Could Coronavirus Cause as Many Deaths as Cancer in the U.S.? Putting Estimates in Context

How the best- and worst-case scenarios compare with other common killers.

Comments: 301

  1. Doesn't it seem possible that the fatality rate would exceed 3%? Seems like a low ceiling given what we're seeing in Italy and can expect to see at our hospitals.

  2. @Miguel The fatality rate varies with age and perhaps other factors. It's possible that Africa, with young populations, might be rather lightly affected. Italy and Japan have the oldest populations in the world. Accurate fatality rates are scarce; probably the most accurate are for South Korea, where testing has been thorough. The US has had little testing until now, so no one knows how many people are infected, except by vague inference from the numbers of the sick and dead.

  3. This is very helpful. Analysis like this helps us as a society to decide if the potential health benefits are worth the medicine (higher unemployment, restaurants closing, bankrupting airlines, etc) This analysis says it is worth the economic pain.

  4. For a baseline, the 1918 flu infected about 28% of the US, and the mortality rate was about 0.5% here, but in other countries it varied between 1%-2%. COVID 19 isn’t the 1918 flu, so I don’t think we can extrapolate the infection rate from 1918. But I do think it’s likely that even if the mortality rate worldwide is close to 2%, a 0.5% rate here is quite possible.

  5. @Gus The rate was low here because Americans were well nourished in 1919. Europeans had little to eat during World War I and so were malnourished when the epidemic arrived.

  6. @Gus Extrapolation from 1918 flu rates is a stretch for a large number of reasons. For example. USA's population is more concentrated now. Think of the farm families of 1918. Their contacts with other people were similar to those of us now "self-isolating".

  7. So much of the death rate depends on how Americans react to the perceived threats. I am sure there are and will remain a goodly portion of our citizens who regard the disease as not much to worry over. As an 83 year-old, I will be cautious and very careful and try to follow the guide lines I read in the papers. Still and all, there are no absolutes.

  8. @Steve Absolutely. It's also the responsibility of relatively younger people to protect the senior citizens like you, by not going to the large gathering and avoiding crowded places. I hope people show more civility in this dire situation. Brunch gathering is not as important as people's lives.

  9. Great article, thank you! The sliders are particularly helpful. As a pair of 75 year olds, my husband and I are minimizing contact with other people.

  10. Fortunately, we have a modicum of control over the speed with which the virus spreads, but that's about all. I think infectious diseases are hard because we have to self-isolate during a time of vulnerability and need. Physical closeness and touch can now kill our loved ones.

  11. This is an excellent article. Among the best I've read properly contextualizing the disease. I have a question. Does the number of Coronavirus deaths in the 70s and 80s age group decrease the deaths by other causes in those groups? There must be a correlation of some sort there because people are not immortal and about that age they/we will begin to die anyway from one reason or another.

  12. @tdb Excellent question. It would have to impact the numbers for other causes of death. The data for other causes of death do not change as one changes assumptions for Covid-19 deaths so this factor is not baked into the analysis.

  13. @tdb Right? If you die from the virus you no longer become a heart disease or cancer statistic!

  14. @tdb IMO Covid 19 deaths among eldarly in nursing homes and hospitals will be understanted. It will be attributed to heart failure and no testing will be performed for Covid 19. These are "attended" deaths so autopsies are not required. Think about it. For-profit hospitals and for-profit nursing homes are not going to expose themselves to losses of business and lawsuits by admitting that their patients died from an infectious disease in an institution supposedly preventing the transmission of infectious disease.

  15. It would be useful to understand how much of the > 70 mortality increase is due simply to old age (with perhaps decreased immune competency) and how much to the prevalence of chronic conditions (diabetes, cardiovascular disease, etc) among the elderly. If you're 75 and have no medical problems, how much does that help compared to an average 75 yo with a typical set of problems?

  16. @Patmos Certainly being both old and with underlying health issues would increase one's risk of dying, but even healthy older people are at heightened risk as the average immune system declines with age, starting quite noticeably after about age 60 for most.

  17. I'm sure the data is scant, but this analysis seems incomplete without factoring in the indirect effects COVID will have on other disease fatality rates. That is, if hosp systems are overwhelmed with COVID patients, then their treatment of normally treatable ailments will be impacted, i.e. more deaths from flu, stroke, cardiac events, etc.

  18. @Marc Just like most diabetics don't die from diabetes directly but by some other condition on the list, induced or aggravated by diabetes, most deaths counted as From Covid are actually just With Covid. Therefore, this table of relative death numbers is hard to interpret, to say the least.

  19. @Marc agreed, in fact I started reading this article thinking it would address that issue.

  20. Very helpful graphics. Nice slider. Keep it up!

  21. @Inge Yes. Did it give you a sense of control over the situation? Of playing god? What were your final inputs? Based on what?

  22. Please report on the number of people hospitalized due to conoid-19, their ages and their previous medical conditions and compare this to the seasonal Flu.

  23. @David J. Krupp Why? Just take a look at Italy if you are attempting to minimize this at this late hour.

  24. What happened to medical errors being the third cause of death????

  25. @Charlotte that study (and yes, there was only one) has been largely discredited.

  26. The US has relatively few hospital beds per capita, due to our unusual emphasis on getting patients out of hospitals as soon as possible. As a result, we have relatively little space for people sick with Coronavirus and comparing our hospitalization rates to those for other countries might be misleading. I'm willing to suppose that Americans are more likely to be expected to stay home, or forced to do so for lack of insurance.

  27. The sliders demonstrate how sensitive the projections are to the estimated fatality rate. If the estimated fatality rate is .7 instead of .5 %, Covid 19 becomes the number 1 cause of death in the US. Meanwhile estimates range as high as 3%. The key to preventing a nightmare is to slow down the spread of the virus. Something that the current administration bungled badly. What is desparately needed is testing capacity. Don't believe the official press releases. Arizona officially has the capacity of performing 450 tests per day. Reality is that they recently tested 50 samples in a day and left a large backlog outstanding. Every state in the country needs hundreds if not thousands of test kits now. This is the biggest and key failure of the Trump Administration and it's "privitazation" policy, aka profiteering on national emergencies.

  28. Don't use used toilet paper,but recycle. Hong Kong has the secret antidote.

  29. Thanks for your excellent article. Most of the reporting on COVID-19 that I've read is repetitive or frantic and doesn't discuss data or projections.

  30. Articles of the sort, though thought provoking, are at the same time very exasperating. The first line and the concluding sentence are the only indications of where we actually stand today. The rest is speculative to the point of being meaningless. We have today no way of calculating rates or estimating trends because we have no way of determining how many people are infected. As of today there is no readily available laboratory test for the novel Corona virus. I would welcome a rewrite of this article, but please not until there is real data upon which to calculate meaningful estimates and trends. We don’t need more fearmongering at this stage of a pandemic. And one or two sentences discussing the development of vaccines would have been much appreciated.

  31. @Ppotts There are specialized statistics used for modeling huge numbers. Those numbers include information regarding probabilities, ranges, and a whole host of information allowing experts/scientists to know what degree of confidence to have in their conclusions. Graduate level and beyond. Education matters.........

  32. @Ppotts In five years, an article can be written with precise numbers of cases, infected ratios at different ages, and deaths. The value of the estimates and comparisons to other viruses is to give us some idea of how to manage this virus NOW and control the spread. To reduce the deaths reported precisely in five years.

  33. The cruise ship off Japan might provide a useful example of a limited population that may have been almost entirely exposed to the virus in some way (that's a big assumption, but in a self-contained environment, maybe?). Out of 3700 passengers and crew, about 700, or under 20%, became infected, and of those, an older population, 7 have died so far, or 1% of those infected, but 0.2% of those who may have been exposed.

  34. @Tom That was with total mandatory lockdown in effect; guests were confined to their staterooms (after the disease had become rampant, admittedly.)

  35. The projected number of deaths by age group needs to be put in perspective. The mortality RATES by age group need to be shown.

  36. @Mike I'm not sure why you want to see this split in statistics. Is it because deaths of old people are less important than deaths of young people?

  37. @Graham Hodge Yes I think can answer that one. Deaths of old people are less important because they are ready to die soon anyway and because they can not contribute much to society anymore...also they consume way way too much of the healthcare resources. That is not fair to younger people.

  38. Since South Korea is the only country that immediately began testing as many people as possible, regardless of whether or not they were symptomatic or had recent exposure to at-risk individuals, the current statistics demonstrate an overall infection rate of approximately 3.4% of the total population, and a mortality rate of approximately 1%. Extrapolating South Korea's statistics for the US would lead to approximately 10 million cases nationwide with a mortality rate of approximately 100,000. On the other end of the spectrum we have Italy where the current confirmed rate of infection is approximately 25%, with a corresponding 10% mortality rate. I'm certain there a multitude of reasons for the disparate outcomes for handling the CV in Italy and South Korea, the one answer that may best summarize the differences is trust in their respective governments, and in that respect Italy fails miserably, and unfortunately for the US our trust in the government, though better than Italy's is much lower than that of South Korea.

  39. @Mike my stats were from the number of actual tests conducted.

  40. @Jim Just because someone tested negative at one point in time does not mean they will not contract the virus in the future.

  41. Please expand the fatality rate to 4.5%.

  42. @Bill Birrell and why would they need to do it?

  43. Whatever the eventual numbers are and as much as I appreciate the perspective of coronavirus vis-a-vis other illnesses, the fact is that most other illnesses have treatments and can be prevented. We don't know enough about this virus to prevent it. The government waited too long to address it in hopes it would simply go away, so doctors and nurses are ill because they don't have N95 masks. While I work to help others stay calm, I am still nervous. With some compromising disorders and being over 70, the simple act of shopping for groceries could be deadly. I'm not ready to go and I'm not ready for my son to be motherless as well as fatherless.

  44. @Barbara Well We know a lot about influenza but we can't prevent it So, your premise is flawed?

  45. @Flyingoffthehandle We have vaccines for flu; we also have effective treatments that at least prevent the flu's worst effects. Neither is available for this.

  46. It is impossible to say if we over reacted to this disease. One truthh in the end is that we will know if we under reacted!

  47. @Chris Washkowiak that does not make any sense once its all said n done hindsight is 20/20 and we for sure will know if we over or under reacted If no more die - over reacted If 600,000 or more under. Trumph said it was a hoax a week ago so our leader has under reacted because it's no hoax.

  48. @Bobj Trump did not say COVID-19 was a "hoax". He did say much of the coverage by media was a hoax. Trump was correct!

  49. @clickhiker It's unclear what Trump was referring to when he said 'it is a hoax', which is typical Trump, whether by design, or by accidental poor choice of words. Where's the proof that the coverage is a hoax, especially since Trump has now stated that he knew it was bad 7 weeks ago, when the media was starting to report about 'a novel coronavirus'?

  50. a brilliant presentation I will share with my patients. Far too many people still dismiss this as overreaction and hype.

  51. @rick what kind of patients do you see?

  52. @Flyingoffthehandle DC day hospital

  53. Another very concerning point is that recent research is showing that asymptomatic or presymptomatic people can have a larger viral load than symptomatic ones. Which makes containment strategies difficult, and it's hard to convince healthy feeling people to isolate themselves. Hoping that the projections are high, but feeling like we are less prepared for the tsunami of cases than we think we are.

