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How We Got Covid’s Risk Right But the Response Wrong
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Michael Ejercito
Oct 29, 2023, 8:07:00 PM10/29/23
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https://www.reddit.com/r/Coronavirus/comments/17ep8jy/how_we_got_covids_risk_right_but_the_response/
How We Got Covid’s Risk Right But the Response Wrong
Early expert projections of how deadly the disease would be were
spot-on, but don’t seem to have led to a good balance between prevention
and costs.
October 23, 2023 at 3:30 AM PDT
By Justin Fox
Justin Fox is a Bloomberg Opinion columnist covering business. A former
editorial director of Harvard Business Review, he is author of “The Myth
of the Rational Market.”
Did we get it right or wrong?
Did we get it right or wrong? Photographer: Scott Olson/Getty Images
In this Article
NEW ENGLAND JOUR
Private Company
Before it’s here, it’s on the Bloomberg Terminal
LEARN MORE
Early in March 2020, I decided to write about the risks posed by
Covid-19. I have no background in epidemiology or even health
journalism, but I can multiply, divide and make charts and was
frustrated with the lack of quantification in most reporting and
public-health messaging on what was soon to be declared a pandemic.
In the resulting column I took what seemed to be the most authoritative
estimate of Covid’s per-infection fatality rate, 1%, and noted that this
was about 10 times the 0.1% fatality rate of seasonal influenza, then
conservatively multiplied a CDC estimate of 61,099 influenza-associated
deaths in the US in the pretty bad flu season of 2017-2018 by five and
10 to get a range of “300,000 to 600,000 deaths.”
BloombergOpinion
A Two-Speed Electric Car Market Is Heading for a Crash
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Mike Johnson Can Succeed Where Kevin McCarthy Failed
Over the 12 months that followed, about 550,000 Americans died of Covid
according to according to the CDC’s provisional estimates and 490,000
according to its tallies of the “underlying cause of death” listed on
death certificates. Both are almost certainly undercounts, because in
the early days the lack of testing meant many Covid-caused deaths were
attributed to other maladies. My guesstimate was also more lucky than
good in that actual seasonal flu fatality rates may be closer to 0.04%,
and the 2017-2018 influenza toll has since been revised downward to
52,000. Still, it was in the ballpark.
I was reminded of all this while reading a passage in a new book on the
history of the pandemic, The Big Fail: What the Pandemic Revealed About
Who America Protects and Who It Leaves Behind. In March 2020, the
authors write, Stanford University health policy professor Jay
Bhattacharya “coauthored an article for the Wall Street Journal
questioning the validity of the scary 2 to 4 percent fatality rate that
the early models like Neil Ferguson’s were estimating — and that were
causing governments to panic. He believed (correctly, as it turns out),
that the true fatality rate was much lower.”
Well, my 1% fatality rate estimate came from a Feb. 10 paper out of the
MRC Centre for Global Infectious Disease Analysis at Imperial College
London, then led by none other than Neil Ferguson. The March 24, 2020
Wall Street Journal op-ed by Bhattacharya and Eran Bendavid
appropriately took aim at the 2% to 4% fatality rates that the World
Health Organization was calculating using confirmed cases as the
denominator, but ignored Ferguson’s estimate and went on to propose that
the actual fatality rate might be as low as 0.01%, “one-tenth of the flu
mortality rate,” and that in the US Covid might be “a 20,000- or
40,000-death epidemic.”
Studies based on antibody testing later found that, in the early days,
among hard-hit, immunologically-naive populations with age distributions
like those of East Asia, Europe and North America, Covid killed close to
1% of those infected. Fatality rates seemed to be lower where incidence
of the disease was lower (although measurement was less reliable there
too), and they have certainly declined over time, especially since
vaccines were introduced. But the very early estimate by Ferguson and
team, described as “approximately 1%” in the summary of their paper but
either 0.9% or 0.8% (depending on assumptions about how long people with
Covid kept testing positive for it) in the text, appears to have been
quite accurate, and certainly much closer to the mark than Bhattacharya
and Bendavid’s spitballing.
It was also not an outlier in early 2020. “The data so far suggest that
the virus has a case fatality risk around 1%,” well-informed amateur
epidemiologist Bill Gates wrote on the New England Journal of Medicine’s
website on Feb. 28. On the same day and in the same place, National
Institute of Allergy and Infectious Diseases director Anthony Fauci and
the heads of the National Institutes of Health and the CDC wrote that
the “case fatality rate may be considerably less than 1%,” and on March
11 Fauci testified before Congress that it was “somewhere around 1%.” A
study published March 30 in Lancet Infectious Diseases, again
co-authored by Ferguson, put it at 0.66% overall, albeit much higher for
those 60 and older and much lower for those under 50, with the fatality
rate for children under 10 estimated at less than 0.002%.
