How to be kind and virtuous in complex times
We shut down most of society because of an outbreak of COVID-19. However, new data shows that COVID-19 is only 2–3x more dangerous than the seasonal flu and, in retrospect, blanket shelter-in-place orders were an overreaction. Reasonable public health standards should reopen society while protecting and supporting the elderly and immunocompromised.
- Misunderstanding the Data — The current reporting and decision-making around COVID-19 is based on confounding the case mortality rate and the infection mortality rate. (more below)
- The Cost of Poverty & Isolation — Poverty and isolation can kill just as readily as upper-respiratory infections through drug addiction, crime, domestic abuse, and suicide.
How dangerous is COVID-19? If you google this, you will find the World Health Organization website states what seems like a clear statement that COVID is roughly 20–30 times more dangerous than the seasonal flu:
“Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected.”
This seems very straightforward; however, this statement is actually deeply misleading.
For COVID-19 they are citing the case mortality rate, but for the flu they are citing the infection mortality rate.
The case mortality rate is the number of deaths divided by the number of confirmed cases. The infection mortality rate, however, is the number of deaths divided by the total number of people who were infected. If everyone who was infected with COVID-19 got tested, then these rates would be the same. However, studies into COVID-19 antibodies are now confirming that the infection rate for COVID-19 is 30–50 times higher than expected. Here is the Nature.com article on the Santa Clara County study that found that while there were only 1,000 confirmed cases of COVID-19, there was antibody data proving that some where around 50,000 people had actually already been infected with COVID-19.
This means COVID-19 is dramatically less lethal than reported, and only truly dangerous to those who are immunocompromised.
The infection mortality rate of the flu is roughly %0.1. With the new antibody data, we can be certain that COVID-19’s infection mortality rate is about %0.2–0.3, or 2–3x times more dangerous.
Before this antibody data was available, mass shelter-in-place orders were reasonable. However, now that we understand COVID-19 better, it would be reasonable to change our orders and guidances to reopen society as a whole while providing strong and compassionate support and protection to people who are immunocompromised.