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Numbers regarding school reopenings

One of the greatest points of disagreement in the media, politics and at home is over the reopening of schools.  On one side of the discussion is that school is critical to the development and well being of children.  Schools provide instruction in important subjects, develop social and emotional skills, safety, reliable nutrition, mental health therapy, physical activity and also allows parents to go to work.  The other side of the discussion is if reopening of schools is safe for the children, teachers and general public.

There are many countries that have reopened their schools and their methods and results should be lessons for the US. https://www.usnews.com/news/best-countries/articles/2020-07-22/how-countries-reopened-schools-amid-the-coronavirus-pandemic

In summary, many countries have demonstrated that it is possible to open schools without causing spikes in cases and more importantly without causing spikes in deaths.  Children are 8 X more likely to die from fly/pneumonia than covid 19.

Denmark was one of the first countries to reopen schools after they shut them down.  Denmark reopened their schools on April 15 for children 2-12.  The measures they implemented appear to be successful as there has been NO increase in covid 19 cases and no serious outbreaks in schools.  On May 18 those aged 12-16 were allowed to return to using the same protocols.

Similarly, schools in Germany, Finland and Norway have reopened without significant spikes in the number of new cases and more importantly, no increases in deaths.

South Korea and Israel are examples of countries that reopened, closed and reopened  In both cases, there was a general increase in the number of covid cases that coincided with the reopening of schools.  However, in neither country was in shown that it was the reopening of schools that caused the general increase in covid.  In both counties other restrictions to the public were also lifted at the same time schools was reopened.  For instance, in Israel, groups of upto 250 were allowed to meet at the same schools reopened.  Schools are now open in both of these countries.

The big question everyuone is asking is “is it safe for children to return to school?’  Often this question is  addressed by the number of children who may become infected.  Although, no one wants any child to get sick, the facts are that people (and children) under the age of 26 have a significantly higher risk of dying from flu than dying from covid 19.

From 2007-2017, 172 million people died from flu and pneumonia.  This is an average fatality rate of 60,000/year.  However, the real detail is in the age of the people effected.  By the numbers, children between 5 and 14 have a 1 in 200,000 chance of dying from fly/pneumonia but a 1 in 1.5 million chance of dying from covid 19.

The following shows the relative risk of death from covid 19 vs pneumonia/flu.  Note that those under the age of 15 have 4 to 9 times higher risk of dying from flu/pneumonia than covid.

Evidence is mounting that children are less susceptible to Covid 19 and are less likely to transmit the virus to others.  When children under 15 test positive for covid 19, almost 40% have no symptoms and majority develop fevers and fatigue but recover. https://pediatrics.aappublications.org/content/145/6/e20200702

The data from around the world is consistent in showing that children are at lower risk from covid than from the flu.  However, there are still concerns about the risk to teachers, staff and student families.  It is likely teachers and staff will be the sources of infection, not the victims.  The results from many countries who have reopened their schools since April and May clearly show that there are ways to reopen schools without causing an increase in the number of cases or the number of deaths due to covid 19.

The current CDC estimate is that the overall fatality rate of covid is .65%.  However, this number is dominated by the fact that the fatiality rate of people over 65 is 5.6%.  The fatality rate of those under 64 is lower than that or flu/pneumonia.

The fatality rate of children who tested positive for covid is .03%.  Or, 99.7% of children who get covid 19 will recover.  This fatality number is much lower than many other diseases and causes for children.

As a last calibration, it is interesting to note that even in this year of the global pandemic, there are still more deaths attributed to pneumonia/flu than covid 19.  Covid 19 is to be respected and avoided but our overall understanding of the disease, use of social distancing, masks, testing and improving treatments have lowered the fatality rates down to levels of other diseases that we have learned to endure without shutting down our society. https://freopp.org/estimating-the-risk-of-death-from-covid-19-vs-influenza-or-pneumonia-by-age-630aea3ae5a9

Covid 19. Reopening: How to interpret Covid 19 statistics and the effect of age.

