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.
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.