I&I Editorial
As the Trump administration tries to figure out when to reopen the economy, and Democrats try to blame President Donald Trump for every coronavirus death, there’s another question lurking in the background. What if we learn that trillions of dollars in economic costs from the coronavirus shutdown bought us little or nothing in terms of public health?
As the disease progresses and our understanding of it increases, that possibility grows.
Consider these facts:
Death projections were wildly exaggerated. On March 16, epidemiologists at Imperial College London predicted that 2.2 million could die here if the country didn’t impose draconian lock-down orders. Even with those in place, it said, the deaths would likely top 1 million.
The White House later downgraded the death toll, but still predicted that as many as 200,000 could die. In late March, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington released a model that projected more than 80,000 deaths, assuming the U.S. maintained its lockdown, which prompted the Trump administration to extend the shutdown through April.
But within a week, that projection dropped to a little more than 60,000, as actual deaths started to come in much lower than expected. In the past week alone, the death toll has been 2,267 lower than the model initially forecast. That puts coronavirus deaths more in line with deaths attributed to a bad flu season.
Reports of overwhelmed health care were exaggerated. There was a steady stream of warnings that the coronavirus would overwhelm the U.S. health system.
When the IHME made its initial forecast in March, for example, it predicted that the disease would cause a shortage of 64,000 hospital beds. Now, it says the bed shortages are almost non-existent. It said daily hospital admissions would hit a peak of over 19,000. Now they say the peak will be 36% lower.
Death counts are likely inflated. Centers for Disease Control guidelines say that even “where a definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID–19 on a death certificate as ‘probable’ or ‘presumed’.” On Tuesday, New York added more than 3,700 people who hadn’t tested positive for the virus but were presumed to have it.
Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, said during an April 7 press conference: “If someone dies with COVID-19, we are counting that as a COVID-19 death.”
How has this affected the death tally? Nobody knows yet, but one would think that applying such loose definitions would inflate the number of deaths attributed to coronavirus.
The death rate is magnitudes lower than it appears. When the WHO said that the death rate from coronavirus was around 3%, it sent shock waves around the world. The flu, which kills about 40,000 Americans every year, has a death rate of 0.1%. In the U.S., 3.9% of those with confirmed cases of coronavirus have died, according to Worldometer’s tracking site.
But “confirmed cases” are mostly those who’ve had symptoms severe enough to get tested. Those with mild or no symptoms wouldn’t qualify.
What matters in determining how the deadliness of a disease, however, is how many in total were actually infected, and the only way to know that is to test for coronavirus antibodies.
Dr. Jay Bhattacharya, professor of medicine at Stanford University told NPR that: “To date, most people that have been trying to calculate death rate have tried to guess how many people have been infected. We don’t know how many people total have actually been infected.”
When Germany tested 80% of the population in one district for coronavirus antibodies, it found that vast numbers had been infected and didn’t know it. As a result, the actual fatality rate in that district was less than 0.4%.
Bhattacharya is conducting a similar test in Santa Clara County, California. In early April, the World Health Organization announced plans to conduct such a test.
Meanwhile, another study tracked influenza-like illness and suggests that some 28 million got the disease, which would put the death rate at 0.1% – right where the flu is.
In a Wall Street Journal op-ed, Bhattacharya said that “projections of the death toll could plausibly be orders of magnitude too high.”
There are clear at-risk groups. As with the flu, it’s often not the disease itself that causes death, but how it affects patients with other underlying symptoms. The Imperial College London found that the death rate is almost 10 times higher than average for those over 80. An analysis of 44,000 cases from China found that deaths were at least five times more common among those with diabetes, high blood pressure or heart or breathing problems.
A study of more than 4,000 patients in New York City found that obesity was the single biggest factor, after age, in whether those with COVID-19 had to be admitted to a hospital.
It’s not entirely clear how well isolation works. At the moment, the lockdowns are credited for keeping the death toll far lower than it would have been. But we still don’t know how effective these shutdowns actually have been.
Sweden has been in the news lately because, unlike almost every other country, it isn’t enforcing a strict lockdown. While the country postponed major public events, it’s taken a “low-scale” approach.
“Most places are open. Some places have reduced hours. Few places have closed. High schools and universities all are closed or working on remotely. But normal, like, elementary schools and middle schools are all open,” Sanna Bjorling, a reporter at the Swedish newspaper Dagens Nyheter, told NPR this week.
