April 10, 2020

“Come with me if you want to live.”

April 10, 2020, 9:00 pm

#stayhomebewell for past, current, and future analysis of the COVID19 pandemic. stayhomebewell.org. and www.facebook.com/stayhomebewell. Please react and share.

*Note: I am rounding some numbers. Given that the actual numbers will vary slightly based on what time of day I happen to document the total, for the sake of easier reading, I may round up slightly or down slightly in order to land on a more easily digestible number. Slight differences are irrelevant, as they will be compensated for as the days progress and the numbers grow ever larger.

Global Cases: up 5.9 percent, or 94,375, to just under 1,700,000.

US Cases: up 7.2 percent, or 33,750, to 502,320 cases. My projection was that we would reach 500,000 cases by April 15. Once again, my projection was too conservative. According to the chart I first plotted on March 15, the US could have expected to have reached the level of 80,000 cases by April 15. I revised it upward several times, as I added points on the chart day by day and saw that the original projected slope was too flat. Each time, as borne out by these posts, I was too conservative. Based on today’s data, it would appear that we can expect to reach 750,000 cases by April 15. That’s an average of 50,000 cases per day over the next five days.

Global Deaths: up 7.3 percent, or 7,000, to 102,700. The global Case Fatality Rate (CFR) is 6.05 percent. This is 60 times the oft-quoted 0.1 percent CFR of the seasonal flu. The extended rolling average growth rate (the average of the last ten 7-day rolling averages) is 10.4 percent, which is trending downward from a peak of 12.8 percent on March 30. As I mentioned yesterday, this downward trend is not cause for celebration. It is merely a reflection of the first wave having crested and crashed down. In the early hours of a terrible squall, when the first wave to demolish your boat passes over you, and you are left clinging to a life raft and gasping for breath, do you rejoice? Only if you are too stupid to know that another wave is coming up behind it, and the storm has only just begun.

US Deaths: up 12.2 percent, or 2,035, to 18,725. At the time of this writing, the US lags Italy by only 125 deaths for the terrible distinction of first place worldwide. This fact hides some very disturbing information. The CFR for Italy is 12.8 percent, while that of the US is 3.7 percent. This is cause for serious alarm. Italy’s CFR is higher because it is coming out from the terrible storm it has weathered, and a much larger portion of its infected Cases have had a lot more time to resolve, either in recovery or in death. The much lower US CFR is not, in my estimation, an indicator that the disease is less severe in the United States. It is more likely a representation of the fact that 91 percent of US infections remain unresolved. In other words, the current Cases (predominantly in New York) who are going to die from COVID-19 in the United States merely haven’t yet run the disease’s course.

My original projection chart from March 15 predicted roughly 1,600 deaths by April 01. We reached that number on March 27, four days earlier than my projection. By April 1, we had reached 5,100. Ten days have passed since that milestone, and US Deaths have surpassed 18,000. Adjusting the projection to continue to match the trajectory of the Global Deaths that preceded the US by 53 days, it suggests we could reach 45,000 deaths by April 15, which would put the CFR at 6 percent.

The rate of growth in US Deaths has been declining since March 30, when the extended rolling average peaked at 30 percent. It has been declining since that time. Recall, however, that the number of deaths continues to increase. This measure merely states that it is increasing less quickly each day than it did on the upward side of this curve.

Global Recoveries: up 5.5 percent, or 19,750, to 376,185.

US Recoveries: up 5.4 percent, or 1,385, to 27,315.

Global Unresolved: up 5.9 percent, or 67,650, to 1,218,925 humans on earth currently documented as ill with COVID-19.

One of my friends joined their ranks today, when his test was confirmed.

A word about this.

My friend is around 50 years old, a former Olympic-level athlete. He maintained a very healthy lifestyle. Nine days ago, he began to notice symptoms. Two days later, they kicked into high gear. He described his experience:

“Testing: I went to Urgent Care (wait time is between 30 minutes -2 hours depending on the hospital) expecting to be tested for COVID – 19 Right away. They asked me a few questions regarding my symptoms and then determined that I have it. They only test those with pre-existing medical conditions such as heart disease, diabetes, etc., and have demonstrated difficulty breathing. I wasn’t at this stage yet, so I was sent home and given an-over-the counter prescription: Mucinex DM MAX for relieving chest congestion, and Tylenol Extra strength to help lower body temperature and relieve headaches (can take up to 1000ML every 6 hours but not more than 4000 ML in a 24 – hour time period). I was already taking these meds.

