Apr 5th 2020

Is the Medical Community Misdiagnosing COVID-19 Death Rates?

by Daniel Wagner

 

Daniel Wagner is CEO of Country Risk Solutions and co-author of Global Risk Agility and Decision Making.

 

Given the shortage of testing kits for COVID-19 around the world, the current testing regimen includes primarily (if not exclusively) symptomatic patients, making the rate of death appear to be worse than it might actually be. According to the US Centers for Disease Control, asymptomatic persons are not routinely tested, so the prevalence of asymptomatic infection and detection of pre-symptomatic infection is not well understood.[i] Similarly, a high percentage of patients who are either elderly or have underlying medical conditions that make them more susceptible to succumbing to the virus may test positive and die, skewing the rate of death among younger, otherwise healthy individuals. Death rates among persons over 80 years of age have been as high as 20%.[ii]

As a point of comparison, during the 2009 swine flu outbreak, initial death rate estimates were thought to be as much as 10 times higher than ordinary flu outbreaks (with a typical death rate of 0.2%)[iii], but after the passage of time, it was determined that death rates were actually no higher than an ordinary flu. Much attention was paid in the media to the high infection rate among passengers of the Diamond Princess cruise ship in Japan earlier this year, but even in that case, the death rate among passengers turned out to be about 1% (7 deaths among 700 positive (mostly elderly) individuals).[iv]

COVID-19 has taken a particularly high toll from a percentage perspective in Italy, but doctors from the Istituto Superiore di Sanità in Rome noted in a Journal of the American Medical Association commentary last week that a combination of Italy's relatively older population (23% are 65 years and older) and the lethality of the coronavirus in that age group partly explains its high death rate (7.2% as of March17). When stratified by age group, death rates of people under 70 in Italy and China look similar, but rates are higher in Italy among individuals aged 70 years or older, and in particular among those aged 80 years or older.[v] The Italian death rate as of March 31st has been about 11%[vi], with many deaths hastily labelled as COVID-19-related when they may not have been.

That said, there is a very real risk that COVID-19 may turn out to be deadlier in its second or subsequent wave(s) of infection than has been the case as a result of its initial outbreak. As occurred in the case of the 1918 Spanish flu, during which a third of the world’s population was believed to have been infected, resulting in more than 50 million deaths. The mortality rate for the initial outbreak is believed to have been similar to that of an ordinary flu (0.1%), while its second wave has been estimated to be approximately 2.5%.[vii] Mortality was high in the under 5, 20-40, and over 65 years age brackets. Its high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of that pandemic.[viii] Let us hope history does not repeat itself.

We should resist jumping to conclusions about what the real rates of infection and death are, have been, or will be as a result of COVID-19. It is simply too early to say, we have too few tests to do a proper job in many countries and globally, and the tests that are being conducted automatically imply being heavily skewed in the direction of symptomatic individuals. Governments around the world will continue to grapple with the best course of action to try to prevent more infections, but they, and the global medical community, should be similarly focused on getting the testing regimen and interpretation of the results of those tests right.

 

Daniel Wagner is CEO of Country Risk Solutions and co-author (with Libra’s Dante Disparte) of Global Risk Agility and Decision Making.

This article first appeared in Fair Observer.

 

 


This article is brought to you by the author who owns the copyright to the text.

Should you want to support the author’s creative work you can use the PayPal “Donate” button below.

Your donation is a transaction between you and the author. The proceeds go directly to the author’s PayPal account in full less PayPal’s commission.

Facts & Arts neither receives information about you, nor of your donation, nor does Facts & Arts receive a commission.

Facts & Arts does not pay the author, nor takes paid by the author, for the posting of the author's material on Facts & Arts. Facts & Arts finances its operations by selling advertising space.

 

 

