Coronavirus

As Trump Imagines '2.2 Million Deaths' From COVID-19 in the U.S., a Top Federal Disease Expert Cautions Against Believing Worst-Case Scenarios

"They always overshoot," Anthony Fauci says. "Generally, the reality is somewhere in the middle."

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During his COVID-19 briefing yesterday, President Donald Trump suggested that the control measures implemented so far should keep the number of deaths from climbing above 100,000 in the United States. Although that is "a horrible number," he said, the death toll otherwise could be "up to 2.2 million deaths and maybe even beyond that."

Trump has pivoted from minimizing the severity of the epidemic to exaggerating the likely outcome in the absence of extreme measures such as mass business closures and stay-at-home orders. Appearing on CNN yesterday, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, offered some words of caution about worst-case scenarios that assume nothing is done to contain, suppress, or mitigate the spread of COVID-19.

Jake Tapper asked Fauci how many COVID-19 cases the United States can expect to see. "To be honest with you, we don't really have any firm idea," Fauci said. "There are things called models. And when someone creates a model, they put in various assumptions. And the model is only as good and as accurate as your assumptions. And whenever the modelers come in, they give a worst-case scenario and a best-case scenario. Generally, the reality is somewhere in the middle. I have never seen a model of the diseases that I have dealt [with] where the worst-case scenario actually came out. They always overshoot. So when you use numbers like a million, a million-and-a-half, 2 million [deaths], that almost certainly is off the chart. Now, it's not impossible, but very, very unlikely."

Those caveats are important because focusing on implausible worst-case projections creates a bias in favor of sweeping and prolonged interventions, which impose enormous costs that might not be justified based on more realistic expectations. In the world we live in, as opposed to the one imagined by modelers when they talk about millions of COVID-19 deaths in the United States, many steps already have been taken to curtail the spread of the virus. These include not just government policies, such as isolation and quarantine, air travel restrictions, and bans on large gatherings, but also voluntary precautions, such as limiting social interactions, working at home, and paying extra attention to hygiene.

When modelers at Imperial College projected 2.2 million COVID-19 deaths in the United States, they were assuming "the (unlikely) absence of any control measures or spontaneous changes in individual behaviour." Although that horrifying number got a lot of attention and has now been embraced by Trump, it was never plausible, even leaving aside the question of whether the case fatality rate (CFR) assumed by the model (0.9 percent) will prove to be correct.

The choice confronting policy makers right now is not between doing "nothing," as that projection assumed, and maintaining lockdowns "for 5 months or more" (or perhaps for "18 months or more"), as the Imperial College report suggested. Rather, the choice involves what kinds of restrictions make sense, where, and for how long.

"Looking at what we're seeing now," Fauci said, "we're going to have millions of cases" in the United States, and it is reasonable to expect "between 100,000 and 200,000" deaths. But he cautioned that "I just don't think that we really need to make a projection, when it's such a moving target, that you can so easily be wrong and mislead people." Deborah Birx, coordinator of the White House's COVID-19 task force, yesterday cited similar but somewhat less alarming estimates, saying "between 80,000 and 160,000, maybe even potentially 200,000 people," could be killed by COVID-19 in the United States.

One unknown variable in these projections is how many Americans will ultimately be infected. Some projections "predicted half of the United States would get infected," Birx said. Another crucial variable is the CFR, which federal public health officials say could be anywhere from 0.1 percent (about the same as the CFR for the seasonal flu) to 1 percent. If half the population were infected and 2.2 million people died, that would imply a CFR of about 1.3 percent, substantially higher than the upper limit of that range—another reason to be skeptical of the worst-case scenario.

Such a high CFR also suggests that the actual number of infections is only about two-fifths bigger than the current number of documented cases, which is highly implausible when testing is so sparse and cases typically involve mild to nonexistent symptoms. "Probably for every case," Assistant Secretary for Health Brett Giroir estimated earlier this month, "there are at least two or three cases that are not even in the denominator."

