On the Covid-19 1% IFR "Blunder" that's Actually the Truth

Adam Larson (aka Caustic Logic)

September 10, 2020

additions on: 9/11, 12, 14, 16 ...

https://www.rt.com/op-ed/500000-covid19-math-mistake-panic/

I call out RT and the author to Malcolm Kendrick ("skepitc, doctor, writer, blogger" - on Twitter) to retract this nonsense. We've had more than enough of this already, but the usual folks are loving this -yet another supposed proof almost no one died from Covid-19 now that it's over, nor was much of anyone ever going to die, except of course from control measures. As his nodding fans all know, this "lockdown" stuff was a horrible mistake, if not an evil plot.

Kendrick argues here a simple math mistake no one double-checked was the basis for the global lockdown reaction - which was already pioneered in its most extreme form by China before the alleged mistake. But anyway ...  It's a short enough read I won't summarize it first, just in explaining how terribly wrong it is, below. If you aren't clear on CFR vs. IFR, it explains that.  

Kendrick: "Covid’s CFR was likely to be about one percent, so one person dying from a hundred who fell seriously ill. Which, as time has passed, has proved to be pretty accurate." False. The global average Case-Fatality Ratio (basically % of KNOWN infections who've died) has usually been around 5% - US is around 3% - almost everyone is over 2% and some are past 10%. The UK currently boasts 11.7% (as currently listed at the Bing tracker). This UK doctor thinks it's less than 10% what it actually is. Because skepticism?

"Almost no-one is dying of Covid anymore" he says. Because of actions including a slowed spread, deaths in the UK have gone from terrible to mild, nearing zero some days. Like many such skewed thinkers in the UK, he conflates this (along with a mythical reading of Sweden's experience) into a global reality. Global daily deaths, with spikes and dips from reporting variance) show the current numbers are almost on par with the worst days. It's been far better in those places hit early, but the virus has been getting its foot in more and more doors worldwide since then. 

So the virus proved harmless after a bit for some reason, as Kendrick concludes, and he then goes on to complain:

"But because we panicked, we’ve added hugely to the toll. Excess mortality between March and May was around 70,000, not the 40,000 who died of/with Covid. Which means 30,000 may have died directly as a result of the actions we took."

I have mapped this out, as shown. Kendrick could not say how these thousands of deaths happened so quickly atop the thousands of covid ones, then mellowed the same way. In the US, we can see the excesses are mostly in classes of death consistent with unknown Covid-19 infection - cardiovascular in nature, and spiking just when Covid deaths do, just before and after, etc (see here). I say this is 70-80,000 UK people dying almost entirely from Covid-19 infection. 

Excess deaths all over suggested the mark of one million dead was passed some time ago. Now it's officially past 900,000 and I estimate 1.6 to  1.8 million actually killed so far. Annual flu deaths range from around 350,000 in a light year to 650,000 in a bad year, with little to no intervention slowing it. This has killed at least 150% of a bad flu year, almost entirely in the last 6 months, despite massive and bemoaned efforts to slow it. Kendrick ... claims to still believe the early predictions it would kill no worse than a yearly flu. He seems to believe it has killed, and will kill that way. He's not alone here in being grossly out of step with reality.

Kendrick says (thinking UK and expanding it to the world) "no deaths were prevented." None. And he's thinking UK wrongly. He thinks the virus stopped killing at those exponentially increasing rates until about 2 weeks after lockdown was imposed, then fall sharply to a low murmur you can think of as gone ... all on its own, coincidentally if not mockingly right when people were trying to make that happen. 

As always for such fantasists, he insist on using past-tense phrasing: "no deaths WERE prevented," not "have been." Covid "was never" going to kill many, etc. He's probably been one of those calling the crisis over from the minute it started. The man goes on to make a number of other dubious claims I'll skip to get to the central point - the predictions of a 0.1% IFR (infection fatality rate) that Kendrick says have been borne out, vs the deadly, lockdown-justifying tenfold exaggeration, which was "horribly, catastrophically, running-into-Mars-at-5,000-miles-an-hour wrong." 

However ... If the 0.1% estimate was actually blundered to 1% (I didn't re-check his reasoning there), it's sort of interesting, and a rather lucky turn, as a 1% IFR roughly predicted the reality to come. It seems the early guesses were the blunders here, and ones with deadly potential if people were to believe in and act on them in the current reality. People in the U.K. especially are hungry to be so misled, and this smug doctor Kendrick has fed that, just casually splashing more fuel on that fire of deadly ignorance. 

Oh, and he's a doctor, so he must know, right?

