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So those are some of the coronavirus numbers as of now. The question is what happens next?
Well, on Monday, a piece in The New York Times asked that -- asked what appeared to be a pretty straightforward question. When will New York City reach the peak of its outbreak? New York City, of course, being the place with the most cases in this country, and you'd think that epidemiologists could answer that question with some precision. But as it turns out, no, they can't.
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Governor Andrew Cuomo predicted the peak will come this week. The head of New York-Presbyterian Hospital predicted April 15th. The state's health commissioner, meanwhile, thought late April or maybe early May. The predictions differed by up to a full month.
At a time when New York is quarantined and people are still dying, that is a very big range of answers. Howard Markel, a physician and professor at the University of Michigan summed up the current state of knowledge this way: "In reality, we don't know."
No, we don't know. In fact, a close look at the data suggests the peak of the epidemic in New York may have already passed five days ago. On April 2nd, 1,427 people were hospitalized for coronavirus in New York -- it's the highest number so far recorded. The next day that total dropped to 1,095. And then on Sunday, it fell to only 358.
In the last two days, new hospitalizations have ticked up once again, but they're still far below last Thursday's peak. If this trend holds -- we don't know that it will -- but if it does, the worst may already be over for New York.
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All of this has come as a surprise to our public health authorities and a welcome surprise to those of us watching. The Institute for Health Metrics and Evaluation, the I.H.M.E., is a well-regarded research center run from the University of Washington. The I.H.M.E. has produced detailed predictions, charting the expected course of this epidemic here in the United States as well as in other countries. Their model has done perhaps more than any other piece of academic research to shape our response to the coronavirus crisis.
So how accurate has that model been? Here's some numbers.
Initially, the I.H.M.E. predicted that on April 4th, the state of New York would require 65,000 hospital beds to handle infected patients. The low-end estimate of what the state would need was nearly 48,000 beds.
In fact, on April 4th, New York had fewer than 16,000 hospitalizations for coronavirus, and many other states fell far below the model's projections as well -- in many states. Over the weekend, the I.H.M.E. updated its model. Its projections across the country have been scaled back dramatically. And yet, they are still significantly overstated.
For example, as of April 7th, the updated I.H.M.E. model predicts that New York will need 25,000 hospital beds. As of Tuesday morning, the real number was just under 17,500. The new model also predicted that as of today, almost 6,600 people would be in intensive care, and the actual number is just under 4,600.
In Florida, the new model predicted 4,000 people would be hospitalized. The reality in Florida is that not even 2,000 are.
And it wasn't just Florida and New York. The I.H.M.E. got it wrong in state after state after state. By the way, for America, this is great news and we should celebrate it. It's much better than we thought. Though unfortunately, on the question of total deaths, the model has been more accurate, though it still tends to overshoot. For example, yesterday, the I.H.M.E. predicted 784 deaths for New York, the state finished the day with about 600.
Whatever is happening, this epidemic appears to be doing less damage than anticipated, and it's receding more quickly. Not so long ago, some of our leaders seemed on the verge of panic
For the entire country, the model predicts about 2,000 deaths today, and sadly, it seems like we'll finish somewhere around that number. But that may not be the whole story. There is nuance within those numbers as there always is in social science.
For many years, the CDC has tracked the total number of Americans who die every week from pneumonia. For the last few weeks, that number has come in far lower than at the same moment in previous years. How could that be?
Well, it seems entirely possible that doctors are classifying conventional pneumonia deaths as COVID-19 deaths. That would mean this epidemic is being credited for thousands of deaths that would have occurred if the virus never appeared here.
We don't know that for certain, but it's certainly worth considering. Something is skewing those numbers. Nor do we know exactly why the model predicted so many more hospitalizations than we have actually had.
Now, you will hear people say -- you're hearing them say now -- but this is evidence that the shutdowns and social distancing must be working. But not so fast -- those measures were built into the model in the first place. They've already been taken into account, and we are still doing far better than what epidemiologists believe was the best-case scenario.
So the question is -- and it's a central question as we move forward -- how did this happen? Well, it is possible the virus is just less deadly than we feared it was, or it's less likely to send people to the hospital. Maybe it spreads less easily than we thought it did. Maybe it spreads more easily than we thought it did, and the number of asymptomatic carriers is higher than we knew.
All of those are reasonable theories. We have no idea which one could be true. Then there's this: In a new draft paper, MIT economist Jeffrey Harris suggests that Americans are following social distancing guidelines more effectively than authorities ever imagined they would, and that's another potential explanation.
Whatever is happening, this epidemic appears to be doing less damage than anticipated, and it's receding more quickly. Not so long ago, some of our leaders seemed on the verge of panic.
On March 24th, for example, Gov. Cuomo of New York descended into a state of frenzy during his daily press conference. Cuomo dismissed the federal assistance New York had received as grossly inefficient. Tens of thousands of innocent New Yorkers are going to die, he said. They will choke to death while doctors do nothing to help them.
New York Gov. Andrew Cuomo: F.E.M.A. says we're sending 400 ventilators. Really? What am I going to do with 400 ventilators when I need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators.
"You pick the people who are going to die." It was effective theater, but it was awful. What a horrifying thought that was.
As recently as last Friday, April 3rd, Gov. Cuomo was threatening to use the National Guard to seize ventilators from facilities upstate. That's how badly New York needed them.
