Coronavirus: How worried should you be?

Is the current coronavirus thing worth worrying about?

We realize that even asking this might be seen as putting us in “Internet commentators who post about ‘crooked Hilary’ a lot” territory because here in the US of A anything can be politicized, unfortunately. But people need to know just how serious the current virus of focus is, or isn’t, because currently the sources of information they tend to rely on, the government and the media, have failed to provide them with accurate data.

People do seem to think that their political affiliation, and if they just believe hard enough, like saving Tinkerbell in Peter Pan, that that will magically affect how bad or good the virus news is.

We say bad or good, because it seems as if both sides of the political spectrum have an agenda here.

And the media world is simple: If it bleeds, it leads. The only news that you’ll get is that virus cases are “spiking” or “surging” (no other verbs may be used) somewhere. Hawaii has virtually no coronavirus, but the local media there still breathlessly reports each new “case” total, leading to many worried comments in the comments section about this “threat.” People who comment on newspaper articles do seem to be a special (in that sense of the word special) breed, and not much given to reflective thought, but conversations we have had with non-medical people also reflect this fear.

And is there anything more distressing, media-wise, then seeing someone who is clearly smart enough to get an article published in a major paper, but dumb enough to talk nonsense, as with this article headline in the New York Times. It’s, if you go by the headline, the kind of statement that is so breathtakingly wrong that you don’t know where to start.

We deserve better. What can we actually extract about “coronavirus” from publicly available records? Keeping in mind, of course, that political biases, bureaucratic agendas and media hype are to a certain extent inescapable. Here are some important questions with attempts to provide some rationality from the data.

What is the typical experience of someone infected with coronavirus?  What percent of the US has had it? What is the real death risk?

The best answer for these questions is checking rates of antibody positive people in a population. Having antibodies does not mean you are currently infected with a particular disease. What it does mean is that you were exposed to the disease enough that your body fought it off, in part by making chemical compounds called antibodies to do so. Antibodies can stay in the blood stream for some time after this happens. By testing a bunch of people in an area, researchers can see how many people have had a disease, not just how many got sick enough to go to a doctor, or get tested for active disease.

You may recall that when this was done a while back in California, there was much politicized outcry over the results, which if we recall correctly, were that about two percent of some Angeles area were antibody positive. Somehow this was seen as pursuing some conservative agenda by exaggerating the number of mild cases?

Anyway, we guess everyone mostly shut up about that, as it turns out most studies show higher rates of antibody positivity. Here’s a study from North Carolina (which was buried in the back pages of the site in question, FYI)

Researchers in this study estimate about 10 percent of the state’s population (about one million people) have had a COVID-19 infection, most of them asymptomatic or with only mild upper respiratory symptoms. In contrast to this, the North Carolina state health department (DHHS) website reports about 50,000 confirmed cases since tracking began.

This suggests that in North Carolina it is possible that for every person with a significant response to this virus, 19 people had it and didn’t even know it.

Here’s a report from New York.

Research suggests that by the end of March over 2 million people in New York City had already had a coronavirus infection by March (again about 10 percent of the population in question.) The NYC department of health reported about 33,000 cumulative cases on March 29.

(As an aside, you can disregard one thing—the ridiculously specific numbers of “cases” and deaths and hospitalizations that the news media report. These numbers are probably reasonably accurate in the US to the ten thousands place, but nobody really knows that there are (as of June 19, 2020) exactly 2,263,770 “cases” or 120,866 deaths as listed on Bing. We can be fairly sure that there have been about 2.3 million cases and 121 thousand deaths, but that’s as close as we can really get. So those hyper-specific numbers are kind of a lie.

And to reiterate—these are cumulative numbers of cases, not current ones, and almost no one is actually tracking “recovery” so the “recovered” cases figure is total fantasy. Both of these numbers are being presented to you in a way most likely to engage you with negative emotions, because that’s what the news media of 2020 thinks they need to do to get that all important click rate. The few places that do track recovery show that the number of people with actual, current, symptoms that were severe enough to trigger some kind of counting mechanism is about 10 percent of the cumulative total.

So, there are about 230,000 people with active infections in the US right now.)

Back to antibodies. Sweden did fewer restrictive measures than some other countries. Estimates of rate of antibody positivity in Stockholm range from 7.3 percent (an actual survey) to 20 percent (probably wishful thinking.)

In Spain, where they did a severe “lockdown” on the other hand…about 5 percent of the population has antibodies.

