Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one, twelve
Speaker 1: since coronavirus was declared a global pandemic. Our main story.
Speaker 1: Even as the infection rates surges around the United States,
Speaker 1: some have pointed to lower death rates as proof that
Speaker 1: this stage of the outbreak isn't as bad as it seems.
Speaker 1: But a close look at the numbers shows it may
Speaker 1: be too early to declare that fatalities are really declining.
Speaker 1: But first, here's what happened in virus news today. As
Speaker 1: the alarming coronavirus surge continues in dozens of U S states,
Speaker 1: New York City postponed a planned return to indoor dining
Speaker 1: next week. Mayor Build a Blasio side rising cases in Florida, California,
Speaker 1: and Texas after some of those states reopened restaurants. The
Speaker 1: city had planned to allow restaurants to have a limited
Speaker 1: number of available tables indoors starting this Sunday. Instead, it
Speaker 1: will now help restaurants expand operations outdoors on sidewalks and
Speaker 1: in curbside parking spaces. He said. Some large US companies
Speaker 1: are also reevaluating their plans to ramp up normal operations.
Speaker 1: Google is pushing back a plan to reopen its u
Speaker 1: S offices. In a memo to employees, the company said
Speaker 1: all US offices will remain closed until September seven, at
Speaker 1: the earliest. An experimental coronavirus vaccine is showing promise. In
Speaker 1: an early trial, fiser and bio n text treatment has
Speaker 1: been shown to be safe. It also successfully prompted patients
Speaker 1: to produce and bodies against the virus that has kept
Speaker 1: it at the front of the pack in the race
Speaker 1: to develop a vaccine. Finally, Europe may be starting to
Speaker 1: see a tenuous economic recovery following months of coronavirus shutdowns,
Speaker 1: but the road ahead will be long. European Central Bank
Speaker 1: President Christine Lagarde renewed her warning at a United Nations
Speaker 1: event that the hardest times are yet to come. She
Speaker 1: said the recovery would be uncertain and uneven, and would
Speaker 1: lead to arise in inequality and unemployment that will leave
Speaker 1: the most vulnerable in difficult conditions. And now for our
Speaker 1: main story, the coronavirus continues it's terrifying rampage of large
Speaker 1: swaths of the country, but the Trump administration has made
Speaker 1: a point of mentioning that even while cases are rising
Speaker 1: deaths are declining. That disconnect is Trump says, proof that
Speaker 1: the COVID nineteen pandemic is under control. But the mismatch
Speaker 1: could be an anomaly caused by quirks in how death
Speaker 1: data is collected and reported. It could also be that
Speaker 1: a greater number of younger people are catching the virus
Speaker 1: not necessarily assigned. The coronavirus is becoming less lethal or
Speaker 1: easier to treat. Robert Langre and Emma Court report that
Speaker 1: medical experts say it's too soon to know for sure
Speaker 1: that deaths are still declining in recent days. In recent
Speaker 1: weeks here in the US, we have been seeing case
Speaker 1: counts rise pretty much across the board, particularly in the
Speaker 1: sun belt in the South and the West. And yet
Speaker 1: one interesting thing about these developments we've been seeing is
Speaker 1: that even as the case counts rise, the corresponding mortality rate,
Speaker 1: the death rate does not seem to be climbing with
Speaker 1: the same rates. And I was wondering if you could
Speaker 1: unpack that for us, what are we seeing here? One
Speaker 1: thing to be really aware of it is sort of
Speaker 1: that that death rates in this for COVID are kind
Speaker 1: of the ultimate lacking indicator. We don't really know yet
Speaker 1: what the death rate is going to be for this
Speaker 1: current rise in case counts. And that's because some of
Speaker 1: the cases in the States are reported rather quickly. But
Speaker 1: you know, deaths really do take a while to come
Speaker 1: roll in. Once you diagnose with COVID, even a bad case,
Speaker 1: it may take the people that do die, it may take,
Speaker 1: you know, two or three weeks for them to die,
Speaker 1: if you're going to die. And then these these death
Speaker 1: numbers that come in, they aren't the deaths that occurred yesterday.
Speaker 1: These are deaths that may have been occurred a week
Speaker 1: or two weeks or even three weeks ago. That that is,
Speaker 1: after once someone dies, it can take a while days,
Speaker 1: even weeks or dr filling the death certificate, turn it
Speaker 1: in for the state authorities to kind of adjudicate and
Speaker 1: verify it, and then reported out to two people so
Speaker 1: to the rest of the world. To some of these
Speaker 1: these death numbers coming are quite you know, quite delayed,
Speaker 1: and it just takes several weeks corresponding to the cases
Speaker 1: we're still seeing now. Is the first thing to be
Speaker 1: very aware of. We don't really know yet, you know,
Speaker 1: what the death rate is going to be for this
Speaker 1: current wave of cases. But there are several reasons also
Speaker 1: to believe to suspect that the death rate, you know,
Speaker 1: when we have the numbers will actually be lower. We're
Speaker 1: now six months into this into this pandemic. I mean,
Speaker 1: is it a question with regards to the death rates
Speaker 1: that were simply treating COVID nineteen more successfully. For months,
Speaker 1: medical providers have been you know, learning about how to
Speaker 1: treat this virus, sharing best practices. And I think the
Speaker 1: answer is yes. You know, we still don't have all
Speaker 1: the information we'd like to have. Doctors still don't have
Speaker 1: like a you know, a perfect treatment for this condition.
Speaker 1: We definitely don't have any vaccines right now, except experimental
Speaker 1: ones that are still being tested. You know, It's true
Speaker 1: that we've learned a lot and doctors have better practices
Speaker 1: now and um, and you know, I think we are
Speaker 1: seeing that payoff. But it's not totally clear how all
Speaker 1: of these factors break down in terms of what we're
Speaker 1: seeing right We think, you know, the death rate lagging
Speaker 1: maybe one factor. Another factor is this friend towards younger patients,
Speaker 1: you know, better treatments. Another potential factor is maybe the
Speaker 1: virus is just not transmitting as well in the summer.
Speaker 1: You know, it was sort of hypothesized that the summer
Speaker 1: might make for less virus transmission because that hot air,
Speaker 1: you know, pushing the virus kind of down out out
Speaker 1: of kind of the path of transmission. But you know,
Speaker 1: it's not clear that that's happening. But it's possible that
Speaker 1: perhaps a weaker form of the virus is being transmitted
Speaker 1: people aren't getting as sick. There's also been a pretty
Speaker 1: high profile theory that the virus is getting sort of
Speaker 1: weaker in and of itself as it applicates around the world,
Speaker 1: and that's been pretty roundly criticized. It's not totally clear
Speaker 1: that's what's happening, but there's a variety of explanations here.
Speaker 1: We just we just don't really know. Unfortunately, it does
Speaker 1: seem to be a lot more complicated or perhaps even
Speaker 1: a lengthy process in recording the death count. And I
Speaker 1: was wondering if maybe you could go into some of
Speaker 1: the different kinds of factors that go into potentially delaying
Speaker 1: the recording of a death due to COVID nineteen. If
Speaker 1: you look a few days ago, there's a huge spike
Speaker 1: of death just like three or four days ago, and
Speaker 1: almost all of that was new to New Jersey suddenly
Speaker 1: adding probable COVID nineteen deaths and we're in its account before.
Speaker 1: And those weren't deaths that occurred in the last few days.
Speaker 1: There was their deaths that went way back this you know,
Speaker 1: county of deak Is a is. It just takes a
Speaker 1: while for the death to roll in. Often, for example,
Speaker 1: in Arizona, one of the researchers of follows Is showed
Speaker 1: me when some of the deaths occurred. And so for
Speaker 1: the deaths reported in the weekending June fourteenth in Arizona
Speaker 1: due to COVID, So it turns out only half of
Speaker 1: those deaths reported that week we're from that week, and
Speaker 1: fully fifty were from two or three or even more
Speaker 1: weeks before. That's when they actually happens. That that's an
Speaker 1: example just how the lag can be. And that's from
Speaker 1: when the death actually happens to whether it's reported as
Speaker 1: a death due to COVID. That doesn't even count the
Speaker 1: fact that you know, you get sick, you got a
Speaker 1: case so to take, you know, and it takes two
Speaker 1: to three weeks for that to play out, and you
Speaker 1: either to get better or not. Deaths lag not just
Speaker 1: because It takes time when someone gets COVID to die, um,
Speaker 1: you know, from the disease, to succumb to the disease.
Speaker 1: But but then afterwards there's these official processes that takes
Speaker 1: some time. Right. It takes time for you know, the
Speaker 1: health officials to adjudicate the death. It takes time, you know,
Speaker 1: doctors have to decide did this person die of COVID nineteen.
Speaker 1: You know, if they you know, had COVID nineteen and
Speaker 1: then seemed to recover a little bit and then ended
Speaker 1: up dying, you know, was that a death from COVID
Speaker 1: nineteen or not? There there are some questions about you know,
Speaker 1: the squish nous of of these subjects, right, And during
Speaker 1: this time, everyone wants to rely on the data, right.
Speaker 1: They put all this trust in the numbers that are
Speaker 1: coming out of the states and the numbers that we
Speaker 1: see about testing on the federal level too. But you know,
Speaker 1: importantly this data is not infallible, right, I mean, especially
Speaker 1: when you think about the fact that you know, in
Speaker 1: terms of diagnoses, the only cases that we know we
Speaker 1: only know about cases that actually get diagnosed. We only
Speaker 1: know about people who test positive because they got a test.
