Coronavirus and math lessons


The Denominator Problem

There was an interesting op-ed in the WSJ a couple of days ago (see link below) by Eran Bendavid and Jay Bhattacharya from Stanford. They ask if the cost of a lockdown is perhaps higher than the cost of no lockdown.

The op-ed is behind a pay wall, so I'll provide a summary of their argument.

The authors claim that the commonly assumed coronavirus (CV) death rate of ~1% is inaccurate (i.e. too high) due to the lack of antibody testing to determine the true denominator for the ratio. (The death rate is calculated by dividing the number of deaths, i.e. the numerator, by the number of infected, i.e. the denominator.) In other words, we don't have an accurate count of everyone who has the virus until we do antibody testing of everyone. That's because many people who have the virus develop antibodies and very mild symptoms and never get tested and never get counted as part of the denominator.

I suspect when the they calculate the death rate from the flu (~0.1%) they assume everyone or almost everyone gets the viruses (the flu is actually several different viruses, always mutating every season). So the denominator used for calculating the death rate for the flu is probably 80%-90% of the population. In other words, we're using a much bigger denominator when calculating the death rate from the flu and a much smaller one when calculating the death rate from the coronavirus or the resulting disease known as COVID-19. No wonder we're coming up with a much higher death rate for CV. When we justify a lockdown for CV, it's important to recall that 61,000 people died in the US from the flu last year, and there was no 24/7 news coverage or hysteria or lockdowns.
As I've pointed out before (in other posts/forums), the flu killed 61,000 in the US last year. And we saw barely any coverage of that on the news. Who is to say how many of those deaths were caused by our longstanding inadequate healthcare system with insufficient coverage, beds, healthcare personnel, ventilators, masks, etc. -- all of the things that are getting exposed now only because of the extra attention given to the novel CV because it is novel (new) and we fear what we don't know?

To this I would add, that those without healthcare coverage in this first-world-not-first-world country are highly unlikely to get tested unless they develop serious symptoms or complications. That further erodes the denominator.

(For those who wish to contest my evaluation of the US healthcare system, I'll provide one simple example from first hand experience of working in the healthcare industry. ICD is a worldwide system for coding medical procedures. In 2010, while every first world country was using ICD-11, healthcare organizations in the US were complaining about the cost of upgrading from ICD-9 to ICD-10. ICD-9 was so backward that it could not distinguish between a right kidney procedure and a left kidney procedure. So patients had to hope the medical practitioners wouldn't perform the procedure on the wrong kidney.)

Finally, the authors contend that the lockdown actually kills many poor people who rely on daily wages and cannot survive under lockdown conditions.

I don't think the authors said this, but I can imagine that people with no fixed address may never get their stimulus checks or unemployment checks or get them too late to be of use. And they may have challenges getting to a bank to cash those checks since they're accustomed to direct deposit.

Also, I know many people who have lost their jobs due to the lockdown. And while the paychecks stop immediately, the stimulus checks and unemployment checks take their own sweet time to arrive. That creates an obvious disruption in terms of cash flow. And we know many people don't make enough to have savings or reserves or live the hand-to-mouth lifestyle popularized by our consumerist society. Add to that illegal immigrants who get paid in cash under the table, don't have healthcare coverage, and won't get receiving stimulus checks or unemployment checks. The lockdown will crush some of the most vulnerable members of our society.

As an aside, I ask you to consider this. If social distancing is such a perfect solution, then how do we implement that in old age homes, jails, prisons, and other forms of involuntary confinement?
https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464

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