President Trump dismissed the severity of the coronavirus pandemic in the United States over the weekend, downplayed the impact of the disease, and said that while testing of tens of millions of Americans had identified many cases, “99 percent” of them were “totally harmless.”
His comments about a virus that has already claimed nearly 130,000 lives were puzzling. Coronavirus is emerging in the Sunbelt states and has recovered in California. At least 2.8 million Americans are known to be infected, and public health officials have said the actual number of infections may be 10 times higher.
WHAT WAS SAID
Similarly, testing: There was no testing for a new virus, but we have now tested over 40 million people. But in doing so, we show cases, 99 percent of which are totally harmless. Results that no other country will show, because no other country has evidence that we have, not in terms of numbers or quality.
False. No matter how you define harmless, most public health experts and respected models of coronavirus disease would flatly contradict Mr. Trump’s assessment.
Estimating the number of victims of a rapidly moving pandemic while it is still in full swing is a sisifan feat, with outbreaks appearing in different parts of the country, even as improvements in care and new therapies reduce death rates.
Experts say the president appears to have seized only an estimate of the death rate of 1 percent or less that does not capture the full impact of the disease, and excludes a multitude of thousands of people who have spent weeks in hospital. or weeks at home with mild to moderate symptoms that still caused debilitating health problems.
That death rate is closely focused on the number of people who die as a percentage of the total number of people affected, including those who are asymptomatic and do not experience any disease, and those with mild cases, who experience fleeting symptoms.
A rough estimate of the death rate in the US, based on the total number of deaths officially attributed to the virus and the number of cases diagnosed by testing, suggests that the death rate is higher, at 4.5 percent of infected people dying. But many experts agree that this rate is very likely to be inflated, because the denominator at this time has omitted many cases, including those that were never diagnosed due to a paucity of tests and those with no symptoms.
And some experts pointed out that even those who tested positive but showed no symptoms should not be considered harmless cases: they can inadvertently transmit the virus to others in the community who are more vulnerable and can develop acute illness.
Studies that have calculated the death rate based on broader antibody tests that account for these silent cases suggest an infection death rate of less than 1 percent, said Dr. Ashish K. Jha, director of the faculty. from the Harvard Institute of Global Health.
“It is always difficult to do this in the midst of a pandemic,” said Dr. Jha. “There are many factors that go into it. But let’s say you took 1,000 Americans at random who were infected. Our best guess is that six to 10 would likely die from the virus. “
And the death rate does not capture all the damage caused by the disease. According to some estimates, between 15 and 20 percent of known patients with Covid-19 may require hospitalization, and of the admitted group, 15 to 20 percent are transferred to intensive care.
In addition to hospitalization, another consideration that would complicate what defines harmlessness is long-term involvement for so many who have recovered or are still struggling to reclaim their pre-Covid lives.
Patients who are lucky enough to survive a long hospital stay and weeks in an intensive care unit or a ventilator face a long road to recovery. Many will suffer debilitating long-term effects, including impaired lung function, neurological problems, and cognitive deficits, and some may require lifelong care and fail to regain full independence.
Some patients have long courses of disease, with fevers and weakness that last for weeks; The disease has also been linked to strokes that can be disabling, and how the disease affects the immune system in the long term is still largely unknown. Residual symptoms like continued shortness of breath, muscle weakness, setbacks, and mental confusion may persist for some time.
“We do not fully appreciate the long-term consequences of having Covid, even mild and moderate forms of Covid that were never admitted to the hospital,” said Dr. Thomas McGinn, deputy chief physician at Northwell Health and director of the Feinstein Institutes of Medical Research, which studies the long-term effects of the disease.
“Are there persistent effects that last three months, six months, a year or more? The question of what percentage has long-term consequences, and the severity of the consequences, is unclear, ”said Dr. McGinn. “We have definitely seen people who have lung scars and have gone home with fibrotic changes in their lungs that continue to have difficulty breathing. And there are people who after three months have persistent changes with their sense of taste and smell. That is not a small problem. People depend on smell and taste to enjoy life. “
