We Americans have been captivated by a particular chart depicting the rise and fall of the novel coronavirus. Put out by the Institute for Health Metrics and Evaluation (IHME) Research institute, the diagram illustrates a peak of COVID-19 infection and then, almost as soon as it pinnacles, an ebbing away of the virus until it’s gone completely.
The White House uses it, along with the entire media. Heck, I’ve been using it. But what I’ve realized over the past several days is that these charts – the ones the public is so focused on – are misleading and could, in the worst case, be flat out wrong.
The fact is that COVID-19 isn’t going anywhere. And, we simply have to learn to live with this truth.
You don’t have to take it from me. In a recent interview with the New York Times, Tomislav Mihaljevic, C.E.O. of the esteemed Cleveland Clinic, said, “the US will not soon be able to test 330 million people. Effective therapies or vaccines may be long in coming. Covid-19 will be a disease we have to learn to live with.”
Charts like the IHME graphic are especially misleading and even dangerous. The IHME chart, in particular, encourages our policymakers and us to believe the false reality that COVID-19 will have run its course by June. This false reality delays reopening and therefore has significant negative economic consequences. We can’t wait to reopen the economy until there’s nothing left to open. If we stall much longer, we run the risk of that becoming the true reality.
Take a look at the IHME chart I’m referencing:
The above picture is worth 1000 words. Americans look at this chart, and others like it and say, “Wow, COVID-19 will be gone soon, so let’s just wait another month or so to reopen.” Wrong.
It’s not that the IHME is intentionally misleading; the institute likely had no idea they would get this much attention. But their underlying method for creating this chart is questionable. The IHME looked at China’s spread and backed the data into a mathematical formula that fit the trend, called the Gaussian Error Function.
According to Alex Engler, an accomplished scholar on data science and public policy from Georgetown University, the Gaussian Error Function used by IHME doesn’t make sense for this virus; there’s no way that we will be at zero COVID-19 cases (or 1 per 1M) by mid-June.
In short, the data isn’t rock-solid – it’s based on statistical conjecture.
The IHME model uses a formula that shows COVID-19 going away as quickly as it spiked. The visual is deceptive, as experts widely agree that the virus will be here until we get a vaccine, which isn’t likely to happen until well into 2021.
The immediate goal of public policy can’t be to eliminate the risk of Covid-19. The goal should be to mitigate, manage, and frame expectations for it – without losing sight of other priorities.
My recent column in the Atlanta Journal-Constitution about reopening Georgia drew some sharp criticism. I knew it would – this is a controversial, emotional, and scary topic.
But I’d like to point out that, because I take the issue very seriously, I look to data-driven resources, not opinion. And when looking at these data sources, I dig deep into the methods and numbers on which the conclusions are based to see if they derive logical conclusions.
So far, looking at the IHME data, the Georgia hospital system has had plenty of capacity. The initial models showed that if we didn’t practice social distancing, we could have been woefully over hospital capacity. In Georgia, we have about 8300 hospital beds and 590 intensive care unit (ICU) beds. As of last weekend, the IHME chart shows that Georgia had already peaked in infections. We had peaked on April 15th. Then, the model whipsawed dramatically. One day this past week, it moved the peak date up two full weeks – now set at April 28th.
Currently, the model shows a similar range that could happen over the next several months – until June 22nd. After that date, the model indicates that we will have virtually zero new cases, with their definition of containment being one case per one million people.
If you look out one month, it says that we still have 590 ICU beds; but we could need as few as 21, or as many as 1216! That’s an incredibly dramatic range, and I doubt its usefulness and scientific basis.
The IHME chart also essentially shows that we need zero beds if we do full social distancing until June 22nd. That’s two entire months from now. Then, to keep COVID-19 at this minimum to no case level, we’d need widespread testing, contact tracing and other such measures.
The White House plan said we should look for 14 days of declining infection, implement testing, and make sure we have plenty of hospital capacity. If we look at a five-day moving average of cases, we peaked on April 11th at roughly 1,000 new cases per day. Since that date, the number of new infections has dropped consistently; we’re now closer to 700 per day. April 11th was more than 14 days ago, and that was likely the data the state of Georgia relied on in its decision to reopen businesses slowly.
According to the data (IHME chart aside), we’ve had more than two weeks of declining cases. The IHME chart says we could have almost no COVID-10 in three weeks, or a spike in cases in three weeks. How is this helpful? Herein lies the problem when we look at models like the IHME chart instead of the raw data.
In the meantime, here’s one thing that is for sure: If the hammer on reopening continues until mid-June, the economic dance will be delayed much too long. Millions of businesses will be out of business, and for good. Remember, the hammer was to reduce the virus so there would be plenty of hospital capacity. Now, Engler sees little risk of a severe hospital capacity reduction in Georgia.
So, it’s a delicate dance of reopening the right way – the smart way.
Alex Engler has a solution – reopening with an “All of the Above” approach. And I agree. We’ve learned a lot about public health over these last two months. We know what works.
If we continue to ramp up testing and contact tracing, and employ mobile data to find counties at risk, we’ll be on the right track to reopening the smart way. If we continue to practice social distancing and spread out people in restaurants and stores, we’ll be reopening the smart way. And, if we all continue with our responsibility for personal hygiene practices like handwashing and avoiding touching our faces, we’ll be reopening the smart way.
The IHME chart has convinced some that we need to wait until we reach a near-zero infection rate before thinking about getting the economy back up and running. We don’t have that luxury. We have seen 26.5 million people lose their job. 26.5 million people. This number is staggering. So, the reopening conversation is a fine balance.
It’s like a delicate dance. In no way will it be perfect. But we must make a beginning – we’ve got to let up the hammer. I do think we will see an ebb and flow of new cases – but we can avoid a spike.
For our country and our state’s sake, I hope I’m right. I believe in people, in us. I have a lot of faith in the power of our ingenuity and adaptation.