Based on the available data, which are very limited in the absence of wide testing, it surely is not safe to assume that COVID-19 is only slightly more deadly than the seasonal flu. But neither is it reasonable to assume that the disease is 13 times as deadly. The truth, as Fauci says, is likely to be "somewhere in the middle." In the face of such uncertainty, decisions with profound economic consequences should not be based on one extreme or the other. "Although people like to model it," Fauci told Tapper, "let's just look at the data of what we have, and not worry about these worst-case and best-case scenarios."

NEXT: The World Must Not Mimic China's Authoritarian Model to Fight COVID-19

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  1. https://twitter.com/alx/status/1244647836031074304
    During a Pandemic it is essential that the Media gives us real and accurate information.

    It’s completely irresponsible for
    @CBSNews
    to use footage from an Italian Hospital when talking about the outbreak in New York City.

    This is unacceptable.

    1. Calling CBSNews a news organization is unacceptable.

      1. Do you utilize a pay pal… because if you do you can include an additional 600 every week to your profit just working on the internet 4 hours every day.. go to this site G00gle Consultancy Company

    2. The media are mostly lying hysterical treacherous people.

      We were disbelieving them before this hysteria and we should go back to that tactic. Ignore the media’s lies.

    3. ITT, De Oppresso Liber, who we call Lying Jeffy, lies some more about what people said, then when questioned runs and hides.

      But don’t worry, he’ll wait a day or two, hoping nobody remembers, then he’ll make the same lie.

  2. “They always overshoot,” Anthony Fauci says. “Generally, the reality is somewhere in the middle.”

    1. You could say the same thing about climate models.

      1. I think the left has quit screaming climate apocalypse because they’ve found a much faster and more efficient means of bringing about massive economic destruction and fostering totalitarianism.

  3. Trump hopes there won’t be too many coronavirus fatalities.

    “He’s not taking it seriously enough.”

    Trump thinks there might be a lot of coronavirus fatalities.

    “He’s spouting worst case scenarios.”

    1. ^This. This shows you the level of actual competence in journalism nowadays. It’s not about discussing the actual, it’s about heightening the rhetoric in order to generate clickbait opinion pieces on a daily basis.

      1. The problem is that there are thousands of people/organizations calling themselves (Or being lumped in with) “news media”. And then we have the editorialists/influencers that are quoting the “news” media. And then of course we have the consumers who are cherry picking everything to suit their prejudices and worldview. This is the free market at its finest (or worst depending upon who’s talking).

        1. No the problem is your constant crying.

  4. I am sure these models will turn out to be as accurate as the global climate warming change models are/were.
    And just as effective in pushing the fascist agenda.

    1. I was thinking the same thing.

    2. The key is to just make a trillion different models, and then using the advantage of hindsight you can talk about the one of them that was actually accurate while ignoring all the other bullshit you put out.

      1. Too bad Jean Dixon’s no longer around to give her predictions.

        1. “Too bad Jean Dixon’s no longer around to give her predictions.”

          Jeane Dixon died? Why wasn’t i told!

          1. See didn’t see it coming either.

          2. It was foreseen by many.

    3. Just got my daily “Briefing” email from Nature mag. That damned organization has gone full retard, pontificating on gun control as if it were a matter of science, throwing in their two cents on the politics of vaping, and embracing AGW as if it were the new gospel, even publishing a so-called science report which merely listed skeptics and deniers to blacklist.

      Here’s the Subject: “Coronavirus could have killed 40 million people if the world had not taken action”

      No shit Sherlock. So could have Ebola, SARS, MERS, HxNy, and all the other pandemics. Tell me something scientific for a change.

      My subscription is up for renewal in June. I do not know if I will renew.

    4. ^ This guy gets it

      The leaders only change their tune on the severity of the crisis when they change their plans to exploit it for power.

