COVID-19 Update: Dispelling Fear with Knowledge (Part I)

You. It's good to see everybody again. The purpose of this video webinar is to walk through some of the numbers and statistics related to the incidence, prevalence, mortality, etc. Of COVID 19. What spurred this was a lot of the stuff going on in the media over the last week. Some of the numbers suggesting other countries are doing things the right way, we're doing the things the wrong way. So what I want to do is just enable you and empower you to look at the actual data, make your own calculations and file things for yourself. So what I'm going to do is I'm going to go through the three major sources online, the University of Washington, the gis from Johns Hopkins and the Worldometer. Walk through those, show you how to look at the numbers. As I walk through these numbers also I'm going to talk about the countries that the numbers represent, why the numbers may be a little different. Look at the graphs, explain them to you a little bit. This is more of like an educational thing. The biggest issue is just because I've been seeing the numbers so misrepresented and people assuming things that we don't really know, making statements that make it sound like we know a lot more than we actually know. So I just want to walk through things with you all to educate you and help you kind of figure things out, you know, because ultimately all education is self education. I truly believe that that's what we teach our kids. And so educating, that's why I teach my patients as well. So educating you how to look at the numbers and make your own assumptions and determinations, I think is one of the better things I could do right now, especially with a lot of misinformation going around. So what I'm going to do is just share my computer screen with everybody real briefly and I'm going to start with the world. Now this is some numbers I've just kind of copied out and I'm just going to walk through these really briefly. So the world population right now we know it's about little under 8 billion. There's about 1.7 million cases in the world so far. With their deaths, the current mortality is 6%. Now that sounds pretty huge and pretty high until you realize that the incidence in the population is only 0.02%. So what that is, that's taking the number of cases and dividing it into the actual population. So what that means is the number of people with this disease in the world is actually quite, quite low, even though the mortality is high. Now, what we know is A lot more people have this disease than actually are reporting it. So that incidence actually difference between the incidence and the looking at the number of deaths and cases and then population just tell us that there's probably a lot of, a lot of underreporting. There's probably a lot of people who don't have the disease. Now the other thing to make a note about the world, we're actually going to switch to the Worldometer here and actually look at the whole world here. Now this Worldometer, this is the Johns Hopkins site. If you look at, you see a lot of red. Of course, it's all in the northern part of the planet right now. The north is in the winter coming into spring. Now in the southern part, Africa, South America, they're just starting to come into the winter time. So if you look over here to the lower right hand side, you'll see this graph of the incidence going up. And you can actually go up and see the individual, what day or you know, how the numbers are going up. The thing to appreciate is this is supposed to represent the total number of cases in the world that are going on right now, active cases. And you'll see it. It's supposed to make a parabolic curve go up and come back down. What you can appreciate from this is this represents probably one fourth of this, of this curve. It's supposed to go up, peak and come back down. Well, you can see it's just beginning. So the point of this, even though there's a lot of red, even though we have 1.7 million cases, is we're still for the world in the beginning of this. But ultimately we are the United States and we need to think about us kind of sort of like what this means for us. So let's look at a couple countries that people been talking about. Sweden is one of the countries that people have been discussing a lot as far as their mortality, what they've been doing. Well, it's a relatively small country. If you look at the number of cases, about 10,151. The deaths, the mortality though for the number of cases is actually quite High at 8.6%. Okay. Now the incidence per population is quite low. They've done 54,700 tests. So what that means is the incidence and the test is 17%. So let's walk through that. That means that 17 out of 100 people that they test are positive. In order to get a really good graph of how prevalent something is in the population, you have to test a lot of people. You actually want to have that 54,000 tests to be as close as 10.2 million is possible, which is not. So you get this difference between the incidence of the tested, the incidence in the population. See that 0.8 difference between 17%, that represents the magnitude difference in the actual prevalence of this disease. And that's a pretty big number. So we hear people say tenfold, 20 fold, maybe even 50 fold more people have this disease than it's being reported. That's where that discrepancy comes