If you're looking for attention, nothing works better than hyperbole. Donald Trump wasn't satisfied with a border wall. Nope, it was going to be the most beautiful wall that mankind had ever seen, and Mexico was going to pay for it. Or not. But you've got to admit, when he claimed that, everyone noticed.
Yesterday, Dr. Jeremy Samuel Faust of Harvard Medical School and Dr. Carlos del Rio of Emergy University saw his border wall and raised him one Coronavirus whopper. In a viewpoint article, they published in the prestigious Journal of the American Medical Association, Drs. Faust and Rio assert that those who see a relative equivalence between mortality rates for COVID-19 and for Influenza are, effectively, morons.
The crux of their argument is that the CDC numbers for the flu from past seasons are based on a murky mix of deaths that are attributed to influenza at the time of death, and posthoc analysis carried out much later. The differences between the raw counts and the posthoc revisions have typically been in the range of a 4-7x increase. In contrast, they argue, coronavirus deaths are currently all direct count and are likely to be re-evaluated much higher once the posthoc analyses are done.
Based on this analysis, the doctors assert that the number of counted COVID-19 deaths for the week ending April 21, 2020, was 10-40x higher than the average number of deaths from Influenza for the past seven years. Look closely: not 10-40%. 10-40x. According to their assertion, if the flu is a machine gun, coronavirus is an atomic bomb.
As they say, that's their money shot right there. That's the quote guaranteed to power a million retweets.
And if you believe it, we truly have a catastrophe brewing. And all the nay-sayers are wrong.
But let's analyze this a bit.
First off, there's Sweden. Sweden trusted in their people and let life go on. If any society was going to be taking a long walk off a short pier, it would be Sweden. But in Sweden, life is continuing, the mortality rate is de-accelerating, and their mortality rate as of May 20 was 0.034% (34 in 100,000 residents). Hmmm...That's not 10-40x higher than an average year of Influenza.
Next, the infinite money tree (also known as federal stimulus acts 1-99) created the CARES act, which increases the Medicare payout for COVID-19 by 20% over baseline--with additional fees if the patient winds up on a ventilator. In other words, there is an incentive for all hospital admissions to be classified as COVID-19. This is not to say that every broken arm is now being coded as COVID-19, but it does mean that if the symptoms might fit, you go ahead and code it. And doctors have indicated they feel pressure to code deaths as due to COVID-19, even if a patient clearly dies from some other, unrelated ailment. So, the direct COVID-19 numbers may well be significantly skewed upward in a way that direct Influenza numbers are not (because no one is paying extra for Influenza patients).
Finally, there's an assumption here that there's going to be a significant scale-up in coronavirus numbers once the CDC does their magic posthoc analysis. But really? Do you know anyone who gets the flu and rushes to the hospital in a normal year? Neither do I. The people who wind up in the hospital for the flu are those who are really really sick and are often nearing death. Some people who should have gone to the hospital don't, and they die at home, and the CDC presumably has to account for them later. The average person's response to getting the flu is "this sucks and I feel like crap and why did I cheap out on the toilet paper?" For coronavirus? The paranoia runs so deep that as soon as someone develops a fever and a cough, they're running to the hospital. It's unlikely there are any people at all just sitting at home hoping to ride the coronavirus out. If the CDC is being honest (and, let's face it, this is a government CYA bureaucracy, so the chances of that are probably slim and none), then I am guessing that the posthoc scale up from the time that everyone became paranoid will be close to 1-2x, not 4-7x.
As a result, I think it's about as likely that the coronavirus is 10-40x more lethal than Influenza as it is that the next budget Mexico announces will include a line item for the border wall, and that they will hereby christen the wall thusly:
Yesterday, Dr. Jeremy Samuel Faust of Harvard Medical School and Dr. Carlos del Rio of Emergy University saw his border wall and raised him one Coronavirus whopper. In a viewpoint article, they published in the prestigious Journal of the American Medical Association, Drs. Faust and Rio assert that those who see a relative equivalence between mortality rates for COVID-19 and for Influenza are, effectively, morons.The crux of their argument is that the CDC numbers for the flu from past seasons are based on a murky mix of deaths that are attributed to influenza at the time of death, and posthoc analysis carried out much later. The differences between the raw counts and the posthoc revisions have typically been in the range of a 4-7x increase. In contrast, they argue, coronavirus deaths are currently all direct count and are likely to be re-evaluated much higher once the posthoc analyses are done.
Based on this analysis, the doctors assert that the number of counted COVID-19 deaths for the week ending April 21, 2020, was 10-40x higher than the average number of deaths from Influenza for the past seven years. Look closely: not 10-40%. 10-40x. According to their assertion, if the flu is a machine gun, coronavirus is an atomic bomb.
As they say, that's their money shot right there. That's the quote guaranteed to power a million retweets.
And if you believe it, we truly have a catastrophe brewing. And all the nay-sayers are wrong.
But let's analyze this a bit.
First off, there's Sweden. Sweden trusted in their people and let life go on. If any society was going to be taking a long walk off a short pier, it would be Sweden. But in Sweden, life is continuing, the mortality rate is de-accelerating, and their mortality rate as of May 20 was 0.034% (34 in 100,000 residents). Hmmm...That's not 10-40x higher than an average year of Influenza.
Next, the infinite money tree (also known as federal stimulus acts 1-99) created the CARES act, which increases the Medicare payout for COVID-19 by 20% over baseline--with additional fees if the patient winds up on a ventilator. In other words, there is an incentive for all hospital admissions to be classified as COVID-19. This is not to say that every broken arm is now being coded as COVID-19, but it does mean that if the symptoms might fit, you go ahead and code it. And doctors have indicated they feel pressure to code deaths as due to COVID-19, even if a patient clearly dies from some other, unrelated ailment. So, the direct COVID-19 numbers may well be significantly skewed upward in a way that direct Influenza numbers are not (because no one is paying extra for Influenza patients).Finally, there's an assumption here that there's going to be a significant scale-up in coronavirus numbers once the CDC does their magic posthoc analysis. But really? Do you know anyone who gets the flu and rushes to the hospital in a normal year? Neither do I. The people who wind up in the hospital for the flu are those who are really really sick and are often nearing death. Some people who should have gone to the hospital don't, and they die at home, and the CDC presumably has to account for them later. The average person's response to getting the flu is "this sucks and I feel like crap and why did I cheap out on the toilet paper?" For coronavirus? The paranoia runs so deep that as soon as someone develops a fever and a cough, they're running to the hospital. It's unlikely there are any people at all just sitting at home hoping to ride the coronavirus out. If the CDC is being honest (and, let's face it, this is a government CYA bureaucracy, so the chances of that are probably slim and none), then I am guessing that the posthoc scale up from the time that everyone became paranoid will be close to 1-2x, not 4-7x.
As a result, I think it's about as likely that the coronavirus is 10-40x more lethal than Influenza as it is that the next budget Mexico announces will include a line item for the border wall, and that they will hereby christen the wall thusly:
It's time for scientists to get back to the business of science, and to leave the poorly founded dime-store prognostication to others.
"A great wall constructed for the incredible Donald Trump"
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Keep on topic!