    5. I think the left has quit screaming climate apocalypse because they’ve found a much faster and more efficient means of bringing about massive economic destruction and fostering totalitarianism.

  5. Apparently the President was accepting some study from Imperial College, that without stringent policies the deaths could go up to 2 million.

    So the question is whether this study the President was leaning on is off base.

    The real question is, of course, not what happens if we do nothing – we haven’t done nothing, if you follow me – but how much beyond nothing we should go.

  6. Where’s all the Trump fanatics who were accusing Fauci of treason for being an alarmist last week? Raise your hands.

    1. At least there’s one aspect of normal life which isn’t affected by the pandemic: Partisan sniping and blaming.

      1. A massive asteroid big enough to wipe all life on this insignificant rock could be barrelling straight towards us and the partisan sniping and blame casting would continue right up until the moment of impact.

        1. #TrumpAsteroid

          1. #TrumpKillingOldPeopleViaUFO

    2. “Where’s all the Trump fanatics who were accusing Fauci of treason”

      Like who?

      1. The voices in his head that he constantly fights for control.

        1. I’m gonna be shocked, SHOCKED!, if Lying Jeffy made this claim and nobody actually said it.

          1. This is the guy who keeps repeating trump stated the virus is a hoax despite himself actually posting the full quote.

            1. If he’s breathing he’s lying.

    3. Please link those comments you’ve made up.

    4. Fauci was pounding on the panic button last week. Trump jumps on the panic band wagon and all of a sudden Fauci is all “now hold on a minute.”

  7. How is the president wrong studies have shown as many as 2.2 million will die if nothing is done but we are doing something which may limit that number to 100,000. Attacking Trump for being correct is just TDS. there is no lie in what he said and possibly claiming 100,000 is over stating based on what has happened so far unless they know something about China and they are not telling us but we know Reason is not privy to that info either. Trump to optomistic bad not optomistic enough bad get a grip Reason

    1. Did we read the same article? I didn’t see an attack on Trump.

      1. the Title alone states the purpose of the article “as Trump imagines…..

      2. To be fair there was one line in the article that said Trump had “embraced” the 2.2 million deaths/ worst case scenario number, and I wouldn’t think that mentioning the worst case number could be described as “embracing” it. Although to be totally honest I didn’t see the actual briefing so I’m only going off of the description of what said here. So that seemed a little incongruous to me.

        But you know how it goes, any and all criticism of the god-king is to be called out for the unforgivable heresy that it is.

        1. God emperor, dude. Didn’t you read Dune? I read all six of the trilogy. The later ones are a great cure of insomnia, though nothing beats Atlas Shrugged for that.

          1. Ouch. I tapped out somewhere in the middle of God Emperor. Really should’ve done it about the middle of Children Of Dune.

            It would be nice if the eggheads could get their predictions straight. Though I think this cocktail is going to make things a lot easier on the ICU bed and deaths front.

            1. I actually liked them all. Even the last one. Then again I also read the Silmarillion.

              1. “Then again I also read the Silmarillion.”

                Everything bigger, more momentous, more powerful….and 100 times as boring. I found it impossible to give a shit, and tapped out about a quarter of the way through. Skimmed ahead—does this ever get better?—-yes, the Great Wyrm is really great, and EVIL. Oops! There went Numenor.

                Still not interested. Why they make vanilla and chocolate, I guess.

  8. Let’s hope it’s not somewhere in the middle. And # b, “”They always overshoot,” Anthony Fauci says. “Generally, the reality is somewhere in the middle.”” perhaps we could introduce Fauci to the environmental movement.

    1. perhaps we could introduce Fauci to the environmental movement

      A guy that really understands the limitations of statistical computer modelling? In government, no less? The AGW crowd would crucify him.

  9. I see we have 2400 deaths. That one lady doc ( can I say that ) says there could be 200,000. It’s gonna have to get going fast to hit that number by April 30 , or May 31 to see that kinda number.

