Looking at the official numbers of the corona virus statistics, Italy has a vastly higher mortality rate than Germany. How can that be? After all, we are dealing with the exact same virus. Investigating this question reveals a lot of problems with the numbers we are reading in the media.
The problem with the corona virus is that it cannot easily be detected. That is because it causes symptoms that are also caused by a number of other viruses. In fact, according to virologists, there are over 100 other known viruses that cause very similar symptoms. These viruses go around the world every season and cause what is commonly called the flu or a cold. And among these viruses have always been corona viruses, which make about 5-15% of the normal seasonal flu.
It is long been known that respiratory viruses which cause coughs, blocked noses, sore throats etc. can be dangerous to some, mostly vulnerable, people. Every year, in a country like the UK, the flu kills thousands of these people. The corona virus is now believed to be a new virus in this group, and because it is new it will kill a lot more people than the other already known viruses, as our immune system does not yet know how to handle this virus. That, at least, is the theory.
One thing that is important to note is that in a normal season, whenever someone dies on the flu, we do not normally test as to which of the over 100 viruses killed the patients. They simply go into statistic of flu deaths.
Let us look at the numbers.
As I write this, Saturday 21st March 2020, these are:
Germany 19774 confirmed cases, 64 dealths, mortality rate 0.3%
Italy 47021 confirmed cases, 4032 dealths, mortality rate 8.5%
How can we explain the difference?
It seems like the more we test, the lower the mortality rate becomes. That is because usually hospitalized and patients who have died are definitely being tested. On the other hand a lot of mild and symptomless people are not. The more mild cases are left out of the statistic, the higher the mortality rate. That means that the more we test, the more accurate the mortality rate, and Germany is testing a lot more than Italy. Because only mild cases are being left out of the statistic, every mortality rate has a bias towards being too high!
2) Who counts as a corona dead?
How do we know that someone has died on the corona virus? The answer is, we don’t really. It is a question of cause and effect. I drank water and wine and I felt sick, I drank water and beer and I felt sick, I drank water an whisky and I felt sick, obviously, water makes me sick. But of course, just because water is present does not mean it causes the sickness. In fact, as we all know, the real cause here is the alcohol.
Hendrik Streeck is the virologist who has examined the most corona virus cases in Germany. He started examining people in one of the first centers of the outbreak, Heinsberg. He reports that there is a problem with how we count the corona dead. He gives an example of a 78 year old man in Heinsberg who was counted as a corona virus dead. The man, however, was ill already and died on a heart attack. The corona virus was present in his body, but it is not clear whether it actually caused the heart attack. He might have just died anyway.
But now we are testing for corona virus unlike in a normal flu season, where we do not care about which virus causes which outcome. So a lot of deaths will go into the corona virus statistics, rightly or wrongly. Hendrik Streeck does not expect there to be more flu deaths (including the new corona virus) this year than in a normal year.
Considering this, I wonder how many people like this are counted as corona deaths in Italy. The average age of a person dying of corona virus in Italy is around 80. 90% are older than 70. That means these people die at an age, where on average we would expect them to die. And of cause many people die all the time. On an average day 2500 people die in Germany. So we can see here how much room for bad statistics there is when it comes to the corona virus.
3) Why are hospitals so crowded
Another reason mentioned for the much higher Italian mortality rate is the overcrowded hospitals. Some people will need hospital care in order to survive. So if hospitals are full and they cannot get that care, they are going to die. This problem is of cause at the very heart of the strategy of the UK government. All the social distancing is about not getting too many people infected at the same time, in order to not overwhelm the hospital system.
The NHS, however, is notoriously overcrowded. Even in a good year they have trouble dealing with all the severe respiratory virus cases. A lot of countries, and I believe Italy is one of them, have adopted a policy of telling people to go to the hospital instead of the GP. The UK is now also sending a lot of people that in a normal year would count as having the flu to the hospitals.
Part of my sister in law’s family got the corona virus while skiing in Italy. Her sister, who is 48, always had some health problems. She developed some mild breathing problems and was put on support in a hospital. But this was more a precaution than urgent. If it was not for the corona virus environment, she would have probably stayed home in a normal year.
So it seems like we are telling more people to go to hospital which makes overcrowded hospitals a self fulfilling prophecy.
And that is problematic in another way too. Hospitals are not just places where people get healed, but have long know to be places where one can also get nasty bugs. This phenomenon is believed to kill thousands of people every year. In other words they die because they went into hospital. If we are telling more people to go into hospitals we can expect that number to rise.
Is there a new virus out there? It sure looks like it. Is this virus very dangerous? So far, the best data we have seems to suggest that it is indeed more deadly than the flu. But looking at the numbers it does not seem to be a lot more deadly.
Given that, we have now adopted some really crazy policies. Sure we should be careful, as we have limited information. And what we know suggests that we are dealing with some danger. So yes, telling people to wash their hands and maybe not socialize as much as usual seems like a justified policy. But from what we know, it seems to me there is no justification for bringing public life to an almost stand still and smashing the economy.
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