The pandemic has been absurdly and grotesquely politicized when it never should have been. In December, January, and early February you could not reliably predict what political party someone was part of based their position on the virus. On February 24th Nancy Pelosi was strolling Chinatown in San Francisco, encouraging other people to do the same while taking precautions for the virus. She certainly wasn’t playing it up. It wasn’t until two days later on February 26th when President Trump made the absurd claim, “You have 15 people, and the 15 within a couple of days is going to be down to close to zero,” that the politicization began and Trump supporters started mirroring Trump at every opportunity.
It marked the strategy Trump would later maintain, claiming that Democrats are just making a big deal about the virus to hurt his re-election chances. Which is a weird thing to say, considering virtually every country has made quite a big deal about it. Does Trump and his supporters think there is a global conspiracy where every country is overreacting on the virus just to hurt his campaign? Of course, that would be ludicrous.
February 27th Trump suggested that, the virus might get slightly worse, but it actually could just “disappear.” March 11th Trump continued downplaying, saying that for “the vast majority of Americans, the risk is very, very low.” On the same day Dr. Fauchi said “bottom line, it’s going to get worse.”
April 3rd is one of the more striking and obvious watershed moments in the politicization. It was the day the CDC made its recommendation to wear face coverings, to which Trump responded by immediately undercutting their message and stating that he personally would be going directly against it. And just like that, his supporters followed suit with near universal mask rejection. Politization at its most deadly and selfish.
March 9th the president tweeted, “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!” The president was suggesting that the coronavirus was no big deal, and was in fact comparable to the seasonal flu. Let’s begin our factcheck here.
Is COVID-19 No Worse Than the Common Seasonal Flu?
At the time of writing this (October 21st, 2020) there have been 8,249,011 confirmed cases of the corona virus in the US, and 220,362 [update: 257,000, 11/24/2020] deaths according to the CDC’s tracker. That means the roughly seven months that Covid-19 has been killing Americans blows the number of people killed by the flu last year out of the water. So simple time has laid to rest this particular aspect of the president’s comparison. Think about that number of deaths though. That is already almost four times more in a few months than the 58,220 US soldiers who died in Vietnam from 1954 to 1975.
And don’t say Trump couldn’t have predicted the pandemic was likely to get much worse; the CDC and WHO had already said it would at that point in time. In fact, within a week, scientists Neil Ferguson et al. (2020) would publish another prediction that it would indeed get much worse. A prediction that right-wing outlets jumped on to misrepresent for not being sanguine enough for their (and Trump’s) taste.
Well what about mortality rate from the virus?
Well the case fatality rate (CFR) is derived simply from dividing reported deaths by reported cases, so 220,362/8,249,011=0.0267137478662594, which boils down to 2.7%. But that doesn’t give us the true mortality rate since many infections go unreported. As of October 5th, the WHO says up to 10% of the world may have already been infected (about 760 million people), around 22 times the reported number of around 35 million in that time period. Doing the math, 1 million and 760 million, that gives a percentage of .1315789. Or simplifying, 1 million is .13% of 760 million.
But that still isn’t the real mortality rate because we’ve accounted for unreported infections, but not unreported deaths. Looking at data from excess mortality (in the US in this case), actual covid deaths may be as much as 60% higher than the official numbers. Adjusting for that we have around a .21% mortality rate. But there is yet something else to take into consideration. The 10% stated by Dr. Mike Ryan of the WHO was not in a report, and with his wording of “may be”, it is likely 10% was a high estimate. If we consider a slightly more modest estimate of 7% of the world, we get 532 million infections, giving us a mortality rate of 3%, more than three times as deadly as the seasonal flu.
This is a serious number already, but I am neither an expert in virology, nor a professional statistician, and the data I relied on for overall infection rate was still very uncertain. If we want to know the most accurate numbers, we should leave that up to the professionals, the people who know the many extraneous variables and best data much better the I.
Including estimates of non-reported infections and other factors, Liu et al. (2020) estimates a true infection mortality rate (IFR) at 0.7% in the United States. The flu, on the other hand, has an IFR of below 0.1% (<0.1%) according to the WHO. In other words, the coronavirus is more than 7 times as deadly as the flu, hence the [257,000] deaths so far. Seven times as deadly as the flu is an especially big deal because Covid-19 seems to be more virally infectious.
But whether .3%, .7%, or 1%, SARS-CoV-2 is extremely dangerous because, not only is it factually several times more deadly than the flu even at a the low estimate, but it is much more infectious, and there was no vaccine for it. The virus is drastically more likely to lead to what is known as super-spreading events, causing localities to swiftly, and with devastating effects, be overwhelmed and swamped by the virus. A super-spreading event is where one person infects a large number of others. That is why so many people were dying in New York that the dead bodies had to be stored in numerous refrigerated storage containers as makeshift morgues.
