We are becoming a nation of reluctant mathematicians. Just as everyone’s tenth grade algebra teacher predicted, there really is a need to understand the basics of exponents and formulas. They just didn’t tell us that we’d be using those skills to measure out bodies.
In charts and graphs, tables and headlines, Americans are discovering a horrible new numeracy of mortality. A whole geometry of death. And we plunge into the cruelest month, we’re doing so with one eye on charts that suggest a grisly peak ahead, and a desperate hope for … hope.
Throughout the last weeks, as governors in the hardest-hit areas have begged for the necessary equipment to meet the wave that was already breaking over their communities, Donald Trump was there to suggest—or more than suggest—that the crisis is still being overstated. Not only has Trump repeatedly accused nurses of stealing protective gear, he has railed against governors for wanting ventilators. Right-wing media has been right there to help, circulating images of a pallet of ventilators in shipment to suggest that requests are meant to make Trump look bad rather than address a need, images of empty rooms in newly constructed field hospitals used to mock the effort of adding capacity, and Fox News creating an entire conspiracy theory over CBS News inadvertently including a scene from an Italian hospital while reporting on New York.
All of it is meant to back up the message Trump is still sending—governors and healthcare workers are making things sound worse than they are and asking for too much, all to make Trump look bad. That’s the the message that all of America is getting every day that networks choose to run Trump’s daily self-praise sessions, and it’s the only message being delivered to the Fox viewers of America.
New York Governor Andrew Cuomo may have seemed more than a little frustrated when trying to explain that building out capacity for tomorrow is the whole idea of planning rather than reacting. Because Cuomo is genuinely trying to protect the citizens of his state. On the other end of the dial, throughout this whole crisis both Trump and his followers have studiously avoided looking ahead. That’s what it means to constantly say that this crisis is smaller than the last flu season, or smaller than the H1N1 epidemic, or smaller than the 1918 epidemic, or … Black Death coming soon to a Fox station near you. What they mean is that it is smaller right now, if you ignore the facts, the math, the models, and the projections that show where things are going.
They’re not saying smaller than 9/11 anymore. Because it’s not.
So … here come some numbers, nation of graph readers and table watchers. Some of them look bad. Some of them look more hopeful. But there are reasons why neither should be taken all that much on face value.
With every day that passes, China slides down the charts. And with every day that passes, the unique position of the United States becomes more clear. Not only has the U.S. vaulted past other nations when it comes to the number of cases, it’s done so after coming from the middle of the pack, and it’s continuing to climb this chart at a rate that is absolutely unmatched. Even other nations that have cleared the “China line,” such as Italy, show some indication that their actions have wrestled the outbreak into something approaching a flattening of that awful curve. It’s difficult to see any clue that this is happening in the United States.
But here’s another look at the same data.
Viewed this way, it seems as if the United States has made all kinds of progress, going from the worst in the world to … still the worst in the world, but better. And that’s true. The United States is no longer stumbling blindly onward. Social distancing measures are having a genuine effect on the rate of new cases within the United States. Had growth continued as it was a week ago, the United States would already be looking at a quarter of a million cases … instead of “just” 180,000.
But the biggest factor driving values down at this point are things that happened two weeks ago, including suppression measures in Washington state, California, and particularly New York that, after a few days delay, had an impact on the current epicenters of disease within the United States. There’s also something else happening that’s easier to see by taking the total cases and doing what I try not to do—using a log scale.
I try to avoid using a logarithmic scale on charts most of the time because I suspect they’re confusing to people unused to staring at graphs all day. But in this case, the log scale shows something in the shape of the data that’s revealing. Take a look at the section of the chart that’s labeled as the “discovery” period. This is where you can really see the United States going from a period of being blinded by an absence of testing, to having greater visibility on what’s actually ahead. The curve of growth in the United States moves from “oh, we’re weeks behind those other guys” to “holy crap, we are ahead of them” over a period of just days, as tests roll out and numbers come in.
It’s no coincidence that this period matches the spikes of “growth” in the middle table, because that growth wasn’t so much a matter of new cases as discovering that the nation wasn’t where it seemed to be from the numbers displayed to that point. Now we have a much better sense of where we are and what we’re facing. As more screening and testing continues to roll out, the numbers will become better defined, but don’t expect there to be another new blob of unknown cases of this magnitude.
No matter how many times someone tries to tell you that there are millions of unknown cases floating around out there, or that they had COVID-19 a month ago without realizing it, or any variation on that … we know this is not true. The reason we know this is not true is simply this—viruses are brainless. There is definitely a percentage of COVID-19 cases that involve mild symptoms. But there is also a percentage that involve serious symptoms. If there had been a huge wave of cases through the nation days, weeks, or months ago … we would have seen it. It would have been visible in the kind of crushed healthcare system, refrigerated trucks lined up at the morgue sense that we’re seeing now. The disease is not “sneaky.” It’s horrific. But not sneaky.
That seems like enough eyeball-searing charts for a single day. However, there are a couple of things left to, unfortunately, sap any nice message that might have come from the rate of growth chart above. One thing is that additional testing in New York is continuing to turn up cases at a very high rate. A very high rate. Like more than half positive results rate. Which shows that not only aren’t things flattening out in New York, even the large amount of testing done there has not been sufficient to identify or isolate even a majority of those infected.
The really bad news is that New York is not hoarding supplies and not over-reacting. It’s going to need everything. And then some.
The other bad news is that there are dozens of other areas on New York’s heels following the same awful curve. These areas are on both coasts, but also in the middle of the nation. Many of these areas are only now getting around to putting in the kind of suppression measures that have been in effect for over a week in New York. Many of these areas do not have leadership that seems willing to impose necessary strictures. Some—universally states dominated by Republicans—seem hellbent on using their citizens as cannon fodder in some incomprehensible game. Governors in some of these states are following Trump’s lead in abdicating any responsibility and simply leaving it up to counties and cities to cobble together a desperate defense.
This will likely change, but it will only change when these states are so far up the rate of exponential growth that it will bring tens of thousands of unnecessary deaths.
In terms of how we go through this, there really are no answers that were not there from the beginning: Use social distancing to drive down the transmission rate of the virus, then use testing and isolation to drive it down even further until it can be lowered to the point at which new cases are appearing more slowly than people are recovering. Then keep on it until it is gone.
That is going to be made more difficult by Donald Trump, who has shrugged off any notion of providing federal guidance on how states should react. And harder still by Republican governors who are refusing to take action for … no reason that makes sense on this planet. The result is going to be a nation out of sync, where there isn’t a peak, but peak, after peak, after peak.
The efforts now underway in New York indicate that they are likely to pass a peak in April—during which time conservative pundits will be welcome to visit field hospitals and ICUs and see every scrap of equipment available put to desperate use. If other states uniformly clamped down now (or better yet, last week, or the one before that) the whole nation might also pass over a dreadful hump in the next month, suppressing the virus until testing and isolation really is adequate to take up most of the burden. Unfortunately, that show of responsibility on the part of conservative governors seems only slightly less unlikely than a modicum of responsibility from Donald Trump.