Coronavirus

Regarding the editorial “COVID-19: What if math is wrong?” (March 24):

This is a very misleading article. First, it is not true that we are relying on Centers for Disease Control data from the United States to get a picture of the death rates. This is a pandemic, and we have data from around the world.

We can compare trend lines from various countries based on levels of intervention. Our trend line is much more like Italy than Japan or South Korea. We have much less testing and targeted intervention than Italy so far. If you want a model of virtually no intervention, look at Iran.

But let’s take the data from the cruise ship as a model. If we assume that the disease “washes through” without intervention, it would affect about 70% of the population. At 1.1%, that is about 3 million deaths. The idea that a 1.1% rate is just like the seasonal flu is absurd. It is 10 times greater.

But looking at death rates is looking at the wrong statistic. The alarming statistics concern hospitalization rates. Those have held constant across the world at 15% to 20%. You cannot have a functioning hospital system or economy if 20% of your population needs to be hospitalized at the same time. That is why you need to “flatten the curve.” If you slow the rate of growth, people will enter the hospitals at different times, allowing them to continue operation.

We have plenty of data, and statistically competent consumers can grasp the implications of the numbers we are provided daily. The math is clear. You just have to understand how to use it.

Dr. Larry W. Chappell
Professor of Political Science
Mississippi Valley State University

Editor’s note: We appreciate the feedback of Dr. Chappell and anyone else to the editorials and columns we publish.

During this time of anxiety about the coronavirus pandemic, though, it’s important to be precise on the data and the scope of the problem — as well as to accurately portray the arguments being made.

The Diamond Princess cruise ship, to which we and Dr. Chappell refer, had 20% of its passengers and crew test positive for the coronavirus, and this was a situation in which, by all accounts, containment of the illness was bungled. Even still, that is nowhere close to a doomsday projection of a 70% infection rate.

As far as the hospitalization rate, according to the CDC, 12% of those in the United States who tested positive through March 16 have required hospitalization, not 15% to 20%. It should be emphasized, too, that this 12% doesn’t take into account those who show little or no symptoms because they are not being tested.

For the sake of argument, even if we extrapolate from these two inflated numbers — 20% infection rate, 12% hospitalization rate — that means 2.4% of the U.S. population would be hospitalized at some point from the disease, not 20% all at one time.

As for the mortality rate, if 1.1% of those infected die, true that would be about 10 times the rate of the seasonal flu. But the point made by the Stanford University professor cited in our editorial is that the mortality rate could be as low as 0.05%, which is half that of the flu. There is simply not enough good data yet to know where in that range the mortality rate will end up being, but the extreme measures being taken so far and the panic being fanned are based on either worst-case scenarios or faulty assumptions.

(1) comment

larchap

Editorial Staff,

Thanks for the response. It is important to have calm, reasoned dialogue in this crisis & no one has a God's-eye view on what is happening. I agree that precision is important, but it is not possible to be fully precise about numbers that are a moving target.

Just a couple of clarifications. I used the numbers from the cruise ship for the sake of argument, not because I believe that we can extrapolate from them. A cruise ship is not an experiment and we have no way of knowing if the small sample is representative of a population under the pressure of a growing epidemic. You are absolutely correct that we don't know the true numbers because we are in the early stages of the pandemic in this country. We cannot, however, extrapolate from anecdotal evidence. We have to rely on unstable population data and whatever controlled experiments we can conduct. That is the way epidemiology works.

The 12% estimate is consistent with what we have seen so far in New York. It may or may not hold when we hit the peak.It has been higher in other countries. It will be important to look at the Louisiana figures, where the Mardi Gras induced curve appears much sharper & the effects. potentially much more severe. Even 12% will overrun our hospitals.

The 70% number is a standard "wash through" estimate.That means that 70% are likely to be infected if the virus is allowed to move through the population without restraint. Iran looks like a wash-through case. That is not happening here precisely because we have social distancing policies to slow its movements. The issue now is whether to tighten or loosen those restraints.

Governor Cuomo made the right point this morning. We can't keep the economy on lock-down forever, but we can't simply endorse a business as usual response. The key is to have a testing regime that we currently don't have. Until we can find out who is infected and have a targeted quarantine policy, we can't simply encourage everyone to move about freely. We don't know for sure, but young people who have been infected have probably developed immunity. They should be able to go back to work more quickly than others. The main point is this: The decisions about public health need to be made based on data we don't have.

What we are doing now is risk assessment under conditions of uncertainty. That is what we do all the time because we lack omniscience. In doing risk assessment, you can't just ask: "What if the math is wrong?" You also have to ask" "What if it is right?" Then you have to decide which set of consequences are the best option. The data we have indicates that any option carries terrible consequences for public health and the economy. I don't think any data support the idea that the public health threat is not mammoth.

Thank you for allowing for disparate voices in the community.

Dr. Larry W. Chappell, Professor of Political Science

Mississippi Valley State University

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