Officials dispute forecast's spike in cases, deaths

President Donald Trump listens during a meeting about the coronavirus response with Gov. Phil Murphy, D-N.J., in the Oval Office of the White House, Thursday, April 30, 2020, in Washington. (AP Photo/Evan Vucci)
President Donald Trump listens during a meeting about the coronavirus response with Gov. Phil Murphy, D-N.J., in the Oval Office of the White House, Thursday, April 30, 2020, in Washington. (AP Photo/Evan Vucci)

WASHINGTON -- As President Donald Trump presses states to reopen their economies, a draft government report is projecting a steady rise in coronavirus infections and deaths over the next several weeks, reaching about 3,000 daily deaths on June 1.

The projections -- based on data collected by various agencies, including the Centers for Disease Control and Prevention, and laid out in an internal document obtained Monday by The New York Times -- forecast about 200,000 new cases each day by the end of May, up from about 30,000 cases now. There are currently about 1,750 deaths per day, the data shows.

The White House sought to separate itself from the report's projections, saying the document, dated Saturday, was not produced by or presented to the president's task force, which does its own modeling.

"This is not a White House document, nor has it been presented to the Coronavirus Task Force or gone through interagency vetting," said White House deputy press secretary Judd Deere. "This data is not reflective of any of the modeling done by the task force or data that the task force has analyzed."

Administration officials said the projections assumed that states resumed normal activities immediately, not according to the phased guidelines unveiled by the White House last month.

The CDC also disavowed the report, though the slides carry the agency's logo. The creator of the model -- Justin Lessler, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health -- said the numbers are unfinished projections shown to the CDC as a work in progress.

Lessler said 100,000 cases per day by the end of the month is within the realm of possibility, an indication that cases could spiral out of control at the same time that the White House has shifted focus toward reopening the economy. Much depends on political decisions.

"There are reopening scenarios where it could get out of control very quickly," Lessler said.

The draft report is not the only forecast for an increase in deaths. Another model, closely watched by the White House, raised its fatality projections Monday to more than 134,000 American deaths from covid-19 by early August. The Institute for Health Metrics and Evaluation at the University of Washington more than doubled its previous projection of about 60,000 total deaths, an increase that it said partly reflects "changes in mobility and social distancing policies."

In making decisions on reopening, White House officials have been relying on models including the one from the Institute for Health Metrics and Evaluation and a "cubic model" prepared by Trump adviser and economist Kevin Hassett and the Council of Economic Advisers.

People with knowledge of the cubic model say it shows deaths dropping precipitously in May -- and plummeting to zero by May 15, where they stay throughout the summer.

EXPERTS' CONCERNS

The draft report's projections underscore a sobering reality: As states reopen -- many without meeting White House guidelines that call for a steady decline in coronavirus cases or in the number of people testing positive over a 14-day period -- the cost of the shift is likely to be tallied in funerals.

"There remains a large number of counties whose burden continues to grow," the CDC warned, alongside a map that offered a detailed view of the growth of the pandemic.

The projections amplify the primary fear of public health experts: that a reopening of the economy will put the nation right back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways amid overloaded health systems.

Under the White House's reopening plan, called "Opening Up America Again," states considering relaxing stay-at-home policies are supposed to show a "downward trajectory" either in the number of new infections or in positive tests as a percent of total tests over 14 days, as well as have a "robust testing program" for at-risk health care workers.

In New York, where the number of overall cases is declining, a cautious-sounding Gov. Andrew Cuomo said Monday that the state would monitor four "core factors" to determine if a region is ready to reopen: the number of new infections; the capacity of the health care system; the testing capacity; and the capacity for "contract tracing" to identify people exposed to those who test positive.

"While we continue to reduce the spread of the covid-19 virus, we can begin to focus on reopening, but we have to be careful and use the information we've learned so we don't erase the strides we've already made," Cuomo said. "Reopening is not going to happen statewide all at once."

Nationally, 27 states had loosened social distancing restrictions in some way as of Monday, and others had announced changes that will take effect in the coming weeks, according to an analysis by the Kaiser Family Foundation. But not all of those states meet the caseload or testing criteria set out by the Trump administration.

Seven states -- Indiana, Iowa, Kansas, Minnesota, Mississippi, Nebraska and Wyoming -- are still showing a rise in daily infections and positive tests but have moved toward reopening anyway.

"It is true that there are parts of the country that are doing better and can begin to look at ways to ease the requirements, but there are large swaths of the country that are not, and the growth that is projected is based mostly on these other parts of the country," said Jennifer Kates, the foundation's director of global health and HIV policy and an author of the analysis.

If anything, the administration's projections are too optimistic, forecasting experts said Monday. In the projections, the number of actual deaths for one of the last days in April turned out to be slightly lower than what the model showed. But for much of April and parts of May so far, actual deaths were some 10 times higher than the model predicted.

"The model is overly optimistic and not particularly useful in guiding decisions about the disease's trajectory," said Dr. Donald Burke, a professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

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Dr. George Rutherford, a professor of epidemiology at the University of California, San Francisco, noted that the government's model has already come in below reported deaths, and that excludes deaths not officially recorded. "Remember," he said, "these are reported deaths; the true number is likely higher."

​​​​​Information for this article was contributed by Sheryl Gay Stolberg and Eileen Sullivan of The New York Times; by Toluse Olorunnipa, Griff Witte, Lenny Bernstein, William Wan, Laurie McGinley and Josh Dawsey of The Washington Post; and by Darlene Superville and Jonathan Lemire of The Associated Press.

A Section on 05/05/2020

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