Unpacking the real source of pandemic panic

Yesterday, I took a few moments to air out some of my own frustrations, as a doctor and native New Yorker, about the frenzied coverage of the ongoing COVID-19 pandemic.

Not because what’s happening today isn’t serious. But because, despite early delays in response, most states are already doing all they can to get our country’s outbreak under control.

So all the doomsday talk about rocketing daily death tolls? Well, it isn’t particularly helpful at this point. And without proper context, it’s also needless fear mongering.

Fewer numbers, more questions

Here’s the bottom line when it comes to the numbers: We won’t have the first clue what we’re really dealing with unless—and until—we get some widespread, rapid testing.

And New York is actually the national leader in testing, with more aggressive practices than any other state.

New York has also been designated the unofficial epicenter of the outbreak, but with over 20 million people living in the tri-state area, that’s really no surprise. Plus, NYC is the nation’s largest city by far, with more people coming and going than any other part of the country, so it only makes sense that we were the first and hardest hit.

You may have also heard that those living in poverty and people of color are dying faster in New York state. But with higher rates of both pre-existing conditions (like obesity, diabetes, and heart disease) and smoking—not to mention less access to quality healthcare—that outcome was tragically predictable, too.

Meanwhile, some other states currently don’t look like they have many cases—but their testing rates are very low. And the numbers by themselves don’t actually tell us much about the extent of this disease’s spread, anyway.

Once again, when you’re looking at the stats, you need to look at deaths per million, or total cases per million. Or in this case, total tests per million.

Let me give you a few examples (as of April 8th, 2020 at 1 p.m. EDT):

  • New York State – 17,334 tests per million
  • New Jersey – 10,693 tests per million
  • Louisiana – 16,008 tests per million
  • California – 3,673 tests per million
  • Texas – 3,179 tests per million

As you can see, there’s a pretty wide gap. So naturally, my home state’s numbers are going to be higher. The more you test, the more cases you are going to find—it’s that simple.

Without data, we’re flying blind

Until everyone in this country has unfettered access to quick testing—and until we have antibody testing that assesses IgG and IgM response (which would tell us who has already had COVID-19)—we won’t know the true extent of infection.

This type of testing would also give us some critical insight into the level of herd immunity we may have already acquired. And it could potentially offer us a path toward looser social distancing measures, too—something that we simply can’t risk without more information.

Bottom line: Without a complete picture of this disease’s infection rate, we can’t have an accurate idea of its mortality rate.

In the meantime, we’re operating in a data vacuum, where, unfortunately, fear is often acting as a placeholder for facts. And that’s as dangerous as the disease we’re fighting, any day of the week.

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