[Coronavirus]: A fiasco in the making? We are making decisions without reliable data [excerpts]
John P.A. Ioannidis , professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University
Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed.
This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.
The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.
Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew ...). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases .... Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.
That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational...
As discussed in a previous post, the people on a tropical cruise are not likely to be representative of the general public. They are likely to be healthier, in a low stress environment, have access to plenty of healthy foods and are absorbing large amounts of sunlight.
Sunlight is needed to make vitamin D, a very important factor in our immune system.
What might the stats be if leaders in government and medicine worked to reduce levels of deficiencies in immune system related nutrients such as vitamin C, D, zinc, etc?