An Alternative Narrative and Analysis of COVID-19 Data

Bradley Tanner, MD, ME, MBA
April 2, 2020

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I decided to start an analysis of the data to assess alternative and diverging conclusions based on the same data. My assumption is that the best science occurs when there are competing theories and assumptions with potentially different conclusions. A world where there is but one truth and one conclusion bears a striking resemblance to Orwell's 1984, Nazism, and to the current Russian and Chinese strategies. In the western world, we value alternate opinions and the data and theories presented here are in that vein.

The overriding narrative to date in the COVID-19 response has been a "better safe than sorry" solution is the best way to proceed. Similarly, there is commonly a statement that saving a life at all costs is the only important metric. I would argue that both may be false. Sometimes risks are worth taking. And saving one life potentially imperils the lives of many others through many other possible negative outcomes; that is, infection isn't the only way people are harmed. So a solution that only has deaths due to the SARS-CoV-2 virus as a metric is missing the true potential impact of those decisions.

In addition, the current coverage has shamefully focused on fear and panic with repeated statements that are generating hype. Statements such as there were more deaths today are merely reflecting what we knew and expected from the beginning. Certainly, after over a month we can stop restating the obvious.

Similarly, statements about new infections are not helping the public to create a reasoned and thoughtful response. My analysis thus focuses more on trends and trying to place the terrifying numbers in context so that one can draw more rational conclusions and predict the future based on the past.

Similarly, this discussion is based on data and data alone without the need for stories. It is equally shameful that the news media has gone to stories about deaths and trauma when in fact deaths are happening throughout this country that are not due to the virus and at a far more alarming rate and in more grizzly terms. And yet those deaths are not documented. One can only argue that the purpose of this media coverage is to generate panic and fear and not reasoned debate, or perhaps simply to generate revenue for the media. It is indeed shameful.

It's important to clarify that in no way do I fall prey to crazy conspiracy theories of a Chinese invasion or that this is a hoax or is an attempt to take down the president of the United States. Nor do I adhere to various "hide your head in the sand" strategies intent on denying the cruel reality that this virus will kill people across the planet. It will. This is a global pandemic that will infect, hospitalize, and kill an enormous number of people. A reasoned analysis of data must be done with compassion but not colored by excessive emotion or predetermined "at all costs" decisions. In this and many cases we cannot yet assess the costs of any decision or the comparative costs of different decisions.

I reject earlier data about R0 that postulated how many individuals one individual could infect. This was a fruitless exercise since the number of variables (e.g., viral load, how transmitted, number of people, length of exposure) varies enormously. Further, who is infected and when they were are unknowns. I have ignored data that is so limited in value or precision that it adds little to any model.

The core facts

  1. This as a highly transmissible virus, in fact, one of the most highly transmissible viruses we've seen. The spread is likely to be rapid.
  2. Given the high death rates among the most vulnerable population, they will need to be isolated from the general population during the viral spread.

In sum, there are multiple ways of looking at the data which will yield different conclusions. Some assumptions that must be considered.

  1. There may be multiple explanations for the spread of the virus
  2. Each explanation may conclude with different means to stop or slow the spread of the virus.
  3. Viral spread throughout the country may be inevitable, as with chickenpox and measles, prior to the introduction of a vaccine.
  4. Potentially a sufficient number of individuals will be infected such that we will reach some percentage that defines herd immunity. Herd immunity will then provide some protection to the few who are uninfected.
  5. Given transmissibility and the ease of travel in the US, the number of uninfected in most towns and cities is potentially vanishingly small.
  6. The uninfected may be safe if they are only exposed to individuals already exposed to the virus and now immune. Otherwise, they will become infected with it and will continue to be at high risk.

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