    1. A successful isolation regime will look exactly like a disease that isn’t that deadly. I’m repeating myself but I think we’re going to be looking long and hard at Spain and Italy’s experience to see how deadly this thing could be/is if it runs rampant. I don’t think China will ever be a good case study because their numbers are way too suspect.

      1. Italy has the 2nd oldest population on Earth, only Japan is older. Italy is a good barometer for what the worst case scenario looks like.

        1. Yup. In the end of KungFlu season, less Americans will die from the following real crisis for America:

          Revolutionary War
          Mexican War
          Civil War
          WWI
          WWII
          Korean War
          Vietnam War
          and probably the military dead in Iraq and Afghanistan.

          VA – America’s wars fact sheet

    2. Why do we think this thing is going to stop killing in the summer? AUS and South Africa have quite a few cases, and they are in summer now.

      The one I’ve been told to look out for as the next basket case, is Buenos Aires and Montevideo: Latin social closeness, Socialist medical system, lots of elderly, decent amount of Chinese contact and money. Winter is coming…

      1. This is NOT Summer for the Summer Hemisphere. It’s Autumn.

        1. *Summer for the Southern Hemisphere…

        2. It was summer, not very long ago. And they had cases then. Not as many as the US or Italy, but some.

          Singapore had a few. Jumped right on top of them. Which you can do if you’re a technological police state. Not that the seasons change much when you’re practically on the Equator. Bolivia, per sources I’ve talked to, is not doing well. Not that they will admit it.

          It’s not a flu, and I don’t think it reasonable to assume Covid will go away just because the sun shines a bit more.

          1. I already posted a paper on Sunlight and virus survivability.

            You’re just going to keep saying stuff that is not supported.

            1. Dude, you are the king here of spouting bullshit that’s unsupported. First it was Covid wasn’t going to kill more people than this, then it was not more than the flu—-while cherrypicking some of the worst flu seasons this country’s had in the last 20 years.

              All of the things I wrote about those South American countries—assuming CQ/HCQ AZT actually don’t slow this down—are reasonable predictions, given their density, culture, and general ineptitude at everything else. As for the US, I’d personally wait on the victory sack dance until the deaths per day started decreasing more than one day in a row. Looking at the worldometers graphs, I wonder if we are getting near the peak of new cases per day? That would be great.

              1. Some of the SA nations are going to get hammered because the countries are fucking shitholes. Brazil, at least in Rio and other high-population areas, and Venezuela are probably the most screwed.

      2. probably for the same reason regular flu season peters out in the summer.

  10. Those caveats are important because focusing on implausible worst-case projections creates a bias in favor of sweeping and prolonged interventions, which impose enormous costs that might not be justified based on more realistic expectations.

    Those caveats are important but it is pretty obvious you don’t understand them. the worst-case model is not assuming something that is worst-case about the disease itself. It is merely assuming that hospitals are overwhelmed. So that the next person who gets infected with a serious case (meaning serious enough to require hospitalization) cannot get into hospital because the hospitals are full.

    You Reason writers are really completely clueless. You are taking for granted things which will break. In order to pretend that you can get back to the way things were.

    Fauci is a physician. That means he has the basic bias of his profession. Which is – if he can treat them (which by definition means flattening the curve through whatever means are and for as long as necessary so that he CAN treat them all), he is confident he can reduce the fatality rate. The worst-case however means that is not in his control. Sullum then takes it a step further and says that as long as Fauci says the worst-case is not likely, then there’s no need to follow the consequences of what Fauci himself says.

    This is like reading a whole bunch of Napoleon Hill. If you can believe it you will achieve it. If you didn’t achieve it its because you didn’t really believe you could.

    1. Reason hasn’t embarrassed itself with its coverage of a single issue since impea… never mind.

  11. During his COVID-19 briefing yesterday, President Donald Trump suggested that the control measures implemented so far should keep the number of deaths from climbing above 100,000 in the United States. Although that is “a horrible number,” he said, the death toll otherwise could be “up to 2.2 million deaths and maybe even beyond that.”