That last might mean that we should rethink the effectiveness of unfocused lockdowns, as Sweden and Spain aren’t that different in results, but the main point here is that populations seem to consistently, after a month or two of exposure, show that about 5 to 10 percent of the population in an area have had coronavirus. It appears, logically, as well that the longer the exposure in an area the higher number of people with antibodies. Also, it seems that about 95 percent of people had such a mild case that they don’t even know that it occurred.

In the United States the overall population is about 330 million. The low estimate of people who have had COVID-19 infection (5 percent) means that 16.5 million people have had it, and the high end (10 percent) would be 33 million. This is in contrast with the approximately 2.3 million serious cases reported.

Now the media is currently using “cases” as their chief scare word. “Cases” are “surging” or “spiking” (the only two verbs permitted.) There were x numbers of new “cases” in such-and-such as area! But all these people having mild or no symptoms is actually a good thing!

Why don’t they scare you with deaths anymore?

Because deaths are falling, both in rate and numbers. Good news is no news.

Here is a list of deaths per week attributed to COVID-19, from the CDC.

Week ending   “all COVID related”  “Pneumonia+COVID”   total of any kind of death

2/1                        1                               0                                     57,965

2/8                        1                               0                                     58,480

2/15                      0                               0                                     57,575

2/22                      4                               1                                     57,833

2/29                      5                               3                                     58,218

3/7                        32                             16                                   58,477

3/14                      52                             27                                   57,364

3/21                      548                           245                                 58,001

3/28                      3041                         1372                               61,967

4/4                        9490                         4541                               70,548

4/11                      15,670                      7020                               77,053

4/18                      16,309                      6973                               74,374

4/25                      14,051                      6018                               70,362

5/2                        11,575                      4901                               65,182

5/9                        10,591                      4479                               62,740

5/16                      8543                         3541                               58,969

5/23                      6388                         2691                               54,640

5/30                      4996                         2021                                50,199

6/6                        3114                         1321                                42,198

6/13                      804                           343                                  21,910

TOTALS           105,214                    45,524                             1,174,273


We have no idea what the “pneumonia+COVID-19 numbers mean. Isn’t a bad lung infection (that is what pneumonia means, translated from fancy doctor talk) the only way you really die of a respiratory virus? Possibly some coding thing? (Every disease entity these days is assigned an “ICD-10” code number, that is used for billing and paperwork purposes.) We include it for information, but we are going with the 105K estimate as being the real deal.

You can see that there was definitely a significant infection event going on in April, even if the numbers on the extreme edges of the time frame reflect some reporting issues, such as lack of awareness in February and incomplete data from last week. You can also see that the numbers of deaths are dropping.

Why is this? Perhaps most of the people who were going to die from COVID-19 have done so. Perhaps other areas have learned from Governor Cuomo’s disastrous handling of the nursing home situation in New York and are better protecting assisted living folks. Perhaps the virus is getting weaker, as viruses tend to do.

As we said, we are going with the 105k estimate (remember those eerily specific numbers like 105,214 are not real.)

If cases are rising, why are deaths dropping? Well, we hate to look like we are in “Confederate flag bumper sticker” territory here, but the people who say it has a lot to do with expanded testing are probably right. One big reason that the “cases” go up in some places and the death rate drops is that relaxed testing standards and more people being tested could mean that more mild cases are being found and recorded. It makes sense. It’s also a reminder that there is a difference between an actual increase and an increase in detecting something.

The five to ten percent estimate is pretty solid. It’s been replicated many places. What does that mean for the overall death rate? 105K (we are going with the CDC here) divided by 16.5 million (the lower number of estimated cases equals an overall death rate of 0.63 percent, or 63 of 10,000 cases overall will be fatal. For the upper estimate of infection, 10 percent, it would, of course be half that or, with rounding, 32 of 10,000 infections would be fatal.

Every year, the CDC and similar bodies estimate that about the same 10 percent of US residents get influenza. Typically, about 35,000 to 60,000 people die. That works out to about 10-20 fatalities per 10,000. So, coronavirus may be worse than the “flu” even with mild cases added. If you use 10 percent for infection estimates for both diseases, you get as we said, 32/10,000 for COVID-19 and 10-20/10,000 for “flu.”

