Issues & Insights

Some Much-Needed Coronavirus Perspective

I&I Editorial

Like just about everyone else in the country, we are sitting in our homes under orders from our state governments, with little to do but follow coronavirus statistics. And they look fearsome.

There are almost 140,000 active cases of COVID-19 in the United States. Nearly 20,000 new cases were reported on Sunday alone. The death toll in the U.S. is now close to 3,000 — with more than 2,000 of them occurring in just the past week.

National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci said on Sunday that the death toll could reach 200,000. Another model says 82,000 will likely die, with daily deaths peaking in mid-April at more than 2,000. By comparison, the last pandemic — the so-called swine flu — claimed 18,000 lives.

Over the weekend, President Donald Trump said he’s extending the federal government’s “social distancing” guidelines through April. In Virginia, Gov. Ralph Northam announced a “stay at home” order through June 10. School systems are starting to consider whether they will even be able to open in the fall.

It’s unprecedented, to be sure. But the problem with all the numbers being bandied about is that they lack any context.

On its own, 3,000 fatalities might seem like a tremendously large number. But that’s before you learn that an average of 7,700 people die in the U.S. every single day. Which means that over the past week, when the coronavirus took 2,000 lives, nearly 54,000 people died from other causes.

As a service to readers, here are recent annual deaths from other causes, many of which go largely unnoticed year by year, but most of which are preventable. (The data are compiled from the National Center for Health Statistics, the National Safety Council, and other sources.)

  • 1,900: strep throat
  • 3,000: food poisoning
  • 5,000: choking
  • 6,946: accidental hanging
  • 7,450: pedestrians hit by a car
  • 7,740: obesity
  • 12,316: pregnancy-related
  • 20,108: inflammation resulting from food or liquids getting into the lungs
  • 35,000: antibiotic-resistant bacteria
  • 35,823: alcohol-induced deaths
  • 36,336: falls
  • 40,922: blood poisoning resulting from bacteria
  • 47,173: suicide
  • 55,672: flu and pneumonia
  • 64,795: accidental poisoning
  • 83,564: diabetes
  • 121,404: Alzheimer’s
  • 160,201: chronic lower respiratory disease
  • 169,936: all accidental deaths
  • 250,000: medical errors
  • 599,108: cancer
  • 647,457: heart disease

Then there are all the scary stories about hospitalizations and how the health care system will be overwhelmed. Here, too, there’s no context.

According to the American Hospital Association, there were more than 36 million hospital admissions in 2018. So, on an average day, hospitals across the country admit more than 98,000 patients.

In that year, there were 139 million emergency room visits. That’s more than 380,000 a day.

Of course, a local area can be overwhelmed by a sudden influx of patients needing hospital care. But it will take a lot more than the predicted course of the coronavirus outbreak to overwhelm a health care system that successfully deals in volumes like this on a daily basis.

There’s another bit of context to consider when it comes to how the country responds to this outbreak. The focus has been almost entirely on how to save lives by limiting exposure to the coronavirus.

But every one of these actions will have second-order effects. Some good. Some bad. The highway death toll will no doubt drop sharply during the months the economy is shut down. Workplace fatalities will decline as workers are sidelined. No children will die walking to school.

There’s the other side of the coin to consider, though. Stress, for example, is known to be major factor in six of the leading causes of death in the country. Work-related stress alone is believed to cause 120,000 deaths each year. As people see their savings disappear, their businesses shutter, their lives turned upside down, stress will increase phenomenally. And that will ultimately lead to more stress-related deaths.

Depending on how deadly the coronavirus actually turns out to be — and at the moment we have no idea — the cure could truly be worse than the disease.

Let’s be clear, we are not suggesting that the coronavirus isn’t a serious threat, requiring extraordinary measures. And we understand that deaths due to a lifetime of bad health habits are different from a death sentence that people can pass on to each other.

But in any situation, context matters. Unfortunately, that’s the one thing missing from the 24/7 coverage of the coronavirus pandemic.

