Another Way to Look at Scary Statistics
March 23, 2020
Dear Families,
I thought I would write this email in response to the CDC’s 1st MMRW report (mortality and morbidity) on COVID-19
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6912e2-H.pdf
This report then prompted this article:
The author reports, “Millennials are not invincible. The new data show that up to one-fifth of infected people ages 20-44 have been hospitalized, including 2%-4% who required treatment in an intensive care unit.” YIKES! At first glance this article and statement seems to be a reason for us all to freak out big time. Right?
Let’s look at what the CDC actually said. So as of 3/26/2020, the CDC had 4,226 cases reported. The reality is that likely we have already had 4,000+ cases just in CA (if not LA). As you know, currently it is basically impossible for one to get tested for COVID-19 unless you are at HIGH RISK. What this means is that the cases that were reported were likely disproportionately skewed towards the very sick in hospitals.
What does the CDC report really say?
- We have no background data on underlying health challenges of those in the report. Were they all healthy? Did they all have serious underlying health conditions? Who knows!
- Only 57% of the reported cases had ages reported. Of this reported data, they clustered the age groups into 0-19, 20-44 and 45-54. It is VERY strange that they clumped 20-44 together, as we have clearly learned that 20-year-olds (y/o), 30 y/o, and 40 y/o have very different statistical risks based on all other countries’ data. Let’s keep going…
- So, they only had 508 patients hospitalized. What? Did you get that? In all the US only 508 cases were hospitalized? We know this number is far, far higher. They reported 9% were >85, 18% were 45-54 y/o, 20% 20-44 y/o. So according to this report the 20-44 y/o group had double the risk of hospitalization vs the >85 y/o. ??? Not sure how that makes sense. We KNOW that the older population is at an astronomically higher risk of hospitalization and harm than those younger. According to prior data from China, the elders are about 70x higher risk….
- Only 121 patients were admitted to the ICU. What? We hear reports that there are not enough ICU beds, but the CDC counted 121? Of these counted, 7% were >85y/o (WHAT?)… 36% 45-64y/o, and 12% were 20-44 y/o. Oh dear! 12% of Millennial cases are ending up the ICU? That is so concerning! OR, perhaps we should ask that astute author who wrote that article, if these millennials she was reporting were actually 43 y/o patients with heart disease, high blood pressure, diabetes, asthma, COPD and 15 other health conditions? We don’t know! Sadly, there are many fellow Americans who are in this awful state of health. How do we differentiate their health outcomes from the 20-year-old healthy, fit younger person?
- What the report does say that I did take note of was that 2-3% of hospitalizations were in <9 years of age, but no ICU admissions. Now sadly, the US also has very high rates of TYPE 2 diabetes, high blood pressure (and all kinds of other fantastic health challenges) in our youngest population! OR, were these children those who have heart transplants, severe asthma, chronic lung disease from severe prematurity, etc.? We don’t know. I would venture to guess that if and when this data is analyzed, we will find some very interesting correlations. We should not dismiss this data, but we should also consider it in the larger context.
Now, let’s look at South Korea, which so far has been the most impressive country in its handling of COVID-19. I could not find the raw data to analyze myself, but here is what is reported.
https://www.businessinsider.com/coronavirus-death-rates-by-age-south-korea
This data, which is probably the most accurate picture of what is happening (when you remove the astronomically high rate of chronic disease in this country), tells a VERY different story. In this very small country, they reported 7,755 cases thus far, with 60 deaths. This means the death rate in S Korea is 0.77% (remember everyone else is reporting 3-4%!!!).
Let’s contrast this to our current CDC data on influenza which suggests a death rate of 0.1%. This means that perhaps COVID-19 is 7-8x as deadly as influenza NOT 30x. Not totally reassuring, but less doom and gloom than what you are hearing. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
This same influenza report also states that we had 22,000-55,000 deaths in the US this last year alone from the flu. DID YOU HEAR THAT? 22,000 (on the lower end). TOTAL COVID-19 deaths stand at 8,969 IN THE ENTIRE WORLD!!! And China is now EXITING their crisis (for now…).
Get this – and this is where that initial article I referenced really falls apart – S Korea also reports zero deaths in younger cases, 1 case 30-39, and only one patient in 40’s dying. This means 0.1% death rate in 30-39 y/o AND 40-49 y/o, which then increased to 0.4% above the age of 50. This is actually 50% lower than even what China had reported to us.
One of our dear families brought to my attention a new pediatric study
https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf
What does this report tell us? By 2/08/2020, China had 2,143 total cases in children. I wish I could find the exact data to correlate with time, but according this one article, there were a total cases of 72,436 on 2/18/2020 in China.
https://www.aljazeera.com/news/2020/01/timeline-china-coronavirus-spread-200126061554884.html
This suggests that 2.9% of all reported cases were in the children. This goes along with other reports we have had so far. Of these children who were reported, about 5.8% of the 2.9% (0.16%) of cases (total number of 125 cases in the entire population) had a severe or critical reaction to the virus (critical being they ended up in the ICU). My understanding is that there are no reported deaths.
This data does raise concerns that children are not completely immune to this virus. What this study does not tell us is who these children were. Were these poor young infants and children extreme preemies with severe lung disease (bronchopulmonary dysplasia) who were on oxygen? Where the older children severe asthmatics with unstable airways? We don’t know.
Let’s compare this to 2018-2019 US Influenza data (2020 not yet analyzed).
https://www.cdc.gov/flu/about/burden/2018-2019.html
Sadly, just in the 0-4 y/o children, there were 25,328 hospitalizations and 266 deaths. We don’t know the number of ICU/critical cases. Let’s compare # of deaths in this age group from Influenza vs critical cases of COVID-19 in this age group (9). This means that a young child has 3.3% chance of having an ICU admission FROM COVID-19 vs DYING from the flu.
Pull yourself out of this darkness that is devouring those around us. Stay focused on the light and use that to give you the strength you need to pull through this. Focus your energy on the things and people (your elderly and vulnerable) who matter. Of course, we need to be responsible and do our part to protect the vulnerable. This is not a time be irresponsible, and we need to be cautious for ourselves, because we still don’t have all the data and anything is possible. What I am saying is that you don’t need to be consumed by fear to be careful and aware.
We will get through this. Watch out for your elderly and most vulnerable family members. We are a community – an extended family – and the community is what has the power to heal. Take that energy that has been devoted to fear and channel it to start healing your society that needs so much healing. Take that energy and bring calm and light to those around you, don’t allow their fear to infect you!
You can do this! We will get through this, and hopefully become wiser and smarter as a result.
In health,
Pejman Katiraei
1821 Wilshire Blvd. Suite 501, Santa Monica, CA 90403 Phone (310) 828-9998 • Fax (310) 405-0908