  54. South Korea has had 75 fatalities as the pandemic winds down there. WHY would America have fatalities in the millions, far, far in excess of any other country?

  55. @Lazyal it has to do with the testing. Testing seems to be tied to mortality rate, is one theory. South Korea tests 3,500 or more per million people. This is just a theory. If we ramp up testing, the United States might be looking at different mortality rates. I don't know the link between testing and mortality and why testing would make a difference, since there is not a cure.

  56. @Windy Testing more gives a more realistic picture of how many people are infected, which in turn gives you a more realistic idea of what the mortality rate is for the virus.

  57. @Lazyal South Korea began testing their citizens in mid-February, whether or not they were considered "at-risk, or not." This early testing allowed the South Korean government to quickly identify "CV Clusters" and then take the necessary steps to isolate only the identified cluster areas. I should note, I have been unable to find information on the true extent of South Korea's actual quarantine measures, the fact remains that their campaign to test as many people as possible appears to have helped "flatten the curve" in a relatively short period of time. I guess South Korea can experience a resurgence in the number of CV cases, but as of now, they seem to have the spread of the disease under control.

  58. Since elderly patients with underlying diseases are more likely to die from COVID-19, a rise in the COVID-19 number of deaths should be accompanied by a fall in the heart disease, cancer, dementia, etc. numbers. Also, a spike in deaths from COVID-19 should be followed by a fall in the number of deaths in the time period thereafter.

  59. After reading this excellent article I am firmly resolved to stop growing older. Old age is much too risky for me.

  60. @BWF I actually figured out how to pull off that trick... But it was 125 years ago and I have forgotten the details. Sorry!

  61. The actual number of cases is being vastly underreported, and that is skewing the apparent mortality rate. We need to ramp up testing, so that, among other things, the apparent mortality rate will drop closer to its likely actual 1% level. That would still be high (10 times higher than seasonal flu), but low enough for everyday life to get back to something approaching normal.

  62. @Matthew Cush The epidemiologists who are estimating mortality rates are quite aware of that. They include their estimate of unreported cases in their analysis.

  63. @tew Yes, and this is why their estimate is between 0.7% and 3.4% That's a pretty broad spread.

  64. @Matthew Cush Some experts also report that the "tip of the iceberg" effect is actually not that potent at reducing the mortality rate - as per their on-going observations.

  65. Someone clarify: When the slide rule is adjusted to, say, 1% overall fatality rates, and the age groups are disaggregated, does the disaggregation then apply different rules (adjust up or down the case fatality rate) to different age groups? Or does it just apply the 1% across all age groups?

  66. To put the coronavirus deaths in context the table should include "All Other Causes". Then a sub-total of all other deaths could be compared with coronavirus estimated deaths. Also, there is a time period mismatch between the data. Dr. Lawler's estimate (which presumably drives the interactive sliders' output) estimates "deaths over the course of the illness known as Covid-19", per the article. We need to know how long his model assumes Covid-19 will be active and fatal (i.e. until widespread vaccine). The other death rates in the table are annual.

  67. @tew On my first read I missed the disclaimer "These comparisons assume that the entire coronavirus pandemic runs its course in one year, though it could well take longer." (I'd add a slider for that!)

  68. The authors would be very naive to think that: "It’s possible fewer people will die here, either because conditions are substantially different in the United States, or because better treatments are developed, or because efforts to slow the spread help protect the people who are most vulnerable to severe disease." U.S. is already hopelessly behind. It has not learned from other countries experiences at all.

  69. 100% Fatality Rate for everybody at some point from something.

  70. Scientists should not be estimating deaths in the US for this virus. It is too soon for estimations. The virus at the time I am writing this is 86 in the USA! I think the warnings should be for people at severe risk. Closing gyms restaurants and sporting events for a virus which has killed a lot less people than hand guns during the same time period is idiotic. Reaction to handgun death is no real problem but a virus that kills people at the end of their life is, stay at home with your stash of toilet paper.

  71. @Stan Himes this is agenda driven not a serious work product as most of us know the death total will not even reach 1000 in the US EOS

  72. @Flyingoffthehandle Your comment is not based upon any scientific facts and is, at best, very wishful thinking. Many thousands will die, and history will not be kind to the Trump administration for their blunders and mistakes. If you don't believe in science - which he and they do not - you cannot possible cope with this epidemic crisis.

  73. @Flyingoffthehandle we do not know that the death rate will not even reach 1000 in the United States. Factor in all variables, I do expect the death rate in the United States to be much higher .

  74. Also left out are the number of people in each age cohort. Boomers, for example,have higher #s than certain other age cohorts.

  75. @pnw A 20% infection rate among people who were isolated on a boat is not the same societal metric as as a town where people go shopping, mail and packages are delivered, people are outside, is it passed along by mosquitoes, etc.

  76. @pnw Recall that in an average population you will connect with an average of 100-150 people, and they with 100-150 people (some of whom will eventually connect back to you), etc. The number of combinatory connections on a ship are significantly lower than in a general population.

  77. What is not accounted for in these projections is how many deaths COVID19 is substituting as a cause of death in place of another. Persons with congestive heart failure, advanced cancer and similar life ending diseases who contract COVID19 are being counted as a fatality in the virus statistics. Unfortunately, they would have died anyway and counted in the statistics of the other causes. What we need is statistics showing the death rate of COVID19 in people without serious underlying health conditions. That would be the true death rate.

  78. @casey mohe Its a good point to make, but don't forget those people with underlying problems are not necessarily going to die soon from the problems. That is, they might have coronary artery disease, but its currently under control. But add the Covid-19 virus and they succumb. Now you tell me - should we attribute the death to the virus or the underlying condition?

  79. @casey mohe "What we need is statistics showing the death rate of COVID19 in people without serious underlying health conditions ?" <- The Million Dollar Question

  80. @Tom Rowe It would be interesting to have an estimate of many years of life each victim of cover-19 death lost. For example, if a person of 80 in good health died of Covid-19 we could say that person lost at least (if not more because of their good health) the full number of years of their life expectancy. If a person of 80 with metastatic cancer died of Covid-19 we would have a reduced number of years of life lost. Unfortunately, I don't think we have statistics on life expectancy at different ages with different medical situations.

  81. It is not really a valid comparison to compare corona virus deaths to other diseases since it appears that the majority of people dying after contracting the corona virus are people that in all likelihood would eventually die from the other disease. In other words, the mortality rate of the people who contracted the corona virus and the mortality rate of people with other diseases are NOT mutually exclusive.

  82. @Hugh Kinsel - you're not properly differentiating what is the proximate cause of death. Of course death rates will be higher with comorbid conditions. Yes, statistically, folks with HTN will die faster than those without. But HTN won't do you in in three weeks whereas COVID easily could.

  83. @Robert - I think @Hugh Kinsel is just making the point that some people who would have died in the same period of these comorbid conditions will die and coronavirus will be assigned as the proximate cause of death instead. Total number of deaths will not necessarily be the sum total of COVID-19 + the sum of all deaths that would have occurred if COVID-19 did not exist, which the tool suggests is true.

  84. @Hugh Kinsel it is the damage to the lungs from Covid 19 that us the cause of death.

  85. These numbers should be aggregated to account for the varying death rates in different populations. A person fro Age 10-19 Does not Have a .5 mortality rate. They have a .2. People in their 80’s have a nearly 15 percent mortality rate. This is the scrabble when you should be playing Chess.

  86. What is the relationship between economic prosperity at a level that we were experiencing a month ago and death rates from the various diseases to which the death rates of COVID 19 are compared? If we experience a prolonged recession or even a depression from this crisis because we have attached such importance to avoiding deaths from the disease that we have done damage to the economy which did not cause the disease, do we run the risk of higher rates of death from other causes? Are we running the risk of saving lives now through actions that cripple the economy only to find out that over the course of the next five years we will have more deaths than we would have had if we had not wrecked the economy in order to save lives now? Is it possible to take a time frame like this into account in an election year? These questions trouble me and I hope others as well.

  87. @John Eley Particularly if these estimates are far inflated.

  88. @John Eley : I suggest that you read abut the 1918-19 pandemic -- 500 mil infected in a world of 1.8bil to 1.9bil. That's 27%. Do you want a repeat of that, with its attendant problems? Of those infected, 50mil to 100mil died. Do you want a repeat of that? You might also read about the infection and death rates in St. Louis (where local govt enforced shutdowns and isolation), which were far lower than those in Philadelphia (where local govt didn't). Perhaps start with this: https://www.nytimes.com/2020/03/17/opinion/coronavirus-1918-spanish-flu.html

  89. From this article: "In Hubei, China, where the disease began, far less than 20 percent of the population has been infected." In fact, based on the most recent numbers this morning it is 1/10th of 1 percent infection rate in Hubei. Total infections 67,799, population of Hubei 58.5 million.

  90. This is an absolute lie. China has over one billion people and only 5,000 deaths. The U.S. will end under 2,000 deaths. The whole situation is overblown.

  91. @Allison I hope you are right but I don't trust numbers coming out of China.

  92. @Allison China masked up 100%, by producing 200 million masks per day. The U.S, with double China's economic strength, is producing less than one million masks per day. Media quoted one young woman returning to China because England is "not taking the virus seriously". Her evidence? "People are not wearing masks". CDC continues the insanity of saying that masks do not provide protection. Every major Asian country is bringing their crisis under control by having everyone wear masks. We need twenty to fifty million masks per day. I live in Arizona with its 20 infections. One victim posted a video describing his experience. He went to get checked wearing an N95 mask after finding out that he had been in close personal contact with another victim. He described the reaction of the health car providers looking at his mask as "though they were seeing a psychopath". None of the healthcare providers who interacted with him were adequately protected. His wearing a mask protected them. Our healthcare system will likely soon become a superspreader institution like those of China. The healthcare providers failed to prescribe anti-virals necessary to fight the virus. As he described symptoms in the three week infection, obviously he does not realize how close to the edge he remains. In a flu report, CDC reports 43% of flu fatalities were not prescribed the anti-virals necessary to fight the flu. Evidently, neither are Covid-19 victims.

  93. @John Huppenthal There is no antiviral drugs for covid 19.

  94. Why the assumption that the U.S. outcome is going to be so much worse than China's ?

  95. I’m skeptical of an article that starts with “its impossible to tell” and then writes 5000 words replete with adjustable graphs and what experts think telling us what might happen. Wuhan province has 60 million people densely packed into it, has magnitudes worse air pollution, 4 times the smoking rate and an inferior health care system. We had the advantage of knowing what we were looking for where China had to identify it after it had already been multiplying in the population. The virus seemed to infect thousands of Chines people and then plateau. Why do we assume that it won’t do the same here at far lower levels? Why would we experience worse outcomes here?

  96. There is a critical missing data point. The deaths from other causes are per year. The deaths from COVID-19 are for the course of the epidemic, which is not a 12 month period. Sadly, the good effort of this article stumbles badly by failing to compare things in a similar time frame. (Unless the COVID figures are indeed annual, which is unlikely, and which the article does not report.)

  97. These numbers should be taken with a large grain of salt since the CDC has very little credibility left and is rotten to the core due to unbridled corruption. I used to do statistical work for them. I know.

  98. @DrJeff Right -- And I believe anonymous comments over NYT articles. /s

  99. Are the gun numbers double counted with suicides and accidental gun deaths? FBI statistics show about 6000 gun CRIMINAL HOMICIDES (murders) every year but these statistics show 39000 "gun deaths." Does that include suicide and accidental deaths and justifiable homicides? If so, very misleading statistic. Justifiable homicides should be attributed to criminal activity (once it is ruled justifiable) and not guns.

  100. The current death rate in the United States is 1.9%, far behind the 7.7% rate in Italy. The case rate per 1M people in the United States is 14.3/M, among the lowest in developed countries. Tiny Switzerland by contrast has a case rate of 308.7/M. I have a lot of problems with words and phrases like could be, might be, probably, worst case, experts say, predict, etc. While we can follow statistical trends and use them for predictions, they are only predictions and frequently they are made by people with no medical experience and political agendas. We are shutting down our entire country and creating tremendous economic harm for the present and the future, for a disease that so far has only 4,748 cases and 93 deaths in the United States. “Experts” agree that children are generally not at risk but we have closed most of our schools, creating tremendous child care problems for people who need to work, instead of focusing most of our efforts on the most vulnerable senior population. Of course it is important that we get control of this and get ahead of it as soon as possible. But creating havoc by pushing doomsday prophecies based on estimates and assumptions of so-called experts (who are frequently proved wrong) is not helpful. Most people are intelligent enough to filter the “news” and determine if there is more or less truth in what they are hearing. The rest hoard toilet paper.

  101. @James B. Davis The comparisons you're making are built on the underlying presumption that we've all been infected at the exact same time, which isn't the case. For a better understanding, start with a baseline of 100 infected and then look at the rate of infection from that point forward and it becomes clear that we are on par with Italy, Iran and South Korea.

  102. @James B. Davis I am guessing the Swiss have a higher rate of testing, though I don't know. I do know that the US currently has one of the lowest rates of testing in the developed world. Less testing = lower case rate but not necessarily good news.

  103. @James B. Davis : Every reputable expert is saying that we're 10 days behind Italy with regard to the curve showing the rate of infection. THAT'S why it's crucial to shut down everything now -- so that we don't continue to follow Italy's path. It baffles me that people are selectively willing to discount experts when they dislike or don't want to hear what the experts are saying. You're happy to put your faith in experts with regard to the science behind the car you drive, the electricity that every part of your life relies on, the technology behind your phone and other devices -- but somehow the same scientific methods are suspect with regard to this pandemic? And your ludicrous "deaths so far" -- this pandemic is going to come in additional waves for 12-18 months, until a vaccine has been created and widely distributed. It is highly contagious and transmitted by people who are asymptomatic. Stop cherry-picking bits and pieces so you can naysay bc you're worried about your investments.

  104. A PhD student of mine, who understands Econometrics tools I teach in my post-graduate classes rather well, has looked at publicly available covid-19 data as of March 13. He found that the average death rate among those older than 65 is whopping 66%. Even after allowing for data biases and other reporting problems, this death rate is alarming and far exceeds the CDC worst case scenario assumptions. Let us hope a treatment arrives soon.

  105. @Hrishikesh Vinod is this from the USA cases only? Could be skewed because of the LifeCare Center in Kirkland WA where many patients were terminally ill.

  106. @Hrishikesh Vinod Your comment is almost entirely lacking in details critical to any attempt at interpreting the graduate student’s conclusion. Taken at face value, we can only wonder how this remarkable finding has escaped CDC’s epidemiologists.

  107. @Hrishikesh Vinod That number doesn't pass the smell test. Do you mind asking him to check his calculation?

  108. Having no reliable data on how many are infected completely changes the context. If 10,000 Americans are already carrying the virus the current fatality rate would be .70. But if that number is 100,000 infected, and without massive testing there is no way to know, then the current death rate would be .07, or below what is typical for influenza A or B, the yearly seasonal flu.

  109. @kevinhugh your argument assumes that those infected with the virus and not showing symptoms will never show symptoms and never die from the virus. Then, yes, 10,000 infected Americans with 70 dead would have a fatality rate of 0.7. The problem now is that we do not know what is going to happen with those people who are currently infected and asymptomatic. If those who are asymptomatic now develop symptoms the rate goes back up. The real point is that none of the contorted arguments people are trying to make to compare this to the flu will decrease the number of people who die from it. If anything these arguments will increase deaths as people become careless, thinking this is just a hoax.

  110. @RN At this point in the US we are only testing those who are symptomatic. Plus, apparently, some athletes. With a supposed 10,000 infected (from your example) and 70 dead you get 0.7 % but we don't know how the 10,000 cases will resolve. There may well be 300 or 800 or 1300 additional deaths.

  111. @RN 10,000 infected and 70 deaths is actually a rate of 0.007

  112. Poor article. Basic fear mongering. These numbers will NEVER happen! Look @ China. If you use this article's assumptions that 30% of people get infected, in China that would amount to 900,000,000. If you don't like this number, let's say 20% or 600,000,000. If mortality is 1% then we should see 6,000,000 deaths in China. So far there have been ~ 3200 deaths. How about Italy? Italy has a population as of 2018 of 60,000,000+. At this time there have been 2158 deaths - definitely higher rate than CHina but still represents 0.0036% of the population; they have reported 27,980 cases or 0.047% of the population. If you believe more people have been infected - say by 100-fold - that still amounts to 4.7%. Do you really believe that only 1% of those infected in Italy have been identified? (27.980/2,798,000? Yeah - don't think so. Dr Lawler's determination, if using 1% mortality rate, would be that ~ 27,000,000 people in the US will get infected, which is 8200 times the documented rate as of this AM.

  113. @Mike The population of China is 1.3 billion. Your numbers are way off. Regardless, China's infection and death numbers are incredibly inaccurate (to put it nicely). They most likely has 10x the number of infected and dead. Do some digging and it's not hard to find. Italy is also in the beginning stages of this, and the US has barely started. They've based these numbers on models from available information, and have specifically said they can be mitigated...rather than rail against predictions, find out why they made those predictions. They are experts for a reason, even if not always right.

  114. It's impossible to tell if we over reaccted. It is possible to tell if we didn't react swiftly enough! To me the analogy is if you believe in God and you do your best to make it to heaven. You are in a win-win situation, you make it to heaven, but you're dead so you can't tell anyone. If there's no heaven your dead and can't tell anyone.

  115. @John No true. deaths are easily identified - infecteed population isnt

  116. Once again, a piece of agitprop. Anything to kill the economy and oust a president they don't like.

  117. @Chip Even Trump is finally realizing how serious covid-19 is.

  118. @Chip You must have missed Trump's press conference today. Looks like he joined the conspiracy too :)

  119. @Chip we have State autonomy and each state is on it's own. There is no telling what the future holds in this without a central command. I do wonder how each state, and their economies, will be able to meet the need for medical facilities and equipment that will. e needed as more people get severely ill. At present, our biggest need is to do more testing.

  120. Five important factors seem to be left out of this article. The first is reinfection rate. Apparently the virus can almost immediately reinfect a survivor and the fatality rate of the reinfection is much higher than the initial fatality rate. The second factor left out is the ability of the virus to mutate. Making a prognosis about this is both necessary and very difficult. The third factor left out is the economic crisis created by the epidemic. If it were to approach that of the Great Depression, it would affect the fatality numbers of many other diseases due to lack of medical care as well as basic life requirements such as food and shelter. Fourth, no one knows how long it will take to get past this virus in the U.S. It may well be years. If that is so, we may well be experiencing the effects of a second virus before this one is over and with little capacity to deal with it. And finally, all of this will divert us from dealing effectively with our changing climate. A potentially existential threat to humans and many other life forms.

  121. @Henry That's an argument for why widescale testing is both necessary and should be mandatory. Without data, nothing can be predicted. We can't even determine how widespread the disease is at the moment let alone figure out how best to combat it. We don't know the rate of reinfection, full periods of incubation, etc. We have broad statistics (very broad, the standard deviations yield the true crisis - lack of response) which this article reflects, but nothing more.

  122. @Henry Your points are all well made. I just want to say that the reinfection issue is not settled. The LA Times has this: "Scientists in and outside China agree that reinfection is a highly unlikely explanation for the patients who retest positive." Today's Guardian: "Definitive answer not yet known, but experts say reinfection seems unlikely."

  123. @Henry Excellent points. I'd like to add that while both Covid-19 and CC are "grey rhino's" as opposed to "black swans" and that both can be averted via decisive adaptation and mitigation measures, the urgency of Covid-19 will naturally takes precedence over CC's.

  124. Note that the statistics for the other listed causes occur every year. My understanding is that the coronavirus is expected to be brought under control through vaccinations, treatments and immunity within potentially a 12-18 month period. So looking over, say, a 5 year period, heart disease and cancer likely will kill far more people. Not that every life isn’t precious, but the interesting thing is that people seem to accept and accommodate the ongoing deaths from cancer, heart disease and other causes but are willing to shut down the country to prevent deaths from the coronavirus. Even for the also contagious seasonal flu, the annual deaths are surprisingly high and add up over the years. Yet, I’ve read that at least half the people in the country do not even bother to get vaccinated (which in a good year is only maybe 60% effective anyway). The interesting comparison to me isn’t the death rates from the various causes but the level of panic the coronavirus has engendered compared to the others.

  125. @Susan 1. A significant percentage of heart disease is lifestyle-related and therefore preventable. Not so with covid19. 2. Heart disease and cancer are typically treated over the course of many years, giving patients time to change their habits and sometimes slow the course. Not so with covid19. 3. Heart disease and cancer aren't contagious. Not so with covid19. 4. The percentage of the population that suffers from heart disease and cancer remains constant enough from year to year such that a sufficient no. of healthcare providers are available to treat all (insured) patients. Not so with covid19. 5. This new coronavirus seems to be far more contagious than the common flus that circulate annually. And bc no one has any immunity to this new coronavirus, it has the potential to infect every American -- literally every American. That would be catastrophic -- not only would 3 million or more die from covid19, millions more would die bc hospitals would be unavailable for anything else, fire and police departments would be understaffed due to deaths in their ranks, drug-treatment centers would be understaffed, etc. A knock-on effect. Any of that help you understand why concern about this new virus is off the charts?

  126. @Susan You really need to read more about comparing Covid 19 to all known diseases

  127. @Susan Best case scenario for a vaccine is 18 mo (so maybe 15 now?). Could take 3 years though.

  128. When the history of this pandemic is written, it will focus on some things we already know: *Trump fired the pandemic chief and staff (part of Homeland Security in 2018. *Trump put a hiring freeze on Centers for Disease Control (CDC) and over 800 positions are vacant - the best and brightest scientists and doctors weren't there to help us in the crisis now. *The first cases in China were reported in January and set off alarm bells in the scientific community - Trump did nothing lest he lose the re-election due to a faltering stock market. *Due to a lack of guidence and a firm comand structure, various Federal agencies dithered and fought over producing a good test for the virus - and refused to use excellent ones developed by other countries. When their model was distributed, it didn't work, delaying further the vital information of how many people and where had the virus. We are still in the midst of a shortage of testing machines. * Trump has - in various press conferences and tweets, lied about how bad the virus would be and how long (muzzling our scientists who could have told the truth * Trump was - and is - slow to respond to the crisis. What we are doing now should have been done weeks ago. Time is critical in a pandemic, and he blew it. The list goes on, but history will show our president was ill-equipped to handle any crisis, including this one. It's a matter of life and death, and many people will die as a result of his mismanagement.

