Coronavirus Trend: One in 10 of Those Hospitalized Die

Mish

US coronavirus stats posted new grim results today. Hospitalizations are of increasing concern.

US Jumps Over Italy and China in Number of Cases

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According to Worldometers, the number of US cases topped those in China and Italy for the first time today.

Hooray, We're Number 1?!

Covid Tracking Project

On March 22, I started a series of charts based on data from the Covid Tracking Project.

My trendline at the time suggested we might hit 100,000 cases today.

On March 22, I received an email accusing me of hyping the data because "It is not presently feasible to get to 100,000 cases in the US by March 26th."

The email also stated "These publications do more to incite hysteria and grab clicks than they provide any basis for decision-making."

Here is my March 22 post: Covid Tracking Project: How Long to 1 Million US Cases?

The amusing thing about my initial post on this data series is my specific statement about trends.

"Those are not my projections, those are observations of what would happen if the current trends last that long at the same pace."

2020-03-26 Observations

We did not hit 100,000 cases today. However, it is a near lock that we do so in the next three days.

Moreover, the data I posted is as of 4:00 PM Eastern. Other sources show we are at 83,672 for today, March 26.

That is about 1 day away from what the trend suggested on March 22.

The original trendline I posted is still close to intact. The US will hit 100,000 cases within a couple days.

New York

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New York Trends

New York is likely to hit 1,000 deaths by the end of the month.

If the trends hold for a week, New York will top 10,000 deaths by April 3. That is not a prediction, it is a projection based on current trends.

The NY death trend is undoubtedly high as it is ahead of the entire US. The US trends are far more likely to be accurate than the US trends.

US Trends

On March 22, the trend for 1,000 US deaths was today. Unfortunately, we hit 1,209 deaths today. (So much for that email of accusing me of hype).

The March 22, the trend for 10,000 US deaths was April 5. Today the trend suggests 10,000 deaths by April 7.

The death rate has accelerated, and if you look at the slope, I downplayed the jump (the last 7 data points are all above the line I drew). Thus, April 7 might be optimistic. An alternate trendline suggests April 4, still in line with the March 22 trend.

Either way, the people accusing me of hype owe me one huge apology.

Hospitalization Trends

The critical trends are not deaths but hospitalizations.

We are overloading hospitals right now at 10,000 cases. The trend suggests we could hit 100,000 hospitalizations by April 5.

Without a doubt, that will blow hospitals out of the water.

New York Out of Beds

Louisiana Out of Ventilators

Guess who forgot to shut down Mardi Gras.

Alabama

What About Gowns?

Please note New York Nurses Out of Medical Gowns Wear Trash Bags

Cuomo to Trump "You Pick the 26,000 Who Will Die"

I discussed hospital bed and respirators in Cuomo to Trump "You Pick the 26,000 Who Will Die"

Rhode Island Afraid of New York

Go to New York for any reason then back to Rhode Island and you are subject to a 14-day quarantine.

For details, please see Rhode Island Restricts Travel to New York.

Conspiracy Theory

Every day, I still have people telling me this is No Worse than the Flu™

They side with Trump.

This a Conspiracy Against Trump led by Blue State Governors and the media. Just send everyone back to work and don't worry about it.

It's still just one big lie. Deaths are exaggerated.

And most importantly, this is No Worse than the Flu™.

Few are dying.

We are at 15 cases, soon to be zero.

Hello Trump Faithful and Conspiracy Believers

Her is my reply again: Hello Trump, It's Not a Media Conspiracy, It's You

Meanwhile, please watch that trend of hospitalizations.

We are out of beds in many places and will be 100,000 beds short possibly in a week.

Acute Care Hospital Beds

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If you want to be 1,000,000 beds short, then hell, just send everyone back to work.

Meanwhile, please note: The current trend suggests that roughly 1 in 10 of those hospitalized will die from the virus.

Well, maybe that trend is wrong.

Carry On!?

Addendum

The NY trends are more than a bit quirky.

