Will high disease projections come true for COVID-19?

Epidemiologists use mathematical modeling to determine how many people are likely to get sick from whatever is floating around. Modeling on COVID-19 indicates that we should expect somewhere between 40-70% of the population to contract this new coronavirus.

With a 3.4% mortality, in a country of around 330 million people–if things don’t change, and the model is correct–a lot of people will die, potentially 4-8 million Americans.

What factors could affect this prediction?

early missteps could make those dire projections more likely

The US test kit for identifying an infection as COVID-19 was flawed (the control wasn’t working). We now have a test kit that is more widely available and accurate, but testing of patients was delayed in critical early stages of the disease, when we were best poised to disrupt it’s spread.

the data from China–the basis for our model– may not be reliable

The death rate for COVID-19 comes from data provided by China. This data suggests about 80% of those infected develop a mild case; and 20% are more serious, with about 2.3% ending in death. Note: The WHO increased the worldwide death rate to 3.4%.

The information could be inaccurate, incomplete, or perfectly valid–we don’t know yet.

for example, death rates could be lower

One way the data could change: if more people had COVID-19 than was reported by China, the death rate could decrease (because the number of deaths would then represent a smaller percentage of the total number of infected). A recent report in The New England Journal of Medicine finds a rate of 1.4 percent (still far greater than the seasonal flu rate of .1%).

In addition, we don’t know if COVID-19 affects people inside China in the same way that COVID-19 affects people outside China. Are people in the US more or less or similarly affected? We need more information to find out.

or death rates could be similar in the US

The health care in China is fairly comparable to US healthcare: China has stockpiles of supplies, hospitals equipped with ventilators and drug therapies. Once sick, even in new, well-equipped hospitals in China, about 2.3% of patients with COVD-19 (still) died.

China efficiently controlled the spread of the disease; if the US isn’t as efficient the death rates could remain high

In order to contain the virus, China quarantined populations of healthy as well as sick people. They controlled how and when healthy people could leave their homes (they needed a pass) and how to purchase food (it was delivered, and then paid for electronically).

Is the US prepared to have major cities shutdown in the name of containing a virus?

willingness to self-quarantine

The extent to which we are willing to quarantine both healthy and infected patients may go a long way toward changing the overall number of people that get sick from COVID-19.

If asked, are you willing to stay out of stores, cancel public events, reduce travel, use good hygiene, and work from home? Will you forego movie theaters, restaurants, and uber?

warm weather could change the equation

Warm weather generally interrupts viral infections but, with COVID-19, the spring is not expected to bring a large change in infection rates. If this is incorrect, and there is a greater relief from the disease’s spread this spring, this relief could allow more time for the development of therapies and vaccines. This could result in a much lower rate of infection overall.

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