  129. @MadBusinessMan Your first two bullets are false.

  130. @MadBusinessMan Trump was also the FIRST one to shut out China ... where the Media blasted him for racism. Trump was the first to shut out Trans Atlantic Flights to Europe ... Europe followed suit a week later. And the Union is closing borders everywhere. Trump is NOT a dictator. He did NOT demand everyone be quarantined, schools, shut down, etc. So, the media blasts him for NOT being a dictator. He has requested everyone quarantine themselves and refrain from groups of greater than 10 people. For some reason, Dems are voting in primaries ! ... These should ALL have been postponed ... and it was in the power of the States to do so (some did). But Trump is NOT a dictator. Be Safe. Quarantine yourself.

  131. @Lara Trump did a few things right. Credit where credit is due. Trump also failed to do an enormous number of other things when it would have made a difference, and that got us to where we are today. And today doesn't feel too bad. But just wait until April. The damage is already done. We are just waiting for the effects to show up.

  132. While trying to reproduce this data for the Netherlands we encountered a substantial difference in the allocation over deaths over various age groups. We assumed the death rates used from the article come from the paper by the Chinese CCDC released on Feb. 17 (www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/). We furthermore assumed that infections spread uniformly over the population. This contrast with your assumptions: "The tables also assume that coronavirus cases will be distributed in the same proportions as have been observed so far in the United States according to data collected by The Times." We believe this assumption is biased towards the age group that shows the most symptoms (70+) and strongly underestimates the prevalence of the virus under the lower age brackets who do not display symptoms. If you assume an infection rate of 50% and fatality rate of (just) 0.5%, Coronavirus will matches the fatality rate of cancer for all age groups > 40, and will be the major cause of death for all age groups < 40.

  133. @Martijn can you give more details?

  134. @Pat it's still work in progress, and it is not my intent to share this widely. But I though to give NY Times a head-up as the information they are currently sharing might be underestimating the risk of the lower age group with up to a factor 10. If you leave me an email address I would be happy to exchange more details with you.

  135. We keep including ongoing cases in mortality rates. We should only use resolved cases. These provide an upper limit assuming many mild cases go unreported. We can't rely on estimates from China. Resolved cases in S. Korea point to a 6% mortality rate there not including mild unreported cases.

  136. @D Guest 0.6%, not 6%. South Korea has testing, testing, testing. Which we have refused to do. They catch the mild cases, via testing, and isolate. Which, again, is something the U.S is not prepared to do. We are going to look more like Italy than South Korea, and in Italy, the rate IS 6-7%.

  137. @Elizabeth M That's incorrect. Yesterday the rate was 6%. Today, their figures are 81 deaths and 1407 recoveries. 1488 total resolved. The rest of their 8320 cases are ongoing, we don't know how they will turn out. 81 divided by 1488 is 0.05, which is 5%. I'm glad it's better than yesterday. But it's not 0.6%. That figure comes from counting ALL cases (actually today it's 0.9), including the ones in which we don't yet know if the patients will live. Or, it's a prediction of mild cases. Hopefully as time goes on they will get better at treating and better at knowing how many mild unreported cases there are. With the unreported cases, the rate will surely be lower, but we just won't know a hard figure for some time. Every mortality rate I've seen reported divides deaths by current total of cases whether those are completed or not. I don't know why they are calculating it in a misleading way.

  138. @D Guest Because they are not actually trying to calculate mortality. They’re calculating the ongoing (preliminary) case-fatality rate... which is the useful epidemiologic measure at this point. Mortality is actually a different concept (cases divided by number at risk over a given period). It’s far too early to have a final case-fatality estimate, which seems to be what you are actually interested in. Patients that recover tend to be sick for longer than patients that die, and that difference in time course introduces bias into an estimate if you only select resolved cases while the epidemic is ongoing. Similarly, early cases tend to be more severe, which also biases the estimate. From the numbers you’re citing, all we can hypothesize is that the final case-fatality will be lower than 5% and (maybe) higher than 0.9% (although potentially not if they are missing enough cases despite the breadth of their testing).

  139. These are sobering numbers. What the doubters and pollyannas seem to forget is that though this virus may only kill an equivalent amount of people as some of the other major causes of death in our country, it will be an injection of victims into our healthcare system we can not accommodate. The extreme measures being taken now are so when the the hospitals start receiving huge influxes of Covid-19 related patients, they can still have some chance to ALSO service everyone else who is victim to the day to day maladies we already face. Cancer, sicknesses, car accidents, will all now have to be treated IN ADDITION to possibly thousands of intensive care patients from this pandemic. I don't see why this is so hard for people to understand. Go to any emergency room on a weekend night and it will be full. Now imagine that with double or triple piled on top from respiratory emergencies from this disease. Almost every healthcare professional I know is terrified of this possibility, and they are usually a understandably cynical bunch.

  140. @Brian And what? is the average age of doc to ors vs nurses that are in those upper age groups. What percent are in that group that could be out of commission for months. And apply fatalities rates to them....curious My wife is an RN and there's growing concern here.

  141. @Brian You could go a long way towards reducing other medical emergencies by putting some temporary restrictions on alcohol sales which, in effect, is being done by closing bars.

  142. @Todd In going to my doctor, the doors weren't propped open, had to push on a push bar with my butt. Needed to push on a touch screen with my index finger to log in. They had surgical masks available for patients but none of staff were wearing them. Without that modeling, none of the patients were wearing them either. When I put the mask on, I got weird looks. Many of these staff are going to get sick and during the asymptomatic phase, they will be transmitting the virus to others. Our experience in the next couple of weeks is going to be a cultural shock. Our current habits leave us wide open to exponential growth of this disease.

  143. There needs to be some discussion of the pain of the death itself. Not all ways of dying are equal. Our motivations shouldn't just be pure numbers as if one death is the same as any other, there are varying levels of suffering in these deaths. I don't want people I care about to die, but I especially don't want them to die painfully.

  144. @Don I dunno. Dying of Alzheimer's, cancer or heart disease (I've nursed parents through this gruesome trifecta) is not going gently into that good night, I'm afraid. If I'm 85+, I'd rather go quick.

  145. It's only because your country is too squeamish. In mine I can choose medical aid in dying for the early stages of Alzheimer's as well as cancer. The problem is people don't want to know they have Alzheimer's so resist testing and slide into incompetency. I have more peace of mind about a good death then Americans do.

  146. @Don So what do you suggest if it is painful?

  147. Deaths from COVID-19 (global) -- 6,668 Confirmed cases of COVID-19 -- 173,316 Deaths from 2019-2020 seasonal flu (U.S.) -- 22,000 Confirmed cases of 2019-2020 seasonal flu (U.S.) -- 222,552 Death rate for seasonal flu is more than 2X COVID-19

  148. @AC Um no.... 16,000 have died from the flu, 280,000 have been hospitalized alone, and 20-25 million have had it. That is from September to present. The Covid numbers? That is from 2 months with countries trying to lock it down, and more than a third of the death rate at .2% of the infection rate. You are misunderstanding the CDC report. They only get a random amount of samples to determine percentage rate and changes so they can extrapolate out the totals, and percentage changes. For example they don't say X number got hospitalized, they say 61.6 per 100k people were hospitilized with flu. Doing quick math with a pop of 300mil and you get 180k. Similarly they don't say 'There has been X number of deaths' they take the number reported and extrapolate it out. 7.1% of deaths have been due to flu so you can extrapolated that to 16,000 (though it is around 22k now apparently). But they never give solid numbers they give percentages and per 100k because they are estimates.

  149. @AC Well, if you don't do any testing, you cannot possibly know how many cases there really are, incubating away and spreading germs. The US is far, far behind in testing because Trump and his minions refused to acknowledge the threat this disease posed until this week.

  150. @AC Think of it this way: the seasonal flu virus is already baked into our society... it's already literally everywhere when it ramps up in season. This COVID-19 is brand new, and is already in all corners of the globe and U.S.

  151. At this point these infection and death estimates are nothing but speculation. Seems like a bit fear mongering going on here.

  152. @dave disagree 100%. All science is "speculation", until it's proven. If that scares you, I'd say that's your problem, not science's. But rest assured: we'll have more data shortly. It won't be good data, I can almost guarantee that, given our slow response. Might actually make you miss the "speculative" models showing 30% infection rates.

  153. @dave An expert "speculating" is not the equivalent of speculation from an average dude. The former has a tighter grasp onto what they are trying to narrow down, while the later is just guessing.

  154. @dave : Spoken like a true red-stater. Just wait and see how things are 14 days from now in the areas where Fox viewers continue to go about biz as usual because they think this is no big deal.

  155. Think of how many won't die, but will suffer its ravages. Doctors in Belgium are shocked at the damage to young adults' lungs, that is permanent. Think of the loss of income, the stress on family, the strain on infrastructure, the loneliness, and the anger. This is not just about how many will die, it's about how we all will be impacted. Nothing will remain as it was.

  156. @Back in the Day... As a 7th grader, I spent 3 weeks in the hospital recovering from pneumonia, as a sophmore in high school, I was laid low for 3 weeks for valley fever. I went on to an outstanding athletic career and ran marathons in great times. When a doc looked at my lung scans in my 40s, he was shocked by what he saw. Lot of extra capacity in the human body.

  157. @John Huppenthal There's the scientifically significant sample size of 1.

  158. @BigDaddy Indeed. That some people recovered from polio does not make the vaccine irrelevant.

  159. None of those other diseases will have the collateral damage of coronavirus however. They will not make so many people lose business, homes, and health insurance (if they had it) because of the economic disruption. Unfortunately, in trying to keep the glass of water from spilling on the table, we are pulling the tablecloth out and upsetting everything at once! At this point there is no good solution, but rigorous testing and early action could have changed that.

  160. What is the rationale behind a 30% assumed infection rate? That baseline is very misleading, especially given Wuhan's infection rate is <1% (100,000 in a city of 11.08 million). The current US infection rate is .0018%. To get to a 1% infection rate (3.3 million cases), the number of current cases would need to increase by 660X. Do we truly think that the US would see 3.3M cases when Wuhan, the epicenter, only saw 100,000)?

  161. @Sam, currently, diagnosed cases are increasing about 20-30% a day in the US. At 30 days of that growth rate, you would see the number of cases increase by a factor of 800. (1.25^31). This does not account for the long incubation time, that people are infectious before they are symptomatic. We may have many more.

  162. @pm Initially, China numbers were up 60% per day. Slowed to 30, then 20, and so on. Not likely we continue at 30%/day. Also, we are now testing many; thus, the rapid increase reflects testing as much as spread.

  163. @Steven Willis China also had a historic shut down when there cases were only 500. They plateued at 80 thousands cases. We didn't shut down and all of what we're doing is a fraction of what China did. We won't will not reach a plateue point for a long long time.

