Massachusetts coronaplague forecast

Back on March 29, we looked at the Massachusetts forecast for coronaplague. Science said that “Nearly as many people in Massachusetts will die as in Florida” (I forgot to write down the number) and that 3,300 Floridians would die. Massachusetts would suffer peak hospital use on April 12:

Science offers a much uglier prophecy today. Our peak is due on April 18, 2020 (another week of suffering and nail-biting). A shocking 8,254 of us will die (out of 7 million). That’s a higher per capita rate than what New York (15,618 deaths out of a population of 20 million) will suffer and more than Florida (forecast at 6,770). The forecast for the entire country remains roughly constant at 81,766. We have less than 10 percent of the ICU beds that we need and only about one third as many hospital beds. In other words, if you’re not crazy you’d be getting into a car right now and driving to Tennessee or Texas (both forecast to have few deaths per capita and no shortage of health care resources; Steve Jobs chose to get all of his cancer care in Memphis, ultimately).

Bad news:

Worse news:

One thing that is very odd is the counting of deaths. In “Number of new COVID-19 cases worldwide is declining now?” I link to the official state reports of deaths. The forecast says that there were “78 deaths per day” (actual) on April 5, 2020. The New York Times today says that we have suffered only 154 deaths total in the greater Boston area (includes southern NH); worldometers says 260 total deaths so far in Massachusetts (I have a tough time believe many are occurring outside of the greater Boston area). The latest report from the state, which includes some deaths from over the weekend (apparently there is a reporting lag) says 356 people have died thus far, so maybe the correct data are being fed into the model.

It doesn’t look as though the U.S. as a nation will run out of health care resources to supply every COVID-19 patient with whatever the state-of-the-art therapy is (i.e., not much that is useful right now). However, since there is no load-balancing system for sending patients to idle hospitals, even within a city or state, some places seem to be at risk of dire Fall of Saigon-style situations. Massachusetts appears to be one of the worst prepared states, on the same scale as New York, but without the military support of a field hospital or a hospital ship.

[What about our shutdown? We’ve closed our schools, restaurants, and stores (except for marijuana and liquor). What did that do for us? The model site forecasts 4,182 deaths for Sweden (population 10 million; not shut down) and 8,254 for Massachusetts (population 7 million; shut down). I.e., we’re almost 3X as likely to die while alone at home watching Netflix compared to a Swede who is out eating and drinking with his/her/zer/their friends.]

31 thoughts on “Massachusetts coronaplague forecast

  1. The worldometers death count for MA is now 356.

    Is there a count of the number of people hospitalized and in intensive care?

    It sounds like hospital networks are bracing for the expected surge, cancelling elective surgeries to free up capacity.

    One reason to try to flood national resources into the NYC-centered hotspot (like the hospital ship) and get it under control is that the more people are infected there, the more other states in the northeast will suffer as well. Unfortunately it looks like New Orleans is going to be a hotspot as well.

    The good news is that hospitalizations in New York, New Jersey, and Connecticut seem to be slowing down. New York is at 17,500 hospitalized, 4600 in intensive care (mostly on ventilators).

    Regional picture.

    Good luck, I hope things in Massachusetts work out better than the model.

    • If you want to see what a shutdown can do, take a look at Washington state, which was an early hotspot, but acted quickly (including a stay-at-home order). It looks like the state is already past its hospitalization peak.

    • A similar story: California vs. New York, exemplified by these two tweets posted by the mayors of San Francisco and New York City on the same day.

      When the number of infections is doubling every few days, even a small delay can make a huge difference. Krutika Kuppalli:

      Anytime you are dealing with an outbreak, if it appears like you overreacted, then you probably did the right thing.

    • Mass. has reported ~750 hospital admissions over the past 7 days, and the numbers day to day are fairly even at ~100/day. If there is an upward trend there it’s pretty slight.

      Deaths are similar at 240 in past 7 days versus 120 in the prior 7. Today’s report was a high of 96, but the state says that includes weekend deaths not previously recorded. The reports on Sat/Sun were 24 and 15, so we will have to wait until tomorrow to see more.

