Worst-Case Estimates for U.S. Coronavirus Deaths

Projections based on C.D.C. scenarios show a potentially vast toll. But those numbers don’t account for interventions now underway.

Comments: 276

  1. If testing is so crucial to mitigating the worst outcomes, why won't the CDC engage in and encourage wide spread testing rather than highly limiting it?

  2. Precisely. If Bill Gates can supply the city of Seattle with testing kits, why can't the United States government provide all major cities with testing kits? I say "major cities" simply because cities are high-density places particularly vulnerable to germs. Why? Because Donald Tump has his reasons, unreasonable though they might be, all of which Mitch McConnell seems to approve.

  3. ...because it the federal government actually allowed testing, the numbers of infected will skyrocket - and that won’t help GOP re-election.

  4. @AC Incompetence, bureaucratic rigidity, inhibition (whether political, ideological, emotional or intellectual)...

  5. As a microbiologist who dealt with infection control during the HIV outbreak (albeit somewhat different conditions needed for control), the article presents a very cogent explanation , and one to be read by all and heeded.

  6. You are completely on target. I have been glued to this story for the last month and this is THE FIRST ARTICLE to break it down and present numbers. These are the sobering stats that will make a difference and change the way we interact in the short term to slow this infection.

  7. Frankly these numbers seem alarmist at best and criminally negligent at worst. There are so many unknowns that such projections are almost worthless. Among the unknowns is the apparent fact that most people who contracted the virus show little or no symptoms. And testing is way behind in the US so we have almost no idea how many people are currently infected, which severely impacts our ability to determine how lethal the virus actually is. We need more reporting the tells people to stay calm as we develop more information about the scope and impact of this illness.

  8. Science and technology can not solve almost any problem if the people in charge don't understand or refuse to accept the issue in the first place and whom to solve it for. It's also the responsibility of the scientists, the real ones, not those phony guys with a PhD in STEM or a job with scientist designation, but without those 'core values' that make people aware of the society and the world they live in. Two basic qualities of a scientist must be 1) honesty to talk straight, and 2) the courage to stand up for truth and honesty, particularly when those "core values" are challenged. Yes, democracy is not about elections or majority opinion to decide or evaluate truth, but about what to do with that. But that would fail miserably if we fail to understand what is *Truth* in the first place. And it's the scientists that actually define what is truth. Philosophers and other original thinkers later can add to that. Forget about communism and other forms of autocracy, even democracy would not work if we fail to define *Truth*.

  9. @Bonku "It's also the responsibility of the scientists, the real ones, not those phony guys with a PhD in STEM or a job with scientist designation." What on Earth is a "real" scientist, one without a degree in Science? What you are proposing is exactly what Trump is doing by appointing Kushner and Miller to make "science" decisions endangering millions of Americans based on their non-academic, uninformed, imaginary understanding of epidemiology. That we as Americans tolerate this disgusting display says a lot about where we are as a country. What's most pernicious is Trump saying that because his Uncle John had a PhD in Engineering - not epidemiology or any medical science whatsoever - Trump is somehow an expert in epidemiology. He actually said that. he said he understands the science behind the coronavirus. It is a level of insanity from a sitting President never seen before in this country. Anyone who thinks Trump is handling this growing epidemic appropriately is grossly uninformed - just like Trump himself.

  10. @Stefan Ackerman. Degree has almost no value to understand truth and logic. It's more so after higher education sector around the world, mainly in the USA, became just another for-profit industry where almost anyone can buy even prestigious degrees from Ivy league universities here. There are so many famous *real* scientists who did not even go to any college or Univ or had PhD but made some ground break discoveries/innovations, e.g. "Father of Genetics"- Mendel. Even Darwin went to a British Univ to study medicine. "He attended the official university lectures, but complained that most were stupid and boring". So he left to study nature! It's the same for many famous leaders in both corporate and public sector organizations. Both leadership and "core values" do NOT much come from formal education, as recent research indicates. Formal education may give skill set, at best, but not how to use it. There are so many reasons why even Harvard MBA can NOT mass manufacture great business leaders or entrepreneurs. Rise of mediocrity and failure of leadership to evaluate people/employees with real talent and/or leadership quality actually make people rely on formal degrees like PhD and MBA. In fact, decline of US industrial competitiveness and erosion of democracy started with declining quality of US education, mainly higher education system and crony capitalism that paved the way for rise of mediocrity and criminals.

  11. @Stefan Ackerman You make some good points and I don't think they contradict what @Bonku said. Of course to become a scientist requires many years of rigorous training - I was one in my previous life so I should known - what Bonku is saying is to not to let one's ambitions (political or otherwise) cloud his judgement. Two teams of Chinese experts visited Wuhan in January, they told the country that there was no human-to-human transmission so the risk was very low, even though by late December it was already clear to medical staff on the front line that there was human-to-human transmission. The ophthalmologist, Li Wenliang, who was muzzled by the authorities and later died from infection to this virus, was later found to have also made postings online back in 2011 supporting a journalist - the journalist was fired for not toting the Communist Party's official line on the train accident that killed 40 and injured 172, and criticizing the rush to resume train service before preserving all evidence for a proper investigation. It was no surprise that Dr. Li tried to warn others, because he was someone with a conscience, while those two teams of experts all of whom had the proper training and credentials, became accomplice to the party apparatus.

  12. The goal has to be flattening the curve. In addition to (or maybe it's included) testing and other mitigation strategies, social distancing and isolation needs to happen for everyone, everywhere. If there are places where it's "ok" or critical to still be with others, distance yourselves (6 ft or whatever the rule is). Witness the current photos of members of Congress, folks on NYC streets, the Stock Exchange trading floor, etc. - all rubbing shoulders, in close proximity with one another. The flat curve is not a positive scenario, still, but it's a better one.

  13. @Jane Bond Agreed. The virus has clearly broken efforts to contain it in the US... so now the nation (and the world frankly) is now in the mitigation phase. The number one priority HAS to be to flatten the infection curve to minimize how badly our healthcare system and workers are crushed and overwhelmed. Peoples lives literally depend on it now.

  14. If we can keep hospital loads under control and keep our frontline healthcare workers healthy, we'll see the low-end projections. This is only possible if we change human behavior. If Americans refuse to moderate / adjust their behavior and movements, then hospital capacity will become overwhelmed and we'll see the higher-end scenarios play out. It's on all of us, as a society, to inconvenience our lives for a few months for the betterment of everyone. It's really that simple.

  15. @TC wrote: If we can keep hospital loads under control and keep our frontline healthcare workers healthy, we'll see the low-end projections. This is only possible if we change human behavior. I believe it is already too late to prevent the healthcare system from being overloaded and crushed by this outbreak. Washington state, with less than 500 confirmed cases, is already seeing some hospitals overwhelmed by this.

  16. 0.25 to 1 percent mortality rate seems extremely optimistic by the CDC. China experienced 3-4%, Italy is at almost 7% and the rest of Europe at around 2-3 percent. Even South Korea, where early testing, treatment and containment has been extremely aggressive, has a mortality rate of 1 percent. Why the low estimates?

  17. @Simon Because it's still unknown exactly how many people have been infected with the virus. The number of people who die from covid-19 is (probably) more accurate. But it's very unclear the number who have been infected, particularly those who only experienced mild symptoms and so never sought medical treatment, or who were not tested.

  18. @Simon Because in the absence of wide ranging testing for who is or has been infected.. it is literally impossible to know the true mortality rate. Right now, even in Italy, mortality rate numbers are masked by limited testing (ie: testing only those who report to a medical facility with symptoms and get tested to confirm). It is extremely likely that there are many times more infected in the community than is actually being confirmed through tests... because their case is mild enough that they are not requiring medical care.

  19. The CDC has officially stated that coronavirus is especially dangerous for those aged 60 and up because infected oldsters are dying or becoming seriously ill much more frequently than those under 60. It has dawned on me that coronavirus may be used as an excuse to cancel US boomers, you know, those old people who consume an inordinate amount of funds for Medicare, Social Security and a wide range of social services. Lest you think I am an alarmist, I will point out that top doctors in Italy, which has the highest coronavirus case-load outside of China, have recommended that rather than admit patients on a first-come-first-served basis, hospitals should give ICU and bed priority to those with the highest likelihood of survival—that is, people under 60. Indeed, this under-60 guideline should apply to all patients needing intensive care treatment and not just those suffering from coronavrius, according to the Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SAARI). Yes, this recommendation is being made in Italy now, but in a couple of weeks, when US—and New York—hospitals and ICUs start to overflow, the policy will be considered in the US. Actors, politicians and other elites over age 60 have the money and power to get preferred treatment for coronavirus; the fate of the rest of us oldsters is up to the vagaries of the virus. Why hasn’t AARP picked up on this?

  20. This is perhaps the 5th time I’ve read this exact comment from you in reader comments. Nobody is trying to cancel boomers! On the contrary, all those restrictions worldwide are to protect YOU. My kids are not going to school, birthday parties, and our spring break vacation not because they’ll get sick, but to protect YOU. My spouse and I are both working from home today, again, to protect not ourselves but YOU. So please stop and be grateful.

  21. @Mon Ray While I don't think it's an overt plan to rid society of the burden of caring for old people, it's true that the reassuring narrative first promulgated by medical experts about how we shouldn't worry too much because the virus only seems to target old people with health problems. As a newly designated old person, hitherto strong, vital, never sick person, it did and does strike me that old people generally don't matter in many other ways. We don't buy things anymore. It costs a lot to take care of us and what we do have to offer society, our wisdom and life experience isn't worth much. Unless of course, you are a rich old white man, in which case you can be anything you want, politician or president with all the best health care money can buy. For myself, I'm doing everything I can to increase my chances to stay healthy and it's all free. I'm not shaking hands, not touching my face, I'm washing my hands, minimizing my outings and avoiding gatherings. I've cancelled my annual trip to Japan to visit family and will make do with our weekly Skype session. Finally, something I've learned from living a long and happy life in a hurly burly world. Minimize your stress. It weakens your immune system. Do what you can, then accept your reality. Take moments and simply breathe, deeply in and completely out, forgetting all else. It's the stuff of life and we take its magic for granted.

  22. @Mon Ray I tend to agree that us oldsters (I'm 85) should not be using up vital resources like respirators, etc. However, what really scares me is the idea that we won't even be given 'comfort care' if we are unfortunate enough to get COVID-19.

  23. I think eventually things will "normalize.' Maybe not normal as we know it now, but normal for living in a pandemic. The markets will come back and life will go on. It will just be a part of life, the way the flu is or AIDS, or even cancer. Almost everyone knows someone with cancer and many of us have had friends or family die from it. We're used to it, and accept it as part of our experience. I think living with this new virus will be like that. Just a new normal.

  24. @Ms. Pea Yes, but the idea is to get to that state without first going through a peak that overwhelms the health care systems of countries, as has happened in Italy.

  25. This is the type of approach that spreads the virus.

  26. Don’t be snowed, Ms. Pea. The new normal you envision will likely be on the order of those following 9/11 and Pearl Harbor, with the tragic distinction that our leaders’ hubris (and the decline of our democratic ethos over the last four decades—excepting a few bright exceptions proving the rule) has brought this catastrophe upon ourselves. Around the world, individuals and governments are at varying points on the learning curve regarding implications of this dress rehearsal for apocalypse. I say ‘dress rehearsal’ because while *millions* are expected to die as a result (likely 1MM in the US alone—inconceivable until this week to all but a cadre of muzzled experts), the dynamics of arrested grief sustaining the denial which brought us to this point are exactly the same as those we must transcend if we’re to save ourselves from the *utterly* obliterating peril of global climate change. Denial, Anger, Bargaining, Depression, and Acceptance are the tasks w/which we must progressively come to terms—individually and collectively—if we ever hope to flatten the emissions curve necessary for preserving the viability of our species and planet. While current attention must remain laser-focused on recovering from the effects of this epidemiological own-goal, I pray we don’t then squander the opportunity to process our horrendous loss through to acceptance of the need to better learn lessons of informed preparation...lest we all then shrivel and die in this precious blue-green pod.