  164. I think this threat should be taken incredibly seriously by the public, at-risk individuals, and potential carriers (everyone) but- to add some perspective- there's much greater odds of having a vaccine for the COVID-19 strain in a couple of years than for cancer, heart disease, and dementia- so the long-term risk to the general population, or people aging and/or deteriorating into high-risk groups could be much lower over time for this particular viral risk. Also, of course, the potential evolution of the virus and/or eventual fatality risks could be deemed much less likely with longer-term analysis of the data. That being said, for current higher-risk populations, national and international medical systems, and the economies of the world, COVID-19 poses a grave, perhaps cascading set of risks. Also, (and this may be to many a morbid perspective, but I think it's an adaptive and important one) this could be a 'dress rehearsal' for future, and perhaps even much more lethal regional and global viral epidemics and pandemics (which are to be expected). Hopefully both societies and individuals learn more rather than less from what's happening now, and can respond in a more agile manner going forward.

  165. @artikhan Sorry, long day, meant to say, "the potential evolution of the virus could be towards less-lethal strains, and in the longer run, data analysis may reveal a fatality rate at the lower end of the current spectrum of estimates. Drier language aside, many people would do much better to put aside their egos and tendency toward denial and understand that being in a somewhat lower-risk group doesn't eliminate risk to oneself or one's loved ones- statistics can't eliminate existential uncertainty!

  166. The way I am reading this is that all those other deaths, plus opiod overdoses, car accidents, firearm deaths are not as important as the COVID-19 deaths. We never shut the American economy down for any of those as we are in the process of doing, most likely causing a 2nd Great Depression. I am hoping I am wrong, but hard not to think the long term impacts of a shudown of the American economy won't be worse than the COVID impact.

  167. @Bob Keep in mind that the other causes of death are not contagious. They can't be stopped the way that a contagious disease can.

  168. @Bob; This is the first internet fueled panic in history. People will eventually learn to discount (put in perspective) what the internet sets before them, but they haven't yet. The news media, thinking to do good by presenting as much information as they can, are actually making things worse.

  169. @Ronald B. Duke (Hello, I am sorry to go against your point of view, but I had to say this. I don't mean to be unpleasant, life is stressful enough as it is...) Maybe cynicism is making things worse by discrediting the seriousness of this pandemic, (which is a word in its own right, not a neologism aimed at augmenting traffic). A projected infection rate of 60% worldwide (Merkel reported up to 70%) multiplied by a lethality rate of 3.4% as per the WHO, is this just trivial? What about the mortality rate increase due to a shortage of access to medical resources? What about long term effects on organs? What about orphans? What about the loss of knowledgeable elders in their communities (including scientists, but not exclusively)? Over 300 dead in Italy within one day! I bet Italians don't need the Internet right now to start panicking. They just need a plain old landline phone, hearing of an acquaintance in ICU or at the morgue. They cannot even bury their dead. What "perspective" is there to take? Maybe one which goes the other way around, unfortunately..

  170. And what? is the average age of doctors vs nurses that are in those upper age groups. What percent are in that group that could be out of commission for months. And apply fatalities rates to them....curious...impact etc My wife is an RN and there's growing

  171. It’s a world pandemic, not a US pandemic. Why not make really clickworthy predictions and base the projections on 8 billion people instead of 300 million? For example, 30% of 8 billion is 2.4 billion. Slide your calculator around those numbers. I think we all know why it’s being done this way.

  172. @TR88 There is a great discussion on why it is useful to discuss statistics on a country-by-country basis at the corona virus pate at the ourworldindata.org web site. In fact that site has a lot of other superb discussions, even a chart showing estimates of how many tests have been run in each country. I strong recommend spending some time perusing that site.

  173. If you look at these numbers from a PURELY Economic angle it could be argued that this virus could have a positive net effective on the overall HEALTH of the GDP....most of the activities/ businesses being Hit Hard by this are purely in the leisure entertainment and non essential sector....if this social distancing stays in place it will have a significant drop in the demand for Gas ....I saw today on the roads a reduced amount of traffic around 30-35 percent....which means Less Global Warming for all the Environmental extremist!

  174. @There for the grace of A.I. goes I Well, it's certainly been very good for the Big Pharma execs and their stock options.

  175. @Fourteen14 If we do nothing or very little, which sounds like what you are proposing, then push both sliders all the way to the right. 70% infected and because the healthcare system will be overwhelmed the mortality rate will skyrocket as many will not get the attention they need. This model only goes to 3% morality. In populations where the healthcare is poor and/or gets overwhelmed we are seeing mortality rates of 5%.

  176. @There for the grace of A.I. goes I: Yeah. And if 90 percent of the population dies it will be much easier to find a parking space.

  177. Does this methodology account for the load on staff and stuff that would be required to treat the dying and critical? In other words, it looks like you're assuming we would somehow still be able to do heart and cancer interventions at the same time

  178. I wonder how many _additional_ deaths COVID19 will cause this year?.... For example, we’ve got many ill elderly folks who would die this year anyway ( be it from cancer, heart disease, stroke, dementia, etc) .... but they will be felled by COVID first/instead.

  179. @GBR 2.6 million people died in 2019. If our infection rate hits 10% with a death rate of 1%, that would be another 300,000 deaths. But, many of those 300,000 would have died anyway, Covid-19 will just be the factor that pushes them over the cliff a few months earlier. If the infection rate hits 30%, then death rates will climb towards 3% as the health care system is overwhelmed and victims can't get access to ventilators and proper medicine. 2.9 million will die. Most of these will be real victims. Covid-19 is almost certainly a seasonal disease, there are 198,000 infections north of the equator and only 1,100 infections south of the border. What that means is that the peak on this will be next February, a really intense peak. The Asian countries are all wearing masks as part of a successful strategy to bring this under control. Our CDC is taking the insane position that masks do not provide any protection.

  180. @John Huppenthal We don't know that about seasonality yet. Most countries south of the equator are underdeveloped with poor health infrastructure and inadequate reporting. How many have been tested in, say, Botswana, or Brazil? Some of the countries reporting heavy tolls are subtropical, like Italy and Iran. Further, if your premise is correct, then the southern hemisphere would be likely to be hit, just during their cold season.

  181. @John Huppenthal I disagree with it being a seasonal disease. It has started to spread like wildfire in Australia - in summer.

  182. Great article. Thank you, NYT. I am curious about the accuracy of testing for this virus, and whether we will learn later that Covid-19 was being lumped in with some other viruses? Or was actually more than one virus. There were all the problems with the CDC test which seemed odd. There has been at least 1 case in the media where someone tested negative in Seattle, then later was identified positive. Experts keep saying they don't know enough and need more data. I don't mean to minimize the seriousness of what we're facing, but perhaps what's being identified as Covid-19 might in fact be more than one virus.

  183. @Turgid Hello, I have read extensively on covid-19 and the virus causing it, SARS-CoV-2, and the idea you are proposing doesn't seem to fit with anything I have read, or heard, from experts from various countries. Maybe the person you are referring to got infected between their two tests? Maybe lab error?

  184. @Turgid I believe the early problems were caused by negative controls that had been contaminated with virus. For a sample to show up as positive (with a contaminated negative control) it would need to have a higher load of virus than the negative control. So those with low levels of virus, although still positive, would not be detected. They would be detected on a second test if a. their viral load had increased or b. the negative control had been fixed.

  185. @Turgid there is always a detection limit in all measurements. He was negative because he was at the beginning of the infection.

  186. So based on this, why wouldn’t we just ask people older than 60 to shelter in place? The economic cost of the containment attempt is enormous for something so disproportionately affecting older groups. Entire industries gutted, people jobless, savings gone, a school year lost.

  187. @Michael i'm 78 and severaly immune compromised. I have been sheltering in place since last week. Our senior community delivers our meals from the kitchen. The only person I see is my husband. If he gets the virus, so will I, but he only picks up medications. He does interact with people in our building, but so far no one is sick. And only medical personnel can enter our community now. I guess it will be until June or probably more like September until I may be able to go out. I've cancelled all appointments, even doctors are managing my care by email. So far, so good.

  188. @Michael: I agree with you. I am 66 and in good health. No lung issues. I live right near Columbia University. I went to the supermarket tonight. For the first time young people were looking at me with what I would call extremely polite fear. It makes more sense for me to make myself scarce than to crash the economy by throwing younger people out of work.

  189. @Michael You should spend more time playing with the data on this simulator. For instance, if 48% of the population is infected (probably a low estimate if everyone younger than 60 is going about their business in a growing epidemic), and if the overall fatality rate is 1.9% (probably a very low estimate in the overwhelmed medical system that would necessarily result), then COVID-19 would still be the primary cause of death for everyone over the age of 10. Sure, older people are more likely to die from COVID-19 than younger people are, but they're also more likely to die from other diseases. In a scenario of 48% infection and 1.9% fatality rate, more teenagers will die of COVID-19 than of any other cause, more people in their 20s will die of COVID-19 than of any other cause, and so forth. And that's not even counting all of the other deaths that would result once the medical system became too overwhelmed to adequately treat accident victims or cancer patients or pregnant women or anyone else in need.

  190. Notice that proper exercise and diet would dramatically reduce almost everything on this list.

  191. @Marc Shulman Yes, as Daniel Lieberman points out, mismatch diseases--resulting from differences in how we live and eat relative to the conditions under which we evolved--are the major source of health care spending, morbidity, and mortality.

  192. @Marc Shulman 80% of healthcare spending is on preventable diseases... no wonder the USA has the highest medical costs and worst outcomes in the developed world.

  193. My overall immune system is pretty good being a big part of my life has involved working with and around garbage so I have built up quite a bit of resistance to all kinds of stuff, but...I have some real problems to contend with. First, I'm 60 which by itself a big strike against me. Second and one I'm not proud of is I'm still a lifelong smoker and unlikely to quit any time soon. I know..I should so please, no lectures. I know what I've gotten myself into. Finally, I only have veterans status so the only real option I have to get medical care is at the VA which I don't particularly trust all that much. I figure if I do manage to not get the virus I might expect to live at least to my 70s, but if I do I know I'm toast. My kids will get my life insurance and hopefully spend it wisely. I do not in any way fear death in and of itself. The method often worries me, but who actually wants to die slowly and painfully? I have an "out" option if push comes to shove, but that would likely nullify my insurance for my kids so if i get the virus I'll likely ride it out at home, die and the coroner will come by, whisk me away and that will be that. In the meantime I plan to use my time like there is no tomorrow and enjoy my family to the best of my ability. I love them all and want nothing but the best for them.

  194. @Martino Good on you mate! I'm a lot older, though never smoked and picked my grandparents carefully (all 80/90s) Also not panicked at the grim reaper (except Mitch!) being careful but living as much as I can.

