Oddly enough, I’ve been thinking a bit about the Covid-19 pandemic lately. It looks to me like the current overall fatality rate may be somewhere around 1%, and since nobody has antibodies yet, I see no reason most of us won’t eventually get infected. Let’s say half the people in the USA get infected. It’s simple arithmetic: 330 million x 50% x 1% = 1.65 million dead people. In the USA alone. And maybe 10% of us here on this forum are included in that count.
But that analysis is an excellent display of the Dunning-Kruger effect—the observation that is sometimes rendered as “Stupid people are too stupid to know that they’re stupid.” The actual Dunning-Kruger effect applies to smart people. Like me. When thinking outside our own technical field, we don’t know enough to realize that we are in no position to draw reliable conclusions.
So back to Covid-19 and the dismal arithmetic I showed above. It leads directly to a sensible conclusion that likely is wrong. How can that be? Dunning-Kruger.
There’s competent Covid-19 pandemic modeling done at Imperial College: the study helped convince the UK government to intensify measures to protect the people. A nice overview is available at https://arstechnica.com/science/2020/03/new-model-examines-impact-of-different-methods-of-coronavirus-control/ with links to the original. They explore how different degrees of social distancing reduce the peak load on the medical system. The results also suggest that all the reasonable measures we are starting to take, like closing schools and gathering places, will still lead to a massive overload on the medical system: many dying people will be unable to get adequate treatment.
So what’s the way out? Where is the reason for optimism? Let’s go back to the original arithmetic. The 2 key knobs are the percent of people who get sick, and the percent of the sick people who die. If we want to turn down the first knob, we have to prevent people from getting sick before a vaccine comes out, and in any case we have to prevent completely overwhelming the healthcare system. To me that means extensive testing and strict isolation to halt the spread, as is apparently happening with success in some of the Asian countries, until such time as the vaccine prevents most people from getting sick.
But the real reason for optimism, which I overlooked until today, is the second knob, the death rate. I made the beginner’s blunder (hello Dunning-Kruger) of supposing that the death rate, currently somewhere around 1%, is a fixed property of this disease. It is not. It is a temporary effect of our current lack of medical knowledge: at present we give supportive care and wait for patients to heal themselves. When the physicians figure out effective treatments to prevent or reverse the infection and cytokine storm, then people who get treated will survive. This doesn’t require the development of a new drug, just figuring out an effective treatment protocol.
Adequate testing and isolation to enable the medical system to cope, plus learning how to treat it. That 's a plausible way to keep the number of deaths down.
