Following the second wave (or not) in the US as the States open up

I’m not about to predict what will happen in Florida a month from now because I don’t know what people in Florida are going to do next.

New York State’s current 7 day daily average of deaths is 17, though. So it looks rather as if Florida’s heading in the direction of catching up.

Current worst ten states in seven day average of COVID deaths per day per one million residents (plus select states).

Rank State Deaths WoW
1 Arizona 10.66 +3.63%
2 South Carolina 9.32 +73.20%
3 Delaware 8.22 +833.33%
4 Louisiana 6.79 +78.23%
5 Mississippi 6.72 +32.08%
6 Florida 5.79 +17.09%
7 Alabama 5.42 +12.05%
8 Texas 5.38 +37.36%
9 Georgia 4.37 +88.95%
10 Nevada 4.04 +61.11%
25 New Jersey 1.46 -47.09%
39 New York 0.87 -28.74%

We can state that both NY and Florida have reasonably similar total infection rates at present but Florida is going to exceed NY by quite a margin. Fortunately medical intervention is far more effective and it should be able to reduce the death rate.

The death rate in Florida reflects infections that were acquired up to 7 weeks ago when the infection rate was increasing by around 2000 cases per day - it is now 10-12 thousand cases per day.

During this same period NY infection rates were at around 700 cases per day and this is resulting in around 10 or so deaths per day.

The current infection rate in Florida is around 10k to 12k per day and we do not know if that is the peak, flattening out or about to decline.

Based upon the current rate of infections it is reasonable to expect Florida death rate to rise in 7 weeks to 5 or 6 times the current death rate so we would prepare for around 800 deaths per day by then - but beyond that it is not possible to know - it will depend completely upon how Floridians behave.

If you want to know what will happen in the future, it is unfortunately beautifully predictable - just look at the infections from the last 7 weeks, even that is actually progress because it was killing people in around 3-4 weeks, now its 6-7 weeks which is proof of medical treatment progress and more are likely to survive - the death curve will still follow the same arc - just at a lower level.

The concern for all Americans is this, in 7 weeks time if the peak has been passed then presidential campaigining will be in full swing - loads of meetings and gatherings and this is very likely to lead to another wave of infections.

The politicians will not be concerned since the resultant deaths will occur after the vote has been held and it will not be politically relevant any more - the irresponsible political actors will have nothing to lose by putting their supporters at risk so they will have no incentive to maintain social distancing or any of the pandemic control measures.

Its Americans that will suffer, the Presidential race will be over and it will be too late to hold politicians to account.

That’s a thought worth taking to bed and sleeping on.

800 deaths per day average in 7 weeks for Florida.

On the one hand, Florida may well be testing a higher percentage of asymptomatic and minimally symptomatic people than New York was during New York’s peak of deaths. That would imply a likely lower proportion of deaths to infected in Florida.

On the other hand, the rate of infections in Florida may well increase; which might well cause a higher number of deaths, even if the above is true.

On the third hand, they might cancel each other out.

On the fourth hand, somebody might actually find a Miracle Cure between now and seven weeks from now; though I’m sure not counting on it.

There are undoubtedly more factors than that. Will Florida get hit by a major hurricane in the middle of this, screwing up both hospital capabilities and transport, not to mention electricity and water supplies for people trying to survive illness at home? And I’m sure I’m still leaving something out.

So I’m still unwilling to commit to a guess. One thing I’m pretty sure of, though: the number will be higher than it would have been if Florida had looked at the example of New York and gone in for better preventative measures.

I think everyone would forgive you if your guess was overturned by a hurricane or miracle cure. Absent those sorts of things you seem to be predicting New York level bad without committing to it.

Why are you trying to get people to commit to a specific number, and for that matter to a specific number at a specific moment? If I say that I think Florida’s eventual total covid-19 deaths over the course of a year will match or surpass New York’s, but I’m not certain of it: what’s wrong with that?

Nothing is wrong with that. I was just a little turned off by your four hands worth of speculation.

Why would you choose NY as an example? Their leadership invited people to a parade and to support local businesses at the start of all this. They relieved hospital space by forcing nursing homes to take covid patients. Their actions ended up delaying opening back up. NY is the working definition of what not to do.

Florida has a higher percentage of people 65 or older so they are more vulnerable than NY. Maine would be a better example for them to follow because of a similar age demographic.

Right now my guess looks a bit out there, but who would have thought at the beginning of March that NY deaths would be close to 1000 per day when known infections were allegedly at 2000 per day - and yes I’m well aware that this number is very likely a huge undercount.

I’ve so far guessed thee would be 150k deaths in US by August 1st, unfortunately I was out by a little - since this was achieved by 28 July

As for the whole of the US - I had thought it might be 160k by 1st August but that was before the opening up - the protests against the restrictions and the BLM protests.

So now by Sept 1st its much more likely to be around 170k headed toward 180k and by October 1st I will stick my neck out and estimate that 200k is a realistic possibility.

I would not want to attempt to forecast any further due to the Presidential campaign and the chances of gatherings which could have a devastating impact.

I’m curious why you think this, apart from simply doing some basic extrapolations on graphs (with questionably certain inputs). It’s because Florida is not wearing masks, or not social distancing, or not closing businesses or gathering spaces? Or it’s something about differences in the relative demographics? What is it about Florida that seems far more susceptible to you?

