The earliest case of the novel coronavirus appears to be November 17th, 2019. Just a little over 4 months later there are over 500,000 confirmed cases, and many more suspected. As the new epicenter of the world shifts from Europe to the United States, the pandemic isn’t what epidemiologists or economists imagined. It’s worse.

You cannot fight a pandemic with stimulus packages or defeat the virus with social distancing. You only slow it down and slow down the economic pain.

The mortality rate of the coronavirus is 4.5% among reported cases, even before the world’s healthcare systems have been overrun. It’s estimated to have a real CFR (case fatality rate) of around 1%, or 10 times more deadly than the regular flu.

It’s not like we don’t know yet what we are dealing with, as successful as Taiwan was at mitigation and South Korea was at containment, the western world has not been so lucky, or so vigilant and organized. We know what we are dealing with now in April, 2020 and some scientists estimate that millions will ultimately die before COVID-19 runs its course.

We know too that the economic impact of the virus will be severe. Within the first week of the shutdown in the U.S. 3.28 million unemployment claims were made. We know that number is just the tip of the iceberg. This number is for the week ending on March 21st, before things escalated in the U.S.

As severe as the pandemic is, so too will the impact be on the world’s economy and consumer activity. However, I think we are being dishonest about how dangerous the virus will become over the course of the next two years. Exponential growth really means there is no end to the quarantine-like environment. The higher the attack rate, the more chances the health system will get out of control.

New York City will be the text book example of this in future years from now. Today the U.S. has 82,000 reported cases of Covid-19, the first time it’s above China on March 26th, 2020. This means it was spreading locally for weeks before testing even depicts a real picture. This means the strongest economy in the world is also likely to be the most impacted by the pandemic. Who would have guessed? Weeks of denial and pointing fingers at China didn’t help.

Half a million workers in New York City will be out of work. ICU beds and ventilators will be in short supply. The U.S. as it turns out was as ill-prepared for this as anybody.

The 1918 flu pandemic led to hundreds of thousands of deaths, but this time it’s worse. With a higher population, in more densely populated regions and with more globalized travel, there’s no stopping the public enemy. To even assume we can is unscientific and a political statement. Why might that be?

This is because of the spread ratio and CFR. Where cases have been doubling in three days in NYC is just a snapshot of the entire United States, and even the strongest economy in the world won’t be able to contain or stop that kind of spread.

COVID-19

R naught (a mathematical term that indicates how contagious an infectious disease is): 2.1

Mortality rate: 4.5% (this number is in flux)

(this number is in flux) World population: 7.8 billion

Covid is just similar enough to SARS and infectious enough to be a pandemic that could put the entire world back 20 years. China did not contain the virus and the rest of the world didn’t see the threat before it was too late. Now contagion has occurred in every country of the world.

While the stock market bounced back this week due to a $2 trillion stimulus package, with rising prices of oil and a President saying we could go back to work in mid April, the reality of the health crisis is starkly different. We cannot shelter in place indefinitely, and we won’t. It will be survival of the fittest in a luck of the draw type scenario. This is because this is just the first wave, and as the economy worsens pressure will mount to resume urban and commercial activities.

The mortality rate is basically the number of deaths divided by the number of infections. It’s also called the death rate or case fatality rate. If it’s already 4.5% among serious reported cases, how high will it be when hospitals have run out of medical equipment and are far over capacity, when going to hospitals becomes more dangerous than staying at home? In parts of Lombardi in Italy, the CFR is over 10%. That’s not a good prognosis for how the United States might be shut down by the pandemic.

As the U.S. will become the epicenter, the CFR will skyrocket there. Here is what it looks like before that event:

The mortality rate generally drops as testing rises and more patients are identified. But epidemiologists caution that the reverse can be true as U.S. hospitals get inundated and run out of necessary equipment, like ventilators, to treat patients who might have otherwise been saved. The U.S. is a far cry from Germany or Taiwan here.

The U.S. ignored testing for weeks (if not months) on purpose to avoid economic and political ramifications. That mistake will end up being one of the most costly mistakes of the 21st century. People will be trying to leave the United States before this is over. Because what is happening to New York City will happen to the rest of the United States.