I added this comment above "The NY death trend is undoubtedly high as it is ahead of the entire US. The US trends are far more likely to be accurate than the US trends."

A Word About Empty Statistics

Mike "Mish" Shedlock

Comments (125)
No. 1-50
njbr
njbr

The sickest of the sick admitted to hospitals. 10% die.

And that 10% is based on still-functioning hospitals. When there is partial staffing due to illness (due to lack of PPE), and no ventilators available, and perhaps no beds--what do you think the death rate will be then?

Google the phrase "pest houses".

Casual_Observer
Casual_Observer

I think most people around the country get it now or have at least sobered up. We know by now Trump isn't the President you really want in this type of crisis scenario. You need someone who is a bit more sober and lot less political. There is going to be a lot of pain, heartache and death in the coming weeks. I would not wish this virus on anyone as it has become more unpredictable and erratic in how it affects people of all ages. I'm hopeful that they are able to get a treatment protocol that works very soon or that the virus starts dying off because of the warmer weather. No country has the sheer capacity to handle tsunami that is coming as no system was setup for this type of pandemic.

Mish
Mish

Editor

About that alleged UK improvement touted moments ago to my last post ....

Unfortunately pictures not uploading still. Here is a link to a 4-part Tweet

2/4 -This is not the case. Indeed, if anything, our latest estimates suggest that the virus is slightly more transmissible than we previously thought. Our lethality estimates remain unchanged.

Tengen
Tengen

Was reading a ZH thread yesterday where groups of people were calling the virus a hoax, with a high like-to-dislike ratio. Interestingly, that same thread also doubled as a Flat Earth circle jerk, with similar numbers of likes on those comments.

People are going to call the pandemic a hoax to the bitter, bitter end. Admitting error is verboten in our culture, so they'll be doing Kevin Bacon "all is well" impressions the whole way. It's all a big conspiracy against Trump by the blue team, the media, and the Chinese, Russians, Iranians, Europeans, Israelis, Turks, Indians, and everybody else. If only they'd get out of the way Trump could MAGA!

Quatloo
Quatloo

13% who gets the virus need hospitalization, 10% of those die, for a 1.3% death rate of those who are infected.

BoneIdle
BoneIdle

According to the CDC, there were 80,000 deaths in the US during the 2018 flu season.
Projections for the 2019-2020 season were between 29 and 59 thousand.

I know this Covid19 - SARS- COV2 is not the common flu, however are deaths from Covid19 being lumped in with common flu deaths?

During 2019 there were 89,000 deaths attributed to diabetes (death certificates)
Approx 10-11% of US citizens have diabetes - a high risk group for Covid19.

That’s for some perspective.

We can’t see what sort of death statistic that will eventuate at the end of this virus cycle.

If you look at the world meters corona virus site you can see the Column for Cases with an outcome. Recovered and deaths.
That’s the important statistic. The death rate is currently 16%

tokidoki
tokidoki

Hei Mish, are you conflating the New York and US Trends? Take a look at the 10k number of deaths. Perhaps I am reading them wrong.

Mspehn
Mspehn

Possible to bury with a bulldozer as in past wars.

truthseeker
truthseeker

I was just listening to Chris Martenson a guy whom I greatly respect, who said it took the Czech Republic just 10 days to get absolutely everybody to wear a mask, and it reduced the number of infections dramatically! Check it out. His report is for today.

pvguy
pvguy

Mish and Karl Denninger are on totally opposite sides on this, which is kind of unusual.

Realist
Realist

The mortality rate for this virus depends on many variables. In most developed countries, which have the proper pandemic response systems in place, ideally, you could probably manage the spread efficiently for the 9-18 months it typically takes to come up with an effective vaccine. With an effective response, you could probably keep the mortality rate below 1%. And you wouldn't have to shut down the economy.

