Having limited time to write, and seemingly unlimited topics of importance to write about, I have until now refrained from writing in any depth about the current COVID-19 outbreak and the media-fueled hysteria relating to it. From the get-go, one thing that seemed apparent, was that the panic was being sustained by the relative success of the “containment”.
If the outbreak died out, as it likely will during the summer months (like other Corona and Influenza viruses tend to do), then the panic would of course subside. But it would also subside if the “pandemic” as they refer to it, simply succeeded in happening, that is breaking out of any type of containment effort. The long limbo state, where the virus seems to have broken out of containment in many countries, but still not certainly since the numbers of confirmed cases are so small (compared to the general populations of these countries), continues to fuel the panic. It is a panic “of the unknown” and based on the fear of what armageddon will occur if the containment fails. Meanwhile, it is coupled with logical economic fears, that people rightfully have about what the panicked voters will force governments to do and how much economic damage that will cause.
So it is the endless containment efforts, that continue the panic and economic disaster that goes along with it.
And of course, when it comes to the stock market, it is everything combined including the always dangerous “I am not afraid, but since I know you are… or at least know that you think that I will think you are (or think that I will think that you will think that I will think you are ad infinitum), and I am not interested in being the last “brave” holding the bag, yea we are all afraid!”
So while the market participants may not be themselves convinced of the logical necessity to fear something, it is enough to fear that others will fear (or themselves think that others will fear), to cause prices to plummet. Prices in the market are not the “correct” prices, but the prices that the “herd” assigns at the moment. And everyone is aware of that; saying nothing of the very logical fear of government actions, which are already crippling the world economy.
How should have it been handled? As you will see in this paper, at most, countries could have quarantined those patients who have the disease, and not cancel international travel (from those that are also quarantining) and other parts of the economy. Even better, doing nothing other than simply letting people know that elderly people should, just like every year, at their own free will, take precautions would have sufficed. Since the elderly often do not work on a daily basis, and they need to take care not to contract the seasonal flu and other viruses anyway (since they are much more dangerous at those ages), this could have been relatively painless.
Besides the exaggerated risks of the virus, there is a typical bureaucratic absurdity that by now, most countries have plenty of reported cases, and people are living in those countries as normally, but are deathly afraid from people in other countries. So here I am writing in Israel, which has reported cases, and everyone around thinks its perfectly safe, but Gd forbid you cannot fly abroad, say to Germany where there are also cases (about the same percent of the population), while Germans are afraid to fly to Israel. So we have cancelled international trade and travel, with massive repercussions, between countries all with the diseases already present within their borders while people travel within those countries spreading it to each other freely.
Why would governments cripple their own economies without good cause?
Good question, and with an easy answer. Because governments are at the mercy of their street, and the masses. And the masses believe as the news media says. And the news media says “Crisis!”. This is their business, it certainly helps sell news, to have crises and if it destroys the Trump economy conservatives keep bragging about ahead of an election, then all the better!
There was also an interesting and ironic interplay between Chinese media and western media that I can cover elsewhere.
Pray tell Lighthouse Keeper, How can you think this is overblown media hype, when so many experts say otherwise!?
Great question. A full answer would require a deep dive into a whole lot of many things, from the nature of mass media to microbiology. Due to the limited time mentioned above, and the subject matter at hand not being worthy of anything approaching a full answer, I will give you a short, but very convincing answer. Unlike many of my articles, and perhaps to the appreciation of many readers, this one will cut to the chase.
A little bit of background and then some numbers.
The corona viruses are a group of highly related viruses (or subfamily to be more exact) that attack mammals and birds. In humans, they typically cause respiratory tract infections that are typically mild and mostly easily overcome by the body’s immune system. They are responsible for a significant percentage of adult “Common Colds”, especially during epidemics and are always very common among children. Yes, the same Common Cold, a mild condition that virtually everyone in the planet is well acquainted with. Coronoviruses and Rhinoviruses together cause the large majority of Common Cold cases.
