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The numbers have become both horrifying and numbing — and there is no end in sight.

The consensus among major Covid-19 modelers is that we could see 20,000 to 25,000 deaths in just the next two weeks, and 160,000 more by Feb. 1. That would be a frightening acceleration as winter approaches.

The experts and their models also agree on the familiar tools at hand that can bend the curve: universal mask-wearing and social distancing. Even so, they say it’s too late for us to head off the surge ahead, as many Asian countries have been able to do.

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“We may have passed the point of no return in terms of getting it to a place like levels we’re seeing in China right now,” said Nicholas Reich, a University of Massachusetts, Amherst, biostatistician whose team compares different Covid-19 models.

The meteoric rise in U.S. Covid-19 cases and death is not another wave. 

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Experts modeling the coronavirus pandemic may differ on details, but they agree that calling this a second or third wave is incorrect because there was never a significant trough before cases began mounting again. 

The outbreak that slammed New York in the spring — as well as cities like Boston, New Orleans, and Detroit — was never brought under control, and instead it’s been allowed to keep building. 

Covid tracker screen cap 11/12/20
The STAT Covid-19 Tracker bears out what modelers say: There have not been significant troughs before cases have risen again. STAT

“I don’t think the United States ever had multiple waves,” said Alessandro Vespignani, professor of physics, computer science, and health science at Northeastern University in Boston who models the pandemic’s impact. “We are leading the same wave that is moving across the country.”

This is not 1918. Then, graphs show, there was a terrifying spike in influenza deaths followed by a flat line, when the epidemic almost went dormant in the summer before a monstrous second wave in the fall. Historical hindsight will have to tell what shape the Covid-19 story will ultimately take, but maybe future modelers will call them humps, Reich offered. Broadly speaking, the U.S. is heading toward a third hump while Europe is near its second. 

There’s a worrying parallel there, Reich said. “It’s just that humans are tiring of having to be so vigilant and it’s really exhausting — emotionally exhausting and socially exhausting.” 

The world’s health is in a very bad place, heading into winter in the Northern Hemisphere with Covid-19 cases, deaths, and hospitalizations all tallying new highs. That’s even before an expected spurt in all three metrics caused by colder weather and drier air, people spending much more time indoors, and overall weariness of lives disrupted by pandemic precautions — all of which make us more vulnerable to viruses. 

Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Institute in Seattle, reminded people taking comfort from an apparently lower death rate than earlier in the pandemic that deaths lag infections by about three weeks. “I expect the US to be reporting over 2000 deaths per day in 3 weeks time,” he tweeted Wednesday. That would be more than double the current numbers.

The U.S. as a whole has seen regional curves go up, dip, climb even higher, dip a bit less, and then ascend still higher to set new records nearly every day and every week. The geography of the pandemic is uneven, with ripples and bursts in the Sun Belt over the summer and infections jumping in the Midwest and Mountain states in the fall. But states in the Northeast that nearly buckled beneath the spring surge have no safe harbor from the continuing crisis. Cases and deaths have been ticking upward for weeks, as regular in their climb as a metronome.

Modelers make forecasts four weeks out, predicting cases and deaths. Separate models can be aggregated to yield an overall estimate of cases and deaths; some but not all include hospitalizations. The Centers for Disease Control and Prevention posts its ensemble forecasts, generated by Reich’s group at UMass from 36 independent models, for the country as a whole and for individual states. Models make assumptions about social distancing measures changing in the future or staying the same. 

Projections go farther than forecasts, but even they stretch only to Feb. 1, when warmer parts of the country might see crocus shoots poking through the soil in early signs of spring while winter is far from over in many states.

The model from the Institute for Health Metrics and Evaluation projects 399,162 total deaths in the U.S. by Feb. 1, based on current conditions. If mask wearing became universal, defined as worn by 95% of the population, deaths would fall to 337,669, the model says. But if mandates for social distancing were eased, the death toll would rise to 513,657.

February might be the earliest that the first vaccines become widely available, should they win approval. That means we are left with the tools and knowledge currently at hand to control spread this winter: pulling up our masks, tamping down numbers of people we gather with indoors (with optimal ventilation), getting our flu shots, and resisting the undertow of pandemic fatigue.

“The projections for this winter, unfortunately, they’re going to hold unless we change our behavior. The vaccine is not going to help us,” said Ali Mokdad, professor of health metrics sciences at IHME. “All we have between now and the vaccine deployment is wearing a mask, keeping a safe distance. I would like to remind everybody in the U.S. we’re not out of the woods yet.”

