More evidence that U.S. health system is not being overwhelmed by COVID-19


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In an article today in the National Review focused on a lot of good coronavirus news the past week, a number stories jumped out at me, mostly focused on the surplus hospital beds available in the states of Florida, New Jersey, Washington, Maryland, Vermont, Ohio, Utah, and in southern Arizona, and in the cities of Dallas, St. Louis, San Francisco, and Orange County.

In other words, my conclusion earlier this week that the U.S. hospital system was not going to be overwhelmed by COVID-19 is proving to be true. Even in New York, which appears to have the biggest problem, they have arranged with twenty hotels to convert rooms for hospital care.

Much of this surplus is unfortunately caused by the forced lockdowns that have forbidden hospitals to do any elective surgeries (with “elective” sometimes defined so broadly that they have caused some hospitals to cut staff and hours) as well as the too-high predictions that have probably caused them to plan for more beds than they will need.

Nonetheless, these surpluses are good news.

Meanwhile, the daily death toll rose significantly today in the U.S., reaching almost 1,500, after several days where it appeared to have stabilized around 1,000. This rise is not unexpected, and further rises will also not be a surprise. The moment of truth however will be when it begins to drop, which should probably happen in less than two weeks. When that happens, we will then finally be able to get a realistic estimate of the total mortality from COVID-19.

I will add that based on the numbers of actual deaths so far in the U.S., it still appears to me that the prediction of between 100,000 to 240,000 U.S. deaths by Trump’s experts is going to be much too high, and very very wrong.

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42 comments

  • pzatchok

    You know NY was blowing up the numbers when the hospital ship pulled up and it took a day or so for them for finally get 20 patients.

    That ship is outfitted to take care of a thousand or more battle field cases.

    Did anyone notice all the democrats complaining that the ship was not in NY harbor faster? Never once realizing that it could not get into the harbor until it was dredged to let such a large ship in.
    Again a NY problem. After 911 they should have made it a priority to keep the passage clear enough for the two navy ships. Just in case.

  • wayne

    pzatchok-
    Good stuff.

  • Col Beausaber

    The medical staff is pulled from shoreside Navy hospitals and reservists with hip pocket orders so the hospital ships are not instantly deployable. IIRC, the standard is to be underway on M day plus 5, which still means they have to have their sea bags packed at all times. And remember that additional reservists need to be called up to replace the deployed active duty personnel, so you have to bake that into the time it took the Comfort to deploy. The seamen and engineers are permanently assigned civil employees of Military Sealift Command (Hence the “TAH” hull number prefix and “USNS” portion of the name as opposed to navy manned vessels which would be “AH” and “USS” respectively), and keep her ready to go from the nautical standpoint. One of my mom’s friends was a Navy Nurse who served in WW2, stayed in the USNR post-war and served on a hospital ship during the Korean War. http://shipscribe.com/usnaux/AH/haven3b-08.jpg and was almost recalled from the retired (20 plus years active and reserve) list for Vietnam. She retired as a Commander, so I had to call her “Ma’am” until I made Lieutenant Colonel !

  • wayne

    Col Beausaber-
    Good stuff

  • Bill

    Talked with an anesthesiologist neighbor yesterday. She said she was sent home from the hospital for a number of weeks because they’ve stopped all the “elective” procedures.

  • pzatchok

    I think they should still be doing elective procedures.
    Just leave it up to the individual hospital to have a 10% to20% empty bed surge capacity. Rooms for C19 patients.

  • David

    I think I have to agree that even 100k deaths is looking extremely unlikely. If the lockdown is working at all, the rate of new infections should be on the decrease, peak infections should be around now, and peak deaths would lag by about two weeks. Even if that peak is 4 or 5 times the current rate, that’s still likely to be just short of 100k. Excellent news. And then we can argue endlessly on whether the total shutdown of our economy was a waste, or what saved us. But if our total national death rate is just barely twice what we expect was the real number in Wuhan alone, that’s really going to put a spike in Pelosi’s desire for round what is it, four?

