In this essay I take on the “debunking” claims surrounding the claims of Dr. Daniel Erickson and Dr. Artin Messihi of Accelerated Urgent Care, whose press conference was removed from YouTube for violating its community standards. Susan Wojcicki, CEO of that social media platform, announced on April 23, the day before Erickson and Messihi’s press conference was posted, “Anything that goes against WHO recommendations would be a violation of our policy and so remove is another really important part of our policy.” I will focus on the criticisms of Erickson’s arguments. They are often uncharitable, irrelevant, or wrong.
The alleged debunking is best described as the action of a fog machine. Because the video was widely shared and is particularly effective (and Erickson is a compelling figure), those who wish to keep alive the myth that COVID-19 is a unique threat to Americans and who insist, therefore, that extreme government measures of shelter-in-place, social distancing, and the wearing of masks are justified, recognize they need to delegitimize the messenger.
Of course, one may quibble with aspects of the claims made in the video. But highlighting the adversarial character of normal science is not debunking. Few studies are without criticism. Indeed, the frenzy of media claims that the doctors’ presentation have been debunked substitutes for any actual debunking. And while consumers of the articles and videos claiming to be debunking are distracted by this manufactured controversy, the antibodies studies that backup the doctors’ arguments are disappearing from the news cycle, hidden in the fog.
In fact, many the counterarguments to the claims in question don’t work. I show you why in this essay. I will trust readers to be familiar with the arguments. If it appears at any point that my characterization of a point amount to a straw man argument I am more than happy to make corrections.
First, I need to make sure readers understand the simple fact that the true number of cases is much higher than the number of confirmed cases. This is an uncontroversial fact in the scientific community even if the media continues to neglect or distort that fact. That means that the actual death rate is much lower than what the public is being told or led to believe. But the media continues to obscure this reality.
For example, a CNN article published today on the Michigan protests states: “More than 41,000 people in Michigan have been infected with the coronavirus and at least 3,789 have died, according to state health officials. Only two states have more coronavirus-related deaths.” Whenever the media state the figure this way alongside the death toll, they’re engaging in an exaggeration of the lethality of this virus. Putting it like this makes the death rate appear to be over 9 percent. They never do this with the flu. If they did, the death rate from the flu would be over 9 percent. That is revealing in itself. However, this is the correct way to put the statistic: “More than 41,000 people in Michigan have tested positive for the coronavirus.” It must be put this way because we know that many times the tested number have been infected with a virus.
What is the true prevalence of this virus? Here are scientific studies that address the matter:
• Just updated (April 30, 2020), researchers at Stanford University published a study, “COVID-19 Antibody Seroprevalence in Santa Clara County, California,” that, using a sample of 3,324 specimens, weighted for population demographics, found that 2.8% of the county’s residents, that is 54,000 persons, have been infected with the COVID-19 virus. That is many more times the 1000 confirmed cases at the time of the survey (April 3-4). In other words, the actual prevalence of COVID-19 antibody was 54 times higher than the number of positive blood serum tests. The upward confidence bound found that it could be 85 times higher (or 4.2%).
• A study of Los Angeles County, conducted by the University of Sothern California, published on April 20, 2020, found that, an estimated approximately 4.1% of the county’s adult population, and possibly as many as 5.6%, had antibodies to the virus. That translates to approximately 221,000 to 442,000 adults in the county who have had the infection, an estimate is 28 to 55 times higher than the 7,994 confirmed cases of COVID-19 reported to the county by the time of the study in early April. The large number of participants were recruited using a database that is representative of the county population. “We haven’t known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited,” said lead investigator Neeraj Sood, a USC professor of public policy at USC Price School for Public Policy and senior fellow at USC Schaeffer Center for Health Policy and Economics.
• A study of New York State residents found that 14.9% of people tested positive. In the New York City, 24.7% of have antibodies for the virus. The results of this study were announced by Governor Andrew Cuomo on April 23.
Any serious critique of the doctors at Accelerated Urgent Care would keep these numbers in mind. More than this, the principle of charity, if observed, would cite these studies in every communication about this case as supporting the doctor’s claims. Any decent human being, knowing the extent and depth of fear experienced over this virus would assure people that it is not nearly as dangerous as they have been led to believe or might have come to believe on their own without access to pertinent and accurate information. To fail to do these things is an intentional act to keep from the audience important information it needs to make a reasoned judgment. It is, in other words, propaganda.
It’s not as if we haven’t known this all along. Consider the writings of Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and one of the lead members of the Trump Administration’s White House Coronavirus Task Force. For example, on February 28, 2020, in an editorial published in The New England Journal of Medicine, he writes, “On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%. In another article in the Journal, Guan et al. report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.”
Here are the main criticisms and my rebuttals:
• Random sampling is necessary to extrapolate in the manner Dr. Erickson extrapolates. His thousands of tests, encompassing half of the residents in the country he serves, finding that 6% of those tested had positive results, are not representative of the population. But do they need to be? It is not explained why if so. They are in line with the number of those who tested positive for antibodies in the other studies and these are representative. The critique deploys technical language to obscure the significance of the fact reported.
• The representativeness of the tests he administered is a bit of a red herring since Dr. Erickson relies on California state numbers available at the time for his primary extrapolation. These are big numbers. There were 33,865 positives from 280,900 blood serum tests in California at the time of the press conference. That means that 12% of cases tested positive. Critics say this is not random, either. But, again, does it need to be? What we should be emphasizing is that this is not the number of cases, but the number of positive tests. To repeat, the true prevalence of the disease is much higher, as the scientific studies cited earlier clearly show.
