As the Trump administration tries to figure out when to reopen the economy, and Democrats try to blame President Donald Trump for every coronavirus death, there’s another question lurking in the background. What if we learn that trillions of dollars in economic costs from the coronavirus shutdown bought us little or nothing in terms of public health?
As the disease progresses and our understanding of it increases, that possibility grows.
Consider these facts:
Death projections were wildly exaggerated. On March 16, epidemiologists at Imperial College London predicted that 2.2 million could die here if the country didn’t impose draconian lock-down orders. Even with those in place, it said, the deaths would likely top 1 million.
The White House later downgraded the death toll, but still predicted that as many as 200,000 could die. In late March, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington released a model that projected more than 80,000 deaths, assuming the U.S. maintained its lockdown, which prompted the Trump administration to extend the shutdown through April.
But within a week, that projection dropped to a little more than 60,000, as actual deaths started to come in much lower than expected. In the past week alone, the death toll has been 2,267 lower than the model initially forecast. That puts coronavirus deaths more in line with deaths attributed to a bad flu season.
Reports of overwhelmed health care were exaggerated. There was a steady stream of warnings that the coronavirus would overwhelm the U.S. health system.
When the IHME made its initial forecast in March, for example, it predicted that the disease would cause a shortage of 64,000 hospital beds. Now, it says the bed shortages are almost non-existent. It said daily hospital admissions would hit a peak of over 19,000. Now they say the peak will be 36% lower.
Death counts are likely inflated. Centers for Disease Control guidelines say that even “where a definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID–19 on a death certificate as ‘probable’ or ‘presumed’.” On Tuesday, New York added more than 3,700 people who hadn’t tested positive for the virus but were presumed to have it.
Dr. Deborah Birx, coordinator of the White House Coronavirus Task Force, said during an April 7 press conference: “If someone dies with COVID-19, we are counting that as a COVID-19 death.”
How has this affected the death tally? Nobody knows yet, but one would think that applying such loose definitions would inflate the number of deaths attributed to coronavirus.
The death rate is magnitudes lower than it appears. When the WHO said that the death rate from coronavirus was around 3%, it sent shock waves around the world. The flu, which kills about 40,000 Americans every year, has a death rate of 0.1%. In the U.S., 3.9% of those with confirmed cases of coronavirus have died, according to Worldometer’s tracking site.
But “confirmed cases” are mostly those who’ve had symptoms severe enough to get tested. Those with mild or no symptoms wouldn’t qualify.
What matters in determining how the deadliness of a disease, however, is how many in total were actually infected, and the only way to know that is to test for coronavirus antibodies.
Dr. Jay Bhattacharya, professor of medicine at Stanford University told NPR that: “To date, most people that have been trying to calculate death rate have tried to guess how many people have been infected. We don’t know how many people total have actually been infected.”
When Germany tested 80% of the population in one district for coronavirus antibodies, it found that vast numbers had been infected and didn’t know it. As a result, the actual fatality rate in that district was less than 0.4%.
Bhattacharya is conducting a similar test in Santa Clara County, California. In early April, the World Health Organization announced plans to conduct such a test.
Meanwhile, another study tracked influenza-like illness and suggests that some 28 million got the disease, which would put the death rate at 0.1% – right where the flu is.
In a Wall Street Journal op-ed, Bhattacharya said that “projections of the death toll could plausibly be orders of magnitude too high.”
There are clear at-risk groups. As with the flu, it’s often not the disease itself that causes death, but how it affects patients with other underlying symptoms. The Imperial College London found that the death rate is almost 10 times higher than average for those over 80. An analysis of 44,000 cases from China found that deaths were at least five times more common among those with diabetes, high blood pressure or heart or breathing problems.
A study of more than 4,000 patients in New York City found that obesity was the single biggest factor, after age, in whether those with COVID-19 had to be admitted to a hospital.
It’s not entirely clear how well isolation works. At the moment, the lockdowns are credited for keeping the death toll far lower than it would have been. But we still don’t know how effective these shutdowns actually have been.
Sweden has been in the news lately because, unlike almost every other country, it isn’t enforcing a strict lockdown. While the country postponed major public events, it’s taken a “low-scale” approach.
“Most places are open. Some places have reduced hours. Few places have closed. High schools and universities all are closed or working on remotely. But normal, like, elementary schools and middle schools are all open,” Sanna Bjorling, a reporter at the Swedish newspaper Dagens Nyheter, told NPR this week.
As the Los Angeles Times reports: “Crowds swarm Stockholm’s waterfront, with some people sipping cocktails in the sun. In much of the world, this sort of gathering would be frowned upon or even banned.”
Sweden’s somewhat more lackadaisical approach is coming under attack as the country’s death toll tops 1,000. But look at the numbers on a per capita basis and Sweden is doing about as good or even better than some of its lockdown counterparts. It has fewer confirmed cases than neighboring Norway and essentially the same as Denmark. It has fewer deaths per capita than countries such as the United Kingdom, Switzerland, Italy and France.
Ventilators might be causing deaths. Time magazine reported last week that doctors are starting to move away from the use of ventilators because of a growing concern that ventilators themselves might be contributing to the deaths of coronavirus patients.
“Some hospitals have reported unusually high death rates for coronavirus patients on ventilators,” Time notes, “and some doctors worry that the machines could be harming certain patients.”
“Generally speaking, 40% to 50% of patients with severe respiratory distress die while on ventilators, experts say. But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.”
We are the first to admit that, because this coronavirus is new and early signs about its lethality were worrisome, extra precaution was warranted as coronavirus spread. But not everyone was hitting the panic button, it’s just that voices of calm were ignored. If it turns out that the risks were far less dire, and the disease far more manageable without draconian restrictions, how will the public react? Who will they blame for needlessly crashing the economy?
We know who Democrats will blame, of course. But if the evidence shows that massive shutdowns weren’t needed, there must be a reckoning. And it should start with the public health “experts” who brought them about.
– Written by the I&I Editorial Board