The Common Cold’s more dangerous cousin is of course the Flu, caused by Influenza viruses. Sometimes though, they are difficult to tell apart (if symptoms are mild especially), and there are plenty of misdiagnosis that go on (for example, many Common Cold cases are themselves caused by an influenza virus) and also co-infection during the overlapping seasons, winter to early spring in temperate climates, is very common. The Flu of course is also a typically mild and common condition, though it can be much more dangerous for the very young and the very old. Many if not all viral infections, including those causing the Common Cold and the Flu, are much more serious for the elderly and those in poor health and a weak immune system. There is no true cure for any of the above, and only partially successful vaccines (since the strains and serotypes change all the time), and so if the body is not able to fight off the infection as in most cases, these maladies can be life threatening.
The Flu for example, in a typical season kills 300 to 650 thousand people worldwide each year. This can vary widely depending on the type of Influenza virus or viruses that year (and of course, the level of medical care at the time in various countries). The Spanish flu in 1918 famously killed anywhere from 20 to 100 million people (though as a side note, this figure of course, though often sited is completely unknown. Either the death rate was many times higher than thought (and so would further make a mockery of the current virus at hand or the death toll is highly overblown. Even reaching within range of the lower estimate would require everyone alive at the time in 1918, approximately 1.8 billion people, to be infected for a 1% death rate to equal 18 million people death toll. To reach the higher estimates seems impossible. This however is further evidence that in general the death rates for these widespread infections are lower than thought because the number of infected is almost undoubtedly always higher than thought. By definition, we know of and overstate serious and fatal cases. For the purposes of this talk however, the point is that the Spanish Flu killed many people and easily spread worldwide in an era without commercial air travel).
Incredibly, the current 2019-2020 flu season, though ignored by the media, was quite strong, and has been estimated to affect 10% of Americans, and killed 18 thousand of them, while having infected around 800 million people world wide, killed 450 thousand!
Half a million people have been killed worldwide by yearly Flu this very same “2019–20 coronavirus outbreak” season to the complete indifference of the media, the authorities and the public.
There has been no travel bans, no quarantines, no worldwide closures of any type to battle this deadly virus. Why? Because telling people that the flu is killing people this year like every other year, does not sell as much news.
Don’t get me wrong, if the coronavirus wasn’t around, they would give it a shot! The influenza strain A(H1N1)pdm09 or “Swine Flu” as the media likes to call it which went around this year can still be used for a lot of panic news and it has been used in the past. It is believed to be very similar to the 1918 Spanish Flu that killed so many a century ago. Bird flu, Swine Flu, SARS, MERS, Ebola, you name it the media can do a lot with this as well if there’s nothing better around!
The COVID-19 Numbers
All right, so to the issue at hand. Without getting too technical here, numbers vary widely from report to report and place to place because the experts don’t really know. This article often quotes what “is believed” by scientists, and you should understand it is conjecture at best, especially when it comes to the coronaviruses and influenza.
They have no cure, unlike many other viruses which humans get once and then nearly never again we seem to get them time and again. This is because they seem to recombine, reassort and undergo antigen shift and/or drift. There are various strains and many more serotypes that we know of, and we only started to be able to identify them and genetically sequence them recently. It used to be you simply had a Common Cold or the flu, and that was that, or if it was really bad pneumonia and/or bronchitis to go along with is, but an accurate diagnosis was rarely achieved. Because these viruses are mild in most cases, and we have lived with them for thousands of years, there has not been a great pressure to isolate them and understand them better. Their rapid changes, and the fact that most human coronaviruses cannot be grown in culture cells has also not helped.
This may change int the near future, but what we have right now is that these viruses are not understood very well at all. There is no consensus on the mechanism by which they constantly mutate to avoid our immunity nor even on the mechanism by which they spread.
For example, is it humidity, sunlight or temperature, or any combination of them, that kills the virus in droplets quicker in summer than in the winter? Or is it simply human behavior of being indoors and closer together that helps the spread in winter? Debated and little understood. Are the different ever strains ever present, but changing immunity in the human population over time determines the strains that flourish and cause epidemics? Or are there constantly new strains due to genetic mutations and recombinations? Same strains and different serotypes, antigen shift or antigen drift? Or any or all of the above? They don’t know.
