daily covid

I enjoyed my Covid news holiday, but here we go again.  My current thoughts:

1.) When all this started, the WHO was saying COVID had a 3.7% death rate.  That is scary.  Very scary.  Given that number and all the uncertainty, I think it was appropriate for the country to shut down.  We could have been facing millions of deaths.

2.) The CDC’s “best estimate” of the fatality rate of Covid for the US is 0.4% for symptomatic cases. (I will have to do some research to figure out what percent of cases they think are symptomatic.) Source.  In my opinion, it is not appropriate to shut down the country for a disease with a 0.4% fatality rate.  The CDC’s estimate of the flu fatality rate is 0.1%.  So, current best estimate is 4x worse than the flu.  Note that the uncertainty is 0.2% to 1.0%.  For the best estimate, fatality rates by age are:

  • 0-49: 0.05%
  • 50-64: 0.2%
  • 65+: 1.3%

3.) Let’s assume 30% of the country contracts Covid with a 0.4% fatality rate.  This is pessimistic since the fatality rate applies only to symptomatic cases, and some unknown percent are asymptomatic.  We would be looking at 360,000 deaths.  That’s obviously a lot.  But consider deaths from various sources in 2017 (last year I found data):

  • Heart disease: 647,000
  • Cancer: 600,000
  • Other diseases in the top 10: 615,000
  • Accidents and suicide: 217,000
  • Total deaths: 2.8 million

I guess I think a 10% bump in deaths in a year is a terrible tragedy but again, not an acceptable reason to shut down the country.

4.) Smoking causes 480,000 deaths annually in the US, including 41,000 deaths caused by secondhand smoke.  16 MILLION americans live with disease caused by smoking.  Yet, we don’t ban smoking.  But we’re willing to ban people leaving their houses and working and going to school, which will save fewer lives (given current data)?

Again, I think shutting down was appropriate for a disease with a 3 or 4% death rate.  I also support an emphasis on PPE (masks) and unemployment protections for the vulnerable.  But its time for the shutdown to end.

Finally, I continue to think that if things go well, we’ll have a widely available vaccine in a year.  Not sooner.  Furthermore, I think the likelihood of that happening is only about 50%.  It’s quite likely there will be a vaccine which is ineffective for the elderly or just ineffective in general.  Or not safe.  When the polio vaccine was initially tested on 10,000 children, it provided no protection against the disease and nine children died.  Many more were paralyzed.  Why?  Because there was a huge rush to try and prevent this horrible disease (polio).  There is obviously huge risk that excessive rushing could result in similar tragedy with Covid.  So I think we need to be very careful about assuming this is all “temporary” and we can just stay home for six more months and then be rewarded for our patience.

Can I spend a few more days not checking Covid news?  Maybe.

4 thoughts on “daily covid

  1. Becca

    I’ve definitely been following the news on the fatality rate. I find this article interesting:
    https://www.nature.com/articles/d41586-020-01738-2

    Says right now studies are converging on a 0.5-1% fatality rate, but it also explains how much uncertainty there was in the early days of the virus.

    I agree with you generally, for fatality rates less than maybe 0.5%, it might mean that this type of extreme shut down might not make sense – though you have to also consider virulence not just fatality rate. 0.5% of the whole country is very different than 0.5% of the 10% of the country that gets infected (I think depending on the year, 10-30% of people get the flu, for instance). You can also target areas (like elderly communities) for protection or take more aggressive measures for those communities. I don’t think its fair to make comparisons to things like smoking, heart disease, etc. which aren’t contagious. With contagious diseases, one person “reopening” is forcing another person to accept the risk that it causes. This is the worst for people in the service industry who will be forced to come back to work or be destitute (once the enhanced unemployment runs out), regardless of their personal risk factors (such as living in a multigenerational home) — so yeah, like you say, you would need employment protections too.

    I am personally really concerned about child care shutting down – every study, since the start, has showed children have almost no risk and there’s serious consequences to the lack of childcare both to the children’s development and the parent’s ability to earn a living (I mean there are concerns with exposures harming caregivers though) . Yet, many of the young families I know with young children have holed themselves in their house like a fortress specifically out of worry for their children’s health (literally have heard “I would hate myself if I didn’t make this sacrifice to protect them”).

    I also agree, we shouldn’t treat this like its temporary and I am angry that it has become so politicized you can only think one thing without the other. I for one can handle both thoughts in my head at the same time.

  2. admin Post author

    “I am personally really concerned about child care shutting down – every study, since the start, has showed children have almost no risk and there’s serious consequences to the lack of childcare both to the children’s development and the parent’s ability to earn a living (I mean there are concerns with exposures harming caregivers though) .”

    Where I live, it is currently forbidden to hire a nanny (and to use daycare) unless you are “essential”. Needless to say, this makes it impossible for me to work with a seven month old. Some studies have shown high risk for children under one, so I wouldn’t put my baby in daycare right now, but I’d be comfortable with a nanny. I do think current policies will drive many women in particular out of the workforce permanently.

    I think comparisons to other diseases are fair because we as Americans live with those risks, which far exceed the risk of Covid. If we are OK with living with those risks, we should be OK with comparable risks. I do think it’s important to impose restrictions on workers at nursing homes and to really focus on protecting the vulnerable. I also think it’s obviously important to ensure hospitals are not overwhelmed, or the death rate will rise not only from Covid but from all illnesses.

    Unemployment protections need to extend to those sharing a household with someone in the highly vulnerable category. Alternatively, the state could help fund alternative housing for people who want to work but cannot due to sharing housing with grandparents, etc.

  3. becca

    Yeah, different considerations for babies.

    Its about to get worse – au pairs are the only child care helping people get by here, since they live in the household and don’t bring in any additional risk, and Trump is not allowing new au pair visas until January, and since they turn over once every two years, lots of families are going to suddenly find themselves without child care.

    In my office a huge number of people are barely functioning because of child care obligations (in both genders — our office has lots of secondary income earners).

    I read this earlier – its a small sample group, but passing from child to adult seems pretty rare, so that was encouraging:

    https://www.npr.org/2020/06/24/882316641/what-parents-can-learn-from-child-care-centers-that-stayed-open-during-lockdowns

  4. admin Post author

    Hey Becca – just read this from NC:

    https://people.com/health/n-c-reports-covid-19-clusters-at-daycares-as-parents-and-providers-weigh-options-amid-pandemic/

    Not encouraging.

    I wish there was more data on spread from contact tracing. Of cases where source of contagion was identified, what percent is indoors vs. outdoors? Restaurants vs. hair dressers vs. bars vs. parks, etc., etc.

    Like playgrounds are still closed here, but restaurants are open. Are playgrounds really more dangerous than restaurants? I’ve seen articles on which behaviors are *thought* to be higher risk, but I haven’t seen data. Show me the data!

    Interesting piece on transmission in a bar:
    https://people.com/health/health-care-worker-15-friends-get-coronavirus-florida-bar/

    Perhaps, just maybe, going out and getting drunk wasn’t the way to start going out after social distancing! I would guess it doesn’t get higher risk than bars. Anyway, she and her 15 friends can socialize away now.

Comments are closed.