Update 23 March 2020: Projecting the number of deaths over the next several days

Update: 23 March 2020, the model predicted 520 deaths for today. The number of deaths as of this evening: 520. Two days, two accurate predictions. No change to the trend line equation I am sorry to report.

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I nearly passed out when I saw this.  

The equation that defines the data for 2/29/2020 to 3/22/2020 is:

y=2.1183 times e to the power of .2293*X. X is an index number beginning with 1. 

Initially, I calculated the trend line using the number of deaths up to 3/21. A few minutes later I found out the current number of deaths (3/22). I recalculated the trend line based on the additional data. The trend line remained the same. I have maintained the calculated value for 3/22 just to show that the trend line appears to be a reasonable projection of the future ... if we continue to do what we've been doing. 

Fortunately, some states have taken action. 

But, please note that the projection is for something on the order of a total of a million deaths just a little over a month. And one percent of the US population dead by the end of April. 

According to the CDC, 675,000 died in the US because of the 1918-1919 influenza pandemic when the population was approximately 103 million. So kind of numbers that this trend line is not all that out of the realm of possibility.

Given the number of deaths and their rapid acceleration, I have to wonder about the actual infection rate in the US. These numbers suggest that many, many more people are infected with COVID-19 than anyone has yet considered. Instead of tens of thousands or even hundreds of thousands, it could be in the millions. 

I'll continue to enter numbers into the spreadsheet day by day so see if the trend line changes ... for the better?

Date	Cumulative Deaths Actual	Cumulative Deaths Projected
2/29/2020	1	1
3/1/2020	1	1
3/2/2020	6	6
3/3/2020	9	9
3/4/2020	11	11
3/5/2020	12	12
3/6/2020	15	15
3/7/2020	19	19
3/8/2020	22	22
3/9/2020	26	26
3/10/2020	30	30
3/11/2020	38	38
3/12/2020	41	41
3/13/2020	49	49
3/14/2020	57	57
3/15/2020	68	68
3/16/2020	86	86
3/17/2020	109	109
3/18/2020	150	150
3/19/2020	207	207
3/20/2020	256	256
3/21/2020	302	302
3/22/2020	414	413
3/23/2020	520	520
3/24/2020		654
3/25/2020		823
3/26/2020		1,035
3/27/2020		1,301
3/28/2020		1,637
3/29/2020		2,059
3/30/2020		2,589
3/31/2020		3,256
4/1/2020		4,096
4/2/2020		5,151
4/3/2020		6,479
4/4/2020		8,148
4/5/2020		10,248
4/6/2020		12,889
4/7/2020		16,211
4/8/2020		20,389
4/9/2020		25,644
4/10/2020		32,252
4/11/2020		40,565
4/12/2020		51,019
4/13/2020		64,167
4/14/2020		80,704
4/15/2020		101,503
4/16/2020		127,663
4/17/2020		160,564
4/18/2020		201,944
4/19/2020		253,989
4/20/2020		319,447
4/21/2020		401,775
4/22/2020		505,320
4/23/2020		635,551
4/24/2020		799,344
4/25/2020		1,005,350
4/26/2020		1,264,448
4/27/2020		1,590,321
4/28/2020		2,000,177
4/29/2020		2,515,661
4/30/2020		3,163,995

And if these numbers don't get your attention, here are the numbers for the first three days in May.

5/1/2020		3,979,417
5/2/2020		5,004,988
5/3/2020		6,294,869

I find it difficult to believe that the US is going to reach these numbers, but this is about 2 percent of the population. 

Death from Despair Part 5: Analysis by Race, by Race Crossed with Gender, by Race, Gender and Age (Analysis of American Indian/Alaskan Native and White Males by Age)

1. Analysis by Race

American Indians/Alaskan Natives consistently have the highest rate of death. That is followed closely by Whites. That the Total line closely follows the White line is unsurprising given that Whites form the largest racial group.  African Americans and Asians fall below the Total line. As we have seen earlier the line for African Americans has risen sharply in the last few years because of sharp increase in drug-related deaths. Asians may have the lowest death rate however, the death rate for Asians continues to rise, not at the accelerated rates of the three groups, but are rising nevertheless. 

