Essential Facts About Covid-19
By James D. Agresti
December 10, 2020
Given the spread of misinformation about Covid-19, Just Facts is providing a trove of rigorously documented facts about this disease and its impacts. These include some essential facts that have been absent or misreported in much of the media’s coverage of this issue.
This research also includes a groundbreaking study to determine the lethality of Covid-19 based on the most comprehensive available measure: the total years of life that it will rob from all people. This accords with the CDC’s tenet that “the allocation of health resources must consider not only the number of deaths by cause” but also the “years of potential life lost.”
The CDC emphasizes that the Covid-19 pandemic is still “a rapidly evolving situation,” and as such, the emboldened figures in this article will be updated each weekday as the CDC publishes new data. Other facts that inform the broader picture will be added on a periodic basis as they are verified.
On one hand, these facts show that:
On the other hand, elderly people and those with chronic ailments are extremely vulnerable to Covid-19, and the disease is highly transmissible, which means it could spread like wildfire and overwhelm hospitals without extraordinary measures to contain it. This would greatly increase its death toll.
However, measures to limit the spread of C-19 sometimes involve fatal tradeoffs, and thus, overreactions can destroy more years of life than they save.
Just Facts asked Dr. Rodney X. Sturdivant—who has a Ph.D. in biostatistics and is the Director of Statistical Consulting Center at Baylor University and an Associate Professor of Statistics—to critically review this research. He assessed it as follows:
Brooklyn, NY, May 24, 2020 (iStock via Kirkikis)
According to the U.S. Centers for Disease Control and Prevention, a total of 24,512,618 cases of Covid-19 have been reported in the U.S. as of January 21, 2021. Given that the population is 331 million people, this amounts to one out of every 13 people in the United States. C-19 cases are not equally dispersed throughout the nation, so this figure is much higher in some areas and much lower in others.
Nevertheless, the current likelihood of being exposed to C-19 doesn’t depend on the number of people who have ever been infected—but on the number of people who are currently infected and contagious. Determining this is confounded by three key factors:
Applying the facts above and related data from the CDC and the Center for Evidence-Based Medicine at Oxford University, Just Facts developed a methodology to estimate the number of people in the U.S. who currently have infectious cases of Covid-19. The calculations—which are detailed in this spreadsheet—find that roughly one of every 60 people in the U.S. is contagious as of January 21, 2021.
Again, this is a national average and is not applicable everywhere because of large differences in the timing and severity of the pandemic in different areas of the country.
Fatal interactions between Covid-19 and other ailments like heart disease and diabetes make it difficult to determine the exact death toll from C-19. A range of evidence suggests that the CDC’s tally of Covid-19 deaths may be modestly inflated but still provides a reasonable measure of the pandemic’s severity.
According to the CDC’s estimate of “confirmed and probable” fatalities from Covid-19, a total of 408,697 U.S. residents have died from the disease as of January 21, 2021. To put this figure in perspective:
In comparative terms, deaths from Covid-19 are currently about:
Although C-19 is a new disease and took its first reported life in the U.S. during late February, these comparisons may substantially overstate its deadliness. This is because fatalities from accidents, the flu, and other common causes of death occur in droves every year, and this is unlikely for C-19 because of the facts below.
Stockholm, Sweden, April 1, 2020 (TT News Agency/Fredrik Sandberg via Reuters)
The primary reason why the flu kills tens of thousands of people every year is that the viruses that cause it mutate in ways that prevent humans from becoming immune to them. Per the Journal of Infectious Diseases, “All viruses mutate, but influenza remains highly unusual among infectious diseases” because it mutates very rapidly, and thus, “new vaccines are needed almost every year” to protect against it.
In striking contrast, a March 2020 paper in a molecular biology journal that cites Michael Farzan, co-chair of the Department of Immunology and Microbiology at Scripps Research, explains that once a vaccine for Covid-19 is developed, it “would not need regular updates, unlike seasonal influenza vaccines.” This is because the part of the virus that the vaccine targets “is protected against mutation” by a feature of its genetic material, or RNA.
The same point applies to naturally acquired immunity. People who catch C-19 and other infectious diseases with low rates of mutation typically develop enduring resistance to them. The physiology textbook The Human Body in Health and Illness explains that such immunity, which is called “active immunity,” is “generally long lasting.”
This is the case with rubella, mumps, measles, and polio. After people contract these diseases and recover, they rarely get them again or transmit them to others. Thus, they become firewalls against the spread of these contagions.
Media outlets like The Atlantic, Vox, and Forbes have turned the truth of this matter on its head by confusing the general nature of coronaviruses with that of C-19. The habit of calling Covid-19 “the coronavirus” can be very misleading because there are different types of coronaviruses, and C-19 is caused by just one of them.
Coronaviruses are a family of RNA viruses that include some common cold viruses that tend to mutate rapidly, but the virus that causes C-19 does not share that trait. Per the molecular biology paper cited above, the virus that causes C-19 “does not mutate rapidly for an RNA virus because, unusually for this category, it has a proof-reading function” in its genetics. The paper also explains that the same physical feature of the virus that makes it so contagious also makes it:
Simply put, the virus that causes C-19 is immunologically fragile, and thus, it is far less likely to take lives regardless of acquired immunity and vaccines. If this proves true in the long run—as all available evidence suggests it will—the lifetime risk of dying from Covid-19 is greatly overstated by comparing its current death toll to yearly fatalities from the flu, accidents, suicides, and other common causes of death. This is because the vast bulk of people will develop immunity to C-19 either by catching it or through vaccines. In vivid contrast, societies don’t become immune to accidents, the flu, or heart disease.
All of the above facts about immunology in general and C-19 in particular were published in medical journals, textbooks, or encyclopedias near the outset of the pandemic in March 2020 or earlier. Yet, the World Health Organization sowed confusion around this issue by publishing a scientific brief and a tweet on April 24th that stated: “There is currently no evidence that people who have recovered from #COVID19 and have antibodies are protected from a second infection.”
Many media outlets parroted that claim, even though the World Health Organization deleted its tweet later that day and wrote: “Earlier today we tweeted about a new WHO scientific brief on ‘immunity passports’. The thread caused some concern & we would like to clarify: We expect that most people who are infected with #COVID19 will develop an antibody response that will provide some level of protection.”
That clarification was closer to the truth but still misleading because it ignored these three key facts that were already proven by that time:
Since April 2020, a torrent of research has continued to confirm those facts:
Time will tell more about the mutations of the virus that causes C-19, but current indications are that it will not dramatically mutate and become an ongoing cause of numerous deaths.
Photo credit: iStock/kupicoo
Beyond raw numbers of deaths, another crucial factor in measuring the deadliness of a public health threat is the years of life that it robs from its victims. In the words of the CDC, “the allocation of health resources must consider not only the number of deaths by cause but also by age.” Hence, the “years of potential life lost” has “become a mainstay in the evaluation of the impact of injuries on public health.”
This doesn’t mean that younger people are more important than older people, but it recognizes and accounts for the facts that:
These realities seem to be lost on some prominent medical authorities, like Howard Bauchner, the editor-in-chief of the Journal of the American Medical Association. He coauthored an editorial comparing 100,000 deaths from C-19 “to the number of U.S. soldiers killed in World War I or in the Korean and Vietnam wars combined.” This is deceptive because it fails to account for the facts that the average:
While ignoring those facts, Bauchner says that “death seems like it should be an accurate measure of the pandemic’s evolution and effects—the worst outcome, an unequivocal outcome.” Given that death is ultimately everyone’s outcome, it is a flawed measure of the pandemic’s severity because it is incomplete.
A much more complete measure of C-19’s lethality also includes the years of life lost by each victim. Yet, determining this is not a simple matter of subtracting their ages at the time of their deaths from the average U.S. lifespan. This is because:
Based on the average life expectancies of people of different ages and the ages of people who have died from C-19, Just Facts calculates that C-19 robs an average of 13.5 years from each of its victims. This is an overestimate because it does not account for preexisting health conditions, and one working paper calculates that the actual figure could be as low as 1.76 years in the United States.
Even based on the exaggerated figure of 13.5 years, the average years of lost life for each person who dies of C-19 is much less than other common causes of untimely death. For example, accidents rob an average of 30.6 years of life from each victim, while suicides take an average of 35.6 years. And once again, these deaths occur every year, while C-19 is unlikely to have an ongoing high death toll because of its vulnerability to antibodies and limited prospects for mutation.
At a March 30 White House press conference, Dr. Deborah Birx, a world-renowned immunologist, presented a slide of projections for C-19 fatalities based on “five or six international and domestic modelers from Harvard, from Columbia, from Northeastern, from Imperial who helped us tremendously.” The model projected that 100,000 to 240,000 deaths would occur if Americans followed social distancing and hygiene guidelines. Birx added that “we really believe and hope every day that we can do a lot better than that because that’s not assuming 100% of every American does everything that they’re supposed to be doing, but I think that’s possible.”
The high-end of that range has already come to pass, but even if 500,000 U.S. residents eventually die from C-19 at an inflated average of 13.5 years of lost life per person, the disease will rob 6.8 million years of life from all Americans who were alive at the outset of 2020. In comparison, the flu will rob them of about 35 million years, suicides will rob them of 132 million years, and accidents will rob them of 409 million years:
Those figures reveal that accidents are about 60 times more lethal to Americans than this nightmare scenario for Covid-19. Likewise, the flu is about five times as lethal, and suicides are about 20 times as lethal. This is a substantially more comprehensive measure of deadliness than the tally of lives lost during a year—or any other random unit of time—because it accounts for the entirety of people’s lives and the total years of life that they lose.
On March 3, 2020, the World Health Organization announced that “about 3.4% of reported Covid-19 cases have died,” and “by comparison, seasonal flu generally kills far fewer than 1% of those infected.” Media outlets widely reported these figures and lambasted President Trump for saying, “I think the 3.4% is really a false number” and “I would say the number is way under 1%.”
On March 11, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told a U.S. congressional committee that the mortality rate of C-19 is “somewhere around 1%, which means it is 10 times more lethal than the seasonal flu.”
Contrary to the statements of the World Health Organization and Fauci, Oxford University’s Center for Evidence-Based Medicine currently estimates that the fatality rate for C-19 is “somewhere between 0.1% and 0.35%.” This is well below 1%, just as Trump stated, and it nowhere near 10 times the flu fatality rate, which has averaged about 0.15% over the past nine years in the United States.
Similarly, the CDC’s current best estimates for the C-19 fatality rate are:
In August, Cambridge University Press published a paper analyzing why early coverage of the C-19 fatality rate was so inaccurate. The study found that purveyors of inflated mortality rates likely confused two different measures of mortality called the “case fatality rate” and the “infection fatality rate.” The first of these is rate of death among confirmed cases of the disease, while the second is the rate among everyone who had it, including those who were asymptomatic or never diagnosed with it. The paper notes that misinformation about the death rate “helped launch a campaign of social distancing, organizational and business lockdowns, and shelter-in-place orders.”
At the time that those exaggerated mortality rates were being broadcast, ample evidence had already undercut them. This is proven by the remainder of this section, which is word-for-word from an article published by Just Facts on March 17, 2020:
Initial media reports of a 2–3% mortality rate for Covid-19 are inflated, and the actual figure may be closer to that of the flu, which has averaged about 0.15% over the past nine years in the United States. A large degree of uncertainty surrounds this issue due to the same factor that prevents accurate counts of infections: unreported cases.
As explained by Dr. Brett Giroir—who has authored nearly 100 peer-reviewed scientific publications and serves as the Assistant Secretary for Health at the U.S. Department of Health and Human Services—the Covid-19 death rate is “lower than you heard probably in many reports” because the bulk of people who contract coronavirus don’t get seriously ill, and thus, many of them never get tested.
Giroir calls this a “denominator problem” because if you’re “not very ill, as most people are not, they do not get tested. They do not get counted in the denominator.” Giroir’s best estimate is that the mortality rate is probably “somewhere between 0.1% and 1%.” This “is likely more severe in its mortality rate than the typical flu” rate of 0.1% to 0.15%, “but it’s certainly within the range.”
Giroir’s estimate accords with a February 2020 commentary in the New England Journal of Medicine by Fauci and others:
A prime example of how journalists misreport on this issue is a March 12th article in Business Insider by Andy Kiersz. In this piece, he compares the “death rates” of Covid-19 from the South Korean CDC to that of the flu from the United States CDC. Based on these numbers, he reports that “South Korea—which has reported some of the lowest coronavirus death rates of any country—still has a COVID-19 death rate more than eight times higher than that of the flu.”
What Kiersz and his editors fail to understand is that the denominator for the Korean rate is the number of “confirmed cases,” while the denominator for the U.S. rate is based on a “mathematical model.” The CDC clarifies how the model works by citing a study on swine flu, which multiplies “43,677 laboratory-confirmed cases” of the disease by 41 to 131 times to calculate the denominator for the death rate. In the authors’ words, they do this because confirmed cases are:
Put simply, Covid-19 death rates that are based upon reported or confirmed infections grossly undercount the number of people with the disease. This, in turn, makes the death rate seem substantially higher than reality.
Photo credit: iStock/2K Studio
Another important factor in weighing the risks posed by Covid-19 is its transmissibility, or how contagious it is. In this respect, Covid-19 is much more dangerous than the seasonal flu because it spreads very quickly and can overwhelm hospitals.
Scientists measure contagiousness with a basic reproduction number, which is the average number of people who tend to catch a disease from each person who has it. This measure is an innate characteristic of the disease because it doesn’t account for actions that people take to prevent it. A February 2020 paper in the Journal of Travel Medicine explains that any disease with a basic reproduction number above 1.0 is likely to multiply over time.
The same paper evaluates 12 studies of the basic reproduction number of Covid-19 in various nations and finds that they “ranged from 1.4 to 6.49,” with an average of 3.28 and a median of 2.79. Based on their analysis of these studies, the authors conclude that the basic reproduction number of C-19 will likely prove to be “around 2–3” after “more data are accumulated.”
In comparison to the flu, a 2014 paper in the journal BMC Infectious Diseases analyzes 24 studies of the seasonal flu and finds that the median result for the basic reproduction number is 1.28. The authors stress that the seemingly small difference between 1.28 and higher figures like 1.80 “represent the difference between epidemics that are controllable and cause moderate illness and those causing a significant number of illnesses and requiring intensive mitigation strategies to control.”
All of the facts above were published in scientific journals by February—but in direct contradiction to them—the Director-General of the World Health Organization gave a press conference on March 3 in which he stated that “Covid-19 spreads less efficiently than flu.”
A range of media outlets echoed that dangerous falsehood, as they did with others from the World Health Organization about immunity and fatality rates. Then with no apparent regard for the World Health Organization’s track record of spurious claims, Google/YouTube adopted a policy in May of censoring people who post content “that contradicts the World Health Organization (WHO) or local health authorities’ medical information about Covid-19.”
The high transmissibility of Covid-19 means that hygienic practices, social distancing, and other precautionary measures can save more lives than doing the same for common diseases like the flu.
Times Square, NY, May 8, 2020 (iStock via Leo Cunha Media)
There are, however, mortal dangers in overreacting because measures to limit the spread of C-19 have tangible impacts that can cost multitudes of lives. Numerous facts have shown that lockdowns, panic, and other responses to the pandemic have done just that. A small sampling of these include the following:
These facts prove that overreacting to C-19 can ultimately kill more people than are saved. Calling attention to this point, a study published by the journal Disaster Medicine and Public Health Preparedness in June 2020 found:
The implications of overreacting to Covid-19 or any other potential hazard are aptly summarized in a teaching guide published by the American Society for Microbiology. This book explains why “the factors driving your concept of risk—emotion or fact—may or may not seem particularly important to you,” but they certainly are because “there are risks in misperceiving risks.”
Photo credit: iStock/flyparade
A slew of lethal outcomes over the ensuing months have proved that statement true, especially the global number of C-19 deaths per day:
A sample of articles from the New York Times shows that this post-lockdown carnage occurred across the globe and took many people by surprise:
All of this was predicted and predictable. Even the Imperial College of London, which provided the impetus for mass lockdowns, admitted in March that the “more successful a strategy is at temporary suppression, the larger the later epidemic is predicted to be in the absence of vaccination, due to lesser build-up of herd immunity.”
Making a similar point eight years before the pandemic, a 2012 paper in the journal PLoS One about “Immunity in Society” noted that:
Equally, if very few people are immune to a disease, they can transmit it to others instead of blocking it. Without a vaccine, the only way people can become immune to C-19 is by catching it and recovering. This means that too much social distancing may cause more deaths because young, healthy people—who would otherwise catch the disease, recover quickly, and become firewalls—remain as potential carriers.
Quantifying those dynamics, a study published by the British Medical Journal in October 2020 found these stunning and “counterintuitive results” about lockdowns in the United Kingdom:
Those outcomes assume a C-19 mortality rate of 1% (higher than reality) and that widespread vaccination does not occur for 800 days (probably slower than reality), but the basic point remains the same: Lockdowns to control the spread of C-19 can actually cause more C-19 deaths by preventing the development of herd immunity among healthy people—the vast majority of whom are very resilient to the virus.
And that only accounts for added C-19 deaths. In addition, lockdowns trigger hordes of other types of deaths both immediately and in the long-term by causing anxiety, depression, missed medical care, unemployment, and poverty.
Despite those facts, media outlets have often scorned the idea of herd immunity, like this October article in the New York Times that claims:
That statement suffers from two fatal flaws:
Collectively, these data indicate that herd immunity could have been achieved with much less loss of life than has already occurred. That would have required doing more to protect vulnerable people and allowing young healthy people greater freedom instead of locking them down. This is precisely the opposite of what certain high-profile media figures called for and government officials have done.
For the purpose of illustration, 43% of the U.S. population—or roughly enough to achieve herd immunity—is under the age of 33. If everyone in this age group went about their business and caught the disease while everyone else stayed Covid-free through diligent social distancing, hygiene, testing, and other creative measures:
In comparison, 240,213 or about 15 times more fatalities from C-19 were recorded among people of all ages in death certificates filed by November 21, 2020. Given the ages of the deceased, this amounts to 3.2 million years of life, or four times worse than the idealized scenario.
That scenario unrealistically assumes prevention measures and herd immunity are so effective that no one over the age of 32 catches C-19—but like the British Medical Journal paper—it shows that there comes a tipping point where broad lockdowns cause more C-19 deaths than balanced measures. Again, that’s in addition to all of the other deadly effects of lockdowns.
However, strategic social distancing can keep hospitalizations at reasonable levels so that victims receive proper care, and it can also buy time to discover and mass-produce effective treatments.
During a March 14th press conference, U.S. Surgeon General Jerome Adams asserted that “this situation will last longer, and more people will be hurt” if “we are complacent, selfish, uninformed,” and if “we spread fear, distrust, and misinformation.” Yet, that is exactly what many media outlets, governments, and big tech companies have done.
Conversely, Adams said that “we will overcome this situation” if we “pitch in” and “share the facts.” The essential facts above confirm the wisdom of his words.