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Covid-19 Infection Fatality Rate (IFR)

Why this recent surge in cases in the Southern US legitimately brings back comparisons to the Flu. And why that matters

All source data will be linked in the final tweet of this thread

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#SARSCoV2 #COVID19

What is Infection Fatality Rate (IFR)?

Simply put, its the ratio of total deaths to total people with the virus. Not total positive cases, which right now is 2.37 million positives. Total people infected, detected or not.

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What is Infection Fatality Rate (IFR)? Part 2

Articles are linked, but studies from Penn State, Santa Clara and others indicate about 11% of the population, or 33 million people, have already been infected.

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What is Covid-19’s IFR?

Best estimates mid-May published by the CDC, John Ioannidis, and @ethicalskeptic calculations calculated a IFR (or ICFR) of 0.26%. Meaning ¼ of 1 percent of the infections end up being fatal. Some estimate it to be as high as 0.40%

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What is the IFR for flu?

Generally it is accepted to be 0.10%, link will be provided.

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How much more deadly is Covid-19 than the flu? Part 1

In February, the estimates that put us into nationwide lock down, including WHO, had IFR near 1.0%. Some estimates had it at 1.4%. These IFR numbers meant possibly millions of deaths, and we locked down Mid-March.

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How much more deadly is Covid-19 than the flu? Part 2

By Mid May, as stated above, data showed the true number declining to .26%-.40%. So mid-May it became generally accepted that Covid-19 was ~2.6 - 4 times more deadly than the flu (Understanding that there is no vaccine)

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So why does the recent surge in cases restart the conversation around IFR and the Flu? Part 1

In March and early April, when we were in the upslope of the pandemic curve, we were seeing ~ 25,000 positives on 100,000 test, and 2000 deaths per day. Not good at all.

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Second half of April thru end of May, we had a steady relationship between reported positive cases & deaths. Both in decline. Cases more slowly because testing kept increasing the sample size. 22,000 positives on 350,000 thousand tests, & deaths falling through 1000 a day

9/n
But since first of June, positives stopped declining and then began drastically increasing, mostly coming from the South. Now its 35,000 positives on 525,000 tests a day. Yet deaths just hit their lowest point of 550 a day.

Look at the trends on these 2 graphs

10/n
Looking at the CDC All Excess Death numbers, no uptick in Deaths there either, it actually has declined faster than the reported C19 deaths. That is an entirely separate topic, but suffice it to day, Deaths appear to be continuing to decline.



11/n
The rate of increase of positive tests indicates that the prevalence of Covid-19 in the population is only increasing. Likely more than 11% now, TES showed 11.3% yesterday. Now approaching 35 maybe 40 million people infected in the U.S

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And with no corresponding rise in deaths, that means more of these cases are asymptomatic, mildly symptomatic, and not nearly as lethal.

If Covid-19 IFR mid-May was 0.26 – 0.40%, what is this recent surge of non-lethal positives going to do the IFR?

13/n
It is going to drive that number down. Again, Flu is 0.10%. TES tweet yesterday, he is calculating an ballpark IFR for the cases in the South the past 3 weeks of approximately 0.03%, which is 3-4 times LESS lethal than Flu.

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Here is the banner page

If Covid-19 IFR gets pushed down from 0.26% and towards 0.10%, then we basically will have a disease that is trending towards being the equivalent in lethality to the Flu.

15/n
The comparison of Flu was dismissed by the media early on in the pandemic as Fake News. And early on, this virus was 3-4 times as deadly as flu, and really ravaged our seniors, hit NYC and a few other hotspots really hard. This was a serious virus, no doubt. Still is.

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But as we stabilized in May, and moved in June, this new surge of positives needs to be looked at through different lenses. The virus either has become less virulent, or the virus has started running out of sufficient numbers of at-risk population to attack.

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Now What?

If Covid-19 IFR continues to trend downward towards common Flu, that means that as a country, we need to reevaluate all of our knee-jerk responses that were ingrained into us in March and April, including:

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Now What?

Do we need to continue to see lock downs as a solution to mitigate this virus? The answer to that should be a resounding no.

Do we need to breathlessly report every hospital that is nearing maximum capacity? No

19/n
Now What?

Do we need to continue with having eleventy billion media outlets reporting every test, positive case and death? No.

Do we need to keep schools closed or reopened with draconian distancing requirements? No

20/n
Remember in 2018, 80M people got the flu, & 80K died (Understanding we have a Flu vaccine). The 1st number still dwarfs this pandemic, the 2nd number is not too dissimilar. Also understanding Covid-19 was a double whammy and hit us hard. 2020 will go down as an awful year

21/n
To summarize, if this recent surge of positive cases continues, it only strengthens the argument that we need to re-open and stay open, get back to our lives, have great hygiene, keep your distance where possible, and wearing a mask indoors if necessary or mandated.

22/n
Finally,

This surge only reinforces that this virus is manageable, and its time to get this train rolling again and ride it out until a vaccine is available, when we can finally put this pandemic behind us.

Links to follow.

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