Browse articles by author

More Current Affairs

Nov 25th 2020
EXTRACT: "To paraphrase Charles Dickens, this is the best of times and the worst of times. As financial markets celebrate the coming vaccine-led boom, the confluence of epidemiological and political aftershocks has pushed us back into a quagmire of heightened economic vulnerability. In Dickensian terms, to reach a “spring of hope,” we first must endure a “winter of despair.” "
Nov 22nd 2020
EXTRACT: "Under a sane national policy, the federal government would spend as much money as it takes to generate the demand necessary to make it worthwhile for employers to re-hire this one-twentieth of the working-age population. Worries about what we can afford would be set aside until the day the world’s savers no longer regard US government debt as a special, singularly valuable asset. That day may never come."
Nov 19th 2020
EXTRACT: "The EU can’t afford to compromise on the rule-of-law provisions. How it responds to the challenge posed by Orbán and Kaczyński will determine whether it survives as an open society true to the values upon which it was founded."
Nov 11th 2020
EXTRACT: "In the interim, he will be nurturing an insidious threat he has left in his wake – a potential low-grade insurgency bubbling beneath the surface. It may well be that America it is about to experience a political paramilitary insurgency. Many of Trump’s supporters are “rough people” who are armed, fiercely patriotic, and firmly believe what Trump has been selling for the past four years – such as that America is being overrun by “colored” people and immigrants, is under attack, and that Canada is a national security threat. Many of them also believe that Trump was cheated out of a second term. They may or may not want civil war, but they will surely want to ensure that havoc and chaos prevail following Trump’s forced departure from office."
Nov 10th 2020
EXTRACT: "The year was 1932, and the transition from Herbert Hoover to Franklin D. Roosevelt occurred in the midst of an unparalleled economic depression and banking crisis. The outgoing president, Hoover, had an intense aversion to his successor,…….. There are two lessons here. The president-elect and those around him need to take extra precautions for their personal safety, given the inflamed political climate and Trump’s ongoing efforts to fan the flames. And Biden now, like FDR then, must reiterate his message of hope and unity as an antidote to the coronavirus and political division. In 1933, it was “fear itself” that Americans had to overcome. Today, when it is fear of each other that Americans must overcome, Biden’s affirmation that there are “no red or blue states, just the United States” is a good start."
Nov 10th 2020
EXTRACT: "It seems clear that, as Donald Trump said a few weeks ago “This will not end well.” Far from being over, this election may very well continue to play out for weeks to come. Trump and the GOP have been telegraphing their strategy for over a month now. They will continue to challenge to validity of the vote in court. They will demand recounts. They will incite their followers to demonstrate at vote-counting facilities. In the end, many Americans will lose faith in the electoral process and America’s democracy will be tarnished in the eyes of the world. That much is clear. "
Nov 9th 2020
EXTRACT: "When CBS, NBC and ABC cut away from President Donald Trump’s news conference at the White House on the evening of Nov. 5, they took pains to explain why they were shutting off the nation’s commander-in-chief...... It was a moment that for me, as a journalism historian, carried echoes of the 1954 takedown of another flamboyant populist demagogue, Sen. Joe McCarthy."
Nov 1st 2020
EXTRACT: "Prominent evangelical pastor and author John Piper has likewise drawn on several biblical texts when writing about the choice facing voters: “There is a character connection between rulers and subjects. When the Bible describes a king by saying, ‘He sinned and made Israel to sin’ … it does not mean he twisted their arm. It means his influence shaped the people. That’s the calling of a leader. Take the lead in giving shape to the character of your people. So it happens. For good or for ill.”......In this reading, the Bible does not have a category for a good leader with bad personal character. Nor does it seem to imagine that a nation can remain untainted by the perceived moral failures of its leaders. "
Nov 1st 2020
EXTARCT: "This pandemic will undoubtedly go down in history as a contrast in political ideologies as much as in the battle between mankind and nature, and the hopeful triumph of medical technology. It is putting to the test the political, economic, social, and cultural diversity of the world’s nations as never before, and has already proven just how fragile the world’s functional ecosystems are in the era of globalization. In laying bare the strengths and weaknesses of the world’s nations, it is also serving to challenge some conventional wisdom about what is, or is not, a preferred method of governance. In this battle, America is badly floundering while China has put itself in a position to dust itself off and move on."
Oct 30th 2020
EXTRACT: "At this stage, the Trumpian personality cult has completely dispensed with the need for actual plans and proposals (indeed, the Republican Party, which Trump now controls, did not even bother to offer a policy platform for the election). Trump embodies whatever his supporters want, even when they themselves don’t know what that is. This is all too typical of fascist leaders, who usually function as a father figure for those susceptible to the appeal of an authoritarian personality. As the father of the “MAGA” nation, Trump decides what is best for his children, and it is this patriarchal authority that provides the rationale for violence, lies, and even dictatorship."
Oct 28th 2020
EXTRACT: "One thing is certain: a highly contested election would cause further damage to America’s global image as an exemplar of democracy and the rule of law, eroding its soft power. Particularly over the past four years, the country has increasingly come to be regarded as a political basket case. While hoping that the chaotic outcomes outlined above do not come to pass – polls still show a strong lead for Biden – investors should be preparing for the worst, not just on election day but in the weeks and months thereafter. "
Oct 27th 2020
