Federal documents: more than 300,000 likely to die if restrictions are lifted |

[bhaigan]

•  300,000 likely to die if restrictions are lifted

  • Introduction
  • The power of social distancing
  • ‘Best guess’ scenario
  • ‘Modeling needs to happen in the open’

Liz Essley Whyte

Reporter

This article was published in partnership with NPR.

INTRODUCTION

Federal health officials estimated in early April that more than 300,000 Americans could die from COVID-19 if all social distancing measures are abandoned, and later estimates pushed the possible death toll even higher, according to documents obtained by the Center for Public Integrity. Some outside experts say even that grim outlook may be too optimistic.

The documents created by the Department of Health and Human Services spell out the data and analysis the agency is sharing with other federal agencies to help shape their responses to the coronavirus. 

While the White House Coronavirus Task Force has cited other models created at academic institutions, the federal government has not made public its own modeling efforts. The documents paint the fullest picture yet of the assumptions underpinning the government’s response to the pandemic. 

The Trump administration is laying out plans for how to reopen America’s economy, and protesters are parading near state Capitol buildings to demand that happen swiftly. But while overestimating the threat of the virus could cause unnecessary job losses, underestimating it means more lives lost. At particular risk are the elderly and African Americans, already disproportionately dying, based on preliminary data. 

The documents outline a range of scenarios for how bad the coronavirus crisis could get, without taking into account continued efforts to tamp it down. This type of model offers a baseline against which to weigh mitigation efforts. The documents say they don’t aim to predict the exact course of the pandemic, but rather to help government officials plan.

“Models like this are also tools to discriminate between possible futures and guide your decisions in figuring out which you would like to avoid and how best you might avoid them,” said William Hanage, a Harvard University epidemiologist who was not on the team that created the HHS documents. “We’re trying to track this moving target and give people the best advice.”

In the documents, the “best guess” for how things will play out without further mitigation says that coronavirus cases and deaths would double about every five and a half days, on average one coronavirus-infected person would spread the virus to another 2.5 people, and that 0.5 percent of infected people who show symptoms would die. Four of seven experts interviewed by Public Integrity said certain assumptions in the documents, such as how deadly the virus is, are too rosy. 

“Their model’s way too optimistic,” said Ashish Jha, director of the Harvard Global Health Institute. He said the government was low-balling the fatality rate and failed to account for overruns of hospital resources. “They’re getting their analysis wrong.”

Some said the government’s calculations were unsophisticated.

“This is just what a rookie would do,” said Juan Gutierrez, a mathematician who produces coronavirus models for the city of San Antonio. He said the government had underestimated how contagious infected people without symptoms are and that the documents begin by assuming numbers that should really instead be proven by calculations.

Others thought the assumptions in the documents were reasonable.

“What they have here now seems in the ballpark to me,” said Pinar Keskinocak, who leads a team modeling the coronavirus’ spread for Georgia Tech. “There are a lot of smart people over there who have a lot of modeling experience. I would be surprised if they do something that’s odd.”

HHS and White House officials did not respond to requests for comment.

THE POWER OF SOCIAL DISTANCING

President Donald Trump on April 16 unveiled step-by-step guidelines for states to allow normal life to resume, including gradually reducing social distancing measures. Decisions about when and how to do that will require up-to-date scientific knowledge about how the virus spreads — the type of information outlined in the HHS documents. Several states, including Florida and Texas, already are easing some restrictions.

“Reopening the US will be a careful, data-driven, county-by-county approach,” Robert Redfield, the director of the Centers for Disease Control and Prevention, said in a tweet last week.

And though many experts agree that Americans have done a better-than-expected job of social distancing and complying with stay-at-home orders to date, the HHS documents show how much more harrowing the pandemic could still be.

The road back to “normal” should be painstakingly and carefully calculated, said other public health researchers who work on modeling the epidemic. 

“Please do not rush in terms of going back to normal after these shelter-in-place orders end,” Keskinocak said. She advised people to stay home and quarantine if any household members are sick, even after businesses reopen. 

