There’s been a lot of signalling that the next two weeks are the hardest, with the Surgeon General comparing this week as our ‘Pearl Harbor’ moment. While these next two weeks will likely be worse than the last two weeks, I want to throw some cold water on the idea that these are the worst two weeks we’ll see. Perhap they will be, the Surgeon General undoubtedly has access to information and analytics that I don’t have. But I think the “two weeks” talk is overly optimistic messaging designed to get some people through the current moment. Remember when we were supposed to get through all this with just a two week national stay at home recommendation? Or when it was supposed to be over by Easter and the economy starting up again? I think the reality is that we are likely to see the numbers grow for at least two weeks, and very likely through the entire month or longer. Here’s why.
NY is currently driving the national numbers in much the way that Wuhan drove China’s early numbers. But unlike China’s case, the virus is already deeply embedded across the country. New York is the tip of the spear, but there is plenty more to follow. Keep in mind that as big as NY is, it is only the fourth most populous state. The top three are California, Texas, and Florida.
California has had virus cases almost as long as Washington. But unlike Washington and New York, the cases are not concentrated in a single metropolitan area where resources can be focused. The San Francisco Bay area has nearly twice the population of the Seattle metro area. Los Angeles metro is twice again as large as that. This doesn’t include San Diego, which is roughly the same size as Seattle. California is fighting a battle on multiple fronts and has been hampered by testing difficulties. There is comparatively little visibility into the virus’ spread in California.
Texas was late to the social distancing game, with its Lt. Governor suggesting that senior citizens should be willing to sacrifice themselves rather than damage the economy with stay-at-home orders. Florida has the second highest percentage of senior citizens, just 0.1% behind Maine. Senior Citizens are both more likely to be infected and to die from the virus. Florida was also late to the game on statewide restrictions, allowing beaches to remain open for quite some time.
And then there’s DC. Although the DC metro is substantially more populated than the Seattle area, the real concern is not just the raw numbers but how those numbers will impact the federal government’ ability to address the situation. If you’re one of those thinking that the federal government isn’t doing much about it anyway, think what it would be like if it were doing even less.
So, when NY does start to improve, there are plenty of other states waiting to take its place, and we haven’t even discussed Michigan, Illinois or Louisiana. Last night, Gov. Cuomo said that he thought New York might be starting to turn a corner as there were fewer deaths than the day before. While I hope he is right, I don’t think he is. The numbers occasionally are just lower one day even though they go on to rise. In the attached graph of New York’s death counts you can see that they were also low the prior Sunday.
This provides a good opportunity to talk about the death counts. Remember that like cases, these are just reported numbers, not actual numbers. There has been some recent reporting on this. Here is the New York Times’ take on it from yesterday. https://www.nytimes.com/2020/04/05/us/coronavirus-deaths-undercount.html As a result, we can’t be certain that the recent plateau in NY deaths is the result of fewer COVID deaths rather than an overwhelmed medical system not accurately categorizing those deaths. This is something that will be a subject of research next year, but for now, we just have the numbers that are reported. I’ll want to see a longer decline in new deaths and cases before saying that NY has really turned that corner. Hopefully, that’s just my skepticism showing.