EXTRACT: "China’s approach today is similar: first, insulate its citizens from a virulent pathogenic contagion with draconian public-health measures aimed at containing and mitigating the spread of the disease, and then – and only then – make judicious use of monetary and fiscal policy to reinforce the post-lockdown snapback. This is very different from the approach taken in the US, where the post-lockdown debate is more about using monetary and fiscal policies as front-line instruments of economic liberation, rather than relying on disciplined public-health measures aimed at virus containment........ This underscores the sharp contrast between China’s COVID-first strategy and the America-first approach of US President Donald Trump’s administration. In China, unlike the US, there is no political and public resistance to masks, social distancing, and aggressive testing as requisite norms of the COVID-19 era. Meanwhile, the US is in the midst of its third serious wave of infection while China continues to exercise prompt and effective control over new outbreaks. Earlier this autumn, for example, some nine million citizens in Qingdao were tested in just five days after a relatively small outbreak affecting fewer than 20 residents. By contrast, Trump wears his own experience with COVID-19 infection as some perverse badge of courage, rather than as a warning of what may lie ahead."
Oct 20th 2020
EXTRACTS: Disney has announced a significant restructuring of its media and entertainment business, boldly placing most of its growth ambitions and investments into its recently launched streaming service, Disney+…. From a corporate strategy perspective, the move is remarkable on two fronts. Firstly, the sheer velocity of this pivot for a company the size and age of Disney is, for lack of a better word, unprecedented….Let’s not forget that it was just last year that Disney held a near 40% revenue share of the US box office….. The fact that in just seven months of the pandemic breaking out, Disney decided to reinvent itself primarily around streaming speaks volumes about its expectations regarding the pandemic length. Clearly the group decided that waiting it out was no longer an option.”
Oct 10th 2020
EXTRACTS: "Strange as it is to say, but it is no longer uncommon to hear talk of insurrection, martial law, and civil war in the United States......... Apocalyptic warnings that next month’s election will descend into crisis are coming hard and fast....... While the atmosphere in the US is already alarming, it is worth considering just how bad things could become. There is ample reason to worry that an election-related conflict could devolve into atrocity crimes against black and brown civilians on US soil........ Genocide and mass atrocities have happened all too often, including in America. The question is not whether it could happen here, but whether it can be prevented."
Oct 9th 2020
EXTRACT: "Fifty years ago, Milton Friedman published an article in the New York Times that articulated what has come to be known as the Friedman doctrine: “the social responsibility of business is to increase its profits.” It was a theme he had developed in his 1962 book Capitalism and Freedom, where he argued that the “one and only” responsibility business owes to society is the pursuit of profits within the legal rules of the game. The Friedman doctrine put its stamp on our era. It legitimized the freewheeling capitalism that produced economic insecurity, fueled rising inequality, deepened regional divides, and intensified climate change and other environmental problems. Ultimately, it also led to a social and political backlash. Many large businesses have responded by engaging in – or paying lip service to – the notion of corporate social responsibility."
Oct 7th 2020
EXTRACT: "China is well on its way to becoming a cashless society. More than 600 million Chinese already use Alibaba’s Alipay and Tencent’s WeChat Pay to pay for much of what they purchase. Between them, the two companies control approximately 90% of China’s mobile payments market, which totaled some $17 trillion in 2019. A wide variety of sectors throughout China have since adopted Blockchain to pay bills, settle disputes in court and track shipments. The Chinese government understands that, via Blockchain, the issuance of its own cryptocurrency is an excellent way to track and record the movement of payments, goods and people."
Oct 6th 2020
EXTRACT: "The American Republic was founded by Protestants, and American elites were for a long time largely Protestant........But something extraordinary has happened since the republic was founded by Protestants in 1776. Five of the eight current Supreme Court justices are Catholics, and soon there may be six. The one Protestant on the court, Neil Gorsuch, was raised Catholic. (The other two justices are Jewish.) Nancy Pelosi, the speaker of the House of Representatives, is Catholic, as is the US attorney general, William Barr. And Joe Biden, who might be the next president, is Catholic, too."
Oct 5th 2020
EXTRACT: "...... the economic pain inflicted by COVID-19 is not being borne by publicly traded companies. It is falling on small businesses and individual service proprietors – from dry cleaners to restaurants to entertainment providers – that are not listed on the stock market (which leans more toward manufacturing). These smaller players simply do not have the capital needed to survive a shock of this duration and magnitude. And government programs that have helped keep them afloat for a while are beginning to lapse, raising the risk of a snowball effect in the event of a second wave."
Oct 4th 2020
EXTRACT: "Trump’s disinclination – and perhaps inability – to reach beyond his right-wing base, which is insufficient to elect him, also calls into question his political acumen, and is one of many reasons to doubt his basic intelligence (an issue on which he is quite sensitive). But one thing about the president is now clearer than ever: in order to perpetuate his hold on power, Trump is testing the constitution in unprecedented ways. "
Sep 30th 2020
EXTRACT: "With the US presidential election barely a month away, former Vice President Joe Biden and his advisers are devising his national-security policy and creating shortlists to fill the cabinet’s ranking positions in the event that he defeats President Donald Trump. But while presidential hopefuls traditionally have focused first on contenders to run the state, defense, and treasury departments, this time is different. With the intelligence community in an increasingly perilous state, Biden should choose a top spymaster before making any other personnel decisions."