States aren’t testing uniformly for coronavirus. That’s creating a distorted picture of the outbreak.

Apr 7, 2020
Of course they're not. Is there really any reason to expect them to be? No country has yet tested everybody. So far, every single country has tested those who show symptoms or who have been exposed to others of known infection. This is true for S. Korea, China, Italy, Spain, USA - everywhere in the world. Everywhere in the world, there is a lack of tests available to test everybody - this is hardly unique to the USA (contrary to what some mediocre US media outlets seem to proclaim). As of late March, I know of only one "population" that has seen 100% population testing - the Diamond Princess Cruise Ship. Of the roughly 3,600-3,700 on board the ship, all were tested. The last I heard/read (a statistical medical study on the Diamond Princes Cruise ship's coronavirus history) was that roughly 800 had tested positive in the end (included post ship-departure quarantine periods) and 10-11 (updated as I had heard very recently that an 11th person had died - but it was not clear if that person contracted the virus from the ship or since departure of the ship and after the quarantine period) of that 800 had died. Now, that was a cruise ship and by age and health "condition" was composed of an exceptionally high-risk group of individuals (based on age and proclivity to pre-existing conditions stemming largely from the age group and cross referenced to death rates in China by age breakdown). The death rate of that high risk group has so far (mid to late March) shown to be just barely above 1%. In the end, I suspect based on this and "transferring" that data to the global population (or that of any modernized country at least), that the realistic death rate of infected people will be in the range of 0.5% to 1.5% (remember, the high-risk population of infected people from the Diamond Princess Cruise ship hovers right around 1% and we are more than a month since the ship has been emptied). In populations that have unusually high numbers of elderly people or communities that have a high level of "poor health" or "poor health habits", then perhaps for these populations - the death rates may range more in the 1% to 2% range. Like for Italy (which has the second oldest population in the world, has a healthcare system that was failing even before Covid-19 hit and has social family habits/lifestyles that promote much more intergenerational habits - vs. that which we encounter/practice here in the USA). So as a result, IMO, the best method to determine the number of infected people in a population (say New York City or New York State) is to look at the actual number of deaths and extrapolate from that number the range of the likely number of people infected. So if there are 1,000 confirmed deaths from Covid-19, we can then extrapolate that there are likely between 66,600 (assuming a 1.5% death rate) AND 200,000 (assuming a 0.5% death rate) people that are infected. So if there are 5,000 deaths in NY State - then we can just multiply/extrapolate the number of likely people infected - using this number it would range from 330,000 to 1,000,000 infected people (counting those who showed no signs or who have completely recovered). In the end, and as we increase (like every other country) the number of test kits available for testing over time, they will become less and less important over time in telling us important information - though the benefit will be to identify those who are infected, track their contacts and remove them from society (quarantine them). In the end, way too many people will 1: not be tested as they show zero signs AND/OR 2: be tested if the goal is to test 100% of the population, but will have already recovered. By mid summer, we will move from the key being testing of people for active infection to testing of people for past infection - and only then and over the coming 2 years (when people have their regular doctor's appointments) will we really know just how may American's were infected with Covid-19.

In the end, we cannot easily stop pandemics. This idea that our government should be ready with huge stockpiles of "ventilators" (for example) for a what if scenario isn't really very wise. Say we stock pile a quarter million ventilators and the next pandemic turns out to be blood based! Depending on who is in office, the media will proclaim why didn't that administration stockpile devices that can remove, clean and re-insert that "cleaned" blood in a stockpile. Or if that is a preferred administration - the media will ask why didn't the prior (unliked) administration didn't prepare us for this obvious outbreak (and the media will find a one-off Ted Talks about some person suggesting the next pandemic would be blood based - not respiratory in nature - and then use that as proof that we should have seen it coming). No, we don't know whether the next pandemic will be blood, brain, nervous system or some other life threatening area of our bodies that will be attacked. So what should we do to be prepared? There are a few things! First and foremost is the recognition that contrary to some people's beliefs - the USA MUST continue to be a manufacturing country! And not just in finished products, but in the whole supply chain. That for the government to step in and support this, we should implement mandatory minimum requirements for certain industries to purchase a specified percentage of their product from American manufacturers who use a 100% American-based supply chain of components, ingredients, etc. . . For example, we can mandate that all US hospitals purchase no less than 15% of their medical masks and PPE items from American manufacturers using American supply chains. Secondly, instead of having the government/taxpayers invest huge quantities of money in stockpiling equipment that over the years will become obsolete, we instead have the government stockpile the means to insure that equipment or goods can be readily put into place to increase the manufacturing capacity in short order. For example, instead of stockpiling 2 billion masks, we stockpile and rotating 25 million masks. But we secure the equipment (molds, machines, automation equipment) that could be quickly installed and producing those products in large quantities. This could be in the molds needed to manufacture parts for ventilators, blood machines, or the equipment necessary to combat various different types of equipment that may be needed to address a future pandemic. This would be far more efficient, far more cost effective and far more likely to provide for the ability to quickly ramp up production of future unknown products or equipment to manufacture the needed items.

The reality is, we are actually far more likely to encounter a bio-terrorism event (though the likelihood is that it would be more prone to be regional or contained in a smaller area) than another catastrophic pandemic - and this in the end creates the same end result in the needed response. The question is how much are we willing to pay in advance? How much are we willing to pay for national security? Because that is what this is really about - a country that can address it's own needs from food to medicines to technology to manufacturing to supply chains is far more nationally secure than any country that must rely on an outside country to support and provide for it's needs. This requires us to throw away some of those feel-good PC philosophies that provide the grandiose belief that we are a better country for addressing the needs of other countries and people that are not American's - than we are for addressing our own needs and our own people first and foremost. It's much like when we fly and are told to put on our own oxygen masks before helping others. As the idea of helping others requires one to first be in the position to help themselves first! We need to protect our own industries (manufacturing, pharmaceutical, agricultural, energy, mining) to protect our own future - after which we will be better prepared to help others in their times of need.