There are so many things happening around the country that covid 19 has almost gotten lost in the news.  This is the latest update on the statistics.

The news headlines may be somewhat misleading.  There are many headlines that reporting an increase number of covid 19 cases.  However, the question is, how do we interpret these numbers?  What numbers are indications of trouble to come and what numbers suggest that we are on the road to recovery?

The main headline has been that on Jun 12, 21 states reported an increase in the number of covid 19 cases.  However, a more granular look at the data provides some better insight.

Recall that the main reasons for a lockdown and stay-at-home orders were to minimize deaths and not to overflow hospital capacity.  The purpose was never to simply reduce the number of cases.

A reminder that at the peak of the Covid 19 infections in April, there were no hospitals that were overly full.  In fact, extra hospital beds provided by the USN Comfort in NY, USN Mercy in Los Angeles and thousands of temporary hospital beds in New York, New Orleans and other cities were not utilized.

 Further, in March and April that were predictions that said that we would be short on ventilators and that several thousand more would be needed.  These predictions turned out to be untrue.  There was never a ventilator shortage anywhere.

Not everyone will get infected.

A seldom reported experience is that some people appear to be immune to the covid 19.  This is seen on people who have been isolated on cruise ships and military carriers.  It appears on the cruise ships between 50-70% of the people get infected, the rest do not.  On a French aircraft carrier, 60% of the sailors got infected.  However, there were no deaths and only of the 1074 infected sailors required hospital type care. https://Berenson, Alex. Unreported Truths about COVID-19 and Lockdowns: Part 1: Introduction and Death Counts and Estimates . Kindle Edition.

Who is dying from covid 19?

In a previous blog, it was reported that 42% of all covid 19 deaths occurred in nursing homes.  However, deaths can also be analyzed as function of age.  World wide, median age of people who died  from covid 19 is 81 years old.  That is, half of the people who died who died from covid were 81 years old or older.42% of covid 19 deaths were in nursing homes and assisted living facilities

In New York, as of May 28, almost 40 percent of the 23,700 reported deaths occurred in people over 80. (https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n)

In Minnesota, the median age of the 1,000 COVID deaths is almost 84. More people over 100 have died than under 50.http://(https://www.health.state.mn.us/diseases/coronavirus/stats/covidweekly22.pdf)

The flip side of the risk to the elderly is that younger adults and especially teenagers and children are at extremely low risk from SARS-COV-2. In Italy, a total of 17 people under 30 have died of the coronavirus. In the United Kingdom, four people under 15 have died. In New York, 14 under 20 and 102 under 30. Worldwide, it is almost certain that more people over the age of 100 than under 30 have died of SARS-COV-2. Many more children die of influenza than coronavirus; in the 2019-20 flu season, the Centers for Disease Control received about 180 reports of pediatric flu deaths. It has received 19 reports of coronavirus deaths in children under 15 so far.

How to interpret increasing number of cases.

There were no patients that were denied access to medical care or ventilators due to overcrowding.

It is difficult to interpret reports simply on the number of covid cases.  This is because each area has a different and changing number of tests being run.  In general, there are more tests being run each day than the day before.  This alone could account for the increase in the number of cases.  For this reason, a better assessment of our ability to cope with covid 19 cases are the hospitalizations (number of people sick enough to need hospital care) and the number of covid 19 caused deaths.

Questions you should ask yourselves when reading about covid 19 statistics, especially number of cases.

  1. Where are the increases in cases occurring? In isolated, bounded areas or are they evenly distributed.  Recall from earlier blogs that 42% of all covid fatalities occurred in nursing homes.  Also, in each state there were just a few counties that accounted for well over half to two thirds of the number of cases is the state.  Am I in area where there are lot of cases?
  2. Who is getting infected? Especially, what age group?  We now know that the vast majority of fatalities were in people over the age of 70 with pre existing conditions.  The fatality rate of people under is not higher than many other diseases and causes of deaths.
  3. It has been over a month since protests involving thousands of people that were not practicing social distancing and/or wear masks. Are any increases in cases due to this?
  4. Are the number of hospitalizations going up so fast that the hospitals can’t handle the number of patients?
  5. Is the fatality rate going up or down?

