Like most mornings, I briefly read through a series of online news sites. A few leading headlines caught my eye. These headlines exclaimed how the U.S. daily death toll has exceeded 2,000 people and is now greater than that of Italy. While it is important to report on the spread and societal impact of COVID-19, alarming headlines and absolute numbers do not help us deal with the current situation.
As a physician, my training and experience has highlighted that numbers in disease reporting need context to be properly understood and used. The U.S. death toll due to COVID-19 on April 10th was 2,035 people. Delving into some percentages, that is a seven percent increase from April 9th, when there were 1,901 deaths, a 4.7 percent increase from April 8th, when there were 1,943 deaths and a 3.1 percent increase from April 7th, when there were 1,973 deaths.
First, note how similar all of these figures are. This suggests that — within this four-day time span — the overall change in the number of deaths was small. But the media only reported the fact that the U.S. had passed the 2,000 mark for daily deaths because the round number catches a reader’s eye. In fact, this small variation suggests that the increase in daily death rate during this period was either fluctuating around zero or close to zero. So many deaths each day is still a tremendous tragedy. However, the relative consistency of the death rate should give us a small measure of reassurance.
Making comparisons and understanding what trend we are on allows us to make determinations about what to do next. Especially when considering the number of new infections per day, which is also stable, we can conclude that we as a society — through social distancing and quarantine measures — are taking the correct actions. Leading infectious disease experts like Dr. Anthony Fauci have put us on the right track by emphasizing these measures.
With these measures, we will continue to see progress. Not only will the death rate and infection rate likely continue to be stable, but it will gradually start to decrease. Of course, this is only an educated guess. But if we go with the model developed by Dr. Chris Murray and the group of researchers at the University of Washington, we really are at or near the peak of the outbreak, with absolute deaths gradually decreasing to zero by approximately June 20th. This model is certainly more optimistic than a prior study from Imperial College London, but the difference is that we now have much more data to enhance the accuracy of our models.
A final bit of context on the death rate due to COVID-19 is to understand who is at greatest risk of dying. An article in the Journal of the American Medical Association published on April 10 showed data on 168 Chinese patients that died from COVID-19. Of these patients, 75 percent were male. They were generally older than 50, and they had at least one chronic condition. These conditions included hypertension, diabetes and ischemic heart disease, which all can individually have profound effects on mortality.
While we are waiting on similar data on patients in the U.S., this data from China still gives us a better understanding of who is most vulnerable. This prompts us to focus on the greatest at-risk populations and sharpen any precautions we have taken to protect them.
In short, understanding where we are heading with COVID-19 infections in the U.S. requires a concerted effort to understand the background behind death rates and risk factors. We can continue to have some amount of relief knowing we are on the right track. At least, the numbers are starting to tell us so.
ALEXANDER KOTLYAR is a fellow in reproductive endocrinology and infertility at the Yale School of Medicine. Contact him at firstname.lastname@example.org .