Notes On COVID-19

NOTE ONE addresses the current data and some possible issues in the data. This data changes day-to-day. I will try to update my comments from time-to-time.

NOTE TWO briefly addresses some of my preliminary views upon arguments against current measures: “quality of life” arguments, “alternative measures” arguments, and “conspiracy theories.” 

***I am in no way an expert. All the data used is from sources that can be easily found by the general public. I am open to correction and only offer this for thought. Since this is a novel situation and newer data is coming out daily, I may find need to adjust this blog as I see fit. 

NOTE ONE: The data

Seasonal Flu and H1N1

          Mortality Rate

We are well on our way to meeting and far surpassing  the death toll of an average year of seasonal flu (from a total of eight years, the average is approximately 38,000 US deaths per year), the current estimated deaths of COVID-19 in the US being around 60,00 by mid-May, which is better than first assumed and attributed to the measures we have now taken as a society. This is admittedly virtually the same number of deaths of the highest flu year estimates of the last decade ( approximately 61,000 in 2017/18), but the highest flu year was a) a huge outlier (surpassing the next closest year of 2014/15 by 10,000 deaths) and b) a year in which no social distancing or shelter orders were given nation wide. 

Moreover, it is fact that the US death toll for this virus has far exceeded that of the most intense 12 month period of H1N1 in the US. With minimal math, the CDC's reports average out as follows: The flu mortality rate is somewhere between 0.04% to 0.1%. As of writing this blog COVID-19 official numbers on mortality rate bear out to be around 4.5%. Even if testing is inadequate and many, many more sick persons should be added to lower this percentage, the actual death toll is evidence enough that we should not think of this as another common illness. Maybe one day it will be, but it is not at the moment. 

          Rate of Infection (R0) / Morbidity Rate

The difference of the rate-of-infection between seasonal flu and coronavirus is alarming. R0 is the rate at which the virus spreads from an infected person. Currently, the assumed rate of the coronavirus, with little or no prevention measures in place, is in the range of 2.0 to 2.5. Seasonal flu is assumed to be 1.3. Taking the low number for coronavirus, a difference of .4 seems negligible. That is only because humans do not often think clearly about exponential growth. 

Taking the fairly set R0 of 1.3 of seasonal flu and the low end R0 of 2 for coronavirus, we can demonstrate the exponential spread by raising both numbers by the 10th power, which would represent ten steps from patient 0. Taking seasonal flu R0 1.3 and raising it to the 10th power (1.3¹⁰) would mean that in 10 steps the virus would go from 1 person to around 14. Yet, for the coronavirus R0, 2¹⁰ would suggest that in 10 steps the virus would go from 1 person to 1024. 1,000 people in ten steps is a drastic difference. (If we go with the higher number of 2.5, the number of infections goes to approximately 9,500 in just ten steps)

Adjustments

The same data points can be added to other, less meaningful sets of data, to make all sorts of arguments, but what is certain, unless one just does not want to research, is that these deaths are real. While no sets of data are perfect, these numbers are cause to suggest we should be proactive in some serious ways, and to be outraged by flux in real time data is unreasonable. First, the flux may only be perceived. Second, the information is coming in daily from all fifty states, all gathering data from countless local sources. 

Being surprised, for example, that doctors give more than one cause of death (COD) is not a a sign of conspiracy. Doctors have always been able to give primary, secondary, and tertiary causes of death (for example, if someone under duress due to COVID-19 actually dies of a heart attack, both are listed as a COD). This is not a conspiracy, but a sign of many layman’s ignorance to proper medical procedures. Likewise, while some reports of “non-confirmed” COVID-19 deaths being added to the overall NYC COVID-19 death toll are concerning, this is not a large scale plot by the medical community trying to unduly worry the rest of the general public. These numbers will continue to be adjusted up and down over the coming weeks. 

If we are willing to admit that the rate of illness should be higher because of inadequate testing, we also must be willing to say the same for the rate of death. That is exactly what NYC medical and governmental officials have done. Comparing the expected mortality rate of NYC to the new projections, the new adjustments does not seems to be some extraordinary inflation of the numbers. The count is not including all who have died in this time period, but those who were listed as moist likely dying of the virus without a corresponding positive test. This means that people that were known to be exposed and high risk who died before tests were available are now being counted, as they should be.

NOTE TWO: Alternative Measures:

Now that we are moving towards a proposed phase program, the below will address the theoretical idea of whether or not we could have done this differently.

