Predicting coronavirus containment in America

*DISCLAIMER: I am not a medical or statistical expert. Please do not read too much into my predictions or make any decisions based on this article. It’s solely intended as a thought piece regarding the potential chronological progression of COVID-19 in America. I based my conclusions predominantly on data from other countries.*

To get a sense for how COVID-19 might progress in America, I first looked at the progression in China. On January 23, Hubei province was put on lockdown, which still stands. FYI Hubei is where the virus originated, so the lockdown was critical to restrict further transmission beyond COVID-19’s source. 

Beyond Hubei - which has about 59 million residents - China later placed some form of lockdown on 174 million other residents. 

As you'll see if you look at Chinese data, the number of active cases there peaked three to four weeks after the Hubei lockdown. We're now about four weeks past that peak and active cases have declined over 80% across the country. So to recap, we’re eight weeks past the initial lockdown and virus transmission has been largely subdued in China. 

South Korea’s data is fairly similar to China’s. We’re about two weeks past peak phase there (in terms of new cases) and the country has also reached >80% containment. In fact, South Korea likely achieved statistically significant >80% containment within just over a week of reaching peak new cases. South Korea acted far more aggressively and proactively than America did (especially in regards to testing), which might explain why it was able to repress the virus much faster. Unlike China, the country did not implement any sort of lockdown. South Korea learned its lesson after the 2015 MERS outbreak, which exposed a lack of test kits.

As a brief aside, South Korea has completed about 5,200 tests per million inhabitants, compared to 74 tests per million in America. That is unequivocally disgraceful. 

Then, I looked at the progression in Italy. The first cases there appeared on Feb 22. Two weeks later, Italy shut down the entire country. It's been one week since then and if you look at the active cases graph, it seems like Italy is peaking right now. Applying China's trend to Italy (considering South Korea’s response will be hard to replicate), I anticipate Italy will be able to reach ~80% containment of the virus in about a month.

Finally, I looked at America. We're about two weeks behind Italy's progression. Right now, active cases are growing at a fairly constant rate (25-30% daily). We're on the verge of a national lockdown - I'd bet on that within a week. Based on China and Italy, the virus should peak here within one to three weeks of that national lockdown. After that, it'll likely take about a month for effective containment.

In calendar terms, I expect America could reach peak cases around early April. Beyond that, we can anticipate somewhere in the vicinity of 80% containment within a month, which gets us to early May. If you include a couple weeks for either fuller containment or simply an extra cushion in the data, you arrive at mid to late May. My cautiously optimistic math lines up somewhat neatly with the CDC's guidance on postponing or cancelling large gatherings (>50 people) until mid May.

One aspect of the data that I haven't mentioned yet is the nature of decline after you reach peak cases. Theoretically, most cases would be "resolved" by patients recovering or dying. But you'd expect a minor level of continued virus transmission even during the decline phase. Thankfully we have data on new cases from China which substantially resolves this question. 

*I’m not using South Korean data here since China has experienced a more complete cycle from initial virus spread to peak transmission to virus containment.* 

The pertinent graph shows wide variability during China's peak, which speaks to the unreliability of Chinese data overall. But there's a clear trend of new cases peaking the second week of February with rapid decline shortly thereafter. We're now a month beyond that point and evidently China's now reporting about 10 to 20 new cases per day. In a country of over 1.3 billion people, that's frankly negligible for the purposes of data analysis. 

Assuming China's data is credible, we can expect (with a reasonable degree of confidence) that new cases in other countries would disappear almost entirely within a month of hitting the peak phase. China’s progression aligns with my prediction of significant (>80%) containment by early May in America.

I'll duly concede it's hard to base predictions for America on other countries. These are very different countries whose societal responses and dynamics vary widely, decreasing the validity of using them for comparative purposes. As I hinted at earlier, China is notorious for disseminating questionable data, although I'd hope that given the circumstances, their data is more credible now.

Furthermore, containment in America will not necessarily reflect or entail worldwide containment. Recall the famous MLK quote that injustice anywhere is a threat to justice everywhere. Applied to this situation, active cases anywhere are a threat to any areas of relative dormancy. Until COVID-19 is suppressed around the world, it’ll be next to impossible for our global economy and society to function normally. 

On the bright side, it appears that the pandemic will bring unintended benefits. A study published this week estimated that reduced air pollution alone has already saved 77,000 lives in China, which is about 20 times as many lives as have been directly lost due to the pandemic. Worldwide, if you account for air pollution and other causes of death that will now be mitigated (like car accidents) on a temporary basis, hundreds of thousands of lives could be saved globally, if not millions. 

The bottom line is that in my humble opinion, there is a light at the end of the tunnel. The world was clearly caught unprepared to handle a global pandemic. It appears that governments now understand the pandemic’s severity and have begun to implement sufficiently effective measures as to considerably contain the threat within a couple of months. The interim containment period will be extremely painful, but if my data-driven prognosis holds true, we can hope to return to something resembling normalcy before the summer.

Whether or not you agree with my analysis, I would urge you to listen to the professionals. I won’t repeat their recommendations, but I will say that ethically speaking, I believe that in our civilized society, we owe it to each other to sacrifice a bit for the greater good. 

On a lighter note, try to take advantage of this period of isolation. There are many options; ultimately I believe we’ll all be better off accepting the circumstances as they are and making the most of them instead of lamenting unfortunate things that are entirely out of our control. 

I am by no means dismissing the gravity of the pandemic, but I think it’s generally a good principle to make the most of one’s circumstances. As the old saying goes, life is 10% what happens and 90% how you react.