As the Los Angeles Times reports: “Crowds swarm Stockholm’s waterfront, with some people sipping cocktails in the sun. In much of the world, this sort of gathering would be frowned upon or even banned.”
Sweden’s somewhat more lackadaisical approach is coming under attack as the country’s death toll tops 1,000. But look at the numbers on a per capita basis and Sweden is doing about as good or even better than some of its lockdown counterparts. It has fewer confirmed cases than neighboring Norway and essentially the same as Denmark. It has fewer deaths per capita than countries such as the United Kingdom, Switzerland, Italy and France.
Ventilators might be causing deaths. Time magazine reported last week that doctors are starting to move away from the use of ventilators because of a growing concern that ventilators themselves might be contributing to the deaths of coronavirus patients.
“Some hospitals have reported unusually high death rates for coronavirus patients on ventilators,” Time notes, “and some doctors worry that the machines could be harming certain patients.”
“Generally speaking, 40% to 50% of patients with severe respiratory distress die while on ventilators, experts say. But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.”
We are the first to admit that, because this coronavirus is new and early signs about its lethality were worrisome, extra precaution was warranted as coronavirus spread. But not everyone was hitting the panic button, it’s just that voices of calm were ignored. If it turns out that the risks were far less dire, and the disease far more manageable without draconian restrictions, how will the public react? Who will they blame for needlessly crashing the economy?
We know who Democrats will blame, of course. But if the evidence shows that massive shutdowns weren’t needed, there must be a reckoning. And it should start with the public health “experts” who brought them about.
– Written by the I&I Editorial Board
If? More like WHEN.
This will probably turn out to be very similar to the Y2K non event. As I recall, none of the great IT people involved in churning up the panic for this non event were ever held accountable.
I agree there must be a reckoning, and it should consider the modelers and those health professionals who relied on them, knowing that their data preliminary and unreliable. But more than this, it should consider the actions of the media, who did more than anyone to create and then inflame a panic, creating a situation that had to be dealt with, and certain politicians (mainly, if not all, democrats) who wished to exploit and extend the panic to politically profit from it.
This was never a “massive” health problem, it was a problem with a manufactured panic. Ironically, the president’s initial reactions will turn out to be much closer to the reality and taking a much more measured and rational approach would have been as effective, or more effective. But because of the panic, especially with it being inflamed by the media and exploited by unscrupulous politicians, rational and measured approaches were not an option.
The modelers were foolish and irresponsible; the health officials were uncritical because they are extremely risk-adverse by nature and unsuited to evaluating the trade-offs necessary in a situation like this, the media were driven by their hatred of the president to being malicious, and the left-leaning politicians saw it as opportunity to indulge their totalitarian nature.
And, of course, the public was gullible and prone to panicking. So there is plenty of reckoning to go around here.
Are you unaware of how many people are dying??
We are quite aware of how many are dying. Are you aware of the co-morbidities which often accompany those deaths? Are you aware how many are surviving and/or have/had COVID-19 with no symptoms? More importantly, are you aware of the second order effects of the shut down? There are reasons the world doesn’t shelter-in-place every flu season:
1. There are a variety of procedures which are not being done in various parts of the world in an attempt to keep hospital space open for COVID-19 patients which are not materializing in the anticipated numbers. In the US, some hospitals may actually end up going bankrupt and be at risk for closure given current volumes.
2. There are a number of people worried about the impact of the shelter-in-place orders on folks prone to depression and/or suicide risks. What is the cost of breaking the social fabric and isolating people? Some of the isolation deaths may ironically be reported as COVID-19 cases, unfortunately.
3. If we don’t get the economy restarted, we may actually end up with critical shortages – some of which are likely to end up to be life threatening. Food shortages, medicine shortages, missing PPE to deal with other non-COVID-19 cases, etc.
Bottom line – yes, it is starting to look like a number of the shut-down/shelter in place orders are very much overreaching and ignore the second order effects. While it is true that people die, for better or worse, that comes with the human condition.
The blame, rightly or wrongly (and I believe wrongly), will fall where it has fallen at least for the past 4 years, on the President. Those who are anti-Trump will jump on that band wagon and not be swayed. Those in his camp will continue to accuse the left and the media of unfair attacks on the administration. The only real question is, who will the moderates and the independents blame?