Of concern, deaths from despair continue to rise for everyone no matter your racial group.

2. By Race and Gender

I further subdivided the data by gender. In the figure below, females are represented by squares and males by circles. 

Every group has shown an increase in deaths from despair, even female Asians who clearly show the lowest rate of increase. As a whole, females show a lower death rate than males. One notable exception is that male Asians have a lower death rate than American Indian/Alaskan Natives and female Whites.

What I find particularly striking about this graph are the lines for American Indian/Alaskan Native Males and White Males. Both lines follow a steeper trajectory with strikingly higher death rates than the other groups. What I find striking as well is that these two lines closely follow each other. And for those two reasons I decided to drill into the data from these two groups with Age as a factor.

3. Analysis of American Indian/Alaskan Native Males and White Males

I added age as an analysis factor for these two groups. The figure below shows the results of that analysis.

American Indian/Alaskan Native male lines have downward pointing triangles. White males have circles. 

Something to note: American Indians/Alaskan Natives have jagged lines. The reason is that the underlying numbers are relatively small so a relatively small change can seem to show large swings in the crude rate. That being the case one needs to focus not on the swings but on the overall trends that unfortunately point strongly upward.

I selected most productive years in 10 year age ranges that consist of the 10 year age ranges of:

• 25-34
• 35-44
• 45-54
• 55-64

For both American Indian/Alaskan Native males and White males the most deadly years range from 45 to 64. For American Indian/Alaska Natives males those years have proven particularly deadly, especially in recent years. And it is clear, that for American Indians/Alaskan Native males, deaths from despair begin relatively early in life and become more strongly pronounced as they grow older.

Something that interested me was the American Indian/Alaskan Native and Whites show similar patterns in the 25 to 34 age range. 

Two more figures separately show American Indians/Alaskan Native and White males.

These two groups are clearly at the most risk for death from despair and the numbers are staggeringly high.

This series of articles will continue. 

Death from Despair Part 4: Analysis by Age Groups

This data was collected from CDC's Wonder database for all the years available: 1999 to 2018. They're broken down into 10 year age groups from 15 to 85 (plus) years old. I removed from the figures the age groups for everyone under 15 years old and all those where the age the person was not reported. The under 15 years old age group data showed crude rates of less than 1 death per 100,000, too low to be included in the figures.

Deaths from Despair by Age Group

The figure below shows the crude rates of death from despair by age group. The dashed line curve is the overall total for all age groups to provide a baseline of comparison and a dividing line for those over, under and on the line. 

As seen in other studies two age groups, 45-54 and 55-64, show the highest growth rate  as well as the highest number of deaths from despair. Those in the 65-74 age group closely follow the Total line.   

I inserted the figure above to call attention to something that I found particularly disturbing. The age groups I have boxed are those ages that could only be considered "the prime of life." One would consider these to be the best years of anyone's life. (I know I do.) Yet in recent years, the rate of death from despair are 1) above the Total baseline and 2) the highest of all the age groups. Furthermore, the growth rates for the 25-34 and 35-44 age groups has noticeably jumped over the last 5 years.

The two age groups with little or no growth are the 75-84 and 85+ groups. Furthermore, they're below the baseline. 

The 15-24 age group has the lowest crude rate, but it's a crude rate has nearly doubled during this 20 year period and that is concerning.

Finally, to point out that during 1999, the data points for most of the age groups were in a much closer range (from 13.9 to 43.0) than in later years where the spread has become much wider from a crude rate of 25.8 to 82.1. 

COVID-19 Spread: Updates from the Washington Post - Updated

When a novel virus spreads, it's important to have access to trusted sources of information. Here's an article from the Washington Post regarding the spread of the COVID-19 virus around the world. This article will be updated from time to time.

Here's the link: https://www.washingtonpost.com/world/2020/01/22/mapping-spread-new-coronavirus/?arc404=true

One more thing ... if you take a look at the end of the article, there's a table of history of various diseases. One of the things that I did, was from the data provided to determine the death rate of COVID-19. Using the reported numbers, the death rate is 3.46%. (86013 inflected and 2977 deaths.) That could be high because not all COVID-19 cases are likely to have been detected. 

