Much Ado About Nothing: The 2020 Pandemic in Retrospect

COVID-19 in Context: A Global US Perspective


Photo by Alexas Fotos

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future


THE WORLD WE KNEW


Once upon a time, when we would talk about the cold-and-flu season coming up, we didn’t waste much time discussing the differences between the two bugs; they both hit us around the same time of year, and they were both unpleasant illnesses that caused a slew of familiar symptoms that lasted a week or two. Many of us would go get our yearly flu vaccines, but none of us were truly concerned about winding up dead.


Influenza


In fact, so few people pass away during flu season that almost nobody in a developed country has lost a loved one to the illness. Every year, as new flu-causing viruses come around, the scientific community quickly and methodically isolates the most dangerous strains, whips up a new cocktail of dead virus, and tries to get it out to as many people as possible. Usually, they get it right. Most of us think nothing of it, and this is what we’ve grown accustomed to seeing, year after year.


We don’t think of the flu as a deadly virus. And while it is sometimes fatal, the truth is that on average, influenza claims up to 646,000 lives around the world each year, which is well under 0.01% of today’s world population, or less than 10 in every 100,000 people. (The percentage is even lower in the US).


>>> Based on deaths by population, the seasonal flu death rate for the US and the world is less than 0.01%.


Deaths are typically highest among the very young, very old, the immunocompromised, and those with limited access to healthcare, meaning that the average healthy child or adult with access to soap, water, and vaccines has an incredibly low risk of dying from the flu. The case fatality rate (CFR) of influenza, the whole family of viruses that causes the seasonal flu, is < 0.1% in the US, which is fairly characteristic of developed countries where we have the technology and resources to minimize the death toll. This is, quite simply, the number reported by our very own Center for Disease Control (CDC); The “real-world-outcome” CFR (my words) for a country or region can be much higher (even as high as > 0.1%) due to complicating factors like sanitation and access to healthcare, according to a comprehensive 2014 study aimed at reexamining and clarifying the case fatality risk of the seasonal flu, and recognizing its variability around the world.


>>> Among those with confirmed cases, the “known” seasonal flu death rate is also < 0.01%.


It’s just a coincidence that the CFR and deaths by population can both be described with the same statistic. The fact is that, year after year, this is the very safe reality in which we lived. The flu didn't scare us. We washed our hands. We counted our blessings. We knew nothing, firsthand, of the terrors that a flu virus had once visited on the world.


Human Coronaviruses


Corona is a family of viruses with a characteristic corona-like or crown-like set of spikes that attacks both animals and humans. Some of these viruses have proven to be harmless; others, quite deadly. Actually, "common" coronaviruses cause 15%-30% of all common colds each year, and of course, we know that catching one of these is almost never deadly.


>>> Four out of the seven known human coronaviruses do nothing more than cause the common cold.


The remaining three viruses you might know by name; each one has made the headlines at some point in the past 20 years, and each one is essentially unrelated to the other six; they're all very distant relatives. Just like most pandemic-causing pathogens, each of these has occurred as the result of the habit of all viruses to transmute into new and unique strains as they replicate.


In 2003, Severe Acute Respiratory Syndrome (SARS) was discovered, an illness caused by SARS-associated coronavirus (SARS-CoV). This pathogen originally appeared and caused an outbreak in Asia; it caused over 8,000 cases and 755 deaths worldwide. SARS-CoV was contained successfully through basic healthcare measures like quarantining of the sick, and essentially disappeared; however, many healthcare experts became vigilant knowing the likelihood of a similar, worse event. Fourteen years later, scientists were able to isolate the bat population where the disease originated.


>>> The SARS outbreak from 2002-2004 in Asia was caused by a deadly coronavirus that was contained fairly quickly; it wasn't extremely contagious.


In 2012, Middle East Respiratory Syndrome (MERS) was discovered, and illness caused by MERS-CoV. It has caused two outbreaks so far, in Saudi Arabia and South Korea, and it has only reached the point of about 2,600 cases and 900 deaths over all this time, worldwide. The two prominent theories as to its origins are bats and camels.


>>> The MERS outbreaks of 2014-2015 in the Middle East were caused by another deadly coronavirus that we've been able to contain very well.


Until now, none of these coronaviruses had ever successfully “crossed the line” and caused an ongoing public health crisis. If either of these COVID-19 predecessors had gotten out of hand, they might have caused the same international panic, but the fact of the matter is that they didn’t. There was the common cold, and there was a couple of briefly dangerous mutated animal viruses, and that was the whole story. Until now.


Infographic by Visual Capitalist

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future


THE WORLD WE NEVER KNEW


Two things stand out very clearly when we look at the US: first of all, we had a relatively tame experience of the Spanish Flu; secondly, we have had an even more muted experience of pandemics and endemic diseases over the 100 years since then. We didn't live through the 1918 pandemic, and we didn't live through the vast majority of premature death happening all over the world in the last century.


