“Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passions, they cannot alter the state of facts and evidence.”
– John Adams
Coronavirus Update: New Estimates and Answers
Today, I’m going to cover some aspects of the pandemic that are not reported, are underreported, or are misunderstood.
The possibility that symptomology is correlated to amount of exposure
On top of my list are two questions about symptomology. Why is it that some young and healthy people have died from COVID-19 when we’ve been told that it wouldn’t happen? And how can we explain the fact that the symptoms range from nothing to mild to severe – even among young and healthy people?
These questions have been posed to Dr. Fauci several times in the past three weeks. He says he doesn’t know – that it’s a mystery.
I don’t understand why he says that, because there is a theory that makes sense to me. It’s been posited by at least two epidemiologists, and has studies behind it. The theory is that the severity of the disease is determined not only by the infected individual’s immune system but also by the amount of coronavirus he or she has been exposed to.
The amount of exposure depends on two things: the size of the molecules that infect you and the way you have been infected.
If someone sneezes directly into your face, you will likely get a large dose – not only of many molecules of the virus but of the larger ones that some scientists believe are more virulent. But if the same person sneezes at you from a greater distance, your chances of getting a large dose are proportionally less.
This is why we’ve been asked to keep a social distance of six feet. The larger molecules that would be emitted from a person speaking would not normally travel that far, but the expulsion from a sneeze is much stronger than that which comes from speaking.
So that could explain why some people get more severe symptoms. They’ve been infected by large doses of the large molecules of the virus.
But the size of the dose is only one factor that supports the theory. The other is that you can also receive a large dose in increments – by being exposed to small molecules of the virus multiple times.
If, for example, a young person spends an evening in a bar or restaurant with friends, one or several of whom are infected but asymptomatic. During the first 5 or 10 minutes, the amount of the virus he or she would be exposed to would be small. But after hours of that mild exposure, there is a compounding effect.
Those repeated exposures add up. The dose increases. Thus, when the infected person comes down with symptoms, they can be strong or even deadly.
This could explain why that doctor from China who “outed” the disease died from it. It could also explain why some young and healthy people have experienced severe symptoms, and a few of them have even died.
If this is true, the takeaways are as follows:
* Six feet is a sufficient distance for conversation so long as you aren’t in the same closed space with an infected person for a length of time.
* If someone that is infected sneezes directly at you from a distance of six feet or less, you may be in trouble.
This may also mean that front-line workers (not just medical personnel, but also people working in restaurant kitchens and service windows, taxi drivers, delivery people, and anyone else working long hours in the proximity of several others) will likely develop more severe symptoms if and when they contract the virus.
How many will be infected?
When Dr. Fauci announced new CDC estimates on how many Americans will get infected and how many will die, he was vague on the first and more specific on the second.
As to the death toll, the CDC estimates were 100,000 to 240,000. As for the number infected, Dr. Fauci said, “millions.”
I believe he was specifically vague not because there were not more accurate estimates available but because he didn’t want to alarm the public.
When you hear millions, you usually think of a number that is less than 10 million. But as I said in my March 30 essay, the arithmetic suggests that the range will be in the tens of millions.
This is likely because of the fact that some 80% of the people that are diagnosed as positive for COVID-19 have mild to medium symptoms. Which means, as the major media are finally figuring out, that the number of people that have the virus today is probably larger than the number of reported cases by a factor of 10.
But even 10 could be too low a multiple.
Michael Mina, Assistant Professor of Epidemiology at Harvard T.H. Chan School of Public Health, recently said, “This is an extraordinarily transmissible virus, and I think it’s more transmissible than we recognize. We really don’t know if we’ve been 10 times off or a hundred times off in terms of the cases. Personally, I lean more to 50 or a hundred times off.”
That means instead of more than a million cases in the world right now, there could be anywhere from 10 million to perhaps 100 million.
Those numbers are too scary to think about.
While waiting for more data, I’m sticking to my guess that the multiple will be 10 and that, after all is said and done, the number of Americans that become infected will be 20 million to 60 million.
If that turns out to be true, the death toll will likely be far more than 100,000. It will be in the range of 200,000 to 600,000.
I know it doesn’t seem possible at this point – with total cases at only 350,000 and deaths at only 10,000. But if you do the arithmetic based on the growth rate now, it’s quite possible.
And finally, some new data…
The tracking services I’ve been following are becoming more specific as the weeks go by. Now they are reporting not just numbers tested and the results of those tests but also number hospitalized, numbers on ventilators, and, of course deaths.
If you look at these numbers as percentages, you can arrive at some odds that are interesting:
* The percentage of people that test positive for COVID-19 has been running just under 25%.
* The percentage of people in the hospital that go into ICU is about 20%.
* The percentage of people in ICU that are on ventilators is 33%.
* A third of the world’s cases are now in the US. As things are going now, the US will have half the world’s cases by the end of the month.
* Right now, the US is not conducting any antibody tests. This is a crucially important test to understand how the virus spreads.
That’s it for today. Coming soon: we’ll take a look at what businesses are doing to stay alive during the pandemic.