COVID-19 deaths in the USA could peak by the middle of the month, a new model shows.
Accuracy depends on actions at state level
Even if the entire nation makes an all-out effort to restrict contact, coronavirus deaths will peak in the next two weeks, with patients overwhelming hospitals in most states, according to a University of Washington study.
Despite its grim outlook, the study offers more optimism than other highprofile projections in terms of how many hospital beds and ventilators the nation will need to battle COVID-19 in the coming months.
The study, released last week and updated Tuesday, also provides a stateby-state forecast for when demands on hospitals and deaths could summit.
Nationally, the University of Washington model predicts a peak daily death toll of 2,214 in mid-April, with a total of 84,000 Americans dead by the end of summer. That’s more than twice the lives claimed during the 2018-19 flu season, which killed 34,000 people, according to the latest available data from the CDC.
But that figure represents the model’s most likely estimate. The range of scenarios spans from 36,000 deaths to more than 152,000, according to the research team led by Christopher Murray, founder and chair of the University of Washington’s Institute of Health Metrics and Evaluation.
The daily death toll likely won’t dip below 100 before June 11, the study predicts.
But that's only if all 50 states take three of at least four major steps this week: closing schools, ending nonessential services, sheltering in place and imposing strict travel restrictions.
“If they don’t, then of course we have to revise upward their forecasts,” Murray said. The earlier those steps are implemented, the bigger their impact on the outcome, he said: “If we’re putting in social distancing, it will change the trajectory of the epidemic.”
The study’s projections are lower than others because it assumes a nationwide response similar to that im
“... so far we’ve seen a disturbing level of reluctance from many Americans to take this pandemic seriously ...” Dr. Vincent Staggs, a research professor at the University of Missouri-Kansas City
plemented in China, said several experts, including Dr. Scott Braithwaite, a professor at NYU School of Medicine.
“If people’s interactions with each other were reduced as dramatically – as suddenly and dramatically – in New York City as in China, then the estimate would be correct,” Braithwaite said. “But the real estimate is probably two to five times higher.”
While the White House was quick to cite the study, other experts noted its limitations, including that it had not yet been through a peer review.
The study assumes the U.S. response will resemble that of Wuhan, China, where the virus first appeared, and yield similar results, said Dr. Vincent Staggs, a research professor at the University of Missouri-Kansas City. That’s a huge assumption considering the two countries’ cultures, Staggs said.
“We place a high value on individual liberty and limit the government’s coercive power, and so far we’ve seen a disturbing level of reluctance from many Americans to take this pandemic seriously, and strong pushback against social distancing from some quarters,”
Staggs said. “Hopefully that’s beginning to change.”
If every state adopted the strict measures outlined in the study, the U.S. would need 220,643 hospital beds – 15% of them in intensive care units. It also would need 26,381 ventilators to help patients with ravaged lungs breathe, Murray’s team predicts.
The nation as a whole has enough hospital beds to meet those needs, the study said, but many individual states will fall short. Only nine are projected to have resources in place to handle their specific needs, and several of those haven’t implemented the social distancing measures the study assumes.
The peaks in each state are expected to range from the second week of April through the last week in May. The model projects the likely epidemic curve in each state and is based on the trends in deaths reported each day in the United States and around the world.
It relates those deaths to the timing of social distancing measures that states have enacted.
The model uses deaths, rather than cases, because the numbers are more reliable, Murray said. Using those deaths as a marker, the model delivers the likely number of hospitalizations and patients who will need ICU beds and ventilators.
The researchers update the model daily with the information provided by states and hospitals and any restrictions on gatherings and travel.
Changes in the daily projections will be greater in states where the numbers are just beginning to increase, Murray said, while the numbers in New York, New Jersey, California and Washington could see little variation.
The ranges within each group of numbers vary widely, said Murray, because of the uncertainties regarding states’ restrictions on contact and the timing of when states will scale up their response to meet the needs.
Predictions change from state to state
New York will need the most beds at 60,000, the study projects. Nine states – California, Indiana, Kentucky, Missouri, Nebraska, North Dakota, Ohio, Oregon and Pennsylvania – will need none, assuming they enact or continue social distancing rules through May.
Some states flattened the curve with early action. California, for example, issued a stay-at-home order and closed all nonessential businesses on March 19, a full week before Colorado took similar action. Colorado is among the states projected to overrun its total hospital bed capacity in the next two weeks.
Louisiana – where New Orleans has been particularly hard-hit after forging ahead with Mardi Gras celebrations in late February – could face a shortage of more than 1,000 beds.
Michigan faces a peak demand for resources April 10, the researchers forecast, with a potential shortage of more than 4,000 beds and 1,500 ICU beds.
Demand in Ohio and Oregon is projected to peak later in April or early May, and both states could experience no bed shortages if physical distancing measures continue consistently.
Ohio Gov. Mike DeWine and Dr. Amy Acton, director of the state Department of Health, have been praised for taking aggressive action to flatten the curve. In daily news briefings, Acton said initial data indicates the state’s social distancing efforts are lowering the case count and the demand on the health care system, allowing it to better prepare.
“We’ve got to clamp down even more,” she said last week when the state implemented a stay-at-home order for all residents not on essential business.
Several states, including Kentucky, Maryland and North Carolina, restricted gatherings in just the past few days. And although Missouri doesn’t have a statewide order in place, many counties and cities have implemented their own.