The Spanish Flu


Different strains of influenza have caused several pandemics since the 1500’s, including the “Spanish” H1N1 Flu of 1918, which got its name due to the efforts of Spanish reporters at the time, who came through with unbiased, groundbreaking news on an international crisis that was suppressed by other war-driven countries. It was one of the most infectious and deadly pandemics in human history, and came on the heels of one of the deadliest wars in world history. At the tail end of World War I (WWI), the World Health Organization (WHO) did not exist, and neither did the science, resources, nor collaboration between countries necessary to collect data on a worldwide pandemic. That’s why there is such a range in possible deaths attributed to the “mother of all pandemics.”


That famous virus claimed 50-100 million lives between 1918 and 1919, or more than 2.5 - 5% of the world population at that time, which would be 2,500 - 5,000 out of every 100,000 people. In the US alone, the virus killed 675,000 people, which was 0.66% of the US population at the time, or 660 in every 100,000 people. Though it was still a time of shocking loss and mass hysteria, this places the US death rate at 3.8 to 7.6 times lower than the worldwide death rate, which may explain why the US participated in suppressing reports of the virus’ impact at the time.


>>> Based on deaths by population, the Spanish Flu was 4-7 times less deadly in the US than worldwide.


The Spanish Flu had an estimated case fatality rate (CFR) of > 2.5% in the US, based on a comprehensive 2006 study which nods to advances in forensic science. This number makes that original strain of H1N1 (a type of Influenza A) at least 250 times more deadly than the seasonal flu — which is due, in no small part, to vaccines and hygiene practices which we use to minimize the death toll each year and to prevent another influenza virus from ravaging our nations. The numbers would not be quite so far apart, otherwise.


>>> Among those with confirmed cases, the Spanish Flu death rate was estimated to be over 250 times more deadly than the seasonal flu in the US and worldwide.


The Spanish Flu killed children and adults of all ages within days, sometimes hours, and was exceptionally contagious. Although the pandemic may have lasted for at least a year, the death toll essentially occurred over a single flu season, from September of 1918 to April of 1919; an official crisis period of 8 months. None of us were alive for that terrifying experience, and so our expectations of the flu in modern life are very mellow. Of course, that’s partly because we do everything we can to prevent another 1918, from promoting sanitation practices to creating new vaccines each year to combat the latest strains - we've just lost touch with the gravity of these practices, 100 years later.


Pandemics of the Last Century


From mid-1919 to mid-2019, the US simply didn’t lose more than about 0.07% of its population, or 70 in every 100,000 people, to any one pandemic (specifically, the Asian Flu of 1957), a mere 10% of the impact of the 1918 pandemic for us, and in the past 50 years nothing has come close to repeating that statistic.


Note that infectious diseases in general, some of which still wreak havoc to the tune of hundreds of thousands of deaths every year elsewhere in the world, are relatively insignificant in the collective memory of people living in North America, Western Europe, Australia, and Japan, not to mention our lack of familiarity with death due to indoor air pollution (think factories), poor sanitation, the environment, and noncommunicable diseases like heart disease, cancer, and diabetes.


Perhaps this disparity between the world and developed countries like the US offers the simplest explanation for our inexperience, alarmism, and devastation in dealing with this pandemic overall. We just haven't had to see so much premature death.


And then, there was COVID-19.


Infographic by the WHO

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future


THE COVID-19 PANDEMIC


COVID-19, the disease caused by the SARS-CoV-2 virus, is the first major worldwide pandemic since the internet was born. The result? A wildly emotional and unscientific commentary, drowning out the information that matters most as soon as it hits the worldwide web.


This is not to mention the reality of toxic national and international politics, as well as private interests, which are merely living up to their expectations as they muddy the waters surrounding the pandemic. There is a goldmine of web-catalyzed opportunities here.


Unfortunately, the origin of COVID-19 is its most controversial aspect. The theories of the US National Intelligence Council and this troubling interview of a former Chinese military virologist both offer compelling food for thought, but ultimately, “Beijing’s lack of cooperation on origins [is] not diagnostic of [any] hypothesis,” according to the NIC. Only Beijing can clear the water surrounding what happened in Wuhan; the rest of us are just raking a pool skimmer through the ocean.


At any rate, let’s address the more pressing matter at hand, and find out just how deadly the virus really is. The numbers are crying out for someone to tell their story, and to leave Joe and Donald out of it. So, let’s take a look, shall we?


Comparing Death Rates


Now, it is incredibly difficult to nail down a case fatality rate (CFR) for an extremely contagious novel virus at all, given all its variants everywhere in the world, so the scientific community has not yet been able to produce a CFR that can be used for comparison purposes. And it’s not their fault. It’s just that age is such a strong determining factor of death for this disease, and the age structure of different countries are so diverse, that it was expressly recommended against by the National Institute of Health (NIH) in October of 2020 to use any of the CFR's that were available for comparison between countries, except "at the very least" age-adjusted CFR's — which isn't exactly a ringing endorsement to use those, either.