Let's start with his sources. It seems that 0.1% estimate came from an early statement by the CDC's Dr. Anthony Fauci in February - one he clearly doesn't stand by today. Kendrick buys and leases it out anyway, even boosting it to a maximum estimate: "Covid was never going to kill more than about 0.1 percent – max." He also cites another February prediction from the CDC that mused the virus' effects would be "akin to those of a severe seasonal influenza,” where only something like one in a thousand will die. The scandal, to Kendrick, is how those same experts soon came out saying it would be ten times worse - 1% were likely to die. They didn't stand by the first guess for long at all. Or maybe they did just conflate CFR and IFR and bungled what they meant to say - maybe on purpose. I mean there clearly is some plan to all this exaggeration and fear-control, right? They wreck the economy, get us in masks, and viola, every dictator's wet dream - people in masks and a wrecked economy. (it's a complicated plot, I gather)

This is supposed to be our glimpse of the truth? Two seemingly retracted early guesses and a supposed mix-up? 

Kendrick says the facts bear it out. But if just 0.1% of infections - or anywhere close - result in fatality, the following would not already be established facts:

* Bergamo, Italy: city and province have around 0.55% of their POPULACE already killed. That means even if everyone had been infected, it PROVED about 5-6 time deadlier than Kendrick would have you believe. Most of the 6,000 killed were by early June, when serology tests showed about 56% had antibodies. (see here) That lapses but not much, so let's say 58% infection rate.

So Bergamo estimate IFR = 0.95% - not 0.1%. 

* CDC report: In Orleans and Jefferson Parishes, Louisiana, "The overall IFR was 1.63%" (Reported deaths were divided by number of persons presumed to be recovered to calculate the IFR) 

- "IFRs found in other seroprevalence studies are lower, ranging from 0.5%–1.2%"

- No mention of 0.1% IFRs here. Some bunch of blunders? More CDC stuff you can only trust up until they started getting more facts in March? 

* New York City Covid-19 deaths: 23,741 (conf. + prob.) - est. by excess deaths: ~25,500 (quick calc.). So just among the city POPULACE (8.4m), not the infected ... something like 0.28% to 0.3% of those once alive in New York City HAVE - ALRAEDY - DIED from the coronavirus - not 0.1% "max" of those infected. 

Similar death rates have been recorded in places like Madrid and Rio De Janeiro, and Mexico City looks especially bad by excess deaths. Those three cities are a mixed-bag for lockdown measures, but all have used at least some control measures people like Kendrick would complain were destructive.  My data is behind or fragmentary, but last I checked  all three come out somewhere well past 0.25% of the POPULACE already killed - not 0.1% of the infected. 

Guayas province, Ecuador, est. from excess deaths of 13-14,000 (as reported just by the start of summer) say close to 0.35% of the POPULACE has died. That will be higher among the infected, and both rates will be higher in their temporary capitol Guayaquil (it's a mess and data is scarce). 

Back to NYC: Among those infected ... est. infection rate 28-30% (just over 27% had antibodies in August - NYC study - NYT report) = 2,352,000 to 2,520,000 estimated infections. Therefore NYC est. IFR = 0.94% to 1.08%

That's eerily close to what we see in Bergamo AND to what that "blunder" had said. Kendrick moans how this error - that turns out quite correct - is what prompted nearly every national and local government on Earth to respond in these drastic ways - after consulting their best expert minds, and just as many of them were dealing with raging infections, swamped hospitals with sickened staff, and unchecked surges of fatalities presaging far more than 0.1% were in serious danger.

Then someone made a typo, and they all decided to lock down. Huh. From Shanghai to Tehran and beyond, including before the error was made. Huh. 

So ignorant predictions of February suggested it would be flu-like, but the facts since have clarified the IFR is frequently as high as and higher than the "blunder" estimate - IN FACT about 1% of those who get this virus so far have died. That average includes the deadly early attacks and should fall in time, unless people gets careless enough, or the virus mutates. But it'll stay far closer to 1% THAN TO 0.1% "max." I'll let Kendrick put the 1% reality back in context - he did that well when he was calling it a fatal error:

"You may not think that percentage is enormous, but one percent of the population of the world is 70 million people – and that’s a lot. It would mean 3.2 million Americans dead, and 670,000 Britons." 

Yeah, if that were happening, that'd be terrible. You'd want to know and take it seriously, right? Because something like that ... even if you slowed it down with drastic measures, but then people resisted them left and right, you might have about 70-80,000 dead in the UK by 6 months in (about now). You might have 250-300k in the US, 900k confirmed worldwide and likely 1.6-1.8 million dead six months in, just thankful it hasn't been worse so far. You might be annoyed with idiots who dismiss the danger with this kind of lazy, self-centered "skepticism" that threatens us all. 

