Contributor Post Created with Sketch. COVID-19 Confusion

 

A scientific study attracted national attention last week by taking the dramatic position that the “excess deaths” from COVID-19 exceeded those observed with the Spanish Flu of 1918, at least for New York City. The absurdity of the claim is symptomatic of the imperfect understanding of the pandemic by this nation’s elites. To be sure, the letter correctly notes that the state of healthcare today is far better and more advanced than that of a century ago given the widespread availability of such impressive treatments as “standard resuscitation, supplemental oxygen, mechanical ventilation, kidney replacement therapy, and extracorporeal membrane oxygenation.” Indeed, those technological advances indicate that the true severity of COVID-19 is even greater than the raw numbers suggest.

With that said, the study is flawed in several key ways. The estimated number of total U.S. deaths from the Spanish Flu was 675,000 in a population of about 100 million people. Assuming there have been about 169,000 U.S. COVID-19 deaths in 2020 in a population of over 330 million people, the COVID-19 death rate is roughly one-twelfth of the Spanish Flu rate. That number could well increase before the pandemic runs its course. According to the Institute for Health Metrics and Evaluation (IHME), the U.S. death toll of COVID-19 could reach 300,000 by December, at which point the ratio would be about 7.5 to 1.

Why then is New York special? New York State has experienced over 32,000 COVID deaths, or about 20 percent of the nationwide total. Its population of 19.5 million constitutes about 6 percent of the U.S. population. The vast majority of those deaths were confined to New York City (over 23,500) and occurred before June 1. The key graphic that makes the case for the comparability of the Spanish flu to COVID-19 in New York shows major spikes in 1918 and 2020:

Nonetheless, the ostensible parallel is fatally flawed. In order to compare the two pandemics properly, the New York death rate from COVID-19 needs to be adjusted downward to account for several important variables. First, the study offers no explanation as to why the early New York numbers were so high. But the best explanation lies in the state and city’s clumsy institutional responses to the virus. Perhaps most notable among the bungled decisions was the deadly order that Governor Andrew Cuomo issued on March 25 requiring ill-equipped nursing homes to take in presumably recovered COVID patients, ostensibly to free up hospital beds for an anticipated onslaught of new COVID cases which never came. Any responsible estimate should subtract out the many, often concealed, COVID deaths from that unconscionable maneuver, both in New York and other states, like Michigan, New Jersey, and Pennsylvania.

Second, with the Spanish Flu, there was an uncommonly high death rate for individuals between the ages of 20 and 40, which was at least in part due to “cytokine storms,” a severe immune response that could lay waste to healthy individuals in less than a day. High death rates were also recorded for children under 5 years of age, as well as those over 65. Notably, COVID appears most severe only in those over 65. As of August 12, the CDC reports that nearly 80% of all U.S. COVID deaths have been in patients over the age of 65 (118,548 out of 149,192).

Third, persons with acute comorbidities—including cancer, diabetes and kidney failure—are often coded only as COVID fatalities, without regard to their underlying conditions. Finally, so-called “probables” are included in the COVID totals, when the “probable” symptoms are often consistent with ordinary flu or other diseases. Take these cases out and comparing the New York death rates in 1918 and 2020 will likely yield a different result from the study’s conclusion.

The current of exaggeration gets even worse when we look beyond the study. A recent New York Times story touts that the full cost of COVID-19 not only includes the inflated death count of 169,000, but also about 35,000 additional deaths attributable to indirect effects. Unfortunately, the story gets the causal connection backwards—one of the many major blunders in New York City and elsewhere was to shut down all forms of elective medical treatments in order to make way for the wave of COVID-19 cases that never occurred. How many deaths did that decision yield? Surely a significant portion of these extra deaths are attributable to misguided public policies. This means that the net deaths attributable to the virus itself should be reduced, not increased, to properly account for the consequences of eliminating elective treatments and other hardships under New York’s lockdown.

Serious social consequences flow from the misattribution of deaths to COVID-19. In New York and other states, a common response to the artificially high death tolls has been to reimpose heavy sanctions in order to stem a second wave. But recently it appears that new cases are in decline. Nor has any second wave occurred in the northeast states that early experienced what still remains the highest incidence of deaths. In places like New York, the trend has been sharply downward, which should ideally lead to a general relaxation of heavy sanctions. Everyone should of course wear masks in indoor public spaces, wash hands, avoid placing their hands on their face when out, stay out of high-density places, get lots of fresh air, and, if ill, take the tripartite treatment of hydroxychloroquine, zinc, and azithromycin or doxycycline, as recommended by Dr. Harvey Risch, to the evident consternation of his colleagues in the Yale School of Public Health.

