Not that long ago I read Hans Rosling’s book “Factfulness” which asks simple questions about global trends and compiles the generally wrong answers given by a wide variety of generally well informed groups. In the book, the author outlines concrete steps that we can all take to ask questions, take perspective, test our ideas and welcome complexity. One of the concepts that I find myself returning to is one of comparing numbers As Rosling puts it:
“Never leave a number all by itself. Never believe that one number on its own can be meaningful. If you are offered one number, always ask for at least one more. Something to compare it with.”
Here in Los Angeles County, local health officials told us that yesterday, another 70 deaths and 11,476 new cases of the coronavirus were recorded. In total, 512,872 cases have been reported and 8,269 people have died of the virus.
I prefer my “other” numbers in the form of a rate. Readers of my blog will be familiar with the epidemic curve which I have been presenting since March. Our previous maximum case rate before this surge was the reporting week ending 7/14/2020 – and that rate was 29.59 new daily cases per 100,000 population. For this most recent reporting week, ending 12/8/2020 that rate was 88.75 (Figure 1 below).
By graphing this week’s numbers, it is immediately obvious how unprecedented the current rise in cases has been. Even more concerning is the velocity of the rise with the current uptrend starting in the first week of November. Public health officials seeing a doubling of cases from 11/3 to 11/10 (nearly matching the mid July peak) should have implemented a safer-at-home order, rather than waiting until after Thanksgiving (which was politically expedient but a public health disaster).
There remains a small cadre of voices who care less about case numbers but concern themselves only with mortality rates. Granted, mortality rates have gone down likely as a consequence of improved in hospital treatment. However, there is a well worn path of increased cases → increased hospitalizations → increased ICU utilization → increased mortality rates seen since March and demonstrated dramatically when Italy’s health system became overrun early in the pandemic.
Mortality rates in Los Angeles are at similar highs seen in early May and again in late July (Figure 2). Given that mortality rates tend to lag by several weeks, we will no doubt set new records in the County.
Also yesterday was a protest march from Hollywood to Beverly Hills- to call for a rollback of COVID-19 restrictions [Link: https://ktla.com/news/local-news/business-owners-supporters-march-through-l-a-calling-for-rollback-of-covid-19-restrictions/]
Here again, Rosling’s advice is enormously helpful – from understanding that “human beings have a strong dramatic instinct toward binary thinking” and that “there’s no room for facts when our minds are occupied by fear.”
Instead Rosling proposes the following equation: Risk = danger × exposure.
He goes on to say, “the risk something poses to you depends not on how scared it makes you feel, but on a combination of two things. How dangerous is it? And how much are you exposed to it? • Get calm before you carry on. When you are afraid, you see the world differently. Make as few decisions as possible until the panic has subsided.”
I cannot think of better and more succinct advice at this time in our County.