Behind the Numbers: What the Coronavirus Death Counts Are, and What They Mean · 11:21pm Mar 31st, 2020
Blog Number 73: Confronting Mortality Edition
This has not been an easy blog post to write, but I think that, after intellectualizing this pandemic for so long, it's frankly overdue. And it's not just the official numbers this time, though they have been sobering in and of themselves. It's also reminding myself what those numbers mean.
Roughly a week ago, I published a blog post on the US death counts from the new strain of coronavirus, measured weekly using reports from the World Health Organization. At the time, I ended said post with a question: any predictions for March 31st?
Well, now we're here. The comparison per week for March is below. It should give you an idea of what we're dealing with.
The US's COVID-19 death toll for Tuesday 3rd March 2020 was: 2 deaths.
The US's COVID-19 death toll for Tuesday 10th March 2020 was: 19 deaths.
The US's COVID-19 death toll for Tuesday 17th March 2020 was: 58 deaths.
The US's COVID-19 death toll for Tuesday 24th March 2020 was: 471 deaths.
And now...
The US's COVID-19 death toll for Tuesday 31st March 2020 (today) is: 2,398 deaths.
Keep in mind that these seem to be conservative estimates. Today, the CDC reported 2,860 deaths. By contrast, the John Hopkins University and Medicine Coronavirus Resource Center interactive map reported 3,606 deaths.
Different sources give different counts, but the takeaway message is that the death rate is shooting up at an alarming rate and shows no signs of slowing down.
Figures from around the globe tell the same grisly tale. With rare exceptions like China and South Korea, the SARS-CoV-2 virus is gaining ground and, if anything, getting a hell of a lot better at it as time goes on. Just look at the same figures for global deaths rather than US-specific ones:
The global COVID-19 death toll for Tuesday 3rd March 2020 was: 2,946 + 166 = 3,112 deaths.*
The global COVID-19 death toll for Tuesday 10th March 2020 was: 3,140 + 872 = 4,012 deaths.
The global COVID-19 death toll for Tuesday 17th March 2020 was: 7,426 deaths.**
The global COVID-19 death toll for Tuesday 24th March 2020 was: 16,231 deaths.
And now...
The global COVID-19 death toll for Tuesday 31st March 2020 (today) is: 36,405 deaths.
* This was back when the W.H.O. reports did different counts for China and the rest of the world. Incidentally, I must apologize as the distinction led me to make an error in the previous blog post about when we globally surpassed the death count of 774, since been corrected.
** By this point, China was no longer being counted separately and was included with the other countries.
I don't have figures from the CDC for the global count, but as of this writing, the John Hopkins map puts it at 41,654 deaths. At a naive ratio, as of this writing, that's roughly between 4.3% and 4.9% of the number of total infectees reported by the W.H.O. (lower bound) and the John Hopkins map (upper bound).
Another way of putting it: if every single person on this planet (according to Wikipedia, this is estimated to be 7.8 billion people as of March 2020) were all infected with the SARS-CoV-2 virus, then (assuming no change in the percentages) that would mean somewhere between 335.4 million and 382.2 million people would be killed. Even the upper bounds for the number of people killed during the Black Death are barely half that size.
Of course, this is somewhat naive of me: some official sources don't put the fatality rate so high. But the jury's still out on what exactly it is - different countries report different percentages - and this is the sort of example that at least gives us an idea of how serious the situation could be, and to an extent is, for a disease against which we have no confirmed immunity.
How specifically do you die from COVID-19?
COVID-19 is the result of an ongoing war between a self-replicating virus and the body's own natural defences. As the virus invades the cells in the lungs, it turns those cells into factories of itself. The mass-produced virus copies eventually overload a host cell to bursting point, and then scatter to neighbouring cells to repeat the whole process.
Initially, the takeover is slow and unimpressive, as are the early stages of all exponential increases. However, more cells mean more launching points for further attacks, and it doesn't take long before the virus is claiming large sections of lung tissue for itself.