      Right now I don’t see the math to get us to 400 deaths by April 18th. Right now confirmed cases are growing at ~10% per day (vs. 17% 7 days ago, and 32% 14 days ago), but let’s assume we stall at 10%.

      That gets us to ~43k cases by April 18th. Given a 4% CFR, that would yield a total of 1733 deaths by 4/18, and 1532 on 4/17, or 200 on the 18th. BUT, that’s assuming that the ~4000 people who were diagnosed on 4/17 are all either dead or recovered on 4/18. In reality we know it will take until at least the end of April to know how many of those did not make it.

      As it stands today we are seeing the same sort of deceleration that is happening in NYC but at roughly 1/3 the level of confirmed cases as them (2200 vs 7100 per 1M). We’re not on the other side yet but there’s signs of promise in the trends.

  2. The models are total GIGO junk. The basic parameters (such as seropositivity rate in general population) are simply not known, in addition to glaring selection and attribution biases in the only available numbers tendering these numbers totally meaningless. One cannot even tell if this an epidemic of a dangerous virus or an epidemic of hyperdiagnostic driven by mass hysteria. Judging from lack of any visible excess mortality and obviously manipulative propaganda in MSM, my bet is on hysteria.

    • A lot of people are dying in New York City. Many times more than usually do die. This is a significant fact. Hysteria might surround this fact and may even be counter-productive, but fear is not without foundation.

      Deaths at home have increased tenfold, though maybe all those people ended up dying in hospitals anyway.

      Whatever the failings of predictions, a lot more people are dying than usual.

    • Not sure if you realize that what is reported as COVID-19 deaths are mostly deaths not primarily caused by the virus. Not according to the normal rules of post-mortems which recognize that a seriously ill patient can be done in by any random infection. I.e. a terminal COPD patient dies from pneumonia caused by a common cold – the cause of death is properly recorded as COPD. Same patient catches nCOV-SARS2 (according to the test) and dies from pneumonia, OMG, COVID-19 death! (And, of course, since terminal infections are rarely alone – the failing organism gets quickly infected by the whole collections of various pathogen – so even if we consider the last straw infection to be the cause of death, we still don’t know which infection was that. Technically speaking, not a single COVID-19 death can be scientifically attributed to the virus in question, because nobody bothered to actually prove causality along the lines of Koch principles).

      That said, you cannot rely on the numbers of COVID-19 alone, they are meaningless due to the blatant violation of standard reporting methodology. This means that to get a sense of what is going on one should look for all disease-related mortality; and there isn’t even a blip there above the statistical noise. (There are very pronounced seasonal variations, again, the basic statistical sanity requires adjusting for that – anyone comparing current numbers with non-adjusted averages is a quack, period).

      The article you cited itself is an example of pseudo-scientific B.S. – additional deaths at home… not tested, so it must be COVID-19. What about stress from incessant barrage of fear porn and uncertainty about the future? (For many in the cohort dying from nCOV the stress alone would be enough to push them over the edge.) What about people who need medical care for other reasons but didn’t go to the hospital due to fear of infection or because of lockdowns? What about skyrocketing drug use and alcoholism caused by isolation? What about domestic violence? We don’t know how much of these deaths could be attributed to this particular infection. Even with that the numbers are still within what one would expect at the peak of a normal flu season.

      The whole country has its panties in knots and quacking in fear over something which won’t even show as a visible spike in the total mortality rate, the numbers are so small. In fact, the growing number of experts are saying now that quarantine is likely to kill more people than the virus itself (and not effective in limiting the spread of the virus, either).

      We actually had a precedent of precisely this kind of manufactured mass insanity before: terrorism. The chances to die in a terrorist attack are 15 times smaller than being hit by a lighting. We’re still being treated like convicts in the airports over that threat (and over a million people murdered in the resulting War on Terror).

    • @averros Your comment is what pseudo-scientific B.S. is. No deaths from Covid-19? Next you are going to say there are no deaths from HIV (also technically correct). No causality? Seems a pretty strange coincidence so many more people dying from pneumonia than in normal times! Oh, must be domestic violence. Because it is pretty easy to confuse such deaths with deaths from Covid-19! But don’t worry, nature doesn’t really care what you think and will proceed relentlessly.

    • @Jarle – sorry for you having reading comprehension problems. I never said people don’t die from COVID-19. What I said is that mortality figures from COVID-19 are significantly (by order of magnitude) inflated by the fact that reporting is not following normal practices (I’m not guessing on reasons for that, though I do have suspicions). This is NOT a conspiracy theory, this is a fact, freely admitted by members of President’s COVID-19 response team (Dr. Deborah Birx, briefing on April 7th):

      “We’ve taken a very liberal approach to mortality. I think the reporting here has been pretty straightforward over the past five to six weeks. Prior to that, when there wasn’t testing in January, and February, that’s a very different situation and unknown. … [Now] if someone dies with COVID-19 we are counting that as a COVID-19 death.”

      Translation: if you got hit by a car and when admitted to emergency they did a test and found you’re nCOV-positive, and then you die from trauma, your cause of death is recorded as COVID-19. “With COVID-19” – NOT “from COVID-19”. According to this way of accounting if 100% population were carriers of a totally harmless virus every single death would be attributed to this virus.

      Now, if you actually try to honestly estimate case fatality rate for COVID-19 you will arrive at a figure very close to that of garden-variety flu. Quite a few respected epidemiologists and medical statisticians did exactly that, and some of them had the balls to talk.

      So, yes, Virginia. The world is being shut down for seasonal flu. Thanks to scared humaniform hamsters who believe any crap told by empty talking heads on TV and pushed by power-hungry bureaucrats (who will then parade their “victory” over imaginary disaster as their personal achievement – and the damage they’ve done isn’t their problem).

    • @GB Please stop spreading fake news from bullshit websites. I was hoping you’d be old enough to realise that not everything you read on the internet is true! I wasn’t particularly referring to the US (remember, there’s a lot more people in the world), but your own CDC writes that pneumonia and influenza deaths in the last few weeks have risen above the epidemic threshold, and that “the increase in pneumonia deaths during this time period are likely associated with COVID-19 rather than influenza.” The same is happening in many other countries.

      @averros Your attempt at trying to twist what you wrote is at kindergarten level. And no, trauma deaths do not get associated with COVID-19. If anything, COVID-19 related deaths are being under-reported worldwide (most notably in China, but also in the UK and other places). Just look at the total number of deaths in this period, and the fact that many countries are struggling with space in morgues and graveyards. I’m not going to do your homework for you, but perhaps it is time to get informed from reputable sources.

    • Everyone: If you can, please try to refrain from attacking other commenters’ intelligence, motivations, etc. Remember that most of the “experts” who have offered opinions/prophecies regarding coronavirus have already been proven wrong to at least some extent. When we have some real data (September 2020?) it will be interesting to see who was the closest to being right. A huge disagreement is playing out right now in real time in Europe (Sweden versus Denmark). If it were obvious which country is making the correct decision then the other one would presumably change its policy.

    • “If you can, please try to refrain from attacking other commenters’ intelligence, motivations, etc. Remember that most of the ‘experts’ who have offered opinions/prophecies regarding coronavirus have already been proven wrong to at least some extent.”

      An Internet wit:

      “social distancing was unnecessary” is the new “why should we vaccinate against diseases nobody gets any longer?”

    • Russil: If you’re a shutdown advocate, I am sure it is fun to associate people who don’t think the economic shutdown was the correct decision with the “anti-science” anti-vaxx movement, but Sweden’s refusal to follow the herd and shutdown is not based on an anti-science position.

      “Sweden’s top epidemiologist explains his country’s radical pandemic policies”

      Sweden still provides vaccines to its citizens, even as it still runs its schools, restaurants, and businesses during the coronapanic.

    • It’s not much of a stretch. In both cases, public health officials like Anthony Fauci are recommending public health measures (vaccination or social distancing), and skeptics wonder whether the cure is worse than the disease. When people distrust experts, it’s not surprising.

    • Russil: You’re ignoring that, as far as I know, every epidemiologist believes that vaccines are effective and beneficial to humankind overall. That is not the case with shutting down societies/economies. The anti-shutdown physician in Sweden, for example, has “a PhD in Medicine from Linköping University in 2003 and a MSc in Epidemiology from the London School of Hygiene and Tropical Medicine in 2004” (in addition to his basic MD from the 1980s)

      The Swedish government, in taking Tegnell’s advice and keeping schools, restaurants, and jobs open, is not “distrusting experts”. It is, in fact, trusting experts (Tegnell and his team).

    • “The Swedish government, in taking Tegnell’s advice and keeping schools, restaurants, and jobs open, is not ‘distrusting experts’. It is, in fact, trusting experts (Tegnell and his team).”

      I completely agree! And like public health authorities in other countries, Tegnell is recommending social distancing measures to slow the spread of the virus. Tegnell believes that voluntary compliance is high enough (given Swedes’ trust in their government) that legal mandates will not be required. But he’s still using social distancing.

      Of course, the public health measures appropriate for one country aren’t going to be appropriate for all other countries. South Korea used rapid testing and contact tracing; Italy needed a full lockdown to get its epidemic under control. I haven’t seen Tegnell suggest that Sweden’s public health measures would be appropriate for Spain (#2 in deaths) or the US (#1).

      Anti-vaxxers believe that the cure may be worse than the disease. Similarly, some commenters on your blog argue that the dangers of the coronavirus are exaggerated, that people are being hysterical and overreacting, and that social distancing measures are as useless as a magic talisman.

  3. Santa Clara County (“Silicon Valley”, includes San Jose) is posting detailed official statistics relating to Covid-19 infections. Early shutdown (and non-existent public transportation) appear to have averted overwhelming the medical system. Just looking at the graphs, it appears to be leveling off there.

    • Detailed information would’ve included methodology behind the numbers. Numbers without understanding of what they actually represent (and what the baselines are) are totally meaningless.

      356742! Run for yor lives!

  4. Kudos to the govt of MA for producing a concise and informative infographic. It provides data and context that people can relate to. It’s at least a baseline, even if the margins of error are big and fluctuating. It’s much more detailed and clear than the info our govt here in canadastan is putting out. But our prime minister turdeau did announce that the 570,000 foreign students currently in canada (an immigration scam to gain residency) are eligible to receive $8,000 each in free money for potential lost wages, even if they’ve never actually worked here.

    • “Informative?” Only appears so to people having zero understanding of statistics.

      In fact, none of the numbers in the “informative infographics” has any discernible meaning due to glaringly huge (and, likely, intentional) biases in both number of cases (selection bias… only people who have reason to think they got the virus get tested, and, besides the total number of tests administered is conveniently excluded from this “informative” propaganda leaflet) and the number of deaths (due to mandated mis-attribution of cases in which the virus is merely present or only has a minor contribution to death of otherwise gravely sick person). Oh, and both biases also quite conveniently exaggerate the mortality rate from the nCOV infection.

    • GB: Thanks for that link. Given American tendencies to don the mantle of victimhood whenever possible, that’s still high enough to keep us cowering in our bunkers. Remember that 35-year-olds who don’t smoke and are of normal weight insist on saying that they are just as likely to be killed by COVID-19 as obese diabetic chain-smoking 90-year-olds who could double for Jabba the Hutt. Nobody wants to be left out as a potential victim/object of sympathy.

    • There is also the American tendency to think that health care and government can prevent all deaths. So if everyone pays attention to Facebook memes, social distancing, etc., and if our hospitals are not overwhelmed (as some have been due to our incompetence at load balancing and inability to send people on 30-minute rides to below-capacity hospitals), we can #SaveLives.

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