Medical staff move bodies from the Wyckoff Heights Medical Center to a refrigerated truck on April 2, 2020 in Brooklyn, New York.
Angela Weiss/AFP/Getty Images
  • As the daily numbers of new US coronavirus cases continue to rise, daily death counts could stay flat or even decline through August, according to new projections.
  • But deaths are likely to surge again in the fall.
  • Around 80,000 more people in the US are expected to die of Covid-19 from now to November, according to models from the University of Washington.
  • For more articles, go to www.BusinessInsider.co.za.

Those keeping an eye on the US's coronavirus case and death curves will notice a seemingly hopeful trend: Although new daily cases are skyrocketing, daily deaths have remained relatively flat recently.

Indeed, new projections from the University of Washington's Institute for Health Metrics and Evaluation (IHME) suggest that this new peak is not expected to be as deadly as the one in April.

That's primarily because increased testing means more mild cases are being confirmed, and young people represent a larger share of coronavirus cases than they did at the start of the outbreak. (Covid-19 is far less fatal in younger people.) In Florida, the median age of coronavirus cases has dropped to 35, compared 65 in March. Cases among people under 40 are also rising in Arizona, California, Minnesota, Ohio, South Carolina, and Texas.

But even if higher case counts don't bring a proportional surge in deaths, there is still reason for alarm. The IHME model projects that the US will see around 80,000 new coronavirus deaths from now until November. That's far more than the number of US combat deaths recorded during World War I.

The projection accounts for seasonality, the amount of testing being done, and how often people are interacting with others outside their household.

Currently, more than 130,000 people have been killed by Covid-19 in the US, so the additional projected deaths represent a nearly 60% increase. These deaths are expected to arrive as other countries' daily cases and deaths continue to drop precipitously.

And if that wasn't concerning enough, there's still a strong possibility that daily coronavirus deaths will rise in the near future.

"No one wants to say too early that deaths are not rising. That would really be a mistake," Dr. Howard Koh, a professor at the Harvard TH Chan School of Public Health, told Business Insider. "If somebody is infected and then has the risk of getting sick and being hospitalised and dying - that whole trajectory takes a number of weeks, at least, maybe up to a month or more."

Hospitalisations are on the rise, too

Over the last week, the US has recorded its highest numbers of coronavirus cases to date: around 49,000 daily cases, on average. Thursday marked the peak of the outbreak so far, with more than 55,000 cases. New cases are rising in the majority of states.

Nationwide, meanwhile, deaths have declined considerably since their peak in April. Over the last week, the US has seen 517 daily deaths, on average, compared to more than 2,7000 deaths on April 21, the deadliest day of the outbreak.

President Donald Trump has attributed the nation's rising cases to an increase in testing. The US is now testing 62 out of every 100,000 people - a lower rate per capita than Russia, Iceland, and Australia, but a higher rate per capita than Italy and France.

But in more than half of US states, the percentage of Covid-19 tests coming back positive is rising - a sign that increased testing isn't the primary reason for the growth in new cases. Instead, experts suggest that the surge reflects increased transmission as people interact more without sufficient distancing or masks.

"We're all speculating that after Memorial Day, it was really the younger people who perhaps reengaged with society too soon and without the proper precautions," Koh said.

Epidemiologists usually predict a two- to three-week lag between when new cases and new deaths are reported. Based on that estimate, the US should already see an uptick in coronavirus deaths. But Koh said a surge is still possible in the coming weeks.

"In places where cases are rising, hospitalisations are increasing, too," Koh said. "We will inevitably see deaths coming in such situations, unfortunately."

Indeed, the daily death total has started to rise in Arizona, Florida, and Texas. And hospitalisations were rising in 23 states as of Sunday, according to data from The Covid Tracking Project.

"We're starting to see that uptick in deaths coming now," Dr. Theo Vos, who works on the IHME model, told Business Insider.

'All the trends are going the wrong way'

The IHME model accounts for two scenarios: Either social-distancing mandates continue to be lifted and mask use stays the same, or countries pull the emergency break by reinstating mandates if deaths climb too high.

Under the first scenario, total US deaths could top 215,000 by November. Under the second, fatalities would be a bit lower: around 208,000.

Either way, though, nationwide deaths are projected to rise in the fall. Many experts think that season will bring the worst phase of the outbreak.

"Our model strongly suggests that there's quite a seasonable component to this disease," Vos said. "Come the fall, we expect the pressure on transmission to go up."

The US is currently seeing around 40 coronavirus deaths for every 100,000 people. Of the 20 countries currently most affected by Covid-19, only the UK has a higher death rate per capita right now: around 67 coronavirus deaths for every 100,000 people. If US deaths continue at the current rate, however, the nation could climb to the top of that ranking.

"If you look at other countries, they are down on the other side of the curve. Their cases have dropped dramatically. Their deaths have dropped dramatically," Koh said. "We're nowhere near that right now. All the trends are going the wrong way."

Deaths could surge in the fall, but masks can help

Experts worry that a surge of coronavirus cases on top of regular flu outbreaks this fall could place additional strain on hospital capacity, leading to many more deaths that could have been prevented.

"I see too many patients die too early of preventable causes and that's an absolute tragedy," Koh said. "What we can accomplish in the long run depends so much on whether we can maximise the power of prevention based on the tools we have: face masks, social distancing, and hygiene."

The IHME model predicts that about one-third of transmission - or between 45,000 and 53,000 deaths - could be prevented if 95% of the US population wears masks in public from now to November.

"It is such a cheap and relatively easy option with quite a potential to make a substantial dent in this epidemic," Vos said.

Koh said a national face mask policy is perhaps the most critical step to preventing future coronavirus deaths. At least 21 states have instituted a statewide mask mandate so far. Texas became the most recent addition to that list on Friday, when Gov. Greg Abbott issued an executive order requiring masks in counties with 20 or more active Covid-19 cases. Failure to comply with the mandate could result in a fine of up to $250 (R4,000).

But the specifics of mask requirements differ state to state, and some cities and counties have implemented their own policies.

"We have 50 states going in 50 different directions," Koh said. "This all leads to tremendous confusion among the public about what's the public-health standard."

Under a universal mask mandate, US coronavirus deaths could dip below 200 per day from September to November, according to the IHME model. Koh said it's important for individuals to realise that these aren't just numbers - they're real people's lives.

"When prevention works, absolutely nothing happens. All you have is the miracle of a perfectly normal, healthy day," he said. "Maybe because I'm a physician I've seen that gift forfeited so many times. We need to convey the fragility of our good health right now."

This story was originally published on July 5. It has been updated with new projections from the IHME.

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