Jacobin (9/19/20) platforms two epidemiologists who argue that “exposures [to coronavirus] in young, healthy people contribute to the herd immunity that will ultimately benefit all”—without spelling out the massive death toll such a policy implies.
I posted an angry piece on Wednesday (9/23/20) about an interview that was published by Jacobin (9/19/20)—and then immediately took it down, because it was based on a misreading of a chart from the Centers for Disease Control.
While I’m sorry I didn’t catch the mistake before publishing (and grateful to the reader who pointed out my error), I’m glad to be wrong, because my error was thinking that children are considerably more vulnerable to the coronavirus than they actually are.
Looking at the correct numbers provided by the CDC on Covid-19 cases and deaths, one can calculate the percentage of reported cases for each age group that result in death. For the 0–4 years group, there have been 89,224 reported cases and 34 deaths, for a 0.04% fatality rate. For ages 5–17, it’s 332,192 cases and 58 deaths, or 0.02% fatality. For 18–29, it’s 1,171,828 and 766 deaths, which is 0.07%.
By way of comparison, the CDC reports a case fatality rate for measles of 0.2%, and for chicken pox, for children 1–14, of about 0.01%.
The line in the Jacobin interview I took issue with was Harvard epidemiologist Martin Kulldorff saying, “Children and young adults have minimal risk, and there is no scientific or public health rationale to close daycare centers, schools or colleges.” While my rebuttal to this claim was based on exaggerated numbers, the question remains: Does a disease that kills two, four or seven young patients in 10,000 qualify as a “minimal risk”? Would epidemiologists say that a new strain of chicken pox that was twice as lethal or more, depending on the age group, and for which we had no immunity to or vaccine for, provided “no scientific or public health rationale” for closing schools?
When Kulldorff assures Jacobin that there is “a more than thousand-fold difference in mortality risk by age,” the interview links to a study by Kulldorff (published on LinkedIn, 4/10/20) that finds extremely low risks of death for children and young adults. But he achieves this through sleight of hand, combining a low risk of infection when exposed with a low risk of death when infected. The policy Kulldorff seems to be advocating, however, is to not try to prevent infection in most children—because, as his colleague Katherine Yih says, “exposures [to the coronavirus] in young, healthy people contribute to the herd immunity that will ultimately benefit all.” So the fact that it may take more exposures of young people before one is sickened than for older people is irrelevant to the question of how risky the policies proposed by Kulldorff and Yih would be.
As FAIR (3/17/20, 5/27/20) has argued before, people who promote the idea of accepting Covid infection in pursuit of herd immunity rarely acknowledge the high death toll that such a policy necessarily entails. There are about 20 million children under the age of five in the United States, according to the Census; if no steps are taken to prevent them from being infected with the coronavirus, a fatality rate of 0.04% implies a worst-case scenario of 8,000 deaths among them.
There are an estimated 62 million children between the ages of 5–19; applying the 0.02% death rate for reported cases among 5-17-year-olds suggests a possible death toll of 12,000 were they all allowed to be infected. For the 45 million between the ages of 20–29, the 0.07% fatality rate for reported cases among 18-29-year-olds indicates a worst case of 32,000 deaths.
If the US truly tried to pursue a herd immunity strategy, the actual number of deaths among children and young adults would almost certainly be less than these numbers; herd immunity would in fact kick in at some point before every child was infected. And there are no doubt cases of Covid in children and young adults that are not reported to medical authorities, so the true case fatality rates are likely not as high as the figures used in these calculations. But how much lower they might be is based on guesses about when herd immunity would be reached, and how many Covid cases there are that we don’t know about.
It’s safe to say, when almost a hundred children have died when less than 1% of the youth population has reportedly been infected, that a policy that deliberately allows a majority of children to be infected will cause a scale of deaths among children that few parents would consider a “minimal risk.”
Case fatality rate also ignores other long-term health problems that result from covid infection. Sentencing thousands of children to permanent breathing problems is just as callous as sentencing them to death, imho.
Has the Jacobin article appeared yet in a presidential tweet (in CAPITAL letters, with multiple exclamation marks!!!)?
You’re totally missing the point! So what if NO kids EVER die from C-19? Assume there are NO adverse effects for kids at all.
Does that make it ok for kids to infect their family members, spreading DEATH to the old and sick?
One of the all-time WORST Fair articles.
On the other hand, if you send the kids home, and their parent’s can’t afford to go to work anymore, what will that do to the parents and how will that affect kids?
Children and young people in day cares, schools and colleges aren’t going to attend unsupervised. There will be adult staff, and children will be returning to their families at the end of the school day. Seems to me the biggest concern is having children and young people acting as a powerful vector for infecting older people, although, as you point out, the expected number of deaths of children and young people is not something to wave off.
After almost a year of daily infection rates and death counts in the media due to covid, it is not surprising that people are finding it hard to accept that this is just a flu and change their behaviour. These draconian measures were justified in the beginning when not much was known about this virus and there was a fear that our health system was not prepared for a possible pandemic but at this juncture most hospitals have the equipment they need and they have several treatment protocols to treat people that do get this flu. Our priority now should be to reach herd immunity as quickly as possible which would be the best way to save people.
