When COVID-19 surged in various places throughout the country, Americans wondered, “When will my country reach its worst?”
The widely quoted model offers several predictions. Institute of Health Metrics and Evaluation COVID-19 Projection quoted in a recent White House briefing and taking into account how the pandemic occurred in several countries in the world. They combine the current death trend line in the U.S. state and estimate the impact of social measures to predict when each state can reach the peak of daily mortality and hospital use.
While these projections are inaccurate, they are useful for policy makers and hospital leaders who are trying to prepare for surges. This model is designed to give hospitals an idea of how fast and how much they need to develop capacity.
Researchers at IHME frequently update models based on newly available data, and some of these changes have resulted in drastic changes. The latest major update, made on Sunday, shows fewer people have died in shorter periods of time, said the model’s lead researcher.
To compare states with large differences in population, NPR analyzes the projections by looking at deaths per 100,000 population.
Understand the projected range
It is important to note that many uncertainties come with modeling into the future. The national model has a large gap between low and high estimates for peak daily deaths: 1,300 and 7,700. But each state has a big gap too. The model, for example, estimates New York daily deaths can range from 200 to 2,800 at their peak.
Chris Murray, the model’s principal investigator, acknowledged the challenges posed by various decision makers at a press conference Monday announcing the update. He advised hospitals to hope for the best case scenario – but to prepare for the worst.
“In places where there is a rapidly increasing epidemic – New York, New Jersey, now other places – the ability to predict that the exact peak is not as accurate as we said before,” Murray said. “Resource planners must pay attention to the upper limit so that we don’t let our guard down.”
New York first close to 5,500 COVID-19 deaths on Tuesday. This is expected to be the hardest hit country, in terms of raw quantities. The model projects between 12,000 and 22,000 deaths in the state, with daily deaths peaking on Thursday. That means between 60 and 110 deaths for every 100,000 New Yorkers, placing New York among the worst affected countries per capita as well.
This model also sees a shortage of hospital beds. It projects a dramatic shortage in New York, peaking this week. On Wednesday, the state is projected to need between 14,000 and 45,000 beds. Under normal circumstances, there are only 13,000 beds available in the state, according to modelers. (This does not take into account ongoing efforts to expand bed capacity.)
Social distance effect
The California project model will see fewer deaths than New York, even though it has twice as many people living in the state. That gave California a much lower death rate than the number of inhabitants.
The difference reflects the distance social measures California is taking, said Ali Mokdad, a professor of health metrics at IHME who helped create the model.
“California began to maintain social distance before New York. [Californians] have one week ahead of them to resolve the problem, and take the right steps, “Mokdad said.” And we see the benefits. “
This model makes several key assumptions about how state leaders will act – and depending on what they do, the picture can change. First, he assumes that all countries will continue social distance until the end of May – which is longer than the White House has asked Americans to practice social distance. Second, it assumes countries that have not implemented three main social steps – closing schools, closing important businesses and issuing orders to stay at home – will do so in one week.
This second assumption is very important for states like Massachusetts, which have closed businesses and schools that are not important, but have not yet ordered residents to stay at home. Republican Governor Charlie Baker has refused a call to mandate an order to stay at home, even though he has been enforced voluntary stay advisor at home. “I don’t believe I can or should order US citizens to remain confined to their homes for days,” Baker said last month.
The highest projection of this model could be a tragedy for Massachusetts, estimating a worse daily death rate at the upper limit than what even New York has experienced so far. But the predicted number will still be devastating for its size: 373 deaths every day near mid-April.
Through social distance, said Mokdad, communities and individuals can still make a difference in how bad things will happen.
“We model [based on] a deck of your cards now, “he said.” If you replace a deck of cards, it will be very different. If people do a better job, it will go down. If they don’t – if they ignore the recommendations and start partying and going – then they will have more deaths. “
Final important note about this model: Data shows the day each state can reach the worst day of death between now and early August. That does not reflect the surge that can occur after that.
This visualization shows the day each state can reach the worst day of death between now and August 4.
Stephanie Adeline, Nurith Aizenman, Daniel Wood contributed to this report.
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