  • Andrew_W

    David, several European countries reached the peak in daily case numbers: Spain, Italy, Germany, Switzerland, Belgium, Netherlands, about a week ago, but the fall-off in daily case numbers has been much slower than the rise to the peak. If Deaths follow the same trend, with the peak in daily deaths two weeks behind daily new infection, the US is likely to have more than 100k deaths, more like 150k deaths.

  • Andrew_W

    The lag between peak daily cases and peak deaths looks to be less than two weeks, more like 7 days, possibly this is due to the mean time between diagnosis and death being much longer than the median time between diagnosis and death, this would bring the peak in deaths forward but lengthen the tail.

  • wodun

    If the death rate is 1.5%, it will take 10-13.3 million people to be infected to get 150-200k deaths. Currently, the death rate is 2.7% but many people aren’t getting tested and testing lags by days or weeks. Deaths we witness in real time. At 2.7%, it will take 5.5-7.4 million people infected to hit 150-200k deaths. Time will tell but it could be the death rate is well below 2.7% and its tough to say how many will be infected. Since most of the country has been on lock-down for several weeks, the number of infected will be much lower than if the virus was left to run wild.

    We can’t stay shutdown forever and the wuhan flu is likely to continue being a problem. Hopefully, treatment, testing, and preventive measures will improve so that we can get back to work and quickly and safely deal with people who get infected.

  • Cotour

    Some interesting thoughts: Information? Or Disinformation?

    https://en.wikipedia.org/wiki/Unrestricted_Warfare

    The book was not a blueprint for a “dirty war” against the West but a call for innovative thinking on future warfare.

    “Three years before the September 11 bombing of the World Trade Center-a Chinese military manual called Unrestricted Warfare touted such an attack, suggesting it would be difficult for the U.S. military to cope with. The doctrine of total war outlined in Unrestricted Warfare clearly demonstrates that the People’s Republic of China is preparing to confront the United States and our allies by conducting “asymmetrical” or multidimensional attack on almost every aspect of our social, economic and political life”

    Like it or not, want to believe in the likelihood of such actions or not, the motivation exists, and the potential exists as demonstrated by the real world actions of the Chinese in many areas.

    Like it or not we are going to have to consider these things as being possible potential offensive actions and we are going to have to keep a sharp eye on this situation. If a virus is in a laboratory its being studied, and if its being studied and is being potentially manipulated then methods of control may well be known, then all potentials exist.

    And those controls do not have to be “Perfect” for those viruses to be utilized.

    I think a little paranoia now and again is good for the sole, it keeps you sharp, especially when it comes to wargaming.

    Refuse to even consider such things and think they can never happen? Willful head in the sand, oh they would never do that, blindness is just not an option for me.

  • Rose

    Cotour, excessive prosecutorial overcharging leads to jury sympathy and acquittal.

  • Lee S

    @Cotour…. Quote “I think a little paranoia now and again is good for the sole”…. I fail to see how paranoia can affect ones feet!
    ( Sorry…. I make loads of typos, and you very rarely do…. But that made me smile… ;-) thank you!)

  • wayne

    “1918 Flu Pandemic in Michigan”
    MLive
    2018
    https://youtu.be/CjS7qQYtorQ
    1:53

  • Cotour

    Rose:

    What you state is absolutely true………..in the 2 dimensional TV watching, Judge Judy Pedestrian Realm.

    However, the 3 dimensional Political Realm, which includes military strategies requires that you consider ALL potentials as they might relate to the situation that you have before you. This is S.O.M. theory.

    When someone is not willing to or refuses to consider the darker side of domestic or international political or military strategy then what you have done is empowered your potential adversaries because you have willfully blinded yourself. Do you think that those in the 3D, even 4D alphabet agencies and the Pentagon are not looking at this current world wide situation in these terms?

    These asymmetrical strategy potentials must be considered, like it or not. Especially since this event has brought China very much along in their stated agenda related to the domination of the planet by 2039 with apparently very little down side for themselves. And that is not IMO hyperbolic conspiracy theory that is stated Chinese agenda.

