Flashback: Why Birx' warning to media on COVID-19 mortality rate matters more today

Saturday’s briefing was not the first time Dr. Deborah Birx has made this argument, but it takes on even more significance after seeing the antibody-study data from New York City. Birx emphasized the need to calculate population into death figures from the COVID-19 outbreaks to properly assess both the disease’s actual mortality rate and the effectiveness of a national/regional response to it. In this presentation, Birx noted that we had a lower mortality rate than six out of the ten nations dealing with major outbreaks — and China and Iran’s better rates are questionable, at best.

“Does anyone really believe those numbers?” Donald Trump asked about China’s reported death rate:

Trump also implied that Iran’s numbers were not to be trusted at the beginning of the briefing:

While we mourn the tragic loss of life — and you can’t mourn it any stronger than we’re mourning it — the United States has produced dramatically better health outcomes than any other country, with the possible exception of Germany. And I think we’re as good or better.

On a per capita basis — remember that: On a per capita basis, our mortality rate is far lower than other nations of Western Europe, with the lone exception of possibly Germany. This includes the UK, Switzerland, Belgium, the Netherlands, Italy, France. Spain, for example, has a mortality rate that is nearly four times that of the United States, but you don’t hear that. You hear we have more death. But we’re much bigger countries than any of those countries by far.

So when the fake news gets out there and they start talking about the United States is number one — but we’re not number one; China is number one, just so you understand. China is number one by a lot. It’s not even close. They’re way ahead of us in terms of death.

All this is true, and it also is incomplete. The missing piece all along for a true calculation of mortality rate was a reliable denominator on the scope of the outbreak. Because we have gotten out of the gate slowly on testing, we only really know how many active infections have been confirmed, and a somewhat-reliable death toll. That doesn’t really give us a true mortality rate, though, because that is calculated by deaths divided by exposure, not deaths divided by overall population or confirmed cases.

As Allahpundit wrote earlier, if if if this is reliable, it’s huge in more than one way:

Those numbers will have to hold up to more scrutiny. Some are already questioning them, but at least for the moment, it shows a far wider distribution of the virus than diagnoses demonstrated, which one would expect when many never notice significant symptoms at all. New York has only confirmed a little over 260,000 cases of COVID-19 infection since the beginning of the pandemic. This data would demonstrate that the actual spread of the virus has been ten times as wide. As Andrew Cuomo announced, that means we can finally get a good handle on the true mortality rate for COVID-19, at least in New York, which he puts at 0.5%. This data, by the way, also speaks to more success than perhaps people believe we have had in fighting this outbreak.

The numbers here demonstrate a significantly higher lethality for COVID-19 than the flu (0.1%), but we have to factor in other conditions to that as well. No state has been a hotter spot than New York, which never “flattened the curve” but instead felt the full brunt of exponential growth. Hospitals and emergency responders got so overwhelmed that they couldn’t keep up with the pace of cases in the initial spread. That has abated, in large part because of the lockdown strategies put in place, as well as increased resources. Under less intense circumstances, with enough resources to meet demand, the mortality rate could be somewhat lower — although it seems unlikely from this data that it’s anywhere as near as low as normal influenza. If that were the case, we wouldn’t have seen the overwhelming number of hospitalizations that took place in New York and especially NYC, even with this level of spread.

If the true mortality rate is between 0.3-0.5%, let’s say, then that calls for some continued mitigation — but only until we get the medical resources in place to handle the expected increase in demand. Once we meet that threshold, which would include sufficient PPE, pharmaceuticals, ventilators, and especially testing, we should be able to send all of the lower-risk people back to work and reopen the marketplaces. This vindicates the “flatten the curve” policies but also reminds us that their intent was correct as well — not to wait for the virus to disappear, but just to put us in position to deal with its deadlier consequences, which will come one way or another.

This data — if accurate and confirmed — makes the White House’s three-phase reopening guidelines look rational and proper. Get the testing in place to make sure there isn’t a sudden acceleration of COVID-19 spread, and then start reopening the public square while observing proper hygiene and social distancing for the foreseeable future. High-risk households, like mine, will have to deal with more self-imposed restrictions, but there is little sense in holding everyone back to the high-risk standard — especially when that may end up doing far more damage than the disease will.