April 23, 2020 Corona Update

Some Statistics:

The number of new cases per day of Covid 19, on a national basis, have leveled off and will begin to decline. New York State and New Jersey together make up 42.3% of all confirmed cases and 47.9% of deaths in the United States as of this morning. New York is now past its peak and is recording fewer cases each day. The remainder of the country, however, is an earlier stage of the outbreak and more rural areas are seeing higher caseloads each day.  

Maryland’s new cases have leveled off and are showing some signs of decreasing. In the last 4 days Maryland averaged 616 new cases per day and in the four days prior, the average was 709. The rate of deaths in Maryland appears to be rapidly improving as well over the last few days. 

Anne Arundel Medical Center reported this morning that 90 beds were being used by COVID patients but did not specify the number in ICU beds. They have planned for a capacity of 600 beds, and this number will likely not be necessary.  

So, from a medical perspective, the caseloads in the United States and Maryland are progressing close to predictions, with the exception of a fewer number of beds and ventilators needed during the infection than expected.  With continued social distancing the number of new cases are predicted to be very few by the end of May. We will survive this phase of the Covid-19 infection from a health perspective. 

From an economic perspective, however, the devastation from the virus cannot be overstated. Unemployment will likely rise to 10-15% in the next few weeks, the stock market has taken a major hit, oil prices have bottomed out (which will result in the loss of thousands of jobs in that industry) and we all know what has happened to retail shops, restaurants, and sports and entertainment venues.  

Medical experts are in agreement that the Virus will return for a second round during the flu season, probably beginning in December. The severity of this recurrence, from a medical perspective, is unknown, but from a psychological perspective this is devastating as well, more worry for an already edgy public. 

Though I am certainly not qualified to make predictions as an economist, there will be medical consequences to this economic collapse including a spike in mental illness, poverty leading to poor health conditions, and homelessness. 

Now that I have cheered you up…. 

How we handle this Medically over the next few months when there is a lull in the action, will determine the severity of Economic consequences going forward. If we do not feel comfortable going to shops and restaurants, if businesses are afraid to open for fear of the health of employees and customers, if we are afraid to travel and attend events in large venues, this country will look like a Mad Max sequel. 

Scott Gottlieb, MD, who has appeared on media channels on both sides of the political spectrum (including Fox News for my conservative friends out there) seems to have put together the most comprehensive plan on how to proceed safely with the least economic fallout. For an exhaustive discussion of this, follow this link. 


As the number of new cases of Covid 19 declines over the next month it will become feasible to investigate and track new cases and their contacts. This will involve extensive testing capability, a work force of public health workers who will track contacts, the ability to perform antibody testing, and likely an electronic means of proving who has a negative and positive test, such as indication on your smart phone. (To go eat a slab of ribs at Adam’s, for instance, you will need an indication on your phone that you ain’t infected)

We will need a military like effort, led by a logistics expert with an army of staff (possibly the National Guard) to carry this out. If you think this is too much, or too expensive, the alternative could be years of living when the highlight of your day will be going to the Walgreen’s to get some Milk of Magnesia, which you may not be able to afford.

This country has solved more challenging problems in the past, but none more consequential.  We all need to be serious about this and not fall prey to rosy predictions, that are not based in fact. This is a challenge, and we are all up to it. 

We remain available in the office, by video appointment, phone, or email. We will plan to start scheduling routine appointments sometime in May, when the coast is clear.

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