SARS-CoV2 infections were originally doubling once every 2.5 days, according to the CDC and the WHO. Over the last 4 days, deaths in different countries have had different doubling rates, but US deaths doubled very close to once in that 4 days.
This is a result of the fact that the places with the highest numbers of deaths also have done the most to slow transmission via shelter-in-place orders and other measures. So even if infections and deaths are doubling much faster in counties and states that haven’t yet been hit hard, the total number of deaths they add from a single doubling might yet be small compared to deaths in, say, New York City, which had over 500 on Friday. (By the way, New York City’s measures haven’t yet been effective at slowing the doubling: their deaths doubled in a mere 3 days.) We are not likely headed for a slowdown of the doubling rate because there are so many places where the virus is just beginning its infectious burn, and while each individual county might be small, there are many counties with many, many people in Texas and Florida and Georgia and other red states.
Since the doubling rate depends on human behavior, it can and will change. But since by the time someone dies of COVID-19 the moment that they were first exposed to the SARS-CoV2 virus is already 2 weeks (or maybe more) in the past, the doubling rate today depends on human behavior 2 weeks ago. All this means that while we can’t know for sure what’s going to happen with COVID-19, there’s no reason for non-experts such as this blog proprietress to think that the doubling rate is going to change much for at least two weeks. Even then, since there are so many exceptions to the shelter-in-place orders in many states (like keeping gun stores open and, I kid you not, a horse show and auction), we can’t possibly see as great a reduction in the growth rate as nations like South Korea. Italy, Spain & France had their deaths double over the last 10, 7, and 6 days, respectively. I doubt we’re going to be better than any of them.
But okay, let’s say that we double our deaths 3 times over the next 12 days before red-state orders begin to have some small effect (remembering that NYC has been trying hard for a while now and still doubled their total deaths over the last 3 days). The next doubling, we can hypothesize, takes 5 days before the next two doublings after that are at a more France-like rate of once every 6 days. In this case, we have 6 doublings over the next 29 days. Given that current deaths in the US from COVID-19 were at 6,593 at the CDC reporting deadline Saturday afternoon, that means that on the afternoon of May 3rd the US should have 2^6 * 6,593 deaths, or 64 * 6,593 deaths. That gives us 421,952 deaths on May 1st. We should actually reach Trumps low-end death total of 100,000 two doublings before that, or 17 days from now when red-state measures are finally beginning to help, but long before we can expect to stop the spread entirely. There really is very little hope at all that deaths will be less than 100k on Earth Day this month. Since we’ll still get more than another doubling by the end of the month if we reach France-like levels of containment on transmission, Trump’s most pessimistic projection of 240,000 deaths from COVID-19 in the USA will be surpassed before sunrise on April 29th.
Of course we knew that Trump has been painting a rosy picture of this pandemic since the beginning and we had every reason to believe that his “pessimistic” projection of 240k deaths was anything but pessimistic. Still, I think it is rather shocking that we have less stringent protective measures in place than France, we have a population at least as willing to disregard government warnings as France given the strong tendency towards science-denialism among Republicans and anti-government sentiment even when they might be tempted to believe the science, and only by making our control measures as effective as those in France as soon as reasonably possible given that red states only just implemented those measures can we delay surpassing Trump’s most pessimistic numbers until after the 23rd of this month. And even then, we only gain a few days.
There is no way to predict human behavior, and we may get progressively better at halting transmission much earlier than I think is likely, based on the experiences of European nations. But right now my best guess looking at the math and thinking about how ready so many are to believe that COVID-19 is a hoax or overblown or a manufactured excuse to implement government control over individual movements, is that we’ll be above 250k cases at the end of this month and that we’ll see at least two more doublings of death after that, even if those doublings take much longer. China’s most recent doubling has taken 49 days, but we can’t entirely eliminate transmission without preventing people from grocery shopping and doing other vital tasks, and even if we don’t hit 420k deaths by May 3rd as seems likely to me, even if we bend the curve downward more steeply than I think the stupid and rebellious among us will allow, we would still hit 250k deaths early in May, and doubling deaths every 50 days (a success rate I don’t think is achievable without a hugely powerful central government such as exists in China), 100 days from May 3rd would be only mid-August, far too soon for us to expect to have engineered and manufactured and distributed an effective vaccine. In the best case it is remotely plausible to imagine (and don’t get me wrong, I think calling it “plausible” is being far more generous than the scenario deserves), we’re should expect one million dead of COVID-19 by mid to late summer.
And all this would be true assuming that we are as good at fighting this disease over the next month as France has this past month, and as good at fighting it for 3 months after that as China has for the last month and a half. With Trump in charge, that seems optimistic to the point of self-delusion. It seems to me that we’re more likely to reach 3 million deaths than to stop short of 250 thousand, and more likely to reach 2 million than to stop short of 500 thousand. Our best hope is not that the federal government or even the states will proactively halt the spread of SARS-CoV2, but that those currently inclined to ignore its risks literally panic as the numbers of deaths climb past a quarter million. Our best hope is that this panic changes their behaviors drastically, enough to slow down the spread in a way that appeals by scientists and governors have not yet managed.
In other words, we can no longer trust our leaders to manage this crisis. We can only now trust our idiots to act from fearful cowardice.