When you write a post that goes viral in which you say things like “I crave knowing when I’m wrong” and if I’ve said something that’s false, “TELL ME” … well, people tell you. And since the majority of what I had to say that night was not hopeful, a few people gave me some hopeful news. It’s time to share! Ready? Let’s go!
First COVID 19 Death
On Wednesday we saw fresh reporting that the first deaths in the US were actually further in the past than we originally knew. It’s rarely good news when you add to the death toll on a pandemic, but this time it is. The timeline stretched from seven weeks to ten. This has implications to pandemic models… they use the first death as the starting point, so if it took 40% longer to get to where we are today, that’s changes the shape of the curve.
This news is pretty much everywhere, but here’s a link to one of them.
When I posted on this topic, the information I shared was based on what we knew at the time. And that information was wrong.
Age DOES Matter
My thinking on Sunday was age was not as important as underlying health issues. Today I think it’s more important. This thing CAN kill you at any age, but for those of you younger than 45, it looks better than we thought initially. Based on NYC data (two days old), the mortality rate curve is dramatically skewed to the elderly. I’ll repeat what I’ve been saying all along… calculating mortality rates during an outbreak is an exercise in futility… but this DOES paint a picture. In NYC, 18-44 year olds known to have contracted COVID 19 are experiencing a mortality rate of 0.8%, giving you a 1/121 chance of succumbing to the illness. Compare that to 65-74 year olds, and we get 14.3% mortality, or a 1/7 chance of succumbing.
That’s NOT what I was saying on Sunday. This is real, actionable data. When we know more about who is most at risk, it makes sense to use different precautions based on actual risk factors.
That said… the underlying risk factor argument still holds water.I wish the CDC had an updated version of this chart, but it’s also compelling.
I made my assertion based on what I knew at the time. Thanks both data maturing over time and me being made aware of some things I could have known at the time, I can safely give myself a grade of “It’s Complicated.” I am much more hopeful on this front than I was a week ago.
I still think that just because COVID 19 is “not in my back yard” you can’t go party like it’s 2019. It wasn’t in my back yard, until it was. That said, I must acknowledge that the community you live in, its risk factors, and how present the disease is, must all come into play as we develop our strategies for “returning to normal.” My thinking continues to evolve here.
This was never an argument I was making. Like most of you, I am very concerned about not just how the shelter in place is impacting us individually, but the economy as a whole. The US economy works, in particular, because we believe it does. Consumer confidence gets people buying things. So does having a job. We have a job loss in my house… I’m feeling it.
It’s worse for people in abusive relationships, bad living conditions, those with mental illness, etc.
We need to find a safe way out of this mess as quickly as humanly possible.
The worst statistic
People are still dying at alarming rates. If it’s true that the United States has entered a period of negative growth (I’ve seen it asserted and refuted in the last 24 hours), it hasn’t shown up in the fatality data. Yesterday there were 3,179 confirmed deaths from COVID 19 in the United States. We’re averaging nearly 2,000 dead per day in April here in the United States.
And yes, I know that many people die from other things. But that’s 1,950 people a day with the country on lock down. Say what you will about ANY of these other, more hopeful data, and it doesn’t change that we’re on pace to lose 60k Americans this month to a disease that didn’t even exist here at the beginning of the year.
Another point of view
Ok – here’s someone else’s voice. I respect and value this man’s opinion. I think you’ll see why when you continue reading. You could easily spend several hours going through all the links and source data he provided. This is my kind of response! Take a read, and see if it doesn’t influence you’re thinking.
Some things about me before starting is background is in Operations Research (not as heavy on statistics but includes modelling and simulation, gaming and game theory) and National Resourcing Strategies. In application in the military, one of my usual tasks was to present the other side of any issue to provide insights. For example, if your position was the glass is half full, I will present the position of the glass is half empty, because all too often accepting any one truth or statistic or metric as the only truth results in deception and bad decisions.
In that vein, the opening of “hard core quarantined” and also thinks this whole COVID 19 thing is being blown out of proportion. Already we have a disconnect, right?
Not necessarily a disconnect.
The state by state (and DC and Puerto Rico) data table fills up a few pages if you paste it, but from the bottom of this link are the data sources: Data Sources: WHO, CDC, ECDC, NHC, DXY, JHU, RCP | Population: U.S. Census | Seasonal Flu 1: CDC 2008–2018 10-Year Avg
Agree that total deaths in the United States as a whole for COVID 19 have passed the 10 year average of total deaths in the United States for an average seasonal flu outbreak. That said, peeling the onion back one level reveals only 8 states and DC have more COVID than flu deaths as of midnight 20-21 April.
This is the IHME model results for 17 April (the last known run I know of) that have been used to update the public. Similar to the previous data set, it can be run at the national level as well as being parsed to each individual state. Anything that changes by a factor of 10 or more catches my attention. The model has been pretty good with New York, estimating ~16,000 deaths in 1 April and up to ~22,000 deaths on the current 17 April run, as well as Michigan, estimating ~3000 deaths on 1 April and currently ~3300. But it has had some order of magnitude changes too: Tennessee ~5000 down to ~250; North Carolina ~2500 to ~250.
This is the latest posted data from CDC on annual deaths. Including because glass half empty is usually looking at only COVID or COVID and flu data, while the glass half full view is to look at all deaths and acknowledging COVID will be an addition to the data this year as the other deaths will not magically stop because the COVID virus is here, and in theory the “Do no harm” regarding health is still being applied equally to any and all individuals in the United States. Given current data and projections, COVID will not even make it into the top 5 causes of death based on raw numbers. It will probably surpass #7 (Diabetes at ~85K, but it will be interesting to see how CDC bins those who passed away with the preexisting condition diabetes as well as testing positive for COVID 19), but unlikely to catch #1 Heart Disease ~650K or #2 Cancer~600K, especially with the following concerning trends:
Many U.S. hospitals and health systems have suspended elective procedures to save capacity, supplies and staff to treat COVID-19 patients. Especially in areas that have not been hit as hard as New York, Detroit and New Orleans, hospitals outside these areas have too much excess capacity.
This is the data for my home state. I include as it shows the number of cases by county. My Congressional District stretches from Montgomery County (2768 cases) to Garrett County (4 cases).
I also follow PA and OH as our parents (all in there 70’s or 80’s) with preexisting conditions live, and to compare and contrast what data is, and is not, shared with the public.
So the conclusion is where you sit probably heavily influences where you stand, and in some instances it is fair to believe that it appears portions of the COVID 19 threat have been blown out of proportion.
Probably too long as most folks do not read more than a page, but including the data links tends to make the one page goal challenging. I also fully support the following from your closing: We had a good conversation about COVID 19. They didn’t convince me of anything, and I didn’t convince them… but we were respectful, and said our piece, and kept it moving. No need to be disagreeable just because we disagree about something. My addition would be even if two or more people agree, there is benefit in bursting the bubble in order to acknowledge that there is another side to every coin.
One final thought for consideration:
I have friends who are health care providers, social workers and law enforcement professionals who work with all forms of domestic violence, and based on the data (the above is just one dataset), state wide stay at home orders are negatively impacting the health of those who do experience emotional, physical and/or sexual domestic abuse in these homes. For all those advocating for quarantines of 12-18 months, have any of those advocates attempted to address the negative health impacts on these individuals?