One of the most striking developments over the past two weeks is how quickly the estimates of death and hospitalizations from COVID-19 are being reduced.
The University of Washington's Institute for Health Metrics and Evaluation (IHME) is the most influential modeler of the novel coronavirus in the United States, with White House officials and other public health professionals using the group's numbers to plan strategy and policy. On March 26, IHME predicted that if current social-distancing policies stayed in place, there would likely be 81,000 COVID-19 deaths in the United States by June 1. In its most recent projection, from April 8, it concluded that there would 60,145 deaths, a figure, as Fareed Zakaria writes in The Washington Post, "on par with the number of people estimated to have died of the flu in the 2019-2020 season."
National Review's Andrew McCarthy notes that IHME has been revising its estimates for hospital beds (including ones in intensive care units [ICU]) and ventilators as well:
On April 8, IHME reduced the total number of hospital beds it had predicted would be needed nationally by a remarkable 166,890—down to 95,202 from the 262,092 it had predicted less than a week earlier (i.e., it was nearly two-thirds off). The ICU projection over that same week was cut in half: to 19,816 on April 8, down from 39,727 on April 2. The projected need for ventilators also fell by nearly half, to 16,845 from 31,782.
McCarthy persuasively argues that "the model on which the government is relying is simply unreliable." The IHME is not simply changing its predictions about the future (which one would assume it would do as people's behavior changes and as new data become available). It's failing to describe present reality. From Zakaria:
On March 30, University of Washington researchers projected that California would need 4,800 beds on April 3. In fact, the state needed 2,200. The same model projected that Louisiana would need 6,400; in fact, it used only 1,700. Even New York, the most stressed system in the country, used only 15,000 beds against a projection of 58,000.
Governments at all levels have pointed to dire forecasts (remember the CDC's worst-case scenario of 1.7 million deaths?) to lock down the economy, which has shrunk by 30 percent over the past month, and to help pass historically high spending bills. Residents in Kentucky and other states who are diagnosed with or suspected of having COVID-19 are being tracked using ankle bracelets and other invasive technologies. Faulty projections of the need for hospital resources "has meant that patients with other pressing illnesses might have been denied care—or not sought care—for no good reason," writes Zakaria.
In short, we have completely upended American society on the basis on projections and descriptions that are unstable and inaccurate. There's no question that the estimated fatality rate and need for hospital beds are coming down partly because of social distancing and other changes in behavior. But some portion of the slippage in the IHME numbers is surely because the models, which presume social-distancing rules stay in place, are flawed. It's understandable why federal, state, and local governments have acted in such extreme fashion, especially in the wake of the CDC's disastrous early failure to implement accurate testing and the explosion of cases in New York, a state that was slow to action.
To date, public health concerns, especially the predicted number of dead people, have pushed all other considerations, including the effect on economic activity and the massive new amounts of government debt, to the side. But as the death projections come down and the actual hospitalizations come in lower than expected, we need to start factoring in other concerns that will allow us to return to something approaching normalcy.