Thread by @SethAbramson

(THREAD) As Trump threatens to roll back "social distancing" measures at the height of the worst global public health crisis in a century—with America at its epicenter—his lies about coronavirus are coming fast and furious. In this thread I address a few. I hope you will RETWEET.

1/ No one in the world—including medical experts—knows what the mortality rate (or CFR, "case fatality rate") for coronavirus is now or will be by the end of the pandemic. Anyone telling you they *know* what we're looking at here in terms of the lethality of coronavirus is lying.

2/ Trump and his team are cherry-picking the rosiest scenarios for their political rhetoric, telling us the CFR for coronavirus will be between .5%—5 times worse than the seasonal flu—and 1.5% (15 times worse). So many things are wrong with that, it's hard to know where to start.

3/ First, understand that because *there is no coronavirus vaccine*, the percentage of Americans who'll get coronavirus—whether with symptoms or without—is higher than we can possibly imagine. Some models have up to 80% of Americans contracting the virus before the pandemic ends.

4/ Even if you took the *rosiest scenario* now being spun by Trump and his team—a .5% case fatality rate—if 80% of America's 330 million population is infected by the virus, it'd equate to *1.32 million people dying*. On average, the seasonal flu kills only *3% of that* annually.

5/ Trump and his team have also falsely told Americans that only *older Americans with preexisting conditions* need worry about the coronavirus. In fact, data coming out of Europe shows half of those admitted to hospitals with "severe complications" from coronavirus are under 55.

6/ Most states don't keep data on how many people with coronavirus end up in "serious or critical condition," but it's certainly enough that—if 80% of Americans contract the virus—millions and millions and millions who *don't* die will be hospitalized with serious complications.

7/ When a person is hospitalized with serious complications from a flu that affects respiratory functions, they can suffer longterm—even permanent—lung damage. One's lung capacity can be reduced by 20% or more for years or even for the rest of one's life (assuming you don't die).

8/ But even if you get coronavirus and don't die or suffer permanent damage to a major bodily function—whether you have no symptoms or get as sick as you've ever been—you're a carrier of the virus who can get *others* sick in a way that could kill them or permanently impair them.

9/ Putting aside how it'd make you feel to know you infected dozens of others, and maybe even killed some of them, let's assume that you stay home without symptoms and harm no one. If 0.5% of Americans die from coronavirus, do you know how many Americans' loved ones that impacts?

10/ If *1,230,000* Americans die of coronavirus—and again, that's the *rosiest* scenario Trump is painting; I'll get to the worse-case scenarios in a moment—it will leave *tens of millions of Americans mourning* for loved ones of all ages who died *when they didn't have to die*.

11/ That's why *none* of this can be compared to car crashes, natural disasters, or the seasonal flu—dangers we can't ameliorate by people doing something as simple as sheltering in place for a short duration.

A coronavirus holocaust would be more like 9/11—a *national tragedy*.

12/ 9/11—a day on which 2,977 people died in terrorist attacks—changed America forever. It was an unexpected national tragedy that occurred in a short period of time. A coronavirus holocaust that kills 1.23 million would be worse in scale *and* because *we could've prevented it*.

13/ Imagine for a moment not merely that a friend or loved one has died in a national tragedy—for instance, a terrorist attack—but that they died in a tragedy that could've been avoided if *folks had avoided the beach for a few weeks*. How angry will you be the rest of your life?

14/ Of course, Trump is selling us on a lie: the rosiest possible CFR—case fatality rate—for coronavirus. But before I explore that, I want to underscore *why* he's able to sell that lie. The answer: the hard data of how a mass infection spreads *favors* political disinformation.

15/ Right now, seasonal flu deaths are in the tens of thousands—whereas coronavirus deaths are under 600. Because many are dazzled by static numbers presented without context—Trump's favorite disinformation tactic—that makes coronavirus look harmless compared to the seasonal flu.

16/ The thing Trump isn't telling you is that, because we have a *vaccine* for the seasonal flu, we have a sense of how bad it can get in any given flu season in terms of CFR—and America has determined that the annual death toll (20,000 to 70,000) is a figure the nation can bear.

17/ When we have a global pandemic for which there's no vaccine—and contrary to Trump's other big lie, for which there will *be* no fully deployed vaccine for 18 months at the earliest—there's no way to estimate CFR in advance and only some ability to properly model virus spread.