    When modelers at Imperial College projected 2.2 million COVID-19 deaths in the United States, they were assuming “the (unlikely) absence of any control measures or spontaneous changes in individual behaviour.” Although that horrifying number got a lot of attention and has now been embraced by Trump…

    I’m not sure off-handedly mentioning the worse case scenario during one of his stream of consciousness briefings can accuratly be described as embracing that prediction, but whatever.

    1. Agreed. We’d all really be best served if the White House reporter pool just disbanded, and Trumps Twitter feed was rebranded “Shit an old guy thinks about during a BM”.

      1. LOL

        Well done.

  12. >>cases typically involve mild to nonexistent symptoms

    world freaks out because mild to nonexistent symptoms.

  13. Millions of jobs saved or created.

  14. I know Donald Trump is not taking this serious because he hasn’t donned a crisis jacket yet. Every politician worth a lick knows that during a crisis you wear something that the common man might wear; only the more expensive high end retail version. Sticking with the blue blazer means he doesn’t think this is that serious.

    1. And when shit really hits the fan, he’ll put on his crisis vest.

  15. Trump is simply trying to gaslight his failure of America having the most C-19 cases and, maybe, soon the most deaths in the world as a success if we stay anywhere below the worst possible publicly known case. His claim of testing the most, as an excuse for our having the most cases, is more of the same. Compared to South Korea, an actual success story, America has tested one third or less of our respective population.

    Trump’s C-19 response is Trump University writ large and in American blood.

    1. This would have happened under any President’s watch. Part of less government means less responsive government. Plus Americans don’t like being told what to do, especially by politicians.

      1. More government is hardly ever the solution. Even during this pandemic, a public health crisis being one the most classic of excuses for the need for government and more government, we see that most of our problems are government hurdles placed in front of the private sector or typically poor or worse government efforts – mostly CYA attempts.

        South Korea got out of the way of its private sector. While Trump first denied the problem, and his administration bungled testing by first trying to hold a government monopoly then limiting forms of both tests and their administration. Testing is a microcosm of the whole response.

        The Trumpist / nationalist mixed system offers the worst possible case of government short of communism, too much government and too much government deniability of its failures. That the nine most terrifying words in the English language are “I’m from the government and I’m here to help.” is not only due to government’s inefficacy and inefficiency but, also, to government’s routine boasting of its “successes” and denial of its failures – Trump and company amplify these traits well beyond any volume before heard in America.

        1. If there is evidence that the administration got in the way of state or national relief efforts then hopefully there will be a reckoning. But aside from perfect 20/20 hindsight, I really don’t know what the correct course of action would have been. It’s easy to blame the president, but I don’t remember any governors proactively trying to get ahead of this either. I’d agree that Trump dragged his feet, but I’m inclined to think that it was out of the desire to prevent the hysteria that we are experiencing, rather than malice or incompetence (outside the normal incompetence of any politician).

          1. The guy who got called racist for implementing measures in January while democrats, including pelosi Cuomo, and de blasio, all said nothing to worry about was the one dragging his feet?

            Do you even believe on federalism? Do states have no responsibility? For someone who basically asserts trump is an authoritarian fascist you sure do want him taking on more and more powers.

            1. I feel like I’ve been pretty generous to the Pres on this…at least as generous as I’d be to any politician. But I understand that you want nothing short of fawning loyalty to the man.

    2. So you’re too fucking dumb to learn why one would normalize data to a pr capita basis?

  16. D.C.Metro announces shut down of all train service in preparation for use of tunnels to store bodies.

      1. Gotta be sarc? I mean, at this point if you add ALL the deaths in DC, VA, and MD together, you don’t quite hit 50…

        1. That 50 who would have lived forever if not for Trump.

        2. The increase in random trolls lately makes me wonder

  17. I don’t know about anyone else, but I have come to appreciate the daily briefing from the coronavirus task force. The one thing I have been very impatient about is the online database Dr. Birx was talking about. Let’s see it.