However, things are rarely ideal. Most countries seem to have been unable to respond quickly and effectively. As a result, an isolation strategy, and the resultant economic shut down, is required to prevent a rapid spread. If a country can successfully stop a rapid spread, it can prevent the health care system from being overwhelmed. If a country can achieve this, they can probably keep the mortality rate below 2%. The cost is high, economically.

If you can't stop the spread, then the health care system overloads and the mortality rate begins to skyrocket as physicians sacrifice the old, to give ventilators to the young. 5-10% is possible. In this case, the economy craters and the cost is many times greater than the cost of a short shut down.

If the US opts for a only a partial shut down, it will be a lesson to future generations of what not to do.

AWC
AWC

One way or another, this will run it’s course. As Fauci, the only person out there with any sense stated, Trump doesn’t decide the timeline, the virus does. Deal with it, or deny the facts,,,the virus doesn’t care either way.

Helene84
Helene84

New York Gov. Andrew Cuomo said Thursday that his stay-at-home order for the entirety of New York State was “probably not the best public health strategy.”

In a press conference in Albany, Cuomo said the smartest way forward would be a public health strategy that complemented a “get-back-to-work strategy.”

If you rethought that or had time to analyze that public health strategy, I don't know that you would say quarantine everyone,” Cuomo admitted. “I don't even know that that was the best public health policy.“

Cuomo stressed the need for both public health and economic growth. “We have to do both,” said the governor. “We’re working on it.”

Mish
Mish

Editor

Addendum

The NY trends are more than a bit quirky.

I added this comment above "The NY death trend is undoubtedly high as it is ahead of the entire US. The US trends are far more likely to be accurate than the US trends."

Mish
Mish

Editor

I also added a possible alternate trend line for US deaths on the lead chart

Rookie57
Rookie57

I have noted that Oxford University reported that 1 in 1000 COVID 19 infected people are hospitalized. If Mish's 1 in 10 hospitalized people die, then by my math 1 in 10000 infected people die using Mish's and Oxford's conclusions. Is my math correct? Does it coincide with the reported mortality rate? Seems lower than the reported mortality rate.

tokidoki
tokidoki

"The death rate has accelerated". I was optimistic a few days ago that this would not happen, but it has :(

Also the day is not over yet, so by tomorrow morning, the US might actually be at 100K. Next week will be brutal.

egilkinc
egilkinc

Less than 1 month from when he said, "One day it's like a miracle, it will disappear", Trump has Made America The Greatest!

QE2Infinity
QE2Infinity

Ron Paul, a medical doctor, was one who played down the virus. But that was early, I think many have adjusted their perspective as more facts have become known.

wootendw
wootendw

"This a Conspiracy Against Trump led by Blue State Governors and the media."

When I was young, I only knew of two conspiracy theories - those of John Birch (Society) and Lyndon LaRouche (USLP). I didn't buy into either but since I started commenting on websites around 2006 or so, I have often been called a 'conspiracy nut' or 'tin hat' for questioning official government pronouncements, especially about things like Saddam's WMDs or Assad's CWs, etc.

I was right about the 'WMDs' but I doubt the government will ever admit to lying again even though it will still be lying.

Most people in government, (if not everyone) are utilitarianists - people who believe that the 'greater good of all' is more important than the rights of the individuals (the ends justify the means).

It's okay to infringe on the rights of a 'small' number of (obnoxious) no-sayers if it serves the 'national interest', 'public interest', 'common good', etc. Utilitarianism is the 'ethical' basis for military conscription, eminent domain, taxation, war, communism and other bad things. It is even the 'ethical' basis of good things like libertarianism and free markets.

Before one accepts utilitarianism, just remember that the 'national interest' isn't what you think it is; it's what those with political power say it is and it is the rights of you, your family or friends that will be sacrificed for it.
That will be a bad thing, but the government people will actually believe they're doing good.