— Written by the I&I Editorial Board

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  • Here’s what the numbers mean. The coronavirus is wreaking much more havoc in American than in countries that have competent leaders. Our cases per million people: 500, our death rate per million citizens: 10. The relevant numbers for S. Korea: 191 and 3, Singapore:150 & 0.5 and Taiwan: 13 & 0.2, These three countries have governments that function as they should. These countries engaged in early, widespread testing, contact tracing of infected patients with quarantine of exposed persons, appropriate social distancing, and testing and/or quarantine of all people arriving from other countries regardless of citizenship. By the way, because these 3 countries jumped on the problem immediately and thoroughly, none of them have had to bring their economies to a halt.
    What our numbers mean is that we botched our response and now we pay with unneeded loss of life and a deeply wounded economy.

    • BobSmith, Now look at China and Italy and tell me who is competent. To use such culturally different examples as Taiwan, Singapore and South Korea is bogus. The culture in those countries have always been compliant to the state. The culture in this country is the state complies with the citizens. At least that is the idea.
      When should Trump have banned travel from China. January 15 when WHO was stating the Wuhan flu was not transmitted human to human? Would it not have been racist then. When swine flu depleted the supply of surgical masks
      was in incompetent leadership in Obama/Biden to not replenish the supply?

      • So being able to test people and track their contacts is a cultural competence and Americans are capable of competence? By the way, China has a fraction of the cases per million and a fraction of the deaths per million people that we have. And now, way late in the game, we are following the Chinese playbook – shut down the economy. Again, if we started testing early and widely, and tracked contacts of infected people, we wouldn’t have to shut down everything. S. Korea tested 200,000 people by the time we tested 1,000. How is that competence related to their culture?

      • bob is trusting the CCP numbers for an “accurate” comparison. they just admitted today that they “undercounted” their results.

    • March 31, 2020

      US cases per million: 500 (five hundred per million). Deaths per million: 10 (ten per million).

      Germany cases per million: 814. Deaths per million: 8.

      France cases per million: 683. Deaths per million: 46.

      United Kingdom: cases per million: 370. Deaths per million: 26.

      Italy cases per million: 1,683. Deaths per million: 192.

      Spain cases per million: 2,019. Deaths per million: 177.

      Netherlands cases per million: 753. Deaths: 61.

      The AP reports three nations, Italy, France and Spain, are not keeping track of coronavirus deaths in nursing homes, leading to an under count in those nation’s handling of the virus.

      • But Trump is claiming that he is “10” in his response. So why are you comparing us to other countries that didn’t have the best responses. If we are 10, then we should have the best responses, equal to or better than Singapore, S. Korea, Taiwan and even China – cases per million 52, deaths per million 2.

      • Germany is correctly reporting deaths based on underlying conditions. Any flu will kill people who are at death’s door.

    • And you actually believe the #’s of WHO and So.Korea and China?
      And for you to inject the word ‘competent’ when referring to the USA is not helpful. I’m not Trump idolater, but the governors of the most affected states had a greater responsibility in it’s initial stages and they dithered mightily. Further, to ‘cast stones’ now is an antithesis to what we need as Americans. Americans are reacting appropriately, given our system of liberty and freedom. China and So Korea are not as worried about public opinion and human rights. They act swiftly and decisively, let the public be damned. Maybe we should take some lessons in retrospect. As some others have said, locally and nationally, the cure could easily become worse than the sickness, but lets (for now) stay focused on America and getting through the disease.

    • every single country in the west except Sweden is doing what the USA is doing

      • They may be seeing if benign neglect will correct their previous immigration errors….

    • Bob – you have cherry-picked a very small set of countries with far smaller populations, differing cultural practices and long experience in dealing with infectious diseases coming out of China. If, instead, you used a population-matched cohort of Western European nations, the reality is that the U.S. has experienced less than 1 death for every 9 experienced by this cohort. That is, we have done far *better* than these nations. The comparison is also much more germane to our case: nearly identical population total (for statistical power), similar cultural practices, similar technology base, Liberal Democracies, etc.