 CONTINUE TO KEEP SOCIAL DISTANCING WHEN POSSIBLE.WEAR A MASK IF YOU ARE IN A CROWD.STAY HOME IF YOU DON’T FEEL WELL.

The headlines are that on Jun 12, 21 states reported increases in covid 19 deaths, but only 9 of these reported increased hospitalizations.  Further, in general the number of total US deaths is decreasing.  As seen in the chart below:

 

It is also important to note that it has been over 2 weeks since the first protests involving thousands of people who were not social distancing and many were not wearing masks masks.  To date, there has been no increase in hospitalizations or deaths in any areas where these protests took place (Minneapolis, New York, DC etc.)  This is yet another indication that covid infctions are depending on location, age and other factors – stay-at-home and lockdowns effectiveness is being questioned more and more.

I have provided from three states for discussion, California, Texas and Florida.

From the chart below, it appears that the number of cases has increase in past week.

CALIFORNIA

However, the following chart shows that the number of deaths has NOT increased during this same time period and remained more or less unchanged for weeks.  The number of hospitalizations has NOT increased with the increasing number of new cases.

It is also reminded that the cases in Calfirornia are very location dependent.  Of the 150,267 cases reported in Ca, 72,023 have occurred in Los Angeles (48%).  Of the 5062 covid 19 fatalities in Ca, 2890 have occurred in Los Angeles (57%).  The county with the second number of fatalities is Riverside with 383 deaths.  It very much makes a difference where you live.

NEW YORK.  New  York has received the most attention throughout the covid 19 crisis because it leads the nation as the state with the most cases and the most deaths.  However, the following charts show that there has been a dramatic decreases in both cases and deaths for New York.

 

 

 

 

TEXAS.  Similar to Ca, the number of cases in Texas has increased but the number of deaths has not.  There has been an increase in hospitalizations for Texas, but they are well under their maximum number of beds available.  There were over 2000 covid 19 hospitalizations in the past 2 weeks but there are over 31,000 hospital beds in the states.  There is substantial hospital space in Texas so time will tell if the number of serious cases continues to rise.  It is a very good sign that the number of deaths has not increased during this same time period.

Similarly, Florida reported the highest single day number of new cases, 2500.  However, the number of deaths did not increase correspondingly, More importantly, there was not a signficant increase in hospitalizations.

 

 

 

42% of covid 19 deaths were in nursing homes and assisted living facilities

The United States has reported 102,294 deaths from Covid 19 on 5/29/2020.  Each day that passes, more is learned of the virus and how it exactly impacts our society.

A very surprising fact became apparent this week, that was not previously noticed or highlighted..

42% of covid 19 patients were in nursing home or assisted living facilities.  This is an incredible statistic, as the number of patients in these places only account for 0.6% of the total US population.

Nursing homes are residential facilities for those needing 24/7 on-site medical supervision; assisted living facilities are for those not needing 24/7 medical supervision.  An estimated 2.1 million people live in nursing homes and the vast majority (>90%) are over the age of 65.

This finding has many important implications.  First although it has been known for some time that the most at risk group was over 65 with some pre existing conditions, it turns out that being in a nursing home is a significant risk factor.  This means the fatality risk of not being in a nursing home is lower.  Less than 1% of the population accounts for 42% of all covid 19 deaths.

Because nursing homes are remain ‘hot spots’ for covid deaths and cases, it may be difficult for some states or area to achieve mandates such as no covid deaths for a number of days.  The deaths may be limited to within specific nursing homes and not a reflection of areas outside the nursing home.

