Covid-19 Case Count and Real Death Rate- Life and Death Statistics

It is a common thread in our world today: the media, the government, various agencies share numbers with the public absent of context or rational analysis, and the public dutifully accepts the numbers (and the actions that they lead to) without demanding an explanation.

The Covid-19 pandemic has been a painful lesson in the superficiality of our present media. As an illustration, let’s take a deeper look at the two most common statistics that are shared publicly: cases and deaths. These numbers are more important than most statistics since they are the basis for so much critical policy and conduct.

Coronavirus Case Counts

As of this morning (April 25, 2020), the reported number of cases is about 870,000 across the U.S., while the reported deaths stand at about 50,000. In the most simplistic analysis, this suggests that the fatality rate is about 5.75% — meaning that about 6 out of every 100 cases results in the patient dying. Were this number to be factual, the disease would have proven to be enormously more lethal than any previous estimates, and the risks to the general population far worse. On the other hand, if the case number were accurate, is it possible that we are vastly over-reporting the death total, implying that the virus is far less of a problem than we are assuming? What seems abundantly clear is that the two numbers are flawed, and some more analysis is required.

Of the two numbers, the fatality total appears to be closer to some relevancy, so we’ll begin with the case number. We can assume some immediate adjustments, starting with the title of that number. The case number quoted is more accurately described as the number of test cases that have been determined to be positive, rather than the number of infected citizens. Since testing has been fairly minimized to date (estimates are in the 4.7 million tests), we can assume that there are some quantity of people who have the disease that we have not included in the case number; given that a significant percentage of people who have the virus are asymptomatic, the potential number of infected is considerably higher.

How much higher? We cannot yet tell, but we can make some reasonable assumptions. The two numbers — tested and infected — seemingly provide us with a starting point. Contrasting tested against infected, we find that about 18.5% of the tests taken have come back positive. In a country of some 325 million, that percentage would imply that over 60 million Americans have the virus… a truly difficult number to reconcile, and one that would have severe implications. It would also imply that the virus had a mortality rate of about 8/100 of 1%, considerably lower than the common flu. Based on that, we can safely assume that the 60 million is false, and that reality lies between the reported number (870,000) and the implied number (60,000,000), a pretty wide range.

Demonstrated Symptom

Fortunately, we do have some information that might be of help. Up to the present day, we have largely tested only those with demonstrated symptoms, or direct and proven contact with infected sources. Therefore, if we can determine the percentage of people who have the virus, but are asymptomatic, then we can make some more appropriate estimations. Different agencies, along with the WHO, have suggested that about 50% of those infected demonstrate no symptoms at the time of testing… since for the most part, those infected people would not be tested, we might assume that the number of actual cases is closer to double, or about 1.75 million people. That number is probably a little closer but still lacks a useful accuracy, since entire segments of the country have not been tested yet, and with the preponderance of testing occurring in areas having breakout infections, suggesting higher percentages there.

Perhaps we can go back to the mortality rate for some insight. We have 50,000 reported deaths due to the virus; these numbers may well be underreported, based on inconsistencies in defining what constitutes a virus-related death, and the lack of testing for many suspicious deaths. That said, original statements by the WHO, and supported by experiences in other countries, suggested a mortality rate of between 1% and 2% for Covid-19 in the general population, with much higher indications for various subsets. Let’s pretend that we have a confirmation of the mid-point there (we absolutely do not), and ask what that tells us: if the 50,000 represents 1.5% of infections, then we would assume about 3.3 million actual cases. This number — about 4 times the reported cases — appears closer, and in line with recent revelations in NY and elsewhere as antibody testing has begun to be applied.

(One note about the fatality statistics: we are discovering (inexcusably belatedly) that one of the insidious aspects of the disease is its impact on the elderly, specifically those in concentrated housing situations. For that population, we are just now computing odds of mortality that are truly stunning — perhaps as much as 30-40%. It is also a population that likely has been drastically underreported, as few of the deceased were tested for the virus before they passed. We may well find that, had we understood the critical nature of the impact earlier, we would have prioritized protection for those populations and had a different, far improved outcome.)

This is the reason for the pervasive insistence by scientists and medical professionals that a massive effort to test the greater population is essential to control and treatment. To date, we have tested less than 1.5% of the domestic population; that number is poor enough to deprive us of critical understandings of the nature of the virus. The number of cases — and potentially the number of people who have some level of immunity — is irreplaceably important to understand the risks of opening up the economy, and for preparing our medical resources for continued capacities.

In addition, we still have a very low understanding of the actual impact of the disease. We have found that a significant percentage of asymptomatic positive tests develop their symptoms later, sometimes much later… we are learning that the virus has neurological impacts that we do not understand, and that may have implications for future health concerns… we have seen a high degree of strokes and blood clots in patients, without fully understanding why. Each of these (and other) considerations could dramatically alter our policies and preparations, both medically and financially; extraordinary increases in testing and informed analysis over time are critical to our national response.

All of this brings us back to the commonly accepted and reported statistics. We can demonstrate effectively that those numbers are false; that they present an inaccurate picture of the virus and its impact on the country. So long as the media and the public accept them as meaningful, the important debates about treatment, about budgeting resources, about policies and about appropriate cautions are all distorted and will continue to lead to poor decisions, decisions that will, in turn, deprive us of our ability to effectively combat the pandemic going forward. As a people (and as a media that is responsible for informing us) we must demand more and better information, presented in a relevant context… many of our lives may well depend on it.