No, it’s not because I am suicidal

No, it’s not because I’m so macho at age 77 that I think I’m invincible.

Here’s why.

Infection Usually Creates Immunity

For close to a month I have stayed indoors like a hermit, and followed all the recommended precautions.  If I had been infected with the coronavirus early on I would probably be immune to it now. If I have not been infected I could still be infected in the near future.  I’d rather be probably immune than certainly not.

In my time as a prisoner at home I have read a lot about the virus. Some of the media has used language designed to panic the reader.  Indeed the panic about the virus has gone viral more rapidly than the virus.

Scary Language Creates Needless Panic

So what is some of the scary language we should understand? A few examples:

Infected only means that something potentially unhealthy has come into my body.  But before this coronavirus you and I were infected daily –  with many different kinds of viruses and bacteria, every time we held the safety railing on the stairs to the subway platform.  Also while pressing keypad numbers on credit card payment machines.  And by touching doorknobs when exiting the washrooms in restaurants.

The daily statistics on the growing number of COVID-19 cases is merely the number infected who have been tested.  This number is a fraction of those who have been infected, but not tested because they had no severe symptoms. Around 90% of people infected with COVID-19 are asymptomatic or have only very mild symptoms, so being infected is far from a death sentence.

Pandemic means an epidemic spread to several countries.  This says nothing about the severity of the epidemic, only that it is in more than one country.  For example, MERS (also known as camel flu) was a severe virus in more than one country,  with mortality about 1/3 of diagnosed cases, but only in the Middle East. From 2012 when first detected until the end of 2019 the total laboratory-confirmed cases of MERS world-wide is 1,847.  That may be why most people have never heard of it.

Deaths also needs explanation, because there is an important difference between “infected with” this coronavirus at the time of death and “died from” this coronavirus.  Some places greatly overstate the deaths actually caused by the virus.  They attribute the cause of death to the virus if the virus in found the deceased’s body.  Yet the evidence from Italy and elsewhere is that most of the dead were elderly (70+), and that most had several comorbidities such as heart failure, emphysema or cancer, which could have been the proximate cause of death.   In an extreme example, someone receiving fatal injuries in a car accident could be classified as a COVID-19 death if the virus was found in their body.  On the other hand, some who die at home rather than in a hospital may not be tested for the virus, potentially offsetting some of the over-reporting.

When emergency rooms are overwhelmed and doctors need to remove those who have died as quickly as possible they will tend to avoid spending lots of time determining the actual cause of death.  Furthermore, a hospital wanting to obtain more resources is better off adding to its COVID-19 death count.  It is fair to recognize that the numbers of deaths attributed to the virus alone are probably exaggerated, but by how much is anyone’s guess.

Case Fatality Ratio means the number of deaths as a percentage of infected cases. This ratio is widely cited to show how scary this virus is.

The best article I have seen on case count statistics is:  Case Counts are Meaningless.  The purpose of testing in most countries is

“…. to allocate scarce medical care to the patients who most need it — rather than to create a comprehensive dataset for epidemiologists and statisticians to study.

But if you’re not accounting for testing patterns, it can throw your conclusions entirely out of whack. You don’t just run the risk of being a little bit wrong: Your analysis could be off by an order of magnitude. Or even worse, you might be led in the opposite direction of what is actually happening. A country where the case count is increasing because it’s doing more testing, for instance, might actually be getting its epidemic under control. Alternatively, in a country where the reported number of new cases is declining, the situation could actually be getting worse, either because its system is too overwhelmed to do adequate testing or because it’s ramping down on testing for PR reasons……

According to an expert survey published by FiveThirtyEight, the number of detected cases in the United States could underestimate the true number of infected people by anywhere from a multiple of two times to 100 times. The same holds in other countries. A recent paper published by Imperial College London estimated that the true number of people who had been infected with the coronavirus in the U.K. as of March 30 was somewhere between 800,000 and 3.7 million — as compared to a reported case count through that date of just 22,141.”

The author of the above article estimates that 90% of corona cases are either mild or asymptomatic, and the Canadian statistics bear this out.  If there are so many undetected cases then being infected is not a significant health problem for at least 90% of those infected.  And the infection may be ‘good for you’ in giving you immunity.

Conclusion

The number of reported cases and deaths is not a realistic measure of the risks we face from COVID-19.  Actually, countries with fewer reported cases to date may be worse off.

In general, a high number of tests conducted suggests a better medical infrastructure and quicker government response in that country. The countries that have already done numerous tests per capita also tend to have lower actual fatality rates.  By lower actual fatality rates I mean deaths as a percentage of that country’s population.  Germany, for example, which is conducting several times more tests per day than the U.K., has roughly twice as many reported cases as the U.K., but only 1/3 as many deaths.  Yet Germany has 84 million people,  25% more than the UK’s 68 million.

The coronavirus is a serious public health problem globally, but we should not panic over the reported case statistics.

Instead, countries like Canada should do many more randomly selected population tests, to determine the level of infections and immunity in the population in different parts of the country. That  is much more useful than testing only some of the seriously sick.

Widespread random testing will likely lead to better outcomes for those countries that do so quickly.  I hope Canada makes widespread immunity testing available soon, so that you and I can find out whether we have immunity.

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