Covid claims

Recently stuff.co.nz published an article by epidemiologist Simon Thornley claiming that the deadliness of Covid was exaggerated (https://i.stuff.co.nz/national/health/coronavirus/120666809/do-the-consequences-of-this-lockdown-really-match-the-threat). The article is full of misleading claims.

He correctly points out that accurate estimates of case fatality rates are difficult because it all depends on who gets tested. However this is really no different for the seasonal flu. There are vast numbers of people who get the flu each year who stay at home, recover, and are never tested. So what is important is not the actual number so much as the comparison.

He points out that case fatality rates decrease over time and that the 2009 swine flu showed that eventually this pandemic proved to be no more deadly than seasonal flu. While this is true what the numbers also showed over time was that this pandemic killed predominantly young people (80% of deaths occurred in those younger than 65; https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html), so his point becomes somewhat meaningless.

So what is the more accurate assessment of the case fatality rate? Taking a small sample of elderly people on a cruise ship then extrapolating to the wider population, as done in the article, is an exceedingly inaccurate estimate and I am sure that any student in a statistics class would be roundly criticised for such methods. Why don’t we look at the numbers where the dust has settled? In China the initial case fatality rate was 17% and it has dropped to 0.17% for those infected after 1st February- this is still 7 times greater than that of seasonal flu (https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/). Perusal of this informative and reliable website reveals that even the most conservative estimates of case fatalities by different countries outstrip that of seasonal flu. Further more the death rate of people admitted to critical care with Covid appears to be about 50%, much higher than standard flu(https://www.microbiologyresearch.org/docserver/fulltext/jmm/66/10/1421_jmm000593.pdf?expires=1585617085&id=id&accname=guest&checksum=7F73E2135F46D7FD6D1B1C9145856085).

He then goes on to address Italy, claiming that many people are classed as dying of Covid, when really they died with Covid. Well, again, this was a daily occurrence prior to this pandemic. Did an elderly patient die of the flu or with the flu? This uncertainty has not changed. The point is then made that the death rate in one analysis was 0.8% in people with no comorbidity. Firstly this is much higher than flu. Secondly, what about the people with comorbidities? This is not some theoretical group. If you have a mother or father over the age of 65 who takes medication they probably fit into the classification of someone with a comorbidity. A lot of discussion around deaths during this time has carried the veiled implication that it is only the comorbid who need to worry. Quite apart from being false, small comfort for those living with chronic conditions who are entitled to a quality life just as much as the rest of us. Even prior to this many people with chronic conditions in hospital come in with an infectious disease that makes their chronic condition worse and this is what they die of. It does not mean the infectious disease did not contribute to their death.

Then follows the claim that Covid cases do not represent an increase in the usual deaths in Italy. Currently Italian intensive care units are overflowing. They have converted operating rooms into makeshift intensive care units. The stories from the frontlines in Italy are harrowing (https://www.weforum.org/agenda/2020/03/suddenly-the-er-is-collapsing-a-doctors-stark-warning-from-italys-coronavirus-epicentre/ ). This does not happen every season. Perhaps the reason for the high case fatality rates is that there are not enough resources for all.

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