TUCKER CARLSON, FOX NEWS: Yesterday, a piece in The New York Times asked what appeared to be a pretty straightforward question: “When Will New York City Reach the Peak of Its Outbreak?” That’s something you’d think epidemiologists could answer with some precision. As it turns out, no they can’t. Governor Andrew Cuomo predicted the peak will come this week. The head of New York-Presbyterian hospital predicted April 15. The state’s health commissioner, meanwhile, thought late April, or maybe early May. The predictions differed by up to a full month. At a time when New York is quarantined and people are dying, that’s an awfully big range. Howard Markel, a physician and professor at the University of Michigan, summed up the current state of knowledge this way, quote: “In reality, we don’t know.”
No, we don’t. In fact, a close look at the data suggests the peak of the epidemic in New York may have already passed, five days ago. On April 2, 1427 people were hospitalized for coronavirus in New York. That’s the highest number so far recorded. The next day, the total dropped to 1095. On Sunday, it fell to only 358. In the last two days, new hospitalizations have ticked up once again, but they’re still below last Thursday’s peak. If this trend holds, the worst may already be over for New York.
All of this has come as a surprise to our public health authorities. The Institute for Health Metrics and Evaluation, the I-H-M-E, is a well-regarded research center run from the University of Washington. I-H-M-E has produced detailed predictions charting the expected course of this epidemic, in the United States as well in as other countries. Their model has done perhaps more than any other piece of academic research to shape our response to the Coronavirus crisis.
So how accurate has the model it been? Here are some numbers: Initially, the I-H-M-E predicted that on April 4th, the state of New York would require 65,000 hospital beds to handle infected patients. The low-end estimate was nearly 48,000 beds. In fact, on April 4, New York had fewer than 16,000 hospitalizations for Coronavirus. Many other states fell far below the model’s projections as a well.
Over the weekend, I-H-M-E updated its model. Its projections, across the country, have been scaled back dramatically. Yet they are still significantly overstated. For today, which is April 7th, the updated I-H-M-E model predicts that New York will need 25,000 hospital beds. As of this morning, the real number was just under 17,500. The new model also predicted that as of today, almost 6,600 people would be in intensive care. The actual number is just under 4,600. In Florida, the new I-M-H-E model predicted 4,000 people would be hospitalized. The reality in Florida tonight is that not even 2,000 are. And it wasn’t just florida and New York. The I-M-H-E got it wrong in state after state, after state.
By the way, for America, this is great news, something we should celebrate. Unfortunately, on the question of total deaths, the model has been more accurate, though it still tends to overshoot. Yesterday, the I-H-M-E predicted 784 deaths for New York. The state finished the day with about 600. For the entire country, the model is predicting about 2,000 deaths today. It seems likely we will finish somewhere around that number. But that may not be the whole story. There’s nuance within the numbers, as there always is. For many years, the CDC has tracked the total number of Americans who die each week from pneumonia. For the last few weeks, that number has come in far lower than at the same moment in previous years. How could that be? It seems entirely possible that doctors are classifying conventional pneumonia deaths as COVID-19 deaths. This would mean the epidemic is being credited for thousands of deaths that would have occurred if the virus never arrived here. We don’t know that for certain, but it’s worth considering.
Nor do we know exactly why the model predicted so many more hospitalizations than we’ve actually had. You’ll hear people say this is evidence that the shutdowns and social distancing must be working. Not so fast. Those measures were built into the model in the first place. They’ve been taken into account. We’re still doing far better than what epidemiologists believed was a best-case scenario.
So how did this happen? It’s possible that the virus is just less deadly than we feared, or it’s less likely to send people to the hospital. Maybe it spreads less easily than we thought. Maybe it spreads more easily, and the number of asymptomatic carriers is much higher than we knew. All of those are reasonable theories. In a new draft paper, MIT economist Jeffrey Harris suggests that Americans are following social distancing guidelines more effectively than authorities ever imagined they would. Another potential explanation.
Whatever’s happening, this epidemic appears to be doing less damage than we anticipated, and it’s receding more quickly. Not so long ago, some of our leaders seemed on the verge of panic. On March 24, Governor Cuomo of New York descended into a state of frenzy during his daily press conference. Cuomo dismissed the federal assistance New York had received as grossly insufficient. Tens of thousands of innocent New Yorkers were going to die, he said, choking to death while doctors could do nothing to help them:
CUOMO: FEMA says we’re sending 400 ventilators. Really? What am I going to do with 400 ventilators when I need 30,000?! You pick the 26,000 people that are gonna die because you only sent 400 ventilators.