from. So if you just take a tenfold increase, the mortality of 8.6 becomes 0.8%. Now all of a sudden we're in a much more reasonable range. And a lot of these estimates are based on the assumptions that, well, the knowledge that we haven't tested everybody and we need to test a lot more people. And so we're kind of guesstimating. Now one thing that's interesting with Sweden, we look at the curve, their curve, they are starting to actually escalate up a little bit here. You can see if it goes straight vertical, you know, you're having a logarithmic increase. But there again are on the front end of things, Sweden's a very, very homog population, very healthy. One thing about Swedes as well is that they do a lot of outdoor winter sports. That's gonna be younger people doing outdoor winter sports, not your younger people. So one of the things to think about with Sweden is the older population hasn't been hit quite yet there. If you think about where Sweden's located, they're just in the process of getting a very, very cold winter. So we can expect as the older population that's older, it gets exposed, but that's going to hop up a lot more. South Korea. South Korea is like the one country everybody talks about how great they've done things, etc. Looking at the 51 million people in South Korea, the fact has been over 10,000 cases, the mortality is 1.9%. But again, if you look at the incidence in the population of the 51 million people, they have 10,480 cases. So that's a really, really low 0.02. If you look at how many people tested, you know, 510,000. Well, that's a pretty good number. But if you look at the incidence in the tested, it's now 2%. So what that means, if you take that 10 fold, that's, that's actually in this case, a hundred fold difference in the incidence of the population and the incidence in the tested, you know, if you'd use that hundredfold difference, the mortality would actually drop to, you know, 0.01%. I don't think it's that we should be looking at that much of a variation. But the point here is that when we talk about these mortality numbers, we're still probably grossly overestimating the mortality. Now, the thing I want people to keep in mind with this, I'm not trying to under to say, hey, we don't have to worry about it, because if we just use flu numbers of 0.1% as the mortality, okay, in an American population, we're still looking at a quarter of a million people dying from this, which is the statistic that Dr. Fauci has actually been giving out. So at the bare minimum, if this is just another flu, we're still talking about 80% of population getting this. Of the 80% of population that get this point, 1% of those people die. Well, that's still about 240,000. That's still a very, very significant number of people. If we do, however, go to the Korean data and we look at their graph, you see how flat it becomes. This is when they say flattening the curve, this is what you're talking about. But one thing I want you to appreciate about this curve flattening is it's not just flattening, it's broadening. Okay? So you see how it peaks here. It looks like it's getting ready to turn back down. So this speaks to me is if we just continue this trend, they still have. They're still only halfway through this. Assuming that the number of young versus the number of old is equally exposed, they're not sequestering the old, which we know is happening there, actually, that the disease is spread equally throughout the population. So I just want to notice that that's a very different curve than what we are seeing, but it is flattening. And that's that visualization of the flattening of the curve that people talk about. Israel is a country I want to talk about briefly, because they closed down very, very early in this whole process. Their country of 8, over 8 million people had about 10,000 cases. Their mortality, interestingly enough, is 0.9%. Quite, quite low. The incidence, the population, again, how many people of the population that's been. Of the cases in the population, 0.11%, which is pretty low. But again, if you look at the instance in the tested, they have 117,000 tests, all of a sudden, the incidence is 8.9%. One of the questions I ask with these different numbers is, you know, what determines who's tested? Where are they being tested? You know, if we're only testing hospitalized patients, the incidence and tested is 8.9% in hospitalized patients, which I would expect to be very high. If we're testing absolutely everybody in the population and the incidence is the zero point, that's pretty low. The reality is it's between these two numbers. It's not gonna be 0.11 and it's not gonna be 8.9. Now, that's a pretty big range of variation. Okay. And even in their country that has a big range of variation, who they're still testing the sickest of the sick and some other general people as well. You know, the mortality is 0.9%. Now, one thing about Israel, they're doing a lot of. I should. I'm gonna pull that back. Actually, we take that back in. They're actually testing lots of the general population, something we have not been doing. So that's probably one of the reasons why their mortality is, um, so down. Germany is an interesting case because if, for those of you remember, Germany, initially, their mortality was quite, quite low, and now the mortality rate is at 2.2% out of their population. The reason for that with their country was that initially the cases were people coming. They're actually skiing in Switzerland, skiing in a bunch of these really amazing places in Europe, coming back to Germany. Now. Who are those people? Well, those are young, young people. So young people were actually bringing the disease back to Germany initially, and their. And their mortality was pretty low. Now started to spread throughout the country, and we're seeing a mortality of 2.2%. If you look at the number of people tested, 1.3 million. That's actually a pretty. Pretty good, you know, hunk of people. 