CautiousObserver
CautiousObserver

There was a significant communication error today by Dr. Deborah Birx regarding Neil Ferguson's data presented in UK. She apparently missed that Ferguson's lowered mortality estimate applied to a lockdown scenario and his model was not revised lower with respect to uncontrolled spread of COVID-19. I watched her segment several times to make certain I did not misunderstand what she said. Birx suggested the potential spread of the virus in the UK was less aggressive than modeled, but according to Ferguson in the tweet referenced by @Mish, this is definitely not the case.

Regarding an accurate case fatality rate, the best case is probably represented by South Korea who did an excellent job of testing for and containing their outbreak (final CFR about 3%). The worst case so far is probably Italy (CFR of about 20%, assuming severely ill victims die about 7 days after hospitalized and tested). Italy's actual CFR might be substantially lower if a large segment of their population was infected and recovered on their own without being tested. I think it is safe to say Italy's all inclusive CFR in hindsight will still be worse than South Korea, even after accounting for cases not tested.

In the US, it is apparent that SARS-Cov-2 is highly contagious as has been forecast by Mish and others, and the CFR will be between 3% and 20%, depending on the population density and medical care provided. Uncontrolled spread should not be allowed, because about 75% of the US population would be infected and about 3% of those infected would die (best case based on South Korea).

Although many social gatherings in the US are now shut down, I still see photos of parks full of people and I still see almost no one in public is wearing masks in places such as grocery stores and hardware stores, so presumably the virus is still actively spreading. The final Worldometers count for 3-26-2020 is 85,435 total cases with +17,224 for the day. It looks like Mish's 100,000 forecast will be very close (within 24 hours).

As of today, the US still looks to me like the next Italy. Sad situation.

Carl_R
Carl_R

This sentence is not what you intended "The US trends are far more likely to be accurate than the US trends." I suspect you meant that US trends are more likely to be accurate than NY trends. I'm sure that NY death rate is about to shoot much higher as they have reached capacity. New Jersey will probably reach that point by Sunday. Louisiana is in third place, probably a week away from a rising death rate.

Here are the states with the most cases per 1/m population as of today:
New York 1999, grew 18% today
New Jersey 773, grew 56% today
Louisiana 496, grew 28% today
Washington 422, grew 24% today
DC 376, grew 16% today
Mass 350, grew 32% today
Michigan 286, grew 24% today
Conn 283, grew 16% today
Vermont 255, grew 28% today
Colorado 248, grew 32% today
Illinois 200, grew 36% today
Mississippi 163, grew 29% today

Once a state reaches 1-2000 per 1m, the death rate goes up because the hospitals can't handle the flow.

Carl_R
Carl_R

I saw a new theory today about a method of transmission. I repeat this for information only. I have no idea if it is correct or not, but it was proposed that the virus can be found in the urine, and that when a urinal flushes, the virus is aerosolized. If true, you could easily inhale it, or it could get in your eyes. Also, when you dry your hands with a blown air dryer, it would be deposited on your hands.

Pat789
Pat789

Looking at the chart listing the number of Corona Virus cases and deaths in the US compared to other countries and especially CHINA.......CHINA is definitely lying about the number of cases and deaths they had. They have been irresponsible from the get go.

FloydVanPeter
FloydVanPeter

Suppose 50% of population gets infected, 10% of them needs hospital care, 10% of these die, then CFR is about 1% (or 0.5% vs the whole population).

This virus forces emotionless rational choices where it hits hard. Consider Italy that denies treatment to older individuals due to the the small chance they recover (so they don't occupy resources that are likely to save less-old people).

Sechel
Sechel

Apparently its fake news. Trump says NY doesn't need 30,000 or 40,0000 ventilators. Says he's never seen a hospital need more than 1 or 2

JonSellers
JonSellers

Mish and his crazy math. Everyone knows mathematicians are just using this hoax to get free money from the government. I know of a number of mathematicians, some as young as 7, who can show that Mish's numbers are all wrong and are more in line with the President's. This is just a conspiracy by liberals to take away our guns, take control of the economy, and turn America into another Venezuela.

sspinner
sspinner

Unfortunately your # are too rosy (or you're making them look too rosy by rounding down to the nearest round #). My, conservative, estimate is 10,360 on 4/4 & 20,720 on 4/7. If we continue at the current pace of the last 6 days we're at 15k on 4/4 & just under 35k on 4/7.

