Discussing anything positive about COVID-19 amid the heartbreaking tragedies it has wrought will understandably be considered to be perverse by many. Letting that perversity prevent the good news spreading and calming fears is counterproductive. People need to be fully informed to make sound decisions about how to proceed. Closing one’s eyes to the light at the end of the tunnel is not helpful.
We hear, “COVID-19 is a unique virus” frequently. That statement is true but insipid (all viruses are unique ). Some of COVID-19’s quirks are especially bad, and others are especially helpful to the task of easing nonpharmaceutical interventions (“NPI”) to improve health outcomes and get the economy turned back in the right direction. Sooner is better than later. Let’s sort some of those out.
The Good News About Covid-19
A Selective Savage.
- The Victims. COVID-19 is unusually selective concerning which groups it severely affects or kills.[i] While we would prefer that it killed no one, a virus that slaughters children and young adults in the prime of their lives would be devastatingly worse than COVID-19. The death of an aged parent fraught with medical problems and much nearer death than their progeny is sad but is often coupled with relief that suffering has come to an end. Additionally, most parents would prefer to trade their lives to save the lives of any of their children or grandchildren, to say nothing of multiple children and grandchildren.
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- The average age of people killed by COVID-19 in Massachusetts as of 4/22/2020 was 82.
- Of all fatal cases in New York State, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness.”[ii] Data from New York City on 4/18/2020 indeed is not entirely representative of everywhere in the US, but it is nevertheless telling as to how the virus discriminates by age.
- For people 20 – 65, the risk of having severe symptoms from the virus is approximately 80 times lower than for people 75+,[iii]e., the risk is negligible.
- The Spared Many. While exceptions[iv] to the rule that COVID-19 spares harm to virtually everyone younger than 21. With the possible exception of NYC, the risk of adults dying from COVID-19 is about the same as the risk of getting hurt driving on highways of a congested city for several hours.[v] Dangerous, but not a reason to upend everything.
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- With or without a preexisting condition, an American under 65 is 15 times less likely to die than a person over 65.[vi] For an American under 65 with no preexisting conditions,[vii] the risk of death from COVID-19 is negligible.[viii]
- This reality creates an opportunity to deploy reopening plans that attempts to protect the exceptionally vulnerable (something NPI is failing to do[ix]) while enabling people with a slight risk of COVID-19 complications to get on with their lives and engage in much-needed commerce.
♦ The country has many more palatable options to ease NPI than would have been expected had COVID-19 pandemic been as predicted.
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Who Needs Protection. Preexisting conditions are a considerable part of the COVID-19 story. COVID-19 is much more lethal to people with certain known preexisting conditions[x] than most cases of flu and kills a somewhat higher percentage of cases. As of April 10, when 96,000 people had died of COVID-19, less than 1% of them did not also have one or more comorbidities.[xi] As you can see from the chart below, the risk of death from COVID-19 in the absence of a preexisting condition is remarkably low. For example, the percentages of people 65-74 years old and 75+ years old who die of COVID-19 with no known preexisting conditions are 1.5% and 0.8%, respectively. Stated differently, 97.7% of the people over 64 years old with no preexisting conditions survive a COVID-19 infection. Of those people whose preexisting conditions were unknown, the vast majority likely had preexisting conditions.
Data Source: Worldometers
♦ We know who needs to stay at home, social distance, wash hands, etc. in order to save lives;
♦ We know who need not distance themselves from people similar to themselves;
♦ The additional COVID-19 risks to the 65+ crowd are almost exclusively about their preexisting conditions that put them at risk of death from COVID-19. The threat to healthy 65+ people is very low, and
♦ The exceptionally vulnerable people are disproportionally dying in the first (and hopefully only) wave of the virus. Conversely, the population that has yet to be infected is likely to be less likely to die than during the first wave.[xii]
The Data Used To Devise NPI Strategies Was Flawed.
As discussed in “It Was “the data,” the “Confirmed Cases” of COVID-19 used to devise the NPI strategy understated the number of infections in countries. COVID-19 death rates are the number of deaths caused by the virus divided by the number of people infected. When the number of infections in the denominator is too low, the death rate is overstated. (More validation of the claims in “It Was “the data” have come in.[xiii]) The US NPI strategy adopted to deal with a pandemic relied on an early Imperial College London model death That model depended on an understated denominator and lies[xiv] about the virus coming from China. TheICL model estimated that COVID-19 would kill 2-3% of infected people and 2.2 million Americans.[xv] The low end of its range is 100 times more than now expected.
Consequently, America’s NPI strategies assumed a pandemic 150 times as deadly as COVID-19 turned out to be. So, US NPI was significantly more aggressive than was necessary or appropriate—even in the nation’s hottest hotspots.[xvi] They were wildly more aggressive than were needed everywhere else in the country.
“Given the positive correlation between population density and influenza mortalities, cities are likely to have greater mortality rates than rural areas.”[xvii] Consequently, imposing, NPI appropriate for major cities in most states was based on fear, not facts and science. Universally applying that NPI anywhere for more than two or three weeks was unwarranted, if not absurd.
♦ COVID-19 is not nearly as deadly as the public has been led to believe.
♦ Easing of NPI designed for a much more deadly virus that COVID-19 is appropriate everywhere.
♦ Decisions not to ease off NPI that proved to be over-aggressive are neither data-driven nor scientific—although reinstituting some NPI in the unlikely event that a hospital becomes at risk of being overwhelmed might be necessary.
We Are Closer to Herd Immunity Than We Thought.
