Counting COVID-19

And learning what counts

06 Apr 2020 | 11:05

Centuries ago, Plato wrote that “a good decision is based on knowledge, and not on numbers.”

COVD-19 proves him right because the numbers we see may not be reliable, causing problems for people attempting to craft protective plans. “As elected officials we usually look to scientists and medical professionals for advice on how to protect the public from diseases like this,” said State Senator Brad Hoylman. “But what’s so menacing about COVID-19 is that the scientific experts don't have many answers at this point, either."

Start with the simple question: how many people are actually infected? Researchers at Johns Hopkins Bloomberg School of Public Health estimate the average incubation period of COVID-19 is about five days and that nearly all people who are infected will start showing symptoms in about 11 days, which validates the Center of Disease Control and Preventions (CDC) 14-day quarantine period. The complicating factor is that American epidemiologists estimate as many as 25 percent of those carrying the virus show no symptoms at all, a figure high enough to make it virtually impossible to say how any cases we have and difficult to predict whether the pandemic is rising, remaining stable, or falling.

Next up: How lethal is this virus? That is, what percentage of the people who contract it will die?

Scientists calculate a disease’s mortality rate as a ratio that looks like this:

Number of deaths divided by number of cases = mortality rate.

Attempting to use this formula for COVID-19 runs smack into two hard walls. First, again, is that the only number of cases we know about is the number that have been diagnosed. The second problem lies in how we characterize the number of deaths.

Mysteries in Numbers

British pathologist John Lee, a consultant of Rotherham General Hospital and former clinical professor of pathology at Hull York Medical School, explained to The Spectator that in the current climate, “anyone with a positive test for COVID-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the COVID-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between COVID-19 causing death, and COVID-19 being found in someone who died of other causes.”

Walter Ricciardi, scientific adviser to Italy’s minister of health, agrees: Italian doctors, he told The Telegraph newspaper, are reporting deaths caused by coronavirus even if the patients were already sick from other things.

Finally, there is one seriously strange statistic to emerge from the COVD-19 data pool, the suggestion that men are more susceptible than women to the virus. The first explanation, in China, was that the initial victims, workers in the Wuhan market, were all men. Then came numbers from Spain’s Institute of Health Carlos III showing that men accounted for 59 percent of the COVID victims admitted to hospitals, 60 percent of those who progress to pneumonia, 72 percent of the intensive care unit admissions, and 65 percent of the deaths. In France, 73 percent of intensive care unit admissions are men; in Norway, 75 percent; in Britain, 71 percent. Because COVID-19 is respiratory illness, it seemed sensible to blame smoking for the difference between the genders, but when tested, it turned out the difference between make and female smokers was minimal.

Eventually, the COVID-19 mysteries will yield to scientific investigation.

Until then, stay safe.

Wash your hands.

And keep your distance.

Carol Ann Rinzler is the author of more than 20 books on health, including "Nutrition for Dummies."

"As elected officials we usually look to scientists and medical professionals for advice on how to protect the public from diseases like this. But what’s so menacing about COVID-19 is that the scientific experts don't have many answers at this point, either." State Senator Brad Hoylman