1.3 out of 83 people are getting tested. So basically, 1 in 80, plus or minus the incidence in the test, it is 9.2%. One of the things you have to look at with these countries as well, when you compare them, how they testing people in the United States, we've only been testing hospitalized patients. We've all been testing people in the ICUs. We have not to date, just recently, in the last week, start testing the general population. So when you look at these numbers, you have to compare apples to apples, which this whole thing, we are not comparing apples to apples. If we look at this was Israel's curve. Sorry, I didn't go over Israel's curve. You see, they're kind of curving up a little bit. There. This is Germany's curve. If you look at their curve, you can see they're still on the way, going up. They've not peaked. It looks like it might be slowing a little bit. Need about a week or two of data to really know if curves are slowing or not. And we don't really see that with Germany here. Again, this GIS database, Johns Hopkins, anybody can look at this information to get a feel for things. The next country is the Netherlands. Now, this is another country that people are talking about, hey, we should, we should do what they're doing in the Netherlands. You look at their curve, it's nice and kind of diagonal. It's not accelerating, it's not decelerating. They're slowing progression of disease in the population. Look at their curve. Let's replicate them. The problem with a lot of these countries as well that we have to think about is when we look at the Netherlands, it's like a smaller state. If you look at Germany, it's like New York, the United States. You have to look at the United States like it's the European Union. You know, we're 50 countries that come together and we call ourselves the United States of America. Every state's different. Texas is different. Wyoming, Des Moines, Iowa is going to have a different incidence than New York. New York, obviously. And so I'm trying to throw this data out there for us to look at, just to start processing the idea that what really matters to you is not what's going on in New York City. That's super important. And we're the whole country and the whole world's paying attention. But the most important thing, if you yourself and your family, in your state of ease and anxieties, what's going on for me, what's going on in central Virginia, you know, anyway, back to the Netherlands. Population 17 million. Mortality 11%. Wow. Mortality 11%. Do we want to replicate the Netherlands? They have a slow increase, as you saw, but the mortality is quite high. If you look at the incidents in the population, again, I'm just taking the cases, dividing in the population, that's all that is. How many cases do they have per population? It's 0.12%. And the incidence in the tested is basically 1 in 5 people, 21% testing positive. The thing that to remember when you talk about the incidence in the population, ultimately that number we are predicting it's going to get up to 80% over the period of two or three seasons. So what my thoughts are is all these instances in the population are so low that because we are not testing every single solitary person. We're testing a small group. If you look at the instance in the tested here, 21%. Who are those people? If that was the entire population, if that was a random sampling of the general population, that would tell us 21% of the population already has the disease. We have to look and see who's being tested to really know what that number means. Now, Iceland's an interesting case in point. There's an article that came out this past week, and the reason I put Iceland in here was because it came out yesterday. And the article will be attached below where this video is put saying that in Iceland, up to half of all people who had disease had no symptoms whatsoever. Just think about that for a second. If that data is true here in the United States and we take the 80% of people that were saying, hey, we'll get this and not go to sneeby, half of the people that had no symptoms are in that category, which means a lot, lot more people have this disease than we think of, than we know today. And we actually want that to be the case because the more people that have this and aren't sick, the better off we all are. So again, mortality, 0.4%. Pretty low incidence in the population. 