>>> According to the NIH, using the highly variable CFR as a tool for comparison during this pandemic is premature and misleading.


Despite this, for some inexplicable reason, the scientific community set forth a CFR of 1.8%, beginning in December of 2020 and declining slightly over the past year, as a key metric for the virus. At first glance, this simply lines up with reported cases and fatalities to date, which do yield a CFR of about 1.6% for the US and 2% worldwide, and it paints a very clear picture of our situation: from these numbers, it looks like COVID-19 isn't too far off from our baseline catastrophe, both in the US and worldwide, and is devastating compared to the seasonal flu; however, when we continue to explore the numbers, it will become clear why the NIH warned against using the CFR in this way, and why their warning still rings true a full year later.


>>> Among those with confirmed cases, COVID-19 death rates appear to be 160 and 200 times worse than the seasonal flu, and 64% and 80% as deadly as the Spanish Flu, in the US and worldwide respectively.


Even if we were to use the "real-world-outcome" CFR of > 0.1% for the seasonal flu (see above), it still looks like COVID-19 is at least 20 times more deadly among confirmed cases than the seasonal flu worldwide, which may be a bit more relevant to the worldwide experience of the pandemic, but ultimately these numbers don’t describe anything of substance about the experience of death in the US and worldwide.


So, let’s try something different. Let’s turn to the metric used to compare pandemic and endemic diseases historically, when all we had to go on was the crude number of deaths and (sometimes) the size of the population. Let’s paint a better picture.


Officially 20 months into the crisis, two years into the outbreak, and going into our third covid-and-flu season, this novel coronavirus has claimed almost 5 million lives worldwide and counting, which is about 0.06% of today’s world population or 60 out of every 100,000 people. Remember that flu deaths every year are < 0.01% of the world population and that COVID-19 has lasted two years, which is not factored into any of my hand-made statistics for the sake of simplicity.


>>> Worldwide, based on deaths by population, COVID-19 is at least 6 times more deadly than the seasonal flu.


For context, the Spanish Flu (which took 2.5% - 5%) was between 40 and 100 times more deadly than COVID-19 (at 0.66%), making a continued comparison of the two pandemics on a worldwide scale essentially baseless — especially when you consider that fact that today’s pandemic has lasted twice as long, both in total outbreak durations of one year versus two and in periods of extreme death of 8 months versus 16 months (excluding summers of 2020 and 2021).


>>> Worldwide, based on deaths by population, the Spanish Flu was 40 to 100 times more deadly than COVID-19.


In the US, the disparity between the two pandemics does not seem so ridiculous, on the surface: the COVID-19 pandemic is credited with the deaths of 740,000, which is about 0.22% of today’s US population, or 220 in every 100,000 people, over two years and overlapping three cold-and-flu seasons (so far); remember that flu deaths every year are < 0.01% of the US population and that COVID-19 has taken 0.22% over twice as many months.


>>> In the US, based on deaths by population, COVID-19 is over 22 times more deadly than the seasonal flu.


For context, that surpasses the crude death toll (675,000) and is about 33% of the death rate per capita (0.66%) of the Spanish Flu pandemic — not forgetting that the 1918 pandemic was also half as long.


>>> In the US, based on deaths by population, the Spanish Flu was only 3 times more deadly than COVID-19.


But of course, we’ve established that the US experience of the Spanish Flu was very tame, being that we were a developed country in a time with very few developed countries; therefore, reproducing the crude deaths of the 1918 pandemic in a country that barely experienced said pandemic (see above) and has more than tripled in size isn’t exactly apocalyptic; and yet, given that the US hasn’t lost more than 0.07% of its population to a pandemic in the 100 years since the Spanish Flu (see above), it may very well feel like it.


>>> In the US, based on deaths by population, COVID-19 is about 3 times more deadly than any pandemic in 100 years.


Compared directly, with crude death rates per capita of 0.22% and 0.06%, respectively, COVID-19 is 3.7 times more deadly in the US than in the world overall; in fact, the US is (currently) the 7th-most-impacted nation in the world.


>>> Based on deaths by population, the US is the 7th-most impacted nation in the world during this pandemic.


Still looking for the silver lining? Unlike the 1918 influenza virus, which struck at random, COVID-19's deaths are targeting a much more specific, at-risk population. This makes it easier to identify and protect that segment of the populace, rather than, well, whatever it is that we’ve been doing.


