The Non-Partisan Facts of the Coronavirus Pandemic – 2021 Update

The pandemic has long been absurdly and grotesquely politicized when it never should have been. In early 2020 you could not reliably predict what political party someone was part of based their position on the virus. On February 24, 2020, Nancy Pelosi was strolling Chinatown in San Francisco, encouraging other people to do the same, not avoid Chinatown out of fear of the virus. She certainly wasn’t playing it up. She did encourage taking precautions for the virus though. It wasn’t until two days later on February 26, when former 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 (and Republicans in general) started mirroring Trump at every opportunity.

It marked the strategy Trump would later maintain until he left office, claiming that Democrats are just making a big deal about the virus to hurt his re-election chances. Which was a weird thing to say, considering virtually every country had made quite a big deal about it. Did Trump and his supporters think there was a global conspiracy where every country was overreacting on the virus just to hurt his campaign? Sadly, many probably did believe that.

February 27, 2020, Trump suggested that, the virus might get slightly worse, but it actually could just “disappear.” Two weeks later on March 11, 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.” We certainly know who ended up being right. The third of April, 2020 was 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 not be wearing a mask. And just like that, his supporters followed suit with near universal mask rejection. Politicization with deadly consequences. March 9, 2020, the former 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. Millions of confirmed cases and hundreds of thousands of coronavirus deaths later, Donald doesn’t seem to have predicted very well.

Fast-forward a year to mid 2021 and the picture is pretty much the same with regards to the political divide and the misinformation. What best predicts whether or not you are vaccinated against the coronavirus? Not sex, race, age, or college status. Politics does; 86% of Democrats say they’ve already been vaccinated, while only 52% of Republicans report the have. Of those who said they would “definitely not” get vaccinated, 2% of Democrats said this, while 23% of Republicans did.

None of this is to shame Republicans. Shaming clearly isn’t going to work. The goal is to convince Republicans that they can be full Republicans and still accept the facts about vaccines, masks, and Covid-19. It is important to help debunk the false information on covid out there. Hopefully people can be persuaded by the facts. Facts from reputable sources like peer-reviewed scientific articles and govt. agencies, not random YouTube videos, conspiracy blogs, and partisan opinion “news” sources.

COVID-19 Deaths & Infections

As of July 29, 2020, there had been 34.6 million confirmed cases of the coronavirus in the US, and 609,441 deaths (compared to 257,000 deaths on 11/24/2020) according to the CDC’s tracker. The total 2020 death toll from covid in the US was 375,000 according to the CDC. That means Covid-19 blows the 49,000 average people killed per year by the flu (Trump’s numbers) out of the water. Covid killed 7.7 times as many as the seasonal flu. To put the number killed by covid more into perspective, 58,220 US soldiers died in Vietnam from 1954 to 1975. Just under 500k US soldiers were killed in all of WWII. In a year and a half the 609k dead from the coronavirus has surpassed all those situations in death toll.

How do we know the deaths aren’t over-reported?

There are many “skeptics” and vaccine-hesitant people that believe Covid-19 is being labeled as cause of death in situations where it is not the cause. Initially the most commonly believed reason was that Democrats did it to make Trump lose the 2020 election. More generally now it is supposedly a ploy by Democrats, the deep state, big pharma, or something else to exaggerate the pandemic to profiteer off of hysteria and/or bring about a totalitarian government for the fun of it. But as I alluded to earlier, since most other countries had reported serious COVID-19 related problems and upheaval like the US, such beliefs would require that all those countries were part of a global conspiracy to oust Trump. That they were and continue to all be willing to lie to their populations and upend the daily life of their citizens just to help the Democrats at the other side of the planet. I find that highly improbable to say the least.

Indeed, there is overwhelming evidence that the Covid-19 death numbers are not being exaggerated or “padded.” In any given year the number of people who die from all causes is easy to record and remarkably stable from year to year. In all of 2020, there were approximately 3,358,814 deaths that occurred in the US. There were 2,854,838 deaths in 2019. That is a 17.7% increase from 2019 to 2020. That is 503,976 extra deaths. To put that into perspective, deaths in the years from 2015 to 2019 only varied between 2.6 and 3% up or down from the average of those years. So there was a huge spike in deaths in 2020. The CDC only attributes ~375,000 of the extra deaths to covid. So if anything, they are under-attributing covid deaths, not over-attributing them.

https://ourworldindata.org/excess-mortality-covid

And the excess mortality isn’t just elevated in the United States. We see the same spike basically everywhere.

https://ourworldindata.org/grapher/excess-mortality-p-scores?country=AUS~BEL~DNK~GEO~FRA~England+%26+Wales~USA~GBR~BRA~MEX

So, if excess overall deaths are above the recorded numbers of Covid-19 deaths, what makes up for the other extra deaths in the US during that time period? Well, 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 when you go there for other reasons, like a heart attack, cancer, or any number of serious ailments. Because of such hospital conditions, those ailments are more likely to kill than during a normal year. Consistent with this hypothesis, an increase in almost all of the top causes of death from 2019 to 2020 explained 80,398 of the extra deaths.