Mokdad calls for a national strategy that would set data standards and improve surveillance of cases and deaths so a coordinated response could be set into motion. 

Northeastern’s Vespignani also said the lack of a national strategy handicaps state efforts to fight the pandemic, especially when prompt reactions to rising cases can make a difference. Models that show climbing case counts, for example, should spur immediate measures before hospitals and their ICUs fill to overflowing two weeks later.

Coherent messaging would help, particularly in a time of White House transition. Any approved, successful vaccine will be a game changer, Vespignani said, but not anytime soon, so telling people what works now will be essential. “We need to enforce the use of masks and we need to have people act responsibly. We need to have a lot of testing and tracing in place,” he said. “And then the most important thing is that we don’t want to catch up with the epidemic. We want to anticipate it.” 

Lockdowns are not on Vespignani’s list. “It would be very depressing. It would mean that we didn’t learn anything in the first nine months of the epidemic.”

One lesson from the spring: Researchers who mined mobile phone data to identify the indoor public places most responsible for the spread of Covid-19 say that sharply limiting the occupancy of these locales — chiefly restaurants, gyms, cafes, hotels, and houses of worship — could help control the pandemic without resorting to lockdowns.

Modelers and policymakers alike struggle to find the sweet spot of doing just enough to keep the pandemic under control while keeping schools open, allowing people to work, and letting them go grocery shopping.

“One of the reasons that Covid-19 is so hard to predict is that the power to change the trajectory is within us,” Reich of UMass said. “If we all of a sudden decided to just be really careful about this for a sustained period of time, it would become under control — or at least become more under control.

“It is the societal challenge of our times.”

  • You seem to be confused about deaths and so-called cases. Massively increased testing with a poor PCR test has resulted in a Testdemic. The real situation is hidden in death figures which, in the UK, are any death from any cause where they have tested Covid positive in the previous 28 days – positives given by a very inaccurate, and misused, PCR test

  • You mention the CDC Ensemble model, which has been the most accurate, but you don’t mention its forecast. Its 2-week prediction is for 8k days/week, far below the numbers you do cite. Please explain.

  • You lost all credibility when you used China as the example to follow. Nobody believes the numbers they have reported, except apparently you.

    • Jason, right. I have a hard time believing our own numbers, but if anything they are OVER estimates.

      China has the credibility of a 5 year old who said he didn’t eat that chocolate, while it’s smeared all over his face and clothers.

    • Hi! Jason & Karl,
      I’m always interested in the views of others re: COVID19, The Number of Reported Infection Cases & Reported Deaths in this Country.
      Karl said he has trouble believing the reported numbers. The numbers are off. I do believe that the numbers are even higher than reported. The reason being, that there is no set regulatory system that demands reporting of Any & All Cases. There are many states who do not always report cases. Yes, some hospitals do.but others don’t.
      As far as China goes, I really do believe that their numbers are down. The reason being, that CHINA IS, ONE, A COMMUNIST COUNTRY, who rules with an IRON HAND!!
      They have STRICT TESTING & QUARANTINE RULES. Their citizens could face a death sentence if they disobey the government. If a citizen bad mouths the country, they could lose their life. So, I think the number of cases are going down.
      I have a friend in Greece, who has a Curfew Everyday. If a citizen is caught not wearing a mask it’s an automatic $175.
      The problem in this country, is that there is not enough testing supplies. This is in us. This country has the ($) to get supplies.
      The BIGGEST PROBLEM IS THE CITIZENS THEMSELVES! We have people all over NOT WEARING MASKS, NOT WASHING THEIR HANDS PROPERLY, OR AT ALL, NOT SOCIALLY DISTANCING THEMSELVES. We have venues still holding large gatherings, restaurants & bars that are not adhering to State Rules & maintaining advised recommendations. There are thousands upon thousands, of people who HAVE A TOTAL DISREGARD FOR COVID 19. People who are (+) with no symptoms, & totally unaware they are contagious.
      The Only People We Should Be Listening To Now, Regarding COVID 19, ARE THE INFECTIOUS DISEASE EXPERTS & VIROLOGISTS, like Dr. FAUCCI. These experts Live & Breathe Viruses. THEY KNOW EXACTLY HOW DEADLY THE VIRUSES ARE!
      This Pandemic has been Horrific! It has caused an unbelievable rift in this country. I understand that people are beside themselves. People are tired, depressed, miss their families, worried about lost jobs, lost businesses, grieve their dead.

