A contrarian view

Joseph here. In the preceding post, I questioned commonly-heard ideas about the coronavirus. That post seems to have pissed off nearly everyone.

Excellent! Still got it! Let us continue.

But before we do, allow me to quote a length a riposte from a medically-trained reader:

This at least twice as contagious as the Flu. For every person that gets the flu, they pass it on to another 1.1-0.9 people. The lowest number I have seen for cv is 2.1 and some estimates as high 3-5. The exponential growth of this is much higher than the seasonal flu.

Fatality rate is unknown, but almost certainly higher than the flu. The US doesn’t have enough beds or ICU beds compared to other nations. People compare us to nations like South Korea, Germany and Japan. They all have many more hospital beds 2-3 times more than US. We allegedly have more ICU beds, I seriously doubt it, I will expand later. All these numbers are based on hospital beds per 1,000 general population. I have studied Ebola, H1-N1, 1918 influenza outbreak. The number of cases of infection eventually peak, plateau, then end. The deaths from those infected are not know for days, weeks, months, years, and decades as our knowledge gets bettter. The mortality rate always goes up.

Here is an example. You have a small outbreak. The number shoots up to 20 infected cases, and keeps doubling every few days until it gets to 70. Then the growth slows and stops at 100 infected. 3 people are dead at this point. The news media reports a 3% mortality. However, there were still 12 people with in critical condition and 3 more die. The actual mortality rate was 6%. Now, imagine if those critical patients can get a bed, or ICU unit in time or at all. Then we have to triage. Only those with the best chance of survival get the needed care. That is why the mortality has spiked in Iran and Italy as the healthcare system is overwhelmed. The dreaded bugaboo of rationing creates actual death panels of frantic physicians and nurses make how to make the best of horrible situation.

Flu people have some immunization is built up over time. As well, we have vaccines that help slow the mortality and spread. Lastly, there is some herd immunity protection for vulnerable populations we don’t have for cv. Although, I have heard pneumonia vaccine does provide some protection in terms of helping people not get it while dealing with cv.

My response to this response: My reader has ignored the actual case fatality rates in countries other than China, Italy and Iran. The term "case fatality rate" is defined here. Basically, it's a simple equation -- so simple that even a math-phobe like yours truly can do it.

X = the number of people known to have a disease.

Y = the number of people who die from that disease.

First, divide Y by X. Then multiply by 100 -- that is, move the decimal a couple of places. Voila! That's your R.I.P. percentage. Your case fatality rate.

I'll show you how it works. Worldwide, at this writing, X = 137,674, while Y = 5080. So grab your calculator and divide 5080 by 137,674, then move the decimal point over two places. That gives us a 3.6 percent fatality rate.

Grim? Indeed it is.

But that figure is driven up by the rates in China, Italy and Iran, where -- for whatever reason -- the virus seems to have hit harder than it has elsewhere. In Germany, by contrast, there have been only six deaths and over three thousand verified cases, for a fatality rate of 0.19 percent, not that much worse than the death rate of the seasonal flu.

There's another point -- an important point that everyone seems to have missed.

All agree that testing has been poor. The tests are lengthy and expensive. Thus, only people who have presented serious symptoms have been tested. The actual number of people with the virus is certainly higher.

Here's the all-important thought that has yet to find a home in your cranium: If testing were more widespread, then the fatality rate would go way down.

Take another look at our equation. Figure Y is a hard number: Corpses are easy to count. Figure X is not a hard number, precisely because testing has been kind of a shambles. The people who have the disease are not easy to count.

Everyone agrees that if tests were cheap and more widely done, X would increase dramatically. A whole bunch of folks with relatively subtle symptoms -- or no symptoms -- would test positive for coronavirus.

Get it? Have you figured it out yet?

If X goes up, the fatality rate goes down.

Dramatically.