      Your attempt to smear the administration is, really, rather transparent and partisan.

      • It is not cherry picking. These are countries with limited borders, but we only two, Mexico and Canada. If your argument is that we have much more travel, that is 100% correct. But we also have way more resources as well. China has locked down the entire country. All foreign travel has been restricted to people on essential business and Chinese returning. And all people coming into China,regardless of reason or citizenship, must spend 14 days in quarantine. Many other countries have been doing this for sometime including countries as diverse as Thailand and and Australia. We still have implemented this rule. My comparisons are not a smear. We have failed, miserably. The Trump administration bungled the testing, (it is still not fixed weeks after Trump said anyone who needed a test could get one), it bungled getting the supplies we need, it bungled and continues to bungle how we handle travelers arriving from other countries. We don’t have a mandatory quarantine program. Hell, we aren’t even taking every traveler’s temperature. We now have more deaths than China and twice as many cases. It is utter incompetence that with 1/4th China’s population we have these results. And based on Trump’s own words today, they are going to get much, much worse. If his predictions come true we will have the highest infection rate and the most deaths per million population of any country with at least 1,000,000. This is not a smear, It is a reality.

    • That’s quite the bit of dishonest cherry picking Bob. Singapore and Taiwan are islands and South Korea may as well be since the border to the north is a locked down DMZ. There are relatively few ports of entry compared to the US and far fewer travelers arriving every day than either the US or Europe.

      A more honest comparison would be the rest of the developed world. Based on cases per million people we are doing much better than Germany, France, Switzerland, Norway, Belgium, Austria, Netherlands. Spain and Italy as well as several others. In fact we are doing better both in cases per million and deaths per million than the European Union as a whole. The EU also has far more deaths from COVID-19; about 7 times as many as the US.

      • Really, the virus came here with people driving or walking to America? What joke. It came here, just like it got to the those island countries, by people flying. It from China (which is a hell of lot closer to your islands than America is) Italy, Egypt, Germany, the UK. etc. etc. etc.

    • At least South Korea has been preparing for this for many years, expecting something like this from North Korea. Don’t know about Singapore and Taiwan. Cdc was assuring everybody they had it covered, and didn’t. I have been running numbers daily and feel like the U.S. is currently doing quite well. Seattle area has slowed considerably and now is in fifth place for deaths. Once the epicenter. Europe is losing thousands every day. This,too, shall pass.

      • Trump does’t share your optimism. He is telling us to prepare for numbers that will dwarf those in Europe. We are adding more cases everyday than the day before. In fact, there only 6 other countries in the world that have more cases than we are adding in one day. And administration officials are saying the peak is two weeks away. They are preparing us for 500,000 to 1 million cases.

    • sorry, bob, china is faking it’s numbers. and the virus came from their level four bio lab, whether accidentally or on purpose. and remember, the health advisers to our president are leftovers from the last administration. he has to deal with faulty comparative data and a bunch of foot dragging drama queens in the cdc.

      • I have a lot of contacts in China, and even though I don’t speak the language, have a good picture of what is going on there. Life in the vast majority of the country is rapidly returning to normal. What is happening on the ground doesn’t support the idea that China is faking the numbers. If you had evidence they are, I would love to see it. As for foot dragging CDC people then Trump should have fired them or gone around them. He has done that with every other agency. It is his responsibility to do at the CDC if they are not performing. But one has to ask, how is it that CDC, which created millions of tests in just weeks after discovering the H1N1 in 2009 couldn’t do now. And if the CDC couldn’t produce the tests, why didn’t we use the German test or the S. Korean test or the test from a host of other countries.

      • Trump said Jan. 22nd we have the virus under control. Jan. 30, very well under control, Feb. 23 & 24, very much under control, Feb. 26, we have 15 and …going down to close to zero. Feb. 27. its going to disappear. March 7. N I am not concerned at all. (Yes, who cares if thousands of us die.) Finally, on March 18 Trump tweets – I always treated the Chinese Virus very seriously. His words, including the State of the Union, were just empty nonsense. He still doesn’t have it under control, it hasn’t just magically gone away, and he should have taken it very seriously in Jan.