9/11 add: Will Merthon on Twitter with a detailed argument even the 0.1% mix-up never happened - Kendrick  passed on a flawed bit of deduction by Ronald Brown published by Cambridge University, involving his own mix-up regarding influenza mortality. P. Hitchens asked if anyone dared respond to Kendrick's "terrific article." I suppose he'll ignore my response.

9/12: People are pointing to Iceland as the low-IFR standard for the world - not Bergamo, Madrid, Louisiana, New York City ... It's said they have (or had) one of he best views of infection rates via widespread testing. If so, it adds some weight to there being only so much higher than 0.63% infected (2,161 confirmed cases to date, pop. 341,243). It might be five times that, but just comparing known deaths (10) to known cases, basic CFR: 0.46%. That's low. Few nations have anything below 1-2%, and most center somewhere near 5%, ranging not much past 10% in worst cases.

The best way to find the actual death rate - in Iceland as anywhere - will not be to compare confirmed AND unconfirmed cases with those same confirmed deaths (the basic CFR-IFR correction used at the Kendrick level). It would be fairer to compare confirmed AND unconfirmed deaths to the same totality of infections. Right? Apples AND oranges compares to apples AND oranges. This is excess deaths type analysis. I'm having a look into this and will report back. 

I noticed the Louisiana study via Dr. Eric Feigl-Ding Sep 6 - he's got some combo of knowing his stuff and having some kind of anti-virus bias for some reason. He also directs us to a re-analysis of Diamond Princess cruise ship outbreak - a case I might have recalled above. A confined and older-skewed population yields a higher-than-usual IFR of nearly 2%, or - mainly - they suggest past estimates were low, based on flawed methodology and then being too decisive or getting taken too literally. In contrast the authors here are methodical and I didn't get to just what they conclude.  2.0% does come up. previously I had: 3,711 passengers and crew - 712 cases - 13 deaths by most reports, some say 14 = 19% infected, and an estimated IFR of 1.83% to 1.96% on the Diamond Princess - even worse than those areas in Lousiana, about 2% of those infected on that cruise wound up dead. NOT 0.1%. tops. Not the 0.3% tops this herd immunity enthusiast adduces from some reading off of Iceland. 

About 1.9% matches the unusually clear (if not definitive) number of cases (and deaths!), and Fig. 1 in the analysis notes "combining the age-stratified nCFR from China with the age profile of Diamond Princess patients, 15.15 deaths should be observed on the cruise." How that last 15% of a death would be observed in unclear, but  that's about what I got in another way. IFR in China ... that's something else to check on.

Add 9/14: More on the IFR that has no one answer: It can get this bad:

* IFR = 30.86% at Life Center in Kirkland, Washingtomn, USA - of 120 residents, 81 (67.5%) were infected and 25 died.

* IFR among people 80+ in Lombardy, prior to mid-March control measures: 30% https://swprs.org/studies-on-covid-19-lethality/

* Belgium nursing home IFR est. 28% to 45% (ibid)

* 2% Diamond Princess

* 1.63% in 2 parishes in Louisiana (1.72% for African-Americans there) 

* 1.4% in Conn. to May 3 (Reason)

* Spain: 0.82% (based on confirmed Covid-19 deaths) and 1.07% (based on excess all-cause deaths).

https://www.medrxiv.org/content/10.1101/2020.06.20.20136234v1

Note some of the are from a useful article at Swiss Policy Research that considers in detail places with high levels like 1%, agrees with it, but suggests there may be 2-5 times as many cases as seroprevalence studies suggest. NYC may be 50% infected or more - Bergamo 114% or more? Again and again he notes "people with anosmia (temporary loss of the sense of smell or taste), a very typical Covid symptom" tended to not have antibodies, suggesting others without antibodies also had it, and maybe a huge portion that would drive down the CFR (twice as many cases to the same number of deaths halves the death rate). For the moment that seems possible, but I've also read than antibodies hold in a vast majority of cases, not in 1/5 to 1/2 of them. 

As for Dr. Fauci's initial 0.1% guess - as WebMD reports: "Fauci and other public health experts have since put the COVID-19 death rate at about 0.6% -- six times that of a typical flu season -- which is the latest CDC projection. “It looks like now that the fatality rate of a person who gets infected with this, on average, is around six times that of the seasonal flu -- so around the 0.6 [percent] range,” say Amesh A. Adalja, MD."

That's lower than what I see - in especially deadly places - but not by a whole lot. And others are faring better, bringing the average down.

* IFR CDC cited range (0.5%–1.2%) refs not openly available, refer to studies in Spain, Switzerland, Brazil. And I suppose it doesn't have to bottom out at 0.5.