    Lee S: Many times auto correct will insert a word that I do not intend, but this case I spelled the word incorrectly :)

    How are things progressing over there?

  • Yes, Lee S, I hope all is improving.

  • Andrew-Winter

    Greetings All:

    I have a request. This is serious. I am absolutely terrible at analyzing charts and data. At this CDC link are two charts, near the botton. One chart are the total number of cases “reported” which includes “presumptive cases” in addition to “confirmed cases”. The second chart shows the number of cases by “Illness Onset”.

    https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

    I have a guess as to what I am looking at when I try to relate the two charts. But, I am so far out of my depth that I don’t even want to say what that guess is.

    Can someone look at this and tell us just how these two charts relate to each other and what they are telling us? Please fell free to email me directly, oh commentors can’t, … darn. I am at a total loss over this.

    Maybe Mr Zimmerman can, and maybe he can tell us what these charts mean.

  • Lee S

    Boots on the ground report…. Ive been symptom free for 72 hours now… So it’s back to work (again!) Tomorrow…..
    The current Swedish death toll is 401 as of this morning, and all flights between Sweden and the UK will be suspended from Thursday. Which is just bloody marvelous as my father has just been confirmed positive for the WuTang flue …. And as he was already ill in hospital, I’m finding it hard to be positive.
    I hope everyone here is keeping safe and well.. For all the back and forth, and different analysis of the statistics, it’s all still very much a known unknown. Wash those hands, and no licking door handles or toilet seats!!

  • Andrew-Winter: I will admit to being a bit puzzled myself, mostly by the second graph. The first is obvious. It shows the cumulative number of COVID-19 cases in the U.S.

    The second graph, titled “COVID-19 cases in the United States by date of illness onset” appears I think to show the number of illnesses that have appeared, on each date. If this guess on my part is correct, then the illness has not only already peaked in the U.S., but has almost completely stopped spreading. The curve shows a rough bell curve, with a tiny number of new cases during the past week.

    This conclusion seems impossible, based on all recent reporting by all the press as well as all government officials. I would love it if some of my more analytical readers would chime in with an analysis.

    I should point out that if this true, however, than our leaders and mainstream press have been doing us such a disservice that some should be drawn and quartered.

  • Andrew-Winter: I should add that in further inspection, the graph also does include a major caveat. For the March 23 to April 2 period, when the numbers of new cases drops precipitously, the graph notes that “illnesses that began during this time may not yet be reported.”

    This would suggest that the data is incomplete, and that the drop therefore is deceptive. At the same time, the flattening of the curve in the week prior to this time period does suggest that the peak had been reached.

    If this analysis is correct, then we will find out in only a matter of days whether the disease is now fading.

  • Andrew_W

    Andrew Winter, the second graph attempts to show to when people were asked “what date they became ill”, ie when their symptoms first appeared, which is very different to the usual way of just presenting when their illness was first diagnosed.

    It should be noted that n for the first graph is over 304,000, while n for the second is only 63,995, so the information for the second graph is very incomplete (not many peoples information on when they first noticed symptoms got as far as the CDC graph), and as Mr. Zimmerman notes, the numbers at the tail of the graph are very under represented.

  • Andrew_W

    Andrew Winter.
    On this page about 1/5 the way down we have “Daily New Cases in the United States”.

    https://www.worldometers.info/coronavirus/country/us/

    It’s more complete information but doesn’t attempt to ascertain date of onset of illness, it’s just the date the illness was reported.

  • Andrew_W

    Lee S, I can only hope for the best with your father, and for you as well under such difficult and heart wrenching circumstances.

    A while ago I suggested Sweden might not be a good “poster boy” for those opposed to government imposed measures, because the numbers for Sweden weren’t looking too good compared to Norway, but I may have been influenced by biased BBC media reports, as you’re actually there you’ll know how Swede’s are actually reacting to the threat posed by the disease, I suspect they’re far less casual about it than was the impression given in the BBC report.

