“We know the numerator, but not the denominator.”
— Leading medical researcher, name withheld, discussing the statistical effect of the coronavirus 2019
One of the most difficult problems in assessing the current coronavirus 2019 (hereinafter COVID-19) pandemic is sorting through the conflicting expert opinions and the evolving statistical data that have — with an enormous assist by the mainstream media — plunged our nation into a state of panic and paralysis. How did we get here? And just how serious is the threat posed by COVID-19?
I’m neither a doctor nor an epidemiologist. But as a prosecutor and trial lawyer, I have spent decades in courtrooms cross-examining highly credentialed and well-compensated expert witnesses and deconstructing their statistical analyses and scientific theories. Moreover, having litigated numerous medical malpractice cases, not only have I interrogated and worked with medical experts, but I have also become friends with a number of intelligent and thoughtful health-care professionals, some of whom have kindly shared with me their insights regarding the current pandemic. Their insights and my basic arithmetic skills and historical analysis form the basis of what you are about to read.
But before we jump into the heart of the discussion, I commend to you the wise words of the celebrated Dr. Drew Pinsky regarding the media’s execrable coverage of the pandemic. Speaking with host Larry O’Connor on the Washington Examiner’s “Examining Politics” podcast, Dr. Pinsky said, “I don’t claim to know what’s motivating the media, but, my God, their reporting is absolutely reprehensible. They should be ashamed of themselves. They are creating a panic that is far worse than the viral outbreak. The bottom line, everybody, is to listen to Dr. Anthony Fauci [Director of the National Institute of Allergy and Infectious Diseases]. Do what he tells you, and go about your business.… Stop listening to journalists! They don’t know what they are talking about!”
Strong words, but Dr. Pinsky doesn’t go far enough.
As you may know, the mainstream news media are staffed by agenda-driven progressive propagandists who have seized on the pandemic as yet another opportunity to bring about the political and societal change that they desire. Not wanting to let a crisis go to waste, they have engaged in an unrelenting drumbeat of doom and gloom regarding the potential impact of COVID-19. In this regard and as you shall see, the facts are far less dire than the panic-inducing apocalyptic scenario being pushed by the mainstream media.
So, putting aside the hype and looking at the facts, how do we go about assessing the challenge posed by the COVID-19 pandemic? A good first step is to put it into the historical context of similar outbreaks. What did we learn from those pandemics, and how does COVID-19 compare?
Let’s start with the 1918 Spanish influenza, which far and away has been the most severe and devastating pandemic of the last 100-plus years.
According to the CDC, in 1918, the H1N1 virus infected an estimated 500 million people, who comprised one-third of the world’s population. The estimated number of deaths was 50 million worldwide, including approximately 675,000 in the United States.
In America, the initial outbreak of the Spanish flu occurred among soldiers at Fort Riley, Kansas. The victims were fit and vigorous young men who rapidly deteriorated following the first onset of symptoms. There are accounts of young soldiers reporting for morning sick call with sore throats or general malaise and being dead by nightfall. The killing mechanism was the fierce and debilitating response of the young patients’ strong immune systems to the viral infection.
As the disease spread, mortality was highest in persons who were aged zero to 5 years, 20 to 40 years, and 65 or older.
There was no vaccine. The control efforts consisted of quarantine, good personal hygiene, use of disinfectants, and limitations on public gatherings. These proved to be of limited value, and, by the time the pandemic had run its course, it had lowered the average life expectancy in the United States by more than 12 years. In short, the Spanish flu had been catastrophic.
Time is of the essence. And that is why President Trump’s farsighted decision in late January to ban travel from China has proven to be so important.
Since then, there have been other epidemics and pandemics in the United States. For example, in April 2009, a novel influenza A (H1N1) virus emerged in the United States and quickly spread across the world. Over the following year in the United States, according to estimates by the CDC, there were between 43.3 to 89.3 million “swine flu” cases among people of all ages, between 195,086 to 402,719 hospitalizations, and between 8,836 to 18,306 deaths. It is estimated that worldwide, 700 million to 1.4 billion people contracted swine flu, with about 150,000 to 575,000 fatalities.
Every year since then, influenza A has circulated seasonally in the United States and, according to CDC estimates, from 2009 to 2018 caused “at least” 100.5 million illnesses, 936,000 hospitalizations, and 75,000 deaths.
Moreover, the CDC estimates that, in the United States from October 1, 2019, through March 7, 2020, influenza A has caused between 36 million and 51 million illnesses, resulting in 17 million to 24 million doctors’ visits; 370,000 to 670,000 hospitalizations; and 22,000 to 55,000 deaths.
Now compare and contrast those numbers with the COVID-19 statistics compiled by the World Health Organization. As of March 15, 2020, there are globally 153,517 confirmed cases and 5,735 deaths. Of these, there are 81,408 confirmed cases and 3,204 deaths in China. According to the CDC, as of March 17, 2020, there were a total of 4,226 confirmed cases in the United States and total deaths of 75.
Unlike influenza A, which has sickened and killed otherwise healthy persons of all ages, COVID-19 poses a threat primarily to persons age 65 or older and persons with co-morbidities such as diabetes and heart disease.
It is unknown how many people have contracted COVID-19. Prior to the lifting of the CDC’s restrictive regulations and its use of the wrong protocol, testing for the disease was limited and produced incorrect results. Now that the full resources of the government and the private sector are being brought to bear, the incidence of proper testing will exponentially increase. And, with the increased testing, there undoubtedly will be a concomitant increase in the number of confirmed cases.