Of all COVID-19 deaths in the US, 94% were among those aged 50 and over, and 75% were among those aged 65 and over. In addition, at least 89% of all those hospitalized with COVID-19 in the US had a pre-existing condition, while 96.5% of all those who died had at least two; "anxiety and fear-related disorders" proved to be the second biggest risk factor among them. There is, of course, significant overlap between these two groups; about 94% of deaths occurred among persons who fell into both categories.


>>> According to the CDC, 94% of COVID-19 deaths in the US happened to people 50 and older, while 75% happened to people 65 and older.


>>> According to a year-long study by the CDC, 96.5% of COVID-19 deaths in the US happened to people with multiple underlying health conditions.


Taking into account that the US population has one of the larger proportions of aging people in the world, as well as the likelihood that that many more immunocompromised people are living in the US than elsewhere (an educated speculation, given that many such people would probably not survive to old age with these health conditions in many parts of the world), may help us to account for some of the difference in death rates.


Infographic by GEOstata
This map compares age structure between countries.


There is only one last metric of the virus’ impact that I’d like to look at, which others have pointed out: comparing death projections for 2020 to actual deaths, based on population. Since no COVID-19 deaths would have been anticipated for the year 2020, all of them should belong to the count of excess deaths, along with all other unanticipated deaths. That number should be about 3 million, based on WHO estimates for 2020.


So, there should be about 3 million excess deaths, worldwide, from COVID-19, which is 0.04% of the world population, or 0.4 in 1,000 people. In other words, the death rate for 2020 should be at least 0.04% higher than it was projected to be. Well, what do the numbers say? The global projection was about 59.23 million, or 0.76%, and the actual death rate was also 0.76%. This means that there was no excess death, statistically speaking. This death rate was incredibly difficult to find, given the rampant misuse of the projection as a statistic and the interesting lack of real data for 2020 provided by relevant sources, such as the UN. I can understand their hesitancy. Please follow the trail of links in any articles you see to find out whether they lead back to a projection or actual data.


>>> The global death rate for 2020 was 0% in excess of its projection.


Another consideration is that a map of excess deaths based on population should include the relative death toll of COVID-19 between countries, and that countries with aging populations should have relative excess deaths that are at least somewhat reflective of their age structures. We should, therefore, expect to find similar excess death among aging countries; the map below should show some correlation with the map above. Especially because all of these aging nations have many things in common as developed countries, with regards to public health policy, resources, and death reporting.


Infographic by Our World in Data
This map compares excess deaths between countries.


Between the two maps, do you find a significant pattern? For a devastating new pandemic that targets the aged population so relentlessly, there should be some level of clear correlation between countries with aging populations and excess death rates. This map shows us that, specifically:


>>> In 2020, the age structure of a country was not a major factor in excess deaths, even though age is the clearest factor in COVID-19 deaths.


Let's set aside the fact that, for this map and the 0% global excess to co-exist, there need to be below-projection death rates somewhere, matching the number of COVID-19 deaths. Australia and Japan weren't significantly below-projection, and negative excess deaths certainly didn't happen in China or India during 2020, so most likely somewhere in Africa there need to be 3 million fewer deaths than projected. This is not entirely infeasible, but it doesn't appear likely, given that Africa has historically been the deadliest continent in recent history (see above).


Excess death is not based directly on death in previous years, but based on projections that look at trends over the years; in other words, if an increase in world death was expected for 2020, which it was, then this is already accounted for in the projection. Excess death is over and above all expected increase or decrease in world death.


Why isn't all of this adding up? Why don't excess deaths for 2020 seem to have any correlation whatsoever with COVID-19?


Test Accuracy and Availability


All of the above statistics, except for the last two, are based on "probable and confirmed" cases of COVID-19 and corresponding deaths, as reported by the US Center for Disease Control (CDC), the European Centre for Disease Control (ECDC), and other regional and national scientific bodies, all of which are then compiled and reported as world data by the World Health Organization (WHO) and its governing body, the United Nations (UN). Of course, the majority of these cases are “confirmed” cases, counted or estimated based on positive test results.


At the start of the outbreak, the WHO worked with regional and national organizations around the world to quickly develop tests to be used in tracking the SARS-CoV-2 virus. This was initiated by sharing the virus genome sequence, which the WHO had made publicly available for use worldwide by January 17 of 2020, at which time the WHO also issued guidance as to an original Real-Time Polymerase Chain Reaction (RT-PCR) test, developed in partnership with China CDC laboratories. This type of Nucleic Acid Amplification Test (NAAT), or “genetic amplification” technology is nothing new; it is designed to recognize the unique RNA-sequence of a virus. The guidance provided by the WHO acted as a protocol for the ECDC and others to develop their own RT-PCR tests.



>>> The original PCR tests developed by national and regional organizations worldwide were based on guidance set forth by the WHO in partnership with China CDC laboratories.