What is likely is that a great part of what is happening is that for the first time we are finding out. We can actually trace epidemics and new strains and quickly genetically sequence them. So each year we have an ample new set of names of what periodically was just called “I have the flu” or “I have a cold”. A rose by any other name…. And it is likely that for centuries if not millennia we have had both coronaviruses and influenza viruses constantly entering and exiting circulation in human populations. If they did not have this ability to avoid our immunity by whatever mechanisms they possess, and then there would be no such thing as the yearly infectious seasons. That is what makes rhinoviruses, human coronaviruses and influneza viruses unique for our purposes. If not, much like measles, mumps, chicken pox and rubella, humans could only typically get them once before becoming immune to them (or simply get vaccinated and not get them at all). So the fact that there would be an endless stream of related Common Cold and Flu causing viruses is inherently obvious from what we know of virology and microbiology for many decades. We just couldn’t keep track of them and name them so easily in the past.
An example of what I am referring to above is the 2009 H1N1 flue season, or “pandemic” as they like to say for effect. Older people fared better than younger people, which is unusual for a flu, and it was particularly young children that were at most risk. People, especially older than 60 or 65, apparently had immunity to the strain due to its circulation many years past. The strain was the same or very similar to the aforementioned Spanish Flu of 1918 which killed millions of people. The current coronavirus on the other hand, is not successfully attacking very young children at all, and is quite dangerous for elderly people.
So, from mechanisms to evolution, we know little about these, other than that they are mild conditions, sometimes relatively dangerous for the very young and/or the very old, go around yearly and have been with us for a very long time. For those of you who may want to know more about coronaviruses specifically, this paper and this paper are great places to start. They include a host of interesting information (and presented mostly humbly due to the great uncertainty on the subject-matter) such as that
Potent neutralizing activity directed against HCoV-NL63 S protein was detected in virtually all serum samples from patients eight years of age or older, suggesting that HCoV-NL63 infection of humans is common and usually acquired during childhood.
The above supports the notion that coronaviruses in general may be very common among humans and children early on acquire full or partial immunity to various strains. But as stated, on specifics we still don’t know very much.
This lack of knowledge extends to mortality rates. We do not know them very well because most people that get these respiratory tract conditions yearly, don’t report it or get hospitalized. And of those that do, very few have actual accurate PCR tests to diagnose exactly what virus or viruses is infecting them. Therefore, if you have untold thousands or millions with a disease, and only find about a few of the ones who have a very severe case or those that end up dying from it or its complications, you cannot calculate a correct mortality rate. If that were not enough, it is not as straightforward as one might think to assign a cause to deaths. Often, people die from complications relating to other pre-existing causes and the most direct cause of death may not be the most scientifically meaningful (if chemotherapy has virtually eliminated a person’s immune system, it may not be as informative to know that the flu killed him (also itself indirectly, as it in fact caused some other complication) as much as it would to know cancer did).
On the other hand, at the risk of lumping various viruses together, since various strains tend to dominate specific seasons, and because they have been around so long, we do get a general idea of the death rate, with a large margin of error.
For example, the current death rate for the 2019-2020 flu is about .06% and others have varied from .1% to 2% or higher. the 2003 SARS (another coronavirus) had a whopping death rate of about 9% in China, but did not spread very much nor easily. The Spanish flu in 1918 is estimated at 2-3 percent death rate, and it spread wildly across the globe (though as previously noted, there are issues with the often-cited figures). All of these rates vary greatly between age groups and genders, as of course with the level of medical care available. These numbers vary widely because again, typically the number of cases is under-reported, especially those that are very mild or even asymptomatic (no symptoms whatsoever). But let’s say they are typically in the ballpark of 2% or less. Viruses that are much less contagious can be much more fatal (potentially an evolutionary pressure) such as the SARS of 2003 (SARS-CoV) at >9%, and MERS-CoV of 2012 at over 30%!
The Ship
For the current COVID-19 outbreak, we actually have some amazing set of numbers. Forget all the hype, there was a boatload of people, stuck together for months in close proximity with the virus in full swing at peak season. For much of the time, the folks there did not have hospital care, but were stuck on the boat (so sub-par conditions and care), and of course they were in general an older crowd as cruise crowds tend to be. This is ripe territory for our so called deadly pandemic Covid-19! This was in the Diamond Princess cruise ship.
Due to the focus and world media attention given to the ship, and its subsequent quarantine, we have a rare case of almost full and perfect or near perfect numbers. And here they are:
A total of 4,061 were tested. But to be conservative and gracious to the weak coronavirus, we will only use the numbers that the Japanese Ministry if Health has given as those having been in the ship as of February 3 2019. This total number is 3,711 (of which 3,618 were tested).