Quality of Life

First, let me admit, it is simply too narrow-minded to say that all those concerned with losses in our “way of life” are merely coldhearted and self-centered, unconcerned for actual life. We know, for example, that a good economy is one factor, although certainly not a sufficient factor, for quality of life. If quality of life goes down, it can impact our lives far into the future, which might better survive and thrive in a good economy. 

Even so, we are facing a real and present threat that must supersede theoretical projections. While I understand how one might wish to consider all factors beyond the immediate threat, hard and fast, even caviler declarations have arisen, which suggest our way of life always overrides actual lives. When the only argument is that more lives will be affected than will be lost, such assertions are cold and inhumane, lacking sacrificial quality. Loss of life is almost always more tragic than loss of quality of life. 

Christians should remember that quality of life issues are what are often used to combat pro-life arguments. If we are to be consistent, we must side with life over perceived future quality. When at an award ceremony this year an actress proudly suggested she chose to terminate the life of her unborn child so that she could attain the quality of life she had been pursuing, many Christians scoffed at how selfish this statement was, and rightfully so. Consistency might demand we not demand our desired quality of life, if it means it risks the loss of life. 

Epidemiological Ineffectiveness

There is the added belief that our government is making a mistake in its handling of the situation as it pertains to epidemiology. In other words, the measures are not only economically stressful, but medically ineffective. If what these people are saying is that, while the virus is serious, there are other measures we should be trying, I will only say that the burden of proof is on these naysayers. I am not an expert, and it surprises me how many people think they are. Only time will tell if our efforts are successful, and even then, we will never actually know if we practiced the most effective measures. Initial reports, however, do suggest we are tamping down the curve and lowering morbidity rates with our current efforts. The real question is, however, are we actually lowering the mortality rate or merely delaying it? I still think we have to try to act in some way. I will further elaborate below:

Conspiracies 

The mixed signals from leadership are not helping. That is for sure. However, neither are outrageous conspiracy theories posted online as alternate “perspectives” very helpful. That our nation is looking into whether or not this could be man-made is not the conspiracy I am speaking of, by the way. Instead, I find the idea that this was a state-planned, totalitarian effort by any body in our nation, to be quite outrageous. Laymen suggesting with absolute confidence that there are better ways is destabilizing enough. The numbers suggest we have to do something, but turning this into a hyper-politicized issue will only cause some to choose to respond with ideology and not with measured thought.

Adding to disunity by saying that this virus is not a real threat is absolutely nonsense, but, as is already evident, it is not beyond the scope of widespread acceptance from ideologues who do not know what confirmation bias is or care to find out. The facts show that this illness is serious. If it were just another, mere “flu-like” illness, I wonder how to then explain the increased use of mass graves in New York or bodies being piled in spare hospital rooms in Detroit. That is antidotal, I know, but the numbers in the above section are not. 

So, what do we do?

Unless one is an expert or, at very least, a very studied and practiced researcher, proffering alternatives based on the acceptance of conspiracy or hoax theories is simply oppositional and divisive. What numbers can be researched by everyone are the ones which concern rates of illness and mortality, and these numbers can be compared to influenza and like illnesses. If we had all the time in the world, we could explore the countless theories, but the best we can do now is look at the current facts and act decisively. Since most of us are not experts, it is probably best to listen to our officials and not fringe opinions. 

Conclusions

I will conclude by saying, as I have before, I am not certain our measures will prove ultimately successful. There are theories of resurgence and the like. I am not arguing our government is making the best decisions. If you know me, you know I am not a blind supporter of government. Yet, I do think we have to do something. I do hope that flattening the curve, while it might not reduce the number who will get sick, will give the medical community a) time to await the production of adequate supplies, b) a better head start on research for ongoing exposure, and c) the time needed to not find themselves overwhelmed all at once. 

Regardless, I am no expert. So, I will listen to experts and those in authority. I also want to go on the record to say that I am concerned that the government might end measures too soon. I do not think the government is infallible and that there is never cause to oppose their action. But, in a society such as ours, we do this by voting, not by disobedience that puts others’ lives at risk. 

I hope that this illness does not impact us as much as the numbers suggest they could. I hope that those who look at the alarms from the medical community and scoff will get what they want in terms of lower numbers than some are assuming. But, make no mistake. This illness, as the data given in this article has already shown, has already been worse. If no more deaths happen as of this moment, this disease has already matched the average loss of lives from seasonal flu, and that is with all the measures we have taken that are never taken to mitigate flu. Sadly, this will not be the last day of deaths, and we have to continue to take this illness seriously. This is not just an academic thought exercise that is up for debate. This is a life-and-death, and any caviler attitudes in the face of such are immoral.