Covid-19: How deadly is it?

	Covid-19
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Covid-19: How deadly is it?
(as of May 2020)
The covid-19 coronavirus is between 10 and 30 times deadlier than the flu, depending on how you count. It is also much more contagious (i.e. it spreads much faster). And, more importantly, so far there is no vaccine, whereas you can easily vaccinate against the flu (most of us don't do it precisely because the flu is not so deadly - guns kill the same number of people in the USA).
The news from the scientific world are not encouraging: a vaccine will take at least one year if we are really lucky. Or it may never come: forty years later we still don't have a vaccine for HIV. We don't always find a vaccine. You catch the HIV only if you have sex with someone who has HIV, hence it can be prevented, but you can catch the covid-19 just by sitting in a bus or standing in line at a supermarket. It is indeed like a flu: anyone can get it, regardless of the precautions one may take.
The first studies of outbreaks in Tianjin and Singapore in January and February showed that the virus is also spread by people who have no symptoms, unlike the flu that you can pass on only if you are sick. The fatality rate seems to be over 3% (Updated data of March 10: 4,589 deaths out of 124,000 cases =3.7%; updated data of March 21: 12,944 deaths out of 300,000 cases =4%; updated data of April 3: it's more than 10% in Italy and Spain - but see later for the definition of "fatality rate": it may actually be higher). We all hoped that Europe and USA would discover many more infected people and therefore lower the fatality rate, but instead the opposite is happening: many of the people who were critically ill are dying while the number of new cases is slowing down (in Europe and Asia).
Donald Trump has correctly stated that in 2019 a whopping 37,000 people died of the flu in the USA. He has omitted to mention that about 35 million people caught the flu. If 35 million people catch the covid-19 infection, more than one million people will die. Somebody should do the math for this incredibly low-IQ man. May 14 update: A study by Jeremy Faust of Harvard Medical School and Carlos del Rio of Emory University shows that COVID-19 kills 20 times more people per week than the flu does (based on COVID-19 and flu fatalities in peak weeks counted and reported directly, not estimated) (paper). May 18 update: A study by the University of Washington estimates that the death rate from covid-19 is 13 times higher than the seasonal flu.
For reasons that i don't quite understand, Trump and his propaganda machine (Fox News etc) have been consistently trying to reduce the fatality rate of this disease. The argument goes that many people have no symptoms and have not been tested, and therefore there might be many more infected people and the percentage of the ones who are dying is not as high as it looks. First of all, it is not something to be proud of that, as of March 12, the USA has the lowest percentage of people tested for covid-19 after Iran. The USA had two months to prepare for this and apparently absolutely nothing was done to get ready, although it didn't take a genius to predict that US citizens returning from infected areas would bring the disease to the USA. That said, the Fox News argument is absolutely correct... as long as you apply the same logic to all other diseases. For example, we calculate the death rate of the flu based on the people who actually showed the symptoms of the flu, i.e. the people who got sick. I have not had the flu in almost 50 years but that doesn't mean i never caught the virus. Most likely i caught the virus several times. I spent a day with a sore throat or sneezing a bit, and then forgot about it. Luckily the immune system protects most of us and we don't even know that we caught this or that virus. If we decide to calculate the fatality rate of covid-19 based on all the people who got infected, even those who show no symptoms, we should do the same with the flu in order to compare the two. Instead, the Fox News approach is to compare two different calculations: the flu's fatality rate based on the people who actually got sick versus covid19's fatality rate based on all the people who test positive. If we calculate the fatality rate of covid19 the way we calculate the fatality rate of the flu (based on the number of people who actually get sick), covid-19 is even deadlier. For the record, the fatality rate was 5.8% in Wuhan (Livescience) and many experts suspect that it was much higher than the Chinese government has admitted. Update: the fatality rate is more than 10% in Italy as of March 28.
At the same time, the fatality rate (measured as a percentage of those who had the virus) could be much lower if it turns out that many people had the virus without showing any symptoms. It really depends if you calculate the fatality rate based on those who get sick or on those who test positive (including those who never got sick).
For the record: in July 2020 Britain's Office for National Statistics reported that only 22% of people testing positive for covid-19 had symptoms on the day of their test (this doesn't mean they didn't have symptoms later on).
Different countries report different fatality rates because, again, the fatality rate is usually calculated from two numbers: the number of people who died divided by the number of people who tested positive. The percentage of the population that has been tested varies wildly from country to country, so one of these two numbers is already very country-specific. And even the other number, the number of deaths, is counted in different ways by different countries. As of March, Italy's and Spain's official death counts do not include people who died without being tested in nursing homes and private homes (and sometimes even in hospitals that didn't have testing kits). Some patients die before arriving at the hospital and the hospital doesn't test them because testing kits are rationed. Britain does not include deaths in nursing homes, whereas France does. Worldwide, covid-19 deaths that happen at home are certainly underreported.
The number of people killed by covid-19 is actually unknown. Virtually every country reports a discrepancy in these numbers. For example, Britain recorded 59,000 more deaths between the end of March and June 2020 than the five-year average while the number of covid deaths was officially 39,000: even subtracting those 39,000, Britain still has to account for an extra 20,000 deaths compared with the previous years.
On March 14, a speech by Trump caused panic: the same man who had been minimizing the risk, claiming that it was less dangerous than the flu, told the nation that the risk is colossal. So we also need to emphasize the other side of the story: the chances that a healthy person dies of this virus is very small. Italy's data of March 12: the youngest person to die was 50. Average age 80.3. Distribution: 14.1% > 90, 42.2% between 80 and 89, 32.4% between 70 and 79, 8.4% between 60 and 69, 2.8% between 50 and 59, no deaths under the age of 50. So far nobody in Italy has died of the virus alone: all the victims were already seriously sick of something else. They died of covid-19 AND something else.
The fatality rate is important to assess the risk, but death is not the only effect of a virus: a virus can also cause permanent damage of one kind or another, and that's another factor to consider when assessing the danger of this virus. A study by Valentina Puntmann at the University Hospital Frankfurt showed that, even months after recovery, covid-19 patients still exhibited lingering heart damage (paper). If that damage is permanent, these "fully recovered" patients will live a much shorter life than they would have.
Are young people completely immune from this virus? No, read this article before you think that you don't need to take precautions because you are young and healthy. We still don't know what this virus does to your immune system: you may find out the hard way ten or twenty years from now.
Addition of October 2020: covid has become a lot less deadly. The top reason of course is that there is better treatment. Doctors have learned through experience how to treat patients. For example, it is actually better to delay ventilation as long as possible, whereas at the beginning it was thought to be urgent upon hospitalization. They also discovered, more or less by accident, that steroids can save lives. Patients can also be given convalescent plasma (blood of people who have been infected and developed antibodies), something that obviously could not be done at the beginning. Last but not least, one study after the other shows that facemasks and social distancing not only reduces the chance of catching covid but also reduces the chances of dying of it if you catch it: chances are that the droplet that enters your body will be smaller than it would have been without the facemask. (See for example this paper). The statistics about the fatality rate in October can be misleading though: many of the weakest people are dead, so covid can't kill them anymore, and many of the new cases are of young healthy people, who have a much higher chance of surviving.
See also:
Back to FAQ/ Q&A about Covid-19,
Data on Covid-19 and selected sources,
Covid-19: How it may change the World,
The Clown & the Virus,
The Clown & the Virus - Part 2,
Trump's Virus,
Sinophobia & Covid-19,
Sinophobia & Covid-19 in US Media,
Was covid-19 made in the USA? in China? TM, ®, Copyright © 2020 Piero Scaruffi All rights reserved.
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