    • And your comment demonstrates the need for this type of reporting. Your post is eminating from emotions, political perspective/opinion, and a “find something/someone to blame” human tendency. For God’s sake, Look at the Facts they cite about how many lives lost every year by other causes, and explain why this event is cause to shut down the entire country? All you’re doing is revealing your worldview, dissatisfaction and lack of respect for our country. If you feel so strongly about how poorly the US and this administration is dealing with this, go live in South Korea or one of the other countries you listed, otherwise stop adding to the numbers of loudmouth whiners. We have enough of them already.

  • the first failure of the medical profession was to claim this could kill anyone … when in fact it kills a very specific group of people … if we just lock down and protect that targeted group the rest of us can go on with life and business … instead we locked down everyone else as well …

    • So the young people working in the old folk home bring to work and kill most of the nursing residents like the Washington state nursing home and that’s okay. By the way, what country has successfully followed that route and done well.? You might say but the workers have to be isolated, but they need to buy groceries. They live with friends, spouses, other family. Okay, so all of those people should be isolated. You can see where this is going. Short of creating special housing for all the risk people and asking all the people who take care of them to also isolate themselves, it won’t work. By the way, we have a very large number of obese people of all ages. And this virus is real threat to them as well. We are in fact more than 20% of the population.

      • I have family in Japan. I speak with them daily. They are wearing masks, practicing social distancing to a certain degree. There economy is functioning. Restaurants, and importantly, bars are open. Life is going on. They are baffled at our approach of killing our economy. Two long standing local restaurant chains in my area just announced they are closing down. Forever. They went bust. Out are 120 long term employees. There will be more. The cure cannot be worse than the disease unless we truly are that dumb.

      • no moron … they don’t infect the seniors … are you really that stupid ?

    • A significant number of young fatalities are emerging as well. This disease infects massive numbers of people quickly. The aged and infirm at extremely high risk, but the idea that it is a minor infection in young people is just wrong. The balance between productivity and quasi-quarantine has been met by precious few nations. China reports of doing so are CCP boilerplate garbage. Even the CCP, with their command of the population and no discernible compassion is still trying to halt their epidemic. This disease takes the young too.

  • Perspective is that as of yesterday 99.9996% of Americans do not have the virus & if the current totals doubled every 3 days til the expected peak still 74% of the population would not have the virus.

    • and you know that 99.996% of the population doesn’t have the virus how? We can’t even test all the people with symptoms let alone the many many more who don’t have symptoms. But lets assume that only 25% of the population gets the virus – that’s 80 million people. Lets also assume the death rate is not 3.4% as WHO suggested, but .66% as the latest paper has suggested. That is still 528,000 deaths, which would make it the largest single cause of death this year, by far. And if the 3.4% number is valid? Then we would be talking about nearly 3 million deaths, way more than all the wars combined that we have fought. By the way, 528,000 would be a death toll only exceeded by our Civil War.

    • To Lackawaxen123 – So for the morons in the crowd – no, people working in the nursing homes don’t intentionally infect the residents, but if the country is not locked down and everyone is going about their business, some of the people working in the homes become carriers of the virus. Thus residents become infected. That is how people at the 1st home in Washington got infected and that is how my wife’s mother became infected. Workers, just going about their daily lives got infected somewhere away from work, but brought to work in the nursing homes with them. Is it really that hard to understand?

  • Context: “Accidental hangings 6946” correct number 6945, Epstein didn’t hang himself.

  • Or look at the cases of the two cruise ships, the Diamond Princess and the Grand Princess, where 4,881 people were around infected persons in a small area for at least several days. Fewer than 20% of those people caught the virus, and only 10 of them died from it. 10 of 4,881 people is a overall death rate of 0.205%, or well below 1%. The crude fatality rate was 1.21% (10 deaths/831 cases).

    • So 700,000 deaths (0.205% of US population of 340 million) is acceptable to you?