‘BEST GUESS’ SCENARIO

The planning documents sketch out a “best guess” scenario and four others — two worse and two better — using 11 parameters to describe the course of the virus and six estimates to help calculate hospital beds and ventilators needed. The documents say the parameters are estimates from current best data on transmission, fatality rates, doubling times and several other factors. 

Figures in one of the documents expired in early April, while a nearly identical, though updated, document says its figures are current.

A table accompanying the older planning document shows that based on HHS experts’ “best guess” calculations in early April, roughly a third of Americans could be infected and show symptoms and more than 300,000 could die over the duration of the pandemic if social distancing and other mitigation measures were to stop immediately. That is far below earlier estimates of 2.2 million deaths predicted by the influential Imperial College model and the 1.5 million to 2.2 million predicted by the White House had the virus gone unchecked. 

Three hundred thousand deaths without social distancing “would assume a very optimistic case fatality rate,” Jha said. “That’s not where the best estimates are today.”

The table shows that in health officials’ “best guess” scenario of a future without continued mitigation efforts, Florida, Maine, Puerto Rico, West Virginia and Vermont would fare the worst in terms of deaths per capita. Florida — which on Friday permitted some beaches to reopen if visitors don’t get too close to one another  — would see more than 23,000 deaths.

“We have at this moment the finger on the spring,” Gutierrez said. “If we remove the finger, the spring jumps. So we will see a lot of cases.”

The number of deaths from the other four scenarios range from roughly 94,000 to 1.8 million.

The updated HHS document revised a few of the earlier parameters, doubling the percentage of symptomatic people the coronavirus would likely kill, from 0.25 to 0.5. It also increased the percentage of symptomatic people who would need to be hospitalized and how long they would be expected to stay. 

The documents do not spell out how many deaths the new, higher fatality rate would lead to in the “best guess” scenario. But a simple calculation by Public Integrity shows it would be more than 600,000.

And while the changes were reasonable, experts said, certain figures still may be low.

“I’m really shocked about the underestimate of hospital parameters just because it seemed like it was so well reported in China and Italy that there were patients staying a long time,” said Joseph Lewnard, an epidemiologist at the University of California, Berkeley.

‘MODELING NEEDS TO HAPPEN IN THE OPEN’

The early April document also used seasonal flu’s impact on different age groups to suggest how the coronavirus might affect them. HHS amended that information in the more recent  document, but the earlier use of the flu as a ***** for coronavirus alarmed some experts.

“Flu and covid are different diseases,” Hanage said. “I hope that statistics which are specific to covid are used as the assumptions for these models.”

The documents do not indicate the extent to which social distancing might alter the course of the virus from here on out. But a separate federal planning document obtained by Public Integrity, which used parameters similar to those in the “best guess” scenario, surmised that shelter-in-place orders would cut transmission of the virus by 75 percent. 

Experts said government officials should publicize their coronavirus assumptions so everyone can be confident in their work.

“There are certain errors that can be made, and if no one’s paying attention they go unnoticed,” Gutierrez said. “Epidemiological modeling needs to happen in the open. Usually you put a lid on the garbage.” 

Public Integrity data editor Chris Zubak-Skees contributed to this story.

[AndhraneedSCS]

already close to 50K undhi ... more over actual may be 100-150K 

[tacobell fan]

4 minutes ago, bhaigan said:

• •  

UP cinema lo animation character la undi deeni face

[tacobell fan]

1 minute ago, AndhraneedSCS said:

already close to 50K undhi ... more over actual may be 100-150K 

 200k ani already brief'd kada

[bhaigan]

4 minutes ago, tacobell fan said:

 200k ani already brief'd kada

ade restrictions ethesthe it will reach 300K ani antunaru

[DaatarBabu]

Anni Lathkore cases Corona lo kaluputhunnaru ani mana @Kool_SRG Anna Cheppindu kada... So original Count 1L, Anni kalipina count 1L-2L Ani disco ayindi ga 

[TrollBait]

38 minutes ago, AndhraneedSCS said:

already close to 50K undhi ... more over actual may be 100-150K 

also no way economy is going back to pre corona levels.

guaranteed drop in consumer spending in 90% sectors. anyway the economy is fcuked whether they lift lockdown or not.

if they have any brains, they'll work on medicare for all plan in this gap to prop up the economy a little bit.

but they don't have brains.

