It strikes me that it might be useful to summarize the Imperial College team’s estimate of likely coronavirus deaths. They provide mortality estimates for two scenarios: doing nothing and doing quite a large amount. What we’re doing right now is somewhere between those two, so I’ve filled it in with an interpolation. The team also provides a range of estimates for massive efforts that are strictly enforced for over a year. Here’s roughly how it pencils out:

The kinds of things the IC team recommends are nowhere near being implemented yet, and to have a serious effect they need to put in place soon. Given where we are now, this means that the only realistic options are #2 and #3. In other words, it’s likely that the US will see 1.1-1.5 million deaths from the coronavirus, with more than half of them coming by June.

Now, this is just one estimate. The Imperial College team used an existing microsimulation model that was created about ten years ago and then plugged in lots of guesses and estimates: what measures would be taken; how many families would comply; average class sizes; commuting distances; incubation periods; etc. Some of these are things we have a pretty good handle on, while others are a lot trickier to estimate. Some of them produce only small changes if you get them wrong, while others are pretty sensitive. So in that sense, take this with a grain of salt.

That said, this appears to be the most sophisticated estimate we have at the moment. It might be wrong, but at this point it would be foolish to simply assume so.

After weeks of downplaying the severity of the coronavirus pandemic, why did President Trump suddenly sound so serious about it on Monday? Everyone’s best guess is that he was briefed on a new study from Imperial College in London, which estimated the death rate from the pandemic if no control measures are taken:

In such scenarios, given an estimated R₀ of 2.4, we predict 81% of the GB and US populations would be infected over the course of the epidemic….In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.

That’s enough to put the fear of God into anyone. If no control measures are put in place, the researchers estimate that we’ll exceed critical care capacity about 25 days from now and see a peak of about 50,000 deaths per day by early June.

So what should we do? The Imperial College team modeled two basic strategies: suppression and mitigation. In both cases, the goal is to reduce the number R₀ (pronounced “R nought”), which tells you how many people are likely to catch the virus from someone who already has it. The team assumes that the virus, if uncontrolled, has an R₀ of about 2.4, which means that everyone who’s infected passes the virus along to an average of 2.4 additional people. This is what causes the exponential growth that you see in the chart.

In the case of suppression, the goal is to get R₀ below one. Obviously, if each infected person passes the virus along to, say, an average of half a person, you get an exponential decline: 1,000 cases quickly becomes 500 cases, then 250 cases and so forth. The problem here is threefold. First, it would take massive—and probably unrealistic—control measures to get R₀ so low. Second, the economic cost of full suppression is likely to be very large in the long term. Third, the control measures would have to be in place for the entire population for well over a year. Until then, if the control measures fail at any point, the epidemic will almost immediately come roaring back because no one has developed any immunity to it.

Mitigation is more realistic, though it still requires plenty of social change. The goal is not to stop the spread of the virus completely but to slow it down. The downside of mitigation is that since it does less to reduce the spread of the virus, it’s a certainty that at some point the health care system will become overwhelmed. Also, a lot more people will die.

The Imperial College team concludes that suppression is the only “viable strategy,” but the “social and economic effects of the measures which are needed to achieve this policy goal will be profound.” Mitigation, conversely, is feasible only if our critical care bed capacity is increased by at least eight fold. And even at that, about 1.1 million people would die in the US. Here’s the inevitable chart:

If there’s any good news in the report it’s this: if we did immediately adopt a maximum suppression strategy, using the most intense versions of each social intervention and keeping them in place for about 18 months, we could reduce deaths by 95-99 percent—though even that depends on having an effective vaccine in place by then. Personally, I consider this so unlikely that it’s not really worth pretending we can do it.

Beyond that, I’m no expert and can’t pretend to have an informed opinion about all this. However, I can say this much: if the Imperial College team is right and the choice is between (a) immense social changes starting instantly and being kept in place for 18 months, and (b) building a huge number of critical care beds fast, I’d say the construction project is actually more feasible—though only if it starts now and is given about the same urgency as the World War II Manhattan Project.

Most likely, the best we can do is to combine a strong but reasonably practical mitigation strategy—in which people are informed that this is the new reality for at least several months—with the immediate, emergency construction of something like 200,000 temporary critical care beds—or the closest we can come to that. And we need to be prepared for a large number of deaths even if we succeed.

Alternatively, we can hope the Imperial College team is wrong.

POSTSCRIPT: One other thing the team says is that it takes a while for mitigation strategies to have an effect. The stuff we’re doing now will start to reduce infection rates in about 2-3 weeks, but before that the growth rate of the virus is pretty much set in stone.

POSTSCRIPT 2: Also of interest is that the team’s model suggests that stopping mass gatherings has little impact “because the contact-time at such events is relatively small compared to the time spent at home, in schools or workplace and in other community locations such as bars and restaurants.” It’s much better to focus on case isolation (widespread testing combined with isolation of detected cases), social distancing (either of the entire population or only of those age 70+), home quarantine (i.e., quarantining the entire family of anyone infected), and school closures.