Speaker 1: There are likely many more people who are not getting
Speaker 1: tested for these symptoms, for instance. So you know, these
Speaker 1: are official counts, but that's important to remember. These are
Speaker 1: the official numbers, right and there are probably a lot
Speaker 1: of numbers that aren't getting captured in these data even now.
Speaker 1: So I think that's also important when you think about deaths.
Speaker 1: You know, there has been some back and forth even
Speaker 1: earlier in the pandemic about whether all of the death
Speaker 1: from COVID nineteen were actually being counted, you know, as
Speaker 1: health to partments got overwhelmed and things like that. So
Speaker 1: these are the official numbers, but do they tell the
Speaker 1: complete and full and completely thorough story, Like we probably
Speaker 1: won't know that for some time, you know, if at all.
Speaker 1: What should we be looking at or taking away from
Speaker 1: the numbers as they stand right now, and what should
Speaker 1: we be preparing for. You know, we don't know exactly
Speaker 1: what's going to happen in two or three weeks from now,
Speaker 1: and that would be very very interesting to watch because
Speaker 1: we do have in some of these southern states increased hospitalizations,
Speaker 1: increased numbers of people in I c u s. You know,
Speaker 1: what does that translate into. So some of the research
Speaker 1: we talked to in Arizona said that what they would
Speaker 1: expect might be, you know, leveling off of this decline
Speaker 1: in depths and you know, somewhat at an increase again,
Speaker 1: you know, and maybe not a huge spike like we
Speaker 1: had before in April when the in New York, when
Speaker 1: this disease is totally new, when we were kind of unprepared.
Speaker 1: Hospitals are better prepared and there are some treatments and
Speaker 1: they have some better strategies. So be very very interesting,
Speaker 1: you know, to watch. And then I have four or
Speaker 1: five or six weeks from now, the deaths, you know,
Speaker 1: haven't gone up at all, and despite lots of people
Speaker 1: in the hospital of I see you, that will be
Speaker 1: an indication you know, we've gotten there's something's changed a
Speaker 1: little about the the the virus, or you've gotten better
Speaker 1: treating it, or somehow you know, we've kept it out
Speaker 1: of the older, most vulnerable people. One of those you
Speaker 1: know three things. I think also an important part of
Speaker 1: this is to understand the different kinds of data and
Speaker 1: how they trickle in, right, I mean, public health officials
Speaker 1: can't wait for deaths to spike to take action to
Speaker 1: control an outbreak, right, they have to start relying on
Speaker 1: earlier forms of data like case counts and especially hospitalizations.
Speaker 1: The problem is the earliest data that we have coming
Speaker 1: in our case counts, and that doesn't present the fullest
Speaker 1: possible picture of an outbreak, but it is the earliest
Speaker 1: indicator we have. And an expert I spoke with at
Speaker 1: Johns Hopkins put this really well. He said, Basically, you know,
Speaker 1: a couple of weeks ago when the case cases were
Speaker 1: spiking in some of these states like Arizona and Texas
Speaker 1: and Florida, which we now know, you know, are having
Speaker 1: problems in terms of the outbreak in their communities. He's
Speaker 1: you know, this is early data in terms of the
Speaker 1: case counts rising, but it's important to act on early
Speaker 1: data because by the time you get more thorough data,
Speaker 1: more final data, you get hospitalization spiking, you get death
Speaker 1: god forbid spiking. You know, that may be too late,
Speaker 1: and I think that sensitivity towards the mechanism of these
Speaker 1: numbers is important for public health officials to be eyeing.
Speaker 1: You know, waiting for the deaths to rise is not
Speaker 1: the most productive tack here. Right by the time deaths rise,
Speaker 1: you maybe four or five weeks behind something that's happening
Speaker 1: in a state or a local area. That was Robert
Speaker 1: Lang and Emma Cord. And that's it for our show today.
Speaker 1: For coverage of the outbreak from one bureaus around the world,
Speaker 1: visit Bloomberg dot com slash Coronavirus and if you like
Speaker 1: the show, please leave us a review and a rating
Speaker 1: on Apple Podcasts or Spotify. It's the best way to
Speaker 1: help more listeners find our global reporting. The Prognosis Daily
Speaker 1: edition is produced by Top for foreheads Jordan gas Pure,
Speaker 1: Magnus Hendrickson and me Laura Carlson. Today's main story was
Speaker 1: reported by Robert Langrath and Emma Court. Original music by
Speaker 1: Leo Sidran. Our editors are Rick Shine and Francesco Levi.
Speaker 1: Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.