Virus Fatality Rates Highly Variable

Infection Fatality Rates?

Michael Schulson writes at Undark Magazine John Ioannidis Responds to Critics of His Study Finding That the Coronavirus Is Not as Deadly as Thought. Excerpts in italics with my bolds.

At issue here is a simple question: How many people actually have Covid-19? Ioannidis and other researchers from Stanford tried to answer that in a draft paper, or preprint, last month. Other experts began pointing out problems in the study, raising concerns about statistical errors, possible issues with a Covid-19 test kit, and shoddy sampling technique.

A few weeks later, the team released a revised version of the paper. The new draft, which, like the original version, has not yet received formal peer review, softens some of the more controversial claims, and acknowledges more uncertainty about the true number of infections.

The following interview — which covers the papers as well as Ioannidis’ appearances on partisan television — has been edited for length and clarity.

Undark: What kind of responses have you been getting so far to the revised draft?

John Ioannidis: Well, we’ve heard from several people. And I think that they’re happy that we have addressed the main issues that were raised on the first round. I also saw that [Columbia University statistician] Andrew Gelman, who was probably the most critical voice in the first round, has posted his appraisal of the revised version, which I think is very reasonable.

It’s hard to recall another paper that has been so extensively peer reviewed. [He laughs]. And lots of accounts were very useful and very constructive. The revised version has tried to address all the major concerns. I think the results are still very robust.

But it’s a single study. You can never say that a single study is the end of the story. You need to see all studies that are done, and by now there’s more than a dozen serology studies, and I think they pretty much paint the same picture.

UD: How so? In terms of estimates for how many infections there are, and what the infection fatality rate actually is — there still seem to be some substantial differences.

JI: Yeah, but this is entirely expected. Infection fatality rate is not like Avogadro’s number. It’s not a constant, like in a chemical experiment, the Km of an enzyme reaction. It’s affected both by how you count the [numerator] and how you count the denominator, and who are the people in the [numerator] and who are the people in the denominator. So, the case mix is very different in different locations. And the way that the serious cases were managed, or could be managed, is very different in different locations.k

So, depending on the setting and the population, the infection fatality rate may be from far less than influenza to far more — from the mild infection all the way to “This is disaster.”

D: I’ve seen your work being widely cited by people — including Fox News’ Tucker Carlson, who had you on as a guest — who are saying that the pandemic is not that serious, that it’s been overblown.

JI: I think that every citizen has the right to read science and try to make some sense of it. I cannot stop people’s interpretations of scientific findings, and it would not be appropriate for me to do that. So, yes, different people from different ideologies and from different backgrounds will read these results in different ways. But, this is not necessarily my reading or my interpretation. To be honest, as a scientist, I prefer to offer the data and try to be as calm as possible.

I think the main question is, should I or others, not talk to anyone — either Fox or CNN or BBC or Der Spiegel or Reuters or whatever? In principle, I have a problem with this perspective. It think that it creates a notion that scientists should not present the work. If you see some of these interviews — I mean, you mentioned Tucker Carlson, you can see my interview. And it’s obvious that I do not agree with lots of things that Tucker Carlson was proposing. At the same time, when he says that this virus is less lethal than we thought, this is accurate. It’s not who is saying it. It is whether this is an accurate statement or not. We started thinking that one out of 30 people will die. You know, when the [World Health Organization] made the announcement.

UD: Who thought that? The WHO said that 3.4 percent was the case fatality rate. Epidemiologists I’ve talked to said that it was clear the true infection fatality rate would likely end up being much lower. One scientist described the argument you’re making right now as “a straw man.”

JI: Well, let’s go back and check the exact announcement. [Note: The WHO announcement in question, from early March, specifies that “3.4 percent of reported cases have died.”] That was at the time when WHO had sent an envoy to China. And [the WHO envoy] came back and he said there’s no asymptomatic cases. Just go back and see what the statement was. He said there’s hardly any asymptomatic cases, it’s very serious and has a case fatality of 3.4 percent.

Of course, that [fatality rate] was gradually dialed back to 1 percent or 0.9 percent. And these are the numbers that went into calculations, and these are the numbers that are still in many of the calculations, you know, until very recently.

You know, 1 percent is, is probably like the disaster case, maybe in some places in Queens, for example, it may be 1 percent, because you have all that perfect storm of nursing homes, and nosocomial infection [an infection that originates in a hospital], and no hospital system functioning. In many other places, it’s much, much lower.

I’m trying to disentangle the accuracy of a scientific statement from who is making that scientific statement. Because if we don’t agree with who is making the scientific statement, then we run the risk of attacking the science, because it was just stated by that person.

We have to be very cautious here. I think that that’s going to be highly detrimental to science. My first opening statement in my first Fox interview was that science is the best thing that has happened to humans. I’m very proud to say that again and again and again.


This is much the same as hysteria over global warming/climate change. All the hype is about tenths of a degree rise of an hypothetical number: Global Mean Temperature, which is estimated with multiple uncertainties, and hides great differences from place to place.  And all the future damages are projected by computer models that assume GMT has a simple sensitivity to fluctuating amounts of CO2 in the atmosphere. The so-called climate crisis is the work of shamans not scientists, and Ioannidis is right to defend scientific integrity against such fear mongering.

And there is another similarity between climate and covid scares.  Climatists obscure distinctions between weather and climate, between natural and human causation, and between the IR effects of H20 vs.CO2. Pandemic discussions typically blur or gloss over the difference between getting the virus and getting the disease. Just as having HIV (virus) is distinct from having AIDS (disease), so too it is increasingly clear a great many people are carrying SARS-CoV-2 (virus) without coming down with Covid19 (disease).

See also On Following the Science

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