  195. There is plenty of speculation by people with limited or no expertise, and we would do well to ignore it. We should be very discriminating when accepting information. Predictions are based on different scenarios, and with the lack of testing in the U.S. they are largely guesswork. The only certainty at this point is that the less contact we have with each other, the slower the spread of the virus. This will ease the strain put on our health care system a bit and hopefully lower the number of fatalities. Perhaps a little perspective is in order. We are not having to shelter in place due to armed conflict. There are no tanks (foreign or domestic) in our streets, no bombers flying over head, and we need not dodge sniper fire. Much of the world has lived like this and in some places the people have known no other life. It is likely that in a few weeks our grocery stores will once again be well stocked with a myriad of choices. Please do your best to limit your social interaction. Minus a vaccine, it is our best chance to save lives. This is a major election year, and I think the incumbent political office holders know that they ignore our economic woes at their own peril. I sincerely hope that the needy get that check from Uncle Sam quickly.

  196. It's not mentioned in this article, but there appears to be an increase risk in the presence of other conditions. That can complicate the simple calculations done here. People with "minor" heart or cancer would be at higher risk than they were before. The strain on the health system and the (lack of) insurance will just make things worse. In Italy for example the hospital capacity has been reached. Actions are needed, in the whole US and even between states.

  197. One question I've never seen addressed: Will all of this social isolation and hand sanitizing also have positive impact on other diseases? Bring about fewer cases of seasonal flu or other infectious diseases?

  198. Minimizing transmission to ensure the health care system is not overrun will likely ensure fatality remains below 1%, as the successes in Singapore, Korea, Japan, etc show. However, if the health care system are overrun, fatality rate will increase to over 2%, at some points even as high as 4%, as the examples of Iran and Italy show. And this excludes higher fatalities from other diseases due to limited health care availability for these patients. Expanding health care supply and radically reducing demand for health care from infected persons are absolutely necessary to ensure fatalities remain as low as possible.

  199. @Frank, yes, relooking at the numbers indicating average worldwide fatality rate (as % of total infected) to be around 4%, with the fatality rates in Iran (6%) and Italy (8%) being significantly higher. However, nearly all experts agree that due to limited testing being done in most countries, the true number of infected are much, much higher than the official numbers indicate, thus the lower estimated fatality rate.

  200. I wonder if, once a coronavirus vaccine becomes available, will anti-vaxxers denounce it and refuse to be vaccinated? At this point many have become heavily invested in the notion that vaccines are bad and are to be resisted, binding them together in a kind of community or cult. This could have serious implications if a natural immunity is insufficient, and reinfection by coronavirus is possible, something not presently known.

  201. @Peter Aretin Very likely so. We have seen the increase in measles cases, but at least we have a vaccine to protect those of us who get it.

  202. Please combine with life expectancy estimates for each age group. I wonder how severely coronavirus will scale back how long the average American can expect to live. Will it bring us back to 1970, 1920, 1800, or the Dark Ages?

  203. Don't these numbers double-count many deaths, especially among older groups? I.e., if death by coronavirus is more likely among those already afflicted with things like heart disease (and general old age), weren't some of those deaths bound to happen anyway in the coming year?

  204. @JR I didn't look, as you move the slider an increase in coronavirus deaths really should produce a decrease in other deaths, not 1 to 1 but something. Do they?

  205. Once this got into the human population, there was nothing anyone could really do to stop its inevitable spread. It's like trying to hold back a tsunami with an umbrella. It is going to continue to be a global disruption for years to come, until some kind of effective antiviral is developed and disseminated or until a vaccine is developed and disseminated. Unfortunately, by the time it is, society may well have broken down completely. We have the mightiest military force in the world. Why is it not being deployed to help handle this greatest threat to civilization since the development of nuclear weapons? We have fought proxy wars for generations. Now it's time to fight a real war right here at home. This is not going to end well for any of us.

  206. A silver lining in all of this is the understanding forced upon us is that we must change our habits. As we do, it is possible that the environment begins to heal itself before our eyes. As an older person, I'm at the high end of risk for everything. But it gives me a great deal of happiness to think that the survivors will come out of this moment with a new understanding of our collective ability to change and live a life in conformity to nature. Beyond the shock of the moment, the future is looking brighter.

  207. @HSM thank you! I have been sick for exactly a month, unable to get a test for covid19. Yesterday was a beautiful day and I drove to the ocean. In an interior estuary and lagoon I saw five white lumps; it was resting pelicans! At least a hundred other birds, flapped wings in the water, dove for food, waded on long legs, foraging with long beaks. I rejoiced, the natural life on earth can perhaps survive, at 78, I will not for too much longer in any case. But for sure I will die sooner without friends and family around me.

  208. Does this way of calculating make sense? Coronavirus is most lethal to elderly people, and people with underlying health conditions, thus many people who might have died of cancer or heart disease or other. Could we be counting the same deaths twice?

  209. Widespread testing and the intrusion into/an the insertion of the government into everyday business will be like being in a totalitarian /country. Americans will begin civil disobedience if this goes on for more than a month. That's how to bankrupt a Nation.

  210. @John Sullivan I agree. The body count and hospital admissions better start soaring PDQ to justify all this upheaval otherwise you're going to be having more dead and injured from cabin fever incidents than viral infections.

  211. @Eric Measures taken to lower infection are only proven to have been effective after lower infection rates became the result! Body count and soaring hospital admissions are proof that measures weren't followed. Cabin fever is likely for those who can't get along anyway and can'ts see other ways to spend time peacefully. Knowing so many people are watching too much Walking Dead and hoarding guns and ammo scares me as much as the virus. Just be considerate of others and patient knowing things will change as time passes and all the numbers and feedback are reassessed and new plans arise.

  212. Many seem to be saying in the comments some variation of "if mostly the elderly will die from CV, then is it a big deal." Yipes, that is eye-opening for folsk to be thinking like that.

  213. This was such a great idea for an article, with the sliders etc. However one really important thing needs to added. If a patient dies of coronavirus, the grim reality is that person is no longer able to die of cancer, for example. So coronavirus, in proportion to other causes, may become even deadlier than the predictions in your article. That sounds terrifying until you look at the flip side. A higher number of deaths from coronavirus should lead to a lower number deaths from other diseases since people cannot die twice. In fact, theoretically, overall life expectancy might actually improve, once you balance out all the numbers. Andrew Brown

  214. With stories like this and many others like it running nonstop in the media, I can see why Americans are panicking and are emptying store shelves of all the staples they can find, including, for some reason, toilet paper. Although the authors of the article state that the number of Americans that will be infected and die from the novel coronavirus is hard to predict, for the sake of discussion, they assume that 30% of Americans will be infected and 480,000 will die--even though no other country where where the virus had been present for weeks before it hit the U.S. shores, including China, S. Korea, Japan and Italy, has anywhere near this infection rate. (That's even assuming that China is greatly underreporting its figures.) Even the Spanish flu, the worst pandemic in modern history, starting in 1918, didn't infect as many Americans, at 25%. Back then, we didn't have the vaccines and other medical advances like we have today. And unlike the Spanish flu, the vast majority of novel coronavirus patients will recover. I understand that the elderly and sick are vulnerable, and we don't have enough hospital beds or respirators. Also, the botched preparations by the Trump administration have left us in a difficult spot. We all must take many extra precautions. But one has to ask, is the suffering that will be caused by shutting down most of the U.S. economy, along with the major disruptions to American life, justified by what we know now about the Covid-19 outbreak?

  215. @DanBal These measures obviously can not continue indefinitely or even for long vastly expanded testing is imperative.

  216. 200,000 to 1,700,000 projected US deaths are absolutely ridiculous (talk about a hoax!). Let's instead look at reality: China. China now is down to about 15 deaths per day and about the same number of new daily cases, with four times the population we have. On March 16th. China had 11 deaths and 13 new cases with a population of 1,400,000,000. Total deaths as of March 16th were 3,226 with 403 more projected from their 4.49% death rate and currently outstanding 8,967 cases of infection. Their fatality rate goes down every day and approximately 15 new cases (that number also declines daily) are added to the total outstanding cases of infection. So China's C19 deaths should not get over 4,000, total. We have 1/4th the population. How then is it possible for our deaths to be even close to 200,000 - the CDC's conservative projection? (I'll not speculate that the CDC, headed by Big Pharma execs via the revolving door, have any motivation or conflict of interest to boost Pharma stock prices, although I'd like to note for the record, that in January 2020, Dr. Julie Gerberding, former director of the U.S. Centers for Disease Control and Prevention, who after leaving the CDC became president of Merck’s vaccine division, sold half her Merck stock options for $9.11 million. She missed a bit of the recent big run-up but still has Merck stock worth $9,000,000) Anyway, I estimate less than 1,000 deaths in the US from C19. I could be wrong, but not That wrong.

  217. @Fourteen14 China practiced extreme social distancing to get the spread to slow down. Residents there are also using PPE ,which are currently not available at many hospitals in the US due to hoarding and, ironically, depleted supply since many of these products are made in China. Finally, China's data is considered highly suspect.

  218. @BCO @fourteen14 I’m not smart enough to figure this out...but what if we say China’s data is X times greater than what they’re reporting? (Suppose instead of 15 a day it’s 150, or initial reporting is off by a factor of 10). Then what does the projection show?

  219. @Fourteen14 It is now April 1st. Yesterday, there were 912 deaths for just that day in the US. Yes, you were wrong - you were that wrong.

  220. Policy makers at State and now Federal levels have decided that all human activity in the US must come to a complete and utter halt in order to stop the spread of this virus. In doing this, they are inflicting immeasurable damage to millions of lives, to our institutions, and to civilization itself. It may the case that our response to this virus ends up costing more in human life - mortality, lost livelihoods, destruction to democracy and civil order - than the disease itself. We are playing with fire here - and little thought has been given to the costs we are inflicting. In that sense, our response feels like an irrational "panic" - where even the mention of reasonable alternatives is dangerous to the questioner. Time will tell whether this unprecedented response was our best choice - or a herd mentality where we threw our entire society under the bus in a mad rush of irrationality.

  221. @Space Needle You are absolutely correct when you say that time will tell if this unprecedented response was our best choice. The scaling back of activities may have some positive psychological and societal benefits that are yet unrecognized. Collectively, as a nation it might give pause for reflection on what is most important to us. People will be spending more time with their families, being outdoors, and reflecting on the worth of truly meaningful things. I don't deny that hardship looms and suffering is bound to occur in whatever scenario plays out. Perhaps the pause in the pumped up frenzied activities of normal life can give many people the opportunity to reflect on the fragility of life. And to calm down, realign and re-focus on some core values that much of the population never knew or has forgotten.

  222. When I was studying the preliminary statistics on the disease a week ago, I came up with similar numbers and first sent them to my friends and contacts and, a day or so later, after reviewing the stats further, I posted similar numbers here on the Times. (One person accused me of scare tactics and it is clear now that the numbers I posted reflected real potentials.) As far as I know, I was the first person in the nation to suggest that the potentials for death could be above 1 million. My projections were based on publicly available information and statements by Dr. Anthony Fauci. He is very careful not to try scare people but, in that process, he has failed to state flatly, boldly enough what we face. I would suppose that he is more blunt in meetings behind closed doors. The best opportunity to defeat the coronavirus probably passed two or three weeks ago. With exponential growth in infections, the sooner you act the better the likelihood is of success and, of course, the opposite occurs when there are delays. It is no stretch to say that the current administration in Washington, DC, has allowed a situation to fester in which thousands are likely to die who might otherwise have been saved. We are in a race against time and, if we don't win, the turmoil the nation will face will be unprecedented.

