160,000 Dead. 190,000 by Labour Day. 300,000 by December?

The United States has now logged more than 160,000 dead from Covid 19. The CDC predicts that number will tally between 175,000 to 190,000 by month's end. If federal and state authorities cannot get American people to wear face masks in public, the death toll could hit 300,000 by December.

Another day, another grim milestone for the U.S. as the coronavirus pandemic continues across the globe. Overnight the U.S. surpassed 160,000 deaths, bringing its total to at least 160,104 as of 4:30 a.m., according to Johns Hopkins. The U.S. crossed 150,000 deaths last week.

The Centers for Disease Control and Prevention updated its COVID-19 death projections, saying the coronavirus death toll could reach 190,000 by the end of August. The government’s ensemble forecast predicts “deaths may decrease,” but another 15,000 to 30,000 more Americans may die from COVID-19 over the next 23 days.

A report released yesterday by the University of Washington's Institute for Health Metrics and Evaluation projects that the death toll could hit 300,000 by December.

The new forecast, released Thursday, projects that between now and December, 137,000 people will die on top of the roughly 160,000 who have died so far.

Other findings - Covid 19 could become the third leading cause of death in the US, behind cancer and heart disease. 

-  the hardest hit states, mainly in the American south, aren't expected to 'flatten the curve' due to public rejection of lockdowns, masks and other protective measures.

-  there is a "roller coaster" effect in play.

"The lesson that we're seeing in the experience in the big Southern states is that there is a behavioral response from individuals," says [IHME team leader Chris] Murray. "When things get bad in their community, individuals are more likely to wear a mask, more likely to be cautious. And that helps put the brakes on transmission." But the flip side of that is that once there is an improvement in daily death tolls, people tend to ease up too quickly. "That creates this potential for [cases] going up, stabilizing, then coming down, [then] people becoming less vigilant, and then cases going up again," says Murray. "I think we will see more of that roller coaster phenomenon through the fall."

-  when cold weather arrives in November, infections will take off again.

...when the weather is colder the virus appears to transmit more rapidly. This is a statistical analysis — so it doesn't explain the cause. For instance, it could be that when the weather turns cold, people spend more time indoors. Or it could be that the virus thrives in colder air. But whatever the reason, the impact is massive, according to Murray. For instance, in Northern states, says Murray, the analysis suggests "at the peak, which will be the first week of February, we would see approximately a 50% increase in transmission." And he says the effect will kick in starting in November.

-  projected death rates could be worse than projected if hard-hit states balk at lockdowns.

-  tens of thousands of projected deaths could be avoided if the public would accept wearing masks.

Murray estimates that currently about 50% of people in the U.S. are wearing masks when they are out and about. The team then ran a simulation to see what would happen if starting today, that share was increased to 95% of Americans wearing masks. They found that this would cut the number of deaths by Dec. 1 almost in half — saving 66,000 lives.

-  even with near universal masking, some 18 states will still need to lockdown.

-  there is always hope that new solutions, beyond lockdowns, mask and handwashing, that are not currently understood will emerge. It's the classic "oh, they'll think of something" sop we've become familiar with on climate change. But, hey, who knows?

The bottom line is that if states take the hard decisions and if the American people voluntarily comply (there really is no way to force compliance), the death toll by December 1 could be just 230,000 instead of 300,000.  Almost 70,000 needless deaths could be averted. It's not going to be easy and it's not going to be painless. Given public attitudes it might not even be doable.