To give an idea for why such exponential increases are so dangerous, I'll tell you a story I once heard that dramatizes the point (paraphrased from faulty memory, alas): a wise vizier once bested his sultan at a game of chess, and was allowed to name his reward, if it be thought reasonable. The vizier suggested that he be rewarded in precious rice, according to the number of squares on the chessboard. So, for the first square, he'd have one grain of rice, for the second he'd have two, for the third he'd have four, and so on, doubling every time.
The sultan saw no problems there (what were mere grains of rice, after all?) and agreed to the proposal. It was only later, as the vizier demanded his reward in full, that the sultan actually followed the "reasonable" claim to its logical conclusion, and realized to his horror how complacent he'd been: by the time he reached the sixty-fourth square, he would end up owing the vizier all the rice then grown in the entire world, and on for a century, and still would not have honoured his agreement.
The virus can become just as greedy the longer it goes on for.
Worse, when the body detects the virus's activities, it sends its main line of defence - white blood cells, phagocytes, and so on - to swarm the site indiscriminately, sometimes consuming and destroying large sections of it as part of its strategy to eliminate the threat. This swarming also causes the tissue to become inflamed, further obstructing the already-beseiged lung cells. Hence inflammatory diseases such as pneumonia and bronchitis.
In a far deadlier form, it's the same principle that causes allergic attacks: an overzealous body's defence mechanism itself becomes a major hindrance, and even a danger, to the body it was supposed to protect.
As this microscopic war blazes around the lung tissue, the familiar symptoms become more apparent to the suffering person. Shortness of breath: the more and more damage is inflicted on the lungs, the more difficult it is for them to extract oxygen from the air. Coughing ensues as the body tries and fails to eject an obvious foreign element; this is also how some copies of the virus escape the body to find new victims. Fever burns through a person's body as the cells, triggered by mediator hormones, collectively try to redefine the body's own set point for a normal temperature (by increasing it), in a drastic attempt to weaken the virus.
Depending on the person, this war in their lungs might be won fairly quickly. These symptoms will be mild as a result.
This isn't the same as the number of people who survive said condition, mind. Even someone who survives COVID-19 may end up with permanently damaged lung tissue. They'll be short of breath even after a gentle stroll. Anyone who likes exercise might lose the wherewithal to do it anymore. An athelete who suffers this fate will have lost their career.
Worst of all is if the virus wins the war. Not only will it have replicated enough to guarantee many of its copies escape through the body's breath and find new victims, but it will have replicated enough to overwhelm the body's own defences.
This is why older people and people with compromised immune and regulatory systems are most at risk; their bodies simply don't have the armies, weapons, and general resources to match a threat like this. The virus simply keeps gaining more and more ground, first tearing its way through major sections of lung tissue, and then finally tearing through major sections of the lung itself. Beyond a certain point, the lungs simply can't get enough oxygen in and enough carbon dioxide out. A person in this position is effectively suffocating from within their own chests.
Then the victim dies.
Death isn't just a number on an international tally. It's flesh and blood - real flesh, and real blood - going cold forever. As important as it is to measure and count and make policy based on those numbers, we have to remember that someone's behind those numbers, trapped in a ball of agony.
In some form or another, the above story is happening for real all over the world, in hospital beds, in home beds, and occasionally in locations even stranger than those. And every time it happens, someone with hopes and dreams and beliefs and feelings - mostly painful ones, by this point - closes their eyes who never opens them again. Someone who's likely leaving sons and daughters, grandchildren, brothers, sisters, aunts, uncles, cousins, friends, mates, buddies, acquaintances, colleagues, clans, tribes, communities, a whole web of people at each other's fingertips.
Academically, we know this. We know that, every time our heart beats, death stops someone else's. Death breaks those threads every day, leaving a pain so deep it's too terrible to imagine. The current strain of coronavirus is just death's newest weapon, taken out of a dark armoury filled with all of humanity's worst diseases past and present (and future too). It's mysterious, and we don't yet have shields to repel it. It wasn't the first weapon used against us, and it won't be the last.