  27. The Cleveland Clinic closed our Lakewood Hospital, and several other local hospitals, over the past few years. We were told our area was oversaturated with hospital beds; that hospital admittance was not how medicine was done anymore. And now we don't have nearly enough bed?

  28. @Laura Available beds don't allow for a huge surge in demand, such as a pandemic. And ICU beds even more so.

  29. @Laura The private sector, predatory capitalist model of healthcare at work. It doesn't take public good into account. Obviously.

  30. @Laura All hospital corporations have been doing this, or similar, for years now. It is the nature of for profit corporations. But setting that aside... there will never be enough hospital beds to deal with everyone needing supportive care.... regardless of past decisions. You simply cannot maintain a 250% capacity level in hospital infrastructure in this country for the rare occasion when something like COVID-19 strikes. Doing so would double the already extremely high cost of healthcare in the US and that cost burden would be passed through the entire healthcare system and onto Americans.

  31. There's one variable that can make things worse: About one half of the political spectrum doesn't believe this is a big deal. Polls show Republican are less likely to wash their hands than Democrats. This shouldn't be a partisan exercise. But with Trump calling it a hoax up until a speech that sent Dow futures taking, and all conservative media personalities except Tucker Carlson singing from Trump's hymn book, millions of Americans will not do what they have to because they think It Will Bo Ok. I hope the worst doesn't happen, but it will be in spite of Trump, Limbaugh, and Hannity, not because of them.

  32. Exactly! That is why this is so surreal. Political pundits who are spreading the “hoax” misinformation will have some explaining to do in the near future. Think the delegation from Brazil at Mar-a-Lago.

  33. Thank you for publishing this detailed and scary article... thank you for giving us this information so that we can make informed decisions on our behavior... for example, I didn't shake hands yesterday at a meeting... none of us did when I reminded everyone to practice social distancing... we all agreed that was a good thing.... so keep digging, keeping telling us the truth, no matter how scary... because truth is light, and it will help us to face this challenge....

  34. We’re running out of time. If the lessons from history are that the sooner you close things down, the better the outcome, why haven’t all cities and states taken greater measures to close things down? Obviously we cannot rely on our mind bogglingly inept federal government but local leaders are smarter than this administration — they should be more proactive in saving lives. Every day they delay, the virus is spreading further, making it more likely our hospitals will be overwhelmed.

  35. Thank you for publishing a sober, honest, reasonable assessment of the potential consequences of the coronavirus epidemic. We will not get such a forthright message from the Trump administration. Not now. Not ever. Trump cannot handle the truth. Because even Trump knows, albeit subconsciously, perhaps, that he is incapable of even being marginally helpful, let alone leading, in such a real crisis. I wish Trump was merely useless. But we're not even that fortunate.

  36. Adding to the difficulty of containing the coronavirus here is the fact that Trump disbanded the US Pandemic Response Team two years ago.

  37. @jdvnew No disagreement, but we need to stop with the constant history lesson retrospectives and get in the present. It serves no useful purpose at this point in time. What matters now is mitigation and saving as many American lives as possible.

  38. @jdvnew I say it bears repeating over and over and over until the American people realize that we have been set-up. John Bolton is no fool. He knew exactly what the consequences would be and he should be held to account for it. There is a reason we are up this creek and there is a reason there are no paddles in our canoe.

  39. @Chuck Let me get this straight. We’re in this situation because the president failed to immediately act to protect the American people but you want us to shut about it now so that same president can start to do something?

  40. These officials at the CDC seem to have made the same mistake climate change scientists made for decades: withholding reasonable projections of what might happen if we don’t act, because of uncertainty in the models. That uncertainty is itself a reason to consider worst case scenarios, as well as more hopeful ones, and plan accordingly.

  41. Climate change scientists most certainly DID NOT withhold information for “decades”. Rather, quashing information about climate change has been the sole purview of Republican political criminals for decades. Put the responsibility where it belongs!

  42. @Jackson Goldie Agreed on the corporate and political malpractice involved in denying and obfuscating climate change.

  43. Science, leadership and a spirit for the good of the collective need to converge for us to have a shot at managing this. I know the science is there, and I see flashes of community where I am but, but I fear for us. The most basic thing that could glue us together, a compassionate and cogent national leader, is quite honestly the most unglued thing about this. Reality prevails, and that terrifies me.

  44. As Churchill said: Americans will always take the right the decision, after they exhausted all other options. With the current leader this is a certainty.

  45. @Ronald Grünebaum Misquote, I'm afraid, and almost certainly not said by Churchill. The current leader "will always take the right decision"? Good luck with that.

  46. @Ronald Grünebaum That assumed normal levels of competence, venality, self-dealing, denial and avoidance. We are not at normal levels.

  47. @Ronald Grünebaum I don't believe it is a certainty that Trump will EVER take the right decision. He just doesn't have it in him.

  48. When the story leads with the worst case scenario of millions in the U.S. potentially dying it is certainly a ratings grabber. There is group panic happening. People are arguing over who gets the TP or bleach. Balance is needed. Reading further along - even just to the paragraph of how already such scenarios are changing due to efforts such as social distancing - not as ratings grabbing but to me heading towards responsible balanced reporting. Unfortunately many aren’t getting the nuance. The media is contributing to that for the sake of ratings — money. The same thing that drove Trump’s rise to power.

  49. @Anonsf Actually this is exactly what the NYT should be publishing, because our leaders are not acting appropriately to mitigate. So citizens need to see the threat for what it is, be jolted awake, and demand closures. In New England, mitigation is happening from the ground up, by school superintendents, business owners, the arts and sports communities... But their mitigation efforts will be blunted if it’s a piecemeal patchwork of social distancing. These data were from February 28 back when our leaders had time to act and mitigate completely... yikes! This might will be made into a tragic film someday that our grandchildren watch, horrified.

  50. The numbers are real! They are based on a JAMA article regarding the Chinese experience. Viral infections don’t care what you think or your political affiliation, or what your favorite news source is.

  51. @AnonSf I do not agree with your opinion that media- NYT in this case - are contributing to the panic. I am grateful for NYT solid informative expertise based reporting, I would rather know the range of expert scenarios. I actually believe the article shows the lower ranges of deaths in wort case scenarios..... and I am basing this on the Italy's numbers.

  52. To the best of my understanding, most of the assumptions built into these calculations seem accurate - but why are we estimating the fatality rate at min 0.25%, max 1.0%? WHO earlier this week released an estimate of 3.4%. Maybe this assumes the infection rate has been higher than tracked (which would increase the denominator and lower the percentage). But even South Korea, which I think has been the most on top of testing/most likely to capture all infections, has a higher rate than that - so I’m worried this “worst case scenario” may be overly optimistic.

  53. @Chris In the long run, fatality rates probably will be closer to 1%. Reason: right now, the only people being tested are those either being hospitalized with severe symptoms, or in some cases people they have come in contact with. As such.. due to limited testing, we are seeing a skewed result in mortality rates (even for China at it's peak of the epidemic). This means there are many more people in the community infected, but having a more mild response to the virus, and as such never being tested and confirmed to have it. What is going to be needed more than test kits now are anti-body tests in large volumes so that every American can be tested to see if they are immune now from already having been infected. In other words, we need a population wide confirmation of anti-bodies for COVID-19. This will help when a vaccine is available sometime late this year or next year.... as only those without anti-bodies would actually need the vaccine and should be given priority for vaccination.

  54. @Chris South Korea's case fatality rate is around .8%. https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 Italy's is 6.6%. Both percentage figures use the reported confirmed cases as the denominator, rather than estimated infected (which is dependent on testing and test reporting over time). South Korea was aggressive in testing and distancing. Italy has a proportionally larger elderly population. Those differences may account for at least some of the CFR difference.

  55. @Chris My take is that the “worst case scenario” described in this article is not actually worst case—it represents a situation where, as in South Korea, the healthcare system is not overwhelmed. It appears that, where all who need to are able to access medical care, the case fatality rate is ~0.7%. This is the case in South Korea, and matches up with the CDC’s high-end infection and fatality numbers here, more or less. However, where the healthcare system is overwhelmed, and people are not able to access modern medicine, the CFR appears to be somewhere north of 3%. Italy seems to be going down that track. That said, without actually seeing the presentation (which should have been provided to the public), we don’t know what assumptions the CDC is using regarding the restrictiveness of mitigation measures, the rate of undetected cases, etc. I hope that these numbers are accurate, and the experts have presented numbers that are free of as much internal bias as possible, but I fear that these numbers are still influenced either by politics, or by a misguided sense that “it can’t happen here.” My gut tells me that, simply due to American habits and culture, the brittleness of our healthcare system, and the spread of disinformation, we are more likely to go follow the Italy track than the South Korea track, at least for a while. Perhaps once hospitals in Seattle look like hospitals in Milan, we will see strict measures to control spread and reduce the loss of life.

  56. Thank you for laying out the numbers so starkly, and presenting our choices clearly (albeit with the inherent statistical uncertainty of efficacy). I've stepped up my personal hygiene, but I know I could be doing more for social distancing. I just wish my employer, children's school, city, county, state and our federal government was also taking more action.

  57. This article is based upon data that is a month old. It's very sobering and a stark contrast to the outright lies told by Donald Trump. The president of the United States is worse than useless: he is an absolute liability. If you voted for Trump, hide your shame, you're complicit in killing Americans.

  58. The Trump presidency has been an ongoing dumpster fire (Trumpster fire?) since the first day, with week after week of controversy and scandal being upstaged by more controversy and scandal. We had become almost numb to it. There is finally a story that Donald Trump can't hide from because now we all can't afford to just "forget" the latest show of ineptitude. Our lives now literally depend on paying close attention.

  59. Here is the problem in the world. Over-population and over reliance on government. We need to lower and stabilize the population and shrink the size of government.

  60. @Chris Ok, we can all just self organize into a bucket brigade for the next fire. Of course, a bucket brigade for the Corona Virus would be a great way to spread the illness as we pass the bucket from hand to hand.

  61. @Chris Why don't you start helping with the trend?

  62. My sole purpose in posting this comment is to give a huge, sustained, giant, public shoutout to Michigan Governor Gretchen Whitmer for her courageous leadership in moving swiftly to mitigate the virus in this state. She is not shrinking from the hard choices that need to be made in order to protect many. Public officials, take note.

  63. @Michigan Native I second that, although I wish that she had stepped up even earlier.

  64. There is an excellent account of the current situation in Northern Italy, where I live https://www.nytimes.com/2020/03/12/world/europe/12italy-coronavirus-health-care.html Please note the Northern Italian public health care system is among the best in the world. Besides, it is 100% free for everybody, nobody will ask you what is your insurance or your credit card number when you call emergency. Please also note that the actual number of cases in the US is a lot higher than you see. In the initial phase of the epidemic, numbers double every two or three days. The time elapsed between when you get ill (and contagious!) and when you take a test and the result is available is serveral times that. So the actual numbers can be 2^3 or 2^4 times higher right now, i.e. 10 times bigger, and they will double every three days if public authorities don't take harsh measures to limit social contact. Given the current total lack of leadership from the top, I see dire times ahead for the US health system.