Estimates of the R naught for COVID-19 have ranged from 1.4 to about 5. The WHO has estimated the R naught of COVID-19 to be around 1.95 and other estimates from researchers following the outbreak put it around 2.2, meaning about two people will catch the virus from every person who already has it. The R naught rises as social cohesion begins to break down. This is what’s likely to happen in certain parts of the United States in April and May, 2020 and gradually things could slide out of control.

Many news articles will tell you we don’t know what we are dealing with. The truth is we know exactly what we are dealing with but are still in denial.

Seasonal flu

R naught: 1.3

Mortality rate: 0.1%

2009 H1N1

R naught: 1.5

Mortality rate: 0.02%

World population in 2009: 6.79 billion

1957 flu pandemic

R naught: 1.7

Mortality rate: 0.6%

World population: 2.87 billion

1918 flu pandemic

R naught: about 1.8

Mortality rate: 2.5%

World population: 1.8 billion (est.)

So what do we know about the 1918 virus? It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.

The world’s population is 7.53 Billion. If one third got it that would be = 2.5 Billion. If 2.5 Billion people get Covid-19 how many would die? That’s 112 million and 500,000 thousand people. So when President Trump says we can go back to work for Easter or the stockmarket thinks a 3-day rally means there won’t be an economic depression, maybe we should have some common sense.

With more people and an spread rate of 2.1, there is no stopping the pandemic without anti-virals and a vaccine. A loss of social cohesion also could break down supply chains and economies very quickly. The stock market lost 37% of its value on the S & P index in about one month. What’s becoming clear is that the United States is the epicenter of the economic impact on the entire global economy of this pandemic.

The 1918 flu was one of the most horrific pandemics of the 20th century, hitting those aged 20 to 40 especially hard, according to WHO. COVID-19′s R naught of 2 is slightly more infectious than the 1918 flu. While Covid-19 targets the old, the higher R naught makes a world of difference. As healthcare systems collapse the mortality rate could actually rise in the U.S. above the 4.5% (a full 3.5 to 3.8% above the real CFR had this thing been contained in Wuhan).

Luckily Covid-19 isn’t SARS or MERS.

SARS

R naught: 2 to 5

Mortality rate: 10%

World population in 2003: 6.38 billion

MERS

R naught: 0.5

Mortality rate: 35%

World population in 2012: 7.13 billion

Ebola

R naught: about 2

Mortality rate: exceeds 50%

Covid-19 is more dangerous because we thought it wouldn’t impact us. We thought we’d be immune being far from China in a so called industrialized democracy. The U.S. has 14,000 new cases today. That’s more recorded cases than most countries up until now. Only France, Iran, Germany, Spain, Italy and China have more in total!

Italy is a fair example of what happens when you let the coronavirus spread without timely action. Without testing the U.S. had little idea what it was dealing with. Without testing and contact tracing to break the chains of social spreading, the U.S. waited 3 months, doing nothing. Now unemployment is likely to go up to 15%. What does that do to morale and our ability to combat the virus or protect the elderly with pre-existing health conditions?

Today 28 out of the United States reported fatalities with the coronavirus. To shelter in place and shut down does not defeat the virus, it only slows it down. The rest of the world has it, even if we contain it. While China had Hubei province and Italy had Lombardi region, the United States is likely to have the New York, Seattle, Los Angels, Chicago, New Orleans and Miami regions hit at practically the same time. No country could adjust to such an impact.

Covid-19 is likely to infect at least 5 times as many people as the Flu of 1918. Obviously in a more global economy than ever before, that’s far worse. It’s worse as a health crisis, as a financial crisis and as a humanitarian crisis.

Pandemics are, in some respects, somewhat more dangerous now, despite all of our advances in medical science, primarily because we’re so global. In our arrogance, the United States has failed in funding its CDC and pandemic preparedness. This could mean the end of its empire’s supremacy as compared with China, depending on how bad things get.

While Germany has a fatality rate of just over half a percent, the U.S. CFR is likely to be somewhere between the global average and Iran’s of 7.8%. This is due to a medical supply shortage and a lack of testing that results in a severe shock to the system in the first wave. A probable CFR for the U.S. in the spring of 2020 is likely to be 6.5%. Today it stands at just 1.4%. But today is the beginning of the U.S. as the epicenter of the pandemic.

So what’s our conclusion? This is just the beginning of the pandemic in the United States. The lack of testing did this to us. We’ve only begun to test and we’re already by March 26th have 85,505 cases. That means by April 1st, we’ll have 200,000 cases.