Birx: 100-200,000 dead is the best-case scenario, if we do almost perfect social distancing

It’s tempting to believe that this is an exaggeration designed to scare people who’ve been skeptical about avoiding mass gatherings into getting with the program. It isn’t. If anything, given the balance of expert opinion, Birx is lowballing the likely death toll.

The CDC modeled four scenarios of the spread of the disease in a presentation last month. The worst case was 1.7 million deaths. The best was 200,000. Other infectious disease experts weren’t as optimistic:

Dr. Lawler recently presented his own “best guess” projections to American hospital and health system executives at a private webinar convened by the American Hospital Association. He estimated that some 96 million people in the United States would be infected. Five out of every hundred would need hospitalization, which would mean close to five million hospital admissions, nearly two million of those patients requiring intensive care and about half of those needing the support of ventilators.

Dr. Lawler’s calculations suggested 480,000 deaths, which he said was conservative. By contrast, about 20,000 to 50,000 people have died from flu-related illnesses this season, according to the C.D.C. Unlike with seasonal influenza, the entire population is thought to be susceptible to the new coronavirus.

FiveThirtyEight looked at projections by 17 different experts and calculated the best estimate among them to be 246,000 deaths, which is up from last week. The range is enormous, from 36,000 dead to 1.1 million, but 14 of the 17 have a high-end estimate of at least 250,000.

The Institute for Health Metrics and Evaluation (IHME) has also posted projections based on the latest numbers. They’re expecting 86,000+ deaths in the next four months, with the U.S. to reach 10,000 sometime around April 5-6, 20,000 within a week after that, and 50,000 around April 24-25. If they’re correct, we’ll start the month on Wednesday with a bit less than 5,000 people dead of COVID-19 and end it with nearly 60,000 deceased. In a worst-case scenario, we could be approaching 100,000 dead — in a month. Deaths will begin to slow in May thanks to the social distancing practices being followed now (and maybe because of warmer weather) but if the projection is right, we’re about to see roughly as many Americans die of this illness in the next four to five weeks as died in the Vietnam, Iraq, and Afghanistan wars combined.

And then, at some point this fall, we’ll need to be ready for a second wave of it.

Unless, that is, antibody testing of the public reveals that many more people than thought have become infected and shaken off the virus without symptoms. That’s the Oxford model of coronavirus, the possibility that it’s spread much further than anyone realizes and that we’ll be largely done with it once this first terrible burst of deaths among people who are strangely vulnerable to it is over. That’s not the way most epidemiologists are betting, though: Per FiveThirtyEight, the expert consensus as of March 23-24 was that known coronavirus cases comprise nine percent of the total number of actual infections in the U.S. There were around 52,000 known cases then; if the experts are right, that would mean 572,000 actual infections nationally. If that’s right then just two-tenths of one percent of the total U.S. population is infected, a number drastically lower than the sort of widespread contagion that the Oxford model imagines. Virtually the entire population remains vulnerable to this disease. We have a very long slog ahead of us.

I’m glad these numbers, or the grim scenes from Elmhurst Hospital in Trump’s home borough, finally got through to the president and convinced him to back off Easter as a possible relaunch date for the economy. Look at the IHME projections and you’ll see how ridiculous that would have been if he had followed through: By April 12 the United States should be seeing more than 2,000 deaths per day. No one was going back to work under those circumstances whether he gave his permission or not. On the other hand, in fairness to him, it’s wrong to assume that people are behaving irresponsibly because of him. Yesterday, the day he wisely advised Americans to continue to avoid gatherings through the month of April, some megachurches were still packing ’em in. Some red-staters appear to be treating the lockdowns as another culture-war skirmish even though Trump himself agrees with the experts this time. This is why Birx and Fauci are on TV in the past 24 hours chattering about death tolls. If more people don’t take this as seriously as Trump is, 200,000 will be the conservative estimate. No pun intended.

We need a little hope after a post this grim so I’ll leave you with this. Things can get better.