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The number of tests needed to have an accurate picture of the spread of COVID-19 varies over the course of an outbreak. As the virus infects more people, testing coverage also needs to expand in order to provide a reliable picture of the true number of infected people. The chart  below shows the number of people tested per confirmed case. We see large differences among countries. In Vietnam, Taiwan and Australia there had been over a hundred tests for each confirmed case. The US, the U.K., and Sweden have performed around 6 tests for every confirmed case.

 

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If we remove New York from U.S. calculations, we can see that the number of cases for the rest of the country is continuing to climb. This makes the small number of tests per case problematic as it is difficult to track the disease progression across the nation, which makes it difficult to determine who should be opening up when.

 

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At the same time, it may not matter when states decide to reopen. The majority of US residents starting staying home in early May, regardless of when the state issued stay-at-home orders.

 

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Similarly, as stay at home orders have been lifted, few people have returned to their previous levels of activity in the community, including reopening small businesses.

 

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But there might be an additional cost to people remaining isolated: an increase in deaths of despair; that is, deaths due to drugs, alcohol, or suicide. Kentucky already has a high per capita rate of these deaths, with an estimated 3,082 deaths in 2018, for a rate of 69/100,000.

 

 

ESTIMATED RATES OF DEATHS OF DESPAIR, 2018

Map showing rates of deaths of despair.

Source: Petterson, Steve et al. “Projected Deaths of
Despair During the Coronavirus Recession,” Well Being Trust. May 8, 2020. WellBeingTrust.org. 

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Wellbeing Trust estimated additional deaths by state by multiplying the baseline rates of deaths of despair by the state’s share of excess unemployment multiplied by the ratio of the state mortality rate and the national rate. The figure below shows estimated deaths for moderate rate of economic recovery from the COVID-19 pandemic. It is estimated that Kentucky will have 439,223 excess unemployed from 2020-2029, which would predict 911 additional deaths of despair, or an additional 20.3 deaths/100,000 residents.

 

 

ESTIMATED ADDITIONAL DEATHS, 2020-2029

Map showing projected deaths of despair rates until 2029.

Source: Petterson, Steve et al. “Projected Deaths of
Despair During the Coronavirus Recession,” Well Being Trust. May 8, 2020. WellBeingTrust.org. 

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