  • Andrew_W

    One other thing about the 2 graphs Andrew Winter references, the first would include positives for both symptomatic and asymptomatic infections, the latter by definition only symptomatic infections, the difference in numbers could in theory be entirely due to 80% of reported cases being asymptomatic rather than incomplete data.

  • J Fincannon

    Noting his past appreciation for the benefits of the creatures, I wonder if Mr. Zimmerman would care to comment about the possibility of backlash against bats due to them being “virus reservoirs”.

    After this is over (if ever), there has to be a fall guy. And given how bats carry things like Ebola and other nasty viruses (rabies, SARS), the Big Finger will be pointed at bats. It may be suggested as public policy to take it out on these little guys. Sure it might have consequences in our ecology, but then do people want more viruses? Who else to blame? Or, better, who else will accept blame?

    Then, we can add to the list other bacteria and virus carrying animals such as armadillos (leprosy) and pangolins.

    Humans are “apparently” good at making animals go extinct (UN says that 150-200 species of plant, insect, bird and mammal become extinct every 24 hours. https://www.huffpost.com/entry/un-environment-programme-_n_684562 ), so perhaps we should focus this expertise on the lethal ones.

  • J Fincannon: Picking on bats in this case would be looking for a scapegoat, and intellectually dishonest, to a point of absurdity.

    But then, humans have done such things before, and they will again.

  • Edward

    Andrew_W’s observation may explain the apparent discrepancies. The first chart is related to report date, the second related to illness onset. This can explain the difference between March 20 and March 21, where the first chart gives a delta of around 5800 but the second chart gives almost 4500 new cases. Those who have never shown any signs of illness may not make the second chart at all.

    Robert’s point about the recent period not including all illnesses is important to keep in mind, while analyzing the second chart. This means that the first chart may have more importance for analyzing where we are right now. Although this chart shows a decrease in the new-cases rate on Saturday, there is a risk that weekend data collection may be not as complete as weekday collection. We will have to see what happens on Monday, when the next weekday data collection occurs. Since it is based upon report-date, we may see a jump, rather than the slow-down between Friday and Saturday.

    I certainly hope that we are now reaching a knee in the rates. We may be able to end this fiasco, someday.

  • wayne

    “China’s deadly coronavirus cover-up”
    Sky News Australia
    April 5, 2020
    https://youtu.be/pKmUxSlOoUE
    25:52

  • wayne

    Owen Benjamin: Citizen Journalism on Coronavirus
    April 3, 2020
    -excerpted from Episode #790 “Citizen Journalism is Winning”
    https://youtu.be/EYJMPic1M8A
    14:00

  • Gary M.

    Wayne-

    The time for Citizen Journalists has clearly arrived.

  • Andrew-Winter

    I think we missed the biggest caveat missed is in the notes above the first graph. That first graph shows “confirmed” plus “Presumtive” The question is, “What on earth does ‘presumtive’ mean”?

    I think including “presumptive” new cases of COVID-19 is the key to over inflating the numbers. BUT,… that is just me guessing. When it comes to data and charts my “guesses” suck.

    But this is definitely a dichotomy here that needs an answer, and so far it looks like most of us are still scratching our heads and trying to come up with a plausible “guess”.

  • Rose

    Lee, I find myself repeatedly refreshing this site in hope of good news from you regarding your father. I know that if my parents were still alive, I’d be quite worried for them.

    Between age and being in recovery from recent surgery, he is certainly in a high risk category, but even in the highest age groups, recovery is still the mostly likely result. Best of luck to you and yours. We are thinking of you.

    Looking forward to your next Boots on the Ground report.

  • Andrew-Winter

    Addressing an ovservation: That “numbers incomplete” observation: Yes I see that. So here is the best read I can come up with,

    3/22 is the last date on Graph #2 that has compete reporting. So the only concrete comparison to Graph #1 would be to look at that chunk from 03/22. 03/22 reported in with 33,000 plus “new” illnesses. CAVEAT “* Data include both confirmed and presumptive positive cases of COVID-19 reported to CDC or tested at CDC” I quote the note above Graph #1.

    We are left with the chart apparently telling us that out of 33,000 plus new cases of COVID-19 only a little over 4200 people actually reported the “onset of illness”.