Of those, 702 tested positive for the COVID-19.
That is approximately 558 passengers and 144 crew memebers.
Of the 558 passengers who tested positive, 329 (59%) were asymptomatic. They would not have known they were sick if you did not tell them. That is a majority of cases, even in this relatively older group.
A similar story with the crew. The crew was infected at a much higher rate since they continued to work to feed and take care of the quarantined population and had more frequent contact with more passengers and each other. Still, out of 144 who tested positive, 81 (56%) had no symptoms at all.
How many among the crew, who were mostly Philippino and younger die of the disease? None at all.
And how many died of the disease or complications (often after they were evacuated to their home country) among the passengers? As of writing our March 5 numbers are at 6 total. All of them elderly, 5 of them over 80 years of age and one of them, an Australian man 78 of age. The one death among the 150 Australians quarantined on the ship.
Now in reality, the Japanese had announced 705 positive cases in the ship back in Feb 26, and they had been growing rapidly on a daily and weekly basis as the virus spread and incubated among the passengers. By March 5th, when we take our latest set of numbers including the death toll, that number would have likely been significantly higher (and thus lowering the death rate). The Japanese are no longer reporting positive cases of people that were not on the ship as of Feb 3 as part of the Diamond Princess numbers (including all sorts of staff that went in and out). But we are going to ignore all that, and err on the side of caution. We are going to ignore the current flu, which obviously was also present in the ship during peak flu season and as stated previously, has killed nearly half a million people this year. We will ignore all that as well as pre-existing conditions and the health of the passengers who unfortunately passed away and this is what we have:
Six dead from a conservative 702 cases aboard a cruise of 3,711 people all stuck together in a ship for many weeks. A death rate of of .85%. In reality, it is much lower among younger people (basically zero) and significantly higher among older people. Since the cruise was an elderly population in general, we get a slightly raised number.
As stated above, the 2009 flu was estimated at about .03% mortality rate. Since it infected a much younger population in general, and elderly people tended to be far more immune to the virus than younger people, the comparative mortality rate for younger people of the 2009 flu was many times greater than this current coronavirus. Additionally, this coronavirus, thankfully does not affect the very young and infants at all (or very mildly). As is the case every year, this coronaviurs, along with the others and influenza is potentially dangerous for older people, and they should, every year, take some precautions. The death rate among older people is still far from catastrophic, and the vast majority who would be infected with coronavirus would easily survive it, but it is significant and care should be taken to avoid if possible.
For younger people, this coronavirus is nothing but a strong case of the common cold. That’s what it is for a minority that is, for the majority it is so weak it goes unnoticed.
How does this compare to the mortality rate official bodies are giving? Pretty good. The mortality in China is reported at 3.8% because of under-reporting and a poor health system (they end up treating only the very worse cases). Morality areas other than China are reported as of March 5th at .7%, in line (and in fact a bit lower) than what I quote occurred conservatively in the ship.
As for the death rate by age group and gender, data relased by the WHO on Feb 29 gives us the following:
I suspect the above chart significantly overstates the mortality rate, due to many factors most important is the under-reporting of the disease in mild or asymptomatic cases, but is still not very far from what I have explained here.
And let me provide some interesting numbers by country:
Germany has reported 1,151 cases so far. Zero deaths.
Sweden has reported 248 cases, zeo deaths.
Belgium 239 cases, Denmark 59 cases, Austria 112 cases, Norway 183 cases, all with 0 deaths thus far.
Obviously, 1st world level of care matters, and percent of detection matters. China’s reported infection numbers must be vastly understated (hence the death rate seems higher).
And those are not the only countries reporting 0 deaths, Singapore, Malaysia, Bahrain, Greece, Canada, Kuwait, Iceland, the UAE, India, Israel, Czech Republic, Lebanon, Portugal, Vietnam, Finland, Brazil, Ireland, Algeria, Indonesia, Slovenia, Qatar, Romania, Russia, Poland, and among many others Oman have reported a significant amount of cases to date and zero deaths. This is not the stuff hysteria should be made of
Finally, you could say OK fair enough it is not that deadly, or that much more deadly then a variety of seasonal viruses, but since it is a new strain it is spreading wildly faster! If the entire world gets it, even very low death rates could be catastrophic. Well, the data does not seem to show that either.