I enjoy the commentary and the articles, so please continue posting.
Bottom line, China got what it wanted, a weakened US. My hope is they have awaken a sleeping giant as was done nearly 80 years ago.
They have ticked off the entire world.
— At the moment, the lockdowns are credited for keeping the death toll far lower than it would have been. But we still don’t know how effective these shutdowns actually have been. —
This is in the nature of the situation: a “crisis” that cannot be repeated for “testing” purposes. (Even if it were possible, would you want to repeat it? Really, now.) Compare the rhetoric of the radically pro-lockdown types to that of Barack Hussein Obama with his “jobs created or saved” nonsense. But never imagine that the matter can be conclusively proved one way or the other.
The critical data will arrive when we are able to assess deaths from lockdown-related conditions other than the Wuhan virus. How much higher was our national suicide rate? How much higher was the rate of death from domestic violence? How much higher was the rate of deaths from exposure due to impoverishment? Those numbers will tell an interesting tale.
How much lower is our death rate from the flu, auto accidents, crime and other causes?
how do you measure massive overreaction?
“WMD!”
Almost 17 million deaths so far in 2020 from all causes. COVID-19 death are rising, but less than 20 of the other major causes of deaths in 2020. Of the more than 16 million deaths to-date in 2020 from all causes, COVID-19 is over 100 thousand. For the world’s population approaching 8 billion, here’s the real time tally on the 20 major causes of the 17 million deaths so far in 2020. https://www.worldlifeexpectancy.com/live-world-death-totals
While it’s a natural question to ask, it’s impossible to answer whether the response was an overreaction or not. I prefer to put a positive spin on the whole thing, and predict that based on what we’ve learned and will learn about the virus, we will be better prepared and far less likely to fork over our rights for lockdowns with unquantifiable results (thank you, Sweden!)
Death of patients with ARDS of any cause requiring mechanical ventilation is 40% across the board. Failure of one more organ system raises the mortality rate to 60% and failure of two more systems raises mortality to 80%. The mortality incidence is therefore absolutely consistent with the data from sepsis with multiple organ system failure of any cause. Any patient with diabetes, which appears to be a highly at- risk group, had underlying kidney disease which quickly deteriorates under conditions of hypoxia, fluctuating blood pressure, and the nature of the virus itself, which attacks both the heart and the kidney at the same ACE2 receptor sites.
I will, and have from the start, blamed states’ governors for their wild, hyperauthoritarian responses to this virus. Living through it in real time, I’ve watched as entire segments of my mundane daily life have had police tape wrapped around them, and my latitude to simply move through space and time has shrunk to ever-smaller dimensions day-upon-day.
All this in the name of preparation for a plague that never materialized, a plague prophesied by the global order’s haruspices of “science” and their reading of the microcircuit entrails of their sturdy little computers.
But never mind, because “science”.
God, I LOVE science!
Quite frankly, I get tired of people claiming that “this is not like normal flu, you can’t compare it! It is much more deadly, and much easier to get!”.
Really? The numbers just don’t reflect that. Before they started shutting things down and making everyone stand outside stores with stupid masks on. (I especially like the crocheted ones with big holes in them. That will certainly help). If you were to say remarks that this is in line with what happens every year with the flu, people want to tar and feather you.
What do we do when the next one comes, next year or the year after? Just ruin the economy again?
Here’s one to think about. If the economy had not been doing so well, with such low unemployment, and a lot of money being made, would this shutdown have happened? Ever notice that when people’s wallets are fat that they will voluntarily submit to the most foolish things…higher taxes, nonsense spending, and shutting down the country for months?
The problem I have with all the stories of mass infections and no one getting sick is the other stories of all the people who showed symptoms and were dead a few days later. Look at New York City, what a mess that is.
The whole world went into lockdown, not just us, and how do we on the outside know what the plans really are on the inside? Our economy could rebound in 2 weeks, we don’t know what our leaders are really up to.
Trump gets the blame.
He gets the blame for not acting quickly or firmly enough, and letting Americans die.
He gets blamed for a knee jerk reaction to an exaggerated problem that killed the economy without due cause.
I assume you are assigning responsibility to him because he is the President of the United States. He did not create the virus, he reacted in a timely fashion based on the advice of his health experts. There are no federal orders for a shutdown. The over-reaction by some democratic governors is causing the most economic pain. Try to look at this in an unbiased manner and you will find this man performed admirably dealing with a unique and heretofore unknown adversary.