So it wasn’t a faulty expert consensus on the risks posed by Covid that
drove the reaction to it. The expert consensus turns out to have been
eerily on-target. But as The Big Fail makes maddeningly clear — and no,
I didn’t stumble over any other mischaracterizations in it like the one
described above — the US did an awful job of balancing Covid’s risks
with the costs of fighting the disease. (I should disclose that the
authors, Joe Nocera and Bethany McLean, are former colleagues of mine
and current friendly acquaintances, although we’ll have to see if the
latter holds up after they read this column. Something I wrote comparing
Covid mortality in California and Florida is cited approvingly in the book.)
The “lockdowns” at the outset of the pandemic — which in the US were
mostly not literal lockdowns but did involve strongly urging people to
stay home — seem to have saved lives when implemented early enough. It
is also undeniable that staying away from other people is an effective
way to avoid catching or spreading Covid. But public policies aimed at
encouraging and even requiring such behavior over extended periods were
extremely costly and disruptive, and appear to have had at best a modest
impact on Covid mortality. The biggest mismatch between risks and costs
in the US involved schooling, as many urban districts did not offer
in-person classes for much or all of the 2020/2021 school year, with
dire consequences for student performance.
How much of a role did misrepresentations of Covid’s mortality rate play
in this faulty decision-making? It can’t have helped that the WHO and
other data compilers continued throughout the pandemic to report
fatality rates based on confirmed case numbers, which the news media
usually passed on without adding context. But I also think that a
disease with a mortality rate of a bit under 1% is just really hard for
people, myself included, to get their heads around. It’s in an
uncomfortable middle ground between seasonal viruses that we’ve all
grown accustomed to living with (as now seems to be happening with
Covid) and high-fatality-rate ones such as Ebola and the original SARS
virus that no one would encourage allowing to spread. The conservative
meme that “Covid is 99% survivable” — as if that made it a mere trifle —
was one indication of this confusion, but Fauci’s waffling over the
course of summer 2020 on whether schools should reopen probably was too.
It didn’t help that some of those clamoring loudest for school
reopening, such as President Donald Trump, so clearly underestimated
Covid’s risks. An underappreciated reason why the October 2020 “ Great
Barrington Declaration” calling for an end to lockdowns generated such
an allergic reaction in public health circles is that two of its three
authors, Bhattacharya and University of Oxford epidemiologist Sunetra
Gupta — who in May 2020 argued that Covid “has largely come and is on
its way out” in the UK, with a fatality rate between 0.1% and 0.01% —
had been so spectacularly wrong in their early risk assessments. These
were not people who had earned a lot of credibility on Covid.
It seems telling — or at least ironic — that Sweden, where public health
officials greatly overestimated how quickly Covid was spreading early on
and thus underestimated its fatality rate, ended up with one of the most
successful and sustainable Covid management efforts among Western countries.
Sweden’s Long-Haul Covid Success
Deaths from all causes compared to projection
Source: Our World in Data compilation of data from Human Mortality
Database, World Mortality Dataset and Ariel Karlinsky and Dmitry Kobak,
"Tracking excess mortality across countries during the COVID-19 pandemic
with the World Mortality Dataset"
Sweden’s approach was never as laissez-faire as sometimes portrayed —
high schools and universities were closed early in the pandemic and
large gatherings banned — and the initial increase in deaths there was
even sharper than in the US, but over time the country’s light-touch
policies were accompanied by excess mortality only moderately higher
than in neighboring Denmark and Norway and much lower than in the US and
the rest of Europe. Getting the risks right may not have been essential
to getting the response right.
More From Bloomberg Opinion:
The US Should Change Its Covid Booster Strategy: F.D. Flam
Nobel for mRNA Vaccine Shows Power of Perseverance: Lisa Jarvis
Why Are Consumers Still So Gloomy? Blame Covid: Claudia Sahm
Want more Bloomberg Opinion? OPIN <GO>. Or subscribe to our daily
newsletter.
This column does not necessarily reflect the opinion of the editorial
board or Bloomberg LP and its owners.
To contact the author of this story:
Justin Fox at just...@bloomberg.net
To contact the editor responsible for this story:
Robert Burgess at bbur...@bloomberg.net
How We Got Covid’s Risk Right But the Response Wrong
Early expert projections of how deadly the disease would be were
spot-on, but don’t seem to have led to a good balance between prevention
and costs.
