How does Wisconsin Flatten the Curve?
We have to learn from our friends in Italy and China. The pattern is evident and persistent.
Here’s what we know:
- People can carry the virus without displaying any symptoms.
- When people don’t show symptoms they carry out their lives as normal interacting with people.
This is the danger. People are spreading the virus at a rapid rate.
The data over the past 2 months has shown us that as the tests become more accessible the number of cases begin to increase. At this point tests are not a precursor of what is to come..they reveal what currently exists. The cases are far higher than we know and are growing at a rapid rate.. with or without the tests revealing the magnitude of the crisis.
The problem: as the tests become available more hospital/ beds will be required.. The quicker we identify cases the quicker we start running out of beds.
Here are the main things that we should do:
- Identify areas with higher concentrations of vulnerable people.
- Facilitate local preparedness (e.g. hospitals, first responders, community health workers)
- Anticipate that a percentage of these individuals will become infected.
- Plan for additional healthcare use.
- Leverage vacant buildings as hospitals.
- Plan for and coordinate efforts with other organizations
- All hands on deck
My biggest concern is that we are not prepared with enough hospitals, first responders and community health workers ..
Let’s look at the data:
Italy had 1,701 cases March 1st. Two days later they had 2,502 impacting .0000417% of their population. The number of cases made a .47% jump in two days.
The United States has 328 million people compared to 60 million in Italy. 1,701 in Italy is comparable to 9,382 in the US. In two days the US jumped from 9,382 to 19,383 cases impacting .000059 % of our population.. a little more than Italy’s population impacted after two days. The US growth was 106% compared to Italy’s .47% in two days.
The data shows that we are only several days away from having an Italy like scenario.
March 1st Italy had .000028% of their population impacted and March 18th we had .000028% of our population impacted. It took 18 days for us to have the same percentage of our population affected as theirs. Italy reached an inflection point 12 days later(highlighted in red) ..the table to the right shows we are projected to hit ours sooner. The data implies we are going to eclipse Italy. This is believable because of our densely populated cities (NY, Chicago, Atlanta, LA).
If they were to scale to US size that would be 82 thousand.. Using Italy as a baseline the US would begin reaching capacity somewhere close to March 24th – March 25. It’s a known fact that the United States has less hospitals per capita than Italy. Italy has 3.2 hospitals per 1000 and the US has 2.8.
The United States had 6,411 cases March 17th and by March 20th had 19,383. The average rate of cases are going up 42% each day. Its projected the nation will reach ~50k cases.. by March 23rd.
What does this mean for Wisconsin?
Wisconsin has a population of 5.8 Million people which is 8% of Italy.
We’ll do basic comparisons against Italy (worst case in the world).
When Italy had 655 cases (.00001% of population) this is equivalent to WI having 53 cases (.00001)% . WI reached this point March 16th.
Feb 29 Italy had 1128 cases (.000018%) which is equivalent to WI having 90 cases (.000018%).. We crossed this threshold by March 18th.
March 1st Italy had 1701 cases(.000028% of their population) this is equivalent to WI having 136 cases… we passed this March 19th this is .000027% of our population.
Italy had 1701(.00003 of their population ..we rounded up) cases, a week later Italy had 5000 cases (.00008% of their population ). This is roughly equivalent to 158 in WI(.00003% of the population). If we’re keeping up with Italy’s pace we will have a projected 650 cases by March 28th. However it appears at our average growth rate we will reach this by March 25th 3 days before march 28th…
Note: Growth rates refer to the percentage change of a specific variable within a specific time period. To calculate the growth rate I subtract the number of cases from the previous date and divide that number by the previous date. This equates to the percentage of growth between the two days.
March 15: ~ 33 cases
March 16: ~47 cases —-42% growth
March 17: ~89 cases —- 89% growth
March 18: 123 cases— 38% growth
March 19: 158 cases – 28% growth
March 20: 234 cases– 48% growth
March 21: 282—20% growth
If we remove the outlier on March 17th of 89% growth (although someone should explain this) we have an average growth of 35 % a day. The Median growth is ~33%. Italy’s average growth rate was 33% until March 8th . After March 8th the growth rate converged to 15% .. Note –March 8th is when they went on full lock down. Let’s learn from this.
Wisconsin’s growth projection through the first week in April with a consistent 33% growth rate.
Wisconsin’s growth projection through the first week in April with consistent 22% growth rate
Italy’s hospitals were completely saturated March 12th at 15,113. That’s comparable to 1,964 cases which we are projected to reach by March 28th/29th (at a growth rate of 33%)
I like to think we can handle 1964 cases by March 28th.. However I don’t believe we have enough beds with ventilators to accommodate this scenario. Let’s be a bit optimistic and locate our inflection point where number of beds and equipment correspond to the anticipated need.
The questions we must ask ourselves:
- How many hospital beds are available?
- How many hospital beds are available with ventilators?
- How many days before our hospitals are completely saturated?
I’m not aware of how many hospitals WI has available so I’ll make an educated guess.
The US only has 900,000 hospital beds. 60 -70% are taken at any given time. 70% of 900k is 630k.. After doing some common sense calculations it appears WI should have ~5,400 beds available.
When do we surpass the need for more than 5,400 beds?
The data above shows that with a consistent growth rate of 33% by April 5th we’ll possibly have 24k+ documented people with COVID-19. 20% of Corona cases are hospitalized. Meaning we’ll be approaching 5k people needing beds by April 4th.
At the growth of .33% everyday our hospitals may start to become exhausted by April 5th.. At the growth rate of .22% we have until April 11th before hospitals are exhausted. After March 12th when Italy reached their capacity deaths started coming in every day over 200+.
It’s very possible by mid April .. we will be turning people away if we don’t take necessary action now.
This is when the deaths start rising like crazy and we end up in the same situation as Italy.
A concern: As more tests become available it’s only going to reveal that more of us have the virus than we initially suspected..people will be panicked and could easily begin to exhaust our hospitals with visits before they begin showing symptoms.
Another concern: If we don’t practice the California “self- sheltering” type of lock down people will continue spreading the virus as they carry on grocery shopping, pumping gas, essential needs trips and negligently visiting friends and parents etc.. This will again increase the cases quicker and cause for the hospitals to get exhausted possibly before April 11th..
Third concern: Death rates. When Italy had 232 cases 7 deaths were documented( 3% of their cases). WI has 282 cases with 4 deaths.. which is 1%.. our rate will begin to climb like Italy’s if we run out of capacity in the hospitals. My data projects that WI will reach 344 cases by the end of March 22nd if we continue to grow at 22% growth rate. Italy is reported 800+ deaths in 24 hours yesterday.
By March 28th we will begin to struggle and by the first week in April I feel we will be needing extra help (note our cases are growing at a quicker rate due to soft shut and increased accessibility to masks).
Actions to Take:
- Request Military all hands on deck help to build more hospitals, we need more beds and more masks ASAP.. Scope out which hotels or vacant buildings can be repurposed for hospitals for the worst case scenario..
- Put everyone on full lock down so that we can flatten the curve as much as possible.
- It’s a simple idea: A huge wave of sudden cases in just a few weeks will saturate our emergency rooms. The same number of cases spread over several months will surely stress the capacity of hospitals but not completely overwhelm them.
- We need to get people in the house so that cases don’t skyrocket.. (I fear that the more tests we have available will reveal that so many of us already have it because of how long its taken us to go on lock down.)
- Waiting on the federal government to make a decision for us at this point is criminal.
- We need Governor Tony Evers to make a Stay Home Order immediately.
What if we take the above precautions..put in all the work.. and none of the above projections happen?
That’s the point…better safe than sorry.