I appreciate that there seems to be a widespread sentiment on this board that it was human intervention that stopped the spread of the virus in its tracks in NY, but I wish I could believe there was compelling evidence of that. Just today I see the reports about arrests at huge house parties (or whatever it was), and I think…yeah, that’s pretty well par for the course, in NY or NJ or just about any other country too. People gonna do what they gonna go – and often, what they have to do – and the human intervention measures are going to have holes. Just no real way around that. Hell, the whole notion of ‘essential services’ is a huge enough hole as it is.

The much, much simpler theory is that NY already has a far higher infection rate than you would seem to admit, and that there is no reason to believe that Florida will end up with anything different.

You’re doing better thnt me for an early guess. I didn’t make one. I would have put it under 200K by the end of the year if I made one in May. The death rate was so aggressive early on I didn’t know what to think.

I don’t expect any of the states to see rates like New York and New Jersey saw going forward. There are too many lessons to have learned.

Also, there isn’t really anywhere in the country as densely populated as NY/NJ.

In response to SayTwo

As we both can see, the data for NY is likely too low but in any event you can only go with the information that is available, but the unduly low (in my opnion) infection rates of NY then have the effect of making the fatality rate appear to be higher than it really is.

That taken into account NY has specific factors that made it much more vulnerable to a wider and faster spread - the mass transit system, the number of international travellers from outside the US of both visitors and US citizens is very large and then there is high density housing on a larger scale than most US states and then certain communities have various behaviours that lend themselves to spreading events such as the Hasidic community.

Some of those conditions are partly present in other areas but not all of them on the same scale.

Florida has its own issues, it has a very large retirement community which is increasing (but then so does NY) and this makes Florida especially vulnerable to a huge spike in Coronavirus deaths, possibly more than any other state and this may well outweigh the advance in medical intervention.

I still think that Florida will still achieve a higher infection rate then NY since it has not yet even levelled off the current increase - it seems to take 3 or 4 times longer for rates to decline than is does for them to rise, and up to now, more people get infected and die in total than during the rise to the peak.

I think you are being overly pessimistic in what we can achieve in terms of behaviour - each nation has its own cultural response to events and each nation has its own response to interventions made by the state - so in the far east people tend to be more community minded and more compliant, Europeans a little less so, and in the US much more self interested. In NY though once the extent and severity of the pandemic became clear IOW it affected them personally, compliance suddenly took off and the effects are there to see, NY is way quieter.

Other US states had more time to learn the lessons - but it became political which pretty much undid any learning from the misfortune of others, I still do not think every US state has taken it a seriously as the situation merits, this pandemic looks to me like it will swirl around all the states several times before the lessons are fully learned because its inevitable that impatience and individualism will outweigh the epidemiology - a lot of folk are going to have to die I’m afraid.

You have seen my prediction - 800 deaths per day in Florida alone, it looks to be well out there - it isn’t although I would be glad to see it less than that and proven wrong - but I won’t, worst case is that is could either go higher or it could decline and Florida will drop its control measures too soon and the numbers will jump up again - which is a viable prediction for the run up to the Presidential campaign.

As a bad example, to start with. Anybody looking at NY should have seen how easy it was for this disease to become a serious problem.

And then as a good example, as they got it back under control.

Florida decided to follow the bad example instead of the good one. Which is why they’ve now got a lot of cases and rising numbers. Why you are snarling at NY for its early behavior but appear to be fine with Florida’s equivalent recklessness is beyond me.

Nearly everybody’s learned to keep their pants on in public. We can learn to keep masks on in public. There are countries that have very little problem with this, although their population is also made up of humans.

Will we ever get perfect compliance? Of course not. We’re never going to get perfect compliance with anything. But we can sure as hell get closer by trying than by throwing up our hands and saying nothing can be done.

I’m not casdave, but yup.

If I bring it up down the road it won’t be an “I told you so”. But I think the death rates of NY won’t be seen again because of the percentage that was concentrated in elderly housing. There should be protocols in place to keep those numbers down. Also, as mentioned, no subways in Florida. I would put the peak at 250 a day and I think that will be high but I’m hedging.

I’m looking at Arizona as the covid canary. They have a significant percentage of people over 65 and right now they are way above everybody else in per capita deaths.

What percentage of NY COVID deaths were from nursing homes and how does that compare to the U.S. as a whole and other states such as Florida?

This report (PDF) from the New York State Dept of Health lists roughly 6500 confirmed and presumed COVID-19-related deaths in nursing homes and adult care facilities between March 1 and July 27. While it includes only deaths that occurred at the facilities, it works out to about 20% of all New York fatalities. That’s not directly comparable to other states, because of different reporting requirements and standards, but for example 75% of Minnesota’s fatalities and 56% of those in Kansas, and a staggering 81% of those in New Hampshire, are linked to nursing homes. (cite) No, it’s not really obvious that New York did much worse than anybody else in terms of deaths in nursing homes.

Sending recovering patients to complete their recovery in nursing home frees up space for much sicker people to be treated in the hospital. This is the kind of thing you have to do when your hospital system is being overrun. While it is less than ideal in many cases it could have been the least bad option of several horrible options.

Meanwhile, this week in Texas…

Virus patients being transferred from El Paso hospitals to nursing home ‘Covid units’

Sometimes you have do shitty things when all your options are shitty.

If you send them to unprepared nursing homes it creates more people going back to the hospital.

If you read the article you posted they went to nursing homes set up to take them.

Therein lies the difference. When the hospital ship was sent to NY it was supposed to be for non-covid patients. The state wanted it for covid patients so they had to reconfigure it.