  223. China masked up 100%, by producing 200 million masks per day. The U.S, with double China's economic strength, is producing less than one million masks per day. Media quoted one young woman returning to China because England is "not taking the virus seriously". Her evidence? "People are not wearing masks". CDC continues the insanity of saying that masks do not provide protection. Every major Asian country is bringing their crisis under control by having everyone wear masks. We need twenty to fifty million masks per day. I live in Arizona with its 20 infections. One victim posted a video describing his experience. He went to get checked wearing an N95 mask after finding out that he had been in close personal contact with another victim. He described the reaction of the health car providers looking at his mask as "though they were seeing a psychopath". None of the healthcare providers who interacted with him were adequately protected. His wearing a mask protected them. Our healthcare system will likely soon become a superspreader institution like those of China. The healthcare providers failed to prescribe anti-virals necessary to fight the virus. As he described symptoms in the three week infection, obviously he does not realize how close to the edge he remains. In a flu report, CDC reports 43% of flu fatalities were not prescribed the anti-virals necessary to fight the flu. Evidently, neither are Covid-19 victims.

  224. @John Huppenthal I agree with much of what you said, but at this point there are no antivirals established to be effective against coronavirus as it is a novel pathogen. There are studies ongoing around the world testing antiviral agents but no data yet as to what is effective. Throwing currently available drugs at this virus with no idea how to use them effectively risks causing resistance.

  225. The current death rate is 3.6%, but when only considering resolved cases it's actually over 5%... yet the slider caps at 3%?

  226. Just about everyone is going to get the virus at some point, so all we are doing now is delaying the inevitable and destroying the economy. Seems like a fair trade (sarcasm).

  227. @philly if we all got it at once we would overwhelm the hospital system. These measures are to try and prevent choosing which person gets a hospital bed and which one gets left to die.

  228. The correct solution: instruct the immunosuppressed/elderly to quarantine. Allow the virus to spread among the healthier populations to enable herd immunity to develop. (The definition of healthier can be dynamically adjusted based on real-time hospital capacity to treat). When the 80% of the population who will demonstrate no symptoms is fully infected/recovered/immunized then life will become significantly safer for the at risk population. Suspending the economy at large is a much worse solution.

  229. @Sean Absolutely, the tricky bit will be threading the needle so to speak, once vastly more testing comes on line these extreme blunderbuss tactics can be replaced with a much more granular and individualized approach.

  230. @Sean this is basically the UKs orginal plan. makes a lot more sense than this current mess.

  231. @Sean precisely! we have had these viruses for years but they used to go unnamed and doctors might note that "something is going around". humans need to continually develop our immune systems to become resistant.

  232. Considering that the official death rate in China is 3.4%, but your "worst-case scenario" only lets us slide the rate up to 3%, it's pretty obvious that you're not really thinking about the real worst-case scenarios. From all of the first-hand accounts in Wuhan, the actual death rate was much higher than China's official count; they managed to burn out 3 out of the 18 incinerators and had to bring in 40 new ones... How about this: Globally, as of today, there have been 7,953 deaths and 81,694 recovered. That puts the death rate at just under 10%. Outside of China, with its supposed 3.4% mortality rate, the dead to recovered ratio is absolutely atrocious; there is one death out of every 4 completed cases. For the math-disabled, that's a death rate of 25%. It would seem that a slider reaching 25% for a worst-case scenario would make more sense. After all, it takes 6-12 days for symptoms ot manifest, then another 18-32 days to either die or recover. And don't forget that "recovered" isn't like recovering from the flu. You get to deal with permanent heart, lung, kidney and/or liver damage and a sizable risk of sterility.

  233. @George Craig lol. Do not forget to account for 80% of people who are infected, but show no symptoms. About 2% or lower seems to be the mortality, which might be an overestimate because more people may be infected and show no symptoms and therefore never get tested. There is no need for fear mongering just because it temporarily feels good.

  234. I noticed that smoking was left off the list. The annual deaths from smoking are 480,000 per year... same as ths one estimate for this virus... Of course what is funny is that this virus is going to burn out eventually and no longer kill anyone... but the 480,000 that die from tobacco related illnesses will die every year. So the real question is why are we in panic mode for this virus and ignoring tobacoo? Shouldn't be be banning any tobacco right now if we are in this kind of panic for one time loss of 480,000 people when cigarettes are going to kill that many every year?

  235. @Yirmin Younger generations don’t smoke. Of course they have started vaping instead but I think that was a blip and is over now after all the severe problems. So, the smokers will all die out. Heart disease, stroke, cancer, emphysema etc are all related to smoking so it wouldn’t be able to be a line item on this chart

  236. @Yirmin I could be wrong, but I would think deaths caused by smoking would fall under "Cancer" and "Emphysema and COPD." Those diseases are what kills people, not the smoking itself.

  237. @Yirmin you don't understand Philip Morris pays a hefty dividend

  238. The more often people are told that no one will not die just because they are younger than 60, the better. Also, Covid-19 deaths will be *added to* all the other causes of death for people of all ages. Car crashes, drug overdoses, cancer, etc., will not just go away. And an overwhelmed hospital system will be less effective at treating everything, not just Covid-19.

  239. These figures presume no specific treatment for people infected with covid-19. No drug treatments have been discussed in the media, in fact. Why is that? Haven't people with the virus been treated in Chinese hospitals? When they're told to go to a hospital, don't they receive treatments? Please discuss victim deaths with/without anti-viral drugs in hospital compared to those who stay home alone. Anywhere. Also, please tell us the rate of death with and without respirators. These numbers look like standard actuarial tables with the addition of comparisons to a very small subset of tested victims. It stokes fear at best, along with frustration at the lack of potentially useful information.

  240. @Erica Blair Little mention of antivirals has been made, partly because very few exist and none are known to be effective, they may be, but so far data is not available. Ventilators help but with enough cases we will run out and they are not 100% effective.

  241. We won’t throw in the towel for cancer or heart disease, but for the corona virus, we’ll surrender $7 trillion in asset value and government expenditure, guarantees and printed money? In like, what, six days? And tell people they have to stay in their house, for two to eight weeks. Americans, sitting at home, for eight weeks. Seriously? Mark my words; Trump will figure out in 14-days how to spin this into some degree of Marshal Law and “temporarily” suspending the November election. So that we can save the lives of 6 of every 100,000 Americans? WWII was a sacrifice. Obviously 9-11 changed our behaviors forever. This? If you told me this was a set-up by the Chinese government to bring down the US and Western world, it would be almost impossible to refute. That we took the bait is a reflection on how complacent we’ve become in choosing a federal government.

  242. @Rich r in WW2 we had 440,000 fatalities over 4 years. Our population is a bit more than double now, so that would be be equivalent to maybe 125,000 per year now. This is not much compared to these other causes of mortality. The regular flu easily kills way more than 9-11 EACH YEAR so apart from a psychological event, it was not really that significant. In the grand scheme of things an extra million deaths in the US will be a noticeable and sad event but should not be civilization ending. Social distancing will not stop this but if it slows it down enough it will allow the healthcare system to be less overwhelmed and save some number that otherwise would have died, maybe a lot. We have been pouring resources into cancer research for decades with only partial success. This pandemic is something that everyone will play a part in, either as an aid in spreading it or and aid it slowing it. The panic buying of toilet paper and hoarding of hand sanitizer is not a good indicator that we will manage this gracefully.

  243. Could it be the allocation of resources is based on the worldview of men in their 70s such as Trump and Biden?

  244. @Rich r what nonsense. Pretending this is China's intention or even saying they're the sole accidental reason is ridiculous. Deforestation prompted very much by our own greed for everything cheap cheap cheap and new new new are much likelier culprits, but it's much harder to face that then point the finger.

  245. So China, a country of ˜1,300,000,000 people, which was the only country truly caught by surprise by the virus, with a late start responding, saw infections peak at ˜80,000 and deaths peak at ˜3000. That is an infection rate of 0.006% and a fatality rate of 0.0002%. South Korea, the second country with a runaway infection, and a population of ˜51M, saw infections likely plateauing at ˜9,000 and fatalities plateauing at ˜90. That is an infection rate of 0.018% and a fatality rate of 0.0002% (exactly the same as China's). Yet, somehow the fear mongers want us to believe that the US will sell over 1M deaths. Pleeeeaaaase.

  246. @Baron95 yes and no yes your math is correct but no in the sense that the estimates are predicated on the scenario in which we do nothing versus taking draconian measures to prevent the unchecked spread of the disease

  247. @Baron95 Its not like China and S. Korea are done with this and antibody testing would probably reveal a higher infection rate and a corispondingly lower death rate. I would take the Chinese numbers with a whole shaker of salt in any event.

  248. @Baron95 Do the comparison to the European countries which have more freedom and despite the advance notice are faring very poorly. Italy was the start, but Spain, Germany, and France are exploding with it right now. It is still early days, the reason for the "fear mongering" is that without controls this will likely be very bad but with controls we can reduce the damage. The impact on the healthcare systems in Europe is overwhelming them and moderately sick younger people are beginning to die as they can't get access to needed healthcare. Doctors and nurses are not immune and the faster / harder they work, the more likely they are to get infected and reduce the capacity of the system.

  249. This is irresponsible. You are using the worst case scenario for coronavirus. None of the countries that have had coronavirus have had even CLOSE to this many deaths. But....I am glad, at least, that there is finally some perspective being put on this. We are about to have possible martial law and perhaps a Great Depression. Millions will lose their livelihoods. We'll maybe even be told to hide indoors and give up al of our culture, our life, our friendships, our loves, our dreams. All to (maybe) save fewer lives than heart disease kills every year. Or cancer. It is absurd. We should have older people stay indoors, and we should practice social distancing and wash our hands. We should test, and isolate sick people. And look for a vaccine. But the rest of us need to get back to work. A. S. A. P.

  250. @Frank This is akin to throwing hundreds of thousands of older Americans into the gutter who will be suffering at their greatest time of need. Society has always sacrificed and shown compassion to help those less able to cope. Without removing protective measures to limit the spread of disease, the infection rate will go up among younger people, they will bring the virus back into their homes, nursing homes, and assisted living facilities. Not to mention these less at risk people will further tax and an overwhelmed health system and unfairly the burden the generous doctors and nurses that are going the extra mile even at risk to themselves. All lives, young and old are of equal value.

  251. @Geoff The vast majority of younger people will get infected and survive without needing a hospital visit. This results in antibodies to COVID-19 so they can't get reinfected or expose others. It's unfortunate that COVID-19 poses such a high risk to those over 60 or with other health issues but the only way to protect these people is for themselves to take proper steps.

  252. Well, as a 75 year old man with heart issues, this got my attention. What I would like to know, and have not seen estimates of, is the accuracy of the diagnostic test. In particular I want to know the rate of false positives and false negatives. I also want to know whether having recovered from it if you can be reinfected. After all, we get colds all the time then get another one.

  253. @Tom Rowe Don't know the accuracy but I was surprised to see early data that showed that even with restricting access to tests to those most likely to be exposed, over 80% of the tests came back negative. That stat is not readily available so I don't know how it is tracking lately (lots more testing is being done, more positives and likely a lot of negatives still).

