In response to “From the Publisher: Houston, the Eagle has Landed,” published May 7

I was pleased Mr. York addressed the coronavirus in his editorial. I did want to take the opportunity to expand on some of his points. 

Mr. York mentioned the box score for COVID-19 yielded a death rate of 5.8 percent, which is the total deaths divided by the total known cases. The good news, however, is that the real death rate is the total deaths divided by the total infections. Total infections are the known cases plus the cases that have not been identified, either from lack of effective testing or because the illness was so mild (or asymptomatic) it didn’t come to anyone’s attention. Since the infection rate will always be larger than the case rate, the actual death rate will almost certainly be smaller. Estimates on the real infection rate vary widely but it’s probably somewhere between 10 and 50 times higher than the case rate, which would make the death rate considerably lower. 

Looking at the overall death rate can be misleading, because hidden in the overall death rate is the fact that overwhelmingly the people who die from COVID-19 are older or have other medical problems. 

The death rate for people over 60 is over 50 times higher than for people under 60. Hence, a healthy 30-year-old infected with the virus has a death rate close to zero, but an 80-year-old has a death rate close to 15 percent. This dramatic difference based on age allows us to be more focused on whom to protect. 

Mr. York and I grew up in a generation before many common vaccines had been developed. Our parents would deliberately expose us to other infected children to ensure that we would get the disease when we were young and healthy. This was their way of immunizing us. Since this COVID-19 appears to be (mostly) mild in children, some have suggested they could safely return to school, recognizing that they might catch the virus, but get over it easily and return to the normal life of a kid. Remember that once they develop antibodies, it is highly likely that they have an immunity to the virus as good as any vaccine might create. But, more importantly, once they have cleared the infection from their bodies, they cannot give it to others—grandparents included.

If standards are relaxed for young, heathy people, we understand that they will likely become infected more frequently but that those infections will convey much less harm. The problem, however, comes at the interface between these young, healthy people with infection and those older people at risk for a bad outcome if they get the infection. Steps need to be taken at that interface between young and old to ensure the safety of the vulnerable. Although young people should approach at-risk people with courtesy and consideration, the ultimate responsibility resides with the vulnerable to take those steps necessary to protect themselves: home isolation, social distancing, masks and hand washing. The greater the risk, the greater the caution.

We seem to have a mixed message about herd immunity and stopping the spread of the disease. They are inherently in conflict—the more we successfully stop the spread of the disease, the less we will develop herd immunity and the longer the disease will be with us. It isn’t the spread of the disease we want to stop, it’s the harm. And since most of the harm resides in an easily identified group—older people and people with health problems—we can target our prevention of spread to that group and tolerate higher risk of infection among younger healthy people, thereby increasing herd immunity with much less risk of harm. 

The picture of COVID-19 harm that is emerging can help guide our approach to reopening the economy. As Mr. York mentions in his editorial, the shutdown has created severe economic stress. The burden of this stress is especially hard on working class families. (Just by the numbers, for each person who has died from the virus, 500 people have lost their jobs.) This stress has its own severe health consequences. Risks associated with the virus have to be balanced against risks associated with economic disaster. Fortunately, many of the people at highest risk from infection are retired and younger people at much lower risk of harm could be allowed to return to work.

The good news is that scientists are developing risk calculators that allow each of us to input our personal information about age and health and occupation to help us understand our own risk of harm if we catch the virus. Then we can look both ways before stepping into the street. 

(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
PLEASE TURN OFF YOUR CAPS LOCK.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.