How is the US Covid19 Mortality Tracking?

           

I plotted Covid19 deaths in the US and matched it against the death curve in Italy, off-set by 14 days (Italy’s death curve is 2 weeks ahead of US death curve). Updated daily.

My calculations/predictions are NOT based on general Covid19 mortality (example: 42,000 deaths/855,000 worldwide confirmed cases = 4.9% worldwide mortality of tested Covid19 or 3800 deaths/186,000 US confirmed cases = 2% US mortality of tested Covid19), but death curve established in Italy that is replicating in developed countries.

Based on current trends, the US:Italy death rate is averaging 1.44 (as of 3/31/2020) based on death ratio of most recent week (7-day) average. This predicts US death rates to be 4275 by April 1st and 13,108 deaths by April 10th.

My death rate prediction is based solely on data and does not consider Ratio 2018 Population (US:Italy) = 5.4. Ratio 2018 Elderly (US:Italy) = 0.70 (source: Statista.com). If I consider the population size as well as % differences in elderly, I would put US death rate to be about 3.8x the death rate of Italy. I don’t see this happening unless there are multiple state-wide healthcare system overwhelms/collapses due to # of critically ill patients who succumb to Covid19 from treatment shortages.

Data from https://www.worldometers.info/coronavirus/

How are we doing in CA? (proportion of u.s. deaths)

% of CA covid19 death rate over US death rate. I also included NY % death over US death rate. Updated as data become available.

Both CA’s governor Newsom and NY’s governor Cuomo announced shut down of non-essential services on March 20th 2020. However, Newsom made the order active on midnight THAT DAY (boxed). Cuomo made the order active almost 2 days later on Sunday 8pm March 22nd (boxed). Based on rate of spread, even one day makes a huge difference in downstream effects.

Suggestions that CA is “2 weeks behind NY” appears SO FAR to not hold, as NY death rates continue to trend upward and CA death rates maintains below 10% national death rate.

For those of us in CA, this is be a good reminder that what feels / appears to be an extremely stringent measure by state and local politicians do/can result in lower mortality rates, which gives CA’s healthcare systems the time required to “surge prepare”.

Why I only track death rates and proportions:

  • Infection rate isn’t accurate because infection rates depends on reliable testing. We do not have widespread, ubiquitous testing. The true infection rate is higher than what is being tested and reported as positive. There will be false positives and false negatives, which makes infection rates unreliable. Infection rate can be used as a ‘sampling’ of how well the quarantine/shelter-in-place measures are working.
  • Death rate is both an indicator of Covid19 mortality and the healthcare system’s capacity at that moment. I don’t see the death rate as a true indicator of mortality, but actually Covid19’s mortality constrained within a country’s/state’s healthcare system. You can have a cohort of patients who theoretically CAN recover from Covid19, but do not, because healthcare providers are forced to assign life-saving ventilators based on the hospital’s algorithm.
  • Death rate is imperfect: there may have been patients who have died from Covid19 complications but were not tested and therefore excluded from official death statistic, This skews the death rate down, making the death rate lower than it actually is.
  • Death rate in Italy is suggested to be so high because of the high % of elderly population.
  • This is why physical distancing and taking shelter-in-place/non-essential shut-down measures must be taken seriously: people often fixate on “infection”, when the true issue is “death by lack of healthcare resources”. We are not shutting in only to prevent infecting ourselves and others. We are shutting in to prevent a usage tsunami of our healthcare system such that a doctor has to remove life-saving vent from one patient to save another patient. Many of us will be infected. Some of us will become hospitalized. A few of us hospitalized will die. We are aiming to PREVENT deaths that can otherwise be AVOIDED if healthcare systems aren’t overwhelmed.

 

FROM NextStrain.org website

Genomic epidemiology of novel coronavirus / How coronavirus mutations can track its spread—and disprove conspiracies

Sit-Rep as of March 27, 2020 for North America:

  • “Within the U.S., transmission patterns are complex: samples collected from opposite sides of the country still show close relationships.” In general, transmission across the US is “complex and not well-understood”.
  • Genetic ancestry of the virus recently in CT show relationship with samples from WA suggesting recent transmission between distant states.
  • California data is still early and limited but available evidence suggests 2 local transmission chains that started in Northern California in Solano County.

 

What Information Sources am I Tracking/USING?

Data Sources: https://coronavirus.jhu.edu/map.html ; specific daily data from https://www.worldometers.info/coronavirus/ and  https://covidtracking.com/

Dr. Rohin Francis (UK) has a Coronavirus Playlist that includes “How We’ll Beat Coronavirus”, “6 Reasons to be Optimistic about Coronavirus”, “Doctor with Suspected COVID19”, and “Are We Doing the Right Thing?” (This one addresses questions relating to the typical death rate and whether “the measures could be as bad as the disease” if typically that many people are going to die anyway, but those objecting conveniently ignores the time-compression of this phenomenon).

Dr. John Campbell (UK) does a daily update of Coronavirus status around the world and addresses specific and relevant topics such as reproduction number (R0), Viral aerosol and surface survival, whether reducing fever using over the counter medicines is “good or bad” (if you can tolerate it, don’t take anything; if you cannot then take acetaminophen*), and whether you can “boost” immune function (you can’t but you can reduce effectiveness of your existing immune function).

Dr. Roger Seheult (US) is a pulmonologist who has been looking at available scientific data relating to Covid19 mechanisms of action/kills as well as experimental avenues of treatment. He talked about zinc ionophores and chloroquine/hydroxychloroquine class of drugs before this became widely discussed. The channel is meant for medical students, but are useful for a public audience who may have a background in healthcare/scientific or are simply curious about actual science.

*Fact Check on concerns about ibuprofen and Covid19

BUT… I NEED TO CLIMB/HIKE/DO-WHATEVER-OUTSIDE!

 I’ll be the first to admit that climbing has a real positive impact on my mental health (you’ve read my climbing as therapy article, right?). To those objecting to shut downs of state/national parks and hiking trails because “I doubt your 90 year old grandma is up there skinning up the trail” — Because first responders will have to RESCUE YOU if you get into an accident instead of helping other first responders with REAL patients needing REAL help in REAL remote areas. That is why accidents are called accidents. NONE OF US plan to have climbing/hiking accidents.

List of “I know how to climb safely”/”I am an experienced climber”/”I am nowhere close to anyone else”/”I know my own limits” cases of sucking up scarce first responder resources:

“Despite mass outreach and the desperate warnings from physicians and health care workers worldwide, climbers from around the country have descended upon Bishop…”

 

Primary Source (First Person) Accounts & symptoms

Note: Just because you recover does not mean your lungs could ever fully recover. Could subsequent infections further reduce your lung function? Time will tell.

Michael Bane, 42M (Chicago IL) “TL;DR version of this is: It’s brutal, and I have no doubt it can kill you. Anyone who is saying it’s just a bad cold is either had a far different personal experience than I have or is parroting stuff they found on the internet.” Excellent personal day-by-day logged experience.

David Anzarouth, 25M (Toronto Canada) “The fit 25-year-old living in Toronto didn’t worry about taking his vacation to South Beach in Miami, Fla., in early March. … “It was the most incredible pain I’ve ever experienced … My body felt like I had been flattened.”” — Not to mention he also exposed many people on the flight he was on.

Deceased Natasha Ott, 39F (New Orleans LA) Healthcare clinic staff was told she was “low-risk” after feeling “the beginnings of a cold” on March 10th. The clinic only had 5 tests and she did not want to take the test away from a more critically ill patient.