Updated (as noted) 3/30
I thought I would write out the things I believe of about C-19 at the moment and update as I learn more or change my mind. I plan to document what I change my mind on and why.
Here are my set of beliefs about C-19 that I feel reasonably confident (i.e. I have not seen any evidence to dissuade me):
- For most people, it’s an illness similar to cold or flu with high recovery rates.
- We now have good enough data to determine who is most at risk — those over 60 with other health issues.
- >98% of people under age 50-60
- 90-95% of over age 60
- Some groups with specific underlying health issues maybe in the 70-80% range.
- It’s probably more widespread than we think.
- My guess is that 10-20% of the U.S. has already had it and recovered from it.
- Another 10-20% currently has it.
- Why? It seems when testing is based on symptoms, like in areas where test kits are scarce, the positive rate is in the 20-40% range.
- When testing becomes more widespread, more like random testing, the positive rate drops to 10-20% range.
- My guess is that the total number of cases are under estimated by a factor of 3 to 10. This is based on testing bottlenecks and the number of people who recovered before testing was available.
- This would mean that the death rates are likely 1/3rd to 1/10th what we currently believe. Though, there may also be also missing some deaths in the count.
- The growth curves of number of cases and number of deaths is more of a function of growth in # of tests administered per day than with spread of the virus.
- The number of new cases per day will grow as long as number of tests given per day grows.
- The number of new cases per day will level off when the number of tests given per day levels off.
- A high percentage of folks who end up needing to be put on a ventilator don’t make it. I’ve heard 90-95%.
- What I don’t know is how this compares to other illnesses like the flu or pneumonia for people with the same risk factors.
- Masks, social distancing, targeted (to the folks with symptoms or tested positive) quarantines and hand washing seemed be better ways to slow the spread than broad stay-at-home orders.
- Government and government agencies have not demonstrated that they understand the concepts of wide testing, contact tracing and targeted isolation.
- There were C-19 deaths before we started testing for it, but were thought to be caused by flu or pneumonia or natural causes.
- I have little faith in the reporting of numbers from government or media sources.
- It’s not that the numbers are wrong, per se.
- It’s that they report numbers without benchmarks or context.
- They report numbers in the most alarming, attention-getting way.
- They appear unaware or ignorant to caveats in the numbers, especially caveats that might remove some of the alarm.
- There may be good things to learn in Italy about how not to run hospitals. My suspicion is that their practices brought C-19 into the hospitals from low risk groups and spread it through to the high risk groups that may have already been hospitalized.
- Update 3/30: I saw today that in some parts of Italy, deaths from C-19 may be 2-3x higher than recorded C-19. That’s not surprising. I don’t expect that all folks with C-19 got tested before they died. So, that’s early evidence that the numerator in the death rate calculation is underestimated. We also need antibody testing to see to what extent the denominator — total number of cases — is underestimated before we will have a truer sense of C-19’s death rate.
What I don’t know or I am less certain about.
- What is the true typical incubation period? Early it was 14 days. Then that seemed to be revised to 5-7 days, but up to 14 days.
- There seems to be a promising treatment, but it’s been quiet for a few days.
- Are there longer term health consequences of having the virus?
- Some people may not get it due to blood type, genetics, hygiene, contact practices, etc.
I will continue to edit this post and keep of log of my beliefs as new evidence comes it.
I’m no expert. But, I’ve been very unimpressed with the experts on this one, so far. I think they have demonstrated some elementary lapses of logic.
I do believe it is better to be safe than sorry (i.e. precautionary principle).
But, I also think some ways of being safe are superior to others and, in the U.S., we’ve quickly chosen some less good ways and seem to have become married to them.
For example…given what we have learned about who is at risk, it would make more sense to me to target stay-at-home orders to those folks and we all pitch in to helping them get through this in isolation.
We can do this by delivering groceries to them, talking to them on Facetime, getting masks to them, making sure they have enough hand sanitizer and soap and making sure they can get treated at the earliest signs of the illness.
Here’s some resources I have found useful:
Politico U.S. Covid Tracker — I like this because it has a benchmark: the number of tests given. I explain in my third bullet point above why I think this is a good benchmark.