I've been following CoronaVirus carefully for more than 2 months now.
I've been independently interpreting the data and making predictions. See my previous posts on the subject:
https://peakd.com/coronavirus/@apshamilton/coronavirus-and-the-world-economy - I was scarily correct on this prediction that Coronavirus would trigger a depression.
https://peakd.com/coronavirus/@apshamilton/why-non-asian-coronavirus-victims-are-in-fine-health - Not fully correct on this, but there are still very significant differences in mortality between countries that may be explained by genetic differences.
https://peakd.com/coronavirus/@apshamilton/us-senate-may-have-coronavirus-outbreak - Correct, but infection of Senate seems to have been from another source
https://peakd.com/coronavirus/@apshamilton/uk-is-on-worse-coronavirus-trajectory-than-italy - Correct for a while, but UK deaths have since slowed
https://peakd.com/coronavirus/@apshamilton/four-positive-things-about-the-corona-crisis Correct
I have been a supporter of early action including closing borders and social distancing.
However, as more of the world heads towards draconian lockdowns that infringe basic freedoms and destroys the local and global economy, I've been less supportive of these harsher steps. I worry that we are heading down the path of totalitarianism and massive economic destruction.
Recently President Trump has been questioning whether the cure is worse than the disease so I had another look at the figures.
What is the real mortality rate and ICU (ventilator) rate of Coronavirus?
Initially I thought (based on early figures out of Wuhan) that the disease had a mortality rate of around 4%, which is very high compared to flu (0.1 -0.5% depending on estimate of unreported cases) and a severe case rate of 20%. This is also very high and is what can overwhelm ICUs and ventilator capacity.
However reviewing the current figures from many countries, with the exception of Italy and Spain, it looks like the mortality rate is around 1% or lower.
This is still worse than flu, but not that much worse.
In Israel for example as of today there are 2666 cases and only 8 deaths = 0.3% mortality - similar to flu.
Israel is also experiencing only 39 severe cases out of 2666 = 1.4% and 68 medium cases = 2.5%.
Thus 96% of cases in Israel are light or asymptomatic.
Based on the Israeli figures, Coronavirus is very similar to flu in terms of mortality and impact on the health system of serious cases.
It is important to note that Israel has only 126 deaths per year from flu because it is a very young, fit and healthy and non-smoking population.
By comparison, Italy has 17,000 flu deaths per year, because it is a very old, unhealthy, sick and smoking population.
This is 2550 times the rate of flu deaths in Israel, so it is not surprising that Italy is suffering badly from Coronavirus.
Human Cost
Given the above, there is a real question of whether these harsh lockdowns are really justified, and even whether they really save lives.
I am very familiar with the concept of flattening the curve and avoiding the health system becoming overwhelmed like in Wuhan and Italy, but there are also very real costs, both in human life and financial, to severe lockdowns such as Israel (since yesterday) has in place and many other countries are also implementing or considering.
Suicide
Firstly, there is the issue of suicide, which alternates with car accidents as the biggest or second biggest cause of unnatural death in most advanced economies.
Forcing people to be locked into their homes, without physical social contact and with very little opportunity to get outside, experience the sun and fresh air and exercise is going to dramatically increase the suicide rate. Indeed it models the winter conditions of Nordic countries like Finland which have horrendous suicide rates (20 per 100,000).
Suicide rates in OECD countries range from about 6 (Israel) to 26 (South Korea) per 100,000 people per year.
So in Israel, with a really low suicide rate, suicide normally kills around 500 people per year - that's 4 times the number that die from flu.
In South Korea, with a normally really high suicide rate, suicide kills over 13,000 people per year. That's 100x South Korea's deaths from Coronavirus.
Even in hard Corona hit, but generally happy Italy, with a suicide rate of 7.1, suicides kill about 4260 people per year, more than their Corona deaths to date.
So ANY substantial increase in the suicide rate is going to create additional deaths of the same order of magnitude as the lives saved by flattening the Corona curve.
But it is not just the effects of isolation that will increase the suicide rate.
People are losing their jobs in huge numbers because of Coronavirus restrictions.
In the US alone 3.3 million people were added to the unemployment rolls last week and in Israel unemployment has hit over 20% from very low figures before the Corona Crisis.
Unemployment is a big contributor to suicide rates and Trump is correct in pointing out that an economic Depression will cause a big jump in suicides.
Whether the increases in suicides costs more or less lives than those saved by a harsh lockdown flattening the Coronavirus curve is an issue that won't be known for a year or more and will vary dramatically by country.
But is is absolutely clear that just looking at lives saved from flattening the curve is only seeing half of the butchers bill.
Suicide vs Corona - Who do you lose?
While in one sense, every human life is equal, there is a big difference between someone aged 15-55 committing suicide and someone over 80 dying from Coronavirus.
Suicide mostly takes people in the prime of their life at great emotional cost to families and loss to society and the economy.
Corona mostly takes people at the end of their natural lifetimes, when they would likely have died from some other illness within a few years in any case. Death at advanced age is expected and normal.
If you calculate things according to years of natural life expectancy lost, then any substantial increase in suicides will easily outweigh the years of life of of very old people gained from lockdowns.
Domestic Violence
There is a funny video doing the rounds in Israel of a kid asking their Dad who they would prefer to be in quarantine with: A) Mum or B) ... and the Dad screams B before the kids says who B is.
It is already well documented that domestic violence rates are sky rocketing because of Coronavirus lockdowns.
Its pretty obvious that keeping a couple or family locked up inside for weeks is going to increase tensions, which in some cases will lead to violence and even death.
So the human cost of Corona lockdowns is arguably equal or greater than the lives saved by flattening the curve.
Claiming that lockdowns "save lives" is a false or misleading claim.
They may well cost more lives than they save and they certainly cost far more years of natural life.
Economic Cost
The economic cost from Coronavirus lockdowns is already immense, far worse than any economic downturn since the Great Depression and almost certain to exceed it if lockdowns continue.
It is important to understand that an economy, like a human body, once stopped it is difficult to restart.
The longer a lockdown continues the greater the number of businesses and jobs that will disappear forever.
The world economy was already weak and fragile before Corona hit and by every measure the impact of Corona restrictions (not Corona deaths or illness directly) has already created the biggest supply shock, demand shock, credit shock, stock market drop and unemployment jump since the Great Depression.
Stop the lockdowns now! - before its too late
If we continue with harsh lockdowns on the false premise of saving lives by flattening the curve we will permanently destroy large percentages of our economies. GDPs will drop by 50% or more sending large percentages of our populations into poverty and causing massive civil unrest.
While Donald Trump was not strictly correct when he said Coronavirus was no worse than flu, it would have been far better for all of us if we had treated it as such.
We are going to be paying the price for a long time of over-reaction, panic and myopic focus on saving the lives of our elderly rather than providing a better future for our children.
Thank you for bringing up suicide and domestic violence as it relates to the coronavirus. I think this pandemic and its results will be studied for a long, long time when it comes to unintended consequences, shortsighted thinking and the fact that with any issue this big, information becomes a weapon for offense and for defense, no longer a matter of being true or false.
I fear we will learn this in the worst way possible. The deaths caused by poverty and other consequences of the economic depression we are rapidly entering will dwarf the casualties we may suffer directly from the virus.