FROM “An Epidemic of Irrationality,” by C. Griffin Trotter MD, PhD :

Today (March 27, 2020) is kind of a landmark day. The front-page headline in the Seattle Times screams “U.S. has most virus cases: With 1,000-plus deaths, more grim milestones ahead.” But the real milestone is that the stark irrationality of our public response to COVID-19 has become manifest as never before. Today the Times has three front-page articles featuring three radically incompatible claims.

The first article makes the same old claim that has been featured on the front page every day for the last month. It is the claim that Coronavirus is a nearly unprecedented medical catastrophe, destined for “grim milestones” of almost unthinkable proportion.

The second article correctly claims that it is very difficult for patients to get tested for Coronavirus. The policy in Washington state is still to test only sick patients. In fact, even sick patients are still often turned away if they are not sick enough, as several examples cited in this article document.

The third article reports that the death toll from Coronavirus, according to a model from University of Washington’s Institute for Health Metrics and Evaluation, could reach 1,430 by July (at which time the model estimates the seasonal epidemic will be over).

Do these three articles hold together logically? Not even close. Washington’s population of 7.5 million persons makes up about 2.5% of the population of the United States. Even in the extremely unlikely event that every other state eventually gets hit as hard as Washington, the death rate referenced in the third article would translate to 57,000 deaths nationwide. That is substantially less than the death toll from influenza in 2017-18, which the media almost entirely ignored. So if the third article is correct, then the first article is radically incorrect. If the third article is correct, then this is not an unprecedented catastrophe, and in fact it will not even be as bad, mortality wise, as a bad flu season.

But the real contradiction comes when we look at the second article – the one that is quite certainly correct. Currently only sick patients are being tested in Washington state, and throughout most U.S. locations where the virus has flared up significantly. That means that people who are infected with Coronavirus but who have only mild illness, or no illness, or for whatever other reason haven’t presented for testing, are not being counted. Since we know with certainty that a sizable proportion of people contracting the virus suffer only mild symptoms or no symptoms, we know that there are a massive number of people who have the virus but who are not being counted in the statistics. Though the media touts their statistics as charting the spread of Coronavirus, what they are really charting is the spread of positive tests. This gives us NO INFORMATION about the actual spread of the virus. To know that, we’d have to do a cross-sectional study, where every single person in a specific population is tested. That hasn’t been done.

If Coronavirus has spread much more widely than what is reported in terms of positive tests, which is absolutely certainly the case, then two important conclusions follow.

First, the fatality rate for persons with the virus is much less than what is being reported. In fact, if we used the same method for computing the fatality rate for persons with the influenza virus that authorities widely quoted in the news media are using to compute the fatality rate for coronavirus, it would yield a death rate of 8.4% for persons infected by influenza. To repeat: the death rate in the United States this flu season, as documented by the CDC and available on their website, among persons with a positive test for influenza, is 8.4%. The death rate for persons in the U.S. with positive tests for coronavirus (the last time I checked, about a week ago), is 1.3%, also documented on the CDC website. But of course we know with certainty that neither of these rates are reflective of the actual death rates in the population at large. Both of these estimates radically exceed the actual fatality rate, because for both influenza and coronavirus, the vast majority of infected people have not been tested. Much is still uncertain about the COVID-19 epidemic, but one thing we can say is that the mortality rate has thus far been vastly overestimated. Coronavirus appears to be at worst slightly more deadly than influenza, and possibly a lot less deadly.

Second, the possible benefits from hardcore social distancing regulations, such as in Washington state where even fishing has been criminalized, are rapidly receding. At some point the damages – including not merely economic damages, but health effects related to increasing barriers to access, increased suicide and mental health disorders, etc. – caused by the social distancing regulations will offset any advantages achieved in decreasing COVID-19 mortality. In my opinion, we’ve already reached that point. If many or most people have already been exposed to the virus in hot spots such as King County, then hardcore social distancing is unlikely to make much of a difference. It is more likely to make an impact in places that have not yet had much exposure – places like Wyoming and Idaho, where, paradoxically, social distancing measures haven’t caught on very widely.

These considerations refute the first article – the one that touts the COVID-19 epidemic as medically catastrophic on a nearly unprecedented scale. The only thing that has approached catastrophic proportions, so far, has been the economic and personal fallout from our reaction to the epidemic.

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