Something that I think is worth questioning as we hit the middle of the third week, day 18, is how numbers are being reported. This matters, since the only information we have is based on those numbers. Political decisions have been, and are being, made based on numbers. And so I looked at the numbers, and found some interesting stuff. Well, interesting to me, at least.
First, the disclaimers. I am not a data scientist, statistician, or anything else that makes this ‘expert’ analysis. I do have a decent brain (still?), and can use Excel to math for me.
Firstly, it’s important to understand that this needs to be analyzed at the lowest possible level. Responses to COVID-19 are different from place to place. The spread of the disease is different as well. Some places, like New York, are being hammered. Some places, like Chicago, not so much. And each place is, and has, approached it differently. Add in all the other places with their own approaches, and you hit an interesting problem. The best numbers are probably state-level. National numbers are good for perspective, but not for policy. Comparing US numbers to other nations is also only for perspective. We all have different people, common comorbidities, governments, health care systems, and health care quality. In short, we are not China, Iran, or Italy. Day 18 in Illinois is not the same as 18 days in elsewhere.
Ok, so let’s look at the questions that I think we need answers to regarding these numbers.
Virgin Soil Epidemics & You
The important term here is virgin soil epidemic. This term describes a new disease in a population. In that case, there is no immunity, and the population is almost defenseless. If you see a disease labeled ‘novel’, it’s likely that the virgin soil concept applies. In these cases, since there is no immunological defense, the disease is unchecked, and able to express itself at it’s fullest.
That means it kills the most people it can.
With diseases like smallpox or Ebola that death rate can be over 90%. Malaria is about 0.3%. Vaccines prevent a lot of these deaths, when available. And, of course, treatment and medical technology change those numbers wildly.
In the last 50 years, the US has dealt with two virgin soil scenarios that stick out in the public psyche. AIDS and COVID-19.
It is important to understand that AIDS and COVID are totally different in how they transmit, and that difference shows up in infection numbers and rates. Which isn’t the number I want to look at.
It’s the case fatality rate.
So…AIDS doesn’t kill people. Human immunodeficiency viruses cause AIDS, and the trashed immune system lets something else kill you. Like pneumonia. Or the flu. Listing the cause of death as AIDS is a political choice, not a medically accurate choice. I’m not arguing that point. I present that as background, not as a debate topic. Listing AIDS as cause of death or not doesn’t really matter to me, personally.
Why This Might Matter
I bring it up because we are seeing indications that the fatality rate in Italy might be way off. Not that the number of dead is off, but the cause of death is. Basically, the 15,362 deaths (as of this writing) is factoring in everyone that dies with COVID-19, not just those dying from COVID-19. The reported Italian case fatality rate is a staggering 12.32%. Those are Legionnaires disease levels. The case fatality rate in Illinois is 2.35%. Italy isn’t some third-world nation with no healthcare, so what happened?
The report was that this number is everyone who has been diagnosed with COVID-19, then died. Regardless of cause of death. If that is the case, then the numbers might better align with the numbers in Illinois, and elsewhere. The next question would then be, do the Illinois numbers reflect those who died from the virus, rather than with the virus?
In the end, it doesn’t matter much. The time to argue about splitting that hair is in the future. For now, it is fair to assume that if COVID-19 was not the immediate cause of death, it contributed. Just like most of us recover from the flu just fine, AIDS makes that deadly. That’s a political point to make, not a human one. It is just one of those things that makes me wonder, and gives me something to write about.
Tracking The Numbers In Illinois
I have been tracking the Illinois COVID-19 numbers. More than just the ‘Day 18’ section below. It is kind of scary, in a way. We are, on track to vastly exceed the kinds of numbers we see from influenza. At the current rates, we will be seeing about 2.5 million diagnosed cases, and 57,000 dead.
The average flu season causes 3500 deaths.
This is something far more serious than the flu, and it really needs to be thought of that way. Be safe out there.
Day 18 In Illinois
Per the state website, as of 4/4/2020 2:30 P.M., Illinois has…
- Tested: 53,581
- Cases: 10,357
- Positive Test Percentage: 19.33%
- Infection Rate: 0.082%
- Deaths: 243
- Case Fatality Rate: 2.35%
Infection Rate is arrived at by dividing Cases into the estimated population of IL, as listed by the US Census (12,671,821)