Yes, President Trump will be blamed, but for totally irrational reasons. The MSM and Democrats have been blaming him for everything they could imagine since he was elected – even for things that didn’t happen. Why should we expect them to quit that now?
Actually, Trump claiming total authority on this is good strategy, He has already proved he cares for our economy …. but if he had not declared the shutdown he would have been blamed for every death. We all know we need to get back to normal some way, some time. Now, the governors will leap into action to take that responsibility off his shoulders. The courts may be involved, too, because the shutdown does involve freedom of religion and assembly.
It’s a hoax to get rid of Trump. Why do you think they fired Trish Regan? For telling lies? Please.
I can’t help thinking that exaggerating the numbers of dead in the USA is the same propaganda in reverse of China’s lying about there being less than there are. It might be to our advantage to appear more damaged than we are.
That would be MSMs fault. But, all they have to do is point and yell Squirrel! and people will look away….
Here’s where your question will end up. MSM headlines across the world in Oct
Trump tried to become a dictator using Fake Pandemic Story.
He’s trying to overturn the Constitution of the US using a story that everyone knows now to be a Hoax
Peolsi to hold emergency hearings to determine if Trump is guilty of suspending the constitutional rights of all Americans using a Fake Pandemic and colluding with the Chinese for this unconstitutional take over.
Excellent article…which generates another question: Who is going to suffer the outrage when, once and for all, hydroxychloroquine is proven to be an effective cure for the virus? Will the democrats and the media, who have chosen to denigrate the drug and discourage its use face the ire of the people who lost family members because the drug was unavailable?
The “wildly inflated estimate” that was based on the information available at the time, and was not unreasonable. One reason for the high number was that this disease, without mitigation, has such a rapid rise in infection rate that a high percentage of the population ends up sick at once. And, at the time of that simulation, the best data was that 20% of them would require hospitalization. Today, that number *may* be lower – around 5% – but even at that level, most deaths would come from massive overloading of the health care system – and the fatality rate would be much higher than 1% as a consequence.
I ran my own simulations, using that same data, at about the same time, and got similar results. The Chinese covered things up, so the data was bad, but that was not known at the time. And, do not be confused about simulations and models: the basic models are solidly grounded – the growth of epidemics is well understood, because we’ve had lots of them, and people have been analyzing them mathematically for well over 100 years. What is less solidly grounded are the numbers that go into the simulation, but what was used was the best available information.
This is a crisis, like a sudden war. Information is far from perfect at the start, and public health officials have no choice but to assume something close to the worst case from the information they have.
So, attacking that estimate is 20-20 hindsight minus the information to understand why the attack was wrong.
As for over-reaction, we don’t have a counter-factual to compare it to. We do know that without substantial mitigation, the health care system would have been overloaded. Those who attack the mitigation efforts always brush that away with the fallacious logic that the health care system hasn’t been overloaded . That’s a clear logical error, since it hasn’t been overloaded when we have a lot of mitigation, while we don’t have the situation without the mitigation to compare it to.
0.4% is four times the fatality rate of the flu.
The Democrat Run Media and the Chinese owned Democrats.
Whaddaya mean, “turns out to be?”
IT ALREADY IS!
9/11 3,000+ Americans died, we invade two countries, hundreds of thousands die in those countries, along with another 4,500 Americans. We now have ISIS and dozens of other splinter group. Taliban will probably be in power again in Afghanistan by the end of the decade.Cost $6, triiion.
At least 40,000 Americans will die of covid19. The economic cost of our shut down is somewhere between $4 and $10 Trillion. Which one was an over reaction?
Responsibility for one’s actions? How quaint.
Who Will Get Blamed If Coronavirus Shutdown Turns Out To Be A Massive Overreaction?
Quick answer is obviously President Trump! If he cured cancer he’d be blamed for ignoring heart disease. More likely answer is no one. They will all take all credit and tell us it’s because of all these actions they took that this virus wasn’t 1/1000th as bad as they said it was going to be. And as an added bonus they now know the American people are no longer the same as those that stormed the beaches, tamed the west or landed on the moon. They now know when they say jump we’ll ask how high.
Overreacting should not be determined by how many get sick, or how many die.