To hammer this point home, the CDC reported an incident where 61 people attended a choir practice that lasted 2.5 hours. Afterwards, 52 of them immediately became ill, with 32 confirmed for Covid-19, and the other 20 as probable false-negatives. Only one of those people had “flu-like” symptoms before the practice.
In other words, mortality rate is only half of the equation. If mortality rate was all that mattered, Ebola would have been a much bigger deal. Because of Covid-19’s unique combination of being more deadly than the flu and more infectious (and us not having a publicly available vaccine yet), it deserves every bit as much of a response as countries around the world, and those in the US excluding diehard Trump supporters, believe it deserves.
How do we know the deaths aren’t over-reported?
There’s a lot of “skeptics” (denialists) that seem to think Covid-19 is being labeled as cause of death with wild profligacy, as some attempt by the Democrats, the deep state, or some other political boogie-man to exaggerate the pandemic to hurt Trump’s re-election prospects.
Well this strikes me as silly right off the bat since most other countries are showing similar results. So, does that mean all those countries are part of a global conspiracy to oust Trump; that they’re all willing to lie to their populations and upend daily life just to help the Democrats at the other side of the world? Of course not, that’s stupid.
The Covid-19 death numbers are not being exaggerated or “padded.” The coronavirus has already killed around [257,000] Americans, and will have killed an estimated 400,000 Americans in 2020 (Bauchner & Fontanarosa, 2020; Woolf et al., 2020). To put that into perspective, World War II killed ~390,000 Americans. Let that sink in. Right-wingers insist the deaths are being exaggerated to hurt their dear leader, but we know this is almost certainly near complete fiction. In any given year the number of people who die from all causes is remarkably stable in the US. From 2015 to 2019 deaths from all causes varied by only around +/- 2.6-3% from the 5-year average. So far deaths have spiked drastically. We are 20% above our 5-year average.
So, if excess deaths are above even the recorded numbers of Covid-19 deaths, what makes up for the other 100,000 extra deaths in the US during that time period? Well, like I said, unreported Covid-19 deaths are undoubtedly a large part of it. However, catching the Coronavirus directly isn’t the only way for it to hasten you to your grave. If your hospital is overwhelmed as a result of Covid-19 cases, you’re less likely to get the care you need if you go there for other reasons, like a heart attack, cancer, or any number of serious ailments. Because of such conditions, those ailments are more likely to kill you now than they were before. There has also probably been an increase in suicide resulting from quarantine isolation as well. So Covid-19 has an indirect death toll as well.
And this is just looking at the United States. We see that in a May report by the BBC, the same spike was found in the UK. Deaths virtually doubled for that period at the beginning of the pandemic.
In fact, virtually every country has seen a significant increase in excess deaths for 2020, not just America, the UK, or European countries. And in most cases, recorded Covid-19 deaths weren’t as high as excess deaths; i.e. Covid-19 was under-reported.
Masks, Shutdowns, and Sweden’s Approach
Following Trump’s lead, the Trump crowd advocates the refusal to wear masks, considering it pointless. They are against shutdowns, and they are against most measures proposed by the CDC and WHO to ameliorate the pandemic crisis. To support this position, they cite Sweden as having a hands-off approach, claiming they’re doing just fine. But is this true about Sweden? Well as the excess mortality list above demonstrates, Sweden certainly did significantly worse than its comparable Scandinavian brethren Denmark and Norway.
The single best statistic to look at is number of Covid-19 deaths per unit of population. Focusing on deaths is helpful because they are more reliably reported than mere infection. And looking at deaths adjusted for population makes it an apples to apples comparison for countries with larger or smaller populations.
Sweden’s death toll is right up there with Italy (~600 deaths/1mil), though the US is worse. Ireland, Finland, France, Hungary, Denmark, and most other European countries have seen a much less severe death toll than Sweden.
In recent weeks Sweden seems to have dodged the up-swell in deaths that much of the rest of Europe and the US have seen, though it is uncertain why. Most European countries and the US had been easing up on their quarantine restrictions, which is likely responsible for the recent bump all those countries have seen.
The US is doing terrible all around. Whether looking at cumulative deaths or just recent ones, the US has done abysmal and continues to do so. Whatever the best approach to the virus would have been, clearly Trump’s was not one of them. That even in March he was pushing a budget cut of 19% to the CDC didn’t bode well for his ability to handle a pandemic. He of course had dissolved the pandemic response task force back in 2018, which clearly wasn’t a smart move. But it went with his general approach of ham-fistedly undoing everything Obama did, good or bad.
China, though denying the virus initially, seems to have squashed Covid-19 deaths through their draconian quarantine actions. And they’ve done this while being the only country whose economy has actually grown this year rather than shrink. This at least proves that you can squash the virus with masks and quarantining and maintain your economy. It doesn’t have to be either or. This binary position is another result of Trump’s politicization of the virus; his push to fully open the country prematurely and pretend we could do business as usual, and his claims that Democrats only want to keep restrictions in order to hurt the economy and thus his reelection effort.
How do we make sense of all the data presented so far, what does it tell us? It tells us we really can’t decide which approach was best to address the pandemic because, between countries, there are too many factors that affect how the virus hit a country; population density, hospital infrastructure, natural geographic isolation, general healthy/unhealthy populations, etc.
The best comparison is to look at what each country looks like when it increases restrictions versus decreases them; a longitudinal approach rather than a cross-sectional one. What we see is that after countries began to shut down in March, Covid-19 deaths decreased. Sweden didn’t shutdown, and thus it maintained a high Covid-19 death rate. Sweden was also hit hard economically despite not shutting down. As countries have eased restriction and started the school year, we have seen a huge swell in infections and deaths. This is strong evidence that restrictions such as reducing capacities in restaurants and other venues, requiring masks, and staying home in fact have an impact, and in fact save lives.
Do masks work against the Coronavirus?
There is no position of certainty on the question, only probability and evidence. We know the Coronavirus spreads by hitching a ride on the particles, usually water vapor, that people emit from their nose and mouths. We know that masks are generally very good at stopping most of these particles. We also know that viruses that spread in similar ways to the SARS-Cov-2 are reduced in infectiousness by masks. So there is extremely good reason to believe in and wear masks. But you don’t have to take my word for it, let’s look at the scientific evidence.
Van Dyke et al. (2020):
“After implementation of mask mandates in 24 Kansas counties, the increasing trend in COVID-19 incidence reversed… Kansas counties that had mask mandates in place appear to have mitigated the transmission of COVID-19, whereas counties that did not have mask mandates continued to experience increases in cases.The findings in this report are consistent with declines in COVID-19 cases observed in 15 states and the District of Columbia, which mandated masks, compared with states that did not have mask mandates.
Ma et al. (2020):
“In this study, the efficacy of three types of masks and instant hand wiping was evaluated using the avian influenza virus to mock the coronavirus… N95 masks, medical masks, and homemade masks made of four‐layer kitchen paper and one‐layer cloth could block 99.98%, 97.14%, and 95.15% of the virus in aerosols. Medical mask‐wearing which was supported by many studies… With these data, we propose the approach of mask‐wearing plus instant hand hygiene (MIH) to slow the exponential spread of the virus. This MIH approach has been supported by the experiences of seven countries in fighting against COVID‐19.”
Abaluck et al. (2020):
“We recommend the immediate universal adoption of cloth facemasks, including homemade, and accompanying policies to increase the supply of medical masks for health workers. Universal adoption will likely slow the spread of the COVID-19 virus by reducing transmission from asymptomatic individuals… Our analysis suggests each cloth facemask generates thousands of dollars in value from reduced mortality risk. Each medical mask, when used by a healthcare worker, may generate millions of dollars in value, and policies to encourage greater production prioritized for health workers are urgently needed.”
Choi and Ki (2020):
“To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks, are absolutely crucial with the participation of the public…”
Sun et al. (2020):
“For individuals, protective measures, including improving personal hygiene, wearing medical masks, adequate rest, and keeping rooms well ventilated, can effectively prevent SARS-CoV-2 infection.”
Cowling et al. (2009):
“Objective: To investigate whether hand hygiene and use of facemasks prevents household transmission of influenza…
Results: In 154 households in which interventions were implemented within 36 hours of symptom onset in the index patient, transmission of RT-PCR–confirmed infection seemed reduced, an effect attributable to fewer infections among participants using facemasks plus hand hygiene (adjusted odds ratio, 0.33 [95% CI, 0.13 to 0.87]). Adherence to interventions varied.”
Offeddu et al. (2017):
“This systematic review and meta-analysis quantified the protective effect of facemasks and respirators against respiratory infections among healthcare workers… Meta-analysis of observational studies provided evidence of a protective effect of masks (OR = 0.13; 95% CI: 0.03–0.62) and respirators (OR = 0.12; 95% CI: 0.06–0.26) against severe acute respiratory syndrome (SARS). This systematic review and meta-analysis supports the use of respiratory protection.”
Zhou et al., (2018):
“This study evaluated the relative contributions of a mask, valve, and Micro Ventilator on aerosol filtration efficiency of a new N95 respiratory face mask… The results demonstrate >99.7% efficiency of each test mask configuration for exclusion of influenza A virus, rhinovirus 14, and S. aureus and >99.3% efficiency for paraffin oil and sodium chloride… Conclusion: The masks, with or without features intended for enhancing comfort, provide protection against both small- and large-size pathogens.”