      • cancer kills ove 600,000 a year… heart disease is beyond that. so, corona virus will POSSIBLY kill 700,000 this year, that total will be a one off event. those figures I quoted are every year. are you ok with that?

      • In 2008, about 2,500,000 people died in the US.

        Current estimates are 80,000 to 220,000 will die from corona virus. Not a good thing, but not a complete disaster. Plus many of the virus victims will be older and suffering from “co-morbidities”, i.e. at death’s door already.

        All in all, the effect of corona virus might be about the same as when we increased the speed limit up to a sane number from the 55 mph it once was. Maybe 2 or 3 years of this.

  • How about murder? Chicago? No numbers for that bet it is pretty high.

  • bravo, sirs! great perspective, flu deaths (really 18/19 are pneumonia not flu) have amounted to between 10,000 to 60,000 annually since 2010 with no curfew imposed. it is disappointing that progress from clinical trials of CURES is not given the same coverage as those suffering. i for one want full details of numbers, duration and demographics of those being tested. i shudder when i think of those in the control groups of such tests that die as those being treated recover.

  • You spend an entire article pointing out that the coronavirus isn’t a serious threat, requiring extraordinary measures, then in your penultimate paragraph state that it is. That’s confusing.

  • One disease not on this list is Hepatitis.
    Which is a virus and contagious.

  • “On its own, 3,000 fatalities might seem like a tremendously large number. But that’s before you learn that an average of 7,700 people die in the U.S. every single day.”

    That argument doesn’t work, it seems to me, because the 7,700 per day is already baked into the cake of civilization. The Wuhan flu numbers are new.

    Imagine if, since America’s first Wuhan flu death on February 29th (just 4 1/2 weeks ago), we lost 3,000 Americans in plane crashes, 5 crashes each week, or a total of 20 plane crashes with 150 people in each plane.

    Would we be so sanguine about the fact that more than twice that number of people die in the US every single day? Or would we take steps to stop 5 planes from crashing each week, perhaps even grounding the fleet until some answers were known?

  • Indeed. The 2017 CDC mortality number was over 2.8 million from all causes, and of those over 2 million were 65+. The vast majority of the 2.8 million were from chronic medical issues.

    While it may seem unsympathetic, why has no one asked what the projected overlap of those who die from corona complications and those who would have died from other medical causes is? I expect that after the smoke clears the overlap will be significant – or in other words, the total number of deaths (particularly in the 65+ group) will not be significantly larger this year than last year.

    This is also providing a full scale exercising of the pandemic response system, fortunately with a disease of a relatively low mortality rate. The defects that have been discovered in the planning and operations execution will stand us in good stead if we ever have to do it again.

  • To put your 7700 deaths per day in context: At the rate that the virus death toll is increasing, in 2 weeks, we’ll have 20000-30000 deaths per day from just the virus. Whether the extrapolation is valid is another matter. The feds seem to think it is.

  • The highest numbers in there – heart disease, cancer, flu, lower respiratory, Alzheimers and diabetes – must certainly have a lot of overlap with Covid. Probably medical error too, since the senior population gets medically treated more than anyone else. I’ve wondered if Covid is taking a bunch of people who were due anyway. If you graphed just the 60+ would it look different than other years?

    However I wanted to point out that occupational hazard deaths are unlikely to go down because those people are all the ones doing the essential work. If anything they may go up.

  • I’ve been hearing this “keep it in perspective” crap for a week, but it doesn’t matter for one simple reason: People don’t risk getting cancer if they hang with cancer patients. Same for socializing with auto accident victims and people with strep. Etc. Your stats are nothing more than a reminder that life can be fragile. Fun party talk.
    Screw perspective. What Americans NEED is a loud chorus of “leaders” explaining exactly how we’re not going to lose our way of life.

    • Exactly. We need answers. We can’t spend the rest of our lives in doors. No one is even trying to give any assurance or prepping for us to go back out into the world. Are we supposed to stay in our homes for a year or even maybe even two?

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