These are unprecedented times.
The information coming from policy makers and the media can be overwhelming, misleading, and contradictory. Are we over-reacting or under-reacting? How much worse than the flu is COVID-19? Will public health measures last for weeks, months, or years?
The answers to these questions at this point in time are not entirely clear. This is largely because we do not have the data we need to provide the answers. As the articles referenced below make clear, we do not know the actual infection rate. Without this number (which requires random sampling to determine), we cannot precisely calculate hospitalization and fatality rates. As a result, we have to make assumptions to guide policy making as we respond to the outbreak in a very short period of time. With extraordinary public health measures in place in California and much of the country, we should have substantially more data to guide our decisions over the next three weeks if the government publishes the key pieces (and this will be the subject of my next post).
For now, I wanted to provide everyone with links to three opinion pieces that provide useful perspective on the pandemic, its size and severity, and the courses it could take with various public policy responses:
The first piece is by Justin Lessler, a professor at Johns Hopkins University:
The second piece is by John P.A. Ioannidis, a professor at Stanford University:
The third piece is an interview with Michael Levitt, a Nobel Laureate and Stanford biophysicist:
If you take anything away from these pieces, please let it be the following: (1) the infection rate is much higher than the number of confirmed cases, which means hospitalization rates and fatality rates are much lower than simply dividing hospitalizations by confirmed cases or fatalities by confirmed cases; and (2) focusing on raw numbers (e.g., number of cases and number of fatalities) rather than rate of increase or decrease can be misleading – you need both to form an accurate picture of the trajectory of the virus (e.g., Italy recorded 601 deaths yesterday, but this was 192 fewer than 2 days before (a 24% decrease), which could mean that Italy’s extraordinary lockdown measures that began two weeks ago are starting to have their expected impact, right on schedule).
Please stay safe and take your social distancing responsibilities seriously. One thing we do know for certain is that social distancing works at slowing the spread of viruses.