The models used to project the number of U.S. deaths from Covid-19 are only looking out to Aug. 1, reports Al Brooks.

If you listen to Dr. Deborah Birx, Coronavirus Response Coordinator for the White House Coronavirus Task Force, the worst case projection for U.S. deaths from Covid-19 is 240,000. Now, how is it that Dr. Brooks (me, I got my M.D. degree from the University of Chicago) still says that the number will be more like 500,000 to 2 million? Why do I continue to ignore the experts?

It is because Dr. Birx rarely completes her sentence. The part that she usually leaves off is “by Aug. 1.” Her defense is that the models that project the number of deaths do not extend out more than three months.

That is a weak defense because she is misleading the public. She and Dr. Fauci will not lie, but they are being watched carefully by the political wing of the White House. They are not free to tell the whole truth because they will get fired.

It is important to note that their influence in the decision process is good. They are afraid that if they get fired, those good things might not continue. That puts them in a moral bind, and I think they are making the best choice.

What will the final total of U.S. deaths be?

Dr. Birx never talks about what the final total number of deaths will be, but to me, that is the most important number. In May of 1942, it would have been nice to know what the number of expected American deaths in World War II would be as of Aug. 1, 1942. But at this point, who cares? All that matters now is that by the time the war ended, 400,000 Americans lost their lives.

In three years when the pandemic is behind us, will anyone ask about the number of dead Americans from the onset of the Coronavirus pandemic to Aug. 1, 2020? That is ridiculous. And it is ridiculous that the media is not calling out Dr. Birx or Dr. Fauci over their claim that 240,000 deaths is the worst case scenario. And this has been a moving target.

You must complete the sentence. The worst case is 240,000 deaths by Aug 1. That does not tell us how many Americans will be dead by the time there is a vaccine next year or once the pandemic has ended. I still think that Dr. Brooks has it right. Whatever number the media reports is wrong because it based on models that only look three months out.

I mentioned last week that most Americans are more concerned about the number of deaths than about the economy. Whatever decision we make will be a trade-off.

No one wants 38,000 Americans to die every year from automobile accidents. Yet, that is what happens. We could always lower the speed limit to 20 miles an hour. Then maybe 5,000 people will die. But the majority of Americans would rather have the 38,000 dead.

We could raise the speed limit to 120 miles per hour. That might result in 100,000 dead. The lawmakers had to pick some number, knowing that they were also choosing what an acceptable number of deaths would be.
This is a similar process with Covid-19 and the debate over reopening the economy. There is a vocal minority who refuse to live under any restrictions. Even if it is only 30%, it is enough to make sure that the pandemic will infect 30% to 70% of the country. If 30% get infected, that is 100 million people. A 1% death rate means one million dead Americans.

If the death rate ends up at 2% and 70% get infected, then four million people will die. I have been saying 500,000 to 1 million because I think that will be the final total.

What is the R-factor?

I have talked several times about how many people one infected person will infect. That number is called R0 (pronounced R-naught, and usually called the R-factor). The current R-factor for Coronavirus is between two and three. That means that each person will infect two to three more people.

But what happens once 99.99% of the population gets infected or immunized? Then the R-factor drops to zero. This is because it will be impossible for an infected person to come into contact with someone who is not immune. That is “herd immunity.” Herd refers to the population of the country. Once enough people get infected, the R-factor drops.

I wrote last week that once it falls below 1, the disease eventually goes away. This is because each group of 10 infected people (or any number) is replaced by a smaller group two weeks later. Over time, the groups continue to get smaller until it is unlikely that an infected person will come in contact with an uninfected or unvaccinated person. There will then be no new infections and the pandemic will be over.

When does herd immunity exist?

Immunity means that a person has antibodies in his blood that will attach to the virus and prevent it from entering, infecting and killing cells. If it cannot enter cells, it cannot multiply, and other immune cells destroy the virus particles floating around in the blood stream.

The more contagious a virus is, the higher percentage of the population needs immunity before the pandemic ends. You might have heard that 70% is the number for Covid-19.

If 70% of the population is immune to the coronavirus, there will be herd immunity. Herd immunity means that the R-factor will be less that one. Once that happens, the number of cases will eventually fall to a low enough number to no longer be a major public health hazard.

The math of the R-factor

What happens once 70% of people are immune? Then when an infected person encounters people in the next two weeks, only 30% of them can get sick since 70% are immune.

Because only 30% of exposed people can get sick, the R-factor will only be 30% of what is was. Thirty percent of an R-factor of 3 is 0.9, which is less than 1. An R-factor of less than 1 results in the total number of infections going down and ending the pandemic. That is why scientists say that herd immunity for the Coronavirus only comes when 70% of the population has antibodies and cannot get infected.

Incidentally, measles has the highest R-factor of most common viruses. It is 12. If a contagious person is in a population of unimmunized people, he will on average infect 12 people. It is so contagious that the air in a room can infect someone two hours after a measles patient leaves. What is herd immunity for measles? For an R-factor of 12, herd immunity requires 95% of the population to be immune.

That is why it is so morally wrong for parents to not get their kids immunized for measles. If only 5% refuse, then measles remains in the population and children not immunized can get it and die.

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