WildBull
WildBull

We need a couple million beds and respirators if there is no other treatment available.

WildBull
WildBull

Someone please calculate the number of respirators necessary to handle this in a year or less. Big clue, it is bigger than 140000.

njbr
njbr

Trump on the subject of ventilators last night....

...In a Thursday night interview with Sean Hannity, Trump dismissed the pleas for more ventilators by governors like Andrew Cuomo. “A lot of equipment is being asked for that I don’t think they will need,” Trump said. “I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they are going to be. I don’t believe you need 40,000 or 30,000 ventilators. You know, you go to major hospitals, sometimes they’ll have two ventilators. And now all of a sudden they’re saying, ‘Can we order 30,000 ventilators?’...

WildBull
WildBull

The questions to predict when this can be over with everyone getting good treatment are:

What percentage of the population will catch c19?
What percentage of those will need a ventilator plus support equipment and personnel?
How long will each need to be on a ventilator?

With this data, it is possible to calculate the number of ventilators needed to support the case load in any particular period of time. I'm sure that there is data to support an answer to each of these questions. Someone has done the math. All we hear is crap. Please, government weenies, tell the truth, make a plan, set a goal. Let us know what it is so that we can be prepared.

Cajundoug
Cajundoug

One thing that I haven't heard discussed is how the time lag between cases being reported and those people dying would affect the rate calculation. It seems to me, to find the correct rate, you should divide the number of deaths by the number of cases reported at today minus that time lag. With an exponential growth of cases, this could make a big difference.

Sechel
Sechel

what's alarming is how many of those needing hopsitalization are under 40. While they live its not like getting the flu, and its not like you go through a process and are fine as someone said

njbr
njbr

Donald J. Trump

@realDonaldTrump
Just finished a very good conversation with President Xi of China. Discussed in great detail the CoronaVirus that is ravaging large parts of our Planet. China has been through much & has developed a strong understanding of the Virus. We are working closely together. Much respect!

229K
12:19 AM - Mar 27, 2020

njbr
njbr

Federal support for Ford/Ventech ventilator project scrapped so other options can be examined...

NewUlm
NewUlm

Please put the 1-10 hospital admissions in context. So, yes 10% is the trend, if you head over to the CDC website and check out flu admission, do the math its 6-8% for a given year for admissions to death. Is this worse - Yes, but is it 10x worse - Not based on admissions. Here is the link: https://www.cdc.gov/flu/images/about/burden/printable-tables2-17-18.pptx

Plus, we still don't have denominator aka the ability to test for sickness or antibody testing, to enable mapping. Until then, fear and speculation will rule the day. Once we can map cases, the predictions will get wildly accurate.

kilroy
kilroy

Great info Mish! Any reason you deleted your comments from the earlier edition a couple of hours ago? I think they are informative and some sarcastically entertaining.

njbr
njbr

Still people with the same as any "ordinary" flu messaging...

Early days still in the US....that's all that can be said for now. We're just entering into the peak phase.

It this is "ordinary" flu, don't you think it odd that there never was any record before of hospitals being overwhelmed with "ordinary" flu, such as is being reported throughout the world?

How would you respond to that...the evidence of the reports from around the world presented at your feet?

Mis-perception? All in our over-active imagination?

WildBull
WildBull

I'll ask again, does anybody know how many ventilators are needed to treat all the patients that need them in a particular time period? In other words, how flat does the curve have to be. Here are some numbers, perhaps. If anyone has better data, please let me know.