18/ At the beginning of March, there were under 100 people in America with the coronavirus. It was seen by many as a problem largely for China and maybe a couple other countries. Today—March 24—50,000 Americans have the virus, and America is the global epicenter for the pandemic.

19/ Right now there are approximately 10,000 new US coronavirus cases daily, with that number rising by about 1,200 daily—meaning that today there may be about 11,200 new cases in the United States; tomorrow, 12,400; and the day after, 13,600. But folks, we won't stay that lucky.

20/ By the end of this month, there'll be more total coronavirus cases in the United States than any other country—with a new cases/day rate more than *double* any other country. Deaths/day, which were zero on March 1, then in the tens by mid-March, will be in the hundreds daily.

21/ Any model you might choose to look at—even the rosiest ones—say America will end up with *tens of millions of people* infected by the coronavirus, with deaths in the *tens of thousands* if we're lucky beyond miracle and *hundreds of thousands* or even *millions* if we're not.

22/ And that's why Trump is talking about "reopening" America *now*—before those numbers hit. Right now, he can point to the nation's coronavirus deaths (around 600) and imply that that number is not just low but will *stay low* no matter what we do. But it won't—and he knows it.

23/ That's why Trump's daily coronavirus briefings are bleeding doctors—because doctors universally oppose "reopening America" at the height of a global public health crisis, whereas the businessmen and far-right politicians Trump's speaking to and letting on stage say otherwise.

24/ Keep in mind, everything I've described so far is the *rosiest* scenario in terms of coronavirus-related illnesses and death. We've no particular reason to think that the "case fatality rate" (CFR) will be anything like what Trump—for political reasons—has chosen to project.

25/ In South Korea—a country that has dealt with this crisis *so much better* than the U.S. in *every possible respect* that their data has almost *no relevance* to ours—the CFR is 1.24% and rising daily. That's *two and a half times higher* than Trump's rosy (0.5% CFR) scenario.

26/ In Italy—which looks to have dealt with the crisis horribly, but slightly better than America—the CFR is over 10%, *more than 20 times higher* than Trump's rosy scenario. We haven't yet seen Italy-like casualties because we're 2 weeks "behind" them in the course of the virus.

27/ The way CFR works is that there's a "confirmed" CFR—which is determined by the following equation: deaths divided by {deaths + closed-case recoveries}—and an "estimated" CFR, which acknowledges that some people got sick but never became "cases" because they were never tested.

28/ CFRs don't take into account "active" cases—cases in which the final outcome, death or recovery, isn't known—for the obvious reason: we don't know what the outcome will be, therefore how could we assume one way or another (death or recovery)?

But Trump? He uses active cases.

29/ If you want to convince people a virus spread isn't bad, you must artificially get the CFR *as low as possible*—and the way to do so is to convince people to *wrongly* include active cases in the CFR calculation (making the CFR equation, "deaths divided by total infections").

30/ That's another reason Trump cites the current death toll—because it has little to do with our real CFR. If the virus takes 7-21 days to reach an outcome, and 90% of our new cases lie inside that window, can you see how our current toll is a comparatively *meaningless* figure?

31/ But even in a scenario in which *many* cases are *outside* the 7-to-21 day infection-to-outcome window, you can't use "active cases" or "total infections" to calculate CFR because doing so forces us to assume *all active patients will recover*—an assumption we can never make.

32/ If we look at China, which has nearly *all* its cases outside that window—as the first wave of the coronavirus epidemic has already hit and passed China, which is not to say more waves aren't coming—what we find is a 4.3% CFR. That's *more than 8 times* Trump's rosy scenario.

33/ Even if we use an "estimated" rather than "confirmed" CFR—that is, if we assume (per current data on asymptomatic cases) only 50% of those in China who contracted coronavirus had symptoms—we may still be looking at a 2.15% "estimated" CFR (over 4 times Trump's rosy scenario).

34/ The way things look right now—with the "confirmed" global CFR (across 120,000+ "closed" cases) at 14% (not a typo), and the "estimated" at somewhere between 5% and 7%—we'd be talking about a death toll in the U.S. that none of us could bear. A figure worse than the Holocaust.

