I don’t want to be too grim on the timeline, but we need real caution. This is a graph of the 7-day running average of deaths and daily cases over time.

https://covidtracking.com/data/charts/2-metrics-7-day-average-curves

(1) If you aren’t looking at running averages, it’s harder to interpret the data because some days of the week see more reporting than others (week days vs. weekends).

If you look at the non-averaged death rate, you can always find some day where the deaths reported are lower and the infections higher .

One of the common lies is that the death rate doesn’t change no matter how the infection rate rises.

If you laid this over the daily infection rate, the noise would be even harder to parse. Looking at the 7-day average of the two, though, it’s very clear that there’s a correlation between detected infections, on about a 2 week time lag.

The 2-week time lag is for the start of deaths; the amount of time it takes people to die can be even longer, and so it takes a little longer to clear the peak.

Infections start to rise in mid-June; deaths start to rise in early July. Infections start to fall in mid-late July; deaths only start to fall in mid-late August.

Now we are on a third bump up. Infections started to rise in early October. Deaths started to rise in mid October.

The infections that have already happened have locked us in for a death toll that will beat what we were seeing in late April and late March.

Now, there are a few things to keep in mind about that first peak in deaths in the spring.

1) The graph of infections in March and April cannot be compared to what we are seeing now, because we did not have testing capacity.

So we don’t actually know what was happening with community infections. People were being admitted to hospitals and not given tests because it was obvious they were COVID positive.

2) We have gotten better at treating COVID in the last eight months. We know a LOT more.

We have a much better idea of when to use ventilators and when to stick with less invasive procedures. We have a handful of pharmaceuticals that we know have therapeutic value. We have a lot more experience.

3) Almost half of those deaths in March and April came from New York City, where the medical system was overwhelmed. Medical staff—nurses, doctors, airway specialists—flew into New York to learn, to provide expertise, and to help ease the burden.

What I said here? It’s true, but the degree to which it is true is misleading. Because our current case fatality rate, which *has* gotten better, assumes people get care. https://twitter.com/courtneymilan/status/1328027643409702912?s=20

I cannot estimate how much our straining systems will hold together. I know that hospitals around the country are talking about what they will need to do to manage the coming surge. I know that they’re bending right now under the strain.

Right now, people are telling a fuckload of lies because they don‘t want to hear the truth. They keep telling you that the deaths aren’t increasing, and they can do that because daily death reporting obscures trends.

They will invent numerous reasons why the tests are giving too many false positives and so in fact this is all a lie.

But deaths have been tracking infections on a fairly clear time-lag since the beginning of widespread testing.

They’re making up theories but just ask the nurses, doctors, and hospital staff who are on the front lines.

More people are sick. Really sick.

We got our case fatality rate down after March and April. We won’t be able to hold it down. The entire nation is under strain, and infections are out of control everywhere in the nation.

What we really need is coordinated federal state action.

What we are going to get is....probably somewhere between bupkis and tokens.

So what do you do?

At this point, my best advice is to give to mutual aid groups in your area so that they can try to help those who are most vulnerable stay at home.

And to try and flip the Senate through Georgia, because a divided government will kill us.

I overhear bits and pieces of planning for the coming COVID surge through Mr. Milan’s ER Zoom meetings. I hear his (very general, patient-privacy respecting) overviews.

This isn’t a lie. This isn’t a testing artifact.

So one last thing? Remember who those people are who are trying to push the narrative that testing is all lying to us and there’s no surge.