In terms of the most circulated myths concerning the 2019 novel coronavirus, this one may be the most persistent, the most widespread, and the one that more than any other fills up my inbox after every post: The idea that you, your friends, and your relatives had the disease, undiagnosed, weeks ago. The corollary of this idea is one that’s still being spread by supposed experts and regularly carried by the media: the idea that the number of cases is being drastically underreported and the real number of cases out there is 10 times what we’re logging, except those cases have few to no symptoms.
It’s understandable why these paired myths keep circulating: They’re comforting. They punch every button and scratch every itch on the “please make me feel better” list. But they’re not just wrong, they’re wrong-headed in a way that makes them dangerous.
The idea that you, or some member of your family, or someone you know, already had COVID-19 weeks ago is comforting in so many ways. First, because that person already came through the disease. They’ve done it. They beat it. They’re safe. And believing that feels so, so good.
Second, it gives the impression that whole families, or whole communities, came through COVID-19 with little more than a few days of cough, and now they’re all better. So this coronavirus stuff isn’t really all that bad. Just take all those numbers about 20% having critical cases and 4% dying and add a couple of decimal places because there are so many, many undetected cases that it’s ... What’s that phrase again? Oh yeah: “No worse than the flu.”
Third, it satisfies the “government is either wrong or lying to me” test. Which is clearly true. The government—this government and others—clearly have provided bad information at just about every step. It’s just as obvious that the United States government hasn’t done nearly as much testing as it should. So we are further up the slope of the infection than we think we are. You even said so, Sumner, I saw it, and you did it, so there.
And finally there’s a good slug of scientific basis behind this theory. Because a look at the genetics of the first known cases of community spread in the United States suggested that it really had been circulating since somewhere in the middle of January. So, score COVID-19 less dangerous, your family safer, and the whole United States miles closer to the vaunted “herd immunity.” Case closed.
Except … sorry, no.
It’s true. Coronavirus has been circulating in the United States since the last two weeks of January, but that doesn’t mean that the cough you had, or your family member had, in January or February had anything to do with it. Because the virus was circulating in the United States in very small numbers. It wasn’t sweeping the country, it was passing between a very few people in a very few places. Unless you happened to be in one of those hot spots, or have direct contact with one of those very early cases, there is absolutely no reason to believe your January cold was anything but a cold.
Let’s bring back the zombies:
Transmission with a factor of 2.
When COVID-19 went “into the wild” in mid-January, it didn’t do so with the release of thousands of people with instructions to spread across the country. At the start of February, the number of cases in the United States was probably still in the single digits. When the first case of definite community spread was detected around the end of February, that case was one of no more than a few thousand, tops. Even in February, if you had the flu, it was pretty much certainly the flu.
Here’s a secret about the chart above: it’s got an intentional error. Because in real-world circumstances, the maximum amount of spread doesn’t happen on the first day someone is capable of transmitting a disease, it happens over the course of the whole period in which they are contagious.
The top zombie up there wouldn’t really pass along the zombie virus to two others on day zero, and this whole stack of virus generations would be much more spread out than the worst-case scenario presented here. It just seemed easier to use in those days than it did something as abstract and difficult to measure as “virus generations.” So if anything, there would have been fewer than eight zombies running around two weeks after the first person was bit.
The real transmission rate of COVID-19 appears to be higher than 2, something like 2.4, and that can make a tremendous difference. But at the time that first community spread case was logged in February, the number of cases out there lurking in the United States was absolutely no more than a few thousand. Possibly still no more than a few hundred. At that point, an effective system of case-tracing and testing would have made a huge difference in the outcome we’re seeing now. That’s exactly the point where nations like South Korea conducted extensive tests and isolation so that, 8,000 cases later, they brought their situations under control.
The United States didn’t do that. It failed to do the broad testing that would have picked up the community spread earlier. It failed to do the broad testing program necessary to trace back and contain community spread when it was found. Because of those things, we’re looking at the worst outcome on the planet. An outcome that is still being compounded by bad decisions and a federal government (i.e., President Donald Trump) that is failing to provide any leadership whatsoever.
It would be nice to believe that things were different. That somehow there had been millions of cases in the United States already, that the case fatality rate is much lower, and that so many more people are already safe. But it’s not true. We shouldn’t act like it’s true, or promote memes that suggest it could be true, because all of this lessens the importance of keeping up measures to suppress the virus, which is all that we have until we finally get enough testing and case management into place.
If COVID-19 were really a disease where the case fatality rate were 0.2% and the vast number of cases went undetected because they had next to no symptoms, we would know it. Because a disease like that would present a completely different profile of growth and a completely different set of outcomes. The math of this whole thing sucks when it comes to providing any good news, but it’s also pretty definitive in telling us about this disease: How fast it spreads, how many people have serious issues, how many people die. These numbers have been tested again, and again, and again, in nations large and small, closed and open. The “10 times as many asymptomatic cases” do not exist.
You didn’t have it in January. It was not that cough that ran through your family, or workplace, or community in February. COVID-19 is, sadly, that disease that comes with lines of people going into the front of the hospital and refrigerated trucks idling by the back. Treat it that way.