We think our models of the world are more real than the world itself. That tendency is understandable since we can experiment with our simple models, while the real world is awash in complexity. We ignore what we don’t know. We shut down civilization because a model of the coronavirus said we were in danger. The facts matter, but we need more than facts and figures and the lastest models to feel safe again.
Are we at risk from COVID-19? Putting facts into perspective lets us see the relative size and distance of our concerns. We can compare the virus to other infections, to other risks we face, and compare the risks in our state versus other states. The first thing to notice is that we are not all the same.
We’ve long been told that diversity is our strength. That is true in the case of this pandemic because we can see that a few states contain almost all the deaths from Covid-19. Even that statement hides how concentrated the fatalities really are. New York state has the most COVID deaths. Even then, it is really New York City rather than upstate New York. Within the city, there are a few nursing homes that provided long-term care where the disease killed significant numbers. We see the unusual death toll in New York City because New York government demanded that patients discharged from the hospital with Covid-19 had to go to state-supported nursing homes to recover from the virus. COVID patients were sent to live with elderly people living in nursing homes even though the new patients were still contagious and shedding the virus. Other states did not do that, and that difference saved tens-of-thousands of lives across the country.
Before we can evaluate the danger of Covid-19, we have to ask if we will deliberately put old people into a dangerous setting. Decisions like that make over a 50-fold difference in the results. That isn’t a model, that is observation.
Covid-19 is now projected to kill about a hundred-and-thirty thousand people in the US this year. That sounds like a disaster, and it is about one-fifteenth of all the people we expect to die in the US this year from all causes. To put that projection into perspective, 130 thousand lives are about twice the number of people who died from the flu over the winter of 2017-2018. It is certainly worth our attention, but not the end of the world anymore than the flu was the end of the world two years ago.
We’ve seen diseases like Covid-19 before. SARS (Severe Acute Respiratory Syndrome) was also a coronavirus. We developed a vaccine for SARS over a decade ago, but SARS disappeared before the vaccine could begin clinical trials. We are again seeing similar behavior from Covid-19.
One well-established theory says that about 60 to 70 percent of us have to be immune to the flu before the disease dies out. One problem with that theory is that we haven’t all had Covid-19 and yet we’re seeing a sudden drop in new cases. Now that we’re six weeks past the peak, have we suddenly become that much more diligent at washing our hands?
We observe that about 17 percent of us may have been exposed to the virus, and yet it is dying out as if we already reached herd immunity. Those are the results from antibody tests taken across the country. One untested theory is that many of us, if not most of us, have a natural immunity to Covid-19. Our immune system, particularly our T-cells, remember similar coronaviruses even if we don’t have the antibodies for this year’s virus. That is only a theory, but epidemiologists are struggling to explain what is protecting many of us from getting the virus as the rate of new Covid-19 infections falls so fast. You might not have heard about that epidemiological puzzle because good news doesn’t sell newspapers.
Here in the USA, it looks like Covid-19 will kill about 4-people-in-ten-thousand. Some places have been much worse and some have been much better. No matter where we live, we want to take care of those who are at an elevated risk, but there are greater dangers out there.
Whether you find that comforting or troubling remains up to you.
- Covid Death Rates by State as of 25 May, 2020- RM