The White House just shared its worst-case-scenario estimates for the possible number of total deaths in the US due to COVID-19. 1.6-2.2 million Americans could be at risk of dying. Here is my quick take on where that number comes from.
We have approximately 330 million people living in the US today.
The CDC estimates that 50% – 70% of Americans could be infected with coronavirus. That translates to about 160 – 240 million cases.
The VERY limited evidence to date on case fatality rate suggests that anywhere between 0.25% – 3% of COVID-19 cases result in death. The current US case fatality rate, based on early numbers, is around 1.5%. The true US case fatality rate remains to be seen, but it is likely that these early numbers are over-inflated. With this in mind, we could conceivably land somewhere around 1% of COVID-19 cases being fatal. (This still makes it 10 times more fatal than seasonal flu).
Thus, 1% of 160 – 240 million cases is 1.6 – 2.4 million deaths in the US. This is my best guess at how the White House came up with its numbers. As you can see, it is a very inexact science. And perhaps premature to be making these kinds of projections. Still, we cant ignore the implications.
The President and his advisers described this as the worst case, if we were to do nothing at all to slow the spread of the virus. Fortunately, we are doing something and it seems most everyone is in agreement that social distancing is critical. The White House announced that it is keeping the nation’s mitigation efforts in place through April 30th.
It was suggested that with these measures, the US death toll could be held to between 100,000 and 200,000. For that to occur, based on the numbers above, either far fewer people would need to become infected or the virus would need to be far less lethal than current estimates. Approximately 1/10th as lethal.
Perhaps the virus is “only” as deadly as seasonal flu, with the main challenge being the sheer number of patients needing acute, intensive care all at once. In this case, fatalities may be more a function of healthcare system capacity than of the virus itself. We really don’t know, and may not know because the two are inextricably intertwined at the moment.
Regardless, these are all hypotheticals without a ton of supporting evidence. 100,000 to 2.2 million is an immense range with an immense amount of unknown left in between.
UPDATE (3/30/20): A study from the Imperial College COVID-19 Response Team, whose members include the World Health Organization and UK Medical Research Council, projected that in the absence of any mitigation efforts, 2.2 million American could die from COVID-19. This worst-case-scenario assumes that 0.9% of cases overall result in death and that close to 80% of Americans become infected. These numbers are similar to those I outlined above.
The study also demonstrates that the number of deaths are reduced significantly as the number, duration, and intensity of social distancing measures increases.
CNN posted this graphic earlier today which provides a visual of the White House statements (apologies for the screenshot quality).