One full year after the WHO first published its test development protocol for COVID-19, in January of 2021, an International Consortium of Scientists in Life Sciences (ICSLS) published an independent, comprehensive peer-review of the "Corman-Drosten paper" — the publication which proposed the original PCR test for use in the European Union (EU) and was published by the ECDC in Eurosurveillance. The ECDC repudiated the uninvited peer-review, and as their official guidance on COVID-19 surveillance does not endorse any specific PCR test, they have not been motivated to take any steps to acknowledge the findings of the review (which you really should read).


The ICSLS peer-review concluded that this most important test to tracking the virus in the EU produced enough false positives to completely rewrite the narrative; the aforementioned peer review suggests that the design of the original PCR test was such that it would yield 97% false positives. It's very possible that the world didn't experience new and unexpected death in 2020 on the scale we think we did — out of the 3 million estimated COVID-19 deaths in 2020, over 1 million of them are attributed to Europe.



>>> The PCR protocol developed in the EU based on WHO guidance was found to yield 97% false positives, by design.



This PCR test was based on that same template recommended by the WHO; in fact, amidst international criticism, the WHO had finally "clarified" the test’s instructions in December 2020 (which only addressed one of the test’s many design flaws, but implicitly admitted that labs all around the world had been "doing it wrong" for months — reflecting a clear expectation of flawed test results due to improper administration of the test).


>>> The WHO was compelled to clarify its most basic PCR test guidelines several months into the crisis, indicating widespread misapplication of the test — inevitably corresponding with a mountain of invalid test results.


So then, what went wrong? How does the “chain of command” work, exactly? Well, after receiving the RNA sequence and test development protocol from the WHO, each localized Center for Disease Control then did some preliminary development and sent out its own protocol to labs across their respective jurisdictions. These medical labs and private production labs then developed the tests and, in some cases, came up with their own slight variations. This means that there are many different versions of each original PCR test, as well as other kinds of COVID-19 tests available, so it’s hard to say how prevalent these design flaws continue to be in the many off-shoots of each CDC’s original PCR test.



>>> The widespread issue with the original WHO PCR test protocol is that certain design flaws were inherited by those basing their tests on the flawed protocol or one of its look-alike, intermediary CDC protocols.



In the US, the CDC reportedly shunned the WHO protocol and developed it’s own original PCR test for SARS-CoV-2. This was done in the space of one week at the beginning of the outbreak, and was granted emergency approval by the FDA within 24 hours on February 3rd, 2020. It was the test we used to determine that this was a public health crisis, and it ultimately became the preferred test used to determine freedom of travel internationally; no other CDC test was approved by the FDA until July of 2020. To public perception, the US PCR test variations and the many WHO-based PCR test variations all appeared to be fairly synonymous, and no real distinction was made between them when it came to international travel restrictions.


In those early months of the outbreak, however, when it came to test production and distribution, the real-world reality in the US, like many other countries, was that constant delays in availability caused the scientific community to discard the preferred practices of cross-testing and re-testing, which augment accuracy. One sick person, one test. A long list of reasons not to get a first test, not to get a second test, not to get both tests. A scientific community trying to extrapolate a tiny pool of unverifiable data to stretch over an entire population. There was only one test, and it was only sparingly available.


>>> Lack of availability during the early months of the pandemic in the US, as with other nations, forced medical professionals to use tests sparingly, which made it all the more important that they be accurate.


Adding to the frustration of the US scientific community, this test and its protocols still appeared to be riddled with issues from the start that obscured the data. Interestingly, the CDC is casually withdrawing its request for the FDA's emergency approval of its original PCR test (which seems unnecessary, regardless of whether they planned on continuing to use it or not) and giving labs a soft deadline of December 31, 2021 to transition it out of use entirely. Doing both of these things together is like saying that the test never should have been used in the first place, despite the CDC’s continued endorsement of the test’s quality and integrity, and their lackluster attitude toward enforcing the transition.


It's almost as if they're trying to play it cool and avoid drawing attention while they hit "undo." Two (privately developed) PCR tests and one “rapid” antigen test, all developed based on US CDC guidance, have already been recalled by the FDA for their inaccuracy; of these three, two were found to be skewed in favor of producing false positives.


>>> The US CDC is “retiring” its original PCR test. Despite rejecting the WHO’s flawed protocol, we appear to have been unsuccessful in producing adequate alternatives.


Not exactly comforting, but although we can't turn back the clock, we can learn from our mistakes moving forward. A new CDC test (and others like it) has been in circulation now since July 2020 that simultaneously tests for SARS-CoV-2, Influenza A, and Influenza B; it's another PCR test called the "Flu SC2 Multiplex Assay." We will have to continue to wait and see, as the greater scientific community continues to hold itself accountable, how this Multiplex PCR test fares. Something tells me that will have to be fundamentally different from its predecessor, but each test must ultimately be evaluated on its own merit.


