Dangerous Curves

If you weren’t very ill in late January or February, you probably know someone who was. The complaints often sounded the same: A fever for days, a stubborn and unusual-sounding cough, a persistent sore throat—the severity of the symptoms seemed worse than the usual influenza.

Doctors, assuming it was a version of the seasonal flu, administered flu-fighting drugs without testing. (My college daughter was very sick with the same symptoms; her flu test was negative.) Plenty of afflicted Americans just stayed in bed without ever seeing a physician.

Obviously, anecdotal evidence that the COVID-19 illness has been around for at least the past few months isn’t enough to make the case that there’s a chance the worst days of the outbreak are behind, not ahead, of us. But data from the Centers for Disease Control seems to support the possibility that the country has been besieged by the novel coronavirus since the start of 2020.

And while political leaders and medical experts push for more and more draconian measures to “flatten the curve,” it raises some questions. Are we looking at the right “curve?” And how accurate is the current curve if it doesn’t include possible cases before the height of the hysteria began in late February and early March?

The curve, according to one report, “refers to the projected number of people who will contract COVID-19 over a period of time.” To date, the novel coronavirus curve undoubtedly looks ominous. Only a smattering of coronavirus cases was reported in the U.S. during January and February; that figure jumped at the beginning of March due to testing availability.

The first known American victim, a Washington resident who had traveled back from Wuhan, the epicenter of the outbreak, was confirmed on January 21. The U.S. coronavirus graph basically flatlines from that date until the last few days of February.

But since the disease originated in China in December at the latest, it’s highly unlikely the number of reported cases in the United States between January 1 and late February is accurate. (It’s important to note that in its order prohibiting most noncitizens from entering the United States from China, the White House confirmed that an average of 14,000 people per day traveled between the two countries in 2019. That means tens of thousands of potentially infected people entered the country for weeks prior to the travel stop.)

Therefore, how could a highly-contagious virus remain nonexistent in a free-moving society for several weeks?

The answer is, it probably did not. The CDC tracks a category called “influenza-like illness,” or ILI. Since symptoms of the flu and coronavirus are very similar, it’s instructive to look at this data, which is based on visits to health care providers in all 50 states, Washington D.C. and Puerto Rico. “For this system, ILI is defined as fever (temperature of 100°F or greater) and a cough and/or a sore throat,” reads the CDC webpage on influenza-like illness.

“What influenza-like illness is saying to us is that you have a virus likely affecting your respiratory system that is making you feel crummy and, currently aside from influenza, there aren’t good therapies for these other viruses, so we just treat the symptoms,” Dr. Michael Ison, a professor of infectious diseases at Northwestern University in Chicago, told WebMD.com in January. The underlying cause could be any number of undetected respiratory viruses.

During the week of January 18, 2020, the number of people complaining of ILI started to spike dramatically. That week, nearly 90,000 Americans visited a health care provider with ILI symptoms; by the following week, that figure jumped to more than 107,000. For the next two weeks, into mid-February, the number stayed about the same. And that doesn’t include people with symptoms who didn’t see a doctor.

During the same period, testing for influenza A and B also spiked. Positive tests for both flu strains began to climb during late January and plateaued in mid-February before declining. At its peak, about 20,000 people per week were diagnosed with influenza—but it also represented a positive rate of around 30 percent. That means lots of people were tested for the flu, had flu-like symptoms, but did not have the flu.

Now, again, one can dismiss those figures as the usual discrepancies in any given flu season. But another CDC chart shows that, with the exception of the highly virulent 2017-2018 flu season, this year’s measurement of ILI reports from January 1 until mid-February is the second-highest in the past decade. Then, from the third week of February until now, nationwide reports of influenza-like illness surpassed the 2017-2018 season and now have leveled off.

Again, that too could be written off as a fluke and unrelated to coronavirus. But the CDC acknowledges a connection between coronavirus and reports of influenza-like illnesses: “Clinical laboratory data remain elevated but decreased for the fourth week in a row while ILI activity increased slightly. The largest increases in ILI activity occurred in areas of the country where COVID-19 is most prevalent. More people may be seeking care for respiratory illness than usual at this time.”

So to recap: The current coronavirus “curve” cannot be accurate since it does not include suspected cases of the illness before late February. (It’s unclear why scientists have not yet produced any models that attempt to calculate the virus’ presence here until testing was available.) A big increase in symptoms very similar to coronavirus occurred a few weeks after the first case was recorded, a timeline in accordance with the estimated trajectory of the illness’ spread. And roughly 70 percent of those expressing flu-like symptoms did not have the flu. So what was it?

It’s not unreasonable, in fact, it’s necessary and responsible, to consider that COVID-19 has been in the states since the first of the year; that people suffering similar symptoms to the flu actually had COVID-19; and that the peak of the outbreak occurred last month. The number of people now testing positive for the virus does not mean that the outbreak is accelerating because the data is incomplete.

That’s not the only concern about the veracity of data related to the transmission, spread, and fatality rate of the disease. Experts are cautioning that the available data is not sound and should not be used to justify draconian government measures now enacted at the federal, state, and local levels at a tremendous cost.

“The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable,” Dr. John Ioannidis, a professor of medicine and epidemiology at Stanford University, wrote this week. “Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 [the virus that causes COVID-19] are being missed. We don’t know if we are failing to capture infections by a factor of three or 300.”

The encouraging news, for now at least, is that the coronavirus does not appear to be as deadly as the seasonal flu in terms of sheer numbers. Based on CDC estimates—again, important to note that even the detection of influenza-caused hospitalizations and deaths is not an exact science—between 36 and 52 million Americans have contracted the flu since last October and anywhere between 22,000 and 55,000 have died.

While the number of detected coronavirus cases continues to rise due to widespread testing, about 150 people reportedly have died from the infection. Nearly half lived in the state of Washington; many states are reporting single-digit fatalities. Further, hospitals are not yet overrun with coronavirus patients and, according to the CDC, hospitalizations this year due to the flu “is lower than end-of-season total hospitalization estimates for any season since CDC began making these estimates.” Good news if indeed the number of coronavirus sufferers requiring hospitalization actually materializes.

This is a dangerous time and not just because of the threat of a treatable disease. Americans are willingly surrendering to government their freedom, their livelihood, their long-term economic security, and their mental well-being over unjustified panic about a virus that might have already spread and now is abating. If this is the new normal, where incomplete data and media-fueled panic rule the day, that is an even more frightening prospect than what’s happening right now.

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