      THIS IS NOT GOING TO GET ANY BETTER, ANYTIME SOON!
      SO…….!!!!
      IT’S US, THAT NEED TO SLOW UP THE DAILY SPREAD, BY FOLLOWING THE WARNINGS OF THE SCIENCE EXPERTS,
      Whether we like it or not. YES IT SUCKS. BUT SO DOES DEATH.

  • The modelers have all been wrong through out the whole corona virus much like the so called experts and flip flopping recommendations from Who, etc. Why on earth would you trust any model? It’s like Charlie Brown thinking he can kick the football only to land on his back – ouch or like all the wrong polling once again embarrassed by the election results. Sorry, models are just that man made models. How well do weather forecasts work? How well do hurricane models work on predicting directions – like Eta – 14-7 days out – 12 different tracks.

    • At least weather forecasters try to input real data from the real world rather than erroneous guesswork.

  • All the modeling is hopeless, and the elder and small business owners are ruthlessly culled – due to despicable UNsocial behaviour of huge selfish masses that like dumb sheep and gun-toting bullies follow a brain-dead, power-hungry, erratic idiot who does not care one iota about the well-being of his country and can not accept defeat. The most realistic model is an America that is not great at all, but doomed instead. Unless attitudes improve and mutual respect and care are restored. The minimal adaptations required won’t kill anyone. The absence of those surely does.

  • The current outbreak in Europe is much more severe than in the U.S…..but, nothing but crickets from STAT on that development. For example, Belgium reported 197 deaths today, where the U.S. equivalent would be 5,629. Other examples are the UK, which reported 639 (U.S. equivalent is 2,746), Italy 638 (U.S. equivalent 3,491), France 425 (U.S. equivalent 2,158), and Spain 356 (U.S. equivalent 2,525). All of the data are easily available on the Worldometers/Info/Coronavirus and European Centre for Disease Prevention and Control.

    Finally, that website shows the cumulative deaths in Europe are 254,772. The total of North America is 258,910. In South America the death total is 304,444 (with Venezuela reporting a total of 838 deaths).

    Really tired of such a U.S.-centric view of a world-wide pandemic.

    • Patrick, I have friend who lives in Belgium, and is plugged into the University medical scene. The public heath officials are counting EVERY respiratory/pulmonary death as Covid.

  • What the pandemic looks like here in Australia is more like two “waves” than in the rest of the world. Wr currently have 1320 active infections: most of these people are in quarantine. There have been 12 new cases since October 28th, most of them occurring in quarantine among Australians who have returned from overseas. The
    latest 2 coronavirus deaths were noted on October 28th. There are still some state borders closed, at least 3 states that have been clear of community transmission for a month or more.
    The authorities here have learned that telling people who arrive from overseas to go home & isolate don’t work very well: it only takes a few loose cannon to send everything haywire, so now anyone who comes into the country gets 2 weeks hotel quarantine at their own expense: about AU$2800 per person. There are guards to make sure they stay in.
    We are anticipating a reasonable Christmas, most of us should be able to be with our families.

  • I do not pretend to really understand this thing but I think both a national 4 to 6 week lockdown and mandatory masks are kind of a tough sell.
    To me, wearing a mask is very easy and i am angered by people who are not doing it. Or absolutely insist on not doing it right, with their nose completely uncovered for example. But you have a lot of resistance, and it appears Federal authority for it is questionable.
    But the lockdown is entirely different. That is a real burden. In 20/20 hindsight it seems certain we should have encouraged people under 30 to get infected if they had no risk factors. IF we do not have widespread vaccines in April, we need to consider doing that in Spring 21 – get kids off in camps, and let them all get infected, isolate for 3 weeks before they can leave, and that would pretty much end the epidemic. We would still need masks and precautions but if the people under 30 are the main spreaders as we are told, with them all immune, I think it will end. Obviously, some young people with no clear risk factors would get sick and even die, but the raw death rate for under 40 people in my area is 1 in 1,200 deaths for every confirmed infection. And that includes ALL people – if you can isolate nearly all the under 40 people at high risk, the case fataiity rate might be 1 in 5,000 or less.

    All those colleges closing in Spring 2020 should have stayed open for the kids, and let the professors and other staff over 40 stay at home – using distance learning – the TAs and RAs are almost all low risk, and would have to take over some extra duties. if we had done that, we would likely have immunity in half the main spreaders.
    The combination of Trump on the one hand, and a possibly overly cautious medical establishment on the other, Fauci et all, seems to have resulted in the worst of all probable worlds.

