U.S. COVID-19 Projections Slashed to 100,000 to 200,000 Deaths
Following our recent discussion in What Price Should We Pay to Fight COVID-19?, some good news has emerged: In a recent interview, Dr. Anthony Fauci stated that, although there was no way to know for certain and he didn’t want to be held to it given the ever-changing nature of the situation, he now estimates that the death toll from COVID-19 will be in the 100,000 to 200,000 range. This is a dramatic reduction from worst-case scenarios that had thought to be around 2,200,000 only a brief time ago.
To put those numbers into context so you can compare them to a normal year, looking at information from the CDC (these figures are as of 2017, the most recent data easily available), this compares to 2,813,503 deaths per annum in the United States. Of those deaths, the leading causes were:
- 647,457 people died from heart disease
- 599,108 people died from cancer
- 169,936 people died from accidents (unintentional injuries)
- 160,201 people died from chronic lower respiratory diseases
- 146,383 people died from stroke (cerebrovascular diseases)
- 121,404 people died from Alzheimer’s disease
- 83,564 people died from diabetes
- 55,672 people died from influenza and pneumonia
- 50,633 people died from nephritis, nephrotic syndrome, and nephrosis
- 47,173 people died from intentional self-harm (suicide)
If population estimates for 2020 hold, the country has around 331,000,000 people. This means:
- Assuming the higher end of the spectrum, only 0.06% of the population will die from the pandemic, or roughly 1 out of every 1,655 people.
- Assuming the lower end of the spectrum, only 0.03% of the population will die from the pandemic, or 1 out of every 3,310 people.
This doesn’t account for the significant number of people who will need medical intervention and who survive, which is why it is still necessary to take counter-measures, and it’s no doubt a lot of deaths, but compared to what we were facing, this is nowhere near as terrible as it could have been. Given the net balance of harms we discussed in our earlier conversation, I would now argue that, if these numbers can hold with an 80% or greater probability, it would be immoral to keep the United States in lock-down in its present form beyond the end of April or into mid-May; e.g., as many mitigation strategies as possible could be kept in place, including some of the earlier ones we covered such as self-isolation of at-risk populations, employment reforms protecting their income, etc., but otherwise there can be no justification, ethically or constitutionally, for entire states such as California or New York to order the across-the-board closure of all non-essential businesses. The consequences are too catastrophic for too many people. (This morning alone, a single company – Macy’s – announced that is furloughing 130,000 people. The department store giant is trying to absorb some of the pain by promising to pay health benefits until at least the end of May but that cannot continue indefinitely; the numbers simply don’t work. That is a staggering amount of paychecks that are not going out to service workers, which will ripple through the system as those employees begin to exhaust any emergency savings and start defaulting on their rent, mortgage payments, utility bills, credit card payments, car loans; perhaps find themselves unable to afford food or medicines; shut down nearly all purchases, leading to lay-offs in other businesses.)
A precise date is, of course, impossible until the trajectories of the virus become clearer on a community-by-community basis but you can at least see relief on the horizon, if only distantly.
This, of course, ignores an important conversation we have not had, which I just touched upon: The fact there are strong arguments shelter-in-place orders are blatantly unconstitutional. As a result, there are challenges being prepared in the court system in the event they go on too long. People of goodwill are tolerating it momentarily but you cannot ignore that the 1st Amendment states, as clear as crystal, that Americans have a fundamental right to peaceably assemble in groups, which the government does not have the ability to restrict:
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances. [emphasis added]
Emergency quarantine power case laws are very old, and very out of date with nearly all being related to the ability of the government to segregate individuals who are infected and order them to stay away from the general population. My guess is that if this – 100,000 to 200,000 deaths – looks like the potential downside, the net balance of harms will result in governors and mayors losing the ability to lock down society indefinitely as courts will begin striking down the orders by June or July otherwise.
The big challenges is going to be the same thing society faces in an airplane crash, where people panic because they see a large number of individuals dying at once even if the odds of dying in such a way are tiny; smaller than the risk of even driving to the airport in a car. As I mentioned in my earlier post, the television channels, newspapers, and social media are going to be filled with pictures and videos of doctors and nurses breaking down, refrigerated trucks storing bodies, (very possibly) mass cremations, interviews with devastated loved-ones, non-optional do not resuscitate orders, triage of care, and a lot of horrors not witnessed since Hurricane Katrina hit the Gulf Coast in 2005.
Update: As of 08/14/2020, the death toll in the United States has reached 170,892 with a not-insignificant portion of this a result of the politicization of masks coupled with the refusal to engage in meaningful social distancing. A significant minority of Americans are driving up the death toll for no reason other than ignorance, pride, and irrationality. To put it bluntly, it would have been possible to greatly mitigate the number of deaths, both absolutely and on a per million basis, given the characteristics of the virus without needing to completely shut down civilization, yet too many people are behaving as if the virus either doesn’t exist or they simply have no concern for their neighbors. This entire period is a demonstration of nearly across-the-board unforced error and folly by both Democrats and Republicans. The former acted like landed aristocrats without any concern for the poor and middle classes, destroying 50-years of gains in income and wealth gaps for minorities by taking for granted that shut-downs were like an economic nuclear bomb going off on the bottom 80% of households. The later is utterly incompetent and acting like this whole thing is some sort of hoax. I’m disgusted by the lack of leadership, courage, and willingness to have mature conversations about harm and trade-offs.