Reducing Covid-19 Fever
In
the end, this flu season will be of greater interest to social
psychologists and social and political historians than to virologists
and epidemiologists. Among an innumerate and paranoid population
obsessed with its health, and which believes that the role of the
government is to solve all problems, it was easy for the media to
trigger a panic that would take down the markets and capsize the
economy. No public official or CEO can risk being viewed as
irresponsible, and the decisions they’ve felt obliged to take have had
devastating economic consequences for the majority of Americans.
There are two ways of looking at the case fatality rate of Covid-19.[i] Originally, some high rates were reported: 3.2% (this figure, from WHO, was repeated by Bill Gates in an alarmist New England Journal of Medicine
editorial), 2%, and 1.4%. By the end of February, as the virus moved
out Hubei province, estimates of the mortality rate were much lower. As
Anthony Fauci, et. al. reported in the NEJM on the 28th, “the case fatality rate may be considerably less than 1%.” The authors go on to conclude
that “this suggests that the overall clinical consequences of Covid-19
may ultimately be more akin to those of a severe seasonal influenza
(which has a case fatality rate of approximately 0.1%) or a pandemic
influenza (similar to those in 1957 and 1968) rather than a disease
similar to SARS or MERS, which have had case fatality rates of 9 to 10%
and 36%, respectively.”
In
the deluge of coverage of the “epidemic,” how many reporters on TV or
in print have bothered to repeat this information from the Director of
the NHI’s National Institute of Allergy and Infectious Diseases?
For
Fauci’s two worst-case scenarios, the epidemics of 1957-8 and 1968-9
(the politically incorrect “Asian Flu,” H2N2, and “Hong Kong Flu,”
H3N2), approximately .44% to .67% of those infected died in 1957-8, and less than .5% in 1968-9.
If
we assume a .5% case fatality rate for Covid-19, you could say that the
virus is five times as lethal as normal flu in a bad season. On the
other hand, you could say, with equal accuracy, that 99.5% of those
coming down with the flu will recover, versus 99.9% in a severe seasonal
flu year, a difference of .4%.
But will anything like this number die?
The
CDC estimates the death totals for the two epidemics in the US to be
118,000 in ’57-8 and 100,000 in ’68-9. The number of Covid-19 deaths in
this country is now about 147.
Are we going to see this figure go up by 80,000%?
There
were about 178 million Americans in 1957, and about 206 million in
1968. So .066% of Americans died of the flu in the first year, and .04%
during the second epidemic. If .066% of U.S. citizens died of Covid-19
this year, the death toll would be 217,800. We have a ways to go.
***
I
remember winning at the LA County Fair in 1968 a bobble-head doll of
Chairman Mao on the base of which was written “So who you think cause
Asian flu?” Otherwise I have no recollection of this epidemic, as I
surely would have if schools had closed. And like Dr. Brian Joondeph,
I can barely recall the 2009 swine flu virus, H1N1. This was a
particularly pernicious strain, in that it affected not primarily the
elderly and people with serious underlying medical conditions, but the
young and healthy.
The
worst flu outbreak of the last decade, in the 2017-18 season, was
hardly newsworthy. It was not a Presidential election year. But 61,000
died according to the CDC. The NFID estimates 80,000. If we take the
CDC’s figure, this represents only 10% of the cancer deaths for 2018,
609,640, and less than 9.5% of those dying from cardiovascular diseases,
about 647,000.
Everyone
is aware of the 1918 pandemic, the specter that lurks behind the
media-stoked fears today. But few people realize that only 10-15% of
deaths are attributable to acute upper respiratory infections. The rest
are the result of secondary bacterial complications. “Had no other
aspect of modern medicine but antibiotics been available in 1918, there
seems good reason to believe that the severity of this pandemic would
have been far reduced,” one researcher concludes.
***
This
is not to say the Covid-19 is not a nasty strain, or that the draconian
measures taken will not help prevent the spread of the disease. If
Americans had been harangued daily about washing their hands and
maintaining social distance, and, especially, if visits to extended care
facilities had been restricted, thousands of fewer people would have
died two years ago.
In
the end, the scaremongering is likely to boomerang. The timing of the
media was off. As the number of cases plateaus and then declines before
the end of May, there will be several consequences.
President
Trump will get credit for acting promptly and aggressively to keep the
number of deaths in the hundreds rather than the thousands. GOP ads
will feature clips of Joe Biden condemning travel bans as “xenophobic,”
which he mispronounces.
Israel
will benefit if it can come up with the vaccine that it’s developing.
How many of the world’s 195 countries contribute anything to the health
and well-being of the human race?
There
may be another response. Some people will be embarrassed in retrospect
by their panicked shopping sprees, and especially hoarding the totemic
toilet paper.
Still
more will resent being manipulated by the media. They will blame
journalists for their 401(k) portfolios plummeting over 20%. In fact
the economy is fundamentally sound, and before the Republican convention
in August, the markets are likely to have recovered and all the
economic indices should be swinging upward. The level of disesteem for
reporters may sink below that for lawyers, politicians, and used-car
salesmen.
There may even be increasing suspicion of the master Chicken Little narrative: anthropogenic global warming.
Image credit: NationalPark Service
[i]
The case fatality rate is the percentage of deaths per the total number
of infected individuals, but this is obviously difficult to determine.
Many individuals harboring the virus are asymptomatic, or have
something like a common cold. And among those who do have flu-like
symptoms, few report it. Did you notify your doctor or the CDC the last
time you had the flu?
No comments:
Post a Comment