In the face of the coronavirus pandemic, it’s almost easy to forget that we still have a Democratic primary race going on. But we do. So just for the record, here are the latest poll aggregates from 538.com for the four primaries being held tomorrow:

Joe Biden is at 60 percent or higher in all four states and 538 now gives Biden a 100 percent chance of winning a majority of the delegates. I hope, for Bernie’s sake, that he concedes graciously after this. It’s just hard to believe that continuing forward does him or his reputation any good.

UPDATE: The Ohio primary has been postponed to June 2nd. However, the other three primaries are still being held.

Just kill me now:

A reporter asked me today why conservatives were initially so skeptical of the threat of the coronavirus. I tried to explain that one of the dangerous consequences of having a totally dishonest left wing news media was that most Americans discounted their hysteria as phony.

— Newt Gingrich (@newtgingrich) March 16, 2020

You can date the beginning of the modern era of scorched-earth conservativism to Rush Limbaugh. Or Drudge. Or Fox News. And they all deserve their share of the blame. But I’ve always dated it to Newt Gingrich, and this tweet is a perfect example of why. Media support was always crucial to the transformation of the Republican Party, but it was still just support. The core of the transformation had to come from within the party, and there’s no question that Gingrich was that core. He worked ceaselessly and with laser focus for over a decade before leading Republicans into a congressional majority that depended on the utter destruction of Democrats and liberals. That’s been the Republican Party ever since.

Gingrich’s influence didn’t last long, thanks largely to a plunge in his self-discipline once he gained power. Today Fox News is far more important. Nonetheless, he’s the wellspring that eventually led us to George W. Bush, the Iraq War, and finally Donald Trump. Thanks, Newt.

My local burger joint had these signs posted at every other table.Kevin Drum

New York and Los Angeles have both shut down bars and restaurants, but only for eating in. Takeout and delivery are still OK. Presumably this means that food itself poses little or no risk of coronavirus transmission, which seems a little odd to me. But apparently that’s the case. Here’s the European Food Safety Authority:

There is currently no evidence that food is a likely source or route of transmission of the virus. EFSA’s chief scientist, Marta Hugas, said: “Experiences from previous outbreaks of related coronaviruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), show that transmission through food consumption did not occur. At the moment, there is no evidence to suggest that coronavirus is any different in this respect.”

….Regarding food safety, the World Health Organization (WHO) has issued precautionary recommendations including advice on following good hygiene practices during food handling and preparation, such as washing hands, cooking meat thoroughly and avoiding potential cross-contamination between cooked and uncooked foods. More information can be found on the WHO website.

Obviously all the usual precautions still apply, including washing your hands and so forth, since a restaurant can have infected surfaces and coughing customers just like anyplace else. But the food itself is pretty low risk as long as you’re not eating at a total dive.

I’m only mentioning this because I like to eat lunch outside the house and I’ve been a little unclear on the guidelines for this. Don’t get me wrong: If I can’t, then I can’t, and I’ll make do. But if I can do it safely, I’ll keep doing it until someone tells me to stop.

Here’s another picture of Slot Canyon X from my Arizona trip in January.

Here are the COVID-19 growth charts through Sunday. Note that France and Britain show some flattening, but that might be due to incomplete weekend reporting. As always, Day 0 is the first day that total confirmed cases went above 100 in each country. The raw data from Johns Hopkins is here.

The Fed cut short-term interest rates to zero over the weekend, which should have caused long-term rates to decline too. But after a quick drop on Sunday, long-term rates have been rising ever since the markets opened today. The stock market also tanked when markets opened this morning. Apparently the Fed has little influence when the economy is stalling because of a pandemic.

This is really depressing:

It’s hardly surprising that the young are less concerned than the old. But there’s no reason this should be a partisan issue. The virus certainly doesn’t care. And yet, thanks to Fox News and talk radio and President Trump, Republicans just don’t think the coronavirus pandemic is a big deal. Overall, only about a third of Republicans are very or somewhat concerned about it.

These people are going to die. They’re going to cause other people to die. It’s insane.

I’m not promising to do this every day, but having done it once it’s now fairly easy to update. Note that the y-axis on these charts now goes up to 140x because the base trendline from Italy has continued to grow. That will continue to go up until the number of new cases flattens out.

It’s worth noting that these growth rates are all based on official figures, and obviously they depend on how widespread testing is in various countries. The US numbers, for example, may be artificially low simply because we don’t have test kits available. We won’t know for sure until kits become widely available and we begin testing larger numbers of people.

Also worthy of note is that actions we take now will affect the growth of coronavirus a couple of weeks from now, but our growth rate over the next two weeks or so is probably set in stone no matter what we do. This is partly because of simple inertia in our public habits, and partly because the pool of victims that will be identified in two weeks already exists. They’re asymptomatic right now, but they won’t be for long. We should be preparing for a 10x increase in coronavirus cases over the next two weeks.

The raw data from Johns Hopkins is here.