In March, most of the country entered shelter-in-place to slow the spread of Coronavirus and flatten the curve. The strategy seemed to be working, even as several states reopened in May. New cases and daily deaths both plateaued and began to decline.
Then came June.
In June, hundreds of thousands of people took to the streets to protest the death of George Floyd. In addition to widespread demonstrations and rioting, many other Americans seemed to experience mitigation fatigue and stopped practicing social distancing and mask-wearing, forgetting that the virus was still present even though its spread had been reduced.
The mitigation was undermined from both the left and the right. Socially conscious doctors and commentators undermined their credibility by telling the country that social distancing was less important than taking to the streets to protest racism. Alarmists on the right attacked the severity of the virus and tore into recommendations for social distancing and masks as infringements on personal liberties. Both helped to revitalize the virus.
I live in Georgia, the first state to reopen. There were dire predictions of a spike in Coronavirus cases when Gov. Kemp allowed businesses to resume operations at the end of April. That did not happen immediately and I can offer some insight on why.
Even though Gov. Kemp declared the state open for business, Georgians weren’t ready to go back into stores and restaurants. Most voted with their feet and stayed home. Many businesses stayed closed or open only for curb service even though they were allowed to be open. When people ventured out, most wore masks. I described all this back in May after I ventured out to eat with my family for the first time in months. Gradually, Georgians became more relaxed and many stopped social distancing and wearing masks.
Now Georgia and other states are paying the price. The US has seen the number of new cases explode. From less than 20,000 new cases per day, the US is now reporting more than 60,000 cases every day. That number is increasing on an almost daily basis.
Some take solace in the fact that the US is doing more testing for the virus, arguing that there are more cases only because there are more tests but that the daily death toll has not increased. These notions are wrong for two reasons.
First, it is true that more tests would yield more positive results as we find more asymptomatic cases. This explains some but not all of the new cases. The rate of positive tests is also increasing even as the number of tests increases. This suggests that the virus is once again spreading rapidly. Johns Hopkins testing data shows that 33 states and Puerto Rico are above the five percent positivity rate recommended as the maximum for reopening.
Second, deaths are a lagging indicator. Coronavirus takes several weeks to kill its victims. The new surge in COVID-19 cases began about the middle of June, therefore the death rate should only now be starting to tick upwards. If we look at the statistics, that is exactly what we see. The seven-day moving average of US Coronavirus deaths started to show an uptick about July 7.
Back in March, I detailed a simple mathematical model created by Inan Drogan. The model assumed a 0.8 percent death rate and that a Coronavirus case takes 24 days to result in a death. Using these assumptions, Drogan forecasted a death toll of 12,800 by April 7. Looking back, the forecast was close but on the low side with the US death toll at 15,743 that day.
I’ll also point out here that July 7, when the US Coronavirus death rate began to increase, is 24 days after June 13. This corresponds very closely with the beginning of the surge in Coronavirus cases.
Epidemiologist Ellie Murray pointed out in The Atlantic that increased testing may also contribute to an increased lag between identifying the case and the patient’s death. More testing means that many cases are identified earlier than they were in the spring. This could prolong the period between identification and death.
There are other signs that a big surge in COVID-19 deaths is coming. Many states are reporting increases in hospital admissions and a diminishing ICU capacity. Arizona, Georgia, Florida, and Texas are among the states where Coronavirus cases are threatening to overwhelm hospital systems. Many of the patients filling these hospital and ICU beds will ultimately succumb to the virus in a few weeks.
The increase in deaths may also be somewhat delayed by the fact that many of the new confirmed cases are among young people, who are more resistant to the virus. Contrary to the belief of many, “more resistant” is not the same as being immune or invulnerable.
“We see people in their 20s and 30s in our ICUs gasping for air because they have COVID-19,” James McDeavitt, the dean of clinical affairs at Baylor College of Medicine, said in the Wall Street Journal. McDeavitt notes that even young patients who are asymptomatic or nearly so can still suffer long-term organ damage, particularly to the lungs, as well as pass the disease to people who are more vulnerable.
Even though younger people do have a lower mortality rate from COVID-19 than older patients, the mortality rate for young adults is far greater than zero. Some percentage of these younger patients will die from the virus, others will suffer long-term or permanent complications, and still others will recover but spread the virus to others before they do. We can expect daily deaths to increase at an increasing rate as young carriers pass the virus to people who are at higher risk of death.
There is some good news, however. Derek Thompson in The Atlantic reports on two studies that show Coronavirus hospital patients are dying at a lower rate. Atlanta’s 11 Alive reported that therapies using convalescent plasma from recovered COVID-19 patients and the drug remdesivir are showing promise. Those treatments were not available three months ago. The data is incomplete but a hopeful sign that doctors are finding ways to help the body fight off the virus.
But that hope hinges on keeping the curve flattened to prevent hospitals from being overwhelmed. Flattening the curve depends on slowing the rate of infection and that, in turn, hinges on maintaining disciplined social distancing, handwashing, and mask-wearing.
Here in Georgia, I’ve noticed that even without new orders from the governor many businesses are returning to mitigation strategies from March and April. I’m once again seeing more masks when I venture out. Some of the new cautionary measures are regulatory, such as mask mandates in Atlanta and Texas, but many people are acting on their own to protect their own health as well as the health of their neighbors.
I’ve said many times but it bears repeating that there are only two ways to return to normal. One is with a vaccine or treatment and the other is by letting the virus run its course. The difference between the two is hundreds of thousands of dead Americans.
If we want to minimize the cost of the pandemic, both terms of lost lives and a damaged economy, we are going to have to embrace mitigation strategies for the foreseeable future. To get the pandemic under control, Americans of all political persuasions need to take the virus seriously.
Stop listening to bad advice from politicians and pundits and start listening to the medical experts. Wear a mask, wash your hands, and keep your distance.
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