  65. @Francesco Casella Agreed. The actual numbers are way higher in the general population. That means that this infection peak or spike they are worried about flattening is going to come way sooner than everyone is expecting. The US needs to be shutting down and enforcing social distancing now. Unfortunately, I don't think they will until the peak slams into them.

  66. @Francesco Casella Sadly, I agree with your assessment of the US response and the consequences.

  67. @Francesco Casella The great irony is that Democrats and Republicans alike say we cannot possibly afford Medicare for All. I would argue we now know we cannot possibly afford NOT to have it.

  68. Keeping NYC public schools open is not helping to flatten the curve.

  69. No data. No ideas.

  70. A friend who is a Trump supporter posted to her Facebook page about how this pandemic is fake news. I was very discouraged by the comment section to find that many truly believe that the pandemic is a hoax perpetrated by the democratic party to finish off Trump. Ironic to see that people who were terrified of asylum-seekers are now casually pooh-poohing the coronavirus. Also ironic is that their behavior will probably lead to its greater spread. 

  71. @Realist Its perhaps the oddest reaction of those in thrall to a cult of personality. Their positions in this regard will be studied for decades by historians, sociologists and medical experts. As the article says, and Fauci confirms, the "worst case" is only avoided if we act accordingly.

  72. @Realist Spring break is around the corner! Party time USA! So great...

  73. @Realist "A friend who is a Trump supporter posted to her Facebook page about how this pandemic is fake news." Tell them if all the trumpers get sick and diebecause they believe it is fake then they won't be able to vote for Trump and so he will lose. Maybe that will get their attention!

  74. Now would be a good time to encourage family and friends to reach for a falafel wrap instead of cheeseburger; get up and walk instead of Netflix: a good time in America to prevent heart attack and stroke.

  75. Please - first, do we have anything worse than an unexpected ‘flu? If so, is it worth wrecking the economy to prevent a relative handful (worst-case) of deaths? Question left unanswered - given the typical victims of a lower respiratory infection, are the fatalities likely to be healthy people or people already suffering respiratory or immunodeficiency problems? This would identify the pool of people in need of protection. It would also pinpoint the larger pool of people at low risk of death if they contract the disease. Closing down schools and universities, museums and professional sports leagues is silly. Telling people in the risk pool and those who are ill to stay home and providing them with free care, continued pay and any assistance they would need to survive (food delivery, etc.) is sane. Cutting payroll taxes, when we are most at need of resources is madness. Clamping down on disease profiteers certainly isn’t - companies making test kits, which currently don’t seem to distinguish between active cases and past cases conferring immunity to reinfection, developers and suppliers of vaccines and anti-virals should be given a choice of being declared heroes - working at zero profit or a loss, or ultimate villains - earning their usual outrageous profits on severely needed meds and supplies - risking the loss of any government-funded institutions’ contracts and being held guilty in the court of public opinion. This is NOT the Plague and it isn’t the mid 1300s.

  76. @etoin dhrdlu - Have you read the articles about the situation in Italy? If not, please do. Are you an epidemiologist? If not, please consider reading the articles about “flattening the curve.” We have a very small window of time in which to act before the virus overwhelms our healthcare system and hurts sizable numbers of vulnerable people. It’s not about me, it’s about us.

  77. since when is a half million or a million deaths considered a "handful"? Go back and read the article again. This is not "an unexpected flu.' To quote the article, "...The most lethal pandemic to hit the United States was the 1918 Spanish flu, which was responsible for about 675,000 American deaths, according to estimates cited by the C.D.C. The Institute for Disease Modeling calculated that the new coronavirus is roughly equally transmissible as the 1918 flu, and just slightly less clinically severe, and it is higher in both transmissibility and severity compared with all other flu viruses in the past century."

  78. @Eatoin Shrdlu You are absolutely wrong. Yes, this is worse than the flu. Read the article, it explains very clearly why this is much worse. Look at China, where the country and Wuhan specifically shutdown down completely over this, and look at how many were infected and how many died. Now, extrapolate that onto a country that has taken NONE of these precautions, and you are looking at a much worse situation. Take this seriously. Our government is downplaying it and the most crucial moment of prevention is BEFORE the confirmed cases start pouring in. That moment is now and the most important thing you can do is isolate yourself and not go about business as usual, because you could be spreading it without knowing you have it.

  79. What this seems to indicate, or confirm, I should say, Is the Trump administration has been significantly downplaying the risks to Americans. States and cities and individual hospitals have been figuring this out and taking the lead. I understand from another news outlet that the World Health Organization offered free test kits to countries, which I understand is why other countries (South Korea) are testing ten thousand a day and we have not done ten thousand total. Why did our government not take advantage of this resource, and can we still do so? This is literally a disaster unfolding before our eyes.

  80. @Joanne I suspect that creating a "made in the USA" test presented a business opportunity to someone.

  81. @Joanne The CDC refused WHO's test and went for its own. Then CDC flubbed the manufacturing quality control and got defective, unusable test kits. CDC then refused public health authorities' begging requests to use alternatively developed tests and unofficial (but perfectly competent) labs to process them. CDC has failed its primary public health responsibility. There's no other way to say it.

  82. @Joanne The BBC reported yesterday that South Korea, mostly on the strength of drive-thru / text results testing, had tested 15,000 people per million. The USA? 5 (Five) per million.

  83. So, where's the testing? The virus is shedding in respiratory secretions up to 48 hours in advance of illness symptoms appearing. That means people can be infectious long before they or anyone else knows it. It means there are a lot of walking zombies out there, doubling every 5-7 days. Not to demonize anybody - it could be any one of us at some point - but that dramatization highlights that we must be careful with everyone we're in contact with because we don't know who's infected and capable of transmission. EVERYONE. Like the oxygen-mask instructions on a plane, take care of your own responsibilities first, so YOU don't burden the system. Quarantine, isolate, distance as necessary, erring on the side of caution. Erring doubly on the side of caution. Then support others to do the same and interact with them with both care and firmness, so THEY don't burden the system. Practice distance not just in dimensional measurement, but in number of contacts, frequency and importantly duration (the longer you're in contact, the increasingly greater the risk). Examine your concept of safety, and then increase it. Same for personal hygiene. Increase what you think is enough. And always keep in mind the zombie infected, including possibly yourself. Hard not to get paranoid, but there's a sweet spot in there between paranoia and complacency that gives confidence and trust. Due attention.

  84. In the US, we don’t censor data about health. Or at least, we used to not censor. Lack of information breeds fear. The a Trump Administration’s close hold on information and its slow response breeds fear and distrust. They’ve been quick to worry about the stock market and sow to worry about people. It’s pretty clear who they are looking out for. And it’s not the “forgotten man.”

  85. In San Mateo County, our head of public health, Dr. Scott Morrow , has frozen in the face of this crisis. In the last three days the positives in our county have risen from 5 to 15 as of yesterday. He states that we have moved to a pandemic plan but he says that means we are no longer quarantining positive cases and we are no longer contact tracing. He says we need to impose lockdowns but then in the next breath he says he can’t do that San Francisco’s international airport is located here, in our county. We are sandwiched between San Francisco and Santa Clara counties . We are the center of the universe. It is critically important for the world that San Mateo County follow the directives of the World Health Organization , when they exhort fumbling countries that the time is now to double down on containment - testing, contact tracing and quarantining - at the same time we are moving to large scale mitigation. Please , everyone who cares , contact the San Mateo County Board of Supervisors and ask that we continue to do our part ;that we haven’t given up and that we understand what our responsibility to the world is .

  86. Too late for containment and no point in doing contact tracing as the virus is far too widespread. Efforts need to be focused on mitigation through social distancing in order to slow the spread and flatten the curve in the growth rate of the virus rather than expending precious resources on a too-late approach to containment.

  87. What is the real explanation for the lack of test kits? Couldn’t we buying them from German or other international companies? Why haven’t university medical centers been authorized to use their labs ? Is this all about Trump wanting to keep the case numbers low? Protecting the American manufacturers from competition? If yes then Trump should be held directly responsible for the consequences in human suffering and death and financial loss.

  88. @nl "Is this all about Trump wanting to keep the case numbers low?" . No.

  89. Your interesting questions should be investigated by the New York Times. Meanwhile, I wonder why so many people are stocking up on things they use everyday. Why do they feel the need to have available, items that they regularly consume? Why don’t they have a good amount on hand all of the time? Test kits however, are not often necessary and which medical administration wants to take the blame for purchasing and storing large amounts of infrequently used items?

  90. @West Coaster The world supply of most items has already been grabbed up globally. Many items come from China and a lt of their plants are shut in quarantine.

  91. I am a 68-year-old woman who is in good health. I am taking this seriously. I am keeping my social distance and doing the appropriate cleaning and sanitizing in my home. I live in SW Ohio where unfortunately too many folks believe that the Coronavirus is fake news, not dangerous, and perhaps not real. They are taking their cues from the president that they strongly support and Fox and right-wing media from which they get all their information. I am afraid these non-believers will not take any precautions until it is too late for them or someone that they care about or to a friend, co-worker or community member to whom they spread the virus. These folks will not come anywhere near a news article like this that presents them with scientific facts--and if they did see it they wouldn't find it credible. Lack of information and willful ignorance are forces that need to be combatted as much as the Coronavirus here in America.

  92. @Meg The president must tell his audience how deadly coronavirus is. He must let them know they can protect themselves: 1) stay away from others 2) wash hands often and thoroughly Get more info from CDC.gov More info: https://www.cdc.gov/coronavirus/2019-ncov/index.html

  93. Your comment shocked me ! There are people who think this is “Fake News” ? I am stunned.

  94. @Meg if I could like this comment five billion times, that wouldn’t be enough. It sounds like people in Ohio have a lot in common with people in Alabama. It’s so frustrating. I’ve been cleaning my house and stocking up on food and medicine, and I plan to stay as isolated as possible for the next two weeks. My parents live about fifteen minutes away — they’re your age but they’re not as healthy as you, my father has high blood pressure and gets bronchitis without fail every year, and my mom has high blood pressure — and today I’m making them some freezer meals so they won’t have to go out to eat. I’ve also been sending out Dr. Dena Grayson’s videos to everyone I know, and I recommend that everyone watch them and follow her on Twitter. The video she most recently posted is a must-watch. She predicted this many months ago and she has the right approach to what needs to happen with the vaccines. But of course people who adore Trump won’t listen to her. It’s basically one of those “educate as many people as you can and maybe some will get it” sort of things. You can lead a horse to water but you can’t make him drink.

  95. Thanks for this great article about what is likely to happen if the transmission rate is not significantly diminished by changing people's behavior. Looking down at 100s of thousand of deaths should get people attention. Saying it is like the flue that kills about a 10th of that is doing the opposite as we already factored that risk as acceptable for most of us. I am a little surprised that the death rate chosen in the model is at maximum 1%. If access to care get challenged as suggested by the mismatch of hospital beds versus the expected millions in need of hospitalization, it could as bad as the worst death rate in China (around 3-4% based on diagnosed cases, so the reality might be half of that). Social distancing of people with pre-conditions and the elderly should also be emphasized as death rate for this population can be has high as 10%. This population is very aware of this at this point. In any case, the US is now taking this epidemic a bit more seriously. That's a good thing. China was able to contain the explosive growth in cases with now very large drop in new cases with under 5k deaths so far. Hopefully we can do as well and keep these dire prediction in the realm of what if we did nothing different.

  96. Nope. These numbers are not what is likely to happen if people don’t change their behavior. These numbers WERE what might have happened as things stood in February if no one did anything going forward. A lot has happened since then; drastic change, in fact. Sensationalistic reporting and selective reading thereof such as you’re exhibiting are the equivalent of telling “Fire!” in a crowded theater. We have a fire and we have burn victims. Let’s not add stampede victims to that toll.

  97. Without quick and widespread testing, we're flying blind here. I don't believe that the CDC or anybody else has a real idea of mortality for this virus, however sophisticated the mathematical modeling. It used to take weeks to get results for an HIV antibody test. Now one can walk in and have results in minutes. We need that for COVID-19. If we had such tests for this virus, we could test passengers coming from other countries, passengers boarding domestic flights, passengers boarding and disembarking from cruise ships, people at drive-up test sites (to limit the exposure of others). And we wouldn't just test those we suspect. Everybody could get a test, and would be required to test if they boarded a flight, a long-distance train, and so forth. For now, we're hobbling our economy in ways that won't be soon repaired just because we lack an instant reliable test in the 90+% range of accuracy.

  98. The fundamental flaw in modeling is in the assumptions they make in developing the model. The second problem is in the data they use in predictions. Human behavior is highly nonlinear, unless, the model consider the nature is partly deterministic and partly stochastic, the models are not accurate and predictions vary vastly. So, one must accept the predictions with a grain of salt.

  99. @Kodali So, reality could be much less severe or much more severe. Hopefully you are not recommending that people take the suggested precautionary measures with the same grain of salt...

  100. @Kodali Yes, choices are made for what type of method to employ. So various methods are used, each with certain advantages and disadvantages, and the results compared. Yes, data quality and composition is an issue. So data is collected from several different sources and carefully scrutinized. Yes, things are seldom simple or linear. So multiple algorithms which are non-linear are available for use. And, models are never 100% perfect, they have errors which themselves are examined for statistical characteristics. But, here’s the important part, they are more useful than not using models.

  101. @Kodali Very true. In the 2017-2018 flu season, over 60,000 people died. This was double the estimate.

  102. This information is of great importance - it's good to FINALLY see open reports of these projections. It's understandable that modellers would be cautious about releasing projections like these prematurely. However, these estimates of our likely need for hospital beds are extremely important for citizens trying to fully understand the situation. Trump's task force should have shared this sort of information themselves.

  103. Waiting for it, waiting for it. Don't need to hold my breath. Trump will shortly blame State Governors for the spread of COVOD-19. 7...6...5...4...3...2....

  104. @DTM And just think of all the people that trump personally could be infecting. His irresponsibility knows no limits.

  105. Out of the mouths of idiots, troglodytes and babes. I just turned in to Fox&Friends to hear Jerry Falwell Jr. imploring all not to close schools. As evidence that coronavirus is being overblown he cited that the “ H1N1 virus killed over 17,000 people and there wasn’t this much hype”. Case proven, fool. If there had been this much hype and action taken with H1N1 perhaps many of those 17,000 deceased would be alive.

  106. @Em Ind Falwell has to keep the contributions coming in to keep his business empire afloat. Prosperity gospel, right?

  107. @Em Ind Anyone listening to a TV preacher for advice on infectious diseases would probably hire a plumber to fly a jet plan.

  108. @Em Ind I think it was Falwell's father who attributed Katrina to acceptance of homosexuality. Once there are 17,000 deaths, Falwell the Lesser has half a dozen groups on which he can cast blame. He and Trump just have to agree on which one, then the next one, then the next one...

  109. Reality Check call national holiday an close schools an allow parents to stay home take care familys .Forever how long takes,use the money we waste on arms mass destruction.

  110. The officials in Omaha (all far right republicans a fact I am pointing out simply because the NYT democratic bias grates on me) have followed all the community procedures outlined in this articles---school closing, no mass meetings etc.---except instituting widespread testing which honestly they have no control over. (The far right republican in the WH really blew that one.) They have been acting aggressively from the first case of coronavirus to emerge in the community and they are acting more aggressively now we have two cases. My suspicion is they are simply following the advice of the doctors at the UNMC infectious disease unit. I am very grateful to live in a place where the local medical structure has real expertise in this area and where local officials defer to the experts. My sense from reading the Times is that this is not that common in other parts of the country (to say nothing of the head of the federal government) and this is regrettable.

  111. @Doug Here in NY we've seen our Governor and local leaders fill the void, but for the kits...and the Governor made serious moves to get testing kits in NY. The yawning wind noises from DC and intentional misinformation from the Echo Chamber is criminal.

  112. @Doug Yes, it is because of UNMC infectious disease unit and also because of there being a hugely important Air Force Base critical to national security right there.

  113. @Doug It appears that many think fierce loyalty to Trump makes them immune to the virus.

  114. The American people need to directly hear from the top biological epidemiology, virology and infectious disease science professionals in the executive branch regarding the COVID-19 threat. The politicians need to step aside and shut-up. And limit themselves to discussing and passing socioeconomic economic legislation to address the consequences of COVID-19.

  115. Put Katie Porter on the planning team

  116. @Colgrove I wish Katie Porter were running for president or, if not that, up next for Speaker of the House. She is the sharpest one in Congress as far as I can tell.

  117. @Colgrove Everyone should watch the video of her questioning the sadly unprepared head of the CDC.

  118. Funny thing, that the only people who seem to have been infected in the US are celebrities, and Russia and China doesn't seem to barely have any cases at all.....!

  119. Nearly 500 cases in Washington state, over 300 in New York, and over 200 in California...and “only celebrities” seem to get it. I suppose the majority of the 31 dead in nursing homes in Washington were world-famous? Such a conclusion can only be made by mentally filtering one’s news intake. The virus is remarkably egalitarian and is hitting across all socioeconomic brackets. No one is completely isolated from it, despite what they may have become acclimated to. Just ask the ranking officials in Iran.

  120. @Mark Eliasson China has the most confirmed infections on earth, 80,945. Out of the 1,268 cases of infection in the U.S., I only know of 2 celebrities.

  121. @Mark Eliasson China has no cases?

  122. These numbers are, of course, important for all Americans to understand, and act upon in their communities, in spite of how terrifying they are. For these are not just numbers, but human beings. Our fellow Americans. But what is more terrifying is that this administration has tried to keep these kinds of briefings under wraps, classifying coronavirus discussions, and sidelining doctors such as Nancy Messonnier who have tried to tell the truth about the threats we are facing as a nation. Silencing experts and denying access to data only serves one purpose: to make the president look good while he says the virus will soon "miraculously" disappear. In fact, he has assured us not long ago, cases could soon go down to zero, knowing full well what the experts are saying behind closed doors. And while, at the same time, his administration fights to kill the last of the ACA. Now that is what I call terrifying.

  123. @avrds Politicizing the problem is not helpful or appropriate. Trump is the President and in times of crisis we need to unite together and not panic.

  124. @Raul Campos No. Trump is the problem. At every turn he has done the wrong thing in ways that are now going to cost exponentially more lives. Look. No one in contesting that we would have had this regardless of who was president. But this man has failed to act in any capacity other than lying and disseminating false information, two factors that make pandemics worse. It is absolutely germane and necessary to talk about that, because we must now insist that he be taken out of the equation. The man should not be allowed in front of a mic again until the worst has passed. He is endangering us. That is important information and you (and the many other scolds on this thread) have no right to tell us what we get to think, feel and say. He is not a god nor a king, though many of you seem to seek that in him.

  125. @Raul Campos There's nothing political about wanting the president to tell the American people the truth about this disease and expecting him to work hard to minimize its impact. Democrats and Republicans should all want that. Instead, we know now that experts have been predicting a deadly impact nationwide if nothing is done, at the very same time the president is out golfing, assuring us everything is fine. Cases will soon be down to zero. It's all a hoax out to get the president. I suspect Americans will unite together, and follow the leadership of their local officials, not the president. But a little transparency could have gone -- and still would go -- a long way to help Americans be better prepared. Classifying coronavirus information so only the administration has the real data may very well cause panic, not prevent it.

  126. This is unacceptable. China has plateaued at 100,000 cases presently, but we are expecting up to 214,000,000 cases? Clearly we need to drastically change what we're doing if we are still on that path. China was building hospitals as the virus ramped up. Italy has shut down. Our federal government appears to primarily be coasting along and doing not much other than casting blame. Instead in this leadership vacuum, individual states, localities, and companies are left to do piecemeal things that might help. I hope the "drown the government in the bathtub" and "he tells it like it is" folks are happy as it all hits the fan. This response so far is what I would expect in a third world country, and I'm not optimistic it's going to change.

  127. Also lying about the availability of free tests.

  128. @Jonathan It's the "free market" forces that may save us. It will be drug makers that develop a protocol and/or vaccine. It will be private labs that allows us to test on a large scale again (after Obama cut them out of the process). The poor showing at the FDA and CDC demonstrates how government control, while important for maintaining standards, etc.. can be a disaster when innovation and speed are required.

  129. @AACNY A national pandemic requires a coordinated response. If wedepend on individual private companies to address the pandemic, we will not be effective because the companies compete with each other for profit-- so if one company 'innovates' a vaccine, it does not have an interest in sharing it with other companies, because then it can charge more money for its innovation. But then, the vaccine is not accessible to people without means, and this does not stem the spread of the pandemic. This is why it's not good or possible to rely on private companies for everything at this time and why corporations are not the solution to all problems.

  130. Yes ... I'm baffled as to why about 30 minutes from now I have to start getting ready to go into work. My job can be done from home and thanks to me being a squeaky wheel, my work place has been looking at how to facilitate a scenario where we all work from home, at least most of the time. And my boss, who is at least prepper by nature, if not an outright survivalist, has been following this outbreak from the start and based on our conversations, really does understand the severity of what is going to occur. And yet here I am, still expected to show up at work today, which for me entails riding public transportation, interacting in close quarters with a Catholic-family-size group of co-workers and somewhere between 10 and 20 clients, vendors, and random people who come in off the street. I don't know what my boss is waiting for to pull the trigger, and move us from the part of the problem column to the part of the solution one, but I know that every day he delays is one where the potential consequences suffered by our staff and caused by our staff (in terms of contracting the virus and spreading the virus, respectively) is a day where the risk is greater than it was the day before.

  131. @Kristin Praying that your boss gets the message!

  132. @Kristin Most the entire Silicon Valley business base is now going on remote working from home as of today. Different companies in the valley each did their own analysis and decided individually, and without government prodding. The companies slowest to respond, have now turned the corner... due to perceived peer pressure in the valley. Basically, no company in the valley wants to be the last one to start mandating working remotely at home.. because it will forever give that company a black eye with employees and potential employees in the future. At this point, if your boss keeps resisting, find ways to embarrass said boss for dragging feet and looking foolish to other business leaders in your community.

  133. @Kristin Can we stop the "Catholic-family size" stereotype please? And I'll try not to think of the millennial stereotypes running through my head.

  134. Humanity will always be vulnerable to the whims of Mother Nature. Much of this is out of our control. But much of it also is not. In fact, one could make the case that the disastrous response to this pandemic is the endgame and the meeting point of all of this nation’s sins over the last four or five decades. Whether it’s our arrogant individualism that has prioritized selfish behavior over altruism. Or our broken healthcare system and an economy that puts profit over human lives. Or maybe it’s the fact that tens of millions of people in this country seem to live in a different reality, consuming news and propaganda that has no basis in fact or truth. This was always where we would end up. Decades and decades of the same status quo policies and institutional neglect led us here. America is the world’s first failed rich state. I hope when the dust settles that people finally wake up. That while pandemics, natural disasters, etc. are out of our control, our actions, our ethos, our values as a society have led us to this point and will likely cost lives. All of the writing is on the wall. I just hope the vulnerable are protected as much as possible and that we come out of this with a new perspective as a country. We can never go back to the way things were before.

