Back on March 3, I did a (rare) twitter rant on why I worried about the US #COVID outbreak (note: there were less than 100 US cases recorded then!!)
It is time for an update on what is next...
It is time for an update on what is next...
A lot has happened since Mar 3:
1) US cases have growth exponentially for 4 weeks, to reach >140K, and the growth is still high: above the theoretical 12%, as testing still ramping up
2) US cases now exceed all other countries, including China and Italy (the previous 'leaders')
1) US cases have growth exponentially for 4 weeks, to reach >140K, and the growth is still high: above the theoretical 12%, as testing still ramping up
2) US cases now exceed all other countries, including China and Italy (the previous 'leaders')
The focus has shifted away from the rampant pending outbreak, the lack of testing and the slow policy response: pretty much everybody knows that the outbreak is locally transmitted and highly problematic in every US state by now.
The focus is now on whether hospitals can cope with the size of the outbreak. Do we have enough ICUs? One concern here is that while the early epi-centers in the US (NY, Washington) may have been able to ramp up hospital capacity/ICUs, it may be harder for others to do so later.
If GM can only produce 6K extra ventilators by end-April, there is a further big gap to fill in the US, as many states have a rampant outbreak, and hospitals are only now starting to prepare for the surge in beds needed (in the states with recent growth).
vox.com/recode/2020/3/…
vox.com/recode/2020/3/…
The good news, however, is that many states have implemented aggressive social distancing over the past 1-2 weeks. The heat-map here shows that many states have now really moved into 'shutdown mode' (although not all)
The other piece of good news is that the situation in Europe is starting to improve. Italy was an important test case, as it was the first 'western' country with a big outbreak, and the first to adopt a national 'lockdown' (on March 10).
Italy has seen better numbers for about a week (down to 6% growth), and other European countries have started to see improvement in recent days too. Hence, there is hope that the social distancing in the US can start to show results in April (assuming a similar lag to Europe).
That said, the US may face a more challenging battle than even the worst hit European countries, as there is still no national lock-down, and only a partial travel ban (while inbound foreign travel is down 60-70% yoy, that still means that 60K are arriving each day!
The key point is that social distancing seems to work in Europe (not just in Korea and China), and seems likely to work in the US too. It is just a matter of how long it will take, and how much damage it will cause to the economy....
The consensus may still be too optimistic on the pace of possible normalization, expecting reduced social distancing by March 24 (60% of those polled). But the crucial point is that the reality is totally different than in early March, and almost everybody is now aware of that.
The surprises from here will not be a further significant growth in the outbreak. Nobody will be really surprised if we have 300K or 500K US cases by mid-April. The shock will come if hospital systems start to strain, and fatality rates rise as a result.
The other surprise may come from lasting economic hangovers, even after #socialdistancing has been reversed. Our data from China shows that even after 'people movement' has mostly normalized by now, it is hard to get people to spend (the mental scars do not quickly disappear).
I will leave it at that. The world changed in the last four weeks. That is for sure. Hopefully, it will start to change for the better in the coming four weeks.
