More Americans may die from coronavirus than from every war in US history
For those who are short on time, I’ll start with the sound bite. If you have the time, please read the rest of the story.
The number of US deaths from the coronavirus pandemic may be as low as 356,000 and as high as 1.25 million. By comparison, the total number of US military fatalities since 1775 is about 1.14 million.
The coronavirus (COVID-19) pandemic is affecting not just the US, but the entire world in ways that were unimaginable even a few weeks ago. One of the scarier aspects of the pandemic is the number of fatalities that may result from a large-scale infection.
The pandemic, as devastating as it has already been, is still in its early stages in most of the world, with exponential growth in the number of infections and the number of deaths. This growth continues even in countries that have taken unprecedented steps to reduce the rates of infection.
How dangerous is coronavirus?
Coronavirus, like the flu, is a respiratory disease that has a minor impact on most infected persons but can lead to serious illness or even death for a small percentage of those who are infected. A study published by the Imperial College COVID-19 Response Team on 16 March 2020 estimated that 0.9%, or nine out of every thousand, of those infected with coronavirus would die. There was quite a bit of uncertainty in their estimate, with the researchers stating that there was a 95% probability that the true infection fatality ratio for those who are infected would be between 0.4% and 1.4%
How likely will someone be infected?
Because most of the world’s population has not been tested for coronavirus, and because the likelihood of virus transmission from an infected person and an uninfected person depends on many factors, there is some uncertainty about what percentage of a country’s population would be infected. For example, Chancellor Angela Merkel of Germany on 11 March 2020 cited expert estimates that between 60% and 70% of the German population would be infected.
That number is actually lower than estimates in the Imperial College study, which stated that if no measures were taken to prevent the spread of the virus, about 81% of the population in the United States and Great Britain would be infected. However, a graphic in that same study implied that if mitigation steps were taken; steps like closing schools, home quarantines, and social distancing; that percentage could be reduced by roughly a factor of three.
Best and worst cases for the US
By the week of March 22nd, many areas of the US had implemented the kinds of mitigations that the Imperial College study implied could limit the spread of the virus to about 27% of the population. Given the current US Census Bureau estimate that the US population is about 329.4 million, and a likely infection fatality ratio of between 0.4% and 1.4%, that would imply that the number of coronavirus-related US fatalities could range from a low of 336,000 to a high of 1.25 million. To put coronavirus in some perspective, the CDC estimated that in the 10-year period 2010 to 2019, the flu killed between 210,000 and 610,000 Americans.
Comparing possible coronavirus fatalities to fatalities from major US conflicts
Since the late 18th century, the US has been involved in two world wars and several other major military conflicts both within the US and overseas. Based on information from the Office of the Secretary of Defense and a study by the RAND Corporation, approximately 1.14 million US combatants have been killed during wars and other major operations from the Revolutionary War to the current conflicts in southwest Asia.
In the table below, estimated fatalities based on the range of infection fatality ratios in Imperial College study; the extremes of 0.4%, and 1.4%, as well as their best estimate of 0.9%; are ranked against current and historical major US military conflicts. The three pandemic scenarios in the following table assume that the US implements effective mitigation efforts and that 27% of the current US population of 329.4 million (about 88.9 million) will become infected.
Comparison to other leading causes of death
On 16 March 2020, the New York Times published an article that compared the number of potential deaths from coronavirus over the next year to the number of deaths from risks such as cancer and drug overdoses. The article allows the reader to change two assumptions about coronavirus, the percent of Americans infected and the percent of those infected that will die, and come up with a range of possible outcomes.
Interpreting the numbers
A pandemic, however insidious, is not an armed conflict, and those who may be infected are not in any kind of combat operation against coronavirus. However, given the range of estimated infection fatality ratios from the Imperial College study, comparing pandemic deaths with war-related deaths puts the numbers into a context that can be widely understood by the majority of those at risk from this virus:
- Under the best-case scenario of a 0.4% infection fatality ratio, there may be more fatalities in the US, about 350,000, than the total number of US military fatalities in every conflict from the Revolutionary War to World War I.
- Under the middle-range estimate of a 0.9% infection fatality ratio, the number of deaths, about 800,000. would be greater than the number of deaths from the Civil War, about 500,000, which was the US military conflict with the highest number of casualties, exceeding even the death toll of about 400,000 from World War II.
- Under the worst-case scenario of a 1.4% infection fatality ratio, the number of US coronavirus deaths, about 1.25 million, would be greater than the total number of combatant fatalities from every major US military conflict from the last 245 years, which is about 1.15 million.
Imagining the number of fatalities
These estimated numbers of fatalities, especially the worst case scenario of 1.25 million, may be hard to imagine for most people, but the US entertainment industry has given the average person plenty of fuel for the imagination. Think of every war-related movie and television show that has ever been made about any US conflict that you may have seen at some point in your life. If you try as hard as you can to remember every one of these productions, the total number of deaths in all the wars depicted in all of those productions would not come close to what may possibly be the number of deaths that the US may yet experience from this pandemic.