* IFR for Belgium, general population est. 0.30% to 0.62% https://swprs.org/studies-on-covid-19-lethality/ 

* NYC to April 1: 0.4% https://reason.com/2020/06/28/cdc-antibody-studies-confirm-huge-gap-between-covid-19-infections-and-known-cases/

* Missouri April 26: 0.2% (ibid.)

* Utah to May 3: 0.1% (ibid.)

Reason article (June 28) noted "These are just snapshots, and the IFRs in Utah and Missouri may have risen as the epidemic progressed in those states, especially if people infected in May were more vulnerable to the disease." So That 0.1% is likely the best it gets, not the "max" death toll there or anywhere. 

Iceland: situation report - Covid-19 conf. cases 2,165 (+4 today) - conf. deaths: 10. Basic CFR: 0.46%. Unconfirmed infections will be higher. Unconfirmed deaths will also be higher, I bet. I had a look at government stats - small numbers that vary a lot week-to-week (population 341,243 - it's a tiny place.)

https://www.statice.is/publications/experimental-statistics/deaths-ex/

The site notes "It is worth pointing out that the number of deaths for 2020 are preliminary and likely to somewhat underestimate the true number of deaths, mainly due to late arrival of death notices." So there might be more than seen here. Also cause-of-death data is unavailable (another page there explains "Reports on causes of death are usually ready a year after.") But I checked (incomplete) deaths by age as a decent indicator. I'll share this graphic I made to visualize it - deaths of those aged 75 and over are below average as much as above, but it's unusually erratic, and the patterns of just when seem related to the rising cases (peaking a bit before and after peak cases) and perhaps unknown cases in late 2019 (as data in several other places suggests). Being 85+ seems pretty deadly all the time, but note how younger classes (lighter sections and gold rings) seem to die at higher levels in April, just after the peak of known cases, and into May. Also note a rise in elder deaths in July, from quite a low level, accompanying a rise in known cases then - and the deaths fall again as case transmission falls. Possibly coincidence, but likely not.

But this isn't much to clearly suggest additional deaths to go with the additional spread. A  few dozen over-average seem likely - possibly up to about 100 depending on average vs. baseline, and something like 60 as a reasonable high end. But more so than usual, I can see it being zero. 

The Center for Evidence-Based Medicine reported that, for Iceland, "Screening suggests 0.5% are infected;  the correct figure is likely higher due to asymptomatics and many not seeking testing: estimates suggest the real number infected is 1%." The high testing rate was noted, speculating they missed less than half the true infections. That would be a good rate - most places likely miss 3/4 of them or more. 

I have 0.63% now with confirmed infections. Let's say 1% was fair, and 1.5 to even 2% is fair now.

* IFR 0.19% if 1.5% inf. by now (5,119) and still just 10 dead 

* IFR 0.88% if 2% inf. (6,825) and 60 dead

* IFR 1.17% if 1.5% inf. and 60 dead

It's somewhere in that broad range - quite possibly at or near the low end. 0.25% or so may be it. Perhaps the virus did spread widely and less-fatally in Iceland. I suspect not one care home outbreak happened, or their care homes are so tiny you can't tell, so only a worst-case-scenario gets to the 1% range here. 

As such, I suppose the IFR varies well below the 1% seen in hotspots, in the right conditions, and even below the 0.5% end of the CDC's cited range. Down to 0.2% may also be plausible, and even 0.1% - but only in fluke cases (like Utah's early phase). Of course it goes even lower - to about zero - in certain demographics, but then it gets to 30 and 45% in others. But all considered, that 0.6% CDC estimate might be the fairest baseline - places will come out somewhere near, above, or below that line. 

Add Sept. 16: Kendrick: "Sweden, which did not lock down, has had a death rate of 0.0058 percent." But that's not what the Swedes say. Official anti-lockdown government's own website says:

"What is the fatality rate of COVID-19? Globally, it is estimated that 0.5–1 percent of those who are infected with COVID-19 die. ...  this might change as new knowledge becomes available. ...  A study by The Public Health Agency of Sweden estimates the fatality rate in the Stockholm region to 0.6 percent, for all ages. The fatality rate among those 70 years or older is 4.3 percent, whereas it is 0.1 percent among those younger than 70 years."

https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/communicable-disease-control/covid-19/

It seems Kendrick the bogus health data expert crunched out 0.0058 from legitimate data, and conveniently forgot to move the decimal over 2 BEFORE making it a percentage. The report in fact says "Dividing the number of deaths with the number of infections gives an IFR estimate of 0.58% (c.i. 0.37–1.05%)" He re-calculated it himself to be sure, and left the decimal point. 

https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/t/the-infection-fatality-rate-of-covid-19-in-stockholm-technical-report/