    • Steve, I had this dream…and the dream was that every healthy non-asthmatic non co-morbid 18-24 year old student would matriculate to campus two weeks early.

      There the college would hold a giant kegger party in the football stadium. They’d all get infected, go back and quarantine inside their dorms for two weeks, have no-contact pizza delivered every night. They could party in their dorms amongst themselves.

      Two weeks later they’d all have gotten over their infections, with most asymptomatic, then they would do their first semester remotely just to be safe, and the everybody comes back to campus the following semester/quarter.

      It was a wonderful dream. Dreams die hard.

  • “Meteoric rise” in Covid deaths? Oh, for heaven’s sake. More breathlessly exaggerated journalism from the STAT crew.

    On November 4th we had bit of a spike to a reported 1,600 deaths on 11/4, but we have moved back to around 7-day average of around 700 or so , the level it’s been at more or less for the past two months. Go to outbreak.info.

    outbreak.info/epidemiology?location=USA&log=false&variable=dead_numIncrease&xVariable=date&fixedY=false&percapita=false

    And that’s assuming these numbers are even right. Wait to this all settles down, and and we see how the reporting is very squirrely, with deaths linked to Covid that shouldn’t have been so in the first place.

    If you dig into the state numbers, Florida’s death rate is down dramatically–and that’s the state that is most open. Texas is flat, despite El Paso. California’s curve is sloping southeast, from around 200 deaths per day, into the 50s to 70s. One needs to look more granularly at these numbers.

    As for the IHME modelers, they have been wrong in so many ways. It’s not science, it’s soothsaying. They might as well cut open the guts of a pig and read the entrails.

    • It IS soothsaying, with the aid of intelligence, experience with the nature of disease and people, computers and mathematics. There are a lot of ways this COULD go. In February I will accurately ‘predict’ what January numbers are.
      Meanwhile, from an interested observer position only – I have not run the numbers, nor do I have the stats background to do it accurately- it does seem the death rate vs infection rate is falling. Is this due only to the people being infected now are the younger, less likely to die group? Are we getting that much better at treating it? Is the virus becoming less deadly? (Reminiscent of rheumatic fever) Is it wishful thinking on my part?
      Meanwhile everyone is holding out for a vaccine, or artificially enhanced herd immunity. What if there is no such thing? What if we never can achieve a long lasting immunity? Then China, South Korea, Taiwan, New Zealand may become the only countries in the world with “normal” lives and an expanding population. I REALLY hope January 20, 2021 brings with it competent science based leadership on this issue, and hope US daily numbers are not in the quarter million (or more) cases per day by then. How could any system get in front of that big a runaway train?

    • Barb, you make a few good points. In ” …. the only countries in the world with “normal” lives and expanding population” that you name : they all wear masks. And indeed Covid treatments have evolved, and more existing and new drugs are evaluated for Covid treatment. But the aversion of wearing masks, keeping distance, washing hands, and keeping gatherings small is the cause of the hell that America will be going through. Corpses rotting in trailers behind hospitals ……

    • Who is a retard now? 1500 a day at the moment. No wavering. 1500 a day. This is why idiots fail math and then try to pretend they are mathematicians. Leave the math to someone that didn’t fail their math classes. You don’t even understand the math when the numbers dip and I end up slapping my head because of the stupid math comments made by people like you.

    • 1500 a day? Where did you get THAT number? And you name call with “retard?” You might consider avoiding projection.

      On November 4th, according to Outbreak.info, we had 1600 deaths. I hate the word “spike” but OK, it was a spike. But if you dig down into the granular detail, nearly 500 deaths that day came from Georgia.

      Really? How did that happen? Georgia was averaging 30-40 deaths daily. A four to five fold spike in ONE day? Especially since the numbers have settled down into that level?

      Did somebody turn off the electricity to all the ICUs in Georgia on November 4th and then turn them back on? Or was there some sort of reporting anomaly?

      Go to outbreak info and look at individual states. Everyone has strange anomalies like this throughout the pandemic. Reporting differences? ACTUAL spikes? If actual, where are they located? Why there?

      Look, the reality is we really DON’T now.

      If anybody says, “masks will solve the problem,” well people are unmasked in Florida and its numbers are good. In Illinois, people wear masks strolling in the park and walking the dog when no one is around, and its numbers are getting worse (again, assuming the numbers are “right.”)