In addition to maintaining social distancing and handwashing, it remains prudent ot wear a mask if you are around others and most important, elderly in nursing homes and restricted spaces should receive extra care and attention to avoid infection.

In the US, two states, New York and New Jersey and nursing homes have contributed to well over 50% of the covid deaths.  This raises the question regarding the overall effectiveness of general  business shutdowns and stay-at-home policies.  Only additional data and study will be able to sort this all out.

There are an estimate 49 million people in the US over the age of 65.  Over 80% of the US covid 19 deaths are from people over the age of 65.  This would correspond to 81,000 deaths.  This corresponds to a fatality of .2%/million people over 65.

However, the fatality rate of being in a nursing home is 6.76% or 30x higher than not being in a nursing home.

The following presents the percentage of deaths that occurred in nursing homes for all 50 states.  The highest fatility rate was in Minnesota where an incredible 81% of covid deaths occurred in nursing homes and the lowest being NY with 20%.  Interestingly, NY has a low percentage of covid 19 deaths in nursing homes because the number of deaths in NY outside of nursing homes is also the highest in the nation.  This will be discussed in further detail below.

Looking at this another way, nn the basis of covid 19 nursing deaths/million people, New Jersey has the highest with 954 deaths/million and Wyoming is the lowest with 7.  This can be seen in the map below.

Some comments on some key individual states.

Florida

Nursing home and assisted living covid 19 deaths account for almost 40% of the 2400 of the states covid deaths.  There are an estimated 155,000 people living in Florida nursing homes.  This is .07% of the population of Florida accounting for 40% of the deaths.

https://www.clickorlando.com/news/florida/2020/05/09/florida-reports-650-coronavirus-deaths-at-nursing-homes/

California

49% of all Covid 19 deaths in California occurred in nursing homes or assisted living facilities.  387 nursing homes have reported deaths with many of them clustered around Los Angeles.

The highest nursing home death toll in the state remains at Redwood Springs Healthcare Center in Tulare County, where 28 residents have died.

https://www.latimes.com/california/story/2020-05-08/california-coronavirus-deaths-nearly-half-linked-to-elder-care-facilities

Minnesota

In Minnesota, 80% of the covid 19 deaths have occurred in nursing homes and assisted living facilities.  The number of residents in these institutions are less than 1% of the population of Minnesota.

 New York

On May 10, there were an estimated 5300 covid 19 deaths in New York nursing homes and assisted living facilities.  This is almost 3x more than the deaths in the entire state of Florida.  However, so many have died outside of nursing homes (highest in the country), that the percentage of covid 19 in NY nursing homes is one of the lowest in the country.

https://abc7ny.com/nursing-home-deaths-cuomo-criticized-in-new-york/6168676/

The U.S. is not an outlier in terms of its nursing home-related COVID-19 fatalities. A study by researchers at the International Long Term Care Policy Network of fatalities in Austria, Australia, Belgium, Canada, Denmark, France, Germany, Hong Kong, Hungary, Ireland, Israel, Norway, Portugal, Singapore, South Korea, Spain, Sweden, and the United Kingdom found that 40.8 percent of reported COVID-19 fatalities took place in nursing homes.

Final note:  I am NOT trying to downplay the seriousness of Covid 19.  Each death tragic.  However, these discussions are hoped to provide information about the numbers and comments you receive by other means in some context.  Also, it is hoped that this information will lead to better policies, decisions and improved health of our country.

Covid 19. Curve is flattened. Hospitalizations Down!

In March, the public was told that closing of nonessential businesses and stay-at-home orders were necessary to ‘flatten the curve’ for Covid 19 cases and deaths.  Besides saving lives, flattening the curve was thought to be necessary as computer models predicted that our hospitals and emergency rooms would not be able to treat all the people necessary.  Along with stay-at-home orders and mandatory business closures, emergency hospitals were built and Navy hospital ships were dispatched to New York and Los Angeles.