I updated the parameters in my quick model to 1) number of persons that an infected person would infect = 2 and 2) death rate = .0346. Number for multiple generational points = 75. 

This is what the model produced:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	4	8	16	32	64	128	256	512	1,024	2,048
Running total infected	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095
Total deaths	0	0	0	1	1	2	4	9	18	35	71	142
Multiple Origination Points Infected	75	150	300	600	1,200	2,400	4,800	9,600	19,200	38,400	76,800	153,600
Running total infected	75	225	525	1,125	2,325	4,725	9,525	19,125	38,325	76,725	153,525	307,125
Total deaths	3	8	18	39	80	163	330	662	1,326	2,655	5,312	10,627

UPDATE: Of note, I reported the COVID-19 death rate as 3.46% based on the numbers supplied by the Washington Post in the article shown above. I reported that value as a death rate with caveats. However, about a week after I stated the above COVID-19 death rate, the World Health Organization (WHO) reported a death rate of 3.4%. I was about to alter my death rate to 1% based on recent reporting. But for now I'm not going to update what my model has predicted with respect to the number of deaths until I receive an updated number from WHO or the CDC.

Changing the number for multiple generational points to 42, here's what you get:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	4	8	16	32	64	128	256	512	1,024	2,048
Running total infected	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095
Total deaths	0	0	0	1	1	2	4	9	18	35	71	142
Multiple Origination Points Infected	42	84	168	336	672	1,344	2,688	5,376	10,752	21,504	43,008	86,016
Running total infected	42	126	294	630	1,302	2,646	5,334	10,710	21,462	42,966	85,974	171,990
Total deaths	1	4	10	22	45	92	185	371	743	1,487	2,975	5,951

So based on the assumptions embedded in the model (and these are speculative assumptions ... please note that fact) the current state of spread of and the number of deaths from the COVID-19 virus has 42 points of origination, spread over 10 generations where the person-to-person infection rate is 2.0 and the death rate is .0346. 

This also suggests that the spread to the next generation could result in a substantial jump in the number of cases (5 figures to 6 figures) as well as well as in the number deaths. But as with all things monitoring the data and updating the model with the new data is essential.

Update

From NBC News, I received a new person-to-person infection rate and the seemingly minor change makes a pretty significant change in the numbers. Here are the parameters: 1) person-to-person infection rate = 2.2, 2) death rate remains at .0346 and the number of origination points = 39 (to match up with current data). Here's the table:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	5	11	23	52	113	249	549	1,207	2,656	5,843
Running total infected	1	3	8	19	42	94	207	456	1,005	2,212	4,868	10,712
Total deaths	0	0	0	1	1	3	7	16	35	77	168	371
Multiple Origination Points Infected	39	86	189	415	914	2,010	4,422	9,728	21,402	47,083	103,584	227,884
Running total infected	39	125	314	729	1,642	3,652	8,074	17,802	39,204	86,287	189,871	417,755
Total deaths	1	4	11	25	57	126	279	616	1,356	2,986	6,570	14,454

To reach the current number of reported infected people with 39 originating people is the 9th generation as opposed to the 10th generation. Also the jump in numbers to the next generation suggest that approximately 18,000 more people will be infected than in the previous table. 

The point I want to make is that even a slight uptick in the infection rate can have significant consequences.  This is why testing is so important. Keeping the infection rate down makes the epidemic more manageable. This is why informing the public regarding what they should be doing to not become or lower the chances of being infected is so important. This is why having competent people managing this public health emergency is so important. 

The Trump Administration

However, it seems that at the level of the Trump Administration, we have people who have no idea of what to do. Who have been denial for weeks about the likely spread of the virus outside of China and into the US. Trump's recent decision to restrict travel to and from Iran, Italy and South Korea in addition to China is not only short sighted, but utterly inane. The virus is in the US, it is spreading in the US. It's too late for travel restrictions to have any real effect. And besides, travel restrictions only buy you time to prepare, something the Trump Administration neglected to do in it's state of denial about how the virus could spread to the US.