Any discussion of how we might transition out of the shutdown back into normal life for some reason has become taboo in this country.
Except it didn't need them. As it turned out, New York has many more beds and ventilators than it needs.
Cuomo: Equipment -- that's the protective equipment, ventilators where we are stretching and moving, but every hospital has what they need today.
So miscalculations like the ones you just saw played out across the country in state after state. On March 14th, for example, the governor of Oregon, Kate Brown, warned that her state's 688 ventilators wouldn't be nearly enough to handle the coming surge of coronavirus cases.'
It turns out she got it backward. Oregon had more ventilators than it needed. So on April 4th, Governor Brown shipped 150 of the machines to New York, which based on current trends, may not need them, either.
Now once again, we ought to celebrate all of this. Fewer hospitalizations are a godsend for this country. And as awful as this epidemic has been and will be, at least so far, it hasn't been the disaster that we feared.
Our health care system hasn't collapsed. That was the key concern. Except in a handful of places, really, it hasn't come very close. Patients are not dying alone in the hallways of emergency rooms with physicians too overwhelmed to treat them. That was the concern. It happens in other countries, it's not happening here. Thank God for that.
All of this means is that the short-term crisis -- the ones that we worried about so fervently, in which pressure on hospitals grew so exponentially day by day with no end in sight -- that short-term crisis may have passed. It seems, but it looks like it may have.
Now, it's time to look ahead. If the virus is doing less systemic damage to our system than expected, then presumably, we can begin to consider how to improve the lives of the rest, the countless Americans who have been grievously hurt by this, by our response to this.
How do we get 17 million of our most vulnerable citizens back to work? That's our task. Other countries are already hard at work doing it.
Adjusted for population, Denmark's coronavirus outbreak has been almost precisely as severe as ours has been here in the U.S. In Denmark, schools and daycare centers are scheduled to open next week. The government plans to roll back more restrictions on May 10th.
The outbreak in Austria has also been similar in scope to America per capita. There, the government plans to let small stores reopen April 14th, followed by large stores on May 1st, and then potentially restaurants and schools in the middle of May.
So that's what they're doing. We're not doing that here. We're not even talking about doing it because we're not allowed to. Any discussion of how we might transition out of the shutdown back into normal life for some reason has become taboo in this country.
Before we go ahead and alter our lives and our country forever, it is fair to ask about the numbers -- their numbers, the ones we acted on the first time that turned out to be completely wrong. How did they screw that up so thoroughly? That is a fair question.
Go ahead and raise the question. You'll find yourself denounced as a tool of Wall Street who doesn't care about human life, often denounced by pro-choice activists who are happy to accept cash from corporate America. But the layers of irony are, of course, bottomless.
But we shouldn't be surprised by any of this. This is what happens when public debate -- healthy public debate -- is replaced by memes, and mindless partisans on social media define the terms of allowable conversation as they have.
And so we plod forward as if the flawed models weren't flawed at all -- as if the reality of what is actually happening in our hospitals should play no role at all in the decisions we make going forward.
Dr. Anthony Fauci has announced, for example, that Americans must brace for 18 months of shutdowns at the absolute minimum, and if a vaccine isn't found, it could go on forever.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases: If back to normal means acting like there never was a coronavirus problem, I don't think that's going to happen until we do have a situation where you can completely protect the population.
If you want to get to pre-coronavirus, you know, that might not ever happen in the sense of the fact that the threat is there.
So life may never return to normal in this country. We may never regain what we've lost. You're hearing a lot of people say that all of a sudden. It's becoming a species of conventional wisdom.
On MSNBC Monday night, where conventional wisdom often is born, UPenn Professor Zeke Emanuel explained that America may be shuttered for 18 months, at least.
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Zeke Emanuel, professor at the University of Pennsylvania: Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that's dreadful news to hear. How are people supposed to find work if this goes on, in some form for a year and a half?
Is all that economic pain worth trying to stop COVID-19? The truth is, we have no choice. If we prematurely end that physical distancing and the other measures, keeping it at bay, deaths could skyrocket into the hundreds of thousands if not a million. We cannot return to normal until there's a vaccine.
Conferences, concerts, sporting events, religious services, dinner in a restaurant -- none of that will resume until we find a vaccine, a treatment or a cure.
You can't go to church until we have a vaccine. The truth is we have no choice.
Heard that before? That's a familiar phrase in Washington. It ought to make you nervous. Do what I say, follow my orders without question or complaint or a million people will die. The oceans will rise. The polar bears will perish. The human race itself will go extinct.
Okay, maybe. These are smart people. We should hear them out. But these are also big decisions, history-changing decisions with consequences. We can't even begin to anticipate this far out.
Before we go ahead and alter our lives and our country forever, it is fair to ask about the numbers -- their numbers, the ones we acted on the first time that turned out to be completely wrong.
How did they screw that up so thoroughly? That is a fair question. If they can answer that question -- answer it slowly, rationally, in a way that makes sense and suggests a deeper humility going forward as they make more decisions -- then that's adequate. That's enough. They're allowed to make more public policy decisions.
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But if they can't answer that question, if they disassemble or dodge or attack the people who ask it, then you know. They are disqualified forever from influencing our lives.
Let's see if they can do it. They should.
Adapted from Tucker Carlson's monologue from "Tucker Carlson Tonight" on April 7, 2020.