COVID-19 forecasts paint grim spring picture for Mass., death projections up as other states open up

CAMBRIDGE — The Massachusetts Institute of Technology is one of several organizations tracking and forecasting the COVID-19 pandemic.

Two weeks ago, its COVIDAnalytics project forecast that by mid-June, Massachusetts would see a cumulative total of more than 60,000 cases of the virus and about 3,500 deaths.

The state actually hit those milestones almost seven weeks early.

"Models are basically a way to get a numeric answer that synthesizes everything we know about this disease and other similar diseases," says Epidemiologist Eleanor Murray of the Boston University School of Public Health.

And that’s precisely what’s made forecasting COVID-19 casualties so difficult: Science doesn’t know all that much about the disease. But, through modeling, it’s learning.

At MIT, researchers found, for example, that Europeans who died from the disease were statistically older than Americans who died. "Why is this so? Is it because of socioeconomic conditions, are there biologies, is it race? Who knows?" said Dimitris Bertsimas, PhD. "But we are investigating."

As more becomes known about a pathogen -- how it transmits, how it mutates, its R0 (the infectious potential) -- forecasts naturally become better.

Murray suggests reliable models will have frequent updates and other indications they are being tweaked and tinkered with so as to incorporate relevant pieces of information about a pathogen.

"If a model isn't changing, we shouldn't have increasing faith in it," she said. "We should probably have decreasing faith in it."

If some of the models are better than even a week or two ago, there is some discouraging -- even frightening news for Massachusetts heading into May and June.

MIT's model has now increased the likely number of total cases by mid-June to around 95,000 and total deaths to about 10,500. This is the second increase in both categories in two weeks.

The University of Washington model, also known as the IHME, increased projected deaths in Massachusetts twice in one week. That organization now estimates 'first wave' deaths in the state could top 5,600, up from 4,200 a week ago.

At the Los Alamos National Laboratory, each state is assigned a best and worst case scenario for total cases and total deaths, as well as a point between the two. Massachusetts has been veering close to the middle on the Los Alamos model. If it remains on that course, the state could see another 100,000 cases of COVID-19 by early June along with 11,000 deaths.

There is a caveat to all COVID-19 models going forward. “Most of the models to this point have assumed some level of social distancing," Murray said. "Basically all the models show that if we open up from lock-down and don’t maintain good social distancing, what we probably expect to see is that over the next two weeks after a state or area lifts its lock-down that cases will start to rise again.”

Bertsimas fears some states have already jumped the gun. "I do expect an increase in the number of cases and deaths," he said. In the coming weeks, the MIT model even plans to incorporate a 'relaxed social distancing' component to account for states opening up businesses, parks and beaches.

One powerful reminder of how well social distancing curbs infectious disease comes from another forecasting model with a local partner, Northeastern University. It estimated that from the beginning of the pandemic in the U.S. to mid-May, if no mitigation measures were taken -- such as social distancing, working from home, stay-at-home orders -- the overall infection attack rate would have risen from 5 percent to 74 percent and more than a million Americans would have died.

Still, at some point, even the scientists behind the models concede some sense of normalcy has to return.

"There's a very fine line of what to do," Bertsimas said. "If you do it too early, you risk, of course, an explosion for the disease. If you do it too late, you risk an explosion on the economy side. It's a very complicated decision."

"This isn't going away any time soon," Murray said. "Until we have a vaccine we're going to need to be operating under some kind of methods to reduce transmission."

That could mean, she said, periodic lock-downs. It could mean continued working at home for those who can and a return to the workplace for others -- but with transmission reduction measures in place such as staggered shifts, physical barriers or personal protective equipment.

“On the science side, everybody’s aware this is a long-term problem,” Murray said. “Things like back to school. Things like voting. All of these scenarios are going to require that there be some more mixing of people and how we do that safely is something we need to start planning for now.”

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