The novel coronavirus has spread in the United States since early March, igniting epidemics in some major cities like New York City, New Orleans and Detroit. Many of the outbreaks have increased rapidly, peaked, and some have now declined. Despite the worst fears, the virus has not spread broadly in the general population.
As of April 10, there have been about 475,000 cases and 17,000 deaths reported in the country. In California, there have been about 20,000 cases and 550 deaths, equivalent to rates of 51 cases and 1.4 deaths per 100,000 California residents. California is currently ranked 30th of 50 states, with a death rate that is about one-quarter of the national rate.
Within California, COVID-19 risk varies substantially by county. About 90 percent of the cases and deaths have occurred in 14 mostly urban counties, particularly Los Angeles, Santa Clara, San Diego and Riverside counties. In the 44 remaining counties, which are mostly rural and less densely populated, the case and death rates are less than half of the overall California rates and are among the lowest in the entire U.S.
Since April 1, new cases have been relatively steady with increases likely due to more testing rather than increased transmission. Our hospital systems have been preparing for weeks. We have seen increases in COVID-19 admissions and cases in intensive care units, but currently our system capacity to manage those cases has been quite adequate.
The number of COVID-19 deaths have been much less than the 750 total deaths that occur every day in California. Furthermore, there is evidence that there have been substantial reductions in the deaths due to seasonal flu, pneumonia and accidents because of the almost exclusive focus on COVID-19 and the current statewide lockdown. Thus, it is possible that there has been no increase in the normal number of total daily deaths. Given the massive societal disruption of the statewide lockdown, it is important to assess the overall mortality statistics.
Many of the predictions on the frequency and impact of COVID-19 in California have been based on statistical models. Indeed, the University of Washington’s Institute for Health Metrics and Evaluation (IHME) Model has overestimated the COVID-19 death and hospitalization rates. The total number of IHME-projected COVID-19 deaths in California has been reduced by nearly 75 percent from the March 26 estimate of 6,100 to the April 7 estimate of 1,611. Similarly, the projected peak number of hospital beds needed for COVID-19 patients each day has been reduced from 15,000 to 5,000.
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