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Are we counting the wrong thing?
Mar. 21st, 2020 06:03 pmEveryone obsesses over calculating the death rate in pandemic diseases. I think a more meaningful statistic is the rate of severe and critical disease (where "severe" means roughly sick enough to need hospitalization and "critical" means you would probably die without intensive medical care). Not only is that the key thing we need to know as we desperately try to gear up our health systems to deal with the influx of patients, I think it is a more meaningful assessment of the actual seriousness of the disease.
Ebola used to be described as a disease with an 80-90% death rate, which it is in its native environment (isolated African villages with no hospitals). When recent outbreaks reached the cities, the death rate dropped to about 50%. That doesn't mean it's any less horrifyingly lethal a disease, it just means that with advanced supportive care in modern hospitals a lot of patients become critically ill, but eventually pull through.
Calculating the death rate after the fact can give you meaningful historical data, of course. Spanish Flu (1918) had a devastating effect on families and communities because somewhere between 2% and 5% of victims died. But if hospital care in 1918 had been similar to what we have today in this country, the death rate would have been much lower, perhaps no higher than "seasonal flu."
For comparison, the available data on COVID-19 is 5% critically ill and 15% severely ill but not critical. That's a hell of a lot of people hitting the hospitals. If the health system manages to keep up with that tsunami, most of those people will survive. If we end up with a health care system as overwhelmed as the one in northern Italy right now, the death rate will be much higher. That's what the governor of California was getting at when he dropped that 25 million number into a news conference on Thursday.
Ebola used to be described as a disease with an 80-90% death rate, which it is in its native environment (isolated African villages with no hospitals). When recent outbreaks reached the cities, the death rate dropped to about 50%. That doesn't mean it's any less horrifyingly lethal a disease, it just means that with advanced supportive care in modern hospitals a lot of patients become critically ill, but eventually pull through.
Calculating the death rate after the fact can give you meaningful historical data, of course. Spanish Flu (1918) had a devastating effect on families and communities because somewhere between 2% and 5% of victims died. But if hospital care in 1918 had been similar to what we have today in this country, the death rate would have been much lower, perhaps no higher than "seasonal flu."
For comparison, the available data on COVID-19 is 5% critically ill and 15% severely ill but not critical. That's a hell of a lot of people hitting the hospitals. If the health system manages to keep up with that tsunami, most of those people will survive. If we end up with a health care system as overwhelmed as the one in northern Italy right now, the death rate will be much higher. That's what the governor of California was getting at when he dropped that 25 million number into a news conference on Thursday.