Those two things are a product of how we managed the outcome.
Needless to say opinions like this are just “something” to say that is mindless banter.
When all the numbers are in, – IF there’s an honest accounting – It will be seen that Covid-19 was around the same level of danger as “ordinary seasonal flu” – Maybe a bit higher, maybe a bit lower.
But the media is their eagerness to sensationalize almost anything, stoked the flames of concern into panic and even a level of hysteria.
Like all other similar threats in the past, we should have quarantined and treated the sick, the vulnerable and let the rest go about their business.Yes people would have died. But people die every day – more in traffic accidents – but do we try to ban all cars and trucks? Tell people to stay home because it’s dangerous to walk on the sidewalk?
Instead, they have trashed the world economy, turned millions of people into frantic, paranoid germaphobes afraid to brush by someone in the street – people in the 3rd world will die of starvation having lost all income. Other diseases like cholera will increase in the squalor. More will die in domestic violence fed by the hysteria and unnatural living conditions.
Freedoms and right have been lost and may never be recovered.
All this because some “experts” took assumptions, hypotheses, wild guesses, created scary-looking graphs and charts which the media gleefully took and ran with….
The should be a lot to answer for. I just hope they do – otherwise it will happen again.
I suggest that a look at the study just published by Prof. Isaac Ben-Israel, a mathematics professor at Tel Aviv University. He examined the spread of COVID-19 infections in a number of countries and then plotted the rate of decline. He found that infections peaked at 40 days after the first reported case and declined to nearly zero 70 days after the first infection. He states that these numbers are the same whether or not the country implemented a strict shut-down policy or not. This is controversial but please keep in mind that the original catastrophic projections came mathematical modeling by groups from the Imperial College London and University of Washington. I hope that Ben[Israel’s paper has motivated several research groups to attempt to replicate his work.
As an aside, it is replication, not peer review that is the gold standard of research.
Gotta go with the CDC on that one – enormous death toll predictions created widespread fear and hysteria. Fanned by the Dems and MSM of course.
I don’t have a serious problem with state and federal ‘authorities’ insisting on years of double blind clinical trials before approving a treatment or vaccine for use. On the other hand, I’m incensed that they then turn around and order closures of the economy and a whole suite of other things with no evidence whatsoever or efficacy. Where are the studies showing school closures work? What about those showing social distancing works? Any evidence that outdoor arenas are a risk? Golfing? Masks have been worn in hospitols and clinics for centuries. Where’s the evidence that they don’t provide any benefit for the general public? Oh wait, where’s the evidence that they do? Government at all levels needs to show a lot more humility. Make recommendations, get out the best information they have available and then let us make our own decisions.
Start with China & the WHO for lying and then covering up the scope of the virus and sowing fear in the public’s mind.
Next in line for blame goes to elected Democrats and the Democratic Party activists posing as journalists for several of the most powerful and influential media outlets in the country.
Impeachment wasted time and diverted attention away from the important state business of much more important to the country.
Once the virus appeared on the radar the president took decisive action by closing the air-link between China and the USA.
Conversely, Democratic Party leaders were unanimous in their condemnation of any actions taken by President Trump including suspending flights from China. They use the same language of lies and smears against political opponents with Donald Trump subjected to the nastiest language accusing the president of racism and xenophobia.
When the president was leaning forward his political enemies were downplaying the severity of the virus and encouraging Americans to go to restaurants, sporting events, movies, shopping, the Saint Patrick’s Day Parade, and Chinese New Year celebrations.
As the virus expanded both the press and the Democrats exaggerated the number of infected, the number of the sick, and the number of the dead. Every presidential decision, every word he uttered, and every word, no matter how minute, were picked apart and the president’s motivations were put into the worst possible light.
Now, it’s become quite obvious that the president’s political enemies are exploiting the crisis caused by this pandemic to in the hopes of destroying Trump’s chances of winning reelection.
This strategy must not be allowed to succeed. The Democratic Party is corrupt, the progressive ideology too toxic, and its leadership too old and week to serve.
I don’t know about anyone else, but I’ll blame Fauci.
The COVID response was marginally adequate in the New York metro, and an overreaction in much of the rest of the country. Hindsight is a wonderful thing. And risk tolerance is characteristic of individuals.
