Make up Your Mind

This week was the first time I’d seen a new bit of misinformation being bandied about. Evidently, some COVID deniers are now misusing data from a study conducted with data from Wuhan to support their claim that asymptomatic transmission of the virus is impossible. What makes this particularly odd is that these are the same people who a while ago were suggesting that the US is far closer to herd immunity than the published numbers would lead us to believe. I’m not sure where those other cases that would lead to herd immunity are supposed to be if we can’t spread the virus without knowing we have it; perhaps this group of deniers is jumping ship from the “herd immunity” camp to the “no virus” camp, but it remains unclear. What is clear is that they share with other anti-lockdown people a wish to get back to normal and outrage at government officials who make that more difficult.

A friend with whom I’ve had the most robust COVID-related debates is anti-lockdown, but she does not deny that the virus exists. In previous posts, I’ve shared some of the articles she’s sent me, which I think somewhat misrepresent the data but do not completely ignore the data. We are all doing cost-benefit analysis to some extent, and she believes we have done more harm to the mental health and economic prospects of people than the virus would have done unchecked. I don’t agree, although I think the response has been mishandled by most governments. We were not prepared, even though everyone knew that a pandemic was more or less a certainty at some point. The UK government still spends an inordinate amount of time on the back foot, making everything worse by vacillating and trying to be popular while controlling an out-of-control virus. They seem surprised by things that were predicted pretty much unanimously by the scientific community and they worsen the economic harm by trying to give people good news right up until the point at which they have to pull the rug out from under them. So, for example, schools were going to reopen after the Christmas break—until the day before they were due to open, when it was announced that they’d stay closed until February. Speaking of Christmas, pubs and restaurants were told they could take Christmas bookings, even though everyone knew that was a bad idea. Then, once they rehired furloughed staff and ordered perishable food, they were told, “Oops, you can’t open, sorry.” And that worst lie of all: “We’re following the science.” Well, when you had to at the eleventh hour, you followed the science, but the openings in the middle of a lockdown in the middle of a second wave were never following the science. But is my friend correct? Is this disease far less serious than the lockdowns and hand-wringing would suggest? What are the numbers of people already infected, many of whom don’t even know it?

So far, the United Kingdom has administered approximately 52 million tests and has a current positive test rate of 10.8%, but the rate has been as high as 30%. Now that number of tests would be almost the entire UK population of 67.6 million, but of course, people who test positive get a second test and there are probably people who’ve been tested 4 or 5 times or more because of their occupations or surroundings—and, of course, people who are tested only once because they receive a negative result and don’t retest.

This all makes it really difficult to know exactly how many people have been infected with the disease, but let’s look at what the UK numbers would have to be to make my friend’s suggestion that the disease has less than a 1% fatality rate true. According to Oxford’s Our World in Data, 74,682 people have died of COVID-19 in the UK. That means that 7.5 million people would have to have been infected with the virus so far for the mortality rate to be 1%. Our World in Data reports that there have been 2.61 million confirmed cases, but that ignores undetected or asymptomatic cases. The Office of National Statistics (ONS), which conducted a random study of households, estimates that as of December 7, 4.4 million people, or about 6.6% of the UK population, has had the disease. This number has, of course, increased over the Christmas holidays, but so have the number of deaths—at a current rate of 500 to 600 a day. So on December 7, there were 61,531 deaths out of an estimated 4.4 million infected people, for a fatality percentage of 1.4%. It’s alarming that there have been over 10,000 more deaths in a month, but so far, it seems that my friend is only about half a percentage point off in her estimate of the fatality rate. But that’s only part of the story. As of December 7, the total number of people admitted to hospital with COVID-19 was 233,394. (Here, the numbers are increasing even faster; as of January 4, that number is 262,668.) That is over 5% of the people infected.

Let’s compare these numbers with flu numbers, since that seems to be what a lot of the people opposed to lockdowns have done. The ONS reports that in the UK, each year from 2013 to 2019, a total of between 500 thousand and 550 thousand people a year died of all causes. Of these, between 25 and 30 thousand died of influenza and/or pneumonia. If we look at just the influenza numbers, this number decreases to 500-1000 deaths a year, but it’s likely that the pneumonia deaths in some cases were also influenza deaths, so I’m using the higher number. In a bad flu year in the UK, then, at most 30,000 people die of flu or pneumonia, compared to over 60,000 in nine months of COVID-19. If we look at the US for the same years, the CDC reports annual influenza case numbers of between 20 and 35 million and deaths between 23 and 51 thousand. That makes fatalities as a percentage of cases slightly lower than the COVID-19 rate, but not markedly so. The total deaths tell quite a different story. In a bad flu year, slightly more than 50,000 people in the US die of the flu. From March 1, 2020 to January 3, 2021, according to Our World in Data, 347,788 people in the US have died of COVID-19. ( Johns Hopkins puts it at 351,590.) Annualizing this 10-month number, we’d get over 417,000 deaths, or 8 times a bad flu year. And that’s still understating it, because if you look at the way deaths progressed, numbers were low for the first month.