The WHO reported the Ro (r-zero) of the virus to be between 1.4 and 2.5. This is a measure of the attack rate of the virus, that is how rapidly it spreads in a population. An outbreak with less than 1 Ro, will gradually disappear. As a reference, the season flu has an Ro of 1.3 and for the quite deadly 2003 SARS at 2.0.
Conclusions
Now you may say that if what I am explaining is true, that there should have been all these extreme measures taken for the flu as well, if in fact it has killed so many people. For that and perhaps other diseases. Perhaps this data simply scares you more, as only ignorance is bliss, and so now you support even further measures in general to contain this and other diseases. That is another point, and it can be discussed, but certainly one would be in favor of logic and putting specific dangers in proportion. I won’t discuss that here in depth but suffice to say that if you believe all measures should always be taken to prevent all loss of life, then we quickly go down a strange rabbit hole.
Driving and cars kill more people than any of this stuff and yet we don’t ban them. One to two million people die each year from car related deaths, and many more, perhaps 25 to 50 million are injured or disabled. And these deaths are not concentrated among the elderly and those in poor health but across the population (ironically the corona virus is saving lives in this area as the reduced driving, especially in China is saving thousands of people’s lives). Trains, planes and automobiles kill people, as does every other activity from skydiving to simply working at your job. The amount of things to ban are stupefying to contemplate, starting with banning all sports of course!
In the US alone, the leading cause of death for people from the age of one to 44 is unintentional injury of some kind. Banning sports and recreational activities would not be enough, work is dangerous too! The death rate for fishermen alone from work related injury is .12% each year! Do it for 20 years and you are at 2.5%. Maybe we should ban fishing. Loggers are at about the same number (followed by pilots) so we should ban paper, and on and on.
Side Note
Safety at all costs is an attractive point when seen myopically, terrible when seen as part of the bigger picture. As a good friend recently reminded me, not so long ago Lord Nelson at Trafalgar not only refused to take cover away from his men, but even refused to change coats and remove his decorations (which single him out as an important target for the enemy). Today, grown men in their prime walk around with masks like oxen.
This reminds me of a worrying trend that I witnessed while serving in the IDF. The hated (by me) phenomena of the “Tachkir Lekach”, roughly “investigation and lesson”. So any time anything negative, of any magnitude happened, there was an investigation that undoubtedly led to a new stupid rule. A soldier got his hand burned in the kitchen… let us Investigate, oh yes, fire is hot and burns, these pots are heated with fire, Lesson, no more hot food! It was most often applied in endless trivial areas, and more worryingly in important areas. A recruit unfortunately died in an extremely difficult and selective “Gibbush” (the physical and mental trials that run several days which recruits must pass to be inducted into special units). Immediately the Gibbush was made less difficult. So sure, now a soldier will not die once in 50 years in that same Gibbush, it will be once every 80 years maybe, and our pilots, as this particular test pertained to pilots, will now be made up of an inferior selection weakening our air force and the safety of the entire nation. As I used to like to joke to the others… someone Gd forbids gets accidentally shot in training, Investigation, hmm M16s are dangerous. Lesson, no more guns in the army. Sure, now a solider will no longer very rarely get shot while training, we will simply all be killed by our enemies from Hamas and ISIS to Hezbollah which surround us because our army is now unarmed. Sure, if you want to do Investigations and arrive at logical Lessons, they must be from a very broad perspective, lest they lead you to absurdity and weakness.
On a more related point…
worldwide the number two cause of death (2002 numbers) is infectious disease (viral, bacterial and parasitic). These vary greatly in mortality and include everything from Tuberculosis, Measles and Malaria to HIV, Pertussis and Respiratory infections like those caused by Coronaviruses, Rhinoviruses and Influenza viruses. Together, they have a death rate of over 2.1% and this means over 16 million deaths worldwide each year! I don’t know about you, but it seems to me we should be on a permanent lock-down, travel ban, quarantine mode year round. Oh, except that way many more would die. Economic collapse, poverty, Civil Unrest, War, famine and starvation.
The very reason we have such advanced medicine to lower the death rates of so meany diseases, infectious or otherwise, is because our freedom and economic development. We cannot be safe at any and all costs, not in the individual sense. Our dignity, our prosperity and our freedom demand otherwise. But ironically so does our very survival. Safe at any cost, is the same as dead at all costs.
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