It’s important to note two things. One is that while coronavirus is “worse,” and of course, it’s an added disease on top of our usual problems, as flu didn’t go anywhere, it’s not “ten times worse.” It’s somewhere in a range of “a little bit worse” to three times worse. Second, comparing coronavirus and the flu is in no way meant to trivialize coronavirus here. At You&Me we have always taken the position that the United States’ neglect of basic hygiene and public health measures to address our massive numbers yearly flu epidemic deaths is a disgrace. The influenza is serious business and a major killer of older adults.

Ah yes, that’s another refinement in the death figures. Here’s an article from the other day calling out Ron DeSantis for saying that no one under the age of 25 had died from coronavirus infection.

Turns out there were actually five people under 25 who had died at the time of the article. That’s five, as in one, two, three, four, five, in a country of 330 million. That article was a couple of months ago, so given what we saw of the death peak in April, that number is probably up to 30 or 40. Again, that’s in a nation of 330 million. 100 million of whom are under 25. That does not diminish the impact of these deaths for these unfortunate few, of course. But during March-mid June of this year many more people in this age group died of car crashes, suicide, homicide, and substance overdoses. It’s basically the same death rate as from autoerotic asphyxiation (0.5/million)

On the other hand, it’s a different story if you are at the other end of the life cycle.  90 percent plus of all coronavirus deaths are in people over sixty, and assisted living residents, who make up about .66 percent of the US population account for about 40 per cent of coronavirus deaths. Age seems to be the reason for this. The news media talks about co-existing conditions, but really people who die of coronavirus don’t have any different numbers and kinds of chronic illnesses than people who don’t. It’s just that illnesses like diabetes, coronary artery disease, COPD, chronic renal insufficiency and hypertension are very common in older people.

Again, scare tactics. Media and government bureaucracies try to obscure the age differences in lethality by using nonsense categories like 18-44. It is our sad duty to report that there is a lot of difference between being 18 and 44, physically speaking. But it is now clear that there is an age gradient in terms of death rates. Essentially, it is extremely rare to die from a respiratory virus, including this one, if you are under 50. Your rate increases somewhat up to about 65 or 70, then becomes worse, and really takes off in the oldest old, that is people 85 and above.

So, anyway, how worried should you be? The answer is it depends, but in general not as worried has the media wants you to be. If you’re a college student, the best scenario for you would be if your school opened up campus, invited all the students to a rave in the basketball arena and sprayed everyone with concentrated coronavirus. A few colds later, everyone would be immune, to their own and society’s benefit. But if you are 85, you have a significant risk (between 10-20 percent,) of dying from this respiratory infection.

The average person could always benefit, in terms of reducing all respiratory ailments, from practicing good hygiene. Minimize contact with surfaces that many people touch, and try to never touch your face after you touch those surfaces, until you can wash your hands. Limit facial touching in general. DON’T SNEEZE OR COUGH ON YOUR HANDS! Use a tissue or your elbow. It’s not perfect but it’s much, much better than the alternative. The US should start encouraging a culture of staying home when sick or keeping/staying home with a sick child as well.

Yes, wearing a mask will not keep out virus particles and is not necessary if you are sure you are not sick. But wearing a mask keeps you from spraying your spittle right in someone else’s face, which is only polite, and it actually helps keep you from getting sick, because it puts a barrier between your fingers and your nose, whereas without a mask you’d be picking that thing constantly and installing disease germs in your own body.

The average person does not need to “freak out” about coronavirus. You don’t need to be a lady we saw in the grocery store the other day, wearing a face shield and sanitizing their hands over and over. “Cases” are not a bad thing. More cases mean more immunity, and most cases are mild. More cases mean that the death rate is much lower than feared, which is a good thing, even if the people saved belong to a different political party than you do.

If you are very old, though, you should be more cautious.

People under 45 or 50 do not need to quarantine. The benefits are so minimal and the social disruptions so severe, especially for the young, who are trying to complete their education, gain admittance into competitive graduate programs and start their careers. We should never have a blanket, one-size-fits-none panic reaction again.

Unfortunately, people being people, it’s unlikely that everyone will say “wow, we really overreacted and destroyed our children’s future and ruined the economy, duh!” and slap themselves on the forehead and move on. It’s more likely to be an Emperor’s New Clothes situation where everyone will convince themselves that all the loss and effort and fear was worth it.

Can we avoid that scenario and come up with useful, impactful interventions that minimize disease risk in a realistic way while also minimizing damage to the rest of people’s lives when the next epidemic comes around?

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