A widely cited model offers some predictions. The COVID-19 projections from the Institute for Health Metrics and Evaluation have been cited in recent White House briefings and take into account how the pandemic is unfolding in several countries around the world. They incorporate the current trend line of deaths in US states and the estimated impact of social distancing measures to predict when each state can reach peak daily deaths and hospital use.
Although projections like these are imprecise, they are useful for policy makers and hospital leaders who are trying to prepare for outbreaks. The model was designed to give hospitals an idea of how quickly and how much they need to build capacity.
IHME researchers are making frequent updates to the model based on the newly available data, and some of these changes have led to dramatic changes. The latest major update, made on Sunday, shows fewer people dying over a shorter period, according to the model’s lead researcher.
To compare states with large population differences, NPR analyzed the projections by examining deaths per 100,000 population.
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Understanding the projected range
It is important to note that there is great uncertainty in modeling in the future. The national model has a huge gap between its low and high estimates for daily death peaks: 1,300 and 7,700. But individual states also have large gaps. The model, for example, estimates that daily deaths in New York could be between 200 and 2,800 at its peak.
Chris Murray, lead researcher on the model, recognized the challenge this wide range poses to decision makers at a press conference on Monday announcing updates. He advised hospitals to hope for the best scenarios – but to prepare for the worst.
“In places where the epidemic is increasing rapidly – New York, New Jersey, now other places – the ability to predict that the exact peak is not as accurate as we said before,” said Murray. “Resource planners need to be careful about the upper limit so they don’t get caught off guard. “
On Tuesday, New York was approaching 5,500 deaths related to COVID-19. It should be the hardest hit state, in terms of raw numbers. The model predicts between 12,000 and 22,000 deaths in the state, with daily deaths peaking on Thursday. This represents between 60 and 110 deaths per 100,000 New Yorkers, which puts New York among the most affected states per capita.
The model also examines shortages of hospital beds. He predicts a dramatic deficit in New York, culminating this week. By Wednesday, the state is expected to have 14,000 to 45,000 beds. Under normal circumstances, there are only 13,000 beds available in the state, according to modellers. (This does not take into account ongoing efforts to increase the bed capacity.)
The effect of social isolation
The model predicts that California will experience fewer deaths than New York, although it has twice as many people in the state. This gives California a much lower mortality rate compared to its number of residents.
The difference reflects the measures of social distancing that California has taken, says Ali Mokdad, a professor of health metrics at IHME who helped create the model.
“California started social distancing before New York. [Californians] had a week ahead of them to deal with the problem, and took the right steps, “says Mokdad. And we see the benefits. ”
The model makes certain key assumptions about how heads of state will act – and depending on what they do, the picture may change. First, it assumes that all states will continue social distancing until the end of May – which is longer than the White House asked the Americans to practice social distancing. Second, it assumes that states that have yet to implement three key social distancing measures – closing schools, closing essential businesses, and issuing home support orders – will do so in a week.
This second assumption is particularly important for a state like Massachusetts, which has closed non-essential businesses and schools, but has not ordered residents to stay at home. Republican Governor Charlie Baker has resisted calls to mandate a home stay order, although he has adopted a voluntary home stay notice. “I don’t think I can or should order American citizens to stay confined to their homes for days,” said Baker last month.
The higher projections of the model could mean a tragedy for Massachusetts, estimating the worst daily deaths at the upper limits than even New York has experienced so far. But the figure he predicts would still be devastating for a state of its size: 373 daily deaths around mid-April.
Thanks to social isolation, says Mokdad, communities and individuals can still make a difference in the seriousness of things.
“We model [based on] your card game right now, “he says. If you change the deck, it will be completely different. If people do a better job, it will go down. If they don’t – if they ignore the recommendations and start partying and going out – then they will have more mortality. ”
One last important note about this model: The data shows the day each state can reach its worst day of death by early August. It does not reflect the surges that could occur later.
You can see the peak and projected totals for your own state below, or see how all the states compare.
This visualization shows the day each state can reach its worst day of death by August 4.
Stephanie Adeline, Nurith Aizenman, Daniel Wood contributed to this report.