0.45. Incense in the test, it was 3.1%. So that just tells me right now, in Iceland, even in the tested, the people they're testing, incidence is pretty low. That's unique for Iceland. It's a small country of 364,000 people. That just tells me Iceland has not been hit, hit yet. And we look at Iceland's curve, see how it's kind of. It looks like they're, hey, they're beating it. Da da, da, da. But I would question that whether they actually are. Have gotten most of their, you know, bang for the buck, so to speak, because when you look at their actual numbers, again, 33.1% in the test that have this disease. Okay, so what that means is either they're not picking the right people or it hasn't really invaded their country at, you know, Italy. This is. We all know about Italy. You know, mortality so far is 12% in the cases with the deaths. But if you look at the incidence in the population, this is where it gets really kind of interesting. 0.23%. So where are we at in the curve with Italy? What we do know from the gis is that Italy is actually slowing off a little bit. And we've been talking about that for the last Week, they've been curving off just a smidgen here. So then you look back at the data here, you say the incense and the test at 15%. So the question is the number of people who've had this in Italy, is it going to be anywhere from 0.23% to 15%? You know, the only way to know for sure would be to test the entire country, which, you know, there's only been 906,000 people tested out of 60 million. So, you know, point is, is that when we look at each country, they're all different, they're all unique. Italy is not the Netherlands is not Iceland is not South Korea is not China. So we have to realize there's a lot of extremism out there in the way things are being reported. They're finding data points and blowing them out proportion. If we stick with flu numbers, which I'm not saying everybody, most of the physicians and epidemiologists agree this is gonna be more dangerous than a flu. Even with that lower estimation, there's still gonna be 250,000Americans that die from this. So I'm not minimizing that. What I'm saying is, look, we need to not freak out about it. So let's go to the United States. Again, the population, 328 million people, you know, 501,000 cases. Of those, 501,000 cases, there's been 18,000 deaths. And that puts our mortality about 3.7% incidents in the population. You can see that we've had 2.5 million people tested so far, and the incidence in the tested is about 19%. So in the United States here, we know that we're not testing everybody. We're only testing people in hospitals, admitted to hospitals. They're really, really sick. So that tells us is most of the people that are being admitted don't have this. At most, 19 to 20% of people in our country have been exposed so far, but it's going to be more than that. Again, 0.15%. These numbers. This is the reason why we need antibody testing. This is the reason why we need to get antibody testing deployed so we can know if we, as well as Iceland, have 50% of people with exposure without symptoms, because that would be absolutely huge. That help us really with what we're trying to do. This is the United States curve. And again, we know everybody pretty much by now knows we're kind of peaking up or going up. The peak in New York is supposed to be happening in the next week or so. These are some Numbers from the Worldometer. This is where I got some of the testing data from. Number of tests. If you look at New York here, you'll see that they represent the vast majority cases in the United States. If you look at their testing, they're testing 21,000 per million population. They're representing the epicenter right now in the United States. We also have New Jersey is a big one. California is actually doing fairly well, not super high. The major cities are Detroit and New Orleans to date. So let's go down to numbers for New York on the mortality in New York right now, number of deaths per cases is 4.5%. Incidents in the population, 0.88. They've tested about 417,000. And the incidence that tested is. That means almost half of everybody tested has tested positive. That means, you know, typically, to get a good idea of what's going on, you want to have more tests than people with disease. So if you test 100,000 people, for example, and only one person's positive, then, you know, hey, you're getting a lot of healthy people there. If you have 41% of people are testing positive, what that tells me is that they're focusing on testing just the sickest, the sick and their population. So let's actually look a little bit here. The other thing I like to want to talk about briefly is the. This is the University of Washington. This is their data. And if you look at this, this is their projection of what's gonna be going on in the United States. You know, our need. You look at their graph of death here, which, you know, is not a very good graph. But at worst projecting, now they're projecting 61,000 deaths by June 1st. Okay. If you go out to July 1st, at worst, they're predicting 61,000 deaths, ranging from 26 to 155. So this is a big range. If you remember back though, we were originally projecting 2 million, 4 million. So the good news is these projections have been coming down and down and down and down in our country. So if we go out to August 1st, we're predicting a maximum of 61,000, ranging from 26,000 to 155,000. So again, in our country, this is not. This is. Would be equivalent to, you know, the worst flu season, non pandemic flu season was the 2017, 2018 season. We had about 80,000 people die. So, you know, we're looking at worse, something around that range, not quite as bad as 153. But again, you know, the nine states we all live in States. So let's look at New York, which is the, in our country