Covid; Why the Panic ?


At this point it seems that we definitely know that the mortality rate of Covid  is much higher in nursing homes. This is true not only in the U.S, but also in Europe. What I haven’t been able to find is how many nursing home residents have this virus, but are asymptomatic. In the real, non-nursing home world, as the number of people being tested goes up, the number of asymptomatic people who have this infection is also going up. (As I mentioned in a letter to the editor months ago, the best way to get a handle on the overall status of Covid in a designated community would be to randomly test for infections in that community. That would be the only way to detect the actual percent of asymptomatic individuals in a community.) 

In a more practical sense for those of us not in a nursing home, “what is our individual risk with Covid-19?“ How many asymptomatic Covid-19 people are out there? Is that number of any practical importance? “Yes,” that number is very important especially when we are talking about the man on the street and the “panic-scale” which seems to be driving a lot of decisions that have already been made as well as those that are continuing to be made.

Here we need a detour – a definition detour. We need to understand the difference between two terms that turn out to be of critical importance in terms of the “panic-scale.”

CFR = Case Fatality Rate. The number of deaths (fatalities) among those who are known to be infected by the virus. To help our understanding, let’s say person ‘A’ feels ill, goes to the doctor, gets tested, and is found to have the virus. If there are 100 of ‘A’ and 2 die, the CFR is 2%. If there are 1000 ‘A’ and 4 die, the CFR is 0.4% (At present the accepted CFR across the board for Covid-19 is 0.4% . . . 4 deaths per 1000 people with a known Covid infection.)

To me, 0.4% is pretty damn good odds! 

And the odds are even better when one looks at CFR for specific younger age groups as follows:

>65 years;  CFR=1.3% ( 13 deaths per 1000 people infected.) -[not as great the older one gets, but still good odds]

50-65 years;  CFR=0.2% ( 2 deaths per 1000 people infected.) – [very good odds]

<50 years;  CFR=0.05% (0.5 deaths per 1000 people infected!) – [outstanding odds]

What these numbers say, in essence, is that for all those < 65 years old, the odds of beating this virus (surviving), are better than very good.

So why the panic ?

The other term is IFR.
IFR = Infected Fatality Rate. The number of deaths among all who have the virus, including those who are asymptomatic or minimally symptomatic, and under ordinary circumstances would never get tested. Some recent studies have suggested that perhaps up to 35% of infections are asymptomatic. If this is indeed the situation, then the IFR drops to 0.2-0.3% (2-3 deaths per 1000 people in the general population.) Even better odds, when compared to a CFR  of 0.4%!

So I ask . . . “Why the panic?”

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