Too little, too late. COVID-19 is on track to be more severe in the United States

Still mostly bad news, but there is a light at the end of the tunnel.

By any measure, the United States is on track to experience more infections and deaths from coronavirus than any other developed country on the planet. Using the latest data from John Hopkins, we see that the number of people dying in the US is growing at an unprecedented rate. As of April 9th, 2020, the mortality curve in the United States is both steeper and earlier than anywhere else from the 100th confirmed death.

This is likely driven by the sheer scale of infections in the United States. Even on a logarithmic scale, we see that the number of cases in the US is a step up from the rest of the world.

The most recent data explains why the forecasting models I released last month only worked for a few days before starting to underestimate new daily values. The key assumption in those models was that it would be more or less the same here as it would be everywhere else — a virus doesn’t discriminate, and nearly every government failed to act early enough and with enough conviction to successfully mitigate the spread of the disease. So, there was no reason to believe that it would be different here with the preliminary data we had at the time. Now we know that assumption was absolutely incorrect, which gives me very little confidence in any statistical model that tries to model the eventual US death toll using data from other countries. We’re truly in unchartered waters.

The response in the US has been dramatically worse, and the data here validates that sad truth. But make no mistake, that’s not to say that the situation couldn’t be worse than it already is. Social distancing and the various mitigation strategies deployed by governors around the country have helped, and they will continue to minimize the impact and speed up the eventual recovery.

There’s plenty of blame to throw around, and there will be a day for that, but it’s clear that the results we’re seeing today are not exclusively the fault of public officials. While it’s true that the response from all levels of government has been woefully inadequate — stories of people purposefully ignoring or going against the guidelines are not uncommon either. Here are just a few: A summary from TIME magazine, one from Reuters, another from USA Today, and a video from CNN.

Undercounting

Worryingly, there are also reports that deaths are being undercounted in the US due to insufficient testing. There seems to be no difference between this claim and the alleged undercounting in China. Since an infection could result in death so quickly, undercounting appears inevitable when the spread accelerates too quickly. Since we now have a sufficient sample of countries with at least one case and one death, we are now able to better understand the speed of the disease.

We can see that the general lag between the first confirmed case and the first death and subsequent ramp-up appears to be consistent across countries. The average delay between the first confirmed infection and the first death, across 143 countries with sufficient data (and excluding China), has been 18 days. The minimum delay observed so far is just one day (Panama, Botswana), with a maximum of 61 days (Sri Lanka).

I’m not entirely sure how useful this is now, but it may serve as a reference for anyone that lives in a country that is still in the initial phases of the disease. As of right now, that appears to be just a few countries in Latin America, Africa, and South Asia.

Additionally, it’s possible that these statistics are associated with the number of days that individuals are fighting coronavirus once infected. To be clear, however, the John Hopkins data is not specific enough to suggest whether or not this is true.

Finally, there is some good news

The most recent data suggests that the aggressive mitigation efforts in Italy, Germany, and Spain are starting to take effect, just as they did in China and South Korea. This is why a discussion about an end to the lockdowns at some point in the future is starting in Europe.

This is what we’re all waiting to see here in the United States. Don’t lose patience. We’ll get through this, eventually, and the experience in Wuhan gives us some insight into what that may look like when we do.