Assessment of potential overreaction starts with identification of the risk prompting the reaction. Death is, and has been the risk that everyone focuses on, but I submit that the risk of an infected individual dying is determined by the availability of, and effectiveness of health care as much as by the specific comorbidities of the patient. And with the exception of certain NY metro area hospitals for limited periods of time, such care has so far been available. In this regard, the response was appropriate.
The US medical system, with rare exception, has NOT been overwhelmed. That was clearly a risk, and I expect despite ‘success’ there will be much discussion in medical and public heath circles in months to come about the need to improve ‘surge management’ at local, regional and national levels.
Specific COVID characteristics – easy communicability by asymptomatic infected individuals, short incubation period, a highly variable and (currently) unpredictable clinical course, and a novel nature that meant there were no existing tools for diagnosis or treatment, set us up for potential mass casualties. The uncertainty factors were, and still are, huge, precluding reliable predictions. Political imperatives drove over reliance on models and on narrow ‘expert’ opinions, which reflected the typical risk adverse perspectives of medical professionals (c.f. Fauci’s position re hydroxychloroquine).
But as we’ve learned more about what drives variations in individual risk, so too assessments of the appropriateness of the reaction change and vary by individual.
Individuals in my experience being commonly more risk tolerant than politicians (DJT excepted) or medical experts, I expect more popular protests against ‘overreaction’ and more defensive politicians and experts.
Ohio said 100K were already infected early March and closed schools. Everyone ran out to buy toilet paper. The ratio is 2:1, so each infected should have infect 2 others. Dr Acton said she was just guestimating. On March 23rd DeWine announced further lock downs. They said at least 65K were infected according the data model for 3/22. Later in April DeWine said the lock down was working and it flattened the curve. So, I guess we can travel time now? Or were the models 10X over estimated? Today 4/16 about 8,000 infected in Ohio. Nice job DeWine killing Ohio economy. He will not be re-elected.
Relatively interesting article, I missed where the purveyors of hyperbole and hysteria were mentioned. Our national media is as responsible as anyone in spreading dis-information, resulting in alarm and much confusion.
There is no doubt our president will be blamed for anything and everything associated with coronavirus, and again our national media will be beating the drum of sensationalism!
How is it an overreaction when we had no testing data on which to base decisions? Had to assume the worst and hope for the best. The entire world was underprepared.
Maybe the additional funding was the reason that the death toll was lower. I would rather we spend the money rather then spending blood.
The World Health Organization, now exposed as totally corrupt and counterproductive by its failure to prevent spread of coronavirus and its subservience to China, is hosting this international online concert to raise money for itself and above all to create a positive PR propoganda cloud of blue smoke to hide behind. Please tweet the following article (or similar expose) to their hashtag #togetherathome, and if you are feeling really zany, to Taylor Swift, Lady Gaga, and anyne else using the hashtag. Thank you. https://thefederalist.com/2020/03/17/u-s-funds-world-health-organization-that-boot-licks-c
Wow, I think you folk have talked yourselves into an alternate universe,with alternative facts.
This is not snark, I am serious. Start getting the news from a more diverse set of sources, for your own good. Stop being manipulated, like with trickle-down and SDI and “WMD!”.
There is no way to discuss events with those whose own ideas are not rational.
Thanks for letting me say it.
Every measurement has a two-sided error bound. We can only say that the true measurement is between these two bounds. When we model beyond the range of actual data, these error bounds expand very, very quickly. So, where we could say today that the US infection, with 90% confidence, is less than 2,000,000, we may only be able to say that in 30 days, the infection rate at 90% confidence is less than the population of the entire world. If we demand these error bounds on all models, we can then trade-off the uncertainty with the severity of the consequences of our decision.
I am 75. You are balancing my life against what?
Good comparison (estimates of course w margin of error) would b – compare annual total death rates by the months for past 10 yrs.
II think this is an ideal situation in which the response should be based on what is happening in the specific state/zip code. An acquaintance who is a nurse in Passaic NJ is working 16 hour days and talking about corpses stacked up in refrigerated trucks in the hospital parking lot. (FYI, for the rest of the country, this is less than 12 miles from midtown Manhattan.)
Meanwhile, in coastal DE, we cannot even walk on the beach. Our statistics look pretty bad, but local reporting will tell you that most of the cases are not in out zip code, but concentrated inland where there are chicken processing plants.
So… it’s not “fake”, and it’s most certainly not “national”.