Post #782: This explains a lot: Our top public health bureaucrats really can’t do math.

Posted on August 24, 2020

Before I start, what is your biggest fear, for the public as a whole, with respect to COVID-19?  Not for you and your family personally, but for the USA?  I have several.  One is that the outbreaks begin to increase exponentially, resulting in massive morbidity and mortality.  That seems unlikely.  Two is that the economy spirals into the next Great Depression, taking my life savings with it.   I still think that’s possible, but “the market” at least is not calling that likely.   Three is that this effectively disrupts education for years to come, resulting in an even-less-educated population, some years from now, than we have now.

I could go on, but you get the point.  If I ask for a biggest fear, we don’t exactly lack for candidates, do we?

And I’ll bet that you didn’t say “the potential interaction with the seasonal flu”. Because, in terms of biggest fears, that’s that pretty far down my list.  And that’s completely rational, based on the numbers.  It shouldn’t make anybody’s list of biggest fears about COVID-19.

I addressed the “flu” issue in Post #735, dated 6/30/2020.  Seasonal flu results in some hospitalizations every year.  If you looked at US totals, this might lead you to worry that the combination of flu, on top of COVID-19, might overwhelm the hospital system.

But if you bother to do the math, you’ll soon realize that’s a baseless worry.  And by that, I don’t mean that flu might be a major factor in those areas where COVID-19 strains the capacity of the hospital system.  I mean that flu cases will be, more-or-less, rounding error in those areas hard-hit by COVID-19.  It’s not even close to being an issue.  I did the math in Post #735.  Pretty sure I didn’t make any math errors.  And here’s my conclusion:

Best guess, based on a variety of sources, the impact of the peak of a bad flu season, on hospital inpatient resources in any one state, will be maybe 5% of the size of the impact of the peak of the COVID-19 outbreak.

The upshot is that if the worst flu season in recent history were to coincide exactly with the worst COVID-19 outbreak so far, it would have added 5% to the increased demand for hospital beds.  Not quite rounding error, but pretty close to it.  To be clear, the problem is COVID-19, not flu.

And so, what do I read in the headlines today:  No less a Personage than The Director of the United States Centers for Disease Control (and Prevention) says (emphasis mine):

CDC director Robert R. Redfield, MD shared his own "biggest fear," about COVID and flu: that together, they could completely overwhelm our nation's hospitals this winter.

Now, admittedly, this news article is just a puff piece to urge Americans to get their flu shot.  (Which, recall, in a good year might be as much as 60% effective in keeping you from getting the flu, as shown above and discussed in Post #741.  Something that neither the CDC director nor this newspaper report bothers to mention.)

And, if you read it carefully, he says it’s his worst fear with respect to COVID-19 and flu.  Which, if you break that down logically, what other fear could you plausibly have about the combination of the two?  So, it’s something of a misreading to say that it’s his greatest fear about COVID-19.

Still, the idea that season flu is a major issue in the context of COVID-19 and hospital capacity is just a canard.  It’s something said by people who are only capable of repeating what they’ve heard, and who can’t bother to look below the US national numbers at the actual detail of the situation. But the reality is, it’s just not true.

And it’s disheartening to see the head of the US CDC spreading that canard. But I wonder if this doesn’t begin to explain a lot about our public health system’s generally poor response to COVID-19.  This fellow is 70.  Dr. Faucci is pushing 80.

The leaders of our national public health infrastructure aren’t supermen.  They are, by and large, elderly successful bureaucrats who maybe don’t know when it’s time to retire and get some fresh blood into the system.  I’m turning 62 this year, and I’m nowhere near as sharp as a used to be.  I can’t imagine what I’ll be like if I reach their age.  But I sure wouldn’t want me running a critical organization, at that age.

Bottlenecks are at the top, as the phrase goes.  I have to wonder about the extent to which our various US public health failures are due to leadership that’s past its prime.  We’re asking 70- and 80-year-old bureaucrats to pass judgment on critical technical decisions, in the midst of (arguably) the worst public health crisis in a century.  Guys who just happened to be in those slots when the @#$t hit the fan.  I’m pretty sure that if we were designing our national crisis response from scratch, that wouldn’t our first choice for the command-and-control structure that would lead out defenses.