From “flattening the curve” to “learning curves”…

A conceptual rationale for why COVID cases are surging but deaths aren’t.

All along I’ve been arguing that the truest and most relevant measure of COVID-fighting is the death rate.

MUST READ: How will we know when we’ve turned the COVID-19 corner?

And, I’ve recently been showcasing the relationship between confirmed cases and deaths.

See: Where’s the case-related spike in deaths?


The data says: Since mid-April, the number of daily confirmed cases has more than doubled, but the number of daily new reported deaths has apparently stabilized at about half of mid-April levels.

How can that be?

Here’s a way of thinking about the how & why…


From the get-go, we’ve been told that we need to “flatten the curve” by taking mitigation actions ranging from lock-downs to social distancing, masks and hand-washing.

The effect was to spread deaths out until an effective therapy or vaccine was launched.

For details see: Does “flattening the curve” really save lives?


In aggregate, the results are largely consistent with the theory: Daily deaths peaked, then slowed … and now appear to have stabilized between 500 and 1,000 deaths each day.


But, again, the number of confirmed cases has more than doubled.

Why the disconnect between confirmed cases and reported deaths?

Some hypotheses: more testing, changed demographics (more younger cases), more effective treatment protocols.

All are probably true to some extent.

So, let’s bundle them as “learnings” … repurpose the “flattening curve” … and start thinking “learning curves”.


My take: This conceptual representation largely illustrates what’s going on these days.

Early-on, deaths were concentrated along the northern Atlantic coast:  New York, New Jersey, Connecticut, Rhode Island and Massachusetts.

Now, new deaths are concentrated along the Sun Belt s states: Florida, Texas, Arizona. California.

These later virus-developing states are testing more and, thus, counting more mild COVID cases … and, more importantly, benefiting from the learning in the early developing states.

For example, hospitals and doctors are reportedly:

  • Isolating “vulnerables” more stringently and prioritizing them for care when they get infected.
  • Treating cases more aggressively on the front-end with anti-inflammatory steroids and  drugs
  • Modifying protocols for ventilator use (i.e. clearly recasting them as a last resort)

So, average hospital stays are reportedly shortened by as much as half … and mortality rates are down.

It’s called a “learning effect” … and helps explain why C-19 confirmed cases and reported daily deaths seem to be disconnected.

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