One of the most amazing moments in the latest press event held by the White House coronavirus task force may have come when Health and Human Services Secretary Alex Azar purposely understated the number of Americans infected, then admitted that others had been allowed to come back into the nation from the cruise ship Diamond Princess or on flights from China. It wasn’t amazing because it was the first time. After all, Donald Trump has been discounting these forty-something cases of COVID-19 since he wandered out for his first “15, on its way to zero” press event. What’s amazing is that, a thousand cases in, the White House is still trying to “spin” the numbers to the extent of subtracting a value from the total that’s increasingly irrelevant.
But on Wednesday the White House went past mixing disinformation into their misinformation, and simply moved to outright oppression of facts. Not only were experts pulled from a House hearing, and two meetings on coronavirus abruptly closed to the press, but Trump has actively classified critical public health data and hearings in a way that makes it more difficult to address this national crisis. And the whole reason seems to be so that no one can be heard contradicting Trump.
In 1918 the government used the just-passed Sedition Act to censor news stories and cover-up health information about the deadly flu epidemic. While local papers might contain some information about the lines of ambulances waiting outside hospitals, or the decisions made in a few localities to suspend large gatherings, across the nation very few people understood the scope of what was happening. Using the final months of World War I as an excuse, officials blacked out information wholesale. There were no web sites to give objective counts of the total infected, and certainly no coverage of steam shovels being used to dig mass graves. In fact, the suppression of public information was so effective that it’s still unclear just how many Americans actually died. The 600,000 number most frequently cited is an estimate that could easily be off by 200,000 either way.
In 2020, Trump may not have the Sedition Act, but he has a compliant Republican Senate and a right-wing media that’s ready to back him no matter what bloody path he takes. In this environment, Trump seems set on repeating as much suppression of the facts as he feels is necessary to make him look halfway effective. That may seem difficult, or even impossible, considering the state of the media and the absence of official censorship to assist. On a factual basis, it may even be impossible. The numbers will be out there, every day, pointing out that the claims coming out of the White House are bunk, hokum, and, yes, malarkey. On the other hand, so is everything else that comes from this White House. The question is whether or not facts still matter … even if those facts come in the form of people in hospitals. Or worse.
Just yesterday, I had warned that the global case status chart was going away unless there was something interesting to see. And one day later … here it is again. The purpose is to note just how sharply that overall number is growing. At the time of writing, cases had just passed 125,000, but that landmark is less interesting than the fact that the numbers of new cases on both Tuesday and Wednesday were greater than any day during the initial China-based epidemic (other than the day in which Hubei province reconfigured its reporting and generated that sharp spike on Feb. 12). In other words, it’s not just that the focus of the pandemic has moved outside of China: It’s now growing at a rate that exceeds the worst that China experienced … and it’s getting worse each day.
Multiple sources, from World Health Organization director-general Dr. Tedros to National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci, are making it clear that the worst is still ahead. Believe them.
Another thing that’s unsettling, in addition to the totals, is how that red slice of the chart above relates to the rest. Case Fatality Rate continues to be one of those values that is being argued around the planet, but there’s something happening in the numbers that no one likes.
Since the beginning of the outbreak in China, there’s been an assumption that the case fatality rate—originally around 2%, and more recently set around 3.4%—was being skewed by the stress placed on the health care system in hard-hit Wuhan. Other than the temporary relief provided by that adjustment in numbers in mid-February, the CFR value has trended slowly upward over time. And while it seemed to finally level off late in the month, the numbers have actually begun moving up again as the majority of new cases, and new deaths, move outside China. This is true despite the < 1% CFR achieved in South Korea. This … is not good.
Speaking of South Korea, it has been a model for how early testing and leading action can address even a significant outbreak and “flatten the curve.” But on Tuesday there was a bump in that good story as a cluster of new cases was located right in Seoul. Whether this represents a real threat to their good news story remains to be seen, but it is a reminder that under that curve are a lot of active cases, any one of which can easily spark a fresh outbreak.
When I started this chart of what’s essentially “the rest of the top 10,” it was dominated by countries in Asia that had acquired their original cases from China. There were also a couple of countries in the Middle East that had been seeded from Iran. But in the last week the story has become Europe plus the United States, because that’s where the real explosion of new cases is happening. At the bottom of this chart, the U.K. appears to be somewhat successful in at least holding down the rate of growth there, enough so that it has already been outpaced by Switzerland. But just assume this isn’t a great time to plan a European vacation. Even if you are feeling invulnerable and tempted by that $120 round trip to Paris, odds are that no one is going to be on hand to serve you crusty baguettes.
In this chart, the U.S. is a day behind its European ... is “rivals” the right word? In any case, this isn’t data being covered up. It’s just time zones.
The last chart today is one more look at a version of U.S. data that ran earlier. While this chart actually cut off when U.S. cases were at 994, at the time of writing we’re currently standing at 1,109. That’s actually good news. If America gets through Wednesday without topping 1,500, call it a win. It will at least be a sign that we may not be doomed to continue the doubling rate in Italy.
And finally, speaking of Italy. Oh … damn. The information coming out of Italy, and particularly northern Italy, is nothing less than horrific. When conditions in Hubei were at their worst, it was difficult to measure just how well their health care system was holding up. But Italy is far more open, and the answer is … it isn’t holding up. Despite heroic efforts, facilities and staff are exhausted to the point where terrible decisions are being made out of necessity. There are only so many hospital beds, only so many respirators. Even when every possible form of breathing device down to CPAP machines and oxygen bottles is dragged into emergency rooms, it’s still proving to be inadequate compared to the need.
We are not months behind Italy. We are no more than two weeks behind Italy. If you have a miracle in your pocket, this would definitely be a good time to bring it out. But considering how well hopes and prayers have worked for school shootings, do not take chances. Treat every trip outside your own door like you’re going into the Hot Zone. Don’t assume that because the reported numbers around you are low, that you can safely do … anything at all, really. It is not safe out there, and the disinformation coming from the White House and sources like Fox News is actively increasing the danger.
It’s not time to panic. But only because it’s time to act. If you’ve been planning, engage that plan now.