You might also assume that, given the increased stress, isolation, and other such things, suicide was part of the increase. Indeed, many conservative outlets at the time vigorously asserted that shut-down/quarantine measures were going to increase suicides enough to outweigh the lives saved from preventing spread of infection. In the conservative New York Post Betsy, McCaughey said the following April 15, 2020:

Before the virus hit, America’s unemployment rate was 3.5 percent… now Goldman Sachs predicts unemployment could spike to 15 percent by midyear. A St. Louis Federal Reserve economist grimly predicts 32 percent unemployment… Every 1 percent hike in the unemployment rate will likely produce a 3.3 percent increase in drug-overdose deaths and a 0.99 percent increase in suicides… These are facts based on past experience, not models. If unemployment hits 32 percent, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs. Deaths of despair.

http://web.archive.org/web/20210523105652/https://nypost.com/2020/04/14/we-must-count-the-deaths-from-shutdowns-as-well-as-from-coronavirus/

How did Betsy’s prediction fair now that we know how things turned out? What does the data say? In 2019 there were 47,511 deaths from suicide. In 2020 there were 44,834. In other words, there was actually a considerable decrease in suicides. In fact, 2020 had fewer suicides than any year since 2015. Drug overdoses did spike by about 30% (about 22,370 extra deaths). Given what we now know, unemployment had already peaked around the time of Betsy’s article at about 14.8%, her first failure of prediction. Even at that unemployment peak, using Betsy’s numbers, there still should have been 35,648 extra deaths from suicide and drug overdose. Turns out, there were 2,667 less suicides, with a net 19,703 drug overdoses. Nowhere near even half of Betsy’s prediction. It is an ironic failure of foresight, considering her snide jeer at scientific “models,” and her accusation of the other side pushing “death and despair.”

https://jamanetwork.com/journals/jama/fullarticle/2778234

How deadly is the virus for those who are infected?

Well the case fatality rate (CFR) is derived simply from dividing reported deaths by reported cases, so 609,441/34.6 million=0.017613901, which makes 1.76%. But that doesn’t give us the true mortality rate since many infections go unreported. As early as October 5, 2020, the WHO said 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. 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 .7%, or 1.76%, COVID-19 is extremely dangerous because, not only is it factually several times more deadly than the flu even at a the low estimate, it is much more infectious, and there was no vaccine for it. The virus (especially the delta variant) 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 in early 2020 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.

Masks, Shutdowns, and Sweden’s Approach

Following the early example by former president Trump, the refusal to wear masks is high among Republicans. They were against shutdowns, and they were against most measures proposed by the CDC and WHO to ameliorate the pandemic crisis early in the pandemic. To support this position, they cited Sweden as having a hands-off approach, claiming Sweden was doing great. Was this true? 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 was right up there with Italy (~600 deaths/1mil), though the US was worse. Ireland, Finland, France, Hungary, Denmark, and most other European countries have seen a much less severe death toll than Sweden.

How are we doing at the end of July 2021? Sweden is still doing worse than Germany and its Nordic neighbors Denmark, Finland, and Norway. And the cumulative number of covid deaths has taken a serious leap for every country.

https://ourworldindata.org/covid-deaths

Did Sweden’s approach turn out better economically? It certainly doesn’t look like it. In general it seems like this point is a wash given the data of quarterly change in GDP. Everyone took a big hit no matter what they did, and everyone rebounded. China and S. Korea did best when considering economics alone, but they also were among the best with preventing infection and death. Both took swift and (some might call) extreme actions at the beginning to stem the outbreak of COVID-19.

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, 2020, 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 eased restriction and started the 2020 school year, we saw 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 saved lives.

Do masks work against the Coronavirus?

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. Thus, this talking point betrays two things in anti-mask people. One, they don’t even have a basic understanding of basic scientific principles like the size of molecules versus the size of viruses. Two, 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?

The former 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 former 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 8, the former president said he was on a regiment of hydroxychloroquine to prevent Covid-19. He still got it, just after his debate with Joe Biden; the former 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).

What about Ivermectin?

The conspiracy theories going around say that Ivermectin is being played down by big pharma because it isn’t profitable enough, and big bad vaccines are what big pharma wants. But what does the science say?

