I recently became a 3rd grade teacher. During a math lesson with my 9-year-old, it struck me that the response policy to Covid-19 seems to be based on a misunderstanding of how division works. This error caused projections for fatalities that were off, astronomically so, and resulted in policies that induced not just an economic, but a societal collapse. One of the many consequences will be a significant increase of class division in America.
So far, this error has not been exposed to the national populace because the fear machine is still running full throttle; social shaming is currently encouraged against anyone not wearing a mask in public. In the near future, however, the fear machine will run out of gas. The 16 million newly unemployed (so far), the victims of mental health, domestic abuse, and child abuse during this government mandated quarantine, and the broader middle class and working poor whose lives will not experience a V or even U shaped recovery, are going to ask, “was it all worth it?”
The answer will inflame the resentment the “have nots” hold toward the “haves” and accelerate a brewing populism that has been relatively silent since November 2016.
In order to understand why people are going to be so angry, it is important to spend a minute reviewing the magnitude of the error itself. Death rate projections assumed a numerator (fatalities) and denominator (people infected), and the experts implemented that ratio without having any idea how many people were infected before we started counting.
The denominator in their math equation does not account for the people who were possibly infected by the 430,000 who traveled from China to the US since the virus outbreak (with many being direct flights from Wuhan to New York, San Francisco, Los Angeles and Chicago.) And it does not account for the millions who came in from Europe prior to March, when we started counting.
We were first told that without immediate enactment of a national stay-at-home policy never before attempted in the history of the country, millions of Americans would die. On March 16, Imperial College published a study projecting 1.7 million to 2.2 million deaths in the US, but also said that projection could be reduced to 1.1 million if suppression measures were immediately put into place. The study recommended, “a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closure.”
Within 48 hours of this study being published, the governors of California and New York had instituted containment policies from stay-at-home to shelter-in-place, which were far more stringent than that recommended by the study, and within a week 98% of America was under some sort of stay-at-home restriction.
New York’s Governor Andrew Cuomo has achieved celebrity status during the crisis. His daily press briefings have become a national sensation, and now many Democrats are wishing for a do-over of their presidential primaries. Not only has the Governor demonstrated tremendous leadership of and advocacy for his state during the crisis, he has also shown that he is not afraid to challenge the president, shouting at him during a March 24 press conference, “you pick the 26,000 who are going to die” because he only sent 400 ventilators.
In that same March 24 press conference, Governor Cuomo said they now knew that the apex of the virus “would be much higher than we thought.” He then gave an update on critical needs:
In addition to the 30,000 ventilators that would be needed at peak, New York would also need 140,000 hospital beds (had only 53,000 at the time) and 40,000 ICU beds because, as the Governor conveyed, “We haven’t flattened the curve, and the curve is actually increasing.” He then urged the Federal government to prioritize their support funding and resources to his state over others, with New York City representing the epicenter of the outbreak.
The Institute for Health Metrics and Evaluation (IHME) at the University of Washington is the noted authority for tracking and projecting the Covid-19 outbreak and is widely believed to be the primary source utilized by both state and federal government leaders when they consider Covid-19 response policy.
According to the IHME, ventilator usage in New York peaked three days ago, on April 8, at 5,000 ventilators (not 30,000.) ICU bed usage peaked just under 6,000 (not 40,000) and total bed usage peaked under 23,000 (not 140,000).
Not to single out just Governor Cuomo. No health care specialist or government leader to publicly announce a death estimate has been even close. The Imperial College projection of 1.7-2.2 million (1.1 million with suppression) was…off by 1.04 million. Dr. James Lawler, an infectious diseases specialist and public health expert at the University of Nebraska Medical Center, projected a Covid-19 death count of 480,000, the same as cancer, on the day the Imperial College published their estimate (March 16).
Two weeks later, March 31, White House Coronavirus task force response coordinator Dr. Deborah Birx projected a “best case scenario” of 100,000 – 240,000 US deaths if curve flattening measures were closely adhered to by all Americans. On April 2, the IHME updated their projection to 93,531. On April 5th the IHME updated their projection again, to 81,766. On April 9 Dr. Anthony Fauci told the “Today” show the death count “may look more like 60,000.”
Apologists will defend Governor Cuomo as well as the specialists whose projections were so astronomically off by arguing that the curve flattened faster due to the adherence of those stay-at-home and economic shutdown policies.
But that is not true.
On March 24, Governor Cuomo said the opposite, in fact. He reported that stay-at-home was not working, that the curve was increasing, not flattening, and that 26,000 New Yorkers were going to die because the President wasn’t sending enough ventilators. The data that caused him to make this declaration was an increase in test availability, which led to a massive spike of infected cases during that week. My third grader has completed his math assignment and can now explain the mistake the governor made.
The fatality rate being used to forecast how many of those new active cases would lead to death was…not even close.
Policy makers had, and still have, no idea what the real infection rate or death rate was or is. The death rate of tested and confirmed cases that have been reported is 4.6% in New York and 0.8% in Utah. Still unknown are positive cases not tested, tested but still awaiting results, or people who already had it in December, January, or February, have recovered, and now carry antibodies (denominator). And we still don’t know the fatalities from before we started counting (numerator).
But this flawed fraction is still being used today to forecast infections/deaths and make policy.
In a vacuum, it was for the best. The spread of the virus to places that had not already been exposed since January (smaller urban centers, suburban, and rural communities), was most likely delayed. Families with financial security, job security, a long-term lease or mortgage on their residence and a Netflix account have been inconvenienced, but life will get back to normal for them without too much permanent damage.
Families that don’t have those things have been destroyed.
Stay-at-home policies, which are based on this math error, are still being extended today.
The “haves” are “standing divided together,” providing Instagram tutorials for how to make a mask at home, while relaying to each other what they saw on TV that “stay home!” measures are working. But the “have nots” are sitting on state unemployment websites that keep crashing while waiting for their $1200 stimulus check that still hasn’t come, so they don’t have to choose between buying food for their kids or making their minimum credit card payment.
At some point these forgotten classes are going to start asking policy makers, “wait…what? Why?” and they are going to be extremely disappointed with the answers they are given.
The IHME now projects that the daily death count for California’s 40 million people will peak on April 13 (at 65/day) and that by May 1, only 995 of the 26,554 hospital beds available in California will still be needed for Covid-19. By May 1, IHME estimates, the virus will have long since been (statistically) unnoticeable to California’s health care infrastructure. What’s more, a recent study indicated that school closure has little to no impact on preventing the spread of Covid-19.
But on April 1, the day after the “100,000 – 240,000 best case” death count was announced, Governor Newsom announced that California’s 6 million K-12 public school students, who have been out of school since mid-March, would remain out of school for the rest of the year. It added all of April, May, and some of June. Today the expected national death count has been reduced to “around 60,000,” but for California, the IHME now projects 1,616 total deaths, and for Covid-19 to be statistically unnoticeable by May 1. No update to the school year closure (all of May and June), impacting 6 million California kids and their families.
Inconvenient for “haves.” Deeply problematic for “have nots.”
A headline on April 9 – unimaginable two months ago – read, “S&P 500 finishes best week since 1974 as jobless claims exceed 16 million.” It is not easy to reconcile those two facts from the perspective of someone who has merely been inconvenienced by it all. The “have nots” could explain it, but they continue to have no voice in the national narrative.
I suspect we will hear from them in November. Again.
Joe Voboril is the co-founder and managing partner of Farvahar Partners.