  135. @BReed, I’ve really appreciated your comments over the last couple months. I especially appreciate that you stated we can never go back to the way things were before. Shouldn’t that be obvious to everyone? And yet it is not evident to millions and millions of people. There’s a large slice of the electorate that has bought into the belief that as soon as we get Trump out of office, we’ll go back to being the great country we’ve always been. “Nothing will fundamentally change.” That is what the leading candidate for president has promised the donor class. I’m afraid that the virus most in need of eradicating is the toxic belief that we’re all rugged individualists courageously going it alone and generating endless wealth because endless expansion is our birthright. Even if we get this virus under control, we’re facing very dark days ahead. If we’re unable to “upgrade” our neuronal wiring to find ways of living in harmony, these dark days have the potential to turn into a new Dark Age. Best of luck to all of us. We’re going to need it.

  136. @BReed Agreed, however I suspect that this coronavirus pandemic is probably small potatoes to other known and unknown pandemics that are out there. We can see that we are at the very beginning of the global warming wave, not the middle, and certainly not the end of it. Social distrust and cohesion are dipping, but humanity has a long history of warfare, so maybe this is just the same old, same old, but then again, as global warming kicks into high gear, access to water is set to be the defining issue that will test our social bonds. I am sorry to be so pessimistic, but my sense is that this pandemic is merely a warmup for what's to come unless we snap out of our "Greatest Nation In the World" opium-induced haze. As Annie Gramson Hill eloquently points out, the nation needs fundamental existential and metaphysical rework and we need to be honest enough to acknowledge that right now our formula is due for a serious tuneup.

  137. @BReed I think we need to take a hard look at the way we treat the animals we eat. That's were these things always get started. I heard somewhere that in some asians countries they believe it makes the meat better if the animal is stressed. Too many people eating too many animals that includes wild and rare populations. Factory farming is not the answer that just adds to the suffering and use of antibiotics. The world needs to switch back to a plant based diet for a number of reasons. Think this is bad, just wait till climate change gets rolling and droughts, floods, fire and severe storms become more common, and huge populations of people are shifting to places like the United States in 20 or 30 very short years.

  138. So the President, I take, was made aware of this report last month. And what did he do? Called it a Democrat hoax? Not only was this administration aware of these scenarios but we also had the experience of China dealing with this. And Trump did nothing. Trump and his administration could have begun mitigating the transmission of this disease. Trump is derelict in his duties as president. And his sycophants are as well. I am beyond disgusted.

  139. @Tom Hawkins February 26: Trump lies to the American people, declaring that the number of US cases is “going very substantially down” to “close to zero”. Is lying about the severity of a pandemic NOT a crime against humanity?

  140. @Tom Hawkins Exactly. Trump has been lying to, and misleading the public since the beginning, and continues to lie with each new day.

  141. Obama took 6 months to declare a national emergency for the H1N1 pandemic, even though it had originated in North America. He did so by releasing a written statement. My source? A keyword search of the NYT archives.

  142. @Bonku - Truth is not something that needs to be "understood" or "defined." Truth simply IS. It IS even when science fails to acknowledge it or prove it. To posit other is to practice what your own post claims you do not preach - worshipping at the altar of something other than fact. In a situation like this, where we have a heretofore unknown virus moving through the human population, science is one of the best places to look for truth, without a doubt. But it's also true that many of the things that are going to allow us to weather this time are decidedly unscientific, and which can both work miracles in their own right and certainly without which mere physical survival would be pointlesss: Faith, Hope, Love, Compassion, Generosity. We need to listen to the scientists now, but we also cannot afford to stop listening to our hearts and our souls, where truth also resides. People physically surviving a pandemic is the goal of scientists. A people spiritually surviving a pandemic is a goal we cannot afford to have overlooked, and it requires acknowledging a larger and less tangible truth - that we are, literally, all one, and we must do everything we can to help each other through this.

  143. We decided to keep our kids home today and onward. Our So Cal school district is open but "monitoring the situation". If there is no widespread testing for covid-19 done - no one can effectively "monitor the situation". The social distancing should start at school now. This just may help to "flatten the curve" and save some lives.

  144. @Marianne Started keeping my child home yesterday. Keeping schools open is unfair to the teachers and staff that still have to commute here, and it’s definitely not proactive in flattening the curve. Meanwhile the Masters was just cancelled...

  145. At the time of the Spanish flu in 1918, the medical understanding of pandemic diseases was primitive. Today we have much more advanced medical science. An underlying problem is that we have many more people. People live close to each other. The modeling algorithms must treat that proximity issue as a major factor in causing the cornavirus to spread quickly. We may find that the worst case scenario is conservative because of the concentrations of humans in the world.

  146. @Michael Edward Zeidler Most deaths in 1918 were from secondary bacterial infections. They didn't have antibiotics. Big, big, big, big difference. The biggest.

  147. @Karen Houghton Interesting fact! Thank you for mentioning this. I agree with what you implied here.

  148. Much more research is needed to determine how this virus behaves particularly related to aerosolized transmission. There's some evidence suggesting aerosolized transmission occurs even when someone is not in what we would consider close proximity to the host person. Large and very small particles "float" in the air and can move tens of meters, etc. in the case of the smallest ones. Humidity above around 45% will significantly reduce virus infectivity. I hope they're going to allocate the resources needed to understand this dynamic and establish protocol to deal with it. So far this administration seems so hostile to "science" and ineffective the crisis will be much worse than it needs to be.

  149. @nastyboy How dare you criticize our Supreme Leader! When he visited the CDC the other day, he testified that he understood everything immediately and much better than the scientists at the CDC. He basically said that he may have missed his calling and that he should be running the CDC. One thing is for certain, we would not have to worry about coronavirus then. We wouldn't even know about it. Ah, what a blissful thought!

  150. Finally, some numbers! Based on the numbers and percentages that were recently published by JAMA, I came up with the projections listed in paragraph 4 and 5 for USA deaths and hospitalizations. Stunning that a smattering of our leaders with high visibility continue to model pandemic inappropriate behavior (engaging in handshakes), and think this “corona thing” is overblown or a hoax. A lackadaisical approach will bring us closer to the worst case projections.

  151. @Carl Wigren Essentially what Fauci said on MSNBC this morning.

  152. This is irresponsible reporting by the New York Times. You report in numbers the worst case scenario if no action were taken, which is truly scary, and then say later in the article that these numbers will be mitigated by efforts taken to control the spread of the virus, such as things already being done in many communities. But you have no numbers to report regarding the more likely situation. Most people will see the numbers and freak out! They will not read your later language and be calmed down, partly because there are no revised numbers, only language. Given the state of panic already existing which is not reflective of the reality, this reporting is irresponsible and will only increase the panic and lead to further problems.

  153. @RLH So, are you saying that the press should be painting a Panglossian view of the situation because people can't handle the truth?

  154. @RLH The idea is to get people to realize you really do need to wash your hands, avoid crowds and self quarantine if you have symptoms. Other wise, the "worst case" could come true. Testing would be even better, but it has not been available to most up to now. Apparently, that will gradually start changing next week.

  155. @Brian no. The article suggests 4 possible scenarios, based on varying the parameters. Then, proceeds to only discuss numbers derived from the worst case scenario.

  156. I can imagine the response when one of the Trumps gets it. 1. Blame Obama 2. Blame Hillary 3. Blame the Democrats 4. Blame MSM 5. Blame the deep state. His responses and actions will have been perfect.

  157. @Lawrence You forgot open another investigation into Benghazi.

  158. Trump has ordered that all discussions about the COVID-19 virus as classified info — only sanitized press releases will be permitted. If this is not Putinesque, I don’t know what is.

  159. @Opinioned! Make sure at least two to four lines of that release praise Dear Leader

  160. Trump, where are the test kits? Why is the subject classified? You need to resign, now, today.

  161. Perhaps, given Trump’s exposure to the virus, he will be tested (or already has been?) and self-quarantine, maybe in Mar a Lago to spare White House staff. Ivanka can stay at home, as can AG Barr, to try not to be vectors to their families and staff, let alone others. But of course, all is secrecy about their exposure to the virus, let alone testing. So the nation may never really learn the truth about, or from, them.

  162. @Doremus Jessup Ask Obama. It was he who ruined our test readiness capabilities at the CDC and FDA It was Trump who restored them.

  163. There will be no way of convincing everybody, certainly not the right wing trolls, that measures were just proportional to the threat once the threat fades. Not exactly lose lose. Lose draw, for those for whom victory over the pandemic trumps victory over your political opponents. That is, not Trump et al.

  164. "The C.D.C. declined interview requests about the modeling effort and referred a request for comment to the White House Coronavirus Task Force. Devin O’Malley, a spokesman for the task force, said that senior health officials had not presented the findings to the group." Huh? So the CDC and the epidemiologists had these calculations in late February, but no one shared them with the White House task force? No wonder we're running so far behind in preparations.

  165. This seemed confusing to me too. This administration does not have much respect for science so I doubt that anything sent to the White House was studied. I prefer to believe the under funded CDC rather than the science denying White House.

  166. Let's not kid ourselves. Either about how serious coronavirus is, or that Americans can handle the truth about how serious it is. The run on bottled water and toilet paper of all things shows that many Americans immediately panic when they are afraid. That of course turns "fake" shortages into real shortages. Nevertheless, if it's a choice between reading sobering articles like this one, or listening to VP Pence claim that "thousands" of Americans may already be infected with the virus, when he should be saying "millions," I will take the truth, whether I like it or not.

  167. yes, there are scientific methods to mitigate and minimize the spread of infectious disease. yes, we have no effective leadership on the federal level.yes we are unprepared due to the false narrative that we are the greatest nation on the planet with the world's greatest health care system. as a very good friend has said to me yesterday, let's hope this is a wake up call that we are a divided nation, that we need bi-partisan leadership. we citizens need to hold our elected officials accountable to the people they were elected to serve. stop trying to accuse the institution of government as " the deep state" and make the government by the people and for the people. is not the constitution written that way? By the people and for the people. why would anyone expect the government's response to be adequate after, Katrina, Sandy and Puerto Rico. I'll answer that - the American people have allowed the Congress and the Senate to carry out the will of the rich and powerful at the expenses of themselves. we are the dumbest electorate on the face of the planet.

  168. The key to controlling this pandemic is massive testing. Priority number one is to develop or purchase test kits from what ever source possible. The CDC at the direction of the administration refused to except W.H.0. test kits from the beginning opting to use US drug manufacturing sources. Clearly a blunder that will now have life and death consequences. At this point the president of the United States should not speak ever again on this subject. All communication needs to be led by professionals, scientists and doctors in an attempt to restore some semblance of rational communication. This administration's ego is now costing lives to say nothing of peoples retirement fortunes. It is time to confine both Trump, Pence and his fox news acquired cabinet.

  169. @Bill T It is too late for testing. In Ohio, 1% of the people are infected. You can’t contact trace this volume. We all need to go on lock-down. NOW. Our hospitals are going to be overwhelmed In just a few weeks, and medical care as we know it will not be available. The current administration needs to pay for what they have done to us. Sheer incompetence. But that will have to wait until the crisis is over.

  170. @Bill T No, the CDC "medical experts" decided that their test was superior and chose to go with their own. Listen to the medical experts, he was told. That was a mistake.

  171. @Bill T I'm not interested in defending Trump, Pence, and cabinet, but somewhere down the line we do have to take a much harder look at the relationship between CDC and "US drug manufacturing sources."

