The co-director of Stanford University’s Meta-Research Innovation Center, John P.A. Ioannidis, wrote in an opinion piece this week a warning to Americans that participating in voluntary shutdowns and allowing the government to set curfews and manipulate the free market before dependable data collected could be a mistake.
The professor of medicine, population health, statistics, biomedical data science, and epidemiology described the the current collection of data as “utterly unreliable” due to the inability to test everyone who had potentially been infected.
Ioannidis said that coronavirus may be a “once-in-a-century evidence fiasco”.
Admitting that social distancing and lockdowns may be initially sowing the spread of the virus, he questions how feasible it is to maintain these restrictions as part of a long term plan.
Ioannidis also inquired how politicians will be able to report on the impact of the restrictions and determine when to restore economic freedom.
States are prioritizing tests differently, and Ioannidis described how data collected in such a manner provides “meaningless” results.
The professor of medicine went on to say: “Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.”
Daily Wire reported on the article.
Ioannidis then zooms in on the “one situation” where “an entire, closed population was tested”: the Diamond Princess cruise ship’s quarantined passengers. While the fatality rate was 1.0%, he points out, the population was largely elderly, the most at-risk demographic. Projected out onto the age structure of the U.S. population, he calculates, the death rate is more like 0.125%, with a range of 0.025% to 0.625% based on the sample size:
Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.
“That huge range markedly affects how severe the pandemic is and what should be done,” Ioannidis stresses. “A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”
Ioannidis claimed that the coronavirus is responsible for many deaths in America every year, but it is usually found in elderly patients suffering from several respiratory infections, so precise testing is a low priority.
Every day, more states extend their reach into the economy, shutting down services, businesses, and in some areas, making it impossible for a business to remain open.
As plants increase the production of tests, and companies like Quest Diagnostics can increase their staff, the wait for results should be reduced dramatically this week, providing better data for the public and policymakers.