In 2018 and 2019, the total number of deaths for all causes in the US held steady at approximately 2.8 million a year. COVID-19 deaths are running at about 15% of this total death figure.  That makes it right now the third leading cause of death in the US, slightly behind heart disease and cancer, and far ahead of every other cause. One last bit of data to think about. In both the US and the UK, the average age of people experiencing serious illness and death has decreased since the start of the pandemic. Of course, say some skeptics, that’s because there aren’t any old people left to die. But if that were the case, the death rates would be going down. Instead, the US is now experiencing the highest rates of death since the start of the pandemic, and the UK, which has a way to go to hit its all-time high in April, is still experiencing a dramatic increase in the number of deaths since the end of the first wave:

All this explains why I disagree with my friend who thinks the disease has been overblown and the lockdowns have been overdone, but she does have a rational point, and if there were no possibility of there ever being a vaccine, I might start to agree with her that the solution is worse than the problem. But the solution was always intended to be a temporary measure, to stop our healthcare systems from being overwhelmed while we figure out how to prevent and/or treat this virus. To a certain extent, the problem lies in different people’s interpretations of “temporary.” If we look back at the “Spanish” flu pandemic of 1918/1919, many of the measures we are now taking were in place then through two waves of the disease, so while I am as impatient as everyone else, I think it makes sense, seeing the hospitals bursting and the deaths mounting, to hold on for the next little bit of time while we vaccinate people.

I understand that there can be differing opinions on the balance between economic disaster and mental health crises on the one hand and keeping people out of the hospital on the other. I have less sympathy with my Facebook acquaintance who had been an advocate for herd immunity but is now sharing a much-discredited article in the (not scientific) journal Life Site News. The article misuses data from a study of households in Wuhan after the virus was brought under control to make the rather absurd claim that there is no such thing as asymptomatic transmission. The researchers who conducted the study have said the data were incorrectly used by the Life Site writers, but no matter—this specious claim has been disseminated on Twitter, Facebook, Reddit and other social media. We need go no further than the Trump White House to see that the claim makes no sense. The people who spread the virus there were not exhibiting symptoms when they came to work. We wouldn’t have a pandemic if people hadn’t spread the disease before they had symptoms—and some of those people, of course, never developed symptoms of any consequence, which is what drove the argument for herd immunity. You can’t have it both ways. Either enough people have the virus without being aware of it, meaning that there are a lot more cases than we know—or people cannot spread the virus without being sick, making it much less transmissible than we know. Or maybe, just maybe, the real epidemiologists and statisticians are right and we should trust their numbers. It seems obvious that the current UK rise in numbers has occurred at least in part due to asymptomatic (or mildly symptomatic) children in schools passing the virus on to family members.

You can see the appeal of the argument that transmission is actually much more controlled than we are being led to believe. If you haven’t personally experienced loss due to the virus, you desperately want to hear that you can get back to your normal life. My Facebook acquaintance is also an anti-vax anti-Big Pharma person and it seems she believes that Big Pharma is pushing their vaccines for their own advantage. Now I have plenty of problems with the pharmaceutical industry, but her conspiracy theory ignores the fact that AstraZeneca, at least, is delivering the vaccine at cost. There is, of course, money to be had from treatments, and the other pharmaceutical companies are not being quite so generous, but it strains credulity that manufacturing a pandemic is a good way to make profits.  

It also ignores the numbers. In under 10 months in the US, over 100 times the number of people who died in the Twin Towers have died. We have passed the number of American casualties in nine years in Vietnam. Yes, the tragedy of Vietnam is that the people who died were young, and most of the people who die from COVID-19 are the same baby boomers who fought in and protested that war. But they are not mostly people who “would have died in the next year anyway,” as one commentator put it. According to Oxford’s Our World in Data, by August 16, the US had 275,000 more deaths than the average over the preceding five years. 169,000 of these were directly attributable to COVID-19. The following chart is even more sobering. Yes, the over-85s are currently experiencing deaths at 16% above the normal rate, but the 65-74 group is more interesting. They are people who might still be out working. They aren’t young, but they weren’t at death’s door. They have been harder hit, percentage-wise, than the very old all the way through. In April, they were experiencing over twice as many deaths as the average over the previous five years and they are currently experiencing 26% more deaths than they experience in non-pandemic years. Going by life expectancy charts, these people could have expected to live between 14 and 24 more years.

The real danger of misinformation about how the virus is spread is that it encourages people to abandon just the sorts of minorly inconvenient practices that would limit transmission—right at the time when numbers are highest, the winter is young, and the vaccine promises light at the end of the tunnel. We see what happens when people ignore the advice. The UK—and parts of the US—were actually in pretty good shape in the summer. At that point, if we’d insisted on mask wearing and social distancing, we probably could have kept businesses open,  with some changes, and still kept the numbers low. But once the lockdowns were lifted in the UK, too many people thought it meant that the pandemic was over, despite the warnings from scientists. They crowded too much, refused to wear masks, and refused to follow advice, pushing the numbers up enough that when the second wave the experts had predicted actually started, we were in a worse place than we otherwise had to be. So now here we are—in a UK-wide 6-week lockdown. Thank heavens at least our scientists are brilliant. Their vaccines seem to be the only way to get back to normality as long as the disinformation purveyors continue their anti-science bias—and enough gullible people believe them.

Advertisement