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150 days into the pandemic, America has reached a COVID-19 milestone many may not hear about. At 501 COVID-19 deaths/million, we're halfway to 1 of every 1,000 Americans *dying of*—not just being infected with—COVID-19. At 20 months, we'll be looking at 1 of every 500 of us dead.
PS/ To put that in perspective, 70,826 live in each square mile of Manhattan. 15 months from now, at our current pace of infection/death, that would mean that—all things being equal—we'd expect 143+ deaths in every square mile of Manhattan. That's just... really hard to process.
PS2/ And of course this imagines (a) that the current death toll isn't a wild undercount, when in fact we know it is by at least 40,000 (current official toll: 166,093), and (b) the average daily toll in the first 5 months won't worsen (when we have every reason to fear it may).
PS3/ Case Fatality Rate (CFR) is impossible to calculate mid-pandemic—many cases haven't closed; deaths are undercounted—but the "observed" CFR across 2.87 million closed cases is below, and the "final" CFR will be somewhat lower than that 6% figure (we don't know by how much).
PS4/ Trumpists have created a cottage industry of COVID-19 disinformation, which either (1) makes up COVID-19 data or (2) deliberately misframes and decontextualizes it into incoherence. First, understand that "IFR" and "CFR" are not the same thing—and the difference is critical.
PS5/ IFR (Infection Fatality Rate) is the percentage of all those who contract a virus who will die, whether or not they have symptoms or know they had the virus.
CFR is the percentage of *confirmed* cases "resolved" with a fatality. So IFR and CFR will never be the same number.
CFR is the percentage of *confirmed* cases "resolved" with a fatality. So IFR and CFR will never be the same number.
PS6/ IFR can only be guessed at now, because the CDC says the number of actual infected persons is anywhere from 6 to 24 times greater than the number of known COVID-19 cases. That suggests the IFR could be 1/6th the CFR, 1/24th the CFR, or somewhere in-between. We don't know.
PS7/ Most experts don't give Trump the political "assist" the CDC does by implying 24 times more people have COVID-19 than have *confirmed* cases of it. Most experts say 6 to 10 times more people have COVID-19 than a confirmed case of it—suggesting IFR is 1/6th and 1/10th of CFR.
PS8/ The upshot: right now IFR is between 0.6% and 1.0%, or 6 to 10 times worse than the flu. Keep in mind that right now the virus is uncontrolled—so who knows what percent of Americans will get it. Right now 1.6% have it or have had it, but that number could eventually be 40%+.
PS9/ It's well within the fat part of the probability curve for about half of Americans to get COVID-19 and for 1% of those who do to die (in other words, 1 out of every 200 Americans dying from COVID-19). That level of death is—it must be emphasized—unthinkable in a rich nation.
PS10/ So the idea that, 5 months into a pandemic, we're looking at a 20-month scenario—i.e., just 15 months from now—in which 1 of every 500 Americans has died from COVID-19... it's incomprehensible. A nightmare of a proportion we can't imagine. But it's happening right now. /end