I'm guilty of this myself, but it's important to remember what death actually is, no matter how much we squirm to try and cram in one mind what it must be like for thousands to choke to death from the inside-out. Every time we see a number like this, we should - however briefly - feel what it means.
It's hard. A million deaths is a statistic, and all that. Even focusing on one person's suffering is something, though. Better a fleeting glimpse of the true horror - so that we're in there with our fellows on the frontline, however briefly or faintly - than a lifetime pretending we know what we're talking about - like generals sitting comfortably in a war room, playing with toy soldiers.
We know not everyone who dies is a blessed saint surrounded by happy families. I don't want to get too naive or maudlin over this. The victims are people, and people can (and, sadly, do) annoy us, confuse us, depress us, enrage us, disgust us, even horrify us. That's a grim fact of life, and being killed by a virus will not suddenly change that. But no one deserves to have their own lungs slowly and painfully kill them; certainly, thousands of random people don't.
At the end of the day, they're humans. They breathe. They bleed. They suffer. They die.
We're humans. We breathe. We bleed. We suffer. We will all die, preferably a long way off from today and without spending our time wishing we were dead already. There's always a mind in there somewhere far more complex than surface impressions can always reveal. However mysteriously or astonishingly, they're subject to the same forces that govern us, that govern all human life. We've all been thrown into the frontline or the war room, into this never-ending war. Even though the battles change, and even though there are oases - those war rooms, where we're a long way away from bleeding at the throat, at least for the moment - we'll all end up on the frontline someday.
When we understand what it's like and what we're up against, only then can we learn how to deal with it. Only then can we appreciate those who fight back, who fight harder and fight longer than anyone else. Only then can we understand those dying on the frontlines.
As an academic topic to look into, I am fascinated by the coronavirus. But to check myself: As a human being, I hate and fear its worst miseries inflicted on humanity, and what it is doing to people from the inside-out.
So for a moment apart from my distant and academic-level blogging of the last few days, I'd like to say, however meaningless this is, coming from one merely lucky person talking abstractly to thousands of suffering strangers:
To you.
I sincerely wish it hadn't happened.
I am sorry. For you, and for those who knew you, loved you, even simply liked you, and who are now suffering a different pain, never to be cured.
I will give you a moment of silence. It's all I can give. I wish I could give more.
To the living who have lost loved ones, I can say no more than this:
Life won't make up for what death has done, and this metaphorical "war" against humanity will come back for all of us, sooner or later. I wish it didn't. I've got nothing to stop it. Better people are delaying it for as long as they can. But I hope it's enough for now to find an oasis in all this, some respite, something that lasts and deserves to last, and even to find joy and happiness there, again, someday. That joy and happiness alone might be the best tribute we can give to the dead.
The war continues. We will have to march. But I at least hope that while we march, knowing what has happened and what will continue to happen on the frontline, for one brief moment of our lives, marching together, we can also sing.
That's all. For now.
Impossible Numbers, out.
Thank you, Numbers for showing the more personal side of this great pandemic. Though most of us, as Bronies (being the kind, compassionate and generous people we are) realize that for every person lost forever, there are others who are equally affected, forever.
Hopefully many of us will share this post and these thoughts with others. Perhaps we might convince those who are still not taking precautions or not taking this deadly situation seriously, will finally stop being selfish and realize that their actions affect everyone.
Stay safe, be careful and be kind.
Not even Henry Kissinger?
(I know that’s the wrong takeaway here, but I won’t feel bad if any war criminals die from this.)
thank you
I saw this happening, back in December, when it was a backseat article to Trump’s impeachment. When I saw the numbers doubling every few days, I got that icy pit in my stomach and realized that SARS 2.0 electric boogaloo was out. SARS scared the world. With a 10% fatality rate (this is what Italy and Spain have at the moment) we feared that it would sweep the globe. Everyone prepared, hospitals went into overdrive, the federal government trained responders and gave out equipment like it was candy.
