How Do We Know If ‘Stay at Home’ is Working? Behold: The Severity Index

My family’s life is unrecognizable from a month ago–yours too?

A month ago my husband and I were employed (4 jobs between us), our son was having a much easier time in first grade than kindergarten, and we were getting our house ready to put on the market for a cross county move–a move that was going to bring us closer to family and our dream careers.  

After a lifetime of living paycheck to paycheck, we thought we’d plotted out our path. A global pandemic was NOT on our 2020 bingo card.  Now we don’t know much of anything other than that we need to care for two young humans in less than 1200 sq. ft for the foreseeable future. And still, we are so lucky. We have our healthy kids, pets, a stocked fridge and Disney Plus. Living in the San Francisco Bay Area of California (with an anxious personality), we already had our Earthquake kits packed with food, masks, tp, pet food…and whiskey. We’re fine.  

We picked our son up from school for the last time on that scary Friday the 13th of March–a pandemic has always been my personal nightmare so it seemed fitting. We have only left our home when we absolutely had to, and have our own version of a decontamination routine fit for sci-fi novels.  

It all feels surreal: standing in line outside our regular grocery store, standing 6 feet apart in masks and gloves, waiting for the security guard to wave us in, one at a time, as people leave. I was so used to breezing in and out of that store, latte in hand, not knowing it would soon look like this, some dystopian scene rife with tension, heavy with silence. As I feel my rage bubble at the maskless man behind me, standing WAY too close, I have to wonder—this is worth it, right?  All these precautions, loss of income and worry about our future—it MATTERS, doesn’t it?  I need to know.  

Watching the news feels terrifying these days, the numbers just keep climbing, and the daily raw totals seem like they scare more than they inform. 

So I began to track daily state totals myself.

As a researcher and analyst, it’s not the first time I have found comfort in neat rows of numbers, making some kind of order of the chaos swirling around.  

Our local and state officials acted aggressively and swiftly, but our numbers still climbed, was it working? Was it failing? California is a MASSIVE state, and the terrifying tallies weren’t really telling the whole story. I found that by controlling for a state’s population, a much different picture emerged.  I created a Severity Index which I can watch change in real time to help me, to help us better understand what is happening on the ground right now. 

The Severity Index, the confirmed death rate controlled for population in millions, can help us compare state to state level current risk and speed of growth.  

In such a fast-moving situation, data is imprecise at best, and this virus is particularly hard to track. However, analyzing the most accurate information we have, in real time, can help us make better informed personal choices and advocate for better responses from our public officials.  

While death rates aren’t exact, they are a significantly more accurate representation of severity than confirmed cases. US testing by state has been wildly inconsistent and as a result we have virtually no current understanding of truly how many cases are out there and what the actual death rate associated with the virus is. As we track this over time, we will better understand how quickly the severity of the pandemic is affecting the day to day lives of Americans and our essential infrastructure.

So, when I drill down on my own home county of San Mateo (just South of San Francisco), with our .78M people and our current death toll of 12, I get a Severity Index score of 16.4 (deaths per million residents).  This is MUCH higher than the California state score of 3.34 and reminds me how desperately we need to continue our hypervigilence. Yet considering how densely we are populated and hit so early, that we are roughly equivalent to Nevada is enough to allow me to sleep a bit AND confidently tell my kids we are NOT going to the playground. 

We can see IN REAL TIME that aggressive, rapid, thorough action is already saving lives.    

I also hope that we can  help our less populous states to understand their true risk. It may seem that California with its current 350 deaths is hit much harder than Vermont with its 22 deaths.  However, given that Vermont is less populated than San Mateo county, the severity of the virus in that state is currently much greater than what is at my doorstep. Early and aggressive Social Distancing measures have been extremely effective.

We also need to recognize the extreme severity facing the state of New York right now. NYC hospitals are war zones, not insatiable ‘complainers’ as the President has suggested. No location has been hit anywhere near as hard, though it is terrifying to watch New Jersey and Lousiana creep up so fast. We should all be advocating for a comprehensive and rapid response to be directed at the most impacted locations.

Comparing states, I can tell you this thing is moving FAST and it is brutal. 

It is worth knowing how quickly severity is changing state by state to understand if we are making any headway ‘flattening the curve’. By looking at the Severity Index a week ago compared to today, we see how fast the risk is multiplying.

This is good news for places like Washington state, the first area impacted by the virus, where their Severity Index increased by a multiplier of only 1.69–less than double–over the past week.  Alternatively, we should be alarmed at the rapid increases across much of the nation. Rhode Island, Iowa, Maryland, New Mexico, Montana, New Jersey, Kentucky, North Carolina, Connecticut, Illinois, and Alabama have all seen severity increase more than 5x in the last week.  

There is so much we can learn about the virus, its path, and what measures are working—this will all become clearer and clear as time goes by, but our collective action matters NOW.  Looking at this, I am comforted that our local action has been relatively successful at slowing the spread. Throwing our lives into this weird, sleepy chaos is saving the lives of my community members. As someone with a history of respiratory issues, my neighbors might be saving my life. This MATTERS. 

To effectively combat the disease now, these figures underscore that we need:

  • Prolonged social distancing measures nationally
  • Rapid, comprehensive testing in every state
  • Ability to quickly ship necessary equipment and supplies to hospitals that need them most
  • Data that is captured consistently at a national level and communicated effectively 

All things are not equal, and some communities and demographics are getting hit harder

Further, we also need to consider exactly who is being impacted in different states and nationwide, with poor and minority communities facing the most severe impacts. Some of the reasons we were able to shut down so fast and are weathering okay here, in my neck of the Bay, is that our area holds a lot of collective wealth and is decently networked. We CAN stay inside. Instacart was already a way of life here. 

When I look at NYC and New Orleans, I see places where there are high concentrations of poverty in close quarters—this is a virus originally spread by the most privileged, traveling willy nilly at the onset of an international pandemic, but the severest cost will be paid by the most vulnerable. 

This virus once again highlights every aspect of our inequality, and the steep price we pay for it as a nation. The intersections of our vulnerabilities have never been clearer, particularly the need for comprehensive and accessible health care, employment protections, living wages, and housing stability for all. We’ll need to redouble our efforts towards these goals as the dust settles. 

In the meantime, stay home.