“I was told to return if I experience difficulty breathing. Thankfully, that hasn’t happened and I don’t plan to make it happen. I scheduled a video visit with my primary physician, who came to a conclusion after conducting a series of breathing exercises with me and evaluation of my symptoms. My doctor recommended a test, which they just did. It’s painful but quick. They ram up this long Q-tip up your nose like they are harvesting your brain. So, be prepared in case you have to go for a test.

“The best way to go about getting tested is to call your doctor who will diagnose you, write you a letter that you can take to the testing center. You will call to schedule an appointment (usually, the next day). No walk-in at the testing center. You will need your driver’s license and the letter from your doctor.

“Symptoms: Whereas I have exhibited most of the symptoms as highlighted below, aches and pains have been the worst for me. Even after taking 1000 Mg of Extra Strength Tylenol, I still experience aches all over my body including my eyes. Sweating profusely one moment and then needing to layer up (sometimes I have to wear multiple jackets to feel warm) is typical. I have lost my appetite and taste.

“What is working for me: over-the-counter drugs, eating even when I don’t feel like it. The body needs nutrients to fight off this insidious virus. I have used Vicks (applied to my chest, neck, and throat) in combination with steaming water, then covered myself with a blanket lasting between 5-20 minutes. I have found this to clear my nose and my face relaxes, which allows me to sleep for at least an hour at night. Nights are the worst. Lots of sweating and nightmares. Hard to sleep. When I am warm, I drink cold drinks (orange juice, pineapple juice, etc.) and when I am cold, I drink hot drinks (ginger, lemon, turmeric, a bit of honey). You have to drink a lot of liquids which results in visiting the bathroom a lot. Light exercises lasting anywhere between 10 -20 minutes, breathing exercise (this has helped me tremendously. When I first started, I couldn’t hold my breath for more than 3 seconds, now I can go between 8 -12 seconds – so getting better over time). Naps help as well.”

Some commentary is warranted.

• At Urgent Care, they determined that he has COVID-19, but did not test him and sent him home. Was he recorded as a positive Case in the CDC database?
• He was prescribed the same over-the-counter medications he was already taking.
• When his doctor recommended a test and wrote him a letter to that effect, he had to return to Urgent Care, to be given the test he was previously denied. He was forced to make another trip out of the house.
  • What do people who don’t have computers, printers, and scanners at home do?
  • What do people without identification do?
  • What do people without primary care physicians to write them prescriptions do?
• He describes aches and pains as the worst aspect of this illness. This is an Olympic level athlete. The level of training he has undergone, the level of muscle and joint soreness he has experienced is far greater than most people will have ever experienced. And yet he describes the aches and pains as the worst part of his illness.
• He forces himself to exercise for 10-20 minutes, operating on one hour of sleep if he is lucky. Again, this is a man with a level of self-discipline that is much higher than that of most people.

The point of all of this? His case and his symptoms are classified as “mild,” since he has not been admitted into a hospital.

When we are told that 80 percent of people infected show either no symptoms at all, or mild symptoms, this falls under that category. Profuse sweating, swings from freezing to burning up, aches and pains all the way to his eyeballs, and rare sleep that is filled with nightmares is classified as “mild.”

Anyone who is blasé about the prospect of becoming infected because you are betting that you’ll be in the “vast majority who experience no symptoms or mild symptoms,” please note well the definition of “mild.”

US Unresolved: up 7.1 percent, or 30,333 (of which my friend is now one), to 456,280. These cases make up 91 percent of the current cases in the United States. Only 5.4 percent of all Cases have recovered in the United States, compared with 22 percent globally. And only 3.7 percent of cases have ended in Death in the United States, compared with 6 percent globally.

In order for the United States to consider itself out of the woods, I would say that, at a minimum, we would need to see the Recoveries exceed 50 percent plus one Case, wouldn’t you?

And given that the timeline depicted in the chart above covers 80 days, or nearly 12 weeks, what would an aspirational date of Easter look like, in terms of “opening the country back up?”

And that question is ridiculous on its face even if you grant that there would not be a single new case entering the data set, which, of course, we know is even more ridiculous still. New York is only the first of many waves to come before this storm passes.

Come with me if you want to live.