about to get rough

Things Are About To Get Rough…

These next few weeks are a crucial period in the COVID-19 pandemic. Here’s what you need to know.

by Steve Silvestro, MD  @zendocsteve


Things are about to get rough—brace yourself.

NOW is the time to hunker down…..This post is long, but it’s important to know this info to understand what’s going to happen.

The U.S. is approaching the peak acceleration point of COVID-19 infections. That means we’re going to start seeing more hospitals overwhelmed and, unfortunately, hear about more people dying.

It also means that IT’S CRUCIAL that you stay home and limit interactions these next few weeks.

Here’s why:

The Institute for Health Metrics and Evaluation (IHME), based at the University of Washington School of Medicine, has been producing some of the best data projections when it comes to predicting where the COVID-19 situation in the U.S. is headed.

Based on their current predictions as I write this on April 1st—predictions that assume that whatever protective measures states are taking right now remain the same—the U.S. is going to hit peak hospital overload on April 16th. On that day, we’ll have over 260,000 people hospitalized, which means we’ll be short 85,000 hospital beds and short 19,000 ICU beds. Because of this shortage and because of how widespread the virus will be, that peak day of April 16th will see over 2,600 people dying of COVID-19. To put that in perspective, we’ve had 3,900 people total die from this as I write right now; April 16th will see 2,600 that day alone.

The peaks of infection, hospital overload, and deaths will vary by state.

Because New York and New Jersey are seeing the lion’s share of infection at the moment, their peaks are earlier—April 9th for New York and April 8th for New Jersey.

The majority of the remaining U.S. states won’t see their peaks until later in April or early May. For example, Maryland is currently projected to see its peaks hit on April 28th. Mississippi is in between, hitting its peaks on April 22nd.

So what does this mean for you? Why am I writing this?

First, you’ve heard this already, but now more than ever, it’s vitally important to STAY HOME—for real, no trips to the grocery store to pick up two or three things. No trips to a second store in hopes of finding something the first store was out of. No returning that sweater you’d forgotten to take back.

But second—I’m sharing this resource because if you live in an area that is peaking in the next 2-3 weeks—New York, New Jersey, Louisiana, and some other states—or if you have friends/family who do, it is VITALLY important that you and they minimize possible exposure as much as you can for the next 3 weeks beginning NOW.


We know that, on average, if a person with COVID-19 infection is going to take a turn for the worst, they do so on average by Day 8 to Day 11. This means that if you or someone you know lives in a state that will hit peak hospital overload in the next two weeks and you get sick NOW, then you will potentially land in the hospital *at the very time* that the hospital’s resources are already stretched beyond breaking point. You’re basically getting hospitalized right when the hospital might not be able to help you.

So while we all really, *really* need to be staying home, cleaning everything, batching grocery and gas trips and washing extremely well when going out and coming home—if there’s someone in your life who needs convincing to actually take these precautions to heart, make sure that they are using all of these precautions *for at least a full 2 weeks before* their state is set to hit its hospital resource peak. Show them the website https://covid19.healthdata.org/, find their state, and point out that there is a window of time—usually a few weeks—during which they might not be able to get the care they need if they get sick.

One final point—this info doesn’t mean that you have a free pass to *not* stay home or *not* use precautions if your state isn’t peaking for another month. You’ll see that for many states, even though the peaks are later, they still hit a deficit in ICU beds in the next couple of weeks—so getting sick now might still lead to a worse outcome for you than not getting sick at all.

And again, these projections are based on current behavior remaining the same—which means that if everyone truly hunkers down and practices the utmost social distancing & cleanliness precautions, we can push the peaks farther out, hopefully flattening the curve enough that many states never need more ICU beds than they have.

Please also know that because things will be really hairy these next few weeks, EVERYONE’s emotions will be running high. If you or someone you know are prone to anxiety or depression—or really, if you’re just human—now is the time to start reaching out to any mental health providers you may need and to make sure you tighten your online/virtual connections to loved ones. Most mental health providers are offering phone and video support and are ready to help.

We’re going to be in this together for the next few months—maybe even much of our 2020. But these next few weeks stand to be the hardest of all. Using the information at our fingertips from IHME and taking the right precautions now—together—is what’s going to get us through.

Dr. Steve Silvestro is a pediatrician, dad, and host of The Child Repair Guide Podcast. Find him on Instagram, YouTube, and Facebook.

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