COVID-19 Death Toll Projections Rise as Models Predict Rebound at End of May in States Easing Lockdown

The number of COVID-19 cases and deaths in the U.S. may rebound at the end of May as states begin to ease lockdown restrictions and reopen businesses, projections suggest.

Researchers at Columbia University used computer models to show the spread of COVID-19 under different lockdown lifting scenarios. One of their projections said that by June 1, there will be 43,353 cases and 1,841 deaths per day across the country. In another, where restrictions were eased even further, they projected 63,330 cases per day and 2,443 deaths.

Projections from Columbia are among those being provided to the White House Coronavirus Task Force.

The U.S. has been the worst affected country in the coronavirus pandemic, with over 1.2 million cases and over 73,000 deaths, according to Johns Hopkins University. States started putting lockdowns in place to curb the spread of the disease in the middle of March, with most, but not all, putting restrictions in place.

These measures, however, are starting to be lifted. According to Columbia University, 25 states are planning to, or have already begun to ease stay-at-home orders. In their latest modeling projections, the team at Columbia looked at how lifting lockdowns may impact the number of cases and fatalities across the country. The projections provide estimates for the next six weeks.

They ran projections for two scenarios. In one, there was a singular 10 percent increase in contact rate after a state reopened. In the other, there was a weekly 10 percent increase in contacts, to indicate more restrictions being lifted over time.

In both scenarios, cases started to increase again by the end of May. In 23 of the 25 states that are planning to ease restrictions, there were found to be large increases in COVID-19 cases. This rebound is projected to start about two to four weeks after states start to reopen, a gap they attribute to the lag time between infection and case confirmation.

In a statement, lead researcher Jeffrey Shaman, professor of environmental health sciences at Columbia, said that this lag coupled with "insufficient" contact tracing and testing, "will mask any rebound and exponential growth of COVID-19 until it is well underway."

The team's article and model has limitations. All projections are based on incomplete data and assumptions about how people will behave, so may not accurately reflect real life. Furthermore, testing practices, population density and control measures vary, and these "differences in space and time make the fitting of any model of this scale challenging," the team wrote.

As Shaman previously told Newsweek, models that project death tolls will always be wrong. "They are projections, not forecasts; they are done for a continually evolving situation for which there is little information on transmission over the last two weeks, limited information on changing social distancing compliance within communities, and no sense of how society will increase or relax its controls in the future."

However, their projections of an uptick in cases and deaths mirrors another widely used model that forecasts total cases and fatalities for the U.S.

The University of Washington's Institute for Health Metrics and Evaluation (IHME), which is also being used by the White House coronavirus task force, is currently predicted 134,475 U.S. deaths from COVID-19 by August 4. This is far higher than the model suggested on April 21, when it was estimating 60,308 coronavirus deaths by this point.

In a statement released on Monday, the IHME said the latest figures were "considerably higher than previous estimates representing the combined effects of death model updates and formally incorporating the effect of changes in mobility and social distancing policies into transmission dynamics."

In a virtual town hall on Fox News on Sunday, President Donald Trump also said the death toll was higher than previous estimates. "We're going to lose anywhere from 75, 80 to 100,000 people," he said.

The IHME said the "growing demand" to lift restrictions and reopen businesses is not currently in pace with the level of testing required. "Carefully tracking what is happening today as locations move to 're-open' will provide vital information for potential COVID-19 trajectories in the coming weeks and months," it said.

Irwin Redlener, Professor of Health Policy and Management and Pediatrics at the Columbia University Medical Center, who is currently working on the coronavirus pandemic, discussed the decision of some states to start lifting restrictions, and the dangers of reopening prematurely.

"It's pretty clear in my mind that we need widespread, rapid and reliable testing for the virus," he told Newsweek. "We're not yet ready to say you can get an antibody test therefore are resistant or immune. We don't know if antibodies reflect immunity or for how long. We need rapid and reliable testing on people who are running shops, stores and restaurants...Without it, you're putting people in danger."

Redlener says that as states re-open "we're going to be facing very steep rises in the number of cases and ultimately fatalities." Reliable and effective tests, he said, should have been developed months ago. "Instead we've been dithering and are now facing the consequences of inexplicable incompetence in getting this testing situation set. We're now catching up with testing but it's still too soon to say we have the tools we need to reopen our shops and local businesses. Is it safe to start providing relief to some restrictions and getting back to our life as usual? We don't have tools yet to say that's the time."

As to when the country could safely reopen, he added: "The whole situation is a mess. It would be foolhardy to try to predict when we'll be in a better state."

This article has been updated to include quotes from Irwin Redlener.

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An employee at a restaurant in Texas, one of the states that has started to ease its lockdown restrictions. MARK FELIX/AFP /AFP via Getty Images