is kind of like the worst of the worst. One thing I want to note, if we look at this, see how, how high this peaks up here, that speaks to the fact lots of exposure, lots of people getting this quickly and spreading it to the population. This is not flattening out the curve. You have to ask yourself the question, why has it been like this? Is it because New York City is a lot of people in a small place? Is it because their subways, their public transportation been running the whole time? Really, really hard to know. If you look at the top, you'll see the beds they've needed versus the beds available. They've definitely been pushing their system to the br. If you've been listening to the governor of New York, the mayor of New York City, one thing he's been saying over and over again, no one has died to date due to lack of access to health, to ventilator care. So even though this is like the worst, the worst, we still have not had that happen to date again. But again, even looking at this, if you look at the needs, it's still a big, big, big, big range. This is the deaths per day. And again, if you look at today is if you put it on the 11th, what you'll see is they're predicting, you know, anywhere from 207 to 2100 people dying today. That's a huge range of variation. And so if we only talk about the 2100 people going to stress, if we talk about the 207, we're not going to be as stressed about it. And that's where these projections can be very tricky because you don't know what they're projecting. This, however, is where we're at right now. Today, again, is the 11th. If I put it on the 11th, right here, that's where right now. And again, you can look at the variation from projection of deaths in New York ranging from anywhere from 9,300 to 24,000. We just have to see how this plays. But again, depending on what number I look at, it's going to tell me what I'm the kind of news, if I'm a, you know, class is half full kind of guy, I'm going to look, maybe it's going to be only 9,000. If I'm a negative kind of, you know, conspiracy theorist, oh, you know, it's going to be, you know, 23,000. And that's a problem with projections. They change all the time. Again, remember how they're projecting around country 2.5 million now, projecting maybe 60 up to 80 so thousand. So the projections have changed greatly. Now, New York is not every state. I live in Virginia. So I actually wanted to look at Virginia really briefly where the state where I live, if you look at ours, you see our curve is actually not flat, not peaking. You look at our number of beds needed, currently 1100, we've got 6500. If you look at ICU beds needed, 232, we have 329. So what we're seeing in Virginia is we have plenty of hospital space, we have plenty of capacity in Virginia. We're not going to overrun our. It's not to say that hospitals won't be busy. That's not to say certain hospitals that take care of certain areas where there's high numbers won't be busy. It's to say that overall in our state, we actually have capacity for what's going on. You look at our death curve, you see a little spike right there in the ninth, again, our projections. But I think the thing that's for me helpful is just looking at this. This is our overall projections of deaths. And if you look at the 11th in Virginia, you see right here, we're just the beginning of our surge, so to speak, versus New York was further on. We are closer to the beginning. Again, the point of this is looking at the variation between the highs and the lows. You know, 239 people projected to die in Virginia up to 2400. That's a big, big range. And so we have to realize projections are just projections. We don't ultimately know how things are going. We need to pay attention to the data. But there's a lot of people out there that are trying push information to push, I don't know, just anxiety maybe. And so I would recommend people looking at. Find their state on here. Whatever your state is, you can click up on here. This is Virginia. You can click and follow your state. Follow it, find it where you live, follow on your local health department. You know, if you want to find what's going on in the world, either following, you know, the lodometer or John Hopkins site, just look, look at things. Follow numbers yourself and get comfortable with this. Otherwise you're going to. You're going to be determined. You're going to need. If your only source is what's being pushed out there in the media, you're going to be pushed to and fro like a wave by the wind. And depending on how much news media you look at will determine the degree of anxiety you're actually projecting. So hopefully this was helpful just to help people put their minds around the numbers a little bit. Overall we are seeing the big gist is the numbers are flattening, the projections are not as bad as we initially thought and going to get through this together. So hope you have a great weekend. Stay safe, be well. If this was helpful, please follow us on YouTube. Like us as well. Share us with friends. I will be doing a few more of these later on this weekend and next week. Just trying to walk through some of the data. I will be talking through about some new medications as well as some of the pulmonary complications people have been talking about and some newer information that actually the hospitals are now using to treat patients. Take care and be safe.