Guest Post by Willis Eschenbach
OK, here are my questions. We had a perfect petri-dish coronavirus disease (COVID-19) experiment with the cruise ship “Diamond Princess”. That’s the cruise ship that ended up in quarantine for a number of weeks after a number of people tested positive for the coronavirus. I got to wondering what the outcome of the experiment was.
So I dug around and found an analysis of the situation, with the catchy title of Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship (PDF), so I could see what the outcomes were.
As you might imagine, before they knew it was a problem, the epidemic raged on the ship, with infected crew members cooking and cleaning for the guests, people all eating together, close living quarters, lots of social interaction, and a generally older population. Seems like a perfect situation for an overwhelming majority of the passengers to become infected.
And despite that, some 83% (82.7% – 83.9%) of the passengers never got the disease at all … why?
Let me start by looking at the age distribution of the Diamond Princess, along with the equivalent age distribution for the entire US.
Figure 1. Number of passengers by age group on the Diamond Princess (solid) and expected number of passengers given current US population percentages (hatched).
When as a young man I lived in a port town with cruise ships calling, we used to describe the passengers as “newlyweds and nearlydeads”. Hmmm … through some improbable series of misunderstandings and coincidences, I’m in the orange zone now … but I digress …
In any case, Figure 1 shows the preponderance of … mmm … I’ll call them “folks of a certain distinguished age” on the Diamond Princess. Folks you’d expect to be hit by diseases.
Next, here’s the breakdown of how many people didn’t get the virus, by age group:
Figure 2. Percentage of unaffected passengers on the Diamond Princess. “Whiskers” on the plot show the uncertainty of each percentage.
In addition to the low rate of disease incidence (83% didn’t get it), the curious part of Figure 2 for me is that there’s not a whole lot of difference between young and old passengers in terms of how many didn’t get coronavirus. For example, sixty to sixty-nine-year-old passengers stayed healthier than teenagers. And three-quarters of the oldest group, those over eighty, didn’t get the virus. Go figure. Buncha virus resistant old geezers, I guess …
Next, slightly less than half the passengers (48.6% ± 2.0%) who got the disease showed NO symptoms. If this disease is so dangerous, how come half the people who got it showed no symptoms at all? Here’s the breakdown by age:
Figure 3. Percentage of Diamond Princess passengers who had coronavirus but were symptom-free. There was only one illness among the youngest group, and they were symptom-free. As in Figure 2, the “whiskers” on each bar of the graph show the uncertainty.
Again, a curious distribution. Young and old were more likely to be symptom-free, while people in their 20s, 30s, and 40s were more likely to show symptoms. Who knew?
There were a total of 7 deaths among those on board. All of them were in people over seventy. So even though the generally young were more likely to show symptoms if they had it, it hits old people the hardest.
Finally, according to the study, the age-adjusted infection fatality rate was 1.2% (0.38%–2.7%). Note the wide uncertainty range, due to the small number of deaths.
For me, this is all good news. 83% of the people on the ship didn’t get it, despite perfect conditions for transmission. If you get it, you have about a 50/50 chance of showing no symptoms at all. And the fatality rate is lower than the earlier estimates of 2% or above.
It is particularly valuable to know that about half the cases are asymptomatic. It lets us adjust a mortality rate calculated from observations, since half of the cases are symptom-free and likely unobserved. It also gives a better idea of how many cases there are in a given population.
To close out, I took a look at the current state of play of total coronavirus deaths in a few selected countries. Figure 4 shows that result.
Figure 4. Deaths from coronavirus in four countries. Note that the scale is logarithmic, so an exponential growth rate plots as a straight line. Blue scale on right shows the deaths as a percentage of the total population.
At this point at least, it doesn’t appear that we are following the Italian trajectory. However … it’s still early days.
Finally, a plea for proportion. US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three … meanwhile, 3,100 people die in US traffic accidents … and that’s not 3,100 once in a decade, or 3,100 per year.
That’s 3,100 dead from auto accidents EACH AND EVERY MONTH … proportion …
My best to all on a day with both sun and rain here, what’s not to like?
w.
As Always: When you comment please quote the exact words you are referring to, so we can all understand who and what you are discussing.