  172. Finally, the media has a ‘worse case scenario’ to further panic people. Under this scenario all our resources and ability to fight the disease are overwhelmed by the sheer number of cases and nothing we can do will change the outcome! How is this helpful in any way? In China, a country of 1billion people, the rate of infected peeked at 80,000 and about 44,000 have already recovered. The number of new cases a day is now less than the number of recovered cases per day. The infection rate has plateaued. In China’s central Hubei province, which is the center of the Coronavirus outbreak, new cases dropped from over 1,600 a day to under 400 a day in February of this year. Rather that stoking panic, which has emptied the grocery shelves of food and caused the financial market to lose 20% of it value, the media should be educating the public about how best to stay safe and avoid spreading the virus. Panic is never good and those that stoke panic do so to incite fear to achieve their own agenda. No, we are not all going to die and this too will pass.

  173. @Raul Campos Dr. Fauci appeared at length on MSNBC this morning. It should be easily googlable. Watch it. He was calm and professional. One of his biggest points (seconded by this article) is that we avoid "worst case scenario" by listening to the medical advice to establish social distance, wash one's hands properly and frequently, self quarantine if one has symptoms of the virus and if one gets worse, get tested. Its about slowing the spread, and tamping down the curve (watch Fauci). Telling everyone not to worry will result in the virus spreading. At this point, doing so is irresponsible. You are not an expert.

  174. The goal of this article, as stated in the article, is not to stoke panic but get the public to take it seriously and to go along with measures to try to contain it. Currently there is a lot of “this isn’t such a big deal, it’s a media/Dems/etc hoax”. That won’t do if we hope to contain this.

  175. One thing is clear: Americans just can’t handle the truth. I’m not sure why, but a large percentage of our population clearly prefers to stick their head in the sand and blame the media. Fear of the truth, rejection of the truth is the hallmark of the GOP in the 21st century. It’s dangerous.

  176. The US has been talking for weeks about gearing up our ability to test for the virus. This should have been accomplished months ago and the talk is still about planning for expanded testing not actually performing the testing. What is the hold up? The CDC's botched testing rollout was recognized last month and we are still just planning for what should be the very first step in any epidemic/pandemic control. The blame for this clearly rests at the ineptitude of our present government.

  177. @Maureen Kelly There is so much latency with the detection of the virus that testing is only so effective. We may know for sure who has it, but we may also give ourselves a false sense of security that we can move about after testing negative, which can result in a major disaster....exactly what happened on the cruise ship off Japan.

  178. @Maureen Kelly Consider that when Swine Flu broke out, testing was permitted at labs all across the country. Obama then allowed the CDC and FDA to take control of testing, imposing major restrictions and creating road blocks that severely limited their ability to respond quickly and in volume. Trump had to get the agencies back to their pre-Obama state and open up the testing again.

  179. My elderly aunt asked me a simple sensible question yesterday: what's the "most likely" scenario for her getting COVID19? This article is the first I've seen that could have distinguished a "most likely" scenario among the A, B, C and D scenarios modeled, but instead chose to only discuss (apparently) the worst case scenario, with slight mention of what appears to be a best case scenario (2.4 million hospitalizations). But I'd done enough modeling and interpretations of models to know that in between worst case and best case is something often called a "most likely case" or median case. That's what m sensible aunt wanted to know, and this article should have provided since understanding "most likely" scenarios is just as important, if not more, for good planning...both for public actions and preparing oneself sensibly to handle things. Panic and resulting unnecessary costs on people (often via businesses) can result from only focusing on worst case scenarios. My answer, without data, was maybe 1 in 3 chance that any American will get it - based on worst case scenarios of Germany at 2/3 and US at 50%. Anybody have a better answer?

  180. That is not the case. The worst case scenario is that millions of people get infected in a few weeks, overwhelming the healthcare system and giving us hundreds of thousands of death, many due to overcapacity. The best case scenario is that millions of people get infected over months or a year, giving us fewer death if the healthcare system can process that many patients.

  181. Yes. Tell her to take the precautions CDC and others list, and get used to the fact that she cannot make herself invulnerable. As for her odds—or mine, for that matter, or yours—depends on what she and her community do. These CDC scenarios tell you about large numbers, not individuals. No statistical analysis can do more than suggest that.

  182. @cljuniper: Absolutely correct. The second paragraph mentions "four possible scenarios" but rather than elaborating them clearly it goes delves into what is obviously the worst case continuing to provoke panic rather than providing a realistic view of the actual situation.

  183. Living near Everett, WA, we've been following all the advice from Governor Inslee. Just yesterday, all libraries are now closed. We've been following all the hygiene recommendations and plan to sit tight for the unforeseeable future. So sorry for all the folks that are losing work hours. But to get to my point, since not everyone is vulnerable, it is a huge economic burden for most of the younger generations, and have heard lots of firsthand resentment about all these measures. My own son is mocking us for following the guidelines. (He's not a trump supporter).

  184. @Toni There is a social divide on this which is not helpful. A friend is off to the theater this weekend, while I've been hunkering down. I believe my friend is misjudging all this. Her decisions will mean I will not be spending time in her company.

  185. I found the “avoiding the hump” graphic very useful to see why we are taking these measures. Also, articles about Italy’s struggles clarify the importance of the graphic. Perhaps that might be persuasive with your son.

  186. @Toni wrote: But to get to my point, since not everyone is vulnerable, it is a huge economic burden for most of the younger generations, and have heard lots of firsthand resentment about all these measures. My own son is mocking us for following the guidelines. (He's not a trump supporter). Americans, for once, need to stop being dismissive and cynical about the government and LISTEN and DO YOUR PART to help reduce the rate of infection, particularly if you feel you are low risk for this virus.... because how you behave now has life and death consequences for other fellow Americans who ARE at risk. Enough with the dismissive attitudes, particularly by younger folks.

  187. I've been making light of coronavirus for weeks now, but this seems really really serious.

  188. @Cooper Suddenly dawning on you and the president.

  189. @Cooper It is!

  190. @Cooper If you were totally convinced, as you should be, replace "seems" with "is."

  191. Sobering indeed. The crux of the issue is that our hospitals can only handle at best maybe one percent of the population. If half the population may possibly get it, and 10 percent need hospitalization, then we would have to flatten the curve dramatically for months and months until a vaccine is found. The question then is, what would be the results from shutting down our society- closing all schools and businesses- for such a long time period? If a short shutdown is not 100% successful, and this stretches into months, would society break down? Would our supply chains provide insulin, food, electricity, gasoline in the face of an economic collapse? It will soon be tough to get toilet paper. I worry about the millions of Americans armed to the teeth doing what they can for their families. We need to start an immediate plan to ramp up hospital beds because the math says that we cannot control this spread to the current level of patient service without the possibility of collapsing our society.

  192. This article seems to suggest that closing schools is a good way to slow the spread of coronavirus. However, a few days ago the Times published an equally persuasive essay arguing that "We Don't Need to Close Schools to Fight the Coronavirus," as it was titled. As that article points out, not only is there no evidence that closing schools slows coronavirus, doing so can have serious detrimental effects on students and their families. Right now many communities are closing schools, even if there is as yet no evidence of coronavirus in their communities. I fear that we are overstating the benefits of such closures, and understating the potential harms. The so-called cure might be worse than the disease.

  193. @Dan Frazier I do not know what the "harm" would be of closing schools. Could you explain it? As far as why they're closing: Medical experts are saying the while kids don't get very ill or ill at all when the contract the virus, they ARE carriers. Which means they can bring it home with them. And we all know kids are not going to be good at washing hands frequently. And then, there are the teachers and staff. Note that the article emphasizes, and Dr. Fauci on MSNBC this morning also said, that only by taking measures to slow the spread can we expect to suppress the number of sick, the number who die, and the number overwhelming the hospitals. Finally, we still don't know how many are infected, as testing has not been available. Fauci said today that such will begin changing next week, but not all at once. Better safe than sorry.

  194. @Dan Frazier, interesting. I would have thought it was a given that closing schools would help delay the spread of the virus-- children are vectors for plenty of other illnesses-- and help protect older people that kids come in contact with, like grandparents. I agree that it's difficult to determine the line where the cure becomes worse than the disease, but slowing transmission seems to be vital considering the shortage of hospital beds.

  195. @Dan Frazier - I just spoke to a friend in Massachusetts. His town closed the schools. The weather has been unseasonably warm, and all the kids on his street are out playng with each other. I suppose it's better to have 6 or 8 kids together than hundreds, but he seemed to think it was ridiculous. I don't know if it is or isn't.

  196. It would be useful if testing were available to all right now. But its not, according to Dr. Fauci this morning on MSNBC. He says the public should notice an uptick in testing availability next week, but it still won't mean everyone can get tested. Test availability will, he says, increase from there. I attribute the multiplicity of models and figure to the fact that we don't know how many of us have it. Its about the failure of our system to get testing available until next week.

  197. If we want to limit deaths, we have to slow the rate of infections and protect those at higher risk. Isolation of nursing homes and other long-term care facilities is critical and can happen now. Social distancing is fine, but we need to keep infected people off the streets and subways. The only way to do this is use screening tests. Screening test have to be high throughput as the goal is to screen everyone, not just people with symptoms. Screening tests don't need to perform as well as diagnostic tests. They can even have false positives. The bottom line is screen everyone in their workplace, on the street, on public transportation for infection. Screening must be free and can be linked to a cell phone. Anyone who comes up as infected should quarantine for two weeks even if they have no symptoms. Anyone not infected can work, which is critical for hospitals, etc. After a few weeks we might even achieve what China has done, without locking everyone in.

  198. I have noticed many commenters concerned that an article like this inflames panic. I have a different take way from this article. Social isolation works. Rather than seeing covid-19 as an unpredictable boogeyman, its risks can be quantified and therefore reduced. I am a public school educator in a district that is contemplating a change to distance learning. At first, I was on the fence, seeing such an action as an unnecessary disruption. And a huge disruption it will be - parents who need to spend weeks away from work to care for children now at home, employers having difficulty meeting staffing needs due to parents staying at home, lack of access to food for those under the poverty line who depend on school-supplied meals, and the inherent inequality of online instruction (some families will be able to provide the structure and guidance needed to make it successful, and others will not). However, I now see school closures as a prudent decision, with potential benefits in lives saved far outweighing the not insignificant impacts they will have on the community. I see this article less as a sensational fear-mongering and more of a critical piece of information in decision making.

  199. @Apple314 thank you for such a thoughtful comment. i, too, am a teacher in a large community college in SF. i initially had a knee-jerk response towards attempting to translate my classes online (i teach studio art) but as the crisis has deepened and the efficacy of quarantine has been proven, i'm on board. all of my other classes (yoga) have also been temporarily suspended, so i'll be using this time to teach myself a cumbersome online platform to help keep my community safe and well.

  200. With awareness of this virus going back months, and scientists weeks ago creating scenarios forecasting that "As many as 200,000 to 1.7 million people could die.", how is it that this country was caught flat footed. We are the only 1st World nation that has failed to provide adequate diagnostic tests to track disease spread. And how does a community respond without knowing who has the infection, and where? This is tragic, and undoubtedly will lead to more deaths. And if it's determined that accelerating test production was delayed in an effort to minimize, and control the appearance of threat for political purposes, this is criminal.

  201. @David Stoeckl Whatever do you mean "how is it that this country was caught flat-footed..". The gop playbook is just that, flat footed. They must prop up that creature come what may. Cannot upset him because he might yell at someone, again. So ignore the obvious life-and-death situation because the numbers, right? So play on with our future. No tests, no bad news. Might be fake deaths anyway. How do we know for sure? The entire gop enterprise has been a criminal operation for quite awhile now. This is just another iteration. Watch how fast they move to make this right for all citizens.

