March 23, 2020

Lance Koonce
3 min readNov 12, 2020


New cases in Westchester yesterday: 1021. Biggest daily increase thus far. double that of the prior day. Hopefully we are nearing the peak here.

Comments [Names abbreviated to protect the innocent]

SS1. This is not good

CF. Thanks, the sharply rising numbers are probably due to more testing. I am still hoping we will figure out soon if there is a model that can make educated assumptions about the number of actual infections — reported numbers and actual infections may not be correlated which could be one of the explanations for the widely different mortality rates in various countries. Given the scarcity of testing, we may be aware of a fraction of the actual cases right now.

CM CF Absolutely agree. I personally know four different people that have it. Two have pretty strong symptoms similar to a bad flu, one had mild symptoms, one had almost nothing. Odds are many will get it and never know.

CF Yes, that’s my hope. Truth is that right now we have no way to know but I think in 4 weeks we will have a better idea. I just don’t think that testing will ever get us there, because no matter how much we test, there is only capacity for a tiny fraction of the population.

KC Thanks is for doing this, Lance.

JH Westchester has 980,000 people in it. I’m guessing 10% infection rate. That would mean 95k more to go.

SS1 If Westchester were its own country, we’d be #1 in the world in terms of infection rate. Almost 3x that of Italy

EM Valid point, but I suspect we are doing significantly more testing that drives up the rate.

SS2 We are doing a tiny, tiny fraction of testing. There are 5–10 people easily who have it and are not able to get tested in NY, for each that does get tested. I did 6 video assessments today for covid, all probably have it, but none need to be hospitalized at this time, so no test recommended. Here’s the Directive since last Friday: “The New York City Department of Health and Mental Hygiene has issued a health advisory discouraging COVID-19 testing in patients with illness that does not require hospitalization. Patients with COVID-like illness not requiring hospitalization should be instructed to stay home since testing does not change clinical management or recommendations about staying home. This includes health care personnel (HCP) who are mildly to moderately ill.”

CF SS2 thanks, this probably means that the more severe cases will be the known cases and the statistical mortality/hospitalization rates in NY will start to look scary soon — because everyone who is not in a hospital isn’t tested.

SS2 CF Yup.

BG Thank you SS2

TC More testing

AL These curves are similar to those from China and Europe (as well as many hospitals). Unfortunately, we don’t know when it will start to plateau.