune reported that influenza in the United States was killing up to 4,000 Americans a week, likely to far outstrip the rate of deaths in the 2009–2010 season.

    Four thousand Americans a week at peak. An average over the approximately 6 months of flu season of about 2541 a week, by my estimate.

    Right now, after 2 months of COVID being in the US, the total deaths from the disease are 2484. The equivalent of one week’s worth of the 2018 flu season. Of course, I expect the pace to quicken, but how much? And of course, we’ve been doing the social distancing intervention for a few weeks, and that affects everything. But I don’t see why people pooh-pooh the comparison to the flu. I’ve even heard some epidemiologists saying it will be likely to be like a bad flu season.

  40. ‘I’ve even heard some epidemiologists saying it will be likely to be like a bad flu season’

    I think Fauci and Redfield basically said that in that New England Journal of Medicine piece of theirs that came out the other day.

    I just can’t match up the unprecedented response to this with the numbers. And the bigger question is are we going to do this every time something like this pops up or even looks like it might? Why would you ever risk starting a restaurant or other small business if the govt could destroy you on a whim?

  41. Griffin:

    That’s one of the thoughts I’ve been having. Do we do this every time?

    If this really is a catastrophic pandemic event like in 1918 or worse it might be worth it. But where do we draw the line in the future? I don’t think we’ve been given any guidance on that. I hope in a month or two we are told more, because we need to know these things for the future.

  42. Right now, after 2 months of COVID being in the US, the total deaths from the disease are 2484.

    Nineteen days ago it was 27 and it went up 23% today. That is with all the measures currently in place. Note that California is still way behind in testing so that is a potentially large unknown.

  43. Chuck:

    California may be way behind in testing, but I am pretty sure they are testing those who die of COVID-like symptoms or those who are seriously ill with them. Their case number is probably artificially low, but it’s the death number you were counting.

  44. Chuck:

    Looking at the US stats on this chart of countries, I get 10% new deaths yesterday. I’m not sure why you get 23%.

    By the way, using the stats at this site, I calculate that about 40% of US deaths are in NY (and most of them in NYC). If you add to those NY deaths the states of Washington (the first “epicenter”) and NJ (most of the deaths there are in the part of NJ that’s in the greater NYC area), you get 54% of US deaths.

    It’s quite astounding.

  45. Maybe I’m wrong but I have to think one number we can be fairly confident in is how many have died of it in the US.

    Other countries use such varying criteria for cause of death it really is a guess. Then you have China, Iran, Russia I guess.

    We may never really know the real numbers.

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