My work in politics and in public health brings me into contact with some people who still believe the coronavirus is a hoax. More frequently, others think that the media exaggerates the danger of COVID-19 in order to damage President Trump’s re-election chances. At least a few of these individuals are persuadable voters. I’ve found that the following points, in some cases, can start a useful dialogue.
If you think the media is exaggerating the impact of COVID-19 in order to hurt President Trump’s electoral chances in November:
Clearly what is an exaggeration is very much in the eye of the beholder. But for those of us working in public health (I’ve been in healthcare for the past twenty-five years and formerly led a national task force on the U.S. public health system and pandemic preparedness) the way that folks process this message is that COVID-19 shouldn’t be taken seriously. This can be a deadly mistake.
For some, the personal risk of death is very low, though not nonexistent. Others are at much higher individual risk. Those who contract the disease and survive may take a long time to recover, and it appears that there may be long-term complications from COVID-19 that we don’t yet fully understand. But even those infected who haven’t yet shown symptoms or who never show symptoms, including children, can spread the disease. This makes it especially hard to contain.
I hope you’ll bear with me as I explain a few reasons why I think COVID-19 fully deserves the attention it has received, and indeed may be under-reported. Please understand that I’m always open to new and contrary data and opinions. What I am summarizing here is only the tip of an iceberg. We are learning more every day.
Excess Death Counts Confirm the Impact of COVID-19
Some think the death toll from COVID-19 is greatly exaggerated or that the coronavirus is a hoax altogether. By contrast, looking at excess death counts year over year shows why most health care researchers believe that the death toll from COVID-19 is probably underestimated.
While the published fatality counts for COVID-19 are far more precise than those for most other diseases, since they represent an actual count rather than an estimate (as for the annual flu, or the 2009 H1N1 pandemic), they can vary somewhat for a variety of technical or political reasons--though we are talking 10-20 percent at most, not an order of magnitude.
What is basically indisputable is the total number of deaths in a state or county on a year to year basis. These numbers— along with the relationship between the number of deaths from different causes-- tend to change very slowly over time. There is a lag time of course between the time deaths occur and when the fatalities are tabulated.
But if you check the CDC or state or county public health websites (or this summary in the Journal of the American Medical Association) or this more recent summary you’ll find a large spike at the moment COVID-19 struck and a steady trendline above the average in most places.
Most of this difference can clearly be explained by the impact of the coronavirus. To be sure, some people died because they had a stroke or heart attack and didn’t go to the ER, but statistically speaking these are likely to be relatively few over a several month period. This would have been a much bigger issue had emergency rooms and ICUs been completely overwhelmed by COVID-19, but in most places that didn’t happen.
Which leads to the broader point: in around five months the United States has incurred more than 170,000 deaths (close to 400,000 on an annualized basis), even in the face of uneven but nationwide efforts at mitigation (physical distancing, masking, etc) from a disease humans hadn’t previously encountered. Without mitigation, studies reasonably suggest that death toll in the U.S. could be in the millions.
Leaving aside politics altogether, how could such a surge of deaths, from a previously unknown disease, not be the overwhelmingly dominant media story? No analogies are perfect. But imagine, for example, if fatalities from car crashes rose by a factor of ten overnight? Or a factor of one hundred, if by analogy COVID-19 had been allowed to run its course without mitigation? Even with all the measures that have been taken the death toll is of the same magnitude as cancer or heart disease (600K and 650K annually). What would the reaction be if we encountered either cancer or heart disease, out of the blue, for the first time?
If anything, this suggests that the COVID-19 story is underplayed—no doubt because the majority of the victims are older or minorities. If the disease affected Americans at random everything would be shut down. Consider, for example, what would happen to civil aviation if passengers died at even the current U.S. death rate per million of COVID-19 (around 513/ million). At 925 million air travelers (2019 figure) that would be around 475,000 deaths or roughly twelve airplane crashes a day. The industry would be unlikely to survive.
The number of deaths of Americans under the age of 45 alone from COVID-19 exceeds that of Americans lost in the Iraq War. This toll will keep rising as cases skew younger and the overall count continues to rise.
COVID-19 is an International Phenomenon
Well over two hundred other countries in the world have been grappling with the novel coronavirus.
In most of them, both governments and the media are preoccupied with the virus. In Italy, for example, officials describe the coronavirus crisis as the country’s biggest test since World War II.
What is especially striking is that there is wall-to-wall media coverage in countries which by and large have done infinitely better at containing COVID-19 infections than the U.S. That testifies in large part to the seriousness with which they are taking the disease and the possibility of exponential spread.
In Australia, for instance, a couple of thousand cases are prompting local lockdowns and travel restrictions between states. New Zealand is taking strict measures with just thirteen new cases. By contrast, the U.S. is averaging some 55,000 new cases daily, even though testing has been cut back. Some are touting this as a relative success, since we crested at more than 70,000 a few weeks ago.
Now it is true that the leaders of many countries are not fans of President Trump and that his international approval rating is dismal. But the leaders of world nations certainly aren’t fanning the media flames in order to hurt the re-election chances of another country’s president.
The coronavirus is a media preoccupation because it is a global pandemic of dimensions unseen previously in our lifetime.
To be sure, most officials, reporters, and private citizens of other countries I have spoken with are incredulous that COVID-19 and the American response is not a bigger story in the U.S. Probably because most Americans are unaware of, or uninterested in, how badly the U.S. measures up by international comparison.
Compare Germany, for example, which like the U.S. is a major travel hub and not a small isolated nation for which determined efforts can make containment easier. Germany, in fact, has multiple disadvantages on paper compared to the U.S. in terms of pandemic response. Its population is much older (ten years on average!), it is has higher population density, and it is in close proximity to countries that were hardest hit early in the onset of the disease, when much less about COVID-19 was known and treatment was poorer.
Moreover, our epidemic defense team at the CDC was considered superior to Germany’s before the coronavirus struck. Nevertheless, Germany has suffered roughly one-fifth the number of deaths per capita as the U.S., its daily deaths are now in single digits, and it generally has about the same number of daily cases as we suffer fatalities. And at the same time Germany’s economy has not suffered more greatly than America’s.
A (Tall) Tale of Two Viruses: Exaggeration in Perspective
During the fall of 2014, on the eve of the U.S. midterm elections, fears were great that an Ebola outbreak then underway in Liberia might spread to the United States. Both the media and GOP campaigns warned that the Obama administration would be held accountable for their potential failure to prevent a pandemic.
Donald Trump, then a private citizen, tweeted that “ If this doctor, who so recklessly flew into New York from West Africa, has Ebola, then Obama should apologize to the American people & resign!” (The doctor did, in fact, have Ebola, but appears to have infected no one.)
Over one thousand segments about Ebola ran on network and cable news in the four weeks preceding the election in November, and GOP candidates routinely stressed Ebola in their closing campaign ads. Studies show that these ad campaigns played a significant role in the GOP capturing the Senate and increasing their majorities in state legislatures.
Just eleven cases and two deaths—both of them of patients who had contracted Ebola outside the United States—were caused by the disease. (To underscore how much the outbreak that didn’t occur was hyped and politicized, Just fifty segments on Ebola ran on television in the two weeks after the 2014 elections.)
This puts the question of exaggeration in a somewhat different light. If two deaths and eleven cases from Ebola generated this level of coverage and political traction, what do more than 170,000 deaths and more than five million cases of the novel coronavirus warrant?