Factual, yet frightening analysis of the coronavirus situation in the United States, and what actions are needed now.


First published in November 2020.


Through their votes, the American people have decided they want a new approach to the pandemic. But we have 73 days until the new President takes office.

73 hard days.

Without action, an additional 100,000 Americans will die by Inauguration Day. At least. So, we cannot wait to act.

The key is that we are not likely to get much action from the Trump Administration.

So we need to look for leadership elsewhere.

But first, a little data on how we got here.

Let’s talk about this moment. (All data come from the COVID Tracking Project using 7-day moving averages.)

First, the current surge started soon after Labor Day. We went into Labor Day with about 35,000 new cases per day.

And now, we are at about 100,000 cases per day.

New Covid infections in the US. | COVID Tracking Project

And as you would expect, increases in hospitalizations followed about two weeks later.

We had about 28,000 people in the hospital in mid-September.

Now, we are at 50,000 people hospitalized.

Hospitalizations due to Covid-19 in the US. | COVID Tracking Project

And, sure enough, increases in deaths followed two weeks after that.

We started in October with about 700 Americans dying daily.

Today, we are at about 1,000 Americans dying daily.

Death due to Covid-19 in the US. | COVID Tracking Project

So now, we are identifying between 100,000 and 120,000 cases per day. This is the acceleration phase. Infections are rising fast.

But there is one more piece of bad news:

The percentage of tests coming back positive has risen a lot. It was around 5% in early September, now it is closer to 9%.

Percentage of Covid tests positive in the US. | COVID Tracking Project

That means we are missing many more infections today than we were two months ago.

Here is the kicker:

I suspect the true number of new infections in the United States now is somewhere between 300,000 and 400,000 per day.

I know. Depressing. But bear with me... I will get to what we can do shortly.


The 1,000 deaths per day today represent the infections from a month ago. Today’s infections are three times that of a month ago. It would not be surprising to get to over 2,000 deaths per day in December.

So, when public health experts say they are worried, this is why.

Can we avoid this? Absolutely!

What do we need to do?

Five things:

  1. We should not accept that Trump’s team will do nothing. We pay them. We need to find ways to get them to do more;
  2. Congress should get money to States for testing, schools, etc.;
  3. States need to ramp up testing. They can with more money;
  4. Everyone just needs to wear a mask. Come on people. To save tens of thousands of lives? It’s a no brainer;
  5. The biggest problem is indoor gatherings – formal (dining) and informal (house get-togethers).

To quote Rhode Island Governor Gina Raimondo, people need to knock it off. We all have to do more. We have a hard couple of months ahead.

In 73 days, we will have a team in place that has promised to use science to drive policy. Good.

But they won’t be able to fix things on day 1.

There is a lot we can do now. All of us: Congress, governors, mayors, us as individuals. If we do those 5 things: push for more federal action, get Congress to provide money, governors to push testing, we wear masks and avoid indoor gatherings.

We can keep schools open, save lives, and prevent healthcare system from collapse.

And that would make for a much better 2021.🔷



Dr Ashish K. Jha, Physician, health policy researcher. Dean of the School of Public Health, Professor of Health Services, Policy and Practice, Brown University, Rhode Island.


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🗳️ Donald Trump

🗳️ Gina Raimondo







[This piece was first published as a Twitter thread and turned into the above article on 8 November 2020 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]

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