Luxembourg, Lichtenstein, Monaco, San Marino, Vatican City—there is no nation so small that it can’t fit in a case of the disease caused by the 2019 novel coronavirus. In fact, San Marino can lay claim to the prize as the most infected spot in the world per capita outside of China right now (having just 33,400 citizens helps with that). All of this may seem pretty trivial information about small, but not trivial, places. However, it’s just an indication of how genuinely universal the spread of 2019 novel coronavirus has become. Two weeks ago there were cases in 31 countries. Last week that number rose to 50. Now it is 96. Unless you’re living in Antarctica, there are cases of novel coronavirus near you.
That’s certainly true in the United States. At the time this sentence was being written, there are 234 confirmed cases in the United States, up by 70 from where the figure stood a day ago. Those cases are from coast to coast, and cases are being exported from the United States to other countries.
Now that number is 236. And counting.
Multiple times I’ve gone over the basic math of the 2019 novel coronavirus pandemic, but a question keeps coming up, so let’s do it again. And, helpfully, this time Bloomberg has also run the numbers, so we have a source other than my calculator.
Understandably, the question that everyone wants answered is simple enough: “If I catch the 2019 novel coronavirus, what’s going to happen to me?” And even more specifically, “Am I going to die?”
Right now, with over 100,000 cases out there in the world, the case fatality rate (CFR), the percentage of those cases that have already ended in death, is 3.4. That CFR is 10 times lower than the CFR of the related coronavirus disease MERS, but it’s over 30 times higher than the CFR of the seasonal flu. But of course, a lot of experts have disputed that 3.4% figure. Some have gone higher—after all, you don’t really know the CFR until after a disease has run its course, and if you compare the current outcomes, 5.74% of those who have reached the end of their time with this coronavirus have died. Some have gone lower—if there are cases out there not being caught, and we know that there are, then the CFR is actually lower than simple math suggests. If testing is only catching about half of the cases around the world, it’s actually 1.7%. If testing is only catching one case in 10, then the CFR is really 0.34%.
There are some good reasons to think that the “about half” number may be pretty close. Both in Singapore, which has been diligently transparent about every aspect of fighting the disease, and onboard the Diamond Princess cruise ship, which became an unwilling human petri dish, about half of cases had few to no symptoms. Bloomberg sets a lowest estimate value for CFR at 0.5%, a top at 4.0%, and a best guess at 1.0%. The initial estimate made by the World Health Organization was 2%. For the purposes of producing some numbers at the bottom of this, I’m going to run numbers for 0.5%, 1.0%, 2.0%, and 4.0%.
Side note: At this point in the writing, the number of U.S. cases is 239.
The next question is whether or not the coronavirus is contagious enough to spread as widely as the flu. The answer to that is: absolutely. Bloomberg sets the question as, “Could Covid-19 really spread as widely as the flu?” but that’s actually a serious underestimate of the potential. Flu may infect tens of millions of Americans each year, but flu is heavily constrained by existing immunity and the widespread use of vaccines. The novel coronavirus can be expected to infect 30%-80% of the total population. That’s much more than the roughly 10% of a bad flu year. But, for table purposes, we’ll look at 10%, 25%, 50%, and 75% infection rates.
So what kind of numbers do those generate? Well, they look like this:
Projected Deaths from unconstrained coronavirus
|
0.5% CFR |
1.0% CFR |
2.0% CFR |
4.0% CFR |
| 10% Population |
163,000 |
327,000 |
654,000 |
1,308,000 |
| 25% Population |
408,000 |
817,000 |
1,635,000 |
3,270,000 |
| 50% Population |
817,000 |
1,635,000 |
3,270,000 |
6,540,000 |
| 75% Population |
1,226,000 |
2,453,000 |
4,905,000 |
9,810,000 |
That sets the lowest projected value at about 10 times the number of deaths from seasonal flu. The number of deaths in the United States from the 1918 flu pandemic was between 250,000 and 650,000. So … that’s on the lower end of these numbers. These are the kind of numbers that the country is facing when stock market provocateur Rick Santelli says it would be great to just get everyone infected now.
It would be bad enough if it was just Santelli and his horn-honking, arm-waving competitors eager to burn a few bodies for the sake of Dow points. It’s not. Director of the National Economic Council Larry Kudlow was out there again on Friday telling everyone that he believes the coronavirus is “contained” and that it’s a real shame people aren’t traveling, attending conferences, going on with their lives. Take one more look at that chart: Every single day that this country lacks solid leadership and guidance at the federal level moves us more toward the right, more toward the bottom. Oh, and while even a number in the lower right corner may be “only” about 3% of the total population, that number of deaths might be a genuine existential threat to the U.S. government.
Also … it’s now 240.
COVID-19: Global case status
On Thursday, the total number of cases worldwide topped 100,000. That is something that was expected for some time, but, unfortunately, that number didn’t come at the top of an arc; it came as case numbers are just going up every. damn. where.The number of cases on Thursday doubled in nations around the globe and grew sharply in many regions, especially in Europe.
In the United States, the number of cases was almost as universal in its spread.
COVID-19: States with active cases
Off the coast of California, the Grand Princess cruise ship threatens to repeat the nightmare of its sister ship, the Diamond Princess. Over 2,400 passengers and 1,100 crew members from 54 different nations are stuck onboard after three people tested positive for COVID-19. The experience of the Diamond Princess showed just how impossible it is to prevent the spread of disease in such confined conditions over a prolonged period. And the alternative is … no one seems to have one. The case in Washoe County, Nevada, is connected to the cruise ship.
With the number of cases in Washington state reaching 75 and more deaths on Thursday, the University of Washington has decided to cancel all in-person classes for the duration of the crisis. Instead, it will offer remote learning in various forms, including online. Expect to see more decisions like this in the coming days. Similar choices have been made in multiple countries, and they have huge ripple effects.
Meanwhile, Las Vegas is pinned because it shows that the United States is also becoming an exporter of coronavirus, after a visitor to a convention there carried the disease home to Canada. These large international conferences are a really bad idea right now, no matter how much that hurts Larry Kudlow’s stock portfolio.
Speaking of international, you might notice that there’s not much of that in today’s recap. That’s because there’s plenty going on right here in the United States … which is not something to be happy about. In any case, I will catch up with the rest of the world tomorrow.
Finally, you may notice today that I’m once again using “2019 novel coronavirus” or just “coronavirus” more often than COVID-19. I embraced the use of COVID-19 when it was coined by the World Health Organization, as it differentiated this disease from the large number of common coronavirus diseases (including about 15% of chest colds). But the name had problems from the beginning. Giving the disease a different name from the virus meant that articles were constantly struggling with terminology such as “COVID-19, the disease caused by the 2019 novel coronavirus.” Also, having that hyphenated number in there made the name clumsy from the outset. It’s also a word that the Associated Press guidelines insist should always be ALL CAPS, even though it’s clearly a portmanteau, not an acronym. Dammit, AP.
In any case, COVID-19 seems to have caught on nowhere. It will almost certainly continue to appear in technical papers, and nowhere much else. So, for the sake of people doing casual searches, I’m making more use of “coronavirus,” even though I will continue to use COVID-19 in tags and occasionally in articles. Expect more use of the much less precise but more common coronavirus.
