100 Days Into COVID-19, Where Do We Stand?

May 7, 2020 — The United States saw its first confirmed case of COVID-19 on Jan. 20. By the end of February, we had our first American death. We’ve now passed the 100-day mark, and the numbers are alarming, with 1.2 million confirmed cases here. More than 70,000 people have died here. And because testing has been limited, experts say those numbers are really much larger. So obviously, it’s bad. But is it getting better?

“We’re not doing well at all,” says Jeffrey Shaman, PhD, a professor of environmental health sciences at Columbia University Mailman School of Public Health, who has led work to model national projections. “We had our first confirmed case the same day as South Korea. We have six times as many people, but 100 times as many cases.”

Even though some states have been relaxing social distancing restrictions, not one has met federal guidelines for being able to do say, says Caitlin Rivers, PhD, a researcher from the Johns Hopkins Center for Health Security who testified before the House Appropriations Subcommittee on Wednesday.

Here’s the latest. As Shaman said, it’s not good:

  • The United States has one-third of the confirmed cases worldwide, but we’re less than 5% of the world’s population. And we’re adding new cases at a faster daily rate than most other places on Earth.
  • Death projections vary, depending on which assumptions researchers make about social distancing and other factors, but most show us at around 100,000 COVID-19-related fatalities by the end of May.
  • The curve is flattening, but slowly. And if you take New York, the hardest-hit part of the country, out of the equation, it’s not flattening at all.
  • Some areas, like New York, Seattle, and New Orleans, seem to be past the worst of the outbreak.
  • Don’t expect life to get back to “normal” any time soon. Without firm federal guidance and a national testing policy, outbreaks will continue to pop up.

The Latest Projections

The Institute for Health Metrics and Evaluation (IHME) at the University of Washington has been making and updating projections based on the latest available data as well as the effects of efforts to ease the pandemic, like social distancing. They now project we could have more than 134,000 total COVID deaths by early August. That number nearly doubled in less than a week, due to the way some states are relaxing their restrictions.

The statistics-focused website FiveThirtyEight tracks five models (including IHME’s), each of which makes different assumptions about social distancing behavior and the way the virus will behave. Those models show anywhere from 93,000 to 111,000 total deaths by May 30.

President Donald Trump said recently that as many as 100,000 Americans could die, twice as many as he’d predicted previously. But a preliminary interagency report from the departments of Homeland Security and Health and Human Services offered a much bleaker assessment, saying we could have 3,000 deaths and 200,000 new confirmed cases every day by early June.

“It’s important to realize that the administration’s model was from Johns Hopkins and was not a full model and not intended to be a forecast,” says Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security.

Are We Flattening the Curve?

That curve refers to new cases, not the number of deaths. It’s about making sure our health care systems don’t get overwhelmed.

“We’re on a very slow decline on a national scale, and it’s highly variable from state to state. Some places are still growing, some are flat, some are in decline,” says Shaman. “But you want to quash it, not flatten it — you’d like to see a sharp decline.” That gives hospitals some breathing room, in case the numbers spike back up after restrictions are lifted.

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