Sa Special–COVID-19 and Numbers

Late last Thursday I realized I could see the two extremes of our present disaster simultaneously: no new cases of COVID-19 in China even as the Chinese loosened the lockdown on one extreme–and dire reports from Italy of health worker fatalities, an overwhelmed health care system, and challenges in dealing with the backlog of corpses–all that on the other extreme.

Then on Friday morning the Spokesman reported a case of COVID-19 in a retirement community, Holman Gardens, in Spokane Valley–in spite of screening staff, a recommendation for social distancing and many residents having self-quarantined. Message: these measures alone are not sufficient. We need to lock down. Disapproval–shaming–of those who refuse to socially distance is necessary and appropriate. If we do all this and do it well there is light at the end of the tunnel.

“But, but,” I heard someone say, “We hardly have any cases here.'” That is so wrong… Why? All along the use of the word “case” of COVID-19 has lulled the population into a false sense of security. We know, the media should know, and the media should explain again and again that each “case” is a very imperfect and fraught representation of a much larger reservoir of infected people who are not yet (and may never) develop symptoms. In nearly all reporting, a “case” is counted only when a person tests positive for Covid-19. As we’ve read, the U.S. is sti”Cases” only provide a general indicator of the spread of infection. The number of cases reported will always lag the actual number of people infected by and possibly spreading SARS-CoV-2 (That’s the name of the virus. Covid-19 is the disease it causes.) A headline that reads “512 new cases of Covid-19” is not useful. It is the change, not the absolute number that is important. Consider: If there were 726 new cases reported the day before the 512 new cases reported today, that would be great news–the rate of spread would be slowing. Conversely, if the previous day’s new cases had been 262, a report of 512 today would suggest continued exponential growth–not good–no tapering off–yet. (Of course, a graph of data covering several days would be even more meaningful. Also, all the numbers are less meaningful if there is a large change in the commonness of testing.)

Thanks to the Trump and his administration’s lack of preparedness due to a toxic combination of ignorance and willful denial of its own study and science in general (“no one knew”) we in this country are woefully behind in testing. Keep that in mind every time you read an isolated number representing new “cases.” We get an “F” rating among developed countries for testing and an “F” rating for leadership–starting at the very top.

Take no comfort in case numbers. They are merely rough indicators. Even if we all self-quarantined in place for two weeks with no contact, i.e. absolutely no opportunity for the SARS-CoV-2 to pass from one human to the next, the daily new case numbers would still increase for at least a couple of weeks on account of the incubation period.

I searched yesterday for information of other countries that are not yet making news that we commonly see. I found it. The New York Times is offering coronovirus coverage with no paywall. Have a look at the bar graph a little way down the page. Every country listed (most of the roughly 195 countries in the world, with North Korea not reporting) reports at least one “case.” ALL the countries reporting more than a hundred cases, excepting Mainland China, also show an increase in reported new case numbers in each reported time segment. Many of these countries are likely to have even less preparedness the we have in the U.S. Remember it was only three weeks ago, February 26th, that Mr. Trump either in willful ignorance or willful denial was reassuring us:

So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.” — Trump at a White House briefing.”

As of yesterday Friday evening (March 20), three weeks and two days later, we have 17,836 “cases” reported in the U.S. (and 238 dead). With that demonstrated exponential growth in mind, with an increase in reported “cases” in nearly every country in the world, and with “case” numbers so vastly unrepresented the number of infected people, I predict we, as a world, are in for a very, very rough next few weeks–at least.

That’s scary and sobering–but remember that China went into lockdown and is starting to emerge with no new reported cases. (Yes, China controls what people get to hear, but after an initial stumble, they’re not likely to suppress a recurrence. Too much is at stake. They know the cost.)

On Monday I’ll cover more of the reasons to hope. There are some. Meanwhile, remember this meme I saw on Facebook (paraphrased): Our parents, grandparents, and/or great-grandparents lived through the Great Depression and all the privations and death of World War II. We are called upon to sit on the couch for a few weeks. We can do this!

Keep to the high ground,