Numbers Matter

According to statistics from Worldometer.info, on May 22 there were 1,645,094 diagnosed cases of COVID-19 in the USA.  Furthermore, there have now been 500,848 cases with final outcomes in which the patient got well or died. Of those cases with final outcomes 403,201 got well (81%), and 97,650 died (19%).  Are these numbers shocking?

Some say, “Yes, the numbers are horrible!”  Others say, “No, the numbers are false.”

Now, it happens that the statistics are, quite predictably, being manipulated to suit those quoting them. But medical evidence is appearing to confirm that deaths and serious cases are very much higher among those who have other conditions which are exacerbated by the virus. The Sunday, 24 May 2020 edition of Medscape begin its lead article by saying, “The hospitalization rate for COVID-19 is 4.6 per 100,000 population, and almost 90% of hospitalized patients have some type of underlying condition according to the Centers for Disease Control and Prevention.”  Some believe that this means no matter what combination of conditions the person had, COVID-19 was listed as the cause of hospitalization.  This leads to unreliable statistics.  “This virus is not so bad.”  The virus is merely a catalyst.  Those being killed would die soon anyway.

The argument continues by concluding that attributing deaths to COVID-19 is fomenting panic. Panic is blocking economic recovery. So, since the numbers are unreliable, just open things back up, separate the vulnerable into safe keeping, and let the young and healthy go back to work and to school. Massive shut-downs are causing political discontent and economic disaster.

On top of that, closing factories, churches, businesses, borders and travel is causing economic disaster without impacting the eventual outcome of the epidemic. Epidemics evolve and the shortest way to get past them is to let them take their course so that populations develop herd immunity. Herd immunity depends on people being immune to the virus once they have gotten over being infected.  It is achieved when enough people have acquired immunity so that the virus no longer reaches vulnerable victims.  Herd immunity advocates insist this is the way epidemics always work with diseases to which people develop immunities through prior exposure.  It is best, according to this theory, to let people be exposed and get over it, which 98% will do, so that in the end there are too few without immunity for the virus to spread.  [As of this date there is no indisputable proof that COVID-19 patients develop immunity to further infection. The plan in Sweden was to count on herd immunity.  The plan in Germany was not to do so, but to impose social distancing to break the chains of infection until medication is discovered.]  If this were Ebola, where death rates are 50% (30% to 90%) rather than 1% of those infected, relying on herd immunity would be unthinkable.

What is being ignored by this reasoning is that even if the virus is no more than a catalyst, it can and has caused great spikes in illness, particularly illness related to lungs. These spikes can overwhelm hospital facilities, and that has happened, but it can be avoided by slowing down the spread by spreading out the population so that everybody has a chance to be treated. Even if keeping people at home is only slowing down the epidemic it is keeping people alive.
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Is this "flattening the spike" worth the cost in terms of hardship, social disruption, actual starvation, and loss of emotional health as the epidemic conditions continue?  Who is being protected by these measures and who is being subjected to collateral tragedy. This brings the matter into the moral-ethical realm. That sort of discussion always revolves around debatable values. On the one hand are those who believe, "If you save a life you save the world." It is immoral to resign any proportion of the population to suffering and death if it can be avoided.  On the other hand, are those who insist, "It is unreasonable to operate as if we expect everyone to live forever. We will all die ... so if the choice must be made, it is better to do it when it serves the greater good."  It’s about numbers.