Let us posit that we suddenly have a test that costs ten cents to administer and takes ten minutes to complete. So everyone everywhere gets tested. The number of corornavirus cases worldwide would surely go up, right? It is hardly unreasonable to suggest that the number would double. Consider the fact that the symptoms (fever, cough) are subtle -- easily mistaken for normal cold/flu symptoms. Consider the fact that someone can carry the virus while not presenting any symptoms at all.

If we double X, guess what happens? The worldwide fatality rate comes way down to 1.8 percent. And that's including the much higher figures in China, Iran and Italy. Fauci has predicted that the final fatality rate will be around one percent.

That was basically the fatality rate aboard the Diamond Princess. In that unique situation, both X and Y are hard numbers. Note that the ship had 3,711 passengers total, out of which 696 caught the coronavirus; seven died. Thus, only 0.18 percent of the total number died.

Not everyone on the ship caught the bug. As our reader noted, "the number of cases of infection eventually peak, plateau, then end." The teevee talking heads have convinced the nation that coronavirus is an unstoppable force destined to engulf the world, not unlike the zombie apocalypse. But trends don't continue indefinitely; nature usually finds a way to apply the brakes. If it rained two inches yesterday, that doesn't mean dry land will disappear within a month. 

"But what about the need for all those extra hospital beds! Our health care system isn't built to withstand such an onslaught!"

As noted earlier, Germany's fatality rate isn't that much worse than what we would expect from a normal wave of influenza. Out health care system has dealt with seasonal influenza for many, many, many years. Most people don't get the flu in any given season, and most people do not go to the hospital for the flu. We deal with the flu by self-quarantining -- that is, we stay home and stay away from others while the bug runs its course.

Even if the coronavirus has ten times the fatality rate of a seasonal flu (in other words, a one percent case fatality rate), and even if affected individuals must recuperate for substantially longer periods of time, I see no reason to flood the hospitals with patients. Those not in high risk groups will stay home and deal with the fever and the cough. Only those known to be at high risk -- the elderly, basically -- should take extraordinary precautions.

All of this talk of "triage situations" is hyperbolic and silly.

If one good thing comes of the coronavirus, it's this: The current scare may force Americans to break the habit of going to work sick. Or, more accurately, employers will have to stop pressuring workers to go back to work before recovery is complete.

Over the past two days, panic has set in. Nobody is thinking straight -- and frankly, I'm terrified. This absurd over-reaction will prove more dangerous than the disease.

Due to privacy concerns, I'm not going to discuss how this particular household makes egg-and-cheese money, but it's fair to say that our situation is parlous, as is the case in many other American households. If the economy craters, if everyone continues to avoid public spaces, your humble narrator could be selling his computer to buy a tent. A man and a woman and a cat and a dog could all become homeless very soon. Seriously: Fucking homeless.

I'm not scared of the virus. I'm scared of that.

I'm also scared of a backlash against the Democratic party. If, weeks from now, catastrophe has engulfed the economy while the coronavirus death rate remains in the double digits -- or even the triple digits -- or even the low quadruple digits -- the average American is going to get pluperfectly pissed off. And that fury will not be directed at Donald Trump.

Yes, I am aware of what people are saying about Trump's absurd speech to the nation. He sounded precisely the wrong note, swinging wildly from his initial slap-happy underestimation of the problem to a wild, barbaric, hyper-nationalistic over-reaction. Only the rubes bought into his racist attempt to portray the virus as a kind of "yellow peril." The travel ban is just stupid. (Scandinavians are banned....? Why? What statistics justify that decision?)

Worse, Trump's delivery was truly bizarre. Either he has the virus himself, or the guy has been hitting the Sudafed again.

Conclusion: No matter what happens during the next few weeks, Trump will not receive cudos for his initial handling of the problem.

At the same time, the public could easily turn against liberals -- against the talking heads on MSNBC who, in their zeal to lambaste this administration, have rationalized hysteria. Fear of the virus, not the virus itself, could inflict economic misery on millions. Closing down Disneyland isn't funny to those who get their paychecks from the Mouse.

I'm not the only one in danger of sleeping rough.