Regardless of the outcome of the international debate over the original wave of PCR tests among scientific communities, the scientific and governing bodies involved in their implementation will always be able to emphasize that these tests were developed in an emergency situation and “believed to be” highly accurate; that they eventually transitioned to the implementation of more thoughtfully-designed tests; that everyone, everywhere, had only the best of intentions. But, wherever there is power there must also be accountability — in matters of incompetency and malfeasance alike.



>>> Given that no test is perfect, limited availability constricted ideal testing practices, and the original PCR tests by the WHO and the US CDC both proved to be unreliable, it's safe to say that we have no idea how many actual COVID-19 deaths occurred in the US and worldwide.



Following the obfuscated path of COVID-19 testing is beginning to feel like a crash-course in plausible deniability. Almost like customers throwing weighted dice that belong to the casino, all of them wondering why they just can’t seem to win — call it a manufacturing error. Perhaps the predicament we are in is not the one we were made to believe.


Photo by Naser Tamimi

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future


Understanding the Statistics


The reasoning behind the statistics I’ve shared with you, the many I haven’t, and what's really worth knowing.


When you read the words mortality rate, slow down. So much confusion has arisen out of presuming certain statistics to be universal and interchangeable with these words. Pay close attention to who is sharing the information and the context in which they are sharing it. Make sure to avoid percentages that don’t specify a population base, or simply claim to be a mortality rate without ever saying which one. It’s incredibly important to know the exact statistic being given, and to remember that people do make mistakes. Try to verify the math, or at least pay attention to the source provided. And, if there's a bias in the words you're reading, there's bound to be a bias in the numbers sitting next to them. Statistics are powerfully manipulated devices.


I calculated the death-by-population percentages based on information provided in the linked sources along with the consistent use of this US population resource and this world population resource, and then multiplied by 100,000 to find a whole number of actual human beings to compare, adjusted for population. The reason I never say "the rest of the world" is because all of the worldwide statistics include the US. I have a degree in Economics and Business Analytics, and I am trained in working with data from different angles to find meaningful patterns, and in evaluating statistics for bias and validity. I calculated many of these statistics myself, trying to make the math as easy to follow as possible by providing well-vetted sources for the data used. Whenever you're comparing statistics between countries or different points in history, always be sure that you're looking at numbers adjusted for population.


I chose not to include data based on the infection rate, because I don’t believe we can pretend to have accurately kept track of the initial spread of this virus in the US, for a myriad of reasons, and therefore can’t say anything intelligent about how many have been exposed to the virus — assuming that the CDC had even been been using accurate tests. If we don’t know where the virus has spread in the first place, how can we truly catch up to it without doing widespread, mandatory antibody testing? And even there, we're a bit too late to catch up with the spread of a 20-month-long pandemic that has already waned (along with antibody counts) over two summers. The point is, viral load and antibody counts do not remain at discernible levels for months on end, and we cannot go back in time to establish a believable infection rate. For this reason, there is no point in trying to assess a meaningful infection fatality rate (IFR) for the COVID-19 pandemic and compare it to the IFR of other viruses; naturally, the scientific community will scramble to produce a meaningful statistic, but we really need to use some common sense here. As years go by and we gather more data about the virus and disease (using more accurate testing), the IFR may become relevant, but only if the data from the flawed tests are excluded.


The case fatality rate (CFR) is not a single number that can become some permanent or exact label to the very large family of flu viruses (for example), nor does it address infectiousness (how contagious these viruses are) or comorbidity (other ailments happening at the same time in the same person). The CFR simply gives us a clear picture of how many, out of all those confirmed as being infected with influenza, are ultimately dying. It’s not a complete or perfect picture — no statistic is — but it’s comparatively very useful and reliable. In order to be included in this number, a person must be sick with flu symptoms and test positive for influenza, therefore presenting a “confirmed case” of the flu. This same thinking applies to the CFR of any virus, and it's why we can't yet use this metric to comparatively understand the present pandemic.


Additionally, many statistics have been wrongly understood to be static attributes of a virus, just like the virus’ distinctive shape and size, rather than relative descriptions of the virus’ behavior. For example, once again, take the known CFR of the seasonal flu in the US, < 0.1%. This statistic says, “based on the data we were able to collect, and an estimation of the data we weren’t able to collect, the influenza family of viruses is generally considered to have a case fatality rate below 1 in 1000, at this time, on average, regarding all of the most recent strains of the virus.” The number stays well-below 0.1%, from year to year, so it’s given as a generalization. That number can change, and it will look very different based on location (real-world outcomes outside of developed countries).


Always remember that unless they specify otherwise, statistics from the Center for Disease Control (CDC) and the National Institute of Allergy and Infections Diseases (NIAID) are going to be based on the United States population, given that these are both national organizations. Naturally, their joint editorial back in March of 2020 reinforces the CFR of influenza in the U.S. of < 0.1%, which is also confirmed by the WHO as the "known CFR," indicating that it refers to a strongly agreed-upon value beyond US borders (outcomes within developed countries and therefore “accurate” in the absense of complicating factors found in developing nations, such as poor sanitation).


Always remember that the World Health Organization (WHO), the United Nations (UN), and other international organizations, unless they specify otherwise, are going to give statistics based on the world population, or else give a "known" statistic based on the rate(s) in developed countries, along with a disclaimer about real-world differences between countries and regions which yield very different outcomes and therefore very different statistics. Sometimes, of course, this means that the data provided by the CDC and the WHO will match. Sometimes.


No matter what organization is providing the information, always make sure to know who is paying them, and with what government structures they are associated. Scientists are not above corruption. I have shared numbers with you from the WHO, CDC, NIAID, NIH, IMHE, and scientific studies usually backed by one of these, as well as institutions and studies elsewhere in the world, all on good faith, because these numbers are presently considered authoritative; if I can use them, respect them, and still come out with a meaningful insight, then I should. I've also focused on less-well-advertised statistics based on the same data, and provided metrics that don't rely on virus-specific statistics to gauge the true impact of the pandemic; I've entertained both the possibility of honest science and the possibility of dishonest science, to make a clear-minded evaluation of the available data. Whenever integrity is compromised, the science will often stand in its own defense.


Always remember that anytime you are comparing any pandemic or novel virus to the seasonal flu, you are comparing a virus family that is still in the process of developing and administering vaccinations to a virus family that has undergone extensive vaccine science and development for decades. We have simply done magnitudes more to combat the flu and have been collecting data for magnitudes longer than whatever it is that we’re trying to compare to it. The numbers aren’t ever going to resemble each other until a disease has been endemic for a certain length of time. Take the COVID-19 vs. seasonal flu comparisons with a few buckets of salt — and yes, once again, I am referring especially to the CFR (which is, otherwise, an invaluable and preferred metric).


And finally, it is key to understand that statistics about a virus include all known data regarding all known variants; for example, the latest data regarding the Delta variant are included in the latest overall data concerning COVID-19, and the latest data regarding this season’s emerging flu strains are included in the latest overall data concerning influenza. This will be true for any and all variants up until the point when, hypothetically speaking, something unique emerges and they classify it as a new virus. Every endemic virus produces new variants all the time that have the potential to be unique and dangerous. It's a reality we've already been living in, and while scientists are rightly keeping track of every little thing, we don't actually have to join them. Remember, pandemic plus internet equals new mistakes. One new mistake is that, as the scientific community floods the web with information most of us aren't equipped to understand (rather than keeping it in an archive and sharing a summary of their findings every now and again), "reporters" are looking into every bit of it to find the next scoop. Let's not encourage them.


In truth, there is a whole host of data out there that might be worth considering, but the moment that we lose sight of the big picture is the moment we risk being manipulated; it’s easy to sway a populace by taking advantage of the difference between the seeming danger of a crisis, and the actual danger of said crisis. At the end of the day, we don’t need to know all of the numbers — just the right ones. And then, we need to know how to practically handle this challenge in our own lives.


Photo by Drew Beamer

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future


INTO THE FUTURE


When looking at the practical steps forward from this pandemic, we need to make sure that we understand how to keep ourselves healthy, how to recover, and what to expect in the years to come. Ultimately, we know the drill; we just don't seem to realize it, yet.


A Categorical Comparison


We're more familiar with preventing the spread of infectious upper respiratory diseases than we might think; it’s just a matter of sussing out the differences between COVID-19 and other, more familiar diseases. First of all, what about of COVID-19 as a viral respiratory disease is new or unique? The answer: basically nothing. It's just much more unpleasant.


>>> The only thing unfamiliar about COVID-19 as an upper respiratory disease is that it presents with a unique combination of all-too-familiar behaviors.


Say what?


Just like the flu, the common cold, and others, COVID-19 is spread by coughing, sneezing, laughing, or shouting while infected, which propels an aerosol spray into the faces of other people; by touching virus-dirty surfaces without frequent hand washing, and then touching your own face; or by walking face-first into a space just seconds after an infected person was breathing there. Can you remember a time when you didn't need to cough into your sleeve or stay home to avoid getting everyone sick? I don't.


>>> COVID-19 is spread the same basic way as other upper respiratory diseases.


But what about asymptomatic spread?! Findings of the Center for Disease Control (CDC) show that asymptomatic cases are only slightly contagious (due to low viral load), and only for a very brief period of time, usually leading to more asymptomatic cases; this is exactly the kind of spread we want to have for a highly infectious disease! And it’s incredibly relieving, given that 25% to 45% of people who catch COVID-19 remain totally asymptomatic. I vote for asymptomatic spread all day, every day. Asymptomatic transmission reflects and builds strong immunity; it means our healthy bodies are kicking vass!


