COVID-19: The New York Problem

I'm not sure exactly what to make of the chart below, but it is very interesting.  This chart shows the total number of reported COVID-19 deaths in all fifty states plus D.C., sorted by population (as of 4/17/20).

As this shows, New York, the fourth most populous state, is an outlier in the country.  And, from what we know, it is particularly New York City where the vast majority of reported deaths have happened.  The next highest number of deaths, New Jersey, NYC's closest neighbor is only 22% of that of New York.  California, the most populous state, is at only 6% that of New York.

Yes, there are sound reasons why New York would have the highest numbers.  While the state is the fourth most populous, New York City (8.2 million) is the most populous city in the country, by far.  The next closest city, Los Angeles is only 49% the size, and not nearly as dense.  But, should New York be this far out of the average?  

Maybe, but lets examine some theoretical possibilities.  Maybe it is because there are so many flights that come to New York from China, where the virus started.  That is why there was so much worry about Washington (state) and California early on, but they are at 4% and 6% of New York deaths.  Maybe everyone else has just done a much better job in limiting the spread of the virus?  I can't believe this is true.

We know, and I covered in a previous post, that the number of deaths have been very liberally counted...I would say over reported.  Could it be that some of the difference is due to a higher level of over-reporting?  Maybe.  As was reported in The Telegraph, Italy now says that only 12% of the deaths reported as caused by COVID-19, were actually caused by the virus.  How much over-reporting in New York?  We can't be sure yet, but let's say, because of the density of  NYC, that their real numbers are up to 25% of reported.  That would be 4282 deaths, still the highest in the country, but seems much more in line.  Regardless of the percentages, I think this whole subject needs to be closely examined...starting now.  This is very important data to have correct when you are making decisions on locking down the economy.

So, what can we do with this data?  Well, if we are going to shut down any economies, maybe we should just do it to New York, and maybe, New York City in particular.   If you break down the number of deaths, you will see that:

• 20 states have under 100 deaths
• 32 states are under 200 deaths
• 43 are under 1000

But maybe this isn't the right metric, due to the relative populations.  So what if we look at Deaths/1M Population?  This is a much better way to view the effect on a given population. If we look at it this way, 43 states are under 100 deaths per million in population.  New York is at 873 per million.  So maybe we lock down the states that are over 100 deaths per million in population?

Regardless of how you look at it, New York is an extreme outlier and we should make it a priority to find out why.  We should also not make policy for the whole country based on New York.  In many types of analysis, you take outliers like this and throw them out because you don't want to make decisions based on the extremes.  If we do have an over-reporting issue in a few states, and those states are locked down when others aren't, I would imagine that they would get their numbers corrected quickly.

As I have said before, and I blame this as much on the Trump administration as on the over-hyping of the media and the Democrats, but I repeat myself (as Andrew Klavan says).  There are not only two choices...SHUT DOWN or WE ALL DIE.  We need much better leadership at all levels than we are getting.  There needs to be more subtly in our response.  This should not be viewed as one size fits all.

#CriticalThinking  #QuestionPower 

EDIT 4/27/20: A new study by MIT economist Jeffery Harris suggests that one of the big causes of such high numbers in NYC may be the subway system.  This article by Reason.com provides an overview of the findings.

COVID-19 Update: 4/4/20

Perspective: The Worldometer site, the one that has been publishing the COVID-19 statistics, added one yesterday - Tests/1M Population.

As of the close of the day yesterday 2,110/1M Population had been tested in the US. With a population of ~329,671,200. That means that approximately 695,606 tests have been done in the US. That is 0.21% of the population.

It also means that only 39.84% of those tested have actually shown to be positive. This number is likely skewed high, and maybe significantly so, for general population exposure since most of the testing is being done for people who have symptoms or who suspect that they have been exposed.  Many who think they may have it are being denied testing and just told to self-quarantine, because their symptoms are not serious enough.

What does this all mean? Well, all the figures being touted for mortality rate, for example, are just guesses based on extrapolations from a very small sample of the population.

It also means that the Total Number of Cases figure means almost nothing. This is just a factor of how many who have been tested. But the news media keeps hyping this number. "The US has now surpassed Italy in the number of cases!" So what? The more significant number is how many have died in proportion to the population. Italy is at about 243 total deaths/1M in population. The US is at about 22 per 1M.

Chart as of close of day 4/3/20

I believe this is why the CDC does not publish "Mortality Rate" numbers for flu and pneumonia. There's no way to know unless they actually test a much larger sample of population.

Let's also remember that only between 2.1% and 2.6% of those known Active Cases are Serious (hospitalized) or Critical (ICU)... and only a percentage of Critical (I heard one doctor say about half) are in need of ventilators at some point.