  202. @David Stoeckl Our health care system is sadly lacking. The insurance companies and the absence of health care for all is one of the reasons. The biggest problem was that the Trump administration cut the CDC budget and removed the funds which were allocated for Emergency pandemic preparedness. Egregious incompetence and criminal negligence.

  203. @David Stoeckl Occam's Razor says: When multiple explanations explain what's going on, choose the simplest explanation. This is not a planned conspiracy, it's incompetence being spun by legions of loyal conspiracy theorists. The UK and Ireland were exempted from the travel ban because Trump has properties there and it would reduce his business there.

  204. "Why are we not using the WHO Corona virus test kits? Is someone blocking them? I recall Donald Trump saying he did not want the people coming off the Princes Cruise ship because he did not want his numbers to go up. Are the people of the USA pawns in Donald's number game?"

  205. The CDC refers questions to the White House so they can lie to us.

  206. Of course the worst case scenario would be to have one's own name on the list of the departed. Vice President Pence would surely tell you: " He's making a list, checking it twice, gonna find out who's naughty or nice" Better get right with....

  207. Bring all our soldiers back and have them care for the sick.

  208. 'An ounce of prevention is worth a pound of cure'. What's so difficult to understand Mr. Trump, so full of yourself you are tripping all over, just to save face? An impossible task, as you are finding out; but then again, stupidity remains in ample supply, made clear by your arrogance. If you could just shut your mouth, we would be able to make real progress...so to overcome, in due time, this viral crisis.

  209. Trump, the president who killed 1M Americans. Worst blunder in presidential history. He will not win a single electorial vote after this, not even Alabama.

  210. @Christopher The questions remains: Is this inept behavior be enough to change any Trump supporters' minds? That is still uncertain. I'm not hearing of supporters defecting, are you?

  211. To reach the worst-case scenarios of 200,000 to 1.7 million deaths, COVID would have to be many times deadlier in the United States than in China, the epicenter of the pandemic. The number of new COVID-19 cases in China has been declining—not growing— for about three weeks. Over the five-month period since the virus emerged, China has had 80,815 cases, 3,177 deaths and 64,151 recoveries. It now has 13,487 cases, of which 4,020 are serious or critical. China is now reporting about 8 new deaths per day, If the rate is sustained, this would be 2,920 deaths over the next 12 months in a country with three times the population of the United States, but the death rate will probably fall. https://www.npr.org/sections/goatsandsoda/ 2020/03/03/809904660/why-the-death-rate-from-coronavirus-is-plunging-in-china https://www.worldometers.info/coronavirus/

  212. @William Case So China essentially shut down their country, built hospitals within days within the disease epicenter, and started massive testing. Is the U.S. doing any of that? No. A gig economy cannot self-quarantine. Where are the test kits? States have had to get help from the private sector, or basically nothing. Enough hospitals, ventilators, etc? Not here in the U.S. Get real! This administration is too self-involved to think of the good of the country.

  213. China locked down and tested it's citizens. We have no tests for people who need them, which means we have no idea where it is spreading or who has it. I would think that our number of reported cases is inadequate to describe the number who are truly infected and passing it along. There is really no comparison between the US and China in terms of response or number of cases. We just don't have enough information.

  214. Rupert Murdoch and Fox News need to immediately stop perpetuating falsehoods and half-truths. Please, please Sean Hannity, Laura Ingraham, et al: this is no joke. Do the right thing and tell your audience to take this seriously and follow the protocols.

  215. As if. If only.

  216. We can thank trump and the Republican Party for this due to their delay and lies. If you a Republican in the House or Senate you can expect the majority of the American public to hold you personally responsible for thousands of unnecessary deaths.

  217. It’s so sad that while I am reading this POTUS is tweeting another message about the federal reserve and interest rates to allow his businesses to get low cost loans to replace the former Russian money he was laundering and tweeting to somehow blame the Obama administrations for his lack of action to the data that was clearly in front of his “team” long ago. The arrogance of this administration is costing lives and disrupting those that survive long into the future. If there is a future.

  218. When I woke up this morning my first thought was that the world will never be the same.

  219. @ Chicago Guy. The world is never the same again. Each day a new shift, each day a new future. Lean in.

  220. @Chicago Guy - Panic? Disease? Suffering? Sounds pretty much the same to me. 20th Century America existed in a bubble of progress that honestly doesn’t represent much of history. Americans need to get it through their skulls that Pax Americana, much like Pax Romana, is something you have to read in a history book at this point. America needs to prepare to become very ordinary.

  221. "In Italy, hospitals are so overwhelmed that ventilators are being rationed." Thanks to this lying president and his efforts to dismiss the severity and restrict testing to keep "his numbers low", the coronavirus pattern in the U.S. is closely following its Italy scourge. Trump may not have started this virus but he most definitely is responsible for its rapid widespread contagion and many fatalities which were untested. Trump was offered the WHO test kit in January and refused them. 3 full months into this pandemic and people with symptoms still cannot get tested.

  222. @JM : Trump is not the President of ITALY -- or China, or Iran. So what's THEIR excuse?

  223. we need someone to take charge of the situation immediately.

  224. I'm surprised - there's nothing here about every doctor and other expert being "amazed" at how much Mr. Trump already knows. (Or did he actually say they're all amazed by how much he does NOT know?)

  225. Germany is closing all schools effective Monday until 17th of April. And we are advised to reduce social contacts. Everything else is cancelled too. The oepople rush to the stores now. We had already started to have a bigger supply of the most needed things two weeks Aveo. People smiled at us and thought we are panicking. Stay safe everywhere.

  226. Wow are we living in a society driven by irrational fear which is just the same as superstition? I'm pretty sure that the reason for the high calculated mortality rates is just the sample size being small so far. This means the more cases (especially from younger people) the lower the calculated mortality rate will become. The majority of deaths are from the elderly who would've probably died anyway of something else. The US and other countries are shutdown because of fear of the unknown lol what a joke.

  227. As a doctor treating covid-19 patients I can tell you that we always hope for the best but plan for the worst. You are clearly unconcerned about "the elderly", But just remember if you or your family need help with a broken bone, heart attack or other health issue, you will be turned away from the hospital. Because they will be overwhelmed dealing with covid-19

  228. Hopefully, politicians and community leaders will reduce the number of people infected by making wise strategic decisions. Then President Trump can claim the virus concerns were Democrat hysteria. Further claiming that the market was not overdue for correction, but Democrat hysteria caused it.

  229. The entire country(world) is panicked and doing what we need to do to stop the virus. These numbers are probably based on a population moving about as usual. People are not 'Usual' these days.

  230. @David Kane yeah, panic is the PERFECT response...just what we "need to do" GOOD GRIEF *rolls eyes heavily"

  231. “The Republican Party today has a catechism. If you want to be a candidate, with very rare exceptions, you have to repeat the catechism in lockstep uniformity: global warming isn't happening, no taxes on the rich. There are about ten things that you have to repeat, whether you believe them or not. Anybody who departs from them is in trouble.” Noam Chomsky never misuses words.

  232. COVID 19 is a test drive for future pandemics that will be far more difficult to control. As the tundra permafrost melts, viruses and bacteria that have been frozen for tens of thousands of years will be released. They might be picked up by migrating birds and spread across the planet rather quickly. Many of these diseases might be unrelated to viruses and bacteria with which we are familiar. Developing antibiotics and/or vaccines could be far more challenging. There will be less resources to deal with these pandemics as the global economy shrinks due to pandemics. We need to vote for those who appreciate the impact of climate change and the importance of science in creating public policy.

  233. What do the current corona virus, mad cow, bird flu, swine flu, SARS, deforestation, antibiotic resistance, climate change, ocean dead zones and species extinction have in common? Eating animals. Were you aware of that? Our consumption of farmed and wild animals, including fish, will eventually kill all of us, including those of us who stopped doing it once we became informed. Your decision to eat animals is therefore not a personal one; it profoundly affects all of us - not to mention the billions of animals who want to live in peace but are instead terrorized in factory farms and mercilessly killed in slaughterhouses. Shouldn't this pandemic be a wake up call to change our destructive behavior? Instead of eating animals and their secretions, can't we consume the delicious plant-based alternatives that are now available in every grocery store and in most restaurants? Please do the right thing - for yourself, for the planet and for the animals.

  234. In our 60's, we moved from a very congested NJ town to a rural one in NH 8 months ago. With only 2,000 people in town, most of my newly made friends did not seem so concerned that the virus would make it up here quickly. Our restaurants typically have no more than 20 tables, and most have under 10. There are no crowds here until summer on the lake begins. It's a small town Mayberry life that I've embraced. When I started reading reports more earnestly in early Feb. about the virus in China, I stocked my pantry for a month. I forwarded articles through emails to many friends and family members, even though they were frightening. My sons both live in cities, LA and Raleigh, and I urged them to stock up on supplies as well. The NJ school where I used to work is closed through the 2nd week of April. Ours closed here this week due to a student who returned from a trip to Italy who 'appears' to have the virus. Suddenly, our churches, club meetings, and other functions are shutting down. If you feel sick but you're not critically ill, stay home. If you're extremely sick, call a dr or hospital. I intend to stay in place, not eat out, work on house projects since we're retired, and lay low. This is a horrible worldwide tragedy that we can help lessen by staying home, if possible. The delays may have come from trying to prevent pandemonium and panic, but now we know what we have to do. Avoid others when possible and stay in. Stay safe.

  235. @mainesummers - All those “isolated” town folks probably shop at a nearby Walmart, stocked by an endless flow of truckers from all over the US. All it takes is one person. Their sense of security is a false one.

  236. who cares about the projections? 1% mortality rate, per dr. fauci in sworn congressional testimony. propagation rate is roughly doubling per week (hospitalization rate with testing). if ultimately half of 320 million are infected, 1.6 million die. if one tenth are infected, 160,000 die. if one in one hundred are infected, 16,000 die. the point, obviously, is that we look out for each other, or thousands will die. putting a number on it is putting a price on it. this article takes the view that the public ethic of the selfie nation is somewhere down around the person who returns the wallet but not the cash, and obedience to authority is par with a two year old. "unclear how far Americans will go" constitutes a fundamental lack of trust in something somewhere. it's not that new things are new and other catastrophes were panicky, but that the government can't be trusted or the people can't be trusted or the press can't be trusted or the standard cures can't be trusted, who cares. the interesting point is the response of businesses and schools who can put everyone online as a text and video avatar, compared to the response of hot dog stands that must fish in a stream of people. and, of course, when markets don't trust the government ability to get a grip, they flee. but store markets, they crash too. and then the whole capitalist thing about growth forever, technology will solve, snaps into focus.

  237. It is time Time to treat this like world war 3. This virus will be with us off and on till a vaccine is manufactured. It is the enemy, and it must be treated as one. If Donald Trump can not find his voice, and do the one thing he is good at - communicate. Communicate that we are going to fight this thing like it’s war, that we are going to do whatever it takes , that the country is now on a war footing. Have his General Patton standing in front of the American flag moment, tells us how we must all pitch in like all Americans pitched in during world war 2, then he must step down or be removed from office. Morale is a big part of every war, sometimes the biggest part. Well right now morale is as low as it’s ever been that’s where the President comes in. Nothing was as scary as world war 2. Freedom itself was in jeopardy , we had been attacked, and the enemy had the upper hand. What did FDR do...he rallied the country with his famous fire side chats and what’s more he rallied industry to do the impossible, and the impossible they did churning out bombers one an hour. What he didn’t do was try to wish it away. Now is the time for great men and great people. Our doctors and nurses are the front line troops and we must give them all the help and ammunition they need, whatever they need manufacture triple. Lead Mr President rally the country , rally the world. You are the President in a moment of crises ...lead. Or step down. There is no other choice.

