Did We Just Blowup the Economy for a Bug with a 0.14% Fatality Rate?

If you remember way back to my second Corinavirus post 6 weeks ago, I posted that the fatality rate of this coronavirus was far less than the media was reporting. Now a new Stanford study just supported that idea after testing a large sample of people in one community. The results look much like my initial thoughts, the death rate of coronavirus is nowhere near what has been reported. Let’s dig in.

The Basic Math Problem with Media Reported Mortality Rates

The media has reported all sorts of fatality rates for COVID-19. Everything from 1% (ten times more lethal than the average flu bug among all age groups) to 3-7%. The actual mortality rates reported back in early March outside of environments that were total chaos were 0.2%-0.65% (1-3). The current US rate based on our total tests versus total deaths is about 0.5%.

However, anyone with a medical or science background has known for quite some time that these numbers are fiction. Meaning that we know that there are huge swaths of people out there who had the bug and never had any or had very mild symptoms and who were never tested. Hence, the real math looks like this:

However, the real rate can only be determined once we know how many are positive for COVID-19 in a given community versus how many died. So what’s that REAL FATALITY number?

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The Stanford Fatality Rate Based on New Data

A crew from Stanford decided to test more than three thousand people in Santa Clara County, California for antibodies to the novel coronavirus on April 3rd-4th. (4). THIS IS THE LARGEST DATASET TO DATE OF THE AVERAGE JOES AND JANES IN THE COMMUNITY. Based on various adjustments including for the test accuracy, the percentage of the population that tested positive for COVID-19 in Santa Clara ranged from 2.5-4.2%. Given that Santa Clara County has 1.93 million people, that means that the researchers estimated that 48,000-81,000 people were infected. If we split that in the middle, that’s about 64,500 people.

First, these numbers show that the virus had spread far wider than anyone had thought. About 50-100 times more widely. That means that you may well have had this virus and never knew it.

Second, there is a MUCH bigger story here. Why? The total number of people who have perished to date due to COVID-19 two weeks later, in Santa Clara county is 73 (5). Even if we add another 20 deaths for people now in the hospital, the total fatality rate is 93/64,500 or 0.14%! 

Comparing COVID-19 Fatality

What’s the fatality rate of influenza among all age groups? Depending on who is reporting the data, about 0.10% or less (6). The best flu fatality rates are in the 0.05% range, but higher death rates are reported, in particular in Asia.

So based on this new data, which is the most expansive to date, COVID-19 is about 2-3 times as lethal as a bad flu bug. Near as I can tell, this is a true statement based on the best available evidence. If you can debunk it with this Santa Clara data or a similar dataset where an entire community was randomly tested for the SARS-CoV-2 virus, please do so in the comments.

Will more data increase or decrease the fatality rate? That remains to be seen.

Why COVID-19 is MUCH WORSE than the Flu

First, as I have written, the SARS-CoV-2 virus is likely 2-3 X more lethal than the flu. However, COVID-19 is different than the flu. First, unlike the flu, it hits the elderly the hardest and it doesn’t seem to hit the very young. In addition, it also seems to kill seemingly random individuals who likely wouldn’t perish from the flu. That could be due to the “cytokine storm” I’ve discussed. In addition, this virus requires significantly more hospital resources than the flu in terms of ventilators and how quickly patients get severe. Meaning COVID-19 patients need emergency intubation much more frequently and unpredictably than severe flu patients, which creates a HUGE burden on the healthcare system and doctors.

So what we did to avoid the overload of the health system was the right thing. However, now that we have our health system prepared and ramped up, it’s time to clear the air and see where we are. Where’s that? We have a nasty bug that can kill quickly, but that kills at 2-3X the rate of the flu. Hence, it’s time to smartly open up the regions of our economy that are showing sharply declining cases or we’re creating bigger problems for ourselves.

The Post-COVID Economic Depression

The unemployment rate currently is believed to be about 17%. That will likely rise over the next few weeks as businesses that are hit hard by COVID shed employees once the Payroll Protection program expires. When was the last time we saw unemployment rates of 20%? The GREAT DEPRESSION in the 1930s. Hence, it’s time to take this new fatality data, begin widespread testing, and continue our clinical trials into effective treatments for COVID-19.

The upshot? This is a bad bug and I’m glad we closed it all down. However, it’s now time to safely begin opening up parts of the country and recognize the lethality of our foe with a very heavy heart, but an equally clear mind.

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References:

(1) Kolate G. Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How. The New York Times. https://www.nytimes.com/2020/03/09/science/coronavirus-is-very-different-from-the-spanish-flu-of-1918-heres-how.html Accessed 3/10/20.

(2) Chinese Center for Disease Control and Prevention CCDC Weekly. The Epidemiological Characteristics of an Outbreak of 2019 Novel
Coronavirus Diseases (COVID-19) — China, 2020. Vol. 2. No. 8. http://weekly.chinacdc.cn/fileCCDCW/journal/article/ccdcw/2020/8/PDF/COVID-19.pdf

(3) Faust J. COVID-19 Isn’t As Deadly As We Think. Slate. https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html Accessed 3/6/20.

(4)  Bendavid E, et al. COVID-19 Antibody Seroprevalence in Santa Clara County, California. medRxiv 2020.04.14.20062463; doi: https://doi.org/10.1101/2020.04.14.20062463

(5) Santa Clara Public Health. County of Satna Clara Emergency Operations Center. https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx. Accessed 4/17/20.

(6) Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study [published correction appears in Lancet. 2018 Jan 19;:]. Lancet. 2018;391(10127):1285–1300. doi: 10.1016/S0140-6736(17)33293-2

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile