Coronavirus Part 4: Should I Be Concerned?
Please note: The images included in this blog were taken as screen shots of various pages on Worldometer's website. My intention was to provide the links for you to verify the screen shots. Within hours of taking these screenshots, Worldometer ceased to display the data in the same manner and has discontinued calculating the CFR (explained below) and displaying it for the public. You will see some data still on display but you will need to calculate the formulas yourself if you want verification beyond these images. The numbers that you see on your screen when you click on the hyperlinks will vary from what you see in this blog because Worldometer's website is continually being updated with the latest data. But after reading this blog, you will be able to calculate the CFR yourself when provided the appropriate data for the variables.
Is COVID-19 an apocalyptic plague that will take out a large portion of the world population or is it all media hype? These are the two polar opposite mindsets that seem to be shaping up in the public during the early stages of the COVID-19 outbreak. A level-headed assessment of the facts can help bring you into a logical conclusion of what is going on here. Today, I'm going to crunch some numbers for you so you can assess the data available. Don't forget to check out the video on this topic posted below.
Mortality Rate - The "Flawed Formula"
We have heard the government, media and medical personnel referencing that 2-3.4% of the people diagnosed with coronavirus have died. This gives the impression that COVID-19 has a mortality rate of 2-3%. Having received considerable training in epidemiology and infectious disease in my schooling, I know that this is not the case. The 2-3% estimates on fatalities that have offered to the public do not include a calculation of time and serve to dilute the true severity of the problem. Worldometers calls this a "flawed formula." (1) Swiss Medical Weekly says this method "does not represent the true case fatality rate and might be off by orders of magnitude." (2) In fact, the likelihood of death in novel, emerging infectious diseases should be calculated using different formulas than chronic (longterm) illnesses such as cancer. For specific information on how to calculate the statistics in the pandemic COVID-19, please see the article entitled "Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease" published in the American Journal of Epidemiology.(8) While the specific data to calculate some of these formulas are not made available to the general public, there is one formula that we do have enough data to run. See below.
Calculating Case Fatality Rate
According to Mortality: Statistics by T. Kanchan et al, case fatality rate (rather than mortality rate) should be used to determine the severity of an acute infectious disease. "An obvious differentiating feature of case fatality rate relative to other mortality rates is that the time period is not considered in the calculation. Case Fatality Rate (CFR) or Case Fatality Ratio is usually calculated for acute infectious diseases." (3)
Case Fatality Ratio = number of deaths x 100
total number of resolved cases
Where total number of resolved cases = number of deaths + number of recovered cases.
This formula provides the best current snapshot of the outcome of COVID-19 cases. Allow me to explain:
Picture, if you will, a house with two exterior doors: a front door and a back door. All those who are sick with the coronavirus suddenly find themselves in this house. They must stay in the house until their illness resolves, at which time they will exit the house by one of two doors: the front door (used for those who have recovered from COVID-19) and the back door (used to transport to the morgue).
The current numbers you are hearing of 2-3% mortality are taking the number of deaths and comparing them (as the numerator in the equation) to the total number of cases (as the denominator). That's like saying "only x number of people have died" out of everyone in the coronavirus house. But the jury is still out on all of those people in the corona house. Some of them will live and others, unfortunately, will perish. Because time has not been factored in, a more accurate look at what the outcome in percentages will be is seen when evaluating and comparing the numbers of only the people who have left the building. So, the number of dead are compared to the number of total people who have left the building. THIS gives an accurate representation of how coronavirus is resolving.
Thankfully, the website Worldometers has been providing this information as the spread of the disease progresses. Worldometers is a data compilation and statistics website - a credible organization that pools figures from the Center for Disease Control, World Health Organization, and many other reliable data sources. It is run by a team of international developers, researchers and volunteers and was voted one of the best free reference websites by the American Library Association. Below you can see the accurate snapshot of COVID-19 cases in the USA (9). On the right is the data that shows the accurate Case Fatality Rate (CFR).
CFR = (396/574) x 100 = 68.99%
Yes, it is shocking. Now you may understand better why the government is reacting so quickly and stringently. COVID-19 is a serious problem. Swiss Medical Weekly aptly summed up the state of the matter in saying, "public health authorities remain torn back and forth between the options of overreacting and frightening the population or underreacting putting citizen at risk in their aim to provide advice to countries and individuals on measures to protect health and prevent the spread of this outbreak." (2)
Let's take a look at figures from some other countries.
CFR = (5,476/12500) x 100 = 43.81%
CFR = (1,756/3,881) x 100 = 45.25%
CFR = (3,261/75,701) x 100 = 4.31%