With Strict Social Distancing, U.S. COVID-19 Deaths May Total 100,000 Which cities and states are days away from facing a spike in COVID-19 cases? Which others are simmering hotspots that will take 2 to 3 weeks to flare? We examine the U.S. map for red flags in data.

With Strict Social Distancing, U.S. COVID-19 Deaths May Total 100,000

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Well, we better get used to social distancing.


PRESIDENT DONALD TRUMP: The better you do, the faster this whole nightmare will end. Therefore, we will be extending our guidelines to April 30 to slow the spread.

GREENE: That was President Trump in the Rose Garden yesterday, stretching social distancing guidelines a full month. Today was supposed to mark the end of a 15-day period of strict guidelines to curb the spread of the coronavirus. The president said he changed the plan based on models projecting that without strict social distancing, 2.2 million people in the United States could die. But even with strict social distancing, the death toll could still be about 100,000.

Let's talk about these projections with NPR global health correspondent Nurith Aizenman. Hi, Nurith.


GREENE: Let's just start with these numbers. I mean, the president made it sound like limiting this to 100,000 deaths would actually give us some relief, which is stunning to even think about. Can you put that into perspective?

AIZENMAN: Yeah. Look; if the U.S. had mounted a more aggressive response sooner, set up enough testing capacity to pick up on the first cases and act instead of allowing transmission to go undetected for weeks, maybe the death toll would have been projected much lower than 100,000.

But at this point, tens of thousands of people in the U.S. have already been infected. So the new model tells us, yes, probably the best that can be hoped for is to keep the death toll to about 100,000 people. That 2.2 million number of deaths that Trump says the U.S. is avoiding, that was from an older model based on what would happen if no action was taken.

GREENE: But so now we have new modeling that accounts for the actions that we have been taking. What exactly are officials looking at there?

AIZENMAN: At the press conference, Trump's scientific advisers said they'll reveal more details tomorrow. But they said by coincidence, their modeling is very similar to a model that researchers at the University of Washington released late last week. And what those researchers are saying is, OK, right now, this large number of people in the U.S. has already been infected. And that means no matter what, some of them are going to pass the virus onto some number of additional people, who will then pass it on to some number of others. And the key question is, how many others can you limit that to until social distancing ultimately slows this spreading process down to a halt by cutting down on the frequency of people's face-to-face interactions?

So this model takes into account the dates when the various states put in their own stay-at-home rules and then estimates, if those rules are kept in place through June 1 - which, by the way, that's a month later than the president's latest deadline - what will this inevitable wave of infections look like? When will the largest number of people flood into hospitals - you know, the peak?

GREENE: The peak. And when would we expect that peak to happen?

AIZENMAN: April 15. On that day, it's projected that more than 2,300 people will die and as many as 467,000 people will need to be hospitalized, which, in a lot of places, is, going to outstrip current hospital capacity. But that's a projection for the country as a whole. The timing of the peak will actually vary from place to place.

GREENE: OK. So it's going to ebb and flow as we move across different parts of the country. How does that alter the picture and what we should be expecting?

AIZENMAN: OK, New York state, which has the bulk of cases right now, is projected to peak in about a week; Louisiana and Michigan in just under two weeks. Then there are states - South Carolina, Virginia, Colorado - that aren't projected to peak for about a month. And of course, even after the peak, for a while there will still be many new cases each day. It's just that the number will get lower and lower until this peters out in June.

GREENE: So will we be able to declare that this outbreak is over at some point?

AIZENMAN: I mean, I put that question to the lead researcher behind the University of Washington model, Dr. Chris Murray. And he says no, the U.S. will not be out of danger because even after this wave of infections is over, the vast majority of Americans still will not have been infected, won't have immunity. And so then, unless we have a robust strategy to prevent a second wave, we start this all over again.

GREENE: NPR's Nurith Aizenman.

Nurith, thanks so much.

AIZENMAN: You're welcome, David.

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