If We Were All Infected

Hiding from Covid-19 is not an option

The original operating theory that was put out to the public was that Covid-19 could kill as many as two million people in the US. That was an absurd projection from the get go. It was shown to be based on a totally bogus and discredited model in the UK. Various numbers have been suggested but there really is no way of knowing how large or how deadly the pandemic will ultimately be, but we know quite a bit now that we did not know then. 

In mid-May the CDC put out their COVID-19 Pandemic Planning Scenarios in which they analyzed all the available data and information that had been learned to come up with what amounted to their best guess of the mortality and hospitalization rate for COVID-19 . They settled on scenario 5 as the most likely track of the outbreak in the United States.

Scenario 5: 

Parameter values for disease severity, viral transmissibility, and pre-symptomatic and asymptomatic disease transmission that represent the best estimate, based on the latest surveillance data and scientific knowledge. Parameter values are based on data received by CDC prior to 4/29/2020.

Here is a screen shot of the scenarios, including scenario 5.

It is quite likely given the actual data that these numbers will be revised downward over time, but this is or was their best guess. One very important number is that R0 on the top. That is the rate at which the infection is spreading. An R # of 1 means that  every infected person will infect one other person. With a R of 1 the infection is basically stable, it will not go away but it will not grow. Anything above a 1 means that the disease is spreading, below 1 it will begin to fade away. In May they projected a 2.5 R factor. Currently   eight states are estimated to be below 1, so the virus is still spreading in most states. Since testing plays a big part in determining the R factor,  today's number are probably far more accurate than they were when this was put out. 

We can use scenario 5 for something else, we can use it to determine just how bad the pandemic "could" be.

You will notice that in the fatality section they project that overall, .004 persons infected will die. So taking that number let us just magically infect the entire US population.

330,000,000 

    x       .004 

    1,320,000

Obviously that is not going to happen and even if it did there are other factors that come into play. For example based on the age factor risks that are present with the disease, we know that nearly 80% of all deaths have occurred in people over the age of 65. Meaning in our hypothetical "everyone is infected" scenario over a million of the deaths would be people over 65. In fact fully 790,000 deaths would be persons over 75 years of age. This means that many of those who would die would have died anyway, especially in the older age groups. Without COVID-19 nearly three million Americans die each year mostly  those people most susceptible to dying from COVID-19 anyway.

We know that every American is not going to be infected, so what other information do we have? A month after the release of scenario 5, the CDC reported that based on cases and serology testing perhaps as many as ten times the number of known cases are actually infected.

The CDC’s new estimate that for every diagnosis of coronavirus in the US it is likely that 10 more people are or have been infected is based on serology testing used to determine the presence of antibodies that show whether an individual has had the disease, the officials said.
The officials, speaking to a small group of reporters on Wednesday night, said the estimate was based on the number of known cases, currently nearing 2.4m in the US, multiplied by the average rate of antibodies seen from the serology tests, about an average of 10 to one.

That sounds reasonable, but there is problem. As of this writing the CDC reports that 3,047,671 Americans have been infected. Using the 10x rule would mean that 30,476,710 are infected and as they say "we ain't done yet." If we again go back to scenario 5 and use the .004 IFR (Infection Fatality Rate) we would be at 121,907 fatalities but we are now at 132,056 fatalities. This would suggest that either the IFR of scenario 5  or the speculated 10x infection rate is too low. There is also the possibility  that the reported deaths are too high, but we won't go there.  My money is on the 10x rate being too low, my guess is that there are far more infected people in the US than even their 10x estimate accounts for. The results of testing over the month since they announced the 10x theory would suggest that. It is very probable however that both figures are off, changes of fractions of either could change the numbers dramatically. 

Then there is another wrinkle in the mix which has changed everything, but is little reported on. There are actually two strains of the virus, a D  and a G strain. The D strain was the original which came out of Wuhan. At some point early on it seems to have mutated and created another (G) strain. As the D strain began to make its way around the world, it was followed by the G strain which fairly quickly became the dominant strain. Early on in almost all nations the D strain began to be replaced by the G strain starting mainly in Europe then working its way into the US then back to Asia. It appears that the G strain is far more infectious than the D strain. Early on the D strain was the primary in California for example and case levels stayed low, but as the G strain came in infection rates grew. This has been the scenario that has played out all over the world. What does it mean? I guess in time we will find out, but it may explain the sudden explosion of new cases in places that were previously doing well. It also could explain lower death counts, nobody knows yet. 
  

Obviously every death affects someone, sometimes many people, and can be a heart wrenching experience for loved ones. But strictly from a societal standpoint even if everyone in America was infected, based on the CDC's best guess, the affect on our economy and society would be minimal. Minimal because the life years being lost are actually as low as a society could hope for in a tragedy of this magnitude. It would not greatly affect the productivity of the nation since a majority of persons would be retired. The youth, the young adults and middle aged  healthy individuals are simply not at great risk from COVID-19, either in our hypothetical or in the real world. Yet as a society we act as if the world is coming to an end when we have barely even suffered 1/10 the deaths that a 100% infection rate would cause. Whatever Covid -19 brings, we better learn to live with it, we certainly cannot hide from it.