The Dismal Trajectory of Covid-19

By Roger Chriss, PNN Columnist

The coronavirus pandemic continues to sweep across the United States. So too does misleading information about the pandemic and its likely trajectory.

“We have fewer deaths per capita than the United Kingdom and most other nations in Western Europe, and heading for even stronger numbers,” President Trump said in a press briefing this week.

Although the U.S. has a lower per capita death rate from Covid-19 than some European nations, the president’s claim is both mistaken and simplistic. Worldwide, the U.S. ranks fourth in deaths per 100,000 people, according to the Johns Hopkins Coronavirus Resource Center.

More important is the trajectory of the pandemic. European nations were hit hard by the coronavirus early on. For example, Belgium, Italy and Spain saw most of their deaths in March and April, and almost none since.

It is more informative to look at how countries have done after the initial onslaught. In other words, what are the trends since May 1st?

The trends in the U.S. are dismal, with only Brazil and India beginning to compare. According to STAT News’ Covid-19 Tracker, the U.S. has had over 100,000 deaths since May 1. Spain, by comparison, has had 3,600 deaths; Belgium: 1,300; Sweden: 3,000; Italy: 7,000; and the United Kingdom: 19,000 deaths.

In other words, the U.S. has had about three times as many deaths as all the other countries listed above combined, whose population is 192 million or about two-thirds that of the U.S. Only the United Kingdom has a comparable rate of increase in deaths.

Trends for confirmed cases since May 1 are even worse. Back then the U.S. had just over 1 million coronavirus cases. It has since more than quintupled, now totaling over 5.2 million cases. In that same time period, infections in the UK doubled and most other European countries barely added any.

Disease trajectories look even worse for the U.S., which keeps adding more than 50,000 new cases daily, despite testing rates falling by over 10% since mid-July. On August 11, the U.S. saw about 1,500 deaths, more than the total number of deaths in Belgium since May 1.

A More Realistic Case-Fatality Rate

Covid-19 deaths lag new infections by about four weeks. This means the total deaths today can be divided by the total number of cases from four weeks ago to determine what the death rate is.

Covid Tracking data shows the U.S. had 145,245 deaths as of July 31. Four weeks prior to that, on July 3, there were 2,786,467 cases. This gives a case-fatality rate of 5.21% for those dates, higher because of the temporal adjustment that accounts for how Covid-19 behaves.

Moreover, because of more testing, the U.S. has greatly increased its total number of confirmed cases, which in turn lowers the case-fatality ratio. In other words, improvements in the case-fatality ratio are due to testing rates rising even faster than death rates, and not because of an effective pandemic response.

Further, there is considerable under-reporting of deaths in the U.S. For instance, some states have updated their numbers with backfill deaths, as New Jersey did with 1,800 deaths in June, Texas did with 631 in July, and Florida did with dozens last week.

It is also informative to look at the total number of deaths. A new analysis by The New York Times estimates that there could be as many as 200,000 excess deaths attributable to Covid-19 by late July.

Lasting Symptoms

We’re also learning that people who recover from Covid-19 often have symptoms that linger long after the active virus goes away. The CDC reports that about a third of patients with Covid take more than three weeks to recover.

Dr. Anthony Fauci, told STAT News that many survivors suffer from profound exhaustion, muscle pain, headaches, and have trouble thinking and remembering – symptoms that are “highly suggestive” of myalgic encephalomyelitis, the chronic illness commonly called chronic fatigue syndrome or ME/CFS.  

The coronavirus pandemic is now recognized as being as deadly as the 1918 flu pandemic. The worst may yet lay ahead. CDC director Dr. Robert Redfield recently warned that when autumn arrives and the flu season returns, the U.S. could be facing the “worst fall” in its history if more Americans do not adopt prevention measures like wearing masks and social distancing.

Roger Chriss lives with Ehlers Danlos syndrome and is a proud member of the Ehlers-Danlos Society. Roger is a technical consultant in Washington state, where he specializes in mathematics and research.