  238. @Lonnie : that is ridiculous. First off, it is not a war -- let alone WWIII. War analogies have been a miserable failure since "the War on Poverty" and "the War on Drugs". MANY illnesses out there are not instantly "curable" with a drug or vaccine. And making this all about Trump is bizarre. Is Angela Merkel at fault in Germany? Justin Trudeau in Canada? why is the leader at fault for a WORLD WIDE pandemic, that can't be stopped or cured? Undoubtedly it would cheer YOU up if Trump resigned over this, but knowing his personality -- he wouldn't do it (and he shouldn't do it!). Why should he? he didn't start the virus or make anybody sick. I certainly was not "comforted" by GW Bush after 9/11! and most liberals sneered at his words. He didn't step down. (And stepping down would give you PENCE -- is that better?) The US did not START OUT churning out bombers in WWII -- you were not alive then and you can't remember it. It took quite a while to turn on the war apparatus. It wasn't instantaneous! This coronavirus will not be cured in a snap of a finger, and no "fireside chat" will make people feel better about it. Presidents are not magical pixies with fairy dust, and it is not realistic to ask of them that they magically cure all problems.

  239. This was an excellent article. Fact driven, serious and informative. Sobering without being hysterical. Thank you.

  240. Trump's inaction on this will cost thousands of lives in the end. He wanted to keep the numbers down by making it impossible to get tested. We need easy, affordable testing ASAP!

  241. We are on the path to nominate or re-elect a leader who rejects the notion of a universal public healthcare option. Good, I won't have to pay taxes for those other slouches who don't work hard enough. But leaving the uninsured to fall ill and infect the rest of us overtaxes an inadequate system motivated strictly by profit. Meanwhile we hoard, pray, and watch our savings slip away. Is this our plan? Is this American exceptionalism?

  242. @Ned what you describe is a consequence of Conservative fiscal policy and hollowing out of government functions.

  243. @Ned - We have turned into an exceptionally stupid and greedy people. American Exceptionalism, indeed.

  244. The Trump admin is doing everything it can to appear to be botching this testing rollout. Only it's actually going pretty much to plan. Because their goal is to suppress the data as much as possible and continue their favorite talking point: Trump's "numbers" are the best in the world. They will spend the summer and fall denying and disputing infection and death rates, purely as a campaign strategy. They will call all the experts' best guestimates (in the absense of data of course) fake news designed to upend the great Donald. Because Donald has the best "numbers" of any in the world. And the only thing left to find out now is whether it will work the way they hope it will. See ya in November, America. And be careful. The party formerly known as Republican will do pretty much anything - even sabotage an effective respnse to a pandemic - to win this election.

  245. Nothing is a problem until it is. And then it’s damage control time. I’m afraid the necessary requirements to fighting this are long gone in our culture: an educated populace, a willingness to listen before speaking, and the selflessness to do what is right. The traits that will mitigate this don’t exist anymore.

  246. @Jordan please don’t blame the people for this mess. Many of us have been screaming to improve our health care system for ages but we face a short-sighted opposition well represented from the top down. Experience changes attitudes and maybe this one will encourage a meaningful shift.

  247. Thanks you! With the complete lack of leadership, honesty, sound directives and integrity with the Trump Administration, we need to look at the worst case scenario and be prepared.

  248. Interesting, I trusted Dr. Anthony Fauci, because he was calling for ore testing. Remember last week Mike Pence promised for testing of all the passengers on the ship that docked in Oakland, and that hasn't happened. This morning, I heard Fauci on the BBC defending Trump's travel ban and he pointed to Italy's failure to ban people from China as the cause for their catastrophic number of cases. He seems to have changed his tone overnight. Is he being pressured by Trump to change his talking points? I think Trump is shuffling his feet on testing because he doesn't want real data. S. Korea has tested 250 K people and the US is still talking about more tests coming next week. Trump is still spinning this instead of implementing widespread testing and a plan to deal with this situation.

  249. @thewriterstuff This is the kind of comment one would have expected three weeks ago. That is is current TODAY is the true crime of this administration.

  250. @thewriterstuff Fauci believes most new cases are coming from Europe; hence the ban. Allegations like this just incite fear and erode confidence. Not really helpful right now.

  251. "Those actions include testing for the virus, tracing contacts, and reducing human interactions by stopping mass gatherings, working from home and curbing travel." And yet all we seem to have done is cancel a lot of events. I still don't know how to get tested, or if I should. It's very unclear, although I live and work in the DC epicenter of the virus. I've semi-quarantined myself as have my friends but stuff still has to get done, so I pick up groceries from the store and walk the dog.

  252. Fausti estiimated the death rate was ten times that of seasonal flu, which is .1%, making the expected death rate 1%

  253. @AACNY I don't think so it's just calculation tricks with the sample sizes being small and few younger people being tested...meaning the more younger people tested the lower the calculated mortality rate will become the real reason why the mortality rate for the seasonal flu being so low is because the sample size is very large around 3-5 million people get the flu every year with small sample sizes a lower count causes higher calculated rates which is why the flu kills a higher total count of people but has a lower calculated mortality rate than the coronavirus

  254. @AACNY Fauci and he's a reasonable man serving the common good for over 30 years.

  255. @AACNY which would make it similar to the death rate in 1918's pandemic.

  256. It’s good to know the truth and this is horrifying. It tells me that more draconian steps need to be taken to slow and minimize the spread of the coronavirus. It should start at the White House. trump should set an example and he tested for infection followed by everyone else in his family and staff. Then he should take a dose of truth serum. The only thing he’s living up to is that he doesn’t need to act presidential.

  257. @Steve Ell what is truly terrifying is scientists were making these forecasts six weeks ago and Trump refused to listen to the scientists and sat on his hands.

  258. Our local school district just closed for two weeks. It was the right decision, maybe even a week too late. However, almost immediately on my local Nextdoor.com, an irate resident posted extensively about how he wanted to complain to the school superintendent about the district buying into the “political /media hysteria surrounding Coronvirus”. Over the last week I’ve encountered several other people that would apparently rather believe in conspiracies than acknowledge their own lack of preparedness. I guess spending a couple of weeks on a ventilator is the only way some people will learn?

  259. This is what people have been warning about for weeks now. The American people deserve to know the truth. This not the flu. This is a real threat. This could hurt or kill millions of Americans. This is going to require major shared sacrifice to get through. Regardless of your political leanings: we desperately need competent leadership now. Trump needs to get out in front of the public and own up to the gravity of the situation. By doing so, he can flush the panic out of the system. The slow drip of the daily news is just making it worse, and making him seem reactionary and incompetent. Once the panic is out, we can start the hard but necessary work of PREVENTING that outcome because then, and only then, will people be ready to take measures that were previously unthinkable. We're going to have to radically expand our social safety net for a short time. We're going to have to ask people to not leave their homes for a long time. We're going to have to shutdown cities. We're going to have to force people onto the unemployment line. We're going to have to shutdown the airlines and the cruise industry. We're going to crater the stock market. But if we do all of that, we can avoid the worst possible outcome, and that's all that matters. We measure success from this day forward, in the delta between that worst case scenario and the final outcome. Everything else will take care of itself once we emerge victorious over this virus.

  260. Schools & Daycares are being closed as a measure to prevent Coronavirus infections. The serious Downside of this measure finds no place in Media discourse. If babies & children of doctors & nurses & healthcare staff & caregivers remain at home & need their parents attention, how will these professionals attend to coronavirus patients ? This measure could potentially cripple Healthcare Services. How does this work ?

  261. This is border line insane speculation. We're not talking about Ebola, a virus that kills at least 70% of people infected regardless of age or health status. In the segment with highest risk of death (people over 70), perhaps 8% of those infected with coronavirus have died. Articles like this only fan the flames of panic rather than providing sensible guidelines about how to minimize one's risk of contracting the disease.

  262. @Kenneth Cowan And in that article about the Chinese doctors, one who died, I didn't see a mention if they were wearing masks 100% of the time.

  263. We know by experiment with the flu that temperature and humidity have a dramatic effect on transmission. "Both cold and dry conditions favor transmission." https://www.ncbi.nlm.nih.gov/pubmed/17953482 "At humidity levels of 23 percent, 70 to 77 percent of the flu virus particles were still able to cause an infection an hour after the coughing simulation. But when humidity levels were raised to 43 percent, just 14 percent of the virus particles had the ability to infect. Most of the flu particles became inactive 15 minutes after they were released into the humid air. "The virus just falls apart," at high humidity levels" https://www.livescience.com/27533-flu-transmission-humidity.html So, run the humidifiers. Keep places warm. We may have sort of known these common sense ideas, but we have numbers too. Infection can drop from 77% to just 14% if humidity rises from 23% to 43%. We can do that in a lot of places. This is because viral life in humid air drops from hours to just 15 minutes. That is an understandable good reason. Tell people about it. Do it.

  264. @Mark Thomason This isn't the flu, there is no evidence to suggest that this virus is sensitive to temperatures like the Flu. Stop spreading disinformation.

  265. @Mark Thomason These articles are several years old and pertain specifically to the seasonal flu virus. There's no evidence that these reports are relevant to the coronavirus.

  266. Finally, some intelligent analysis. If people's behavior changes, the amount of infections slows dramatically, changing the ultimate outcome dramatically: 1. We need to blanket social media and traditional media with public service announcement campaigns on hand and surface sanitizing and social distancing 2. The President and Vice President need to LEAD and stop saying (stupidly) that they are still shaking hands, and be part of the PSA campaign. 3. They should get sports and entertainment personalities to do the same. (Note: They could "tell" Google Microsoft and Apple to have the PSA announcement run immediately when they open a browser for the next two week and intermittently thereafter. For traditional media - TV and radio - they could tell all FCC licenses entities to run the 5 and 10 second spots four times every hour for the next two weeks and then about 10 times a day thereafter). It is a simple plan to get a unified message out, calm fears and give people something to do. Right now, there is a disjointed message and people are panicking and getting into a hunkering down mentality - which is actually unproductive and does nothing. And they are turning to a huge variety of sources for information on what to do. To the Trump Administration: give people something to do! Give them the leadership they need!

  267. TheHill.com just reported that NYS Gov. Cuomo announced our state's first drive through testing facility. The testing logjam has been broken. Excellent news.

  268. I don't believe the NYT (or anyone) should be publicizing the private discussions of the CDC. I know it's hard for an investigative journalist to think that their job is to do anything other than uncover scandal and bring the truth to light, but it is worthwhile for the CDC (and other groups) to be able to have frank, internal discussions. The failures of American institutions dealing with this pandemic have not been so great that that presumption of privacy should be disturbed.

  269. Trump, Ivanka, and AG Barr have all been with individuals with COVID19 within the past few days. Shouldn’t they be tested? Maybe self-quarantined? Or have they already been tested but are not admitting it or telling the public the results? If results of testing were negative, wouldn’t they be crowing all over the chicken yard about it? So what are we to assume about the deafening silence in circumstances in which others would be trying to get tested and act responsibly?!

  270. Not mentioned is the military's capacity to step in and provide bed/treatment.

  271. Thanks for a clear and honest analysis—something the Trump administration and GOP seems intent on denying us in the midst of a crisis.

  272. All for one and one for all. Every individual has an impact on how this will play out, including you. Do your part.

  273. Is it true there are a lot of false positive and false negative results in the tests for coronavirus? Congress must ask why U.S. authorities didn’t accept the WHO Coronavirus diagnostic test. How was the testing franchise awarded? What organizations are making tests or test kits for America?