The numbers seem catastrophic, overwhelming, beyond a magnitude that the human mind or heart can grasp: What do 60,000 — or even 240,000 — deaths look like?
Those are roughly the lower and upper limits of projected fatalities in the U.S. from Covid-19 in models that have been informing U.S. policy. Last month, when the lower estimate was 100,000, the White House recommended nationwide countermeasures. Those started with a ban on gatherings and quickly escalated to closing schools and businesses, advising people to wear face masks, and reminding them to stay physically apart. This week, when the lower estimate (from the Institute for Health Metrics and Evaluation) dropped to 60,000, reflecting how well those measures are working, it stoked optimism that the epidemic might soon end with less loss of life.
The lower number, 60,000, is a little more than the capacity of Dodger Stadium in Los Angeles. It is the number of passengers in 180 full jumbo jets. It is more than the number of U.S. combat deaths in the Vietnam War.
And 240,000, of course, is four times any of the above.
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But are these large numbers or small numbers? At the beginning of the pandemic’s spread in the U.S., President Trump dismissed early projections of thousands, even tens of thousands, of U.S. deaths as no worse than the lives lost in an average influenza year. So far this season, flu deaths total 24,000 to 63,000 (data from the Centers for Disease Control and Prevention are estimates with wide uncertainties).
Whether you think a multiple of up to 10 on top of that is a tragedy or merely unfortunate is a personal call. For what it’s worth, about 8,000 Americans die every day from, almost overwhelmingly, diseases and other natural causes. Those, of course, haven’t stopped; Covid-19 deaths are in addition to those (with a caveat noted below).
To make these numbers easier to grasp, we show how 60,000 to 240,000 compares to some of the leading causes of death and to previous pandemics.
One note about methodology: The projected Covid-19 deaths come from models that see the number of cases and deaths plateauing nationally in the next few weeks, as they have already done in Seattle, San Francisco, and other places that were hit first. If stay-at-home orders and other countermeasures keep working, there should be few deaths after July. We therefore treated the 60,000 to 240,000 deaths as occurring over five months, from March to July, as the IHME researchers do, and therefore calculated five months worth of cancer, heart disease, and other deaths. Of course, as Anthony Fauci, a member of the White House Covid-19 task force, told a JAMA webcast this week, the new coronavirus “is not going to disappear from the planet, for sure,” after July.
But the concentration of deaths is “truncated into weeks,” said Fauci, director of the National Institute of Allergy and Infectious Diseases. That is what captures our attention and overwhelms hospitals.
Covid-19 is particularly severe in — and more likely to kill — the elderly and people with existing illnesses, including heart disease. Some people taken by Covid-19 would likely have died from these diseases even in the five-month time frame. We do not try to calculate how many of the Covid-19 deaths “substitute” for other deaths; that is an important calculation that researchers will be eager to do once the crisis passes.
You may believe a different methodology paints a truer picture of how Covid-19 deaths compare to others. As we said, how to think about deaths is deeply personal.
I would like a straight/honest answere to the following:
When CDC, Worldometer etc. report U.S. Corona 19 deaths is that number based on deaths specifically caused by Corona 19 or does the number reported
include deaths of people who died with Corona 19 present regardless of whether the virus caused the death and thus was only an underlying possible factor in the death but not provable.
I believe this to be a very, very important question that I think needs to be clarified.
Thank you….Bob
The numbers absolutely count anyone who dies with covid, whether or not covid killed them. Some people who die at home of covid also never get counted. Which cohort is bigger? Hard to say. Overall, the number of deaths is more accurate than the number of infections, which is multiple times undercounted. It’s very possible that the IFR is as low as 0.3% in all age groups (and well below 0.1% for the young). The last estimate in the Lancet was 0.66%, and I think we’ll find that is still an overestimate.
And preemies at 21 weeks can survive with help.
Probably should include a bubble for deaths without social distancing, business closures, or other interventions. I’m not sure of the author’s intent, but many people reference this type of information to prove their own bias that the media and government are blowing this out of proportion.
The fact is no one knows. Once we have antibody testing we’ll know if this was an overreaction or not. I’m still leaning towards not an overreaction, but we seriously don’t know.
What’s also confusing is the different numbers quoted by different publications. I’ve not, so far, found any two publications who quote the same numbers of deaths v. cases. What’s also, I believe, in accurate is that when these numbers are compared to the flu many publications site the CV number of cases “probably” higher because some with mild cases recover at home. Wouldn’t they also be true of the flu? Yours is the first publication that sheds a more accurate light on those deaths being complicated by other health issues. When govenors make recommendations as to CV contamination they should warn those with other health issues to be that much more careful. I have yet to hear that distinction verbalized during these news conferences.
Flu deaths are estimates.
Compare covid deaths to those caused by preventable medical errors, never a favorite topic of STAT.
As they day in show business, you ain’t seen nothing yet
The most important decision is the pre-prepared for what follows death. For We all have the same appointment. I have the guidance of the one who died and rose again. And he’s available to everyone.
Thanks so much for the comparison — very helpful!
the number of death is most likely under the real one since no one believe in the chinese numbers, and that many eople may have died from it without having being diagnoses specialy in countries with weal public medical system (africa, south america etc.). It could be useful to look at the number of death observed in any country above what was observed each year for the same month for each of the last five years. The number above the average of the last five years would in my opinion give another interesting data point
Well, this will be interesting because large scale lockdowns are also preventing other kinds of deaths like traffic accidents. Deaths from covid are both overcounted (many who die with covid rather than from covid are still counted) and undercounted (died without test, died at home), with more widespread testing the undercount will become smaller, while the overcount will likely remain the same because we don’t have time to do autopsies on all the plague dead.
Please everyone, stop posting about politics. Medical professionals who would be posting if they were not driven away by all this squabbling. There are many places to argue on the Internet, this place was a source of important medical information. P