Potential good news for the US COVID-19 outbreak?

The US may have been late to act but could be catching up

I’ve been closely watching the COVID-19 outbreak data on a daily basis for about two months now. Despite all that study, I, like a lot of people, honestly did not think the US would see as serious of an outbreak as we are now seeing here.

A few cases like SARS? Of course. But thousands? So fast and so soon? Definitely not. (And if anyone out there claims to have seen this coming, they can easily prove it by showing how they sold all their stocks and have been holding cash - because if you expected this then really a market crash was inevitable.)

Well, here we are:

We have over two thousand confirmed cases. That is bad. There is no doubt the United States could have done more to prevent the outbreak but, in hindsight, I also don’t think total containment was ever going to happen.

The virus is too slippery and the world far too interconnected. Many of the early cases in the US were tracked closely for contact tracing. But, it wasn’t enough. I am not sure any amount of preparation would have been enough, though we certainly could have done more. Unfortunately, we can’t change the past.

That being said, there is still some potential good news. While the number of cases is growing incredibly quickly, we have not seen the same relative rise in deaths. Taking the ratio of deaths to infections, we get the following trend:

Just two weeks ago, the high number of deaths in the US and low number of cases screamed something was wrong. Even though many of the early deaths came from the elderly in a nursing home (who have a much higher death rate from COVID-19), something felt off. With the global overall death rate around 3.5-4.0%, the US, especially with its advanced health care services, should have been on par or lower.

After a lot of testing, though much less than has been done in other countries like South Korea, we are seeing some indication that the US is catching up to the outbreak. That’s because we are now trending below the global death rate. The US was late to act but we might be making up some lost time. And, it’s better late than never.

If this hopeful little theory were to be true, the next thing we would expect to see is a slowing of the overall US infection growth rate. The last few days we have been around 30-40% growth, which is crazy fast. It’s really unlikely the true number of cases is growing that fast, so we should start to see that growth rate come down if we are truly front loading case detections.

Transparency is critical and, fortunately, I think we are trending in that direction. Testing has been late but is ramping. This is one of those cases where the data could quite literally save lives. So, let’s continue to hope we get this right.