You’re factually wrong at every turn. It hasn’t been almost a year, the shutdowns began somewhere in March. You also act as if the crisis is largely taken care of when the US is still losing roughly 1,000 people a day to this thing. Talking about herd immunity outside of a vaccination campaign is nonsense. People get reinfected and there is evidence suggesting that the immunity to COVID-19 doesn’t last very long, to say nothing about the long term health effects of COVID on its survivors. Also, your reply ignores the very real fact that medical bills are the leading cause of bankruptcy in the US. It will be a catastrophe wrapped in a disaster, and your wishful thinking will have greased the wheels to it all.
“Talking about herd immunity outside of a vaccination campaign is nonsense.”
Tell that to Sweden. That’s exactly the strategy they pursued and they have been falling steadily down the death count charts while everyone else tries to hide from the virus. And reinfections? Prove it. More like people are testing positive again for viral fragments from an infection that has already resolved. The CDC’s own data shows that above 33 amplification cycles PCR tests are not picking up live virus.
A “vaccination campaign” is a very flimsy leg to stand on, considering there has never been a successful vaccine for any previous coronavirus–SARS, MERS, Zika, etc. Waiting for a vaccine for an otherwise treatable disease is a pipe dream.
Even if the death rate for anyone 20 years old or younger were 0.000001%, as long as they’re interacting with older people, such as their parents, grandparents, older siblings and teachers, the rationale for letting them be exposed is clearly flawed. Why was this not even touched on in the article?
Jim cites 92 deaths from Covid among children 0-17.
During last year’s flu season there were 188 deaths from seasonal flu among children 0-17. See https://www.cdc.gov/flu/spotlights/2019-2020/2019-20-pediatric-flu-deaths.htm
The flu appears to be more fatal than Covid for children 0-17.
If the discussion is about children and school openings, I don’t understand why Jim cites the 18-29 age group.
FAIR should be asking why corporate media is censoring the low rates of fatalities and hospitalizations among children, not attacking people who point them out. FAIR has dropped the ball on this issue.
Full disclosure: I’ve been a supporter and contributor to FAIR for at least 30 years.
Jim, I am assuming that the “sleight of hand” you refer is Kirkland going from Relative Risk to Absolute Risk. “Minimal risk” as you point out is a relative term. Risk is a judgement call which is why informed consent accompanies medical procedures. If and when a covid19 vaccine becomes available we will all have to weigh the known and unknown risks (whether they are minimal or not) and exercise our medical rights to decline or accept the vaccine based on all the data. (I hope you will speak out when the psychological shaming begins for people who decline based on the principle of informed consent.)
Kirkland and Yang are not alone in proposing “controlled infection” as the Jacobin article discusses. They specifically mention Sweden as the model which attempted to find this balance. I just read that Dr. Johan Giesecke, Former Chief Epidemiologist, Sweden Member of the Strategic and Technical Advisory Group for Infectious Hazards, WHO, is in the process of advising Ireland on controlled infection which incorporates much of what was covered in the Jacobin article.
Quarantine and bad economy kill people too. Some study found that for each 1% increase in unemployment rate, 40,000 people will die. Unemployment rate went from under 4% in February to over 14% in may, so that is about 400,000 extra deaths.
Estimated 30 to 40 million are facing COVID related eviction. Imagine what will that do to homelessness rate, crime rate, disease rate and ultimately death rate.
And even just not sending kids to school means that many parents will need to somehow find a babysitter or lose their jobs entirely. What will all that stress and desperation from parents do to the kids long term? Who knows.
Jim–
Thanks for correcting the numbers. The idea put forward by the epidemiologists is simply that the same number of people but skewed to the younger demographic will mean fewer deaths, as opposed to a flat distribution. Herd immunity is attained either way. Why not make it less painful?
–Chris Bystroff, Professor of Biology and Computer Science at Rensselaer Polytechnic Institute in New York.
Your estimations of total deaths of children if the US had pursued herd immunity is over-estimated because you have to consider that the majority of pediatric cases of COVID are asymptomatic and therefore rarely are such kids brought in for testing. So the death rate per total infections for kids is likely far lower than estimated. I also agree with the above comment that comparing COVID death rates to the seasonal flu is the better comparison when considering policy. Of course I am not advocating throwing caution to the wind for any group of people regarding COVID – I’m just a stickler for accurate stats/logic.
Martin Kulldorf emailed Jim Naureckas, asserting that Jim’s corrected calculation remains flawed and exaggerated. Martin sent me a copy of the email because I had notified him about Jim’s first article, which Jim retracted.
Especially since Jim has leveled an ad hominem attack on Martin — accusing him of “sleight of hand” — I think it’s incumbent on FAIR to give Martin an opportunity to defend his position on the FAIR website. Even better, why not get an expert who disagrees with Martin to debate him, and post that debate on the website? FAIR should not be in the business of ad hominem attacks and censoring dissent — which is where things stand at this time.