Perspectives: How bad is it?

Remember that big question raised at the beginning of the pandemic – How bad is COVID-19 anyway?

This question is really fun because it’s like an optical illusion. The answer greatly depends on perspective, and the final outcome greatly depends on what we believed at the beginning. This time it’s not one of those inspirational “if you believe it, it will be!”, but rather the opposite.

Ironically, if we had believed it was bad when we saw the first cases in the US, we would have done everything possible to contain it and it wouldn’t have “been so bad”.

But because of the outbreak and the tragically lost lives in the northeast, the rest of the nation decided that it was something to take seriously and took preventative measures…which then kept it from being tragic in other parts of the country…(leading to protests to open things back up because “it wasn’t so bad after all).”

What a clever trick. By believing it isn’t such a big deal, it becomes a big deal. Believing it is a big deal, we keep it from being a big deal.

While we’re talking about the importance of perspective, let’s look at the question of the magnitude of COVID-19, first from a birds-eye view and then a more personal perspective, using hard data. (What did you expect from an engineer?)

During its first five months,¹ the coronavirus has already killed more people in the US than the flu AND pneumonia did over the course of the entire year in previous years, having killed 34.52 people for every 100,000 people. That means it is already more deadly than the flu, diabetes, and Alzheimer disease, and it continues to climb. If you calculate the rate of deaths per month, COVID-19 is the third deadliest threat in the US this year, after heart disease and cancers.

Here is the trend worldwide instead of just in the US, and a much cooler infographic than I can do in Excel. (Here’s the link in case it doesn’t show up for  you.)

 

 

So there you have a bird’s-eye-view perspective. Now let’s look at the perspective of personal experience – how individuals might be experiencing the mortality rate of COVID-19.

First, there are those that have lost their lives or lost loved ones due to the disease, like my friend who lost her grandmother. My heart goes out to you. These numbers that I’m analyzing will seem really cold and useless to you. But they might help explain why there are many people out there that are apathetic and ignoring or even denying the pandemic.

In the US, people are currently (as of June 11) dying from COVID-19 at approximately the same rate (actually a bit higher) as people died from accidents in previous years, making it the third most prominent cause of death after heart disease and cancer. Did you know someone who died in an accident last year? Odds are that if 1,200 people read this, only one person will answer “yes”.

Another way to look at it: How many people do you know (think Facebook friends and real friends.) If you know 1,200 people, the odds are good that you will know one person who died from COVID-19. But actually, even that’s not completely accurate because nearly 42% of deaths have been in New York state, New Jersey, and Connecticut.¹ So if you don’t live there or don’t know many of people there, the odds of knowing someone who has died from COVID-19 go down to one in about 1,700 people. If you don’t know 1,700 people and you don’t know someone in an outbreak area, odds are good that you don’t know someone who died from COVID-19.

So to summarize:

Is COVID-19 killing more people than the flu?

• Yes – at more than five times the rate of flu deaths.

Is COVID-19 is a major cause of death for people in the US this year?

• Yes – it’s the third leading cause of death this year so far.

Are you likely to know someone who has died from COVID-19?

• Depends on where you live and who you know, but the majority of Americans likely won’t personally know someone who died from it.

From a birds-eye-view and for those who have lost loved ones, it is obvious that COVID-19 is a deadly disease. That said, the majority of the US population has not been directly affected by a COVID-19 death, and that might help explain why some people are more upset about the shut-downs than the sickness itself.

Speaking of those shut-downs, let’s not forget that they are the reason that the death rate isn’t higher than it is. Closing things slowed the spread, buying us time for at least three important preparations:

1. Public health education. Closing things drew attention to the problem – it forced people to pay attention, creating an environment and time to disseminate information so that people could protect themselves and others. Even after opening, the virus will not spread as quickly as if we hadn’t shut down, simply because many people are now taking precautions.²
2. Hospital preparation. The closures slowed the spread, gaining the majority of the US time to reinforce hospitals, acquire supplies, and train staff.
3. Improved treatment. The closures bought us time to learn how to more effectively treat patients. Every day we learn something new about treating the virus (like patient positioning, monitoring blood oxygen levels, and the use of oxygen and ventilators). Additionally, every day researchers are working towards a vaccine.

So closing down and slowing the spread means that thousands of people didn’t get sick in April. Now that they know how to protect themselves, thousands might not even contract the virus. As things are opening up in many places, many people will get sick in June and July, but by then, doctors and hospitals will be better prepared to treat them, which will mean the difference between life and death for many.

But we are not through this yet. We still control our destiny. Remember the paradox: COVID-19 was deadly at first because we didn’t believe it was so deadly. Once we believed it to be deadly, it became less deadly because precautions were taken.

So as things begin to open up, and we continue with our daily lives, remember that while we bought ourselves time and our hospitals and doctors are now more prepared, if we take it too lightly, that tricky paradox could get the best of us.

What a clever trick. By believing it isn’t such a big deal, it becomes a big deal. Believing it is a big deal, we keep it from being a big deal.

Famous Footnotes:

This article was an interesting survey of how epidemiologists are managing risk in their personal lives to find that right balance between taking care of their mental and physical health while protecting themselves and others from the virus. It reinforced my decision to engage in outdoor activities, maintaining 6-9 feet from people outside my safe circle, to wear a mask in public, and to avoid indoor spaces with people outside of my safe circle altogether.

1. https://www.npr.org/sections/health-shots/2020/03/16/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s

I calculated the current monthly death rate in the US to be 7.3/100,000 people, and 5.0/100,000 excluding NY, NJ, and CN, compared to accidents at 4.1/100,000 people.

2. There is still a great deal of misinformation out there and some people not taking the necessary precautions, but the fact that many are really help control the spread. We will see in the following months if it is enough to keep things under control.

**Here’s a good table from the CDC breaking down deaths from COVID and pneumonia and the flu, if you like that level of detail: https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm