COVID-19: The real mortality rate and why Boris Johnson may get you killed

Like most of us, I refrain from posting strong opinions, but I will make an exception today. I am going to state my mind on a couple of topics, because right now selfishness may be even more dangerous than this virus.

THE REAL MORTALITY RATE OF COVID-19

I’ll start with the actual mortality rate: It’s likely to be higher than WHO’s declared 3.4% (at least in the confirmed cases). The reason is that WHO’s figure is calculated as all known deaths divided by all confirmed infections. Because infections happen about 14 days before death and new cases are significantly growing, that formula has the denumerator all wrong. 

Let me illustrate this with an extreme example: As of March 16 we have ca. 7,000 deaths and 180,000 cases. Mortality rate = 7,000 / 180,000 = 3.9%. Say that tomorrow we get one million new cases. Number of deaths won’t grow much because they come from infections started weeks earlier (say they’ll go to 7500). Tomorrow, WHO’s formula would show a mortality rate of 7500 / 1,180,000 = 0.6%.

But of course a virus mortality rate shouldn’t be affected (or at least, LOWERED) by more new infections.

As the virus takes about 14 days from first symptoms to death, the right way to calculate mortality rate is to introduce a time modifier in the denumerator: current deaths / confirmed cases 14 days earlier (NOTE: This is an approximation - The right number may be around 10-11 days, since most infected people would wait a couple of days of symptoms before getting tested, and test results take 1-2 days).

Let’s run the numbers then: 14 days ago there were about 90,000 confirmed infections. Mortality rate: 7000 / 90,000 = 7.8% (when you look at the so called closed cases, that is those which already had a positive or negative outcome, the rate is actually 8%).

HOWEVER, the actual mortality rate is very likely to be significantly lower than this, because it’s true that many people who show no or very mild symptoms may not appear in the official case count (so, the real numerator is likely higher, especially in countries still lagging in testing, but nobody knows by how much). It looks like half of the cases go asymptomatic, and we are surely missing many mild cases. Deaths in Italy may also skew the numbers, as Italy has one of the highest share of older people in the world.

But nobody knows how many non-reported cases have been missed and in doubt better to be conservative. In any case, the real problem is a different one: Whatever the real mortality value, the current rate has been kept as low as possible by the availability of ICUs and mechanical ventilators. About 10% to 15% of (declared) coronavirus infections require hospitalisation and in most cases ventilator support. Once the limited capacity for ventilators is exceeded, the mortality rate of the virus will easily jump up SIGNIFICANTLY. And those who will die will die a slow and agonizing suffocation death.

BORIS JOHNSON'S INSANE PLAN OF ANNIHILATION

Rather than doing their best to contain the virus, UK leaders now plan to have up to 80% of the population contract the virus over time, eventually developing a country-wide immunity (“herd immunity”) to the virus and its returning seasonal waves.

The motive behind Boris Johnson’s actions (or Trump’s, for that matter) is purely economical and has nothing to do with protecting the health of citizens. The UK already took a big financial beating since announcing Brexit and Johnson can’t afford the economy to slide any further. So what better way than keeping the country running while other countries are in partial production halt? And what if we could create a country of superpeople who next year would all be immune to the virus? Genius. A truly great plan…if you’re a psychopath or a villain straight off a Marvel feature.

This strategy doesn’t hold water. Let’s debunk a few myths right away:

1) Herd immunity: We know very little about this virus. Will it go away and return in seasonal waves, like the influenza? And if it does, will people who already had it truly be immune, or will it behave like the influenza with new strains every year? No point being immune to last year’s strand.

2) Healthcare infrastructure capacity: UK officials are planning to spread the infection over various months, so that the NHS can absorb it.

Let’s run the numbers over 8 months (no way they can contain it longer than that with massive exposure): Expected 53 million (80% of population) infected. Infection will grow from maybe a million per month to over 15 millions in the last month. Their experts are modeling 4% hospitalization (3 times lower than the current figure, so they probably estimate two thirds of current coronavirus cases are so mild they are not reported…which is optimistic). I’m going to assume it’s double that, meaning the UK will need almost 100,000 ICUs and ventilators at the start and over one million in the last month.

The UK has less than 5000 intensive care beds equipped with ventilators and even with increased production, absolutely no chance to handle the surge in cases. Global demand for ventilators is now huge, so the UK won’t be able to buy much from abroad. Johnson is therefore thinking of turning manufacturers of cars and other products into ventilator factories. Like during World Wars. Notwithstanding all the manufacturing changes (and cost) this would entail. A plan clearly out of one’s ass.

3) Death rate and total casualties: UK “experts” in Johnson’s administration modeled a 0.7% death rate. Hence, with 53 million infected, about 380,000 casualties. For that 0.7% math to work, it would mean that over 90% of total coronavirus cases have never been detected. Possible, but unlikely. But the main issue is that severe lack in healthcare facilities would bring the virus mortality to 3-4 times higher than modeled. That would mean up to TWO million deaths. Even if the actual mortality rate for all cases were only 2%, we'd be talking of over one million dead.

To put this into perspective, the UK lost about 450,000 people in World War Two. Johnson plans to calmly oversee the deaths of ten times what the UK lost in the War. And possibly for nothing, since there is no guarantee this will create long-term immunity in the population. And even if it did, trying to develop a vaccine would seem a more reasonable way to explore than self-annihilation, right?

4) Economic value: All of the above is planned not to suffer long term economic damage (take the hit all at once and move on). But even this argument is weak: it will cost a fortune for the UK to go through this ordeal. Destroy lives and morale. And likely make the country the epicenter of the disease for up to a year. If other countries will have contained the disease by then, all UK citizens will still be banned from their borders. That’s some serious Brexit right there.

But let’s play devil’s advocate for a second and say the UK plan makes sense. You see, this strategy MIGHT have half a shot of working if it really was taken to its full extent. But there is no way this will be allowed.

The public is not rioting now because they cannot visualize the numbers Johnson’s health chiefs are talking about. But eventually, when the casualties start to pile up, even the current public supporters (unbelievably, almost 40% of the UK population trusts this approach) will push back on this self-inflicted genocide. Would you continue your support once your parents die because you didn’t even try to protect them? Would you say goodbye to your father because of the “greater good”? I don’t think so. It doesn't matter if from a species standpoint achieving herd immunity may be the best course of action. People won't stand for that for long once they see their loved ones die a terrible death.

So Johnson will be forced to run a compromised version of the approach (nor meat nor flesh). Which means that it will have zero chances of achieving the intended target, while killing tens of thousands and have a million infected loitering around.

With all this in mind, the strategy outlined by the UK is pure madness, has no chance of actually working, and it should be stopped by the international community…because this is not a problem that can be left to local governments.

We have a deranged social narcissist on the other side of the Atlantic who’s lying to everyone, blaming everyone else, and telling to go on as normal as the virus is “under control” and will dissipate on its own (risking that by doing so, the US may become the worst hit country in the world). While he is secretly trying to get German CureVac to produce the vaccine EXCLUSIVELY for the US (see above: can you imagine the economic power the only immune country would get? And what a hero Trump would be to Americans?). Of course the Germans will never allow that, of this I am sure.

But we know Trump. He is a monster and a fool and doesn’t surprise us anymore. But here, in Europe? Are we really going to let a narcissistic sociopath do his worst here as well? And possibly related, has really bad hair become a symbol of narcissistic psychos?

Even in the (surely unlikely) case you didn’t care about the fate of the citizens of the UK, keep in mind that this virus needs to be fought globally with the same strategy: only social distancing, country lockdown, and home-based quarantine can work. It can buy us the time for a vaccine to be developed and produced. Or, should this virus prove a seasonal one, it can buy us time until this virus wave runs its course. But all this will not work if selected countries have millions of infected. They’ll just bring it back to “safe” countries as soon as the borders reopen. We truly need to be united in our approach and cannot allow self-centered amateurs to run the show, anywhere.

To conclude, let me ask a question to our Boris Johnson. Boris, if you’re so sure that’s the way to go, why don’t you lead by example, get infected first, and pave the way?

If you are in the UK, voice your opinion. If you’re out of the UK, voice your support.