Inouye et al. (2006):
“In case of a new influenza pandemic, provision of masks to coughing patients could be used to slow expansion of the epidemic. To quantify the efficacy of different masks, we used an ultrasonic anemometer to measure the velocity of airflow from the mouth in coughing. We found that even the cheapest paper masks reduced the airspeed to less than 1/10, implicating their effectiveness in decreasing viral spread. We therefore propose that governments provide free masks to coughing patients in the general population…”
The body of scientific literature goes on like this, I didn’t cherry-pick. Nobody is claiming masks are 100% effective, but they are in fact highly effective when worn properly, especially when worn by most people in a population.
What is definitely not true are the silly claims about masks trapping CO-2 and leading to health problems, problems worse than Covid-19. This is funny because mask denialists contradict themselves. They say that masks don’t stop the virus because it’s too small, while at the same time claiming CO-2, a molecule that is drastically smaller than SARS-Cov-2, can’t seem to escape. This is a stupid self-contradictory set of positions.
Thus, this talking point betrays two things in anti-mask people. 1. They don’t even have a basic understanding of basic scientific principles like the size of molecules versus the size of viruses. 2. It shows they aren’t coming at this from a position of good faith truth-seeking, they’re coming at it from a point of partisan confirmation bias. In other words, more politicization.
Does hydroxychloroquine work?
Another politicized aspect has been treatments for Covid-19. In his long list of silly claims throughout the pandemic, the president claimed hydroxychloroquine might be some miracle drug to treat Covid-19 with, despite no evidence to support the claim. Immediately after, it was the official talking point for all Republicans and Trump supporters.
The FDA authorized research on the drug after pressure from Trump. After mountains of failure the FDA revoked the authorization, and the politicization by Trump continued.
The president then praised praised the crackpot “doctor” Stella Immanuel because she said masks don’t work and hydroxychloroquine does. The problem is, this “doctor” in one video said female gynecological problems like cysts result from demons sex in one’s dreams:
“We call them all kinds of names – endometriosis, we call them molar pregnancies, we call them fibroids, we call them cysts, but most of them are evil deposits from the spirit husband… They are responsible for miscarriages, impotence – men that can’t get it up.”
Immanuel claims this is how demons reproduce.
“They turn into a woman and then they sleep with the man and collect his sperm… Then they turn into the man and they sleep with a man and deposit the sperm and reproduce more of themselves.”
She’s also regularly made claims that many pharmaceutical products have the DNA of aliens in them, that witchcraft is real, and that the government is run in part by aliens and “reptillians.” If you have to lean on so-called doctors like this to support your scientific claims, you may want to re-evaluate your position. Trump will support anybody who sings to his choir, no matter how insane.
In any case, as of May 8th, the president said he was on a regiment of hydroxychloroquine to prevent Covid-19. He still got it, just after his debate with Joe Biden. Let that sink in. The president still got infected by Covid-19 despite taking his toted wonder-drug to prevent Covid-19 infection.
Along these lines, multiple studies have shown that hydroxychloroquine is not useful as a treatment for people with Covid-19, nor is it effective at preventing Covid-19 infections (e.g. Boulware et al., 2020; Cavalcanti et al., 2020).
Here is the way the game always plays out, not just with scientific evidence on hydroxychloroquine but everything from masks to climate change. Right-wingers will claim the science supports them. Then when confronted with mountains of scientific evidence (peer-reviewed academic studies) against them, they retreat to a conspiracy theory accusing all scientists of being in some self-serving cabal against Republicans. As if the scientists in other countries care about hurting or helping the Republican party in the US.
Or, after being confronted with the scientific evidence, they will claim that there’s plenty of evidence on both sides of the debate, so they are justified maintaining their view. This is of course as false with hydroxychloroquine as it is with climate change. Sure, there are usually a handful of studies contradicting the consensus, but when the evidence is 90% pointing one direction, 5% neutral, and 5% pointing the opposite direction, the choice is clear; it is most rational to conclude in favor of where 90% of the evidence is pointing. Trump people are concluding in favor of the 5% because it is politically convenient.
On hydroxychloroquine, the evidence has been against Trump the entire pandemic. And instead of accepting it and caring for the American people, he continues to reject and downplay the virus for the purely political fears that it might hurt his reelection efforts.
None of this is to say that the democrats haven’t taken advantage of the pandemic for their political benefit, they certainly have. But at worst democrats are playing up true things about Covid-19, while Trump supporters are straight up denying the facts, and inventing conspiracy theories to support this denial.
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- Bauchner, H., & Fontanarosa, P. B. (2020). Excess Deaths and the Great Pandemic of 2020. JAMA, 324(15), 1504. https://doi.org/10.1001/jama.2020.20016
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