      I’m sorry to disillusion all the lovers of “science” and “math” who come on here, but the modelers are not “mathematicians” — they are Excel spreadsheet jockeys.

      The epidemiologists aren’t “scientists” — they don’t do what real scientists do, which is falsifiable hypothesis testing. No, epidemiologists in the midst of pandemics are pontificators, making a range of qualified claims based on very noisy data that they can’t verify let alone control — claims they always couch in the word “could” and which too often they have to backtrack from.

      And innumerate and politically compromised journos like some here on STAT hyperventilate over the latest “this is bad” pronouncements of the “experts.”

      Unfortunately, we have only two palms and one face in which to put them.

  • Given the positivity rates, a quarter of the country must already have had the virus by now? That being the case, the rate of rise of infection is going to hit some kind of a wall soon is it not? Inadvertent heard immunity, plus natural immunity should end up blunting rates at some point.

    • They seem to studiously avoid this question, don’t they?
      Another thing it is hard to find reported is the actual LOCAL current probable infection rate – my county has extensive Covid data online – but avoids, as best I can tell, reporting anything positive, or that would actually enable a person to roughly determine CURRENT RISK – which is really what we need most from them.
      So, they have cumulative cases since some time in March 2020 I think – about then – they even have it broken down by zip code – utterly worthless information in great detail – because it is cumulative, it may have no relation to current risk. Somewhere that looks like Covid central on a cumulative map of cases may be very safe now.
      And, one would think assessments of estimated immunity would be important info – if we do get a vaccine, we need to know where it is needed most, right? If we give it out to people in NYC where 1/2 of those who would otherwise be spreaders are immune, we are wasting a lot more shots than if we give it out somewhere most people are still vulnerable. But they seem to not be willing to tell us any of that.

    • It is not. Herd immunity, according to Mayo, will not be effective until north of 70 percent of the population has been infected or inoculated. That’s 200 million plus. If the current mortality rates (2.3 percent per Johns Hopkins) hold, that would be 4.6 million deaths.

    • Help me understand why you wonder if “given the positivity rates, a quarter of the must ready have had the virus by now”. Are you somehow using New Cases Diagnosed per Numbers of Tests Administered (i.e. “test positivity rates”) in some way to estimate a hidden prevalence figure ? Thanks.

    • 25%? What’s the question mark for? Because you made the number up? It’s 10% after 7 months. Considering the pullbacks and exponential growth between it will take over 2 years to hit the wall and 3 million deaths just in the US. Don’t make question mark statements. It just looks stupid.

    • 25%? What’s the question mark for? Because you made the number up? It’s 10% after 7 months. Considering the pullbacks and exponential growth between it will take over 2 years to hit the wall and 3 million deaths just in the US. Don’t make question mark statements. It just looks stupid.

    • Help me understand why you wonder if “given the positivity rates, a quarter of the country must ready have had the virus by now”. Are you somehow using New Cases Diagnosed per Numbers of Tests Administered (i.e. “test positivity rates”) in some way to estimate a hidden prevalence figure ? Thanks.

    • Things are bad but I think you are making claims which are probably excessive:
      1. The claim we need 70% immunity to get herd immunity is disputed, as you probably know, by people who believe it is too simplistic – mostly, they say the assumption of random infection is wrong. Rather than infecting strangers randomly, people tend to infect the people they work and live with, when they are immune, they do not infect those people – so that there is significant resistance to very fast growth in the epidemic long before 70% of people get infected.
      2. I am not sure the death rates you quoted are really accurate now. My county has extensive data online and it shows 40% of deaths are in people over 80. But that is going back to the beginning of the epidemic, when there was inadequate checking and a lot of people in old folks homes got sick. Now, everyone knows better, and they seem to be better at keeping the virus out, and the young kids know they are at low risk and they are taking risks and getting sick, so the average age of patients, at least those verified by PCR test, is a lot lower. The young folks can get infected and get immune without getting very sick. Things are bad but I think you are overstating how bad.

    • Things do seem bad. How bad probably depends on where you live. People primarily infect those they work and live with unless many people are flaunting the recommended behaviors. That’s happened where I live. Defining herd immunity with a percentage is always going to be problematic and a resistant rate of infection would be expected as more people interact with the virus.

      Yes, the average mortality rate is just that, so it should come down as medicine becomes more familiar with how to combat covid and people take recommendations seriously. The rates, however, will probably not fall to those of influenza, and none of this takes into account the long-term impacts of having and surviving covid for many people.

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