The story of the pandemic is the story of people. The soaring numbers on charts and tables aren’t numbers of cars rolling off an assembly line, or the distance between the Earth and some point in the night sky. They’re all people. Every digit is misery. Every measure, grief.
As more than one Internet wit has pointed out, the time Americans have spent looking at exponential charts has risen … exponentially. That may finally be about to end. Not because the rate of growth is suddenly slowing. Because it’s not.
On Saturday, the United States crossed a new set of bitter milestones: 300,000 infected, 8,000 dead, and a case fatality rate that has risen to 2.7%. That last number is the most important, because it shows that we’re no longer facing the gusts and squalls in advance of the main storm. It’s here. Over the next two weeks, healthcare systems across the nation are going to be pressed to limits and beyond. This week already brought the unthinkable decision in New York City where heart attack victims are no longer being brought to hospitals in an attempt to revive them. There are a lot of steps on that road. We’re going to visit them all.
We’re only beginning to translate this story from numbers and graphs to names and faces. Right now, the rate of infection in the United States is still only about 1 person in 1,000. It won’t stay there, but for the moment it’s quite possible to be someone who has no friends, or family members, or even co-workers struggling with the disease. Right now, deaths are about 1 in 40,000. They’re someone’s favorite uncle, someone’s dear sister, someone’s friend and partner. We are all going to ache for the day when it was still someone’s.
But we still look at the numbers. Not just because the numbers are less heartbreaking than the torrent of names and faces that is only now starting to flow through social media, but because the numbers, even when they’re terrible, offer a strange sort of hope. Like searching the night sky in search of some hint of a dawn ahead, the numbers are all we have when we hope to see some end to this nightmare.
Not so long ago, Italy was the definition of what it meant for a nation to be crushed by COVID-19. With 125,000 cases and a staggering 15,000 dead, there’s nothing good to be found in Italy’s numbers, but as the chart above indicates, they’ve taken the growth there out of the exponential range and turned it into simply linear. It’s a long, long way from ideal, and the almost 5,000 cases added on Friday greatly exceeds the rate at which Italians are recovering and freeing up precious healthcare resources. But if you want to see what tightly enforced suppression actions—social distancing on steroids—can achieve. This is pretty much it.
In terms of rate of growth, Italy has pushed its values down to the lowest in the Western world. The problem is that an increase of just 4% a day is massive, when that increase is working against a number as large as 125,000 cases. Reducing that number below 4% using just suppression measures may be impossible, or at the very least, highly painful and impractical. To make additional progress, Italy needs to do what every nation that’s been successful in genuinely ending the period of linear growth and “bending the curve” to near zero growth — individual testing and isolation. At this point, Italy has conducted 650,000 tests. That seems like a lot, but it’s only 1 test for 100 people. That’s less tests per person than were used by South Korea, and South Korea moved to apply widespread testing, isolation, and quarantine much, much more quickly than Italy. For Italy to reduce the numbers to the point where it has not just slowed the growth of misery, but begun the process of recovery, is going to take tests in the millions and a dedicated, military-scale effort to identify and isolate every positive, as well as follow-up and quarantine potential contacts.
Italy is starting now from a point where that seems like a massive undertaking, but at least it’s in the realm of possible. In the United States, the limited social distancing measures have hit a limit at a value that doesn’t seem all that much bigger on the graph above, but in the real world has an enormous implication. In the last week, the United States rate of growth has seemed locked in at 14%. With 300,000 cases on the books, that’s better than 40,000 new cases a day. America isn’t ridding an exponent that’s as rocket-like as it was two weeks ago, but cases are still skyrocketing as new epicenters develop in every corner of the country.
To get to the point where we can be like South Korea, we have to first be like Italy. We have to crank up the knob on suppression to straighten the growth, even as we expand testing. Eventually we can turn this from something that isn’t about locking away the nation, into something about carefully putting a shell over the fire until it finally burns out. But we’re not there yet. If there’s any glow on the horizon … it’s probably not the sun.
For now, stay home. Stay safe. And I am so, so sorry about your someone.