  18. One thing that IS the truth: as of now, more people in the USA have died from COVID-19 than were killed by terrorists on 9/11. And that started a quagmire of mini-wars that still haven’t ended.
    I’ll wager that before this is over, New York alone will surpass that total.

    1. More people die from Flu/Cold EVERY YEAR than died on 9/11.

      650,000 die EVERY YEAR from heart disease.

      Hysteria is hysteria.

  19. Boy, unreason really is scared.

    1. unreason has sock trolls literally repeating Narratives so they dont have to write more articles printing the same bullshit.

  20. This is how you know Trump isn’t a proper politician. His first reaction is calm and rational, and he doesn’t get to the hysterical fearmongering until much later, after the politicians and bureaucrats have explained how he’s supposed to be promoting fear and hysteria as much as possible in order to seize the maximum amount of power for the government.

    1. +100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000

  21. Doctors know we will be in this for the long haul. And that will be proven right after April 30, when the President ‘reopens’ the country, and the virus begins it’s resurgence about two weeks later. I’m bracing for it! We need two things: 1. : testing for everyone. 2.: masks for EVERYONE! This is the way S. Korea is winning!

  22. A lot of people have been getting paid for a very long time to predict when the next Spanish flu would strike. When this novel virus emerged in China it looked like this was the one. The numbers were terrible and the world descended into low level hysteria. If only we had actual evidence to work with. But wait. Turns out there was a live basically controlled experiment taking place on a cruise ship.
    “As of February 20, tests of most of the 3,711 people aboard the Diamond Princess confirmed that 634, or 17 percent, had the virus; 328 of them did not have symptoms at the time of diagnosis. Of those with symptoms, the fatality ratio was 1.9 percent, Russell and colleagues calculate. Of all infected, that ratio was 0.91 percent. Those 70 and older were most vulnerable, with an overall fatality ratio of about 7.3 percent.”
    “Extrapolating those numbers to China, the team estimates that 1.1 percent of symptomatic cases there turned deadly. Considering asymptomatic cases drops that ratio to about 0.5 percent in China, the team calculates.”
    https://www.sciencenews.org/article/coronavirus-outbreak-diamond-princess-cruise-ship-death-rate
    While this is a serious illness the vast majority of Americans will not contract it and the vast majority of those that do will survive. COVID-19 simply is not living up to it’s hype.

    1. “While this is a serious illness the vast majority of Americans will not contract it and the vast majority of those that do will survive. COVID-19 simply is not living up to it’s hype.”

      Needs to be repeated. Even the 1918 flu didn’t infect most people—20-25 percent is the figure I’ve seen most often. The Italians are the group doing the worst with this and they are only seeing a 10 percent ish death rate from their serious cases. Most people that catch this, even the aged, are only going to think they had a shitty case of the flu. At worst. A small, but significant, percentage are going to have a bad time.

      We’ll all have a bad time if those reports that Hoot was posting here pan out: that you can catch this again after having caught it, gotten over it, killed the virus, and have antibodies to a new infection. I really hope that’s due to a data artifact.

  23. that statment what are u do ?
    “Looking at what we’re seeing now,” Fauci said, “we’re going to have millions of cases” in the United States, and it is reasonable to expect “between 100,000 and 200,000” deaths. But he cautioned that “I just don’t think that we really need to make a projection, when it’s such a moving target, that you can so easily be wrong and mislead people.” Deborah Birx, coordinator of the White House’s COVID-19 task force, yesterday cited similar but somewhat less alarming estimates, saying “between 80,000 and 160,000, maybe even potentially 200,000 people,” could be killed by COVID-19 in the United States. galgado.com

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