• Dr. Erickson performs the extrapolation using the population of the state of California (39,500,000), the number of positive tests, and the 1,227 deaths assigned to COVID-19 the time: 1,227/(0.12 x 39,500,000) = 0.00026 or 0.03%. He concludes that COVID-19 is not worse that influenza. Crucially, the tests are mostly those who are sick. Even without a random sample, it is a reasonable extrapolation; Erickson can be off by a lot and still have his argument. Do the calculations using the antibody tests cited above. We know from the antibodies studies in California that the rate of infection is between 28 and 85 times greater than what testing shows. For New York, the prevalence is even greater than Dr. Erickson’s extrapolations. The studies confirm the rough order of magnitude of his extrapolation.
• If these are sick people, two things follow: (a) they are sick from something else (like influenza); (b) the finding is a death rate is 0.03% among people sick with COVID-19. For (a), since most cases were not positive for SARS-CoV-2, many of those cases of flu-like illness are likely influenza. It would be much lower than this if all of those who are not sick but who are infected with the virus are considered. For (b), we know that, for the vast majority of people, the disease is asymptomatic or mild, estimated to be somewhere between 80 and 95% of cases. They generally aren’t tested. In all likelihood, his number is too conservative.
• Another complaint is that, without COVID-19, those with comorbidities would not have died. It is said that comorbidities merely help COVID-19 kill people. But many people die with COVID-19 not from it. The public is not told this obvious fact—and not because it is obvious. Most people who die from COVID-19, given risk of death in light of age and condition of health, will die this year or next year without COVID-19. Moreover, those likely to die with COVID-19 are not only at risk to die anyway from their ailments (sorry to be blunt), but, since they are not testing many of these patients, they can’t know if they died from influenza or a bacterial infection. We know from the tests that most sick people test negative for SARS-CoV-2, which means that what is sickening them is another pathogen, probably influenza (at least the CDC would have said so in another year), which has conveniently disappeared from the landscape. In other words, if a person have pneumonia, it may not by SARS-C0V-2 causing it. If they are on a ventilator, it is not be because they have COVID-19.
• Since the vast majority of healthy persons survive COVID-19, it is obviously not true that COVID-19 kills people with the certainty the government and media claim. A bullet to the head will very likely kill a healthy person. COVID-19 is very unlikely to kill a healthy person. This matters when we talk about causation. I say that to say this: that the comorbidities associated with death in suspected cases are common only means that these ailments are more likely to be the cause of death. The claim that if there were rare one could say COVID-19 isn’t what killed them, a critique one hears, is nonsensical. If these cormorbidities were rare, they would easily be ruled out as a cause of the death, since most people would die without them. But they don’t. So the argument is backwards.
• Dr. Erickson is criticized for saying that the death rate from the flu is the same. His claim is countered with studies showing an overall death rate from COVID-19 is higher than 0.03%. A typical account uses a widely accepted study from China showing that the death rate is 0.66% overall. That is higher than 0.03%. Interestingly, the estimates used in this study rely on undiagnosed cases, they are extrapolations, which, according to his critics, should disqualify it (which disqualifies much of what the CDC does—but then, the critics operate with a double consciousness on estimating virus cases). However, this statistic is revealing in that, while 0.66% is greater than 0.03%, it is much smaller than the case-fatality rates routinely cited or suggested by the media. And, by the way, the same study shows that the death rates for children 9 and younger is 0.0016%, while people over 80 years of age die at a rate of 7.8%. In other words, the death rate for healthy adults is much less than 0.66%. So is it worse than the flu? Maybe. But the point is that it is much less worse than the public is led to believe by government and media. Much, much less worse. In other words, it is not unusually deadly.
• Another criticism is that the claim that the failure of COVID-19 to kills massive numbers of people means the initial models were wrong does not take into account the impact of social distancing in changing those projections. But the claim that social distancing reduces deaths is not supported by the evidence. Governments and media outlets keep saying this, but they have no data to back up that claim. That chart we keep seeing with the trend lines is propaganda. All social distancing is likely doing is preventing the population from acquiring herd immunity. And that is a bad thing. Which is one of Erickson’s points about the problem with the lockdown. And he’s right. We need immunity for this thing. There is no vaccine and it will come back.
• Finally, there is a claim that, whether or not we think that COVID-19 is especially deadly, we are doubling deaths because COVID-19 piggybacks off of the flu and that, somehow, this is an important rebuttal to Dr. Erickson’s argument. It’s a red herring. But it does raise a problem for the pro-panic crowd. Flu deaths have been running over the last nine years at around 50 thousand annually. There is not much variation around mean in the long-term, but the last several years have been particularly bad at around 60 thousand. Yet, this year, the CDC says we’re done with flu deaths at 24 thousand. Just in time for COVID-19. There is no explanation for why deaths from the flu are so much less than they have been in past recent years. Moreover, there isn’t a doubling in pneumonia deaths, which is what we’re actually talking about (since most pneumonia deaths do not have an established cause). There is a greater number of deaths this year than last year, to be sure, but the CDC estimates that as many as 95 thousand people died in the 2017-18 flu season. So we are at this point pushing up against the 2017-2018 numbers, numbers that were regarded as so unremarkable that the media did not even bother to report them. And to stop you from asking why they simply say, “This is not the flu,” a true statement that is beside the point.
As I stated at the outset, the alleged debunking is best described as the action of a fog machine. It’s a propaganda campaign by desperate authoritarians. Because the video was widely shared and makes a compelling argument from a confident doctor, those with power and purchase who desire to keep the COVID-19 myth of extreme death going recognize they need to kill the messenger. YouTube did its part by making it difficult to see what Dr. Erickson actually argues by removing the video. So this has become something of a one-sided conversation. I am bringing the other side back into the debate.
freedom and reason 