It was a horrifying thought. As recently as last Friday, April 3, Cuomo was threatening to use the national guard to seize ventilators from facilities upstate. That’s how badly New York City needed them. Except it didn’t. As it turns out, New York has many more beds, and ventilators, than it needs:
Miscalculations like this played out across the country. On March 14, Oregon Governor Kate Brown warned that her state’s 688 ventilators wouldn’t be nearly enough to handle the coming surge of Coronavirus cases. It turns out, she got it backwards. Oregon had more ventilators than it needed. On April 4th, Gov. Brown shipped 150 of the machines to New York — which, based on current trends, may not need them, either.
We ought to celebrate all this. Fewer hospitalizations are a godsend. As awful as this epidemic has been, at least so far it hasn’t been as terrible as we’d feared. Our health care system hasn’t collapsed. Except in a handful of places, it hasn’t really come close. Patients aren't dying alone in the hallways of emergency rooms, with physicians too overwhelmed to treat them. That happens in other countries. It’s not happening here. Thank god.
All of this means that the short-term crisis, in which pressure on hospitals was growing exponentially every day, with no end in sight, may have passed. Now it’s time to look ahead. If the virus is doing less systemic damage than expected, then presumably we can begin to consider how to improve the lives of the countless Americans who’ve been grievously hurt by this. How do we get 17 million of our most vulnerable citizens back to work? That’s the task.
Other countries are already doing it. Adjusted for population, Denmark’s coronavirus outbreak has been almost as precisely as severe as ours. In Denmark, schools and daycares are scheduled to reopen next week. The government plans to roll back more restrictions on May 10. Austria’s outbreak has also been similar in scope to America’s. There, the government plans to let small stores reopen on April 14, followed by large stores on May 1, and then, potentially, restaurants and schools in mid-May.
That’s what they’re doing. We’re not doing that here. We’re not even talking about it. We’re not allowed to. Any discussion of how we might transition out of the shutdown back into normal life has become taboo in this country. Raise the question and you’re denounced as a tool of Wall Street who doesn’t care about human life — often by pro-choice activists who are happy to accept cash from corporate America. The layers of irony are bottomless. But we should’t be surprised by it. This is what happens when public debate is replaced by memes, and mindless partisans on social media define the terms of allowable conversion. And so we plod forward, as if the flawed models weren’t flawed at all — as if the reality of what’s actually happening should play no role at all in our decision-making. Doctor Anthony Fauci has announced, for example, that Americans must brace for 18 months of shutdowns, at the absolute minimum. And if a vaccine isn’t found, it may go on forever:
Dr. Fauci offers sobering assessment about return to normal, saying it will only happen "when you can completely protect the population" with a vaccine and treatment. Otherwise: "If you want to get to pre-coronavirus, that might not ever happen, since the threat is there."
Life may never return to normal. This is becoming a species of conventional wisdom. On MSNBC last night, where conventional wisdom is often formed, U-Penn professor Ezekiel Emanuel explained that America may be shuttered for 18 months. At least:
EMANUEL: Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that's dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half? Is all that economic pain worth trying to stop COVID-19? The truth is we have no choice. If we prematurely end that physical distancing and the other measures keeping it at bay, deaths could skyrocket into the hundreds of thousands if not a million. We cannot return to normal until there's a vaccine.
“The truth is we have no choice.” That’s a familiar phrase in Washington. It ought to make you nervous. “Do what I say — follow my orders without complaint — or a million people will die. The oceans will rise. The polar bears will die. The human race will go extinct.” Ok. Maybe. These are smart people. We should hear them out. But these are also big decisions — history-changing decisions, with consequences we can’t even begin to anticipate this far out. Before we go ahead and alter our lives and our country forever, it’s fair to ask about the numbers. Their numbers. The ones that we acted on the first time, but that turned out to be completely wrong. How’d they screw that up so completely? That’s a fair question. If they can answer that question — slowly, rationally, in a way that makes sense, and suggests a deeper humility going forward — then that’s enough. They’re allowed to make more public policy decisions. But if they can’t answer it — if they dissemble or dodge or attack the questioner — then they’re disqualified forever from influencing our lives. Let’s see if they can do it.