Then I saw how the US response to this was going. Denial. Downplaying. Gross incompetence. I’m scared. Not for myself, I’m far too depressed for that. But for people I know. If the fatality rate is 1%, the low end expected, that is 2-3 million or so in this country alone. Thats horrible.
If the healthcare system gets overwhelmed, we could see numbers like Washington state and Georgia, closer to 5%. 10-15 million people dead. For perspective, that means that for every 20 people you know, one dies. That’s horrible. It’s beyond horrible. Words... don’t do it justice, and I’m supposed to be some form of word smith here. And then there is Italy and Spain, with a 10% fatality rate... If we hit those kinds of numbers here... I don’t even want to think about it.
I hope beyond hope that the optimistic numbers are true. And I hope that everyone here, and everyone we know are spared from the worst of it. But what we need is truth. Brutal, honest truth. And you’ve given it to us here.
I don’t know why I wrote so much. I think this whole situation upsets me is all. It’s a blueprint for why authoritarianism doesn’t work. When governments care more about appearance, image, and holding onto power more than they care about actual effective governance... it makes me angry that it didn’t have to be this bad. It didn’t. I just hope that we can prevent the worst case.
Good post, mate.
You wrote this very poetical, more like it's a tragic poem than an analyzis. You even write stories when you aren't even writing stories.
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I hope it very much is getting through to people that this is not some "overblown" crisis. Just looking at the numbers again recently, it's easy to see this pandemic is growing more and more extreme, far worse than I'd feared a week ago (I was half-hoping we'd reach a peak soon and stabilize, but the virus clearly isn't done yet). There are always going to be some people who still dismiss it regardless, but frankly I find it harder and harder to understand, let alone condone, such an outlook.
That's also why I wanted to step away from simple numbers in this blog post. If we treat it as some sort of impersonal game, we don't realize those numbers have real-world consequences, and that's not the same as saying "just count the number of people who have stopped breathing". The living are hit especially hard too.
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So long as you know that's the wrong takeaway...
I mean, I fully understand hating someone vile enough to wish painful death befall them - human emotions is human emotions, after all, and we can at least agree there are some people we'd rather didn't exist and didn't ruin other people's lives - but I personally would hesitate to genuinely wish painful death even on my worst enemies. And as I pointed out in any case, the virus is much less discriminating than we are.
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You're welcome. If nothing else, then given how detached a lot of my initial interest in the virus was, this post felt like a necessary counterbalance.
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Grimly, that would at least explain why the US in particular has seen such an explosion of cases in the last few weeks. I have to confess I myself was on the "not taking it seriously" bench until as recently as Sunday 22nd March, whereupon I actually did some research on this thing and realized how much I'd underestimated it. And that was before I started totting up horrifying numbers over time.
What's sobering to me is the realization that this virus might be with us for a long time yet. The original SARS outbreak lasted over a year (the two-year timespan was actually due to a second, lesser outbreak from a lab), and that was mostly confined to China and Hong Kong. That's why I'm skeptical of projections that say we'll be back in business in a matter of weeks.
Especially given how it keeps climbing even now, I'm assuming we're stuck with this COVID-19 pandemic for a good long while yet even if it eventually stops climbing. "Hope for the best, prepare for the worst."
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As much as I wanted to keep to the facts (though I might have to revise the part about how the virus kills individual people; from what I've read, the virus actually - maybe even deliberately - triggers an overreaction in the immune system rather than overwhelms it, similar to an allergic reaction), I also wanted to impress upon people the real human toll wrought by the virus. I felt a more rhetorical and less analytical approach would get the point across.
It's a lamentable fact about human psychology that numbers and dry academic talk don't really speak to people's emotions, even when said numbers and dry academic talk is about people dying horribly.