Why Don’t We Know More About the Coronavirus Risks?

Why Don’t We Know More About the Coronavirus Risks? | By Mike Critelli

Recently, I had a heated debate with a good friend about whether our government officials are overreacting to the Coronavirus crisis.  His response was logical and compelling: “We don’t know about the scope or seriousness of this virus, so we have to take more drastic steps to control it.”

His remarks begged this question:  Why do we not know more than we do?  Several thoughts came to mind:



"Rome, 13 Mar 19:12 - (Agenzia Nova) - The people who died of coronavirus in Italy, who did not have other diseases, could be only two. This is what emerges from the medical records examined so far by the Higher Institute of Health, according to the President of the Institute, Silvio Brusaferro, during the press conference held today at the Civil Protection in Rome. "The positive deceased patients have an average age of over 80 years - 80.3 to be exact - and are predominantly male," said Brusaferro. "Women make up 25.8%. The average age of the deceased is significantly higher than the other positives. The age groups over 70, with a peak between 80 and 89 years. The majority of these people are carriers of chronic diseases. Only two people have not been found to be carriers of pathologies at the moment", but even in these two cases, the examination of the records is not concluded and therefore causes of death other than Covid-19 may emerge. The president of the ISS has specified that so far "just over one hundred medical records" have been received from hospitals throughout Italy."

Italy has begun to look not only at the ages and genders of those who have died, but the chronic diseases they had prior to contracting the virus.  They are only 100 health records into their analysis, but they have done a better job than we in figuring out who is at risk. Unfortunately, they are doing a national lockdown, because they have no good data on the broader population to determine where the most prevalent disease hotspots within the various communities might be.

Public health became a credible government discipline in 1854 when UK physician John Snow isolated a cholera outbreak to a single contaminated drinking water supply and those who accessed it.  London did not do a citywide lockdown. Dr. Snow diagnosed and solved the problem at its source. We are incapable of doing the same thing here and are destroying our economy because we lack more granular data.

In the Monday, March 16, 2020, issue of The Wall Street Journal, USC Associate Professor Neeraj Sood has published an Op-Ed piece in which he proposes nationwide statistically valid random testing for the Coronavirus, so that we can get more representative data on whose is getting infected and whose symptoms are migrating to a more serious level.  It is an imperfect way of addressing the problem, but it is far better than the non-random testing occurring today, which will tend to overstate the risk and draw in those who have more serious symptoms.  

We know that far more people have the virus than are in confirmed cases, but we do not know how many, who they are, or what the rate of progression to a serious illness level would be for the entire infected population. 

The statements by Dr. Fauci and by our Surgeon General make it clear that they believe that the situation “will get worse before it gets better” but we do not know what that means.  If we had 20 million cases equivalent to a mild flu outbreak, we would not be taking the drastic steps we are taking. However, we do not know what a higher level of cases means for us.  That is preventable and fixable, but we need the political will and the imagination to address it.


He noted that we successfully controlled the death rate of HIV/AIDS, even though we have yet to develop an effective HIV/AIDS vaccine.  I agree with his recommendations.

As I have posted on LinkedIn, there are serious short and long term consequences from enforced social isolation, especially for older people who suffer from mental health conditions and other chronic diseases.


I would hope that this crisis will force us to move more aggressively to comprehensive health records, the creation of national health registries, telehealth solutions to reduce the strain on in-person providers, and anti-viral drugs.