Let's just all keep perspective and look past the hype to try to understand what the true numbers are...what they really mean...and what they don't tell us.

COVID-19 Update: 3-31-20

The reason I post these updates is to help keep COVID-19 in perspective.  There is an increasing number of experts and observers coming out who are questioning the need for such economy-crushing measures to  fight a virus who's death toll is lower than seasonal influenza.  Then there is this video, where a doctor on the front lines of the outbreak in New York City says that says that avoiding the disease is easy.  Dr. Price says:

“The ways that you get this is the transmission of the virus almost exclusively from your hands to your face, from your hands to your face and inside your eyes, into your nose or into your mouth...”

“Become a hand Nazi. Everything you know about your hands, just keep it clean and you will not get this disease...”

“That is incredibly empowering. The thing that makes me smile a little bit is I actually know now that I won’t get this disease because I know how to protect myself...”

With President Trump's declaration yesterday that the lock-downs will remain in place until at least April 30th, it is probably too late to save the economy from serious recession, but maybe we can learn a lesson about perspective and critical thinking from this debacle. 

Now to the numbers:

Looking at the closing numbers from 3/30/20, the ratios are staying pretty constant.

The percentage of active cases that are Serious/Critical are hovering between 2.1% and 2.6%, which means >97% are categorized "Mild."  This does not mean fun, but it means that there is no need for hospitalization.  These cases can be treated at home with normal flu type treatments of rest, hydration and treatment for fevers.

Compare these numbers to Influenza deaths in the chart below.  2020 Influenza deaths are through week 11 of the year.

COVID-19 Update: 3-27-20

Not much change in the proportions.  This is the kind of comparisons we need to keep this in prospective.

2020 Influenza totals are for only the first 10 weeks of the year.

COVID-19 Update: 3-25-20

Okay, tell me why our health care system is supposedly being overwhelmed, if not for panic?  With only 1,175 "Serious, Critical" active cases in the US, I don't know for sure, but my guess is that if all of these were in New York City, they would probably be able to handle them...if not in the city, I'm sure in the Greater New York area.

Even across the world, it is tracking with similar proportions.  Although, the ratio of total cases to active cases seems to be wider.  Does this mean we have seen the world-wide peak?  Time will tell on this, I guess.  But, if we have, it would track very similarly to Influenza time frames.

COVID-19 Update: 3/24/2020

2020 Influenza numbers are for the first 10 weeks of the year only.  COVID-19 numbers are total. 

COVID-19 in Perspective

I have been making the case that the COVID-19 Pandemic should be kept in perspective with other epidemics.  I spent some time looking at statistics and here's what I've found.

While many people are claiming that COVID-19 is particularly devastating, if you compare it to Influenza, it clearly is not even close.  I pulled the current statistics for COVID-19 here, and downloaded a table from the CDC here to get the summary in the tables below.

As these statistics show, Influenza causes way more deaths every year in the US than COVID-19 has any signs of showing so far.  In fact the COVID-19 death rate in the US is currently only about 0.15 deaths per 100,000 in population.  This compared to Influenza in just the first 10 weeks of 2020 where the rate is 1.31 per 100,000.

Additionally, if you look at death rates for Influenza in 2018, you see that these rates jumped all the way up to 4.43 per 100,000.  With 14,510 deaths that year, it was nearly as high as the current COVID-ID deaths world-wide.  I doubt that many outside the health field even remember that 2018 was a particularly bad year for the flu.

While it is relatively early in the COVID-19 cycle, the numbers seem quite low in comparison.  Remember, the 2020 Influenza  deaths are for only the first ten weeks of the year, where the COVID numbers are total for this outbreak.

We are, at the time of this writing, in week 13 of 2020.  The COVID numbers will surely go up...but so will the Influenza numbers.  According to the CDC table, the Influenza deaths start dropping off rather quickly from here...bottoming out at about week 21 - 23.  Many expect COVID-19 to follow a similar trajectory. Chart below shows Influenza deaths.  Notice the large spike in 2018.

With numbers like these, does it make sense to be taking the extreme measures we now are seeing?  Steps that by all accounts, Republican and Democrats agree, will certainly cause significant damage to the economy. Estimates are that the recession could be significantly worse than we had in 2008, with 20% unemployment, and cost over $1T in government bailouts.  What happens next year, or the year after when another bad flu season comes along?  Can we afford these kinds of actions from our overzealous politicians?

This data was easily found.  It is from reputable sources.  Don't take my word, look for yourselves.

“Those who would give up essential liberty to purchase a little temporary safety, deserve neither liberty nor safety.” ~  Benjamin Franklin