Terminology: Yes, I know that the virus is now called 2019-nCoV, that it stands for 2019 novel CoronaVirus, and that the disease is called Covid-19, and that it stands for COronaVIrus Disease 2019 … so sue me. I write to be understood.
Data: For those interested in getting the data off the web using the computer language R, see the method I used here.
Other Data: A big hat tip to Stephen Mosher for alerting me to this site, where you can model epidemics to your heart’s content … Mosh splits his working time between Seoul and Beijing, he’s in the heart of the epidemic seeing it up close and personal, and he knows more about it than most.
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It is hard to say how many had the disease on the ship. Some could of had it, then recovered quickly, and then tested after recovery. The test would then show up negative.
There is a hypothesis that might explain the age distribution.
That we have had one like this some years ago, without knowing it, and old people have still got partial immunity. Until they are so old that their immune systems are compromised.
Babies still carry immunity from parents and in any case are less socially interactive. Young fully active people are the most socially mobile, and have less immunity.
As I say, just a hypothesis, but the fact is some people get it and have almost no symptoms at all.
“As I say, just a hypothesis, but the fact is some people get it and have almost no symptoms at all.” That seems quite in line what a friend of mine, a veterinarian, with over 30 years on the job, has told me. When you are in contact with a family of viruses, as veterinarians often are, there is more than a fair chance that there is some sort of side immunity, which may be the reason why this virus is recognized by the immune system as somehow unfriendly and triggers a response.
So if you have pets like cats or dogs mainly, as carriers of corona virus family members, your immune system becomes more robust.
I note that the number of deaths aboard the cruise ship is low – so any small amendment will have a large effect on the percentage.
That said, has there been a correction for deaths expected from natural causes? There are regular deaths on board cruise ships – in fact, there’s a special web site tracking them https://www.cruiseshipdeaths.com but I can’t see how to get an average out of it…..
I calculated the number of deaths to be expected in a month in the absence of covid-19 based on the passenger count by age group on the ship from https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf and the Social Security life tables for death rate by age from https://www.ssa.gov/oact/STATS/table4c6.html , and got 6.5, with a standard deviation of 0.7. That’s not significantly different from the 7 actual deaths. Calculation is here: https://docs.google.com/spreadsheets/d/17hBCRj6CTN_dsUyFpDMulzwhoP9x1eXbosHO3YAEprw/edit?usp=sharing . I think this is really important, and I would appreciate it if someone would check my calculation.
https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-by-air-land-sea/cruise-ship-travel says the death rate for cruise ship passengers is 0.6 to 9.8 deaths per million passenger-nights. There were 3700*30 passenger nights on the diamond princess. So even at the high end, only 3700*30/1e6*9.8 = ~1 death was to be expected. So never mind.
The Diamond Princess spends all her time on sea water.On the open ocean or moored off shore,passengers are exposed to sea or ocean air. Could this exposure provide lungs with a degree of protection? Does ozone have an impact?
I am not a fan of conspiracy theories.
However, believing the virus “jumped” abruptly from a bat to a poor Chinese guy on a seafood market is a nonsense. Chinese eat bats raw since 10,000 years.
And this should happen in Wuhan. 600 km away from any bat, but at the very center of the virology research in China.
I put here a list of references. Not any dubious CT sites.
Rather, these are Nature, NYT and like these:
1. https://en.wikipedia.org/wiki/SHC014-CoV
2015:
2. https://www.nature.com/articles/nm.3985.pdf?origin=ppub
A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence
2015:
3. https://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research-1.18787
Although the extent of any risk is difficult to assess, Simon Wain-Hobson, a virologist at the Pasteur Institute in Paris, points out that the researchers have created a novel virus that “grows remarkably well” in human cells. “If the virus escaped, nobody could predict the trajectory,” he says.
4. Aug. 5, 2019:
https://www.nytimes.com/2019/08/05/health/germs-fort-detrick-biohazard.html
5. August-September 2019:
“Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products”:
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
Emergency department (ED) visits related to e-cigarette, or vaping, products continue to decline, after sharply increasing in August 2019 and peaking in September.
6. 18. Okt. 2019 – 27. Okt. 2019:
https://en.wikipedia.org/wiki/2019_Military_World_Games
7. 24. November 2019:
https://www.military.com/daily-news/2019/11/24/cdc-inspection-findings-reveal-more-about-fort-detrick-research-suspension.html
8. 27. November 2019
The first identified COVID-19 Chinese victim
Has never been to the seafood market.
Strange story.
Regarding the older passenger aged between 80 and 95, I am 93 13.3.27, we were the pre anti biotic times. Is it posible that we have already exerienced such virusus before and are now imune.
It seems likely that social media and politicians like a pamic, from which they can then “Sav e us”
that it is no worse that a bad case of the usual flue season, and best to let it go through the community, and let things gs return to normal.
When noting deaths, we should also compare e these figures wit what on e can expect in “Normal times””
VK5ELL MJE
Stay well, bro’, the world needs more geezers like you and me.
H44WE w.
Important note I would like to share. French health officials are warning about using fever reducers with covid.
https://www.google.com/amp/s/amp.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection
Identified as fake news.
Forget it!
Or not.
https://www.dailymail.co.uk/news/article-8121255/NHS-no-longer-advises-coronavirus-patients-ibuprofen.html
We have an anti fake news law now. I hope our own gov isn’t violating it right now!
I agree with the doctor, but not for the reason he mentions, i.e., Ibuprofen suppresses immune system. The very thing he recommends – acetaminophen – suppresses the immune system by depleting glutathione. Ibuprofen is bad because it increases ACE2 expression in the lungs.
And another thing, anti-imflammatories are typically prescribed for this infection to tone down the immune response, so the doctor’s reasoning makes no sense.
Thanks for insightful article Willis.
However, unless we take steps such as social separation, the disease will continue to spread until at least 50% of the population have been infected with subsequent immunity. As long as the R0 is above 1.0, the number of infected will grow. Even if the morality is as low as 1%, the number of deaths will be horrible high.
The only way to stop it before we have vaccines or effective antiviral drugs is to take steps to reduce the R0 to below 1.0.
We can hope for the best, but we have to take actions, and we have to follow the advises from the government.
/Jan
Indeed, Jan. I support social distancing, hand washing, all the usual precautions.
I suspect we will have both a cure and a vaccine before too long … if I get it, I’m taking zinc and chloroquine.
Stay well,
w.
Running? I thought you had an obesity problem over there?
Tonyb
What? Do you Insinuante that Europe has a worse obesity problem than the US?
Do you get chloroquine without prescription over there, or do you have to visit a doctor and simulate Malaria to get some?
/Jan
No idea, Jan, never bought it anywhere but in the tropics … ok, a bit of research shows that yes, you need a prescription. I reckon my Dr. would write me one, he’s known me for forty years …
w.
I just wonder what the effect of salt in the air on a cruise ship is? Salt seems to have a fairly good record as a preservative…….
The SARS virus rapidly loses its ability to stay stable on surfaces when temperature increases and relative humidity increases. For the life of me I don’t understand why government is not telling businesses to increase temperature and humidity their buildings.
Study:
https://www.hindawi.com/journals/av/2011/734690/
Common sense – that seems quite rare today – would suggest that it would be far easier to try to isolate those who are 60 and older with other medical conditions and their carers. This is a relative small percentage of all people. Then having fairly strict measures to limit the movement and contact of the rest of people over 60 for say a couple of months.
The rest of the population can continue with normal contact excluding those who have medical conditions that makes them vulnerable. There are some serious logistical problems like hospitals and caring homes and keeping these people supplied and cared for during isolation. However, continually keeping everyone apart at two arms length and not allowing contact with surfaces that are not continually being cleaned appears a complete impossibility. The economic damage is also likely to hurt the health and welfare of far more people.
I wonder if the virus were allowed to move quickly through the healthy and under 60 population that we would find far less deaths among the total population, far less economic damage and a significantly reduced period of disruption? I hope some doctor/biologist can address these matters on this site.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
You can play with the numbers to get your own estimates. They have them for the critical variables. Its a pretty simple model. If they are right, Willis’ forecast is way, way optimistic.
In some ways, they want to kill the patient so they can save him.
look at the R0 ,it starts at 2 and goes up to 2. 6 when Wuhan was 2.54. look at social habits such as spitting. Italy had a R0 of 1.7 . USA and NW Europe will have R 0 of less than 1.7. Also large numbers of people in Wuhan will have become ill with the virus very early on. It is likely large numbers in Wuhan became infected at the beginning and so with a R) of 2.54 the total numbers increased rapidly. Also many may have had poor health . Consequently, Willi’s approach makes sense .
Adding to my previous comment:
If – according to Dr Birx – the virus not appearing in 99% of people who are sick, this means the US has shut down the biggest economic system in the world for a virus that is not appearing in 99% of the people who are sick. Truly disturbing but I doubt the media, politicians and many medical people who have fanned the flames of the virus alarm will ever be held accountable for the huge economic damage they have caused. This is not unlike those promoting climate alarm.
So far, in the United States, from LabCorp and Quest, they’re running about a 99 to 98 percent negativity.
https://m.youtube.com/watch?v=bpE2NijA5tQ
Dr Wodarg is a retired German public health official, a former MP, a pulmonologist and epidemiologist. Whas he has to say about statistcs, databases etc. concerning Corona is worrying. We are being mislead by scientists and politicians craving for public attention. Activate subtitles unless you are fluent in German, please.
He may be right about everything. He’s certainly correct that this “crisis” has created conditions for a power and money grab that is short on rationality.
Thank you for some sensible medical information.
Douglas Altman, † 2018, waged a long-running campaign to improve the use of statistics in medical research. A professor of statistics in medicine at the University of Oxford, in 1998 Altman described the problem: “The majority of statistical analyses are performed by people with an inadequate understanding of statistical methods. They are then peer reviewed by people who are generally no more knowledgeable. Sadly, much research may benefit researchers rather more than patients, especially when it is carried out primarily as a ridiculous career necessity.”
This problem continues today. A leading biologist, I know well, recently told me about the link between funding and how researchers distort and lie to obtain support. I have also had many conversations with an engineer who is deeply disconcerted by the way media, politicians and many medical people are spinning with statistics. To adapt the phrase
There are three kinds of lies: Lies, damned lies and coronavirus statistics
Just discovered Dr Wodarg’s lecture Lösung des Corona-Problems: Panikmacher isolieren i.e. Corona problem solved: Isolate panic makers.
It is short but only in German.
https://www.wodarg.com/vortr%C3%A4ge/
Someone listed three simple steps to deal with the virus:
1. Wash your hands regularly
2. Do not go outside if you are feeling sick
3. Do not watch CNN 🙂
All of the cases from the cruise ship were intensively treated. If these numbers scale up on a national scale the no. of symptomatic cases in just the UK will still be over 5 million. The death rate will be higher than the implied 264 k in the UK because the health infrastructure will be unable to cope with the sudden exponential rise in demand.
Get in before the rush or don’t get it at all……
Willis..thank you again. Always enjoy your take, and personal excursions.
I may have missed it in your acticle or comments, but hasn’t the accuracy of tests has been an issue. Would knowledge of test accuracy change your assessments?
I thought there was an issue of the EU tests with high false positives. Wouldn’t that reduce the “has virus, but
no symptoms” grouping?
Thanks again, and keep safe
I had just sent the following opinion letter to our local paper when I took a look at your commentary. It doesn’t address the cruise ship directly, but it does support the attitude, which I think you share, that we need to maintain a critical look at the effects of our response to the situation.
The current strategy of “social distancing” will not stop the spread of the corona virus, but we hope that it will slow it down enough to buy time for organizing medical facilities and developing effective treatments. That it will thus save lives would seem to be an unanswerable argument for pursuing this strategy.
But we face other existential threats than the corona virus. From the CDC website:
“Suicide…was responsible for more than 47,000 deaths in 2017…In 2017, 10.6 million American adults seriously thought about suicide, 3.2 million made a plan, and 1.4 million attempted suicide.”
It is clear that many of us are living on the edge. The current strategy of alarm, social disruption, and economic chaos may well push significant numbers over the cliff. Epidemiologists and political leaders should pay attention to the effects of “social distancing” on this at-risk population.
From the report …. (asymptomatic cases were either self-assessed or tested positive before symptom onset)
“tested positive before symptom onset” is not the same thing as asymptomatic. How many people who tested positive LATER showed symptoms?
Thanks for this very informative post.
Indeed, there are data that do not add up.
Compare France and Germany with respect to the ratio :
r = (deaths + Serious cases) / total known cases.
r(France) = 8.26%
r(Germany) = 0.276%
Knowing that France and Germany have quite similar healthcare indexes there is a Big discrepancy between the two.
Someone is wrong somewhere.
Yes, something is amiss.
Let’s assume that they know how to tell if a patient is dead or not. Then, perhaps the testing for the virus could be wrong.
The French have an entirely different culture of greeting. In Germany, a handshake and that’s that. The French, even adults, embrace each other and it is quite common to kiss each other on the cheek.
This does not change the ratio (see my post) and the declared cases are in the same range.
In France, by custom, we kiss (on fait la bise) 2, 3, or 4 times according to the region.
By now, not so much.
Non Nomen
The same applies to the Italians who in addition are very family oriented with frequent tactile contact at get togethers encompassing several generations, many of who might be infected but don’t realise and pass on the virus to the older generations .
This is different to Anglo nations who on the whole are more stand offish and do not hug kiss or embrace even strangers
tonyb
it might be the way tests are being carried out. If France, say, were restricting testing to just those presenting at hospital while German tests included a large proportion of the less severe cases that could go some way towards explaining the discrepancy.
I’d take some of the numbers with a pinch of salt at the moment. All countries have a lot more cases than the figures published. The UK probably has 50k cases at the moment while the figure from tests is less than 2k. This is good, in a sense, since it reduces the fatality rate.
Hi Willis,
Thanks for this data, very interesting. However, I interpret them somewhat differently than you do. The reason is your assumption that transmission conditions were ideal. They were not. Cruise companies have great experience with viral infections like Norovirus and know precisely what to do. I bet the crew has been following a protocol based on long and informed experience.
What happened on the ship was that the moment it was clear the a virus was going around they imposed a lock down, strictly confining passengers to their cabin. We saw them on the news complaining about it, not understanding. But that stopped the transmission conditions from being ideal to pretty tough from the virus’ point of view. The large percentage of passengers not getting infected does not reflect their susceptibility but the success of the lock down protocol.
Now that should be considered good news too.
There were communication failures that led to long delays before any action was taken. In one case, notification that a Hong Kong passenger tested positive for the virus was not even read for 72 hours and this was in addition to the time that it took for the test results to come back, which was several days on top of that.
Cruise companies may have good protocols but unless they follow them, there is no effect. In addition, a link above concerns a virologist that went on board and who described the conditions on the ship as frightful.
In retrospect, this is good news.
6 people died out of 3700 on a cruise ship where they would have been subject to repeated contamination and where 32% are over 70 years of age of which 5.4 % are over 80 years of age. This is death rate of 0.16%. The flu epidemics of 1957 and 1968-9 are likely to be worse. How many days were people on the ship before quarantine started ? Everyone was probably infected or every surface waws contaminated. The virus last 9 days on plastic and 4-5 days on wood and metal.
The R0 figure is how many are infected by a single person. The peak at Wuhan was 2.54, it is now 0.34 and in Italy it was 1.7. How does this compare with flu. it would be interesting to look at flu deaths since 1945.
It was 7 people dead and about a dozen still in IC. Still, not like what happened in Wuhan.
It could be that a more virulent strain is dying with the dead people it kills.
Ed
Nice theory and well argued but bearing in mind the number who come down with such as noravirus I am not sure their systems are as good you say
tonyb
Ed Zuiderwijk March 17, 2020 at 6:21 am
Thanks, Ed, but a Japanese epidemic expert who actually visited the ship and says the exact opposite. He said he’s worked with lots of epidemic diseases and this was the first time he felt he might catch one.
w.
Really great work Willis. Thank you.
Thanks, Jeff, on my planet your approval is valued.
w.
Re: Occult Transmission
The China strategy was to “chop off” the curve by brute force…rather than heading slowly into “herd immunity” status (as is usually done for influenza).
As I think about that, the claim that a significant number of infections result from transmission from asymptomatic carriers cannot be true…or it must be rare.
If significant numbers of occult carriers were constantly “at large” in China, outbreaks would pop up all over the place. Total population quarantine would be required to prevent those “occult” infections. Quarantine WAS required in China for whole families when any family member showed signs of illness including fever (which was measured on all workers daily). But a general quarantine has not been in place.
“Chopping Off” the Curve prevents herd immunity from developing (at least very quickly), so China is still vulnerable to the resumption of the epidemic…too few have immunity.
The UK appears to be aiming for herd immunity. That is probably going to horribly overtax the hospitals in the next 3-4 weeks. But afterwards, the population becomes immunized…without a vaccine. They are trying to isolate those over 65 (as we are in the US), so that should help a lot toward preventing overwhelming the system, but this elderly (UK & USA) will have to remain isolated until herd immunity is established or until we have a vaccine. The UK should have herd immunity in 12 weeks…the US in a year if we stay locked down.
It appears that the US is “locking things down” tightly enough to keep from overtaxing the system. However that prevents herd immunity from developing sooner than about a year out. So widespread immunity will ultimately depend having an effective vaccine soon…and “soon” also won’t happen before the year is out.
We have a precedent, an infectious disease much more transmissible than the Wuhan virus: measles.
With no vaccination, we had the horror of 1 death for 25000 persons and a few proportion of cases were serious: most cases were young and at that age it’s almost never serious.
With mass vaccination, the proportion of cases that are very serious increased greatly.
(That data provided to you by the heath authorities aka provax people.)
niceguy, STOP WITH THE ANTI VAXX COMMENTS!!!! This post is about the Diamond Princess. I warned you about this already.
If you continue, I will personally do something I never do. I will simply snip anything about vaccination out of your posts. I don’t like doing that, but you remind me of the mule in the story.
TL;DR version: You are more than welcome to comment about anything else. But if you comment any more about vaccination, on this or any of my posts, I’m gonna have to get out my 2×4 …
w.
You are unhinged.
The moderators need to do something about you. I have warned you before.
Stop promoting unproven dangerous drugs.
Stop attacking me.
Stop the insults.
Just take some calming pills.
(Stop derailing the topic!) SUNMOD
Willis, he’s a proven idiot; do as you see fit (preferably a ban, IMO).
SNIP – take your vaccine rants, questions, ideas, and soliloquies elsewhere, thanks.
w.
You are a bunch of pathetic bullies. This website is crap.
niceguy March 18, 2020 at 10:05 am
If so, then surely you should stop posting here. You should take your brilliant thoughts, like say your genius claim that polio vaccine had nothing to with polio eradiation worldwide, to some other website where your fantastically insightful ideas might find some agreement, no?
You’re welcome to do that, you know … in fact, I’d go so far as to encourage you to do so.
Regards,
w.
“If so, then surely you should stop posting here”
FREE SPEECH
Therefore, be it RESOLVED, that ng be “voted off the island” on the grounds of absolutely no redeeming value, social or otherwise, on a permanent basis.
SNIP – I told you, NO MORE DISCUSSING VACCINES FOR YOU!
w.
(Snipped) SUNMOD
niceguy March 17, 2020 at 4:36 pm
Ah, yes, I am so humiliated. I cover myself with sackcloth and ashes.
w.
SNIP – No discussion of vaccines, either pro or con.
w.
SNIP – You’re a slow learner, aren’t you? Pick another topic, any other topic.
w.
No thug. YOU ARE A SLOW LEARNER.
I want your excuses.
SNIP – Was I somehow unclear? Leave vaccination along and post about something, anything, els.
w.
“STOP WITH THE ANTI VAXX COMMENTS”
What comment?
My comment disappeared or maybe I didn’t hit send. All I wrote though was very nice work Willis, this helps very much.
Thank you.
Variable susceptibility: some may have been immune due to having fought off another virus earlier in life.
7 people out of 3711 died. That’s a mortality rate of 0.001886
…
There are over 300 million people in the USA.
…
300,000,000 * 0.001886 = 565,885
…
Oh, and don’t forget that there are less than 70,000 ICU beds in the USA
That’s not a like for like situation as 300 million Americans are not locked up in a small room being infected by people serving them food
tonyb
Correct, half of the 300 million people are running around infecting each other.
As has been said often on WUWT, cold weather kills more often than hot weather. I would suggest that an economic downturn is more dangerous to more people than the corona virus.