Will the House Cat 'Kill' the Elephant?

Wednesday, March 18, 2020

Statistician-Epidemiologist John Ioannidis, whose work I admire and have mentioned here before, has finally weighed in on the corona virus pandemic and governmental responses to the same.

Noting that this "once-in-a-century pandemic" may actually be a "once-in-a-century evidence fiasco," Ioannidis rightly questions the draconian measures governments have been imposing in response to the epidemic and notes further that the same lack of data will make evaluating their impact against the disease impossible to measure.

Will voices of reason win out? Let's hope that ship hasn't already sailed. (Image by Peter Hansen, via Unsplash, license.)
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We don't know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population. [bold added]
As a consequence, even after studying the effects of the virus on a closed population, as the quarantine or the Diamond Princess allowed, it is hard to tell what, if anything, we should do about this virus:
... Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.

That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be [sic] totally irrational. It's like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies. [bold added]
I have noted here the possibly dire economic consequences of the school closures and lockdowns already imposed, but Ioannidis notes a potential negative consequence of the school closures I hadn't considered: "School closures may also diminish the chances of developing herd immunity in an age group that is spared serious disease."

So much for the unlimited virtues of precautionary thinking.

Much later, Ioannidis adds:
In the most pessimistic scenario, which I do not espouse, if the new coronavirus infects 60% of the global population and 1% of the infected people die, that will translate into more than 40 million deaths globally, matching the 1918 influenza pandemic.

The vast majority of this hecatomb would be people with limited life expectancies. That's in contrast to 1918, when many young people died.
But even this highly unlikely scenario pales in comparison to what could be in store for us if these society-wide clamp-downs go on for long. Ioannidis briefly outlines what some of those could be, and "financial crisis," is only the first -- and the most benign -- that he lists.

I urge you to read the whole thing, and point others to this.

Let's hope voices of reason such as his ultimately hold sway, lest this "evidence fiasco" prove far worse.

-- CAV

P.S. At Watt's Up With That is a guest post by someone who read a paper (PDF) about the Diamond Princess. Among other things, he notes the following: (a) 83% of the passengers never got the disease, and (b) about half of the cases were asymptomatic.


Dinwar said...

My company once put a running count of injuries up on our employee home page, so it was the first thing you saw when you logged on in the morning. The higher-ups freaked out, and had a mandatory stand-down to discuss incident rates for the entire company (20,000 employees or so). The thing is, the system was working as intended. Our injury rate was below any other year--we had a record year for safety! But because it was in their faces, the higher-ups got concerned.

If you wanted to design a way to cause panic you could not do better than how we handled COVID-19. That's true regardless of how serious this virus actually is (which is still an unknown).

Gus Van Horn said...


Yes. Insofar as the government response is not opportunistic, there is a heavy element of exactly this running through it.


Snedcat said...

Yo, Gus, amusing note: The title of this post led me to expect something about politics in the House of Representatives.

Gus Van Horn said...

Hmmm. AOC would "kill" the Republicans -- although she shouldn't -- in the same sense and with the aid of their own panic when morally challenged, so there is that...