[jetwings]

29 minutes ago, DaatarBabu said:

Anni Lathkore cases Corona lo kaluputhunnaru ani mana @Kool_SRG Anna Cheppindu kada... So original Count 1L, Anni kalipina count 1L-2L Ani disco ayindi ga 

Its a tricky situation about counts...

Lets say, there is a guy who has heart problem... met an accident, and his heart fails and dies..  Did he die because of accident or heart attack.. we count it under accident or heart fail?

Here, the case with corona is, it effects lungs, heart and other organs also..

And, if there are any preexisting conditions, the virus may hit badly..

Here, if somebody is an asthma/cardiovascualr patient, and got attacked by corona and dies, it will be counted under corona itself.. not under lungs fail or heart fail. May be, those patients' expected lifespan is less, and they may die soon anyway, but died because they are hit by cvd. So, where should the count go..?

 

[sri_india]

GO Corona GO ... anteee adi manam encourage chesthuam anukoni inka rechipothundi 

[TrollBait]

13 minutes ago, jetwings said:

Its a tricky situation about counts...

Lets say, there is a guy who has heart problem... met an accident, and his heart fails and dies..  Did he die because of accident or heart attack.. we count it under accident or heart fail?

Here, the case with corona is, it effects lungs, heart and other organs also..

And, if there are any preexisting conditions, the virus may hit badly..

Here, if somebody is an asthma/cardiovascualr patient, and got attacked by corona and dies, it will be counted under corona itself.. not under lungs fail or heart fail. May be, those patients' expected lifespan is less, and they may die soon anyway, but died because they are hit by cvd. So, where should the count go..?

 

This is not some cricket score to keep count. the question should be how best to treat infected, and how to build infra to avoid potential spread of the infection overwhelm the health care system.

very few countries are doing it. US is not. India is not. 

[bhaigan]

37 minutes ago, jetwings said:

Its a tricky situation about counts...

Lets say, there is a guy who has heart problem... met an accident, and his heart fails and dies..  Did he die because of accident or heart attack.. we count it under accident or heart fail?

Here, the case with corona is, it effects lungs, heart and other organs also..

And, if there are any preexisting conditions, the virus may hit badly..

Here, if somebody is an asthma/cardiovascualr patient, and got attacked by corona and dies, it will be counted under corona itself.. not under lungs fail or heart fail. May be, those patients' expected lifespan is less, and they may die soon anyway, but died because they are hit by cvd. So, where should the count go..?

 

housetheesi chyna chesina number manipulation ade na

[jetwings]

1 minute ago, bhaigan said:

housetheesi chyna chesina number manioulation ade na

Looks like china did lot of hiding. But they cant hide for long though.

[TrollBait]

2 minutes ago, jetwings said:

Looks like china did lot of hiding. But they cant hide for long though.

what did they hide? Even India is hiding then, in that case.

westbengal only conducted 5000 tests so far.. lol.

tg only 15k..

rest of the states are not that much better. and the new cases keeps coming up inspite of the lockdown. what is India hiding?

[bhaigan]

9 minutes ago, TrollBait said:

what did they hide? Even India is hiding then, in that case.

westbengal only conducted 5000 tests so far.. lol.

tg only 15k..

rest of the states are not that much better. and the new cases keeps coming up inspite of the lockdown. what is India hiding?

I agree with you in case of India

also I am guessing after these rapid tests results reported they gone announce clusters and community spreads in India

[Sarvapindi]

8 hours ago, sri_india said:

GO Corona GO ... anteee adi manam encourage chesthuam anukoni inka rechipothundi 

lol 😂