For the past month I have watched a classical case of hysteria present itself around me driven by a news media that seems to show no end to its willingness to sensationalize – even at the expense of our liberties – and an international and national public health apparatus that seems both confused by it’s legal/moral duties and eager for the attention. At the risk of finding myself on the receiving end of the endless wrath of trolls who have not actually looked into this, I wanted to share this information to both lay a groundwork for those that would argue that the actions being taken by overzealous politicians are an overstep and also simply to reassure people. I am citing my sources for anyone that wants to double-check me.
Let me begin with this, COVID-19 is a serious illness and every loss of life is tragic. There have already been too many and there will be many more. I absolutely support us taking basic precautions to prevent the spread of this disease, just as I would with any other disease, but those precautions should be reasonable based on the danger presented.
Here are the publicly available facts as of the end of March 2020:
- The mortality rate of COVID-19 was initially thought to be in the vicinity of 15% when it broke out in China (Kim, 2020). This is very high and created a panic – particularly in the media.
- At the time the Kim article was published (Feb, 2020) the mortality rate around the world was 2.4% and the mortality rate outside China was 0.4% (Kim, 2020). The most current rates can be calculated using the numbers provided at https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 which is provided by Johns Hopkins.
- Influenza mortality rates are difficult to find a clear answer on. This is because the CDC primarily tracks pneumonia and influenza attributed deaths rather than overall mortality. That said, the pneumonia and influenza associated mortality rate exceeded 10% for 4 consecutive weeks during the 2017-2018 flu season (CDC, 2018). Compare this to the 0.4% outside of China with COVID-19.
- The reproduction rate (which is the number of people someone infected with a disease may transmit it to) for COVID-19 is estimated to be about 2.68 (Wu, Leung, & Leung, 2020).
- As a comparison, the reproduction rate for SARS was 2.7 and the reproduction rate for MERS was 3.9 (Wu, Leung, & Leung, 2020). The mortality rates for these diseases were approximately 9.6% for SARS 34.4% for MERS (Soucheray, 2020). The overall reproduction rate for seasonal influenza overall is still being studied. The number is likely under 2.
- Airborne diseases are diseases that can be spread through the air due to people coughing, sneezing, etc. Some types of influenza are likely airborne some are not. Many other diseases are.
There are a lot of statistics here so let me summarize. COVID-19 can be dangerous but is substantially less so than many other diseases that have not shut down our nation. Mortality rates for COVID-19 keep going down and, in my opinion, will end up on the low end of some of the major flu epidemics in the United States. COVID-19 may or may not end up being more contagious than most strains of the flu but that is still unknown.
One thing to note about all of the mortality statistics, it is difficult to give precise numbers for mortality related to the flu as mentioned above. When people are using comparisons in the news they are based on statistical extrapolations (very educated guesses) related to the entire population including people that have the flu but whose symptoms are so mild that they do not report them in a way that the CDC can track. The same thing will happen with COVID-19 but no one is reporting or discussing that. It gets substantially more clicks to us a headline that says “COVID – 20 Times More Deadly Than the Flu” than “COVID and the Flu – Similar Mortality Rates”.
Finally, COVID-19 follows a similar trend to the flu in another important way. It is far more dangerous to the elderly and at-risk individuals than others. This terrible characteristic contributes greatly to the death rates of those dying in Italy.
Ultimately, I think the question we should be asking ourselves right now is whether this is severe enough to warrant what we are doing to our economy and freedoms. I think we all owe it to each other to take steps to ensure this does not spread – washing our hands, staying home if we are sick, etc. – but are mandatory lockdowns acceptable? Will we do this again with the next major flu epidemic? This is a question unanswered by the Supreme Court but maybe someone should ask it.
CDC. (2018, June 8). Update: Influenza Activity in the United States During the 2017–18 Season and Composition of the 2018–19 Influenza Vaccine. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a4.htm?s_cid=mm6722a4_w
Kim, H. (2020). Outbreak of novel coronavirus (COVID-19): What is the role of radiologists? European Radiology. doi:https://doi.org/10.1007/s00330-020-06748-2
Soucheray, S. (2020, February 24). Study of 72,000 COVID-19 patients finds 2.3% death rate. Retrieved from CIDRAP – Center for Infectious Disease Research and Policy: http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate
Wu, J., Leung, K., & Leung, G. (2020). Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. The Lancet, 689-697. doi:https://doi.org/10.1016/S0140-6736(20)30260-9