The first sign of an impending tsunami is that water pulls away from the shore. It’s deceptive, this seemingly innocuous change in the ocean. The advent of camera-enabled mobile phones means any number of YouTube videos showing people marveling at suddenly dry rivers or harbors.
They are apparently unaware of what comes next.
What comes next is that the water returns, slowly and steadily rising to replace the water that receded and, then, to overpour its past boundaries. More and more and more water sweeping away buildings and drowning those who hadn’t anticipated its arrival.
Maybe this metaphor is heavy-handed, but so be it. That the United States is seeing as many or more deaths per day from the coronavirus as it did during the deadliest period last spring is no more surprising than a tsunami’s floodwaters because, like the tsunami, we could see it coming.
As of writing, The Washington Post has tallied more than 273,000 deaths from covid-19, the disease caused by the coronavirus. Last spring, the White House coronavirus task force suggested that, with containment measures, we might see as many as 240,000 deaths. A few weeks later, President Trump began publicly disparaging those measures, and here we are.
There have been more deaths from the coronavirus alone this year than there were in any single month of 2019.
And every day we’re adding about 1,600 more — a figure that continues rising.
We knew this was coming. We knew because we saw the number of cases rising. We knew because we understood that more cases inexorably meant more deaths. We saw the water receding and knew what followed.
There are five metrics we can watch to evaluate how the pandemic is unfolding. The number of tests, which gives us some context for the number of newly detected cases. The positivity rate, which is a measure of how many of those tests return positive. The number of hospitalizations, a clear representation of the spread of the threat. And, of course, the daily death toll.
Here’s how each has evolved since March.
(Some anomalies in the hospitalization data have been de-emphasized for clarity.)
Case totals are far above where they were during the surge this summer — and it’s not simply a function of testing, given the percentage of tests coming back positive (according to data compiled by the COVID Tracking Project) is near 10 percent. Hospitalizations increased after the surge in new cases and deaths after that.
Admittedly belaboring the point, that chain — cases to hospitalizations to deaths — is not only intuitively obvious but also predictable. Hospitalizations often begin to surge a week or so after cases, as infections become dangerous. A week or so after that, the worst cases lead to fatalities. So there’s a spread of several weeks from new cases to deaths.
That allows us to put together a rough ratio between the two figures. Since Aug. 1, for example, the number of deaths has been fairly consistently about 1.7 percent of the number of cases 22 days prior. There are other lag times that one could consider, but the 22-day period at this point yields the most stable result.
This provides a useful way of viewing future death tolls. If we retroactively apply that percentage to case totals, we can see that the number of deaths we’d expect to see tracks neatly with the number of deaths we actually did see.
Except for the past week or so. In the set of graphs tracking the pandemic above, you may have noticed similar blips in recent days, deviations probably due to data gaps because of the Thanksgiving holiday. The projection above — and the daily figures over the past two days, each of which topped 2,500 deaths — suggest the average will soon come back in line with the projections.
What’s important to note about this, too, is that it suggests not much has changed in our efforts to fight the virus in recent months. Trump often likes to proclaim that the fatality rate of the virus has dropped 85 percent since the springtime peak. But that’s looking at the ratio between the number of deaths and the number of cases recorded on a single day (April 19 or so) with the similar rate now.
That’s misleading for two reasons. The first is that we know deaths lag behind new infections by weeks. The second is that the number of cases recorded in April was necessarily limited by the number of cases that went undetected. On April 19, the country only conducted about 150,000 tests; there was no way that we could have recorded 200,000 new infections even if they occurred.
The implication of this ratio is clear. We’re adding 165,000 new cases per day at this point, meaning that by Christmas, we can expect an average of 2,800 deaths.
Maybe this is overstated. Maybe the ratio, which has been lower in recent weeks, will not stay at 1.7 percent. Regardless, we’re on track to easily pass 300,000 total deaths this month and perhaps (looking at one oft-cited projection) as many as 350,000 or 400,000 by Inauguration Day.
It’s also possible these estimates are understated, that America’s heavily business-as-usual Thanksgiving will itself have boosted the number of new infections the country will see. This was the concern expressed by the country’s leading infectious-disease doctor, Anthony S. Fauci, that the country would see a “surge on top of a surge.”
A tsunami on top of a tsunami. That as the floodwaters rose in one spot, the water was being drawn out in many more.
There was a decision made by officials at many levels of government, including by the White House, to let the virus spread. This result was inevitable.
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