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COVID-19 is a cruel disease. It preys on the old and vulnerable, while most young and healthy people can shrug it off. But the virus is also unpredictable. Youth is no guarantee, and young and middle-aged people die, too, even if it’s rare. And, COVID is a lonely way to die, in an isolation ward, hooked up to a respirator, separated from family and friends. Over the past five months, 160,000 people in the U.S. have died, and millions of family members and friends have been shattered by their deaths. It’s no wonder we are afraid of COVID-19 – either catching it ourselves or giving it to friends or loved ones. It’s no wonder many of us aren’t shopping at stores or planning vacations. Or that we are short-tempered when we see people being careless about social distancing or masking.
The Good News
However, there is growing evidence that we may have turned the corner, and that, with care, we will see the virus recede over the next couple of months. This is not true for all parts of the country, but it is likely true for most. The virus may resurge in the fall, of course; no one knows for certain. But some parts of the country may have reached herd immunity (e.g., New York City), and most of the rest of the country, except perhaps California, is headed in the right direction.
This assessment is based on the trend of COVID-19 hospitalizations. Hospitalizations are the best indicator of the severity of the pandemic, because they are not confounded by testing bias and are highly correlated with COVID-19 deaths two weeks later. Despite the uptick in cases in July in the South, the pandemic’s severity is less than in late March and early April. The following chart shows hospitalization trends for six states and the US overall for the last four months.
In April and early May, New York, New Jersey [not shown], and the District of Columbia had the highest levels of COVID-19 hospitalizations on a per capita basis. Texas, Arizona, Florida, and other southern states surged in June and July, although their hospitalization rates never approached the levels of New York, New Jersey, or DC. By late July, hospitalization rates in these states began trending down again. Meanwhile, COVID-19 hospitalizations and deaths reached new lows in New York, with only 3 deaths recorded on August 3.
A similar pattern is evident in the rate of positive tests, as shown in this chart from Johns Hopkins Coronavirus Resource Center, although this measure is confounded by rapid growth in the number of tests we are doing.
These charts probably surprised you. The media would have you believe that COVID-19 is an out-of-control epidemic that is engulfing the country. As the New York Times put it a week ago, “…the coronavirus caseloads continued their brutal rise in the South and West.” This week, Mayor de Blasio of New York City ordered vehicles from 34 states and Puerto Rico to be stopped at bridges and tunnels into Manhattan to enforce a 14-day quarantine. (This is a little ironic, since none of the states have had outbreaks nearly as severe as New York’s initial outbreak.)
90%+ of the media are Democrats, and reporting on the virus is hopelessly conflicted because of their desire to drive President Trump out of office. To bolster their case, they misuse statistics in order to keep everyone scared. For example:
- Most report cumulative statistics, which are always increasing. We hear a lot more about “confirmed cases,” which are cumulative and never go down, than “new cases.”
- Case counts, both new and confirmed, are confounded by our rapidly expanding testing program. The more tests we do, the more confirmed cases we will find, even if the virus is stable or shrinking.
- As always, the media reports on the hardest hit areas, ignoring what is going on in the rest of the country.
Democrats and the media attribute the rise in cases in Southern states to irresponsible behavior by red state “deplorables,” aided and abetted by President Trump and Republican governors who have failed to “show leadership” in keeping businesses shut down and ordering everyone to wear masks.
There is an alternative explanation – namely, that this is the normal course of the virus across a large, diverse, and mobile country and that the initial spurts we experienced in New York, Detroit, New Orleans, etc., were outliers due to our delayed response to the seriousness of the epidemic. Back in mid-March, The New York Times published state-level projections for the pandemic under different “lockdown” assumptions that were developed by a team of epidemiologists from Columbia’s Mailman School of Public Health. This study, which was based on county-level data, made the following projections for New York, Arizona, California, Florida, Texas and Alabama:
In their words, “The coasts are likely to get hit early, but the infection rate is much lower and later if control measures are imposed… Counties in the country’s interior will mostly see infection rates peak later.”
These projections fit the actual experience of the states fairly well. New York’s cases peaked earlier than projected in the “no controls” case, perhaps because of the decision to discharge sick COVID patients to nursing homes. Southern states peaked about a month later than projected in the “some control measures” case, but this may have been because they implemented more severe controls than the ones the researchers modeled.
An important general point of the Columbia study is that control measures flatten the curve, but they also push the peak of the epidemic later. California, which has been one of the most controlled states in the country, kept its curve relatively flat for several months. But the virus hasn’t gone away, and California is one of the states that has seen a recent resurgence. Another example is Florida, which took aggressive early action to lock down long-term care facilities. These actions succeeded in flattening the curve for nursing home residents for months. Unfortunately, however, deaths in Florida’s nursing homes are now rising. As one nursing home operator explained, “We have essentially set up the closest thing to a virtual COVID wall, but what you can’t control is friends and family of caregivers.”
As awful as COVID-19 can be for vulnerable people, the trajectory of the virus is reason to hope that this epidemic may be winding down. Clearly, we are not out of the woods, and careless activities could spark a resurgence. But if we continue to take reasonable precautions, we may have seen the worst of it, vaccine or no vaccine. Then, all we will have to deal with is the economic and social fallout, which has been at least as devastating.