These various precautions significantly reduce COVID-19 costs, freeing up resources for other uses. Unfortunately, the same panicked responses that led to so much unnecessary suffering in the early stages of the pandemic continue to wreak havoc today. One prescription that seems to have gained favor is the demand for the wearing of masks in outdoor public places in order to slow down the spread of the virus. Democratic Presidential nominee Joe Biden insists that “[e]very single American should be wearing a mask when they’re outside for the next three months at a minimum,” claiming that this “will save 40,000 lives during that period.” In the same vein, the IHME claims that “if mask wearing in public increases to 95%, more than 66,000 lives could be saved,” which would cut fatalities in half.

Right now, masks are already worn in the places where they are likely to do the most good, where there is close and continuous contact between individuals, as in hair and nail salons. But is there any reason to think that wearing masks in public parks, where the contacts between individuals are fragmentary and fleeting at best, could produce dramatic results? It is worth asking about the trade-offs that come from the more widespread use of masks, as the Dutch government has recently done by citing the risks of wearing masks: First, masks offer people a false assurance of safety; even the best masks cannot filter out most viruses, especially when improperly worn; second, the reuse of dirty masks increases the likelihood of contamination; third, the inability to cleanly expel wastes may well reinfect persons with COVID-19 through the nose, throat, and eyes; and finally, the lack of fresh air can cause headaches and compromise the immune systems, especially for the elderly and ill who are most subject to the virus. The law of diminishing marginal returns applies to masks as it does to everything else.

Next there is the touchy subject of quarantines. Many states, including both New York and Illinois, have imposed travel restrictions on individuals that come from states with high numbers of daily coronavirus cases. The usual sanction is an order to self-quarantine for a two-week period. In New York, both Columbia and Barnard College have, as a result of the order, abandoned on-campus instruction, given that many of their students come from out-of-state. In Chicago, the order applies to any state that registers 15 new COVID cases per day per 100,000 people. The Chicago order, like all these orders, is flawed: It does not apply to people who come to Chicago from other hotspots within Illinois, but it does apply to people who come from specific areas within states that have low COVID counts. Moreover, the order fails to exempt individuals who have tested COVID-negative just before entering Chicago because these people “can develop symptoms and become contagious up to 14 days from their last exposure.” At the same time, it fails to acknowledge that sick people are less likely to travel, and the rate of transmission for asymptomatic individuals seems to be lower than that for symptomatic people.

Compliance with such orders effectively kills tourism, as well as a significant amount of business activity. Yet city officials in cities like New York and Chicago do not offer estimates of the potential harms that result from allowing free movement across state lines of people who test COVID-negative, nor do they give any sense of the expected losses, possibly in the millions of dollars, from their policies. In the effort to control COVID-19, we must remember that the dangers of over-deterrence have to be weighed against those of under-deterrence.

© 2020 by the Board of Trustees of Leland Stanford Junior University.

Published in Healthcare, Law
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  1. CarolJoy, Thread Hijacker Coolidge

    Part One:

    Any disease that exists would be able to bill itself as holding “epidemic” or “pandemic” status if the remedies for the ailment was withheld from the public. Why the public is not rising up and demanding the remedies be made available, I cannot fathom.

    I did read this sentence all the way through and will remark on its truth-i-ness:

    “According to the Institute for Health Metrics and Evaluation (IHME), the U.S. death toll of COVID-19 could reach 300,000 by December, at which point the ratio would be about 7.5 to 1.”

    Again, why aren’t the people who must have some intelligence to be working at such an institute not be spending their time insisting we in the public get the remedies!! Rather than getting into lengthy discussions about the Spanish flu?

    If my car didn’t work, and your car didn’t work, w/ people all across the nation saying their cars would not work, who would care about lengthy discussions of the history of automobile manufacture in the US, & the difference between current day automotive assembly & what occurred in the Ford Motor Car factories in 1918. I would want someone to make the 20 dollar fix available. Wouldn’t you?

    ####

    • #1
    • August 18, 2020, at 1:36 PM PDT
    • 2 likes
  2. CarolJoy, Thread Hijacker Coolidge

    Secondly, the COVID vaccine might be available to the public by October. It will more than likely end up being the type of vaccine that “sheds.” The dirty little secret about vaccines, which people discover only after they begin researching on their own after an injury, is that vaccines shed the very material that causes a “supposedly” mild version of the actual wild version of the disease that the vaccine exists to prevent.

    The vaccine that is supposed to prevent whooping cough actually sheds and then causes whooping cough. While whooping cough infections were dropping off the charts until the vaccine came about, once it came about, there were serious contagions of the disease cropping up across the United States.

    The measles vaccine inserted inside the MMR vaccine that was mandated in states back East in Spring and Summer of 2019 caused many instances of shedding. If the COVID vaccine does this, we could be in trouble.

    Also some researchers found out that the version of measles suffered by children from exposure to the shredded material were far more serious cases than the wild version of measles would have caused.

    It is also true that flu vaccines have existed for over 40 years, most of which still leave us with some 40,000 to 60,000 flu cases each and every year. Why the public should accept a rushed into development flu vaccine, which is expected to be unlike any other type of vaccine we have had before, no one can tell me.

    Remember the main proponent of the vaccine is none other than Bill Gates. This is a man who became notorious for his philosophy of how the best way to make money on computers was to see to it that computer viruses came about, so that newer “virus-resistant” versions of Windows could be sold.

    Recently Gates even let it slip during one interview that “‘this first pandemic’ would… blah blah blah,” without his even realizing what he was giving away as far as what our future holds when he made that slip. On that same interview or another one, he claimed that 2020 to 2030 would be the decade of vaccines.

    • #2
    • August 18, 2020, at 1:36 PM PDT
    • Like
    • This comment has been edited.
  3. The Reticulator Member

    CarolJoy, Above Top Secret (View Comment):
    Remember the main proponent of the vaccine is none other than Bill Gates.

    There are several companies working on vaccines. Are they all associated with Bill Gates?

    • #3
    • August 18, 2020, at 1:52 PM PDT
    • 2 likes
  4. Bruce Caward Thatcher
    Bruce CawardJoined in the first year of Ricochet Ricochet Charter Member

    Even if the masks do help when in close proximity to others, that doesn’t mean that insisting they be worn in more and more places will help more.

    If people wear life jackets while in boats and it is shown to save lives from drowning, you don’t save more lives by mandating that they also wear them while on shore, while in their homes, while in bed, etc.

    But of course politicians always know best, and, you know, “better safe than sorry”.

    • #4
    • August 19, 2020, at 6:31 AM PDT
    • 3 likes
  5. The Reticulator Member

    Bruce Caward (View Comment):

    Even if the masks do help when in close proximity to others, that doesn’t mean that insisting they be worn in more and more places will help more.

    If people wear life jackets while in boats and it is shown to save lives from drowning, you don’t save more lives by mandating that they also wear them while on shore, while in their homes, while in bed, etc.

    But of course politicians always know best, and, you know, “better safe than sorry”.

    Regulating is better than not regulating. Mandates are better than choice.

    • #5
    • August 19, 2020, at 10:07 AM PDT
    • 2 likes
  6. MISTER BITCOIN Member

    Bruce Caward (View Comment):

    Even if the masks do help when in close proximity to others, that doesn’t mean that insisting they be worn in more and more places will help more.

    If people wear life jackets while in boats and it is shown to save lives from drowning, you don’t save more lives by mandating that they also wear them while on shore, while in their homes, while in bed, etc.

    But of course politicians always know best, and, you know, “better safe than sorry”.

    great analogy

    also, I’m a terrible swimmer

     

    • #6
    • August 19, 2020, at 6:04 PM PDT
    • 2 likes
  7. CarolJoy, Thread Hijacker Coolidge

    The Reticulator (View Comment):

    CarolJoy, Above Top Secret (View Comment):
    Remember the main proponent of the vaccine is none other than Bill Gates.

    There are several companies working on vaccines. Are they all associated with Bill Gates?

    I’m hearing that Bloomberg and also Kushner are funding vaccines for COVID. I haven’t vetted that one way or the other.

    • #7
    • August 19, 2020, at 6:50 PM PDT
    • 1 like
  8. CarolJoy, Thread Hijacker Coolidge

    @thereticulator

    I just found some information I had not noticed before, inside one of my social media groups:

    NIAID’s parent department, HHS, has awarded $483 million to accelerate development of vaccine mRNA-1273, including “funding the development of mRNA-1273 to FDA licensure and manufacturing process scale-up to enable large-scale production in 2020 [before licensure is granted].” The U.S. Government has also already reached a $1.5 billion deal to purchase 100 million doses of mRNA-1273. HHS has even granted those developing and selling this product, including NIAID and Moderna, broad immunity from liability for injuries caused by this product.

    Dr. Fauci has been tirelessly promoting the mRNA-1273 vaccine that will potentially make individuals in his agency, NIAID, multi millionaires and will drive millions more dollars into his agency. It should not be permissible that the federal department responsible for testing and licensing a product would include individuals who stand to earn millions of dollars from selling that product. It creates conflicts of interest that can cloud the vision of the most clear-eyed individuals.

     

    • #8
    • August 19, 2020, at 8:24 PM PDT
    • 1 like