“We lose thousands of people a year to the flu. We never turn the country off,” President Donald Trump said on Tuesday from the White House’s Rose Garden as he argued in favor of easing lockdown orders across the country for the sake of the economy.
“We lose much more than that to automobile accidents. We didn’t call up the automobile companies and say, ‘Stop making cars,’” Trump went on.
The U.S. is likely still weeks away from finding out just how bad the coronavirus outbreak is going to be, but already the president appears to have shifted his focus back to the markets. According to Trump, the global health crisis may be unprecedented, but there are many people in the U.S. who die of certain unnatural causes each year, and we accept it as a cost of modern living. So why all the disruption for COVID-19, the disease caused by the coronavirus, when we don’t shut down public schools during flu season, or tell people to shelter in place to avoid being in a car crash?
Here’s your answer.
COVID-19 is in a different class than the flu: It has a much higher mortality rate and it’s a lot more contagious.
There is currently no vaccine for the new virus. And while the influenza mortality rate is around 0.1% in the U.S., the COVID-19 mortality rate is at least 10 times higher.
“Depending on whose numbers you’re looking at,” said Dr. Georges Benjamin, executive director of the American Public Health Association, the coronavirus mortality rate is “anywhere from 1.5% to 3.5%.”
Because it’s not known how many people have had the virus without showing symptoms and getting tested, researchers are still figuring out the overall mortality rate. Currently, the numbers differ vastly across countries. Italy’s mortality rate is around 10%, based on data compiled by the World Health Organization, and in France it’s about 5%. In the U.S., it’s just over 1% so far.
It is possible that we are overstating the true mortality rate. “Problem is, no doctor wants to take that risk,” Dr. Howard Markel, director of the University of Michigan’s Center for the History of Medicine, told HuffPost.
“I’ve been a doctor for over 30 years and I’ve never had a patient come back to me and say, ‘Hey, Doc, I want my money back because you said it’s better to be safe than sorry,’” Markel added. That’s why critics are hammering the Trump administration for moving so slowly on securing extra medical equipment.
Another thing wrong with Trump’s comparison has to do with how the coronavirus can spread between people. The new virus has an incubation period of anywhere between one and 14 days, whereas you’ll know you have the flu one to four days after getting infected.
“Normal flu, if I get that, I’m going to infect about 1.3, 1.4 people,” Dr. Hugh Montgomery, chair of intensive care medicine at University College London, explained in a video for Channel 4 that’s gone viral. If those people pass the virus on, and then those people pass it on, “by the time that’s happened 10 times, I’ve been responsible for about 14 cases of flu,” he explained.
With COVID-19, each person could pass the virus to about three others. “Now that doesn’t sound like much of a difference, but if each of those three passes it to three, and that happens at 10 layers, I have been responsible for infecting 59,000 people,” Montgomery said.
So the coronavirus is both much deadlier and much more contagious. That brings us to the hospitals.
The health care system is only built to treat a certain number of people at any given time, because that’s how health care facilities avoid going bankrupt, Markel explained. Individually, facilities can’t be constantly prepared for a pandemic, he said, especially considering how equipment like respirators and ventilators need to be regularly cleaned and maintained.
“These things happen so rarely that it would be folly ― it would not be a good use of health care resources ― to do that,” Markel said.
That’s why public health experts have stressed the importance of flattening the curve, or staggering the number of cases over a longer period of time. COVID-19 has the potential to completely overwhelm the health care system if we all went back to work as soon as Trump wants us to.
Traffic deaths aren’t contagious at all.
Trump’s comparison of COVID-19 deaths to traffic fatalities is even less useful.
First of all, traffic deaths are not contagious. Failing to quarantine one person with coronavirus may result in two cases the next day, four the next, eight the next and so on. The infection spreads exponentially, with early intervention making a profound impact on the later severity of the outbreak.
Traffic fatalities don’t have this characteristic. While road deaths are indeed highly sensitive to factors like speed limits, road design and ambulance response times, failing to prevent a single car accident today doesn’t result in an even larger number tomorrow.
But Trump’s use of traffic fatalities to defend his inaction on coronavirus is false in another way too. Far from inevitable, road deaths can be reduced through the same basic good-governance efforts as disease outbreaks.
The United States has the highest rate of traffic fatalities in the developed world. Due to lax enforcement of speed limits, lenient drunk-driving laws and poorly designed streets, Americans are roughly 50% more likely to die on the road than Europeans.
And it’s getting worse: Between 2010 and 2017, most countries have seen a decline in road deaths. The United States has seen the world’s second-largest increase in road deaths after Colombia. While some of this increase can be explained by the rise in distracted drivers and worsening urban congestion, it also stems from America’s unique addiction to cheap gas and large vehicles.
This makes Trump’s analogy even worse. Not only do traffic deaths have wildly different characteristics than the coronavirus, but they have been getting worse due to the same inaction he has displayed during the pandemic. While some cities and states have committed to reaching “Vision Zero” — no traffic fatalities for an entire year — these efforts have been hamstrung by the Trump administration’s refusal to invest in public transportation and other, safer alternatives to driving.
So when Trump says holding him responsible for coronavirus deaths would be just like holding him responsible for traffic deaths, maybe he’s on to something.