  254. @Tom Rowe there have been cases of reinfection. Accuracy of the diagnostic tests is a good point, I'd be interested in those numbers too.

  255. @Tom Rowe From what I have read, reinfection is not likely and scientifically, this makes sense. When you get infected with something you develop antibodies to it. If your body encounters that organism again, it is able to quickly mount an immune response and fight it off. This is the entire premise behind vaccines. We get repeated "colds" that might seem the same, but in reality each time we have cold symptoms we have been infected with a new organism (various strains of coronavirus being among them!). Even if you got COIVD-19, recovered, then were exposed to it again, you would have antibodies that would help you fight it off faster and with fewer or no symptoms. You are exposed to things all the time and never know it because your body has antibodies to fight it off. People who have been diagnosed are being treated with plasma donated by those who have recovered for this very reason - it contains antibodies.

  256. What about those testing kits, Mr. Trump? Seems as if we'll need them until the pandemic you claim to have predicted "washes through."

  257. "If you use this article's assumptions that 30% of people get infected, in China that would amount to 900,000,000. " The arithmetic seems to be totally wrong. How did you get the number 900 million? What is the current population of China? 1.45 billion What is 30% of 1.45 billion? the answer is not 900 million. The answer: 435 million.

  258. @Padman: Also, note that the actual number of infected reported by China is currently ca. 81,000, an infection rate of only 0.0059%.

  259. @Padman: Also, note that the actual number of infected reported by China is currently ca. 81,000, an infection rate of only 0.0056% (of 1.45 billion).

  260. I cannot help but being convinced that this was engineered in China perhaps it was or was not designed to be delivered in the manner in which it was but the timing and the facts are far too convincing to me. The countries only level four bio lab located precisely at Ground Zero China's disregard for human life especially of their own people their stated desire for world domination coupled with the recent unprecedented challenges to them from Washington all threatening the ruling parties lust for power versus an random act of nature being a mirror coincidence if you buy that I have a bridge you may be interested in.

  261. @Jj Agreed! Been saying it all along.

  262. @Jj random act of nature? How about decades of deforestation only encouraged by our own need to consume many, many cheap products. So much easier to blame the "other".

  263. China has reported ca. 3300 deaths and ca. 81,000 cases so far, in a population of 1.36 billion. That's an infection rate of 0.00595% (cases/population) and a mortality rate of 3.99% (deaths/case). Even with fewer containment measures in the US than in China, is it realistic to assume that the US would have 3,400 times the infection rate (Lipsitch's low-end estimate of 20%) than China, and 62 times as many deaths as China (CDC's low-end estimate of 200,000 in the US vs. 3300 actual in China)?

  264. @Bur Davis do you understand we are 3 months only into a worldwide pandemic? All the things presented here are projections, but they are based on the real data that now exists. This virus does not just go away. The scale of this could be massive, globally and nationally.

  265. @Bur Davis Wuhan has a population of 10 million. They barricaded that city early on. We should be using the 10M number and not the 1.4B number. About 1% infection rate. We haven't locked down any cities yet.

  266. @Bsloma sorry but you don't get it. look up the term Farr's law. Farr was a noted epidemiologist. China is on the downslope of the curve and deaths are now declining each week. Also, the death rate is likely far far less than what is projected because it is widely accepted that many more people are infected but asymptomatic. I have heard estimates that 8 people were infected but not tested for every 1 that was. viruses like this are not unusual and the curves suggest that this will be far less than Swine Flu and Sars. you must consider political motivations of those making these claims and the leanings of those media outlets that choose who's research to publish.

  267. Great article. And I really like the calculator. Clever idea.

  268. Stop comparing death by coronavirus to deaths due to other, non-contagious, causes. The difference is obvious, I hope. Contagious vs. non-contagious.

  269. While the statistics outlining the number of deaths in the USA as a result of the Coronavirus shown in the article are quite sobering, it begs a very important question. “How many people who are projected to die from the Coronavirus would have died anyway from another malady??” Since the disease seems to prey on the old and infirm I really wonder what the true death rate is considering that many of those who are projected to die of Coronavirus would have died anyway and also required serious medical/hospital attention?? Are we assuming a much higher actual death rate then will actually be the case and unduly panicking the general population???

  270. @Stuart E. -- absolutely agreed. China has reported ca. 81,000 cases so far, in a population of 1.36 billion. That's an infection rate of 0.00595% (cases/population). And this article is citing a low-end estimate of 20%? Even given that we may have been complacent to start with, and are not as communal a culture as China, that figure just doesn't make sense.

  271. @Bur Davis I don’t think we can truly trust any data that has come from China. A country with a subpar healthcare system at best; if the U.K. and Germany is predicting 50-60% of their population is likely to be affected by this, it’s fair to say that the figures China has provided are grossly misrepresented.

  272. @Stuart E. Everyone dies, it's a question of when and how.

  273. This is little consolation, but death rates due to cancer and other comorbidities will also fall. Some people who would have died of these other diseases will have already passed away.

  274. @doug Many people who would have recovered from cancer and other comorbidities might die, due to not getting treatment

  275. I am disappointed at seeing the comments here trying to pretend that there is no problem. That's wishful thinking. Wishful thinking is NOT reality. One more thing. Trying to compare COVID-19 to cancer is really quite pointless. Cancer is NOT a pandemic disease; cancer is NOT contagious.

  276. Sometimes being old has it advantages, while I am not looking to downplay the effects of COVD-19, or it dangers, I would just like to put things in its proper perspective. Prior to 1955 there were 20,000 cases in the US every year of POLIO, anyone born after 1950, has no idea how devastating POLIO was, you got Polio you were crippled for life (FDR), or you spent your life in an iron lung, so while this virus is dangerous I will take it over POLIO.

  277. I am an old person (77 years of age currently). I am a retired physician and volunteer at a local free clinic. I believe it is important for oldsters to be able to contribute and perhaps to some degree shield the young from threats, rather than be advised generically to isolate ourselves. Such isolation may reduce the immediate death toll, but the gain in our longevity is likely to be very little. And lonely is very sad. Stephen Rinsler, MD

  278. @Stephen Rinsler I believe that eventually everyone is going to be exposed to this virus and a 30% infection rate seems reasonable. Right now the main issue is to flatten the curve so we don't overrun the medical systems' ability to treat COVID-19 and non-COVID-19 patients. Since COVID-19 is 20 times more likely to kill a 70-year-old compared to a 40-year-old then preventing exposure to a 70-year-old is 20 times more likely to flatten the curve compared to a 40-year-old. The data shows that it is up to those over 60 to take extra precautions (minimize contacts, extra handwashing, non-touching of the face) to flatten the curve. It's a sacrifice this age group needs to make for the good of us all. Meanwhile, the rest of the population can get back to work to get our economy back on track. (my 88-year-old father in law is practicing self-isolation, I safely video chat with him daily to help with the loneliness issue)

  279. @Merritt Phillips, thanks for comment. My view is rather different from yours . "Extra precautions" are recommended for all, not just people over 60. If our medical care resources are overwhelmed, we will need to prioritize who gets what care. In that circumstance, I believe priority should go to those who have a long life expectancy (think children, their caretakers and other young and middle agers). I would give myself a lower priority, even though I believe I am considered a pretty vigorous and functional person. With this in mind, I reject the idea that I must hide in my room for the next however number of months before this coronavirus is no longer considered such a great threat.

  280. Can't help but wonder where HIV/AIDS ranks on this list since it isn't mentioned and regularly claims many lives every year...

  281. Nice tactic. Give people slider bars letting them go to whatever level scares them. Scared people are easier to manipulate.

  282. Check my math for me on the WHO site, but isn't China's infection rate 0.0057%? I see 81,000 cases of flu in a population of 1.4 billion. The calculator does not even go below one percent infection rate. That is hundreds of times higher than the China infection rate. Since it is meant to show scenarios, not only worst case, is this misleading?

  283. Decimating the global economy so that we boomers can outrun death for a bit longer is madness.

  284. @Gardengal I used to think that. But now I look forward to the book called "How the Coronavirus Saved the Planet".

  285. @Gardengal Uh, some boomers are only fifty-five years old and have hardly been "outrunning death." You also don't take into account all those under age sixty with a preexisting condition. And I'm sure all the overweight/obese people under sixty with prediabetes are at greater risk of complications and death from the coronavirus, and they place more of a burden on health-care workers just by virtue of their weight.

  286. The fatality rate in France, where we have taken extreme measures to contain, is 2%. Just sayin'. Stay home, take this seriously. If you're infected and you take a bed, the teenager with appendicitis has a lower chance of survival. It's not about you.

  287. @anne from france ,I live in Turkey and I do not believe the news about the virus. I want to read the news from reliable sources. What kind of precaution should we take?

  288. Where are suicides in this table as the 10th leading cause of death? What does guns deaths mean?

  289. In every area that's got ahead of this thing (Korea, Hubei, Singapore, other parts of China) there's a strong social norm to wear masks. Even a napkin held over your face significantly protects others - it pribably does nothing for yourself but that's not the point. We should be manufacturing, distributing, and mandating masks as fast as we can. And those without masks should be making them out of paper towels and tape. It's hard to believe this would not save lives.

  290. @Dave The mask deters touching the face - a hard habit to break. Since there's a shortage, the government line is that you don't need a mask unless you're sick. If masks were mandated then government would have to provide them. It won't.

  291. Left out of this is the fact that — at a minimum — the three leading causes of death are considered by most to be death in the due course of aging, which every mortal human understands is inevitable.

  292. Thomas Malthis would love these scenarios!

  293. This is meaningless. At the upper end of the scale, (50% and 3%), it gives about 5 million casualties, while the deaths from other causes REMAIN THE SAME! More sensible would be an estimate of the change in life expectancy for the different age groups. Minutes? Days? Months? At the lower end of the scale, I would bet minutes or days.

  294. All fear, all the time. What possible benefit can there be in putting a "slider" in the article? Reporting pure speculation is bad enough. Literally giving people a vehicle to fuel their worst fears is irresponsible.

  295. @G Good Agree. I fear we are destroying our economy on fear. Don't agree with these high estimates. For the vast majority of people -- this is minor, not even detectable. What happened in 2017, when 60,000 people died from ... the simple flu. Should we shut down folks every year.

  296. @Pat The difference between the coronavirus and the flu are: 1. Far more people get the flu and the deaths although numerically higher are proportionately smaller. Percentage-wise, death rates from coronavirus have been reported to be anywhere from 8 to 23 times higher. So, yes, we can have from 60,000 x 8 to 60,000 x 23 dead from coronavirus if we decide to let coronavirus spread as broadly as we allow the flu. 2. We understand the flu. We do not understand the coronavirus. We don't have vaccines for the coronavirus, for example, to protect our most vulnerable. 3. As a result, treating coronavirus patients requires significantly more medical resources, which means we have less to care for those who need it. Say you have a heart attack and your local ER is full of intubated coronavirus patients. That is not going to go well for someone. We don't want that to happen. Until we have a vaccine, we need to take precautions.

  297. @G Good I agree, too. I am tired of reading articles that either contain almost entirely speculation or the results of ONE study. One study?! I like the NYT but am beginning to think some of the reporters are getting desperate to find material.