“In this randomized clinical trial… the duration of symptoms was not significantly different for patients who received a 5-day course of ivermectin compared with placebo… The findings do not support the use of ivermectin for treatment of mild COVID-19”

https://jamanetwork.com/journals/jama/fullarticle/2777389/

“Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives.”

https://www.sciencedirect.com/science/article/pii/S2589537020304648

“countries with routine mass drug administration of prophylactic chemotherapy including ivermectin have a significantly lower incidence of COVID-19.”

https://www.sciencedirect.com/science/article/abs/pii/S0924857920304684

To sum the science up, Ivermectin may in some isolated instances have a positive effect in preventing COVID-19. In general, however, it is fairly impotent, and a vaccine is drastically, drastically more effective.

Was COVID-19 from the Wuhan lab?

COVID-19 isn’t a bioweapon developed by China. However, it is possible that COVID-19 came from a lab in Wuhan where it evolved to a minuscule degree before accidentally being spread to the world. In the most likely case, COVID-19 was not a designer pathogen. It is natural enough where it could have developed naturally as easily as it could have come from a lab. It doesn’t really matter.

The COVID-19 vaccines

The CDC VAERS project is a list of people who’ve had an “adverse event” or died after a COVID-19 vaccine (after, not from). This number is around 6,000 now (which is about 0.0031% of the 189,494,180 Americans who’ve had at least one dose). In case you didn’t know, tons of people die every day, vaccine or no vaccine. The 6,000 is not the amount who’ve died or suffered adverse effects from the vaccine, it is people who died after the vaccine. The CDC says the following:

VAERS is an early warning system used to monitor adverse events that happen after vaccination. VAERS is the frontline system of a comprehensive vaccine safety monitoring program in the United States… It is especially useful for quickly detecting unusual or unexpected patterns of health problems (also called “adverse events”) that might indicate a possible safety problem with a vaccine. If a health problem is reported to VAERS, that doesn’t mean that the vaccine caused the problem. It warns vaccine safety experts of potential problems that may need investigation and alerts them to take further action, as needed. Millions of people in the United States have received COVID-19 vaccines. Other than rare reports of severe allergic reactions, analysis of VAERS reports has not detected any patterns that would indicate a safety problem with COVID-19 vaccines.

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vaers.html

There have been the occasional rare allergic reaction to something in the vaccine, but that is the case with any vaccine; the COVID-19 vaccines aren’t special in that regard. The CDC has not established a link between a single death and a covid vaccine. But just for the fun of it, let’s take the 35ish Americans who developed a dangerous blood clot after the receiving the vaccine and assume they were a direct result of the vaccine, let’s assume all of those people died, and let’s round the number up to 100 deaths. That would be a death rate of 0.000052% from the vaccine. Anti-vaxx people like to say only old people die from covid, so let’s look at young people. About 2,470 Americans 18-29 years old have died from covid. In relation to the 34,978,461 confirmed Americans infected, that is a 0.007% kill rate. But let’s say there are about three times that many infections that go unnoticed. That would lower the kill rate for young people to 0.0024. Thus, even in this scenario in which I’ve been very generous to anti-vaxxer assumptions, COVID-19 is still drastically, by multiple orders of magnitude, more likely to kill a young person than a vaccine. So even if you’re a young person who cares only about your own health and nobody else’s, you should get the vaccine.

The arithmetic in favor of getting vaccinated gets even stronger when you actually take the health of other people into consideration. People 40-49 are ten times as likely to die of covid than 18-29 year-olds. People age 50-64 are 35 times more likely to die; ages 65-74 are 95 times more likely to die; people 85+ are 600 times more likely to die! If you are vaccinated, even if you are infected, your body sheds far smaller quantities of the virus, and for a much shorter time, making vaccinated people much less likely to give the virus to older at-risk people. So if you care about mom and dad, or grandma, or someone else’s parents, at all, get vaccinated. Take personal responsibility for the danger of infection that you put other people in.

And the vaccine does work. The Moderna and Pfizer vaccines are 94% effective at keeping you from getting sick, and they are almost 100% effective at keeping you from dying. A scientific study by Shrestha et al. (2021) looked at the Cleveland Clinic Health System and found that 99.7% of the people hospitalized for COVID-19 were un-vaccinated. Even if you assume all those numbers drop 5-10% in effectiveness with the Delta Variant, we’re still dealing with overwhelming efficacy.

The math is pretty simple. Get vaccinated. Young or old, get vaccinated. You cannot be a mathematically rational person who accepts the scientific facts and choose not to get vaccinated.

In closing

The list of things within this wild pandemic ride on which the Trump-style right-wingers have been wrong on has become enormous. The pandemic would just go away? It didn’t. COVID-19 wasn’t worse than the flu? It was. Deaths attributed to COVID-19 were being padded? They weren’t. Did lock-downs make suicides skyrocket? They didn’t. Did Sweden do nothing? No. Did Sweden fair better than countries with stricter covid measures? No. Are masks ineffective at meaningfully slowing transmission of COVID-19? No. Is hydroxychloroquine effective against COVID-19? Not even a little. Is ivermectin better than the vaccines. No. GET VACCINATED.

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