This is a long blog that will provide the basis for the observations:

  1.  The curve of covid 19 cases and deaths has flattened
  2.  Hospitalizations are decreasing and the health system was stretched but not overwhelmed
  3. 7 states that did not have shutdowns and stay-at-home orders continue to have low numbers of covid 19 cases and deaths.
  4. Several states have begun to reopen businesses and there has been no signficant overall increase in cases or deaths

It is critical that people continue to social distance, wash hands regularly and wear masks in crowded areas or in enclosed spaces.

After months of enduring business closures, travel restrictions, stay-at-home orders, and the stoppage of nonemergency medical care,  the ‘curve’ has flattened.  It is difficult to make hard conclusions based on the number of reported cases as the total number of tests are going up daily, so it is difficult to tell if there is an increase in the number of reported cases because more people are getting infected, or if the increases are simply due to running more tests.  However, the number of deaths and hospital utilization are two better assessments of how we are doing against covid 19.

On 5/23/2020, there were 98685 reported US deaths attributed to Covid 19.  Note that this number is an estimate.  Several states have revised their fatality reports to lower the number of deaths due to covid 19.  This was done to separate those patients who actually died from covid 19 from those patients who died for other reasons, but tested positive for covid 19.

A granular look at the data shows that New York and New Jersey account for 41% of these deaths even though they only have 9% of the US population.  They are clearly not behaving like most of the other states.  The states with the 4 highest deaths/million people are:

StateTotal DeathsDeaths/millionPopulation (millions)
New York29112149619.5
New Jersey1108312488.9
Connecticut367510313.6
Massachusetts63049156.0

These 4 states account for 50% of the total US deaths and represent 12% of the population.

It is also reminded that 7 states did not have a statewide ‘lockdown’ and stoppage of businesse.  These states were Arkansas, Iowa, Nebraska, South Dakota, North Dakota, Utah and Wyoming.  All of these states have a low number of cases and mortality rates in comparison with the other states.  These states did close selective activities such as schools, tattoo parlors and gatherings of more than 10.  However, other businesses were allowed to stay open and follow CDC guidelines for social distancing, masks, etc.

There has been no significant increases in deaths or hospitalizations since Georgia, Texas and Florida began their phasing in plans for reopening businesses in the beginning of May.  The following charts shows that overall, the number of daily deaths is decreasing.  The ‘curve’ is definitely flattening.  The reopening of businesses has NOT resulted in an increase in the effects of covid 19.

The 5 states with the highest number of deaths are:

StateDeathsDeaths/million
New York281341446
New Jersey102601155
Massachusetts5705828
Michigan4880489
Pennsylvania4489351
Illinois4129326

There were 7 states that did not have statewide shutdown of nonessential businesses.  These states did shut down schools and limited crowd sizes.  Some selected businesses were shut down, but, by in large, businesses were allowed to decide whether to follow health guidelines and stay open.

StateDeathsDeaths/millionPopulation (millions)Rank Deaths/mil
Arkansas98323.145
Iowa3461103.234
Nebraska123641.936
North Dakota4255.838
South Dakota4450.940
Utah78243.347
Wyoming712.650

There has always been concern that when stay-at-home orders are removed, that there would be an increase in the number of cases, deaths and hospitalizations.  Since Georgia, Texas and Florida began to lift restrictions at the beginning of May, there has not been a general increase in cases, deaths or hospitalizations.

Texas began it first phase of business opening on May 1.  The daily deaths from May 1 to May 14, appear to be about the same as between April 14 and May 1 (before the reopening of business).   As reported in a blog about New York, the distribution of cases through Texas varied greatly.   There are 254 counties in Texas that have reported a total of 1527 deaths on 5/23/2020.  However, like in most states, the covid 19 cases are not evenly distributed around the state.   Three counties (Harris, Tarrant, Dallas accounted for 40% of the cases and 53% of the deaths.  7 counties account for 60% of the deaths. 153 counties have reported fewer than 50 cases and less than 10 deaths.  If you live in Texas, it makes a difference where you live.

Texas has a reported deaths/million value of 46.  This ranks Texas 40th in this category.  (NY is first with 1446 deaths/million).  The following graph indicates that the average deaths/day in Texas has been decreasing for the past week, even as more businesses open.

Florida has reported a total of 2233 deaths.  Like Texas, 3 counties account for 54% of the deaths.  Similarly, the data looks similar for Florida after the beginning of phase 1 opening on May 4.  The following graph shows the 7 day average of deaths/day is the lowest it has been since the early April.  Florida reports a fatality rate of 91 deaths/million.  This ranks Florida 28 out of 50.

It is interesting to compare this data against 3 states who have maintained stay-at-home and business shutdown orders.  These states have announced that they will maintain their stay-at-home orders for another month or more.

StateDeathsDeaths/millionRank deaths/mil
California32088130
Virginia100211722
Arizona6799327

These values are comparable to those states that have begun to reopen businesses.  Again, it is reminded that these are averages for the entire state.  Within each state, there are a few ‘hot spots’ that have a higher number of deaths and there are many more areas which have very few deaths.

Hospitalizations.

The number of covid 19 patients being hospitalized is decreasing in most areas.  It is important to remember that a large factor in issuing mandatory business shutdowns and stay-at-home orders was to avoid overwhelming the healthcare system predicted by computer models.  Fortunately, the models have been largely incorrect.  There have been no reported cases where a patient could not be admitted to a hospital or have access to a ventilator if needed.   Emergency hospitals set up in New York, Louisana, and California were essentially not needed.  The hospital ships USN Comfort in New York and USN Mercy in Los Angeles received very few patients.

At the current levels, even if there is a modest increase in cases due to business reopening., there appears to be sufficient available space in hospitals.

Early assessment of business reopenings.  The early indications are that there has not been a significant increase in the number of cases, deaths or hospitalizations in Georgia, Texas and Florida.  Those 7 states that did not have business shutdowns or stay-at-home orders continue to exhibit low numbers of infections and deaths.

In each of these states, there are definitely ‘hot spots’ that still have high numbers of infections and deaths, but the majority of the states seem to have decreasing number of cases and deaths.  How these states are managed will determine the success reopening.  Each state must establish a plan that reflects the level of infection and fatalities of local areas.  This means that not all parts of each state will be operating under the same guidelines.   ‘Hot spots’ must be reopened more carefully and monitoring will be key.

When businesses open, it will be the people that determine the success of reopening.

People must maintain social distancing.

People must continue to wash their hands regularly.

If you are feeling sick, don’t go out or go to work and don’t; come into contact with anyone.

Wear a mask if you are an enclosed space particularly if you can not maintain social distancing at all times.

The indications are that businesses can safely open if people remain vigilant and follow the guidelines.

The ‘curve’ has been flattened and the hospitals are not overwhelmed.  Given that these were goals of the shutdown, business reopening should begin cautiously and the people must be responsible for their own actions.

 

 

 

Reopen Businesses – What should the new ‘normal’ be?

Returning to normal…but what’s normal?

As the nation and the world turns toward reopening the world to business, there has been a lot discussion of whether we could ‘return to normal’, but what does that mean exactly and how do we know when get back to normal?  We have lived with numerous causes of death that are higher in number than we are seeing for Covid, yet we did not shut down our country for any of these other causes.  In other words, we accepted as ‘life’ that there are many things cause death but we continue to go through life without stopping.

We should not have to complete end or stop Covid 19 before we ‘return to normal’. ‘Norma’l includes yearly deaths many times that caused by Covid 19.

We get daily briefings and headlines about Covid new cases and new deaths from the US and around the world.  To date (April 27, 2020) there have been 1,004,942 Covid 19 cases and 56,527 deaths.  However, the view of the number of actual cases has drastically changed in the last week.  The availability of antibody tests, which can determine if someone has been infected, has resulted in several reports that the actual number of people that were infected may be somewhere between 16 to 80X higher than this value (up to 21% of the population).  This means the actual number of Covid 19 cases may in the range of 16,000,000 to 80,000,000.  This makes the fatality rate between .34 and .07%.  This is in the range of the seasonal flu. New York: Nearly 3 million infections – not 276,000

The early concern over Covid 19, which caused the nationwide lockdown were basically two concerns. The first was the seemingly high fatality rate which was generally reported to be between 5 and 10% back in March.  The second was the concern that the number of infected patients would overwhelm our health and hospital systems, and whether we could treat everyone who needed help.

As it turns out now, fortunately, neither of those concerns happened.  The fatality rate is most likely be well under 1% and may be in the range of the seasonal flu.  There was not one city, including the hottest spot, New York where there was a shortage of beds, intensive care units or ventilators.

The shelter in place and closing of businesses undoubtedly helped to slow the spread of the virus, but perhaps not as much as we previously thought.  Before antibody testing, we were operating under the fact the 1 million people had been infected.  In a country of 370 million, this would seem to say that the lockdown was very effective.  However, the antibody testing now suggests that the number of people infected may be as much as 80 million!  This means that the lockdown was not nearly effective as we thought.  It also means that the vast majority of those who were infected did not need hospital care and had no or minor symptoms.

As plans are being considered to how reopen America’s business, the question is what state of health are we going to return to or accept?

To try and answer this question, it is useful to examine the top 10 causes of death in the US in 2018.  The CDC reports:

CauseDeathsDeaths/100,000
Accidents1671,2748
Alzheimer's122,01931
Cancer599,274149
Diabetes8494621
Heart Disease655,381164
Kidney52,38613
Lower Respiratory (COPD)159,48640
Seasonal Flu5912015
Suicide48,3449
Covid 19 4/27/202056,527*15*
  • Covid 19 Numbers still increasing, but rate of increase has slowed

Note that as a society, we did not shut down our businesses or go into lockdown over these numbers.  In particular, it interesting to note that in the 2018 season, flu claimed more lives than Covid 19 has caused to date (although Covid 19 is sure to increase further).  We also did not stop driving cars even though over 100,000 per year die from car accidents.

It would seem reasonable that if Covid 19 statistics could be brought into line with these other causes of death that we would be back to ‘normal’.

A key factor to consider is that Covid was much more fatal to those over 65.  Currently 79% of the Covid 19 deaths were in people over the age of 65.  The 65 and older group represents just 16% of the population.  The data strongly suggests that those over 65 may suffer more fatalities.  The younger you are, the less likely that Covid will be fatal, even if you get infected.

When businesses open up, both businesses and individuals may have different behaviors depending on the age of the people involved.

Although, there has been a long and strong voicing that Covid 19 is not the flu, it acts more and more like a flu the more we study it.  It has been thought that Covid 19 was more contagious than the flu, but the recent finding that the number of infections known may be off by many millions, it is not clear how much more contagious it is.  As I always state, comparing Covid 19 to the flu is NOT downplaying the seriousness of Covid 19 – instead it is a reminder that the seasonal flu has always been deadly (25,000-60000 fatalities a season and up to 60 million infections) and will continue to be so.

I will discuss vaccines in an upcoming blog, but it is critical to note that the data regarding the seasonal flu is WITH an annual vaccine.  There is no current vaccine for Covid 19, so Covid 19 statistics should look much better once a vaccine is found.  However, it is very important to know that the seasonal flu vaccine does NOT always work well.  The effective of the seasonal flu vaccine has varied from 10 to 50% depending on the year.  Hopefully, the Covid 19 vaccine will perform much better.

Covid 19 Tests: What we can and can’t say.