October 23, 2023 at 3:30 AM PDT
By Justin Fox
Justin Fox is a Bloomberg Opinion columnist covering business. A former
editorial director of Harvard Business Review, he is author of “The Myth
of the Rational Market.”
Did we get it right or wrong?
Did we get it right or wrong? Photographer: Scott Olson/Getty Images
In this Article
NEW ENGLAND JOUR
Private Company
Before it’s here, it’s on the Bloomberg Terminal
LEARN MORE
Early in March 2020, I decided to write about the risks posed by
Covid-19. I have no background in epidemiology or even health
journalism, but I can multiply, divide and make charts and was
frustrated with the lack of quantification in most reporting and
public-health messaging on what was soon to be declared a pandemic.
In the resulting column I took what seemed to be the most authoritative
estimate of Covid’s per-infection fatality rate, 1%, and noted that this
was about 10 times the 0.1% fatality rate of seasonal influenza, then
conservatively multiplied a CDC estimate of 61,099 influenza-associated
deaths in the US in the pretty bad flu season of 2017-2018 by five and
10 to get a range of “300,000 to 600,000 deaths.”
BloombergOpinion
A Two-Speed Electric Car Market Is Heading for a Crash
India Is Pushing the World Toward Another Rice Crisis
A Tokyo Neighborhood Wants to Cancel Halloween. That’s a Mistake.
Mike Johnson Can Succeed Where Kevin McCarthy Failed
Over the 12 months that followed, about 550,000 Americans died of Covid
according to according to the CDC’s provisional estimates and 490,000
according to its tallies of the “underlying cause of death” listed on
death certificates. Both are almost certainly undercounts, because in
the early days the lack of testing meant many Covid-caused deaths were
attributed to other maladies. My guesstimate was also more lucky than
good in that actual seasonal flu fatality rates may be closer to 0.04%,
and the 2017-2018 influenza toll has since been revised downward to
52,000. Still, it was in the ballpark.
I was reminded of all this while reading a passage in a new book on the
history of the pandemic, The Big Fail: What the Pandemic Revealed About
Who America Protects and Who It Leaves Behind. In March 2020, the
authors write, Stanford University health policy professor Jay
Bhattacharya “coauthored an article for the Wall Street Journal
questioning the validity of the scary 2 to 4 percent fatality rate that
the early models like Neil Ferguson’s were estimating — and that were
causing governments to panic. He believed (correctly, as it turns out),
that the true fatality rate was much lower.”
Well, my 1% fatality rate estimate came from a Feb. 10 paper out of the
MRC Centre for Global Infectious Disease Analysis at Imperial College
London, then led by none other than Neil Ferguson. The March 24, 2020
Wall Street Journal op-ed by Bhattacharya and Eran Bendavid
appropriately took aim at the 2% to 4% fatality rates that the World
Health Organization was calculating using confirmed cases as the
denominator, but ignored Ferguson’s estimate and went on to propose that
the actual fatality rate might be as low as 0.01%, “one-tenth of the flu
mortality rate,” and that in the US Covid might be “a 20,000- or
40,000-death epidemic.”
Studies based on antibody testing later found that, in the early days,
among hard-hit, immunologically-naive populations with age distributions
like those of East Asia, Europe and North America, Covid killed close to
1% of those infected. Fatality rates seemed to be lower where incidence
of the disease was lower (although measurement was less reliable there
too), and they have certainly declined over time, especially since
vaccines were introduced. But the very early estimate by Ferguson and
team, described as “approximately 1%” in the summary of their paper but
either 0.9% or 0.8% (depending on assumptions about how long people with
Covid kept testing positive for it) in the text, appears to have been
quite accurate, and certainly much closer to the mark than Bhattacharya
and Bendavid’s spitballing.
It was also not an outlier in early 2020. “The data so far suggest that
the virus has a case fatality risk around 1%,” well-informed amateur
epidemiologist Bill Gates wrote on the New England Journal of Medicine’s
website on Feb. 28. On the same day and in the same place, National
Institute of Allergy and Infectious Diseases director Anthony Fauci and
the heads of the National Institutes of Health and the CDC wrote that
the “case fatality rate may be considerably less than 1%,” and on March
11 Fauci testified before Congress that it was “somewhere around 1%.” A
study published March 30 in Lancet Infectious Diseases, again
co-authored by Ferguson, put it at 0.66% overall, albeit much higher for
those 60 and older and much lower for those under 50, with the fatality
rate for children under 10 estimated at less than 0.002%.