Regardless, the simple fact is that several studies around the world, such as these two from China and Germany (which demonstrate a complete absence of asymptomatic spread), overwhelmingly support the WHO's original statement that asymptomatic transmission is "very rare". Fauci himself, director of the National Institute of Allergy and Infectious Disease (NIAID), said in January 2020 that "asymptomatic transmission has never been the driver of outbreaks." Furthermore, research in Canada concluded that more research is needed to "better understand how asymptomatic cases contribute to the pandemic," which is, in other words, inconclusive; this sounds a lot like something we've heard before...


>>> Asymptomatic spread of COVID-19 resembles that of other upper respiratory diseases.


For those who are not asymptomatic, infectiousness appears to peak right before or right at the beginning of symptoms, which happens too quickly for a person to isolate themselves before spreading the virus. But wait — doesn't this sound familiar, too? As it turns out: yes, it does.


>>> Pre-symptomatic spread of COVID-19 resembles that of other upper respiratory diseases.


Speaking of symptoms, those of COVID-19 seem to be consistent with both the cold and flu, although the incubation period is a few days longer. Symptoms do seem to be worse overall, making this bug the most unpleasant. And unfortunately, just like its distant cousins, SARS and MERS, COVID-19 can leave a person with lingering fatigue and other long-term symptoms that can last weeks or months, for critical patients; they’re calling it “long covid” — it seems that the majority of those recovering from acute COVID-19 experienced at least one lingering symptom for at least two months after being discharged from the hospital, especially those in the at-risk group. I did not find any similar studies on the flu or other respiratory diseases with which to compare this study.


>>> Aside from longer incubation and more highly variable duration and severity, the basic symptoms of COVID-19 resemble those of other upper respiratory diseases.


For critical patients, the development of either COVID-19 or the flu leads eventually to Acute Respiratory Distress Syndrome, co-infections such as pneumonia, and stress to multiple vital organs that can cause injury and even failure, all of which happens in the final stages of disease as the virus dies down but the body cannot recover. A grim picture, to be sure — but not something we haven’t seen before.


>>> Generally speaking, the complications of critical COVID-19 infections resemble those of other upper respiratory diseases.


Also key to understand is the at-risk population. Who is most vulnerable to becoming critically ill or dying from the disease? We’ve established that COVID-19 targets those over the age of 50, especially those over 65, and that it targets those with multiple underlying health conditions, including fear and anxiety disorders. A whopping 64% of all COVID-19 hospitalizations might have been prevented if not for a very specific, short list of pre-existing conditions. How does this compare to the friendly flu? Well, it’s… the same, yet again.


>>> The at-risk population for COVID-19 resembles that of other upper respiratory diseases.


So essentially, the situation in which we find ourselves is that our previously at-risk population is now more at-risk, and so it’s all the more imperative that we support and protect them. But we do need to recognize that it’s the same group of people; otherwise, in our rush to needlessly protect ourselves and the general population, we’ll stampede right over them. Let's get creative and thoughtful as to how we can do that, in addition to doing what we already know:


>>> When sick people stay home, and we all wash our hands and eat a vitamin-rich diet, we are already wielding the most effective defense against respiratory diseases just like COVID-19.


We have many tools at our disposal to fight this disease in our everyday lives, regardless of how long it takes the scientific community to come up with our next easy fix.


Common sense is still enough, the vast majority of the time.


The Aftermath of a Pandemic


We now have all of the facts. The final piece of the puzzle is to get our psychology straightened out, and give ourselves permission to breathe a sigh of relief. To realize that we don't need to become jaded about our lives, futures, and opportunities, when we still live in the United States of America. We still miss out on most of the world's horrors and have more civil liberties than most people throughout most of human history could have dreamed. We still get to have this beastly thing called the internet, and to fill it with beautiful and hopeful expressions to lift the heavy hearts all around us.


The truth is, we don't live in unprecedented times. We've been here before, and we know the way out. We will still try to learn everything we can from the mistakes made here, and to ensure a better, safer, saner future for our children. We will still rebuild, innovate, and grow our way out of this mess like we always do; it's inevitable. Soon enough, we'll be calling it the covid-and-flu season, and going on with our lives like we always do.


So, after this post, go look at a cat video and then turn off your phone. You're not in danger; you're just in an anxious state. Don't feed that. Hell, maybe even open up a bible to the book of Proverbs and sharpen your discernment of the world. Take a step back from the prolonged mass hysteria and hit unsubscribe. Don't think anymore. Just do it.





Naiveti is 100% politically unaffiliated. And I dare say, I plan to keep it that way.


Infographic by The Pacific Community

The World We Knew / The World We Never Knew / The COVID-19 Pandemic / Into the Future





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