Is the Coronavirus as Deadly as They Say?
Current estimates about the Covid-19 fatality rate may be too high by orders of magnitude.
https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464
In this article on the WSJ two Stanford University professors of medicine conclude:”A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns.”
We know very little on the covid-19 epidemic. We will only understand the spread of the epidemic by conducting serologic tests (that check for antibodies) on random samples of the population. These are expected shortly.
Early news and dramatic images from the epidemic first from China then from Italy and Spain caused public opinion and governments to panic. Apocaliptic scenarios were developed. Containment measures were imposed even before reliable data became available. These were justified by the need to avoid the collapse of the health systems. Maybe rightly so.
But now we are reaching a different stage. Public Health works at a different level from Clinical Medicine. The latter aims to solve the problems of each patient in a granular way. The former looks at whole populations. Sometimes the two views are in conflict with each other. The media and public opinion, likewise Clinical Medicine, focus more on individual cases. Wider public health concerns should take centre stage now.
Some experts are highlighting circumstancial evidence that the number of infected people is greatly underestimated by official reports. If this is confirmed by the serological tests it means that the virus is much more widespread and is much less lethal than reported. It would mean also that a big percentage of the population go through the infection with just minor symptoms and build immunity.
This would call into question the efficacy and, more important, the need for strict isolation measures, except for some groups that show a higher fatality risk – the elderly and those suffering from some illnesses.
Governments are making the economy collapse based on poor data. Jobs are being destroyed which may have much higher costs (even in human lives) than the benefits of bulk lockdown strategies.
A few articles came up in the last two days from experts that discuss the points above.
Highlights from the WSJ article:
“Fear of Covid-19 is based on its high estimated case fatality rate—2% to 4% of people with confirmed Covid-19 have died, according to the World Health Organization and others. So if 100 million Americans ultimately get the disease, two million to four million could die. We believe that estimate is deeply flawed. The true fatality rate is the portion of those infected who die, not the deaths from identified positive cases.
The latter rate is misleading because of selection bias in testing. The degree of bias is uncertain because available data are limited. But it could make the difference between an epidemic that kills 20,000 and one that kills two million…
Population samples from China, Italy, Iceland and the U.S. provide relevant evidence. On or around Jan. 31, countries sent planes to evacuate citizens from Wuhan, China. When those planes landed, the passengers were tested for Covid-19 and quarantined. After 14 days, the percentage who tested positive was 0.9%. If this was the prevalence in the greater Wuhan area on Jan. 31, then, with a population of about 20 million, greater Wuhan had 178,000 infections, about 30-fold more than the number of reported cases. The fatality rate, then, would be at least 10-fold lower than estimates based on reported cases.
Next, the northeastern Italian town of Vò, near the provincial capital of Padua. On March 6, all 3,300 people of Vò were tested, and 90 were positive, a prevalence of 2.7%. Applying that prevalence to the whole province (population 955,000), which had 198 reported cases, suggests there were actually 26,000 infections at that time. That’s more than 130-fold the number of actual reported cases. Since Italy’s case fatality rate of 8% is estimated using the confirmed cases, the real fatality rate could in fact be closer to 0.06%…”
Dr. Bendavid and Dr. Bhattacharya are professors of medicine at Stanford.
Two other articles from the FT are also worth reading:
“Coronavirus may have infected half of UK population – Oxford study.New epidemiological model suggests the vast majority of people suffer little or no illness”
https://www.ft.com/content/5ff6469a-6dd8-11ea-89df-41bea055720b
“Sweden bucks global trend with experimental virus strategy.Fewer restrictions than other leading countries and schools remain open.”
“https://www.ft.com/content/31de03b8-6dbc-11ea-89df-41bea055720b?”
https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464