A surprising percentage of the population already has immunity[1] from COVID-19.[xviii] As of 4/28/20, America had about 1 million “Confirmed Cases” of COVID-19. New York City and its surrounding area account for about 27,000 of those cases. “Hard-hit New York, the first state to do its own antibody testing, found an estimated 13.9% prevalence rate statewide, Gov. Andrew Cuomo said Thursday. The rate was even higher in New York City, at 21.2%.” The 13.9% prevalence is about 15 times the prevalence that the “Confirmed Cases” would suggest. Using the 15x multiple would indicate that possibly 15 million or more Americans have already had the virus. Two California studies found even higher multiples.[xix] Whatever the actual multiplier is, it is considerably higher than the multiplier used to impose the first NPI.
Antibody tests cannot be perfect, i.e., sometimes they produce false positives or false negatives. Not wanting to record or tell people that they are immune when they are not, antibody tests are designed to err on the side of producing false negatives.[xx] Consequently, more people have immunity than antibody testings suggest.
♦ We have an unexpected jump start on reaching herd immunity. A goodly percentage of people can neither spread the virus nor be harmed by it.
♦ The likelihood of people becoming infected today is lower than the probability of becoming infected was when the outbreak started.
♦ Most important, the nation’s vulnerable people are less likely to become infected now than they were when the outbreak began, i.e., the likelihood that the virus can avoid the multiple dead-end paths that prevent the virus from landing on vulnerable citizens has fallen significantly.
Many more pieces of good news could be chronicled. However, once honed by marketing professionals, the good news described above could empower the mainstream messengers to calm the unwarranted fears of healthy young people that are needlessly preventing them from reasonably safely getting on with their lives, and thereby increase protection of the vulnerable and get the economy turned in the right direction.
Let’s do what we can to get this good news message to the public.
[1] Dr. Birx and others have mentioned they do not have data to prove that COVID-19 infections confer immunity, but neither do they have data or analysis to confirm that the virus does not confer immunity. The possibility that it does not is unlikely.[1]
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[i] “Perspectives on the Pandemic | Dr. John Ioannidis Update: 4.17.20 | Episode 4” @15:58
[ii] “The data is in — stop the panic and end the total isolation.”
[iii] “In New York City, the U.S. epicenter of the pandemic, the death rate for people 18 to 45 years old is 0.01%, or 10 per 100,000 in the population. People aged 75 and older, though, have a death rate 80 times that. For children under 18, the rate of death is zero per 100,000. That’s zero,” and “The data is in — stop the panic and end the total isolation.” and “Far more people may have been infected by coronavirus in one California county, study estimates.”
[iv] Until recently there were no remarkable exceptions concerning children. Recently (months into the pandemic), some concern about a possible association between COVID-19 and Kawasaki disease in children has arisen. “Kawasaki disease is a very rare, but treatable, condition that causes inflammation in blood vessels, and toxic shock syndrome is a life-threatening bacterial infection.” While “Three New York Children Have Now Died from Mysterious Illness Linked to Coronavirus,” the motivations of those who are making the link and why the link is made to COVID-19 is an important issue. How do they explain (1) why some children with the disease have not tested positive for either the virus or COVID-19 antibodies, and (2) why the disease is an issue in so few countries. In addition, it is likely to be a very long time before proof that the bacterial infection is not due to NPI deployed to fight the infection on account of being couped up in the relataively sterile envoroments rather than the virusCOVID-19. Right now, there is no science to say that the virus is even the likely culprit.
See, “15 Children Are Hospitalized With Mysterious Illness Possibly Tied to Covid-19” and[v] Id. @15:54
[vi] Id. @17:39
[vii] “People Who Are at Higher Risk for Severe Illness.”
[viii] Id. @21:15
[ix] Generally a losing battle: “The Real Issues Concerning COVID-19—Part IV, The Herd Immunity Messaging Problem.”
[x] “Groups at Higher Risk for Severe Illness” and “Evidence Mounts for Greater COVID Prevalence.”
[xi] “FROM THE NUMBERS: Only 150 Americans to Date With No Pre-Existing Conditions Have Died From the Coronavirus or 0.9%.”
[xii] “Why lockdowns are the wrong policy – Swedish expert Prof. Johan Giesecke.”
[xiii] “The Fight against COVID-19: An Update from Dr. Jay Bhattacharya.”
[xiv] “The Comprehensive Timeline of China’s COVID-19 Lies,” “US intel believes China hid severity of coronavirus epidemic while stockpiling supplies,” and “New Report Says Coronavirus May Have Made Early Appearance in France.” [We do not know when the Wuhan outbreak started.]
[xv] “Epidemiologist Behind Highly-Cited Coronavirus Model Drastically Downgrades Projection.”
[xvi] An exception to this statement could be NYC, but its politicians urging people to stay the course, attend the Italian Festival, etc. were are large part of why its hospitals came close to being overwhelmed. See “The mistakes that turned New York into an epicenter of the coronavirus epidemic.”
[xvii] Economic Effects of the 1918 Influenza Pandemic.”
[xviii] “Cuomo Says 21% of Those Tested in N.Y.C. Had Virus Antibodies.”
[xix] “The study estimated that 2.49% to 4.16% of people in Santa Clara Country had been infected with Covid-19 by April 1. This represents between 48,000 and 81,000 people, which is 50 to 85 times what county officials recorded by that date: 956 confirmed cases,” and “LA COVID-19 antibody study adds further support for a higher-than-suspected infection rate.”
[xx] “State officials said the test had been calibrated to err on the side of producing false negatives — to miss some who may have antibodies — rather than false positives, which would suggest a person had coronavirus antibodies when they did not.”
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This is encouraging for us old folks, Harvey!
Thank Don. I hope you’ll forgive the length of this and the prior post. There was just too much misinformation floating around to skimp on a response.