A respected epidemiologist estimates that about 2/3 of the population will get C19. In Korea, where everyone gets treated, the death rate is about 1%, in Italy it is about 6%. So we might assume that 6% of the victims need a ventilator... This is a WAG on my part. Again, does anyone have better data? If each patient needs two weeks on a ventilator, that is 26 patients per year per ventilator. If 6% of 220000000 in the US need ventilators for two weeks each, we need a few over 500,000 ventilators to accommodate all that need one. This assumes the load is flat over a full year.

Does anyone have better data? Someone please refute this with math and real data.

There will be riots. D

njbr
njbr

Abstract: Lack of evidence on SARS-CoV-2 transmission dynamics has led to shifting isolation guidelines between airborne and droplet isolation precautions. During the initial isolation of 13 individuals confirmed positive with COVID-19 infection, air and surface samples were collected in eleven isolation rooms to examine viral shedding from isolated individuals. While all 15 individuals were confirmed positive for SARS-CoV-2, symptoms and viral shedding to the
environment varied considerably. Many commonly used items, toilet facilities, and air samples had evidence of viral contamination, indicating that SARS-CoV-2 is shed to the environment as expired particles, during toileting, and through contact with fomites. Disease spread through both direct (droplet and person-to-person) as well as indirect contact (contaminated objects and 20 airborne transmission) are indicated, supporting the use of airborne isolation precautions.

One Sentence Summary: SARS-CoV-2 is shed during respiration, toileting, and fomite contact, indicating that infection may occur in both direct and indirect contact.

Sechel
Sechel

china got wuhan under control by sending 40,000 doctors from around the country into the province. a very strong directed action. we're not doing that with ny

abend237-04
abend237-04

It appears to be one in ten overall presently, but if you're over 65 and have an existing health issue, then when you show up in ICU with this thing, your odds of dying are roughly 50/50 and you'll be on a ventilator when they pull the plug after it grinds down your immune system for a week or two.

Absent a vaccine, the trick seems to be staying out of ICU. The only purely prophylactic regimen that I've seen targeting the most vulnerable, with symptoms, is by Dr. Zelenko, north of New York City.
It appears to be working, based on several hundred being treated who are NOT going to ICU, NOT being hooked up to respirators and, most importantly, Not dying. He's simply aiming at keeping the viral load down.
Had The Donald not publicly endorsed one of the antivirals being used by Dr. Zelenko, I'm convinced Hydroxychloroquine, Azithromycin and Zinc would now be routinely used to manage this crisis. Maybe they are; Dr. Zelenko says he's beginning to run low.

WildBull
WildBull

@Sechel I've noticed these numbers, too. I don't think so many Americans under 40 are very ill because Americans are more susceptible to the virus. I think that many times more people under 40 have the virus than is believed by the experts. Our society is much more stratified by age than China. It has probably spread like wildfire for months through school, daycare and work before Grammy and Grampy ended up in the hospital. This would be very good news, as we may be much closer to the peak than anyone suspects.

effendi
effendi

The 13% figure of requiring hospitalizations is wrong. It is much lower than that as 90%+ of those infected don’t appear in the stats as they are either asymptomatic or have very mild symptoms and are not tested. So the real infection rate is in the millions and the severe cases as a percentage of that is much lower. Sucks for those tens of thousands who will die but then again more than that die each year from the flu, plus most of those who die are already ill and elderly and had perhaps only a year or 2 cut from the end of their life. Does this warrant millions being made bankrupt and homeless by the shutdown? Will it be worth it in the many thousands of suicides the ruin will cause or the increase in family breakdowns, divorce, abortions etc etc.

WildBull
WildBull

@effendi
I believe that you are right about the under counting. Also, it's been here longer than is thought.

JohnH
JohnH

Excellent article and video from Dr John Ioannidis from Stanford University.

Brief article:" In the coronavirus pandemic, we're making decisions without reliable data".

1 hour video - worth watching! "Perspectives on the Pandemic with Dr John Ioannidis of Stanford University".
He presents some well thought out perspective that is worth considering. https://www.youtube.com/watch?time_continue=3&v=d6MZy-2fcBw&feature=emb_logo


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