    So,…. maybe? Possibly? Could it be that out of 33,000 new cases only 4280 people actually got sick?

    Hmm, no that can’t be right. That would not include the gestation/incubation period. Which according to https://www.worldometers.info/coronavirus/coronavirus-incubation-period/, which is a practically useless metric. Okay it’s a range.

    If that is just two days incubation then we would go back to 03/20 annnnnd, we get 4200 plus illness onset vs. 18,000 new cases. Go back 14 days and we get 420 new cases reported. Okay how does that happen. Ten times as many illness onsets than actual cases reported?

    Hmmm.

    The cynic in me is thinking of that great meme. “Lies, Damned Lies, and statistics.

    There is nothing I can do to make any sense of this data, and not just assume that the whole darn thing is just made up. I do not want to go there.

  • Rose

    Regarding graphs, I quite like “Covid Trends”: https://aatishb.com/covidtrends/

    Note that “exponential growth as a straight line” is not a feature of the log-log scale (though it would come from a semi-log scale). It is instead from the graph being in essence that of f-dot vs. f — that is, the time derivative of a function vs the function itself — with f being either Confirmed Cases or Reported Deaths, and as we all know, the derivative of an exponentiation function is some multiple of that function, with that multiple representing growth rate. (The ordinate is actually weekly growth, done to smooth the random daily fluctuations.) True to its name, it does a great job of revealing incipient trends. Unfortunately, “USA is Number One” here (and not in a good way, as in its International Country Calling Code). Switch to Linear Scale and it stands out even more, but note that it displays total numbers, not per capita figures (say, cases per million people), and the US is rather populous. Still, it’s the shape of the trends which matter.

    Compare the state-by-state results of Australia and the US. I had thought that the US was initially a week or two ahead of Australia with regard to infection rate, but Australia really seem to have turned it around.

    Time isn’t on the static map, but is instead revealed via animation when you press the “Play” button at bottom left. I think Charles Joseph Minard would approve.

  • F16 Guy

    I just saw this:
    https://www.libertynation.com/coronavirus-statistics-in-perspective-deaths-trends-and-more/

    “Just for a moment, why don’t we stop all the hype, the press briefings, the models, the bending of the curve and get down to brass tacks? It would seem that a reality check is needed, here. As Americans sit home a la Betsy Ross and dust-off Grandma’s sewing machine to make masks, perhaps some data is in order. The best place to begin is with a Coronavirus state tracker outlining deaths, trends, and more.

    Stat reports on health and medicine and offers a lot in the way of data concerning COVID-19 and little in terms of opinion. It could be just what America might need at this odd time in our history. Here’s their snapshot of the virus statistics in the U.S. as of April 5.

    Total cases reported – 337,646

    Deaths attributed to COVID-19 – 9,648

    Current U.S. death rate – 2.9%

    New York, as everyone knows, has been hit the hardest. Here are the Empire State numbers:

    Total cases reported – 123,160

    Deaths attributed to COVID-19 – 4,159

    Current NY death rate – 3.4%

    This tells us that 43% of U.S. deaths attributed to the Coronavirus have occurred in the state of New York. Now let’s hop on over to the second-highest infected state – that of New Jersey:

    Total cases reported – 37,505

    Deaths attributed to COVID-19 – 917

    Current NJ death rate – 2.4%

    Thus, we can ascertain by these numbers that 53% of all U.S. Coronavirus deaths are coming from the two states of New York and New Jersey. The state with the third-highest infection rate is Michigan, and frankly, it’s not in the same league as the first two. Total cases reported in Michigan are 15,718. Next comes California with 15,158 and Louisiana with 13,010.

    Data shows the death rate is still bouncing up and down in New York and New Jersey. On April 3, 835 people passed away from COVID-19 then on April 4, New York reported 347 deaths, and on April 5, their numbers shot up again to 594. New Jersey is experiencing a similar situation with 182 who died on April 2, 109 on April 3 and 200 on April 4. The data for April 5 in New Jersey shows just 71 deaths.

