Tuesday, April 21, 2020

If COVID-19 is no more deadly than the seasonal flu, then shouldn't we end the shutdown?

Every year people die from the seasonal flu.  In the United States, deaths from the yearly flu can be as high as 60,000 people.  And in the most severe flu seasons, it can be over 100,000 (as in the 1957 flu pandemic).  But we have never tried to shut down large sectors of our economy to reduce those deaths from the flu, because we have rightly concluded that the costs of an economic shutdown would far exceed the benefits of avoiding some of these deaths.  Even in the 1918 flu pandemic, in which 500,000 to 750,000 Americans died from the flu, no state or local governments ordered an economic shutdown.

But now American political leaders--President Trump and most of the state governors--have told us that we must shut down our economy--even at the cost of creating a new Great Depression--because COVID-19 is much deadlier than the seasonal flu, perhaps as deadly as the flu of 1918.

Now, we have clear evidence that this is not true.  We have seen fearful case fatality rates for COVID-19 as high as 4.5 percent--that is, of those reported as being infected with COVID-19, 4.5 percent will die.  But this number is actually meaningless, because most of the people who have been infected with the virus show no symptoms or mild symptoms, and most of them don't even know that they have been infected.  Only when we know how many people have been infected, can we then calculate the true mortality rate.

Yesterday, the director of the Los Angeles County Department of Public Health reported a study of a representative sample of 863 adults who were tested to see how many of them had antibody to the virus, which indicated that they had been infected, perhaps without knowing it.  It was found that the likely number of people in LA County who have been infected is 28 to 55 times higher than the number of confirmed cases of COVID-19 infection.

This suggests that the true fatality rate for COVID-19--the proportion of those infected with the virus who are likely to die--is somewhere between 0.1 percent and 0.3 percent.  This means that the fatality rate for COVID-19 is about the same or a little higher than for the seasonal flu.  A study by Stanford University researchers looking at people in Santa Clara County, California, reached the same conclusion.

Even this fatality rate can be misleading for various reasons.  Many of the deaths attributed to COVID-19 are people who would have died within the next year even without the COVID-19 infection.  And many people who die with this infection are not necessarily dying because of this infection, but because of something else.

If these studies of the COVID-19 fatality rate are confirmed, they support three conclusions.  First, the economic shutdown in the United States--and in other countries--should be immediately lifted.  Second, all the political leaders who demanded the shutdown should be removed from office.

The third conclusion is that far fewer people will die from the COVID-19 virus than will die from the economic shutdown.  David Beasley, executive director of the World Food Programme, has recently said that as many as 130 million people could die around the world over the next few months from famine caused by the economic shutdown.  He has warned: "There is a real danger that more people could potentially die from the economic impact of COVID-19 than from the virus itself."


Anonymous said...

If these research findings hold up, it would be very good news indeed.

However, I would like to add that if the fatality rate for COVID-19 is equal to that of the seasonal flu, that does not mean an equal number of people would die if it spread throughout the population. That is because every year we have a vaccine for the flu, but we don't yet have one for the coronavirus.

--Les Brunswick

Anonymous said...

There is evidence that the disease spread much earlier than had been thought. I think that would tend to support the idea the fatality rate is lower than most of the experts have assumed


--Les Brunswick

HK Fleming said...

I don't want to argue for or against closures, but this and the last post struck me as uncharacteristic of your writing.

You stated, we have clear evidence ..."
Yet then say, "Only when we know how many people have been infected, can we then calculate the true mortality rate."
and your words
"...which indicated that they had been infected..."
"...the likely number of people in LA County..."
This suggests that the true fatality rate (can one say"suggests" and "true" in the same sentence? I guess one can but...)
"If these studies of the COVID-19 fatality rate are confirmed...."

I keep looking for your "clear evidence"

Fatality rates - "because of the scarcity of testing and other reasons, we will find that the number of COVID-19 deaths has been grossly underestimated." The final death toll is going to depend on multiple factors: the density of the population; availability of testing; genetic factors (both host and virus); the public health response; and the robustness of the healthcare system." (https://www.medpagetoday.com/infectiousdisease/covid19/85925)

an aside - There was a vaccine ready by the time the 1957 flu came to the US. “When the new flu strain hit the United States in September, … the country was ready with a vaccine.” https://www.history.com/news/1957-flu-pandemic-vaccine-hilleman. The history.com article also says “Making a vaccine for a new flu strain is very different from making a vaccine for something completely new like COVID-19…. Doctors and scientists first developed viable flu vaccines in the 1940s, so they were not starting from scratch when they went to work on the 1957 flu vaccine.”

There may have been a few closures, granted not many.(1957 didn't have the information infratructure we have today)
(“Fairfax County closed 32 public schools to prevent spread of the disease.” https://www.washingtonpost.com/local/in-1957-a-new-flu-appeared-in-asia-the-world-watched-and-waited-for-it-to-spread/2020/03/17/9f5205b4-685f-11ea-b313-df458622c2cc_story.html. )