Sunday, August 16, 2020

Coronavirus Update: Somebody Lied To My Neighbor

It's been a few years since this blog has had a post, and for a couple of reasons. First, the concerns that have been expressed here about the behavior of the government have become so mainstream there's been less point in authoring posts on them here. Second, the investments that have occupied the author's interest haven't been publicly-traded assets but things like single-family homes and small retail centers, where generalized conversation isn't useful because it's not specific enough to be actionable and highly-specific conversation isn't useful because it involves assets that aren't available to parties other than those involved in the transactions.

But a neighbor of mine recently said she didn't understand why everyone should be so exercised about COVID-19 risk when H1N1 was worse. To get an idea what COVID-19 has done in this country since winter ended, one can look at the Centers for Disease Control and Prevention's page on the illness. As of this writing, the novel coronavirus has killed over 168,000 Americans. It's worth noting that it's currently August, and the flu season hasn't begun. By contrast, the CDC's page on the H1N1 pandemic presents full-year data from the H1N1 impact on the United States. From April of 2009 through April of 2010, the CDC's best estimate of deaths caused by the pandemic is 12,469 individuals. We're not yet one year in, and the death toll from COVID-19 is already over an order of magnitude worse than entire H1N1 pandemic.

Why's COVID-19 worse? First, it's more contagious. Contagiousness is often measured using the illness' spread in a population with no immunity, with R0 ("r-naught") representing the average number of infectees to whom one host will transmit the illness during its life cycle in the host. For H1N1, R0 is thought to lie in the range of 1.46 and 1.48. COVID-19's R0 is estimated to lie between 1.5 and 3.5. Two significant facts are worth keeping in mind. First, when R0 is less than one the infected population dwindles rather than grows: the illness dies out because infected carriers don't on average infect enough people to maintain a stable patient population. Second, R0 isn't a static figure: it can be manipulated with mitigation efforts. When Austria's government observed low spread rates in some Asian countries and mandated face masks, its infection rate dropped 90%. Apparently anyone can kill local spread by reducing the spread of airborne exhaled particles, which can be accomplished with face masks. Cheap.

The second factor differentiating the current coronavirus from the H1N1 "Swine Flu" pandemic of 2009 is severity. The published data on H1N1 are that the United States had 60.8 million cases of H1N1, 274,304 H1N1 hospitalizations, and 12,469 H1N1 fatalities. This means that an H1N1 case had a 0.45% chance of hospitalization and that 4.5% of those hospitalized died, with deaths amounting to 0.02% of total estimated cases. So far in the United States the CDC reports 5,340,232 total cases and 168,696 deaths, for a case fatality rate of 3.2%, which means a confirmed case of COVID-19 is more likely to kill a patient than a confirmed case of H1N1 was likely to put a patient in the hospital.

Naturally, these facts left me wondering what could possibly have left my neighbor thinking the current pandemic was a relative non-event, less disruptive on its own than an H1N1 season that closed no restaurants and halted no flights. The answer isn't hard to fathom: politics. Rather than base public health policy on data, quite a few elected officials have taken positions based on the positions of other politicians. Accordingly, some politicians have proclaimed that the current economic problems have been created by government restrictions rather than by the necessity of responding to an illness.

Sigh.

The article about Austria is dated in April, people. April. You can read, right? And now that you understand R0, you know how to stop the pandemic. You're better informed than officials who rushed to crowd people unmasked in bars, and can take action.