2nd April 2020 – (Washington) The White House projected on Tuesday that 100,000 to 240,000 US citizens will die from COVID-19 pandemic even if current social distancing guidelines are maintained. Officials suggested that if no social distancing measures had been put in place across the country between 1.5 million to 2.2 million people would have died. Dr Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases said that, “as sobering a number as that is, we should be prepared for it“.  Meanwhile, President Trump also urged US citizens to brace themselves for a “rough two-week period” but predicted the country would soon see a “light at the end of the tunnel” of the global catastrophe.

Dr. Fauci also said yesterday that coronavirus vaccine trial is on target and will be ‘ultimate game changer’ in the fight against the virus. He said that  public distribution is still projected in 12 to 18 months. U.S. health officials have been fast-tracking work with biotech company Moderna to develop a vaccine to stop COVID-19. They began their first human trials on 16th March. “It’ll take a few months to get the data to where we’ll feel confident to go to the phase two, and then a few months from now, we’ll be in phase two and I think we’re right on target for the year to year-and-a-half,” Fauci said at a White House press conference with President Donald Trump’s coronavirus task force.

In the face of rapidly changing data, a range of case fatality ratio estimates for COVID-19 have been produced that differ substantially in magnitude. According to the latest research by The Lancet published on 30th March, using data on 24 deaths that occurred in mainland China and 165 recoveries outside of China, they estimated the mean duration from onset of symptoms to death to be 17·8 days and to hospital discharge to be 24·7 days. In all laboratory-confirmed and clinically diagnosed cases from mainland China, they estimated a crude case fatality ratio of 3·67%. 

Total worldwide COVID-19 cases have reached 935,959 with 47,245 deaths as of 12pm today.  The US recorded 884 coronavirus deaths in one day. The confirmed number of COVID-19 cases in the United States has passed 215,215 with 5,110 deaths as of today.

As COVID-19 continues to spread rapidly around the world, several countries including U.S., U.K. Italy, Spain, France and Germany seem to be moving along a similar upward trajectory. However, in Italy, the country reported 727 new coronavirus deaths Wednesday, the lowest count in six days, as the government extended lockdown measures to 13th April. According to numbers by Johns Hopkins collected by the website Worldometers, case counts in the U.S. and Germany have been growing at similar rates since hitting 100+ cases, which happened on 1st March in Germany and 2nd March in the U.S. Italy, where there are currently more than 40,000 cases and public life has shut down, hit 100 cases on 23rd. February, about a week earlier than Germany and the U.S. as well as France.

Source: Statista
Source: Worldometers
Source: Worldometers
Source: Worldometers

According to New York Times, when there were just over a dozen official recorded cases of the new coronavirus in America, at least 50 people who later tested positive were already feeling ill. By the time 50 cases were officially confirmed, at least 1,200 people had already started showing symptoms of COVID-19, the disease caused by the virus. As many as 25 percent of people infected with the new coronavirus may not show symptoms. A Massachusetts coronavirus cluster with at least 82 cases was started by people who were not yet showing symptoms, and more than half a dozen studies have shown that people without symptoms are causing substantial amounts of infection. Several experts interviewed by CNN said while it’s unclear exactly what percentage of the transmission in the outbreak is fueled by people who are obviously sick versus those who have no symptoms or very mild symptoms, it’s become clear that transmission by people who are asymptomatic or mildly symptomatic is responsible for more transmission than previously thought. There was also classified government data leaked by local media that shows more than 43,000 so-called silent carriers were not counted in the number of confirmed cases in China by the end of February. When silent carriers are taken into account, the number of infected people on the mainland exceeds 120,000. If there are silent carriers around us who do not display symptoms, this means that the virus will linger even longer amongst us.

Source: New York Times

On Tuesday, China revealed for the first time its number of asymptomatic coronavirus cases. The National Health Commission said 1,541 asymptomatic COVID-19 cases were under medical observation. The new figures reflect the current number of asymptomatic cases; what remains unknown is how many asymptomatic infections China has had over the course of its outbreak. Without that comprehensive total, the extent of China’s experience with the disease, which it says has infected 83,225 people and killed 3,312, is incomplete.

If the White House predicts that between 100,000 to 240,000 US citizens will die from the virus, based on the fatality ratio of 3.67%, it is estimated that a total of between 2,724,795 and 6,539,509 US citizens will be infected during the course of the global pandemic.

Based on a hypothetical and conservative average increase of 25,000 cases per day, it will take around 2 to 8 months to reach a total of 2.7m to 6.5m in US. However, if the total number continues to move in an upward trajectory, the period may be shortened further to less than 4 months. If no social distancing measures had been put in place across the country, a higher number of 1.5 million to 2.2 million people would have died, an increase of 10-fold. Based on the projections, it seems like the world may stay in lockdown for another 4-6 months before countries like US will stop restriction on movement of people and possibly to re-open its border again.

In third world continents like Africa and South Asia, the projection may be far more acute than the situation in U.S. In our previous article, we said that many countries around the world have closed their borders and locked down cities to stop the spread of COVID-19 but such measures are not “sustainable,” said an expert on infectious disease epidemiology. The entire notion of restricting movement of people around the world may be effective only in delaying the epidemic from spreading and to reduce pressure on the health care system. Furthermore, the world will not shut down forever until the vaccine or antidote is found in the next 15-18 months. As soon as there are signs of recovery, borders will re-open, people will be eager to travel again and the pandemic will be fixed in a constant loop of high and low seasons of infection. The constant process of re-opening and shutting down of borders, again and again, will slowly take a toll on travelling as frustration will set in. Similarly in Hong Kong, business outlets will close for 14 days whenever a COVID-19 case is detected and re-open again before new cases that will happen repetitively as silent virus carriers will always go undetected even if their body temperature is checked.

Henan province in central China has taken the drastic measure of putting a mid-sized county in total lockdown as authorities try to fend off a second coronavirus wave in the midst of a push to revive the economy. Curfew-like measures came into effect on Tuesday in Jia county, near the city of Pingdingshan, with the area’s roughly 600,000 residents told to stay home, according to a notice on the country’s official microblog account. During his recent inspection trip to Zhejiang province, President Xi Jinping emphasised that China must take careful steps to get life back to normal and warned officials to ensure “no loopholes” to prevent a return of the epidemic. For now, China has allowed domestic flights to resume but its international border remains locked. Hence, the total new cases are still kept under control.

The burning question is, will all countries shut their borders for 15-18 months? As long as cases begin to slow down in each respective country in the next 4-6 months, it is very likely that they will open up their borders and shun only countries where cases are still rampant. It will be an uphill task to prevent a second or third wave of infection in large continents like E.U., U.S., China, South Asia and Africa as many leakages are bound to occur.

It seems like the world must be prepared to stay put for at least 4-6 months before we enter a new phase of unknown cyclical period of high and low seasons of pandemic until the antidote or vaccine is found. We will definitely see light at the end of the tunnel but perhaps during the third quarter of 2021. World Bank said that the coronavirus pandemic could push 11 million people in Asia into poverty. Sadly, we think the number will be higher if livelihood will stay compromised for over 1 year.

Note: The main picture shows an empty subway train seen in New York on 17th March. Credit : Jeenah Moon/Reuters