But increased testing will not tell us the full extent to which COVID-19 has spread. Why? Because, unlike the devastating Spanish flu or even influenza A, the symptoms of COVID-19 are in many cases quite mild and may be mistaken by the infected person as a minor ailment such as a cold or sore throat.
Consequently, any accurate estimate of COVID-19’s spread or fatality rate is at present unknown. As the world-ranked clinical researcher quoted at the top of this article said of COVID-19’s mortality rate, “We know the numerator (the number of deaths), but we don’t know the denominator, which is the number of people who have been infected by COVID-19. And without the denominator, we have no way of estimating either the spread or the fatality rate of COVID-19.”
Some published analyses of COVID-19’s fatality rate have been based on a comparison of the number of deaths to the number of confirmed cases. This has resulted in alarmingly high estimates of COVID-19’s lethality. But, as we have seen, the number of confirmed cases is not the same as the number of people who — without knowing it — have been infected with COVID-19. As with the expectation that increased testing will dramatically raise the number of confirmed cases, the cases of COVID-19 that have come and gone undetected and may in the future be dismissed as minor ailments will also enlarge the denominator.
But what is certain is that the denominator will grow, and, as it does, the fractional death rate will decline. Which is why Dr. Anthony Fauci, one of the architects of the government’s COVID-19 countermeasures, and two equally distinguished colleagues published an editorial in the February 28, 2020, edition of the New England Journal of Medicine in which they opined the following:
If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.
While all of that is certainly good news, a serious concern remains that the highly contagious COVID-19 could result in a tsunami of cases that could swamp our hospital and ICU resources. To spread out the number of cases, the government has recommended a nationwide self-quarantine. Or, as Dr. Fauci has in televised remarks described the process, the graphical “bump” indicating a pronounced increase in infections will be “smoothed out” by, in effect, spreading out over time the number of infections that will occur.
In addition, the self-quarantine is calculated to hold down the contagion until spring arrives and the risk of infection will drop as the virus may be killed by rising temperatures. If we can postpone the reckoning until the next flu season, a COVID-19 vaccine may be available by then. Similarly, the delay will afford us the time to address and remedy any deficiencies in our medical facilities, equipment (such as ventilators), staffing, and resources.
In that sense, time is of the essence. And that is why President Trump’s farsighted decision in late January to ban travel from China has proven to be so important. Although Trump’s ban of travel from China to America was universally condemned by the mainstream media as xenophobic and racist, epidemiology experts have universally hailed it and Trump’s ban on travel from Europe as major prophylactic steps in limiting the spread of COVID-19 in this country. Or, as James Hodge, a public-health law professor at Arizona State University, explained in the March 13, 2020, edition of the Wall Street Journal, “We do use travel restrictions extensively in response to conditions like [this COVID-19] where we have no vaccine and no treatment, because it’s a socially distancing measure … It has got the potential to slow the spread, not completely eliminate it, but slow it while we develop vaccines.”
Thanks to the pandemic, the handwriting for bringing our manufacturing base home is on the wall.
All of the foregoing comes down to this: compared to other pandemics, COVID-19 is relatively benign in that it poses a threat primarily to persons 65 or older and persons with co-morbidities. It’s not a catastrophically fatal 1918 Spanish flu that wiped out young and old alike and appears to be about as statistically fatal as the seasonal influenza A. And although it could possibly threaten to overwhelm our medical facilities, that’s a problem that our nimble free-market system is particularly well-equipped to solve.
So, take a deep breath and relax. This isn’t the zombie apocalypse, and we’re well on our way to getting on top of COVID-19.
But wait! There’s more!
The pandemic has highlighted and substantiated the critical need to close our borders (including building the southern wall) and to move our manufacturing base and supply chain back to this country. Our lax border security has always been a public health concern. And, in regard to President Trump’s efforts to bring good-paying jobs home by repatriating our manufacturing base, we should thank the thugs who run the Chinese Communist Party, who got the brilliant idea to threaten to cut off America’s supply of antibiotics because our government had criticized China’s lack of transparency in dealing with COVID-19. This imbecilic threat highlighted the fact that 95 percent of our antibiotics are manufactured in China. This astounding fact, coupled with the alarming prospect that our supply of vital pharmaceuticals can be cut off, should serve as a wake-up call and spur the repatriation of all critical manufacturing and supply chains. Thanks to the pandemic, the handwriting for bringing our manufacturing base home is on the wall.
These developments are positive benefits of COVID-19. I could elaborate on this concept, but I’ve gone on too long already. And, more importantly, I couldn’t state the proposition as well as an excellent piece titled “The Coronavirus Will Save America” by my old friend, brilliant engineer, and distinguished public servant Gordon Wysong in the March 16, 2020, edition of American Thinker. You should read and ponder Gordon’s terrific and reassuring analysis as you assess this nation’s current situation.
To sum up, we’ve hit a rough patch, but we’re well equipped as a society to meet the challenge and prevail. The long-term consequences of COVID-19 will be positive in that we will be better equipped to handle future widespread medical emergencies, and our economy and national security will be immeasurably enhanced by the closing of our borders and the repatriation of our supply chain and manufacturing base.
Not bad for a lousy virus.
George Parry is a former federal and state prosecutor. He blogs at knowledgeisgood.net and may be reached by email at email@example.com.