Nervous residents in Galveston County might have received a bit of good news this month when representatives for the U.S. Centers for Disease Control and Prevention revised downward their projections for how many people might contract the virus and die during the pandemic.
But local and national health experts cautioned this week that projections are just that, and residents would do well not to overly rely on single statistics when it comes to understanding the coronavirus pandemic — a complex new virus, about which much is still unknown.
“The problem with any death rate estimates is that they are, in fact, estimates,” Galveston County Health Authority Philip Keiser said.
The new projections divide into five separate possible scenarios, with the current “best guess” estimate, Scenario Number 5, projecting the virus might kill about 0.4 percent of symptomatic people — a considerable drop from some initial estimates that the virus might kill as many as 1.5 percent.
Even with that improved death rate, however, projections currently show about 500,000 people in the country dying from coronavirus by the end of the pandemic.
But representatives with the CDC did not respond to requests to comment about how they came up with the numbers by deadline Friday, and several health experts had some doubts about the projections.
“They are extremely rosy projections,” said William Hanage, an epidemiologist at Harvard T.H. Chan School of Public Health. “I have no idea where they even came up with Scenario 5 being the best estimate.”
Projecting death rates, and knowing how to read any projections, is an incredibly complicated process, said Laura Rudkin, an adjunct faculty member in preventative medicine and population health at the University of Texas Medical Branch.
“There’s just a lot we don’t know, and there is more data all the time,” she said.
Even talking about something like a fatality rate takes some qualification, Rudkin cautioned. For instance, a true death rate would involve comparing the total population infected with the number that die. But the symptomatic fatality rate is dependent on how many people are identified — the more cases health officials identify, the larger the denominator and the rate will decrease.
“That doesn’t mean the severity of the virus is different,” she said. “It just means you’ve identified more cases.”
National health officials are trying to use systems for recording coronavirus deaths similar to those used to calculate how many people die each year from influenza, but because of how much is unknown, it’s unclear how reliable the information is at this point, Keiser said.
“You’re seeing a huge difference in the death rate almost based on where you are,” he said. “Some places in New York, for instance, have huge death rates, while other places are not nearly so high.”
Modeling any infectious disease is incredibly difficult, Hanage agreed. But there are some lessons to learn from what we’ve seen so far.
“New York City shows what happens when this virus gets into the community and spreads,” he said. “That should be a sobering thing. We can say with some good reason that New York is not like other places, with its high density.
“But that doesn’t mean it won’t transmit to other places — it just will be slower. But it certainly doesn’t mean the fatality rate will be any lower.”
There’s already some debate about whether the number of coronavirus deaths are being over counted or under counted, Keiser said. But he believes the death number is under counted.
“Unfortunately, this has now turned into a political issue,” he said. “You can almost tell how someone votes based on what they think. But the virus is not political, and the numbers are what the numbers are. It’s out there, killing people. Fortunately, it’s not as many as we feared.”
That latter thought has led to some in Galveston County arguing the response should be more reasonable.
“An epidemiologist isn’t a politician, and I think they are saying what they know,” said Seth Alford, a League City resident. “But it’s kind of grotesque theater watching the polarization taking place. I think this has gotten out of hand. This affects different sets of individuals differently.”
Ultimately, some older residents should be cautious and try to practice social distancing, but it’s time for businesses to begin reopening, Alford said.