So it wasn’t a faulty expert consensus on the risks posed by Covid that
drove the reaction to it. The expert consensus turns out to have been
eerily on-target. But as The Big Fail makes maddeningly clear — and no,
I didn’t stumble over any other mischaracterizations in it like the one
described above — the US did an awful job of balancing Covid’s risks
with the costs of fighting the disease. (I should disclose that the
authors, Joe Nocera and Bethany McLean, are former colleagues of mine
and current friendly acquaintances, although we’ll have to see if the
latter holds up after they read this column. Something I wrote comparing
Covid mortality in California and Florida is cited approvingly in the book.)
The “lockdowns” at the outset of the pandemic — which in the US were
mostly not literal lockdowns but did involve strongly urging people to
stay home — seem to have saved lives when implemented early enough. It
is also undeniable that staying away from other people is an effective
way to avoid catching or spreading Covid. But public policies aimed at
encouraging and even requiring such behavior over extended periods were
extremely costly and disruptive, and appear to have had at best a modest
impact on Covid mortality. The biggest mismatch between risks and costs
in the US involved schooling, as many urban districts did not offer
in-person classes for much or all of the 2020/2021 school year, with
dire consequences for student performance.
How much of a role did misrepresentations of Covid’s mortality rate play
in this faulty decision-making? It can’t have helped that the WHO and
other data compilers continued throughout the pandemic to report
fatality rates based on confirmed case numbers, which the news media
usually passed on without adding context. But I also think that a
disease with a mortality rate of a bit under 1% is just really hard for
people, myself included, to get their heads around. It’s in an
uncomfortable middle ground between seasonal viruses that we’ve all
grown accustomed to living with (as now seems to be happening with
Covid) and high-fatality-rate ones such as Ebola and the original SARS
virus that no one would encourage allowing to spread. The conservative
meme that “Covid is 99% survivable” — as if that made it a mere trifle —
was one indication of this confusion, but Fauci’s waffling over the
course of summer 2020 on whether schools should reopen probably was too.
It didn’t help that some of those clamoring loudest for school
reopening, such as President Donald Trump, so clearly underestimated
Covid’s risks. An underappreciated reason why the October 2020 “ Great
Barrington Declaration” calling for an end to lockdowns generated such
an allergic reaction in public health circles is that two of its three
authors, Bhattacharya and University of Oxford epidemiologist Sunetra
Gupta — who in May 2020 argued that Covid “has largely come and is on
its way out” in the UK, with a fatality rate between 0.1% and 0.01% —
had been so spectacularly wrong in their early risk assessments. These
were not people who had earned a lot of credibility on Covid.
It seems telling — or at least ironic — that Sweden, where public health
officials greatly overestimated how quickly Covid was spreading early on
and thus underestimated its fatality rate, ended up with one of the most
successful and sustainable Covid management efforts among Western countries.
Sweden’s Long-Haul Covid Success
Deaths from all causes compared to projection
Source: Our World in Data compilation of data from Human Mortality
Database, World Mortality Dataset and Ariel Karlinsky and Dmitry Kobak,
"Tracking excess mortality across countries during the COVID-19 pandemic
with the World Mortality Dataset"
Sweden’s approach was never as laissez-faire as sometimes portrayed —
high schools and universities were closed early in the pandemic and
large gatherings banned — and the initial increase in deaths there was
even sharper than in the US, but over time the country’s light-touch
policies were accompanied by excess mortality only moderately higher
than in neighboring Denmark and Norway and much lower than in the US and
the rest of Europe. Getting the risks right may not have been essential
to getting the response right.
More From Bloomberg Opinion:
The US Should Change Its Covid Booster Strategy: F.D. Flam
Nobel for mRNA Vaccine Shows Power of Perseverance: Lisa Jarvis
Why Are Consumers Still So Gloomy? Blame Covid: Claudia Sahm
Want more Bloomberg Opinion? OPIN <GO>. Or subscribe to our daily
newsletter.
This column does not necessarily reflect the opinion of the editorial
board or Bloomberg LP and its owners.
To contact the author of this story:
Justin Fox at just...@bloomberg.net
To contact the editor responsible for this story:
Robert Burgess at bbur...@bloomberg.net
HeartDoc Andrew
Oct 29, 2023, 8:37:22 PM10/29/23
to
GOD" (Ephesians 6:11) which we put on as soon as we use
Apostle Paul's secret (http://bit.ly/Philippians4_12 ). Though masking
is less protective, it helps us avoid the appearance of doing the evil
of spreading airborne pathogens while there are people getting sick
because of not being 100% protected. It is written that we're to
"abstain from **all** appearance of doing evil" (1 Thessalonians 5:22
w/**emphasis**).
