In light of a horrific April that saw close to 60,000 Americans lose their lives because of the coronavirus, bringing the national total to more than 63,000, it’s fair to ponder whether the U.S. will reach 100,000 deaths.

Researchers are hard at work trying to come up with an answer and there’s no clear consensus, but one telling fact stands out: The number of deaths the U.S. endured in April is larger than the combined total during the entirety of the pandemic for the next two countries on the list, Italy and Great Britain (54,738).

How much worse will it get? At one point, White House officials projected 100,000 to 240,000 deaths, even with social distancing restrictions, but they have since lowered the expected figure considerably.

The answer will depend in part on the public response to measures implemented throughout the country, which are starting to get relaxed because of the heavy toll they’ve taken on the economy. At least 30 states are planning to reopen in one form or another by this weekend.

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For now, the widely cited COVID-19 model from the University of Washington’s Institute for Health Metrics and Evaluation (IHME), often used as a reference during White House media briefings, projects 72,433 deaths by Aug. 4, though with a maximum range up to 114,228.

The IHME model, which has predicted at most 93,000 deaths, uses mobility data gathered from four companies, including Google and Facebook. After adding recently available numbers for presumptive deaths – those not tested but believed to have been killed by the virus – the model’s forecast rose from 67,000-plus deaths to 72,000-plus.

Ali Mokdad, a public health researcher who teaches at the IHME and was previously an official at the Centers for Disease Control and Prevention, said the model takes into account constraints to combat the pandemic, but he doesn’t expect their relaxation will lead to a huge surge in predicted deaths.

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Medical assistants wait to be handed testing kits at a drive-up coronavirus testing site in Seattle.

“We are seeing an increase in mobility, but remember, when they ease the restrictions, say in Georgia or in Texas or in Florida, people are not going to go back to what we call normal,’’ Mokdad said. “They will practice social distancing, they’re going to be wearing masks, they’re going to be afraid. Even when some businesses are opening, many people are not going.’’

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The IHME model has been accused of being overly optimistic. Others predict the nation will reach 100,000 deaths in the latter part of May. That’s the case for the model produced by the Los Alamos National Laboratory, which features detailed state-by-state information that includes one-week and six-week forecasts as well as situational updates.

Youyang Gu, a data scientist whose model is one of seven listed by the CDC website, concurs with the late-May estimate for reaching six figures. Gu’s COVID-19 Projections, which relies on data from Johns Hopkins University to forecast future deaths through a combination of artificial intelligence and a classic infectious-disease model, factors in the expected loosening of stay-at-home orders.

Gu foresees as many as 166,000 deaths from COVID-19 by Aug. 4, more than twice as many as the IHME, and trouble ahead for states reopening without knowing whether the virus has been contained.

“We believe this will cause the infection rate to increase in those states, leading to a ‘second wave,’’’ Gu said.

Scientists studying the virus’ impact generally agree the confirmed tally of cases – currently at 3.3 million worldwide and approaching 1.1 million in the U.S. – falls well short of the actual totals for a disease that can be transmitted by asymptomatic carriers.

In addition, determining whether the death rate is on the rise or decline has been a difficult proposition. It can be argued that the peak of the virus hit on April 16, when the Johns Hopkins coronavirus database recorded 4,591 U.S. deaths in a single day. That peak occurred in the same week when New York City reclassified several thousand deaths as coronavirus related.

But the daily death figures have not been steadily declining since then.

After opening following the coronavirus pandemic, Shelley Craft, owner of The Men’s Refinery BarberSpa gives a haircut to Kenneth Gregory at her salon in Augusta, Ga., Friday morning April 23, 2020.

The past three days are an illustration of that. Tuesday’s death toll was 1,378, but the next day the total shot back up to 2,096. And on Thursday, it increased again: 2,612 people died on that day. 

Looking at the numbers through the prism of state death totals presents a worrisome picture of the past few weeks. New Jersey reported a new single-day fatality high of 460 deaths on Thursday. And Massachusetts added 1,000 new deaths in five days this week as the pandemic peaks in that state.

A number of states with the largest increases in COVID-19 cases in the past week have no statewide stay-at-home orders, such as Nebraska and Iowa, which reported a 70% and 86% increase, respectively, in new cases per 100,000 residents over the seven days ending on April 29, according to 24/7 Wall Street.

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It’s also worth noting that death counts fail to take into consideration the number of people who may have perished for reasons indirectly related to COVID-19, such as those whose life-threatening conditions did not get treated because of the health crisis. Data released this week by the CDC indicates several thousand “excess deaths’’ not directly attributed to the coronavirus may be linked to it.

“This is clearly another important impact of the pandemic that should be influencing policy decisions,’’ said George Barbastathis, a professor of mechanical engineering at MIT who was the co-developer of the school’s model.

Neither that model – which accounts for infections but not deaths – nor the one developed by the University of Texas at Austin forecasts the day the U.S. may reach 100,000 deaths.

The latter, which relies on mobility and mortality data, aims for a narrower focus than others and won’t predict beyond three weeks ahead. By May 20, the UT model estimates the U.S. death toll at between 67,938 and 78,797.

School researchers are also among those keeping a close eye on developments as states loosen restrictions.

Lauren Ancel Meyers, a professor of integrative biology and statistics and data sciences who leads the university’s COVID-19 Modeling Consortium, said whether the pandemic resurges will hinge on several factors: the public’s efforts to limit contact and take precautions; the effectiveness of programs to test, contact-trace and isolate; and attempts to protect high-risk populations.

“If COVID-19 does start spreading more quickly, it will take several weeks before we see the impact in the mortality data,’’ Meyers said. “Since COVID-19 deaths typically occur several weeks after a person is infected, an increase in transmission around May 1 may not be apparent in the mortality data until the end of May.’’

For anyone thinking the worst was over in April, those are sobering words.

This article originally appeared on USA TODAY: Coronavirus in America: US nearing 10,000 deaths, record cases in May

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