Editor’s Note: The article by David Wallace-Wells (writing in the New York magazine) from which the excerpt below is taken, is one of the best summaries I’ve seen of where we’re at and where we’re not at in the COVID-19 pandemic, but it rests on a counterintuitive assertion, that the Corona virus fatality rate is lower if its infectious rate is higher. The proof is in the simple math formula: fatality rate = deaths <divided by> total-infected, or FR = D/TI. The bigger the divisor TI, the smaller the value for the result, FR. There is massive uncertainty in the US about the true value of the total number of infected, and that’s because our testing is inadequate. We are barely keeping up with testing those who have problematic symptoms. The best way to get a true measure of the infected rate is to do what the author calls “serological” testing, widespread testing of the serum of both the symptomatic and the asymptomatic alike. It may turn out that asymptomatic cases are more plentiful than is commonly assumed, in which case the fatality rate may be lower as well. My personal caveat, speaking as an elderly person (and therefore more at risk of death), given the facts in this article, plus the growing evidence that the virus can be transmitted as an aerosol result of simple breathing, I must now assume that everyone I meet is an existential threat. My wife and I will probably need to stay hunkered down, so to speak, until our community is generally vaccinated against this virus, and well into herd immunity. That could be a couple of years!
“Each of those deaths is a tragedy, and a horror. It is also a numerator, or part of one. The denominator is made up of how many people out there contracted the disease. And the fraction tells you, in theory, roughly how bad the outlook will be when the disease has finally passed through the entire population (which, barring the arrival of a vaccine, may take longer than the achieving of “herd immunity,” which is our clearest path back to “normal” life). The bigger that denominator, the less severe the disease at the population level: If roughly 13,000 Americans have died out of a total number of infected of 400,000 (the current “confirmed” case number), that is a pandemic nightmare of a certain scale; if 13,000 Americans have died out of a total number of infected of 4,000,000, that implies a final toll of a different, considerably lesser scale; and if the total number of infected is 40,000,000, even more so, with hospitalization and case fatality rates much, much lower as a result. It would also suggest that we are much further along the timeline of the pandemic and much closer to its conclusion. The bigger that denominator, the more people caught the coronavirus without realizing it, and the more people that caught the coronavirus without realizing it, the less severe the disease looks, and the faster we’ll likely get through its brutality and emerge into a strange-seeming post-pandemic future.
“So, how big is that denominator number? Unfortunately, we don’t know. Worse, in the U.S., it is at this point, and for the very foreseeable future, unknowable. A second-order outrage about the pathetic, outrageous lack of test kits, and the backlog processing even the tests we do have, is that in addition to limiting our ability to treat those patients we know are ill and to take public-health measures to protect the vulnerable parts of our population, we have very little sense of the scale of the outbreak we are dealing with. When we can’t even test all those patients who show up at hospitals complaining of symptoms, we are miles from a clear sense of how many other people might be carrying the disease around — infecting others, of course, but also changing the size of that denominator. This is one of the reasons there has been so much recent enthusiasm for the possibility of what’s called serological testing, which can tell anyone, even the asymptomatic, if they’ve already acquired immunity. Until we do institute large-scale serological and “community testing” of that kind, we will be living in darkness.”
Read the complete article here: