Has the world overreacted to Covid-19?

Covid-19 has brought to the forefront a little-known medical phenomenon called a cytokine storm, when a person’s body overreacts to a virulent invader, say the novel coronavirus, and the immune response goes into overdrive, inadvertently attacking its own cells.

In many cases, this leads to death.

I can’t help but draw a parallel between this and what we’ve done as a global community. Have our drastic containment efforts, i.e. nationwide lockdowns and shuttering the economy, caused more harm to ourselves than the virus would have done on its own?

The latest data seems to suggest that this could well be the case.

In a groundbreaking pilot study just this past week, Dr Jay Bhattacharya, a professor of medicine at Stanford University, performed antibody tests for 3,330 people in Santa Clara County in California, US, and found that Covid-19 was 50 to 85 times more prevalent in the community than official data indicates.

While it may sound horrible, it’s actually good news. It means that far fewer people die of the virus than official data suggests; and it indicates that we’ve been grossly overestimating how fatal Covid-19 is.

His study puts the infection fatality rate (IFR) at a lot less intimidating 0.1% – 0.2%, which places it “somewhere between ‘little worse than the flu’ to ‘twice as bad as the flu’ in terms of case fatality rate,” Bhattacharya says.

This flies in the face of official data that indicates that the infection fatality rate of Covid-19 is anywhere between 1% and 8%, depending on the country, with the global fatality rate being in the 3% range.

This entirely changes the game. We would act very differently if a virus only killed one in a thousand as opposed to three in a hundred, as previously thought. Dr Bhattacharya’s work is spurring researchers from many parts of the world to perform similar studies.

The fact is, the number of infected people – whether in Malaysia or the rest of the world – is not accurate. Scientists think the actual figure could be about 10 times more.

For instance, epidemiologist Trevor Bedford of Seattle’s Fred Hutchinson Cancer Research Center says, while “estimating the total number of infections is difficult without serology… I’d guess that we’re catching between one in 10 to one in 20 infections as a confirmed case”.

Professor Neil Ferguson of Imperial College said in February that China might have detected only around 10% or less of its coronavirus cases.

Scientists say that some people could be infected by the novel coronavirus yet show no signs of the disease.

Sergio Romagnani, professor of clinical immunology at the University of Florence, for instance, says blanket testing at a village called Vo Euganeo near Venice, which was isolated by the authorities following Covid-19 cases, showed that 50%-75% of the people were asymptomatic but were capable of infecting others.

China’s National Health Commission says 130 of 166 new infections, or 78%, identified within a period of 24 hours on April 1 were asymptomatic.

What about Malaysia? Universiti Sains Malaysia epidemiologist Associate Professor Dr Kamarul Imran Musa thinks the actual number of Covid-19 cases is four to 10 times more than the confirmed cases.

Another factor to be considered is that testing is not widespread in most nations, including Malaysia.

In addition to the above factors, it’s important to keep in mind that the world does not yet have a Covid-19 vaccine, unlike the flu. The novel coronavirus is capable of wreaking more havoc, as it already has, and it is also two to three times as contagious as the flu, infecting many more people and in a much shorter time.

This is why many were rightfully worried about healthcare systems being overwhelmed and why it’s crucial that we “flatten the curve.”

For perspective, since September 2019, the flu has killed about 22,000 people in the US while Covid-19 has killed close to double that as of now. While any death is one death too many, Covid-19 certainly does not seem like the global calamity many at first believed, or would have us believe.

Professor Ferguson, the author of the widely cited Imperial College study that is said to have greatly influenced the British and American containment policies, and subsequently the rest of the world, says two thirds of those who die of Covid-19 in the next few months would have died by the end of the year anyway.

This is because the vast majority who succumb to the virus are either old or seriously ill and would have died of some other cause nonetheless. In a situation like this, it makes more sense to not merely look at the number of deaths but rather the loss of productive life.

Losing someone who has, say, 30 years of productive life would be a bigger tragedy – from a societal and mountaintop view – than losing someone who has less than one. But since we don’t tabulate data in such a nuanced way, we don’t get a complete picture of the situation.

This is borne out in the data from Italy where 99% of those who died had other illnesses and their average age at time of death was 79.5. This is in a country where the average life expectancy is 83.

A more accurate way of viewing the situation would be to think of Covid-19 as merely nudging them over the edge that they were inching towards anyway. This is just to state the facts: it does not mean that a single life is unimportant or that the old can be allowed to die. I know that for those who lose a family member, it is the greatest of tragedies.

Meanwhile in the US, the data initially suggested that things were going to get so bad that at peak load, they would need around 40,000 lifesaving ventilators in New York alone and many times more nationwide. This would have resulted in a severe shortage as they only had 172,700 ventilators to go around.

This caused a mad scramble by both the US and UK governments to get their manufacturing powerhouses to start producing ventilators. However, the peak is said to have come and gone in the US and they only needed 14,407 ventilators nationally, which is way below what was predicted.

Michael Levitt, a Nobel laureate and Stanford biophysicist, says: “What we need is to control the panic,” and that in the grand scheme, “we’re going to be fine”. He adds: “The real situation is not nearly as terrible as they make it out to be”.

Unfortunately, due to flawed predictions and the subsequent mass panic which resulted in governments bringing their countries to a standstill, we might have just released a global cytokine-like storm that will end up causing economies to go into freefall and ruin the livelihood of millions. - FMT