35/ For instance, imagine a 5% CFR and 50% infection rate (meaning 1 in 2 Americans get coronavirus, but only 1 in 20 die). That would mean 8.25 million deaths.

Or let's say we halve both: a 2.5% CFR and 25% infection rate. In that case, "only" 2,062,500 people—2.06 million—die.

36/ Or let's assume a more realistic infection rate (70%) and a CFR identical to South Korea right now—1.24%, keeping in mind that that CFR is rising daily in a country that has tested more citizens than almost any nation on Earth. In that case, nearly 3 million people would die.

37/ These numbers sound crazy—but they're real. It's just that we're speaking of the number of deaths in the next year, rather than something happening all at once. But is anyone in America—besides Trump—so monstrous as to say 3 million deaths is *okay* if it happens over a year?

38/ And keep in mind, all these numbers assume something *else*—that our hospital system doesn't get completely overwhelmed. Which it will be... if even a *fraction* of any of these scenarios comes to pass. The moment the system is overwhelmed, people start dying... via *triage*.

39/ That's right: in Italy, Spain, Iran and elsewhere, folks died of coronavirus in *droves* having never gotten proper medical treatment. Because it wasn't available. Not enough medical personnel, beds, ventilators, respirators, surgical masks or gloves... not enough *anything*.

40/ So *every* scenario I've imagined in this thread would be made almost unimaginably worse—in terms of CFR—the *second* a given locale's hospital system is overwhelmed, as "triaging" would lead medical personnel to choose who gets treatment and who doesn't. Who lives, who dies.

41/ And did I mention that all these scenarios imagine the level of illness and death in the US over the next year... when in fact there'll likely be *2* years of vaccine-free coronavirus pandemic in the US, so every number I've provided may need to be *doubled*? Yes—it's scary.

42/ It's in *this* context we have a POTUS dispensing medical advice on TV daily without a license; spreading disinformation doctors have begged him not to spread; and focusing on—I'm serious—the "suicides" a closed stock market and shuttered businesses could cause, *not* on CFR.

43/ It's in *this* context Trump ignores what top medical experts are telling him, and ignores worldwide data—in the hundreds of thousands of cases, active and closed—on the eventual toll of coronavirus, to focus instead on how a damaged economy could *harm his re-election odds*.

44/ It's in *this* context Trump's top allies, like Texas's Lt. Governor, are *openly* saying elderly persons with preexisting conditions (a *dishonest framing*, as we've seen) should take one for the team by dying to preserve the economy—and, implicitly, Trump's reelection odds.

45/ The *good* news is Trump can't actually "reopen America"—as the decision on whether to close schools, universities, and businesses is in the hands of state and local government/public health officials. So what game is Trump playing here? Well, it's a worse one than you think.

46/ Remember, Trump's no longer listening to doctors—so we know he's not basing his decision on public health. And he's already succumbed to business leaders—it's a done deal—in choosing not to use the Defense Production Act to force production of medical supplies to save lives.

47/ So if he doesn't care about using his power to save lives (his insane rambling about bad economy-provoked suicides notwithstanding), he's already at the mercy of business leaders, and can't overrule state/local officials on closures, what's all this "reopening America" about?

48/ Answer: it's about him being reelected. Not just because he *wants* to be reelected, but because he *has* to be. If he loses the 2020 general election, he loses his invulnerability to criminal indictment—and he's already an unindicted co-conspirator in a federal case in SDNY.

49/ Every Trump biographer, every Trump pal who's come clean, every politico without an agenda—*all* agree Trump will do *anything* to stay in power and avoid indictment. So he's chosen this: a plan under which he blames anything bad on others, and takes credit for anything good.

50/ If somehow America comes through this with minimal illness/death—I can't see how—Trump will take credit. If it goes south—as it already has and will continue to—he can blame governors whether they take his guidance on "re-opening America" or not. His rhetoric fits either way.

CONCLUSION/ In short, in one of the most cowardly, un-American acts in the history of the US presidency, Trump is about to embark on a political plan of action that risks killing millions—and has as its only purpose a rhetorical framework that *could* aid his 2020 reelection bid.

BREAKING/ In an FNC town hall just a day after his lies on FDA approval for chloroquine caused the death of a man in Arizona, Trump has said he wants to "reopen" America in 19 days at the latest. Experts say this pandemic will hit us hard *through August*. thehill.com/homenews/admin…