Source:
https://biblehub.com/1_thessalonians/5-22.htm
Meanwhile, the only *perfect* (Matt 5:47-8) way to eradicate the
COVID-19 virus, thereby saving lives, in the US & elsewhere is by
rapidly ( http://bit.ly/RapidTestCOVID-19 ) finding out at any given
moment, including even while on-line, who among us are unwittingly
contagious (i.e pre-symptomatic or asymptomatic) in order to
http://WDJW.great-site.net/ConvinceItForward (John 15:12) for them to
call their doctor and self-quarantine per their doctor in hopes of
stopping this pandemic. Thus, we're hoping for the best while
preparing for the worse-case scenario of the Alpha lineage mutations
and others like the Omicron, Gamma, Beta, Epsilon, Iota, Lambda, Mu &
Delta lineage mutations combining via slip-RNA-replication to form
hybrids like http://tinyurl.com/Deltamicron that may render current
COVID vaccines/monoclonals/medicines/pills no longer effective.
Indeed, I am wonderfully hungry ( http://tinyurl.com/RapidOmicronTest
) and hope you, Michael, also have a healthy appetite too.
So how are you ?
...because we mindfully choose to openly care with our heart,
HeartDoc Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist with an http://bit.ly/EternalMedicalLicense
2024 & upwards non-partisan candidate for U.S. President:
http://WonderfullyHungry.org
and author of the 2PD-OMER Approach:
http://bit.ly/HeartDocAndrewCare
which is the only **healthy** cure for the U.S. healthcare crisis
Michael Ejercito
Oct 29, 2023, 9:18:39 PM10/29/23
to
Michael
HeartDoc Andrew
Oct 29, 2023, 9:32:02 PM10/29/23
to
Michael Ejercito wrote:
While wonderfully hungry in the Holy Spirit, Who causes (Deuteronomy
8:3) us to hunger, I note that you, Michael, are rapture ready (Luke
17:37 means no COVID just as eagles circling over their food have no
COVID) and pray (2 Chronicles 7:14) that our Everlasting (Isaiah 9:6)
Father in Heaven continues to give us "much more" (Luke 11:13) Holy
Spirit (Galatians 5:22-23) so that we'd have much more of His Help to
always say/write that we're "wonderfully hungry" in **all** ways
including especially caring to
http://WDJW.great-site.net/ConvinceItForward (John 15:12 as shown by
http://tinyurl.com/RapidOmicronTest ) with all glory (
http://bit.ly/Psalm112_1 ) to GOD (aka HaShem, Elohim, Abba, DEO), in
the name (John 16:23) of LORD Jesus Christ of Nazareth. Amen.
Laus DEO !
Suggested further reading:
https://groups.google.com/g/sci.med.cardiology/c/5EWtT4CwCOg/m/QjNF57xRBAAJ
Shorter link:
http://bit.ly/StatCOVID-19Test
Be hungrier, which really is wonderfully healthier especially for
diabetics and other heart disease patients:
http://bit.ly/HeartDocAndrew touts hunger (Luke 6:21a) with all glory
( http://bit.ly/Psalm112_1 ) to GOD, Who causes us to hunger
(Deuteronomy 8:3) when He blesses us right now (Luke 6:21a) thereby
removing the http://WDJW.great-site.net/VAT from around the heart
8:3) us to hunger, I note that you, Michael, are rapture ready (Luke
17:37 means no COVID just as eagles circling over their food have no
COVID) and pray (2 Chronicles 7:14) that our Everlasting (Isaiah 9:6)
Father in Heaven continues to give us "much more" (Luke 11:13) Holy
Spirit (Galatians 5:22-23) so that we'd have much more of His Help to
always say/write that we're "wonderfully hungry" in **all** ways
including especially caring to
http://WDJW.great-site.net/ConvinceItForward (John 15:12 as shown by
http://tinyurl.com/RapidOmicronTest ) with all glory (
http://bit.ly/Psalm112_1 ) to GOD (aka HaShem, Elohim, Abba, DEO), in
the name (John 16:23) of LORD Jesus Christ of Nazareth. Amen.
Laus DEO !
Suggested further reading:
https://groups.google.com/g/sci.med.cardiology/c/5EWtT4CwCOg/m/QjNF57xRBAAJ
Shorter link:
http://bit.ly/StatCOVID-19Test
Be hungrier, which really is wonderfully healthier especially for
diabetics and other heart disease patients:
http://bit.ly/HeartDocAndrew touts hunger (Luke 6:21a) with all glory
( http://bit.ly/Psalm112_1 ) to GOD, Who causes us to hunger
(Deuteronomy 8:3) when He blesses us right now (Luke 6:21a) thereby
removing the http://WDJW.great-site.net/VAT from around the heart
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