    If you throw out the numbers for the top five and bottom five states, removing the extreme highs and lows – the other 40 U.S. states (including Puerto Rico) will have suffered an average of 70 deaths from Coronavirus.

    It seems worth the effort to look dispassionately at these numbers so Americans can determine whether the national response to the Coronavirus has been appropriate or disproportionate to the crisis at hand.”

  • J Fincannon

    Zimmerman: Picking on bats in this case would be looking for a scapegoat, and intellectually dishonest, to a point of absurdity.

    https://www.msn.com/en-us/news/other/a-google-plan-to-wipe-out-mosquitoes-appears-to-be-working/ar-BB12ejxB

    It seems a precedent for this exists for this kind of extermination with the mosquito. You can’t deny they are “virus reservoirs” just like bats.

  • J Fincannon: Mosquitoes carry and transmit the disease directly to humans and are ubiquitous. Bats are not ubiquitous, nor can they transmit directly without significant human action and assistance. They are not in any way similar to mosquitoes. The comparison is apples and oranges.

  • Lee S

    @Rose… Thank you for your kind words…. Acctually some good news, according to the nurse I spoke to today, he is stable, no longer needing oxygen, and flirting with the nurses…. That sounds more like my father :-)
    Boots on the ground report….
    Sweden remains with very little restrictions enforced by law, although there seems to be an upswell amongst health professionals to enforce a lockdown before the weekend… Easter is a time to travel and visit relatives. The outbreak is pretty much confined to the 2 largest cities here right now, but many of my peers have family scattered all around the country…. The school age kids are on holiday this week and all out enjoying the spring sunshine, the kindergarten over the road is also full of little ones bouncing around. My first day back at work today, and I was “requested” to wear a mask as I still have a slight cough, but no fever or difficulty breathing, I think I just made my throat sore either by coughing last week, or an excess of whisky.
    In general, the Swedes seem worried, but trusting in the government policies. It still remains to see if that trust is well founded.
    @J Fincannon, the difference is, as far as I know, no one ever thought it was a good idea to eat mosquito soup, and no bat ever buzzed around the room all night sucking your blood ( and no, vampire bats don’t do that in real life!)
    Stay safe guys!

  • Lee S

    One more quick boots on the ground you may have not heard yet… The UKs prime minister has been moved to intensive care… An abundance of caution, or is very ill… Who knows? I wish him all the best…. as a human, and He is turning out to be a decent right wing leader…

  • F16 Guy: Great catch. I am including this in a post I am just finishing.

  • Max

    Killing mosquitoes has unintended consequences.
    The artificial female estrogen hormone used to prevent mosquitoes from mating also affects the fish and reptiles. Spraying near the Florida Everglades, for example, has caused reptile males to change sex preventing them from breeding. There are 1/10 as many alligators as their should be. (Where did all the frogs go?)
    It’s not bats that are to blame, but there is another animal we will soon be blaming… Just as they’re killing dogs in villages in some countries, the cats might be the next on the list.

    https://www.nytimes.com/2020/04/06/nyregion/bronx-zoo-tiger-coronavirus.html

    How did Tigers catch it from their keeper? Or is this related to the virus thats killing the big cats in Africa, decimating the population.
    The question is, can a human catch it from the tiger? Cats?

    BTW,
    Local medical reserve, are on the way to New York from Utah.
    The largest convention center just installed 250 medical beds and equipment in case the hospitals in the area need more room.
    Unlikely, my daughter is a nurse and they have a few patients. The hospital has been running drills to keep the staff busy and alert. Their focusing on the cross training specialties.

  • Andrew-Winter

    I think I have reconciled the two charts on that CDC page. I am working only with the numbers up to 03/26 because that it the cut off date on “illness onset” as I write.

    I added up all the illnesses on the “onset” chart, and by 03/26 I got a total of 82625. That coincided with a the total reported (confirmed and presumed) cases as of the that date on the total cases chart showing that on 03/26 the total cases had reached 85356.

    I still don’t know what it means but at least the addition works and looks sane.

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