Just a Little Coronaflu

Whereas our Governor here in New York started talking around this time last week about “glimmers” and “flickers” of hope that the daily death toll in City and State were peaking (claims which were dutifully parroted by the media and promptly followed by significant spikes in daily deaths), I think we can now, as of Friday, start to talk –somewhat more meaningfully – about a plateau in our COVID-19 fatalities in what, for the time being remains the national epicenter of the disease, in the country which has now become the global epicenter of the pandemic. It remains my expectation that this gruesome plateau will extend roughly to the end of April, though I’ve been encouraged to read that daily hospitalization rates have leveled out. We may yet avoid the apocalyptic scenario for which we were all braced, although I think it’s been apocalyptic enough already in many of the City’s neighborhoods.

Not that my complaints played any role, but the City has addressed a problem in their data reporting to which I’ve pointed of late, and the City’s official COVID-19 data portal now includes a note reading: “Deaths in NYC Reported by New York State,” after which the number – easily calculated by simply adding up the death tolls for the five NYC counties from the State’s official COVID-19 data portal – is shown. One wouldn’t have thought it would have taken quite so long to get some basic things right, but such are the many signs of how woeful was our unpreparedness for this crisis.

Of course, problems still abound with our data – chief among them, that neither the City nor the State had been counting the hundreds of people a day dying at home from COVID-19. Between March 20th and 31st, reporting by WNYC/Gothamist suggests that between 500 and 1,000 New York City residents died at home from the virus; since April 1st, reporting by the New York Times suggests that roughly 200 City residents have been dying at home from COVID-19 each day on average. In response to the former coverage, the City has announced that it “will begin to count suspected COVID-19 deaths of people who die at home,” but that doesn’t appear to have happened yet (at least not retroactively) as back-of-the-envelope calculations based on the above numbers would suggest that roughly 3,000 deaths had not been counted, and I’ve observed no such spike in City or State data. The inclusion of those missing 3,000 dead would put the total number of City fatalities already close to 10,000.

As always, it is helpful to contextualize these numbers. A few weeks ago, I shared this bar graph to which friends had pointed me (strangely, it is no longer available at Information is Beautiful although they have continued to update their COVID-19 Datapack). Less than a month ago, COVID-19 sat well outside the top 10 deadliest diseases in the world based on estimated deaths caused per day.

According to the graph below (from Our World in Data), every day since March 28th, COVID-19 has caused more deaths daily than tuberculosis does on average. Yesterday, April 10th, total confirmed deaths globally from COVID-19 exceeded 7,000, although the actual number of deaths the disease caused was likely significantly higher.

At the time of this writing, the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) tracker has the global death toll approaching 110,000.

Again, according to Our World in Data, that would put COVID-19 (based on 2017 numbers) already into the top 30 causes of death worldwide for 2020, most of which causes are not communicable diseases. This does beg the question why we do so little – compared to shutting down the entire global economy – to address problems like AIDS, tuberculosis, malaria, road fatalities, or even cancer and heart disease (which, of course, get a lot of attention and have a lot of 5Ks run to “cure” them, but the root causes of which – caught up as they are in the power of Big Ag and multinational CPG corporations; Big Tobacco; the fossil fuel/petrochemical industry; the agrochemical industry; etc. – we are generally very reluctant to examine).

In the United States, the CDC estimates that seasonal flu mortality has varied roughly between 20,000 and 60,000 deaths per year over the course of the past five years – with the estimate highest for the unusually bad 2017-2018 flu season, and somewhere in the middle for the flu season just ending. Already – again according to the Hopkins tracker – the US has recorded more than 20,000 confirmed COVID-19 deaths and, optimistically, Dr. Anthony Fauci (with whom I think we’re all familiar by now) has reduced his estimate for total US COVID-19 mortality to approximately 60,000 – down from the 100,000 to 250,000 range that had previously been floated (and the high-end estimate of more than 2 million deaths under a business-as-usual/no-action scenario).

Put differently, by shutting down the entire US economy and instituting shelter-in-place/stay-at-home orders across almost the entire country, we may manage to reduce mortality from COVID-19 to that of an especially bad seasonal flu season. We may – though, of course, if 20,000 is already the number of confirmed deaths, the actual toll must already be significantly higher. Based on the example of New York City, I don’t think it’s unreasonable to imagine a 50% undercount, which would put the actual number of COVID-19 deaths in the US to date at ~30,000.

In New York City, according to NYC Health, “There are roughly 2,000 deaths each year from seasonal influenza and pneumonia,” a fact reflected in the graph below.

You can see that, less than a month after the first official COVID-19 death in NYC, the disease has already killed more New Yorkers than all but the two leading causes of death (again, as in the world, so in the City: heart disease and cancer) kill each year. It is very likely that COVID-19 will be the leading cause of death for 2020 in New York City, and it has already killed between 3-5x as many people as generally die in the City from the seasonal flu. So much for the horrible claim that was rolled out by so many of our elected executives in justifying their own inaction.

In the end, we know that most elected officials don’t have an incentive to count any more of the dead than they have to, or alternately, that they have a strong disincentive to acknowledge any more deaths than they must. Politicians like Andrew Cuomo and Bill de Blasio – who bear much of the responsibility for our disastrous pandemic response in New York City – would likely prefer not to count people who died at home from this disease, and men like our President in the US, Prime Minister Bolsonaro in Brazil, and Prime Minister Modi in India – who consistently denied the seriousness of the pandemic and continue to spread misinformation about the disease while exploiting the crisis for their own narrow and vicious political ends – would be happy, one imagines, to simply let the poor of the ghettoes, favelas, and slums – that is, people’s neighborhoods – die of whatever they die of and be forgotten.

This must not be allowed to happen, and holding these politicians to account is a key aspect of the struggle for the post-pandemic future. Especially in this country, with what Noam Chomsky – in my view, rightly – has called “the most crucial election in human history” upcoming, people must not be allowed to forget that the President and his cronies brought this plague down upon us. The Washington Post video “How Fox News has shifted its coronavirus rhetoric” and Trevor Noah’s “Heroes of the Pandumbic” both point toward the type of not-forgetting that needs to be done right now, but we need a lot more of it and should expect this fight over who controls the past to be a constant feature of our effort to reshape the future. The truth must not be erased.

Postscript: Speaking of truth, the City has now released more clearly labeled graphs on it’s “NYC Emergency Department Surveillance Data” for “Influenza-like Illness and Pneumonia” suggesting that, contrary to my prior claim (one that was made widely in the media based on the City’s own data, although perhaps I should’ve known better than to link to the Wall Street Journal), there was no spike in emergency room visits and admissions starting on March 1st. I’ll continue to look for reliable sources on this front, but apologize if my claim turns out to have been mistaken.