When can we relax the quarantine?

The graph above is a continuation of the tracking we have been doing of the day-to-day increase in the number of deaths from COVID-19 in the USA. It has been revised to take into account the new policy on reporting of deaths resulting from the disease. We believe that the rate of increase has fallen to a level that indicates that we have reached a peak in the number of daily deaths, and that the increase will shortly enter a decline.

We now need to look for coherent strategies for future relaxation of the quarantine restrictions. We need look no further than the Institute of Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington.  They have been conducting an extremely detailed, state-by-state analysis of the statistics, and while we have differed in methods, and therefore results from their overall findings, they have an incredibly detailed pool of data upon which to draw, and are in the best position to provide policy prescription and the National, Regional, State and even City level. Their website is an incredibly rich source of data and analysis. (https://www.healthdata.org/)

IHME Recommendations

These are necessarily a set of complex recommendations, but in summary the proposal is to begin relaxing restrictions in a progressive way once the infection rate, using IHME criteria, falls below 1 per million of population; further requirements include “robust containment strategies (e.g., widely available testing, contact tracing and case-based isolation, restricting mass gatherings)” The following diagram shows the IHME estimates for threshold dates that the relaxations could be exercised:

Source: healthdata.org/covid/updates Uploaded 11:00am EST 4/18/2020

Comparison Between USA and Europe

A great deal of hot air has been expended on both sides of the political divide about US policy choices, and who is “responsible” for how many deaths. It is an extremely unhealthy public debate, one best kept for some future date, preferably a year or two into the future, because so much remains unknown. However, one thing is clear: the comparisons that have been making their way around social media purporting to show how badly the US is doing compared to Europe are simply wrong. The comparison below, normalized for population, shows that USA is doing significantly better than an set of countries with the highest GDP in Europe, and with a similar population and GDP as the US. Of the European countries, only Germany evidences better outcomes – very much better outcomes – than the USA . The reasons for Germany’s outstanding results, versus the rest of Europe’s mediocre results are as yet unclear. The reason the USA is performing so much better than Europe may be due to many factors besides policy and execution: however, the comparisons should be made on equivalent populations. Today we have added to our daily table the IHME projection for total death by country. Our projections for the US total mortality are somewhat higher than the IHME (closer to 75,000 than 60,000), but we do not have comparative analysis for Europe, so we are using their estimates. Even our higher estimate would be a significant improvement on the IHME estimate for the European countries in the sample.

Historic information is, as in the past, downloaded from https://www.worldometers.info/coronavirus/