Flat White

Corona care: stay up to date. The experts aren’t infallible – let alone the media

27 March 2020

3:28 PM

27 March 2020

3:28 PM

There are a lot of basic data errors being made in the media as we try to get our head around the scale of the chicomvirus and the necessary response.

Many of those mistakes, such as this one by Dr Daniel Horn, an expert in population health at Harvard Medical School who is leading preparations at Massachusetts General Hospital, writing in the New York Times about the genuine concern over ventilator capacity, are causing alarm.

The New England Journal of Medicine study Dr Horn cites found that 2.3 per cent of admitted hospital patients required invasive ventilation. The actual number was 6.1 per cent for all ventilation and the number of available ventilators is more than 175,000, versus 160,000. But he goes on to make a more fundamental data interpretation error of many magnitudes by suggesting 2.3 per cent of all cases might require ventilation rather than a fraction of those hospitalised as the study found.

Most confirmed cases (85 per cent or more) are either asymptomatic or resolve without any medical intervention let alone hospital admission or ICU or ventilator care. And that is before we count the large cohort of untested, undiagnosed cases.

To put that in the current Australian context, relatively high and growing testing rates reveal about 2800 active diagnosed cases, less than a dozen of which are hospitalised in a serious or critical condition. The crude fatality rate is 0.4 per cent or 10 times lower than WHO estimates.

And it has now transpired that the Imperial College epidemiologist Dr Neil Ferguson who had predicted a half millions Britons would die from the virus now says the number will be 20,000 and many would have died from other ailments they are battling. 

Hospitalisations and deaths lag new case data, so these ratios will change. But it appears clearer as each day progresses that the focus of concern must be to support older and vulnerable Australians in protective home isolation rather than shut down so much of our life-sustaining economy.

The doctors, nurses, technicians, researchers, hospital administrators and public health officials are being run off their feet preparing for the chicomvirus, including Dr Horn who makes some good suggestions about how we can scale up manufacturing capacity to meet the medical need. We owe them our gratitude for their dedication, professionalism and training.

I trust my doctor and I listen to what he says. I trust his judgement all the more because he doesn’t mind admitting that he’s not infallible.

The same holds for the medical establishment, generally, and what is loosely termed medical or scientific consensus. Until very recently a couple of Aussies won the Nobel Prize for thinking differently, the scientific consensus was that stomach ulcers were caused by stress and too many hot curries and salsa dips.

They will get us out of this but we have to keep our own minds and think more broadly about how we do it. As laymen shouldn’t flinch from questioning expert opinion. Sometimes it can be badly wrong.

Pollies, doing their best, are also having to make some monumentally big calls. It is fair to criticise them if we think they get it wrong. We live in a democracy after all, not China. But they also deserve to be included in our prayers.

It’s early days yet and there will be more tragic news for families across Australia. We face a serious risk to public health but there are growing reasons to be optimistic that the lurgy unleashed in Wuhan wet markets may not be as deadly as the Italian experience seemed to indicate and that we should rethink the blunt-force, costly way we are tackling that risk.

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