As a Kentuckian, are you gonna get COVID-19? Will you die from it? Is a school kid gonna cause the death of the lunch lady? 

Are we missing some of the info we really need?

Though I’m not afraid of dying, I’d rather not die. I can do stuff to reduce the risk of dying but I’m kinda out of the driver’s seat on this one. We do things every day that you can die from. Driving or riding in a vehicle, eating cheeseburgers or even simply falling (yes nearly 600 Kentuckians die from falling every year). But COVID is different, right? I mean–this is spreading so fast and so easily and so many are dying that we have no choice but to shut down, keep our kids out of school, damage economies and indefinitely limit our way of life until a vaccine saves the day. After all, the credible data and scientists have proven all that, right?

And the vaccine will save the day, right?

The hard truth is that no one knows. Not Trump, not Andy, not Fauci/Birx, not the CDC or the WHO. There is no certainty a vaccine can impact this in the near term especially without its own series of risks. While there is consensus among medical professionals, there isn’t agreement on the certainty that masks stop the spread–just look at the curve in Japan, one of the most mask-compliant societies in the world. There is limited evidence (very few studies with remarkably small samples), but there is no proof or disproof of systemic long term health consequences of COVID if you don’t die, the same way there is no proof or disproof that overuse of alcohol-based hand sanitizer has long-term health consequences. Can an asymptomatic kid give this to grandpa or the school lunch lady? Well, yes, no, it’s possible or only on Tuesdays before 9pm if it’s cloudy. They don’t know. 

Science is generally a best guess business. ‘Trust the science’ means trusting the people that study this to guess on our behalf. And that’s fine as long as those educated guesses don’t disproportionally increase risk of death and impact a way of life. If you’re gonna do that to me, then you might need to have a few things figured out and if they knew what was happening with COVID they’d be able to define a clear standard of success. And they can’t. It’s flattening the curve, no—we did that—twice. It’s limiting death, no, we’ve been doing that in KY since May with no appreciable difference. It’s the number of cases, no, that’s trending down when adjusted for increased testing levels. It’s the positivity rate, that can’t be because if we all go get tested in the next 2 weeks, that’ll drive the positivity rate to under 1%. When the goalposts are always changing, it doesn’t exactly inspire confidence that their educated guesses and the associated limitations on our lives are justified. 

Then how do you make decisions for yourself and family? It’s called measuring relative risk. There is a chance you’ll die in a car wreck, but you still drive. There is a greater chance you’ll be shot with a firearm if you own one, but we are still free to own them. We make calculated decisions (intentionally or not) about the relative risk of doing stuff every day. So, how do we measure the relative risk of COVID with all the uncertainty?

Look at the data. No, not the “micro-stats” you hear about that one hospital in Miami putting new patients in a bread truck because they are out of capacity, but all the data. As a numbers guy, I can tell you how easy it is to pick a single data element and either scare the hell out of you or make you feel like a million bucks. Both are complete lies unless you put the data in the full context. Talking about case growth without testing growth is a lie. Talking about those 5 kids contracting COVID being a perfect reason to close schools is a lie. Talking about the 22 Clemson football players contracting COVID while arriving on campus being a harbinger of death is a lie. But when you put things in context, the numbers tell a story you might not be hearing during the Governor’s daily campaign to ‘take care of you’.

 

Let’s start with ‘cases’

This looks awful, right? I mean…while it’s dipping down a bit, the overall growth has been crazy. Eventually we’re all gonna get this and when we spread it to older or fatter family members they will likely die. And we’re all a little fat, right? Settle down a second.

This graph doesn’t show that 99.3% of Kentuckians HAVE NOT CONTRACTED COVID. Even the fat ones. When people talk about death rate they do it context of those that have contracted it (I’ll talk about that later), but they leave out the fact that the overwhelming majority of Kentuckians have not contracted it–and even if this grows 10x–most still won’t get it. Here is a breakdown of cases by age that make things even more intriguing:

 

  • Kentuckians over 80 have a 0.73% greater chance of getting COVID than the 20-29 group. Even if over 80, 98.27% of that age population HAVE NOT CONTRACTED COVID. 

  • If all these reckless kids are running around giving COVID to seniors, wouldn’t the infection rate for for 60 and 70 somethings be higher than the infection rate for younger folks? 

  • While there may be anecdotal examples of that, there is no systemic trend of school-aged kids putting the elderly at increased risk. In fact, the risk of getting COVID is less if your 50-80 than if you are 20-50. But 20-50 year olds are highly unlikely to experience serious illness with COVID.

Also, there is another interesting phenomena at play. In a recent national survey, people 20-30 think they are more likely to get COVID and die of COVID than people who are 50-80. That aligns with Kentucky testing data. The largest testing group by age in the state are 20-29s, followed by 30-40 and then the graph trends downward from there. Or said another way, the people with among the smallest risk of serious illness, are the most panicked over serious illness.

So, let’s talk about death.

 

The hard to extract small, flat red line at the very bottom–that’s the trend in deaths for Kentucky. 

Wait a minute, so you mean to say that despite all this prolific growth of ‘cases’ the death rate has remained relatively flat?
 
Yep.  And that is largely because we are now testing younger people that are statistically not dying very often and no longer just testing the sickest people (oldest) like we did in the beginning.  The media runs around talking about the explosion of cases in this age group, but we weren’t even testing them before. 
 

So, what are your chances of death from (or even with) COVID in KY?

Even if over 80, a Kentuckian’s chance of NOT dying from COVID is 99.66% and the younger you get those numbers become as close to 100% as statistically possible if not actually 100%. From birth to 40, seven people have died. SEVEN. But what if you do get it?
 

Well, here’s where it gets interesting. If over 80, the IFR (infection fatality rate) is 19.5% and 8.3% if 70-80. Yikes.

Before you freak out, remember 3 things:
  • There is still a 99.66% chance that those over 80 won’t get it. Even better for those 60-80.
  • Old people are more likely to die of stuff. I know that’s not very heart felt, but it’s a fact. People over 80 have a significantly higher chance of dying from…well…lots of things because old people are going to die of something sooner than younger people.
  • Long-term Care Facilities (Nursing Homes) have been a tragedy. The inability to manage COVID at these facilities has led to astonishing death rates. The majority of deaths in KY (476 out of 752) and nearly 50% across the country. And this is where a high population of those over 70 live.

 

Wait a minute, majority of KY deaths from LTC facilities? While that’s terrible and the state should do a better job managing this clearly vulnerable population, what do the numbers look like for the 99.93% of us that don’t live in a LTC facility?

Here comes the boom…

 

The IFR for Kentuckians over 80 NOT living in a LTC facility comes down to 4.26% from 19.5% with the chance of NOT dying from COVID for all Kentuckians over 80 at 99.93%. And accordingly, the numbers also improve for every other age range. 276 deaths in 5 months. If we annualized that, we’re talking about 662 deaths in KY for the worst pandemic in the history of memory. Meanwhile, 51% of all Kentuckians in the workforce (about 1,000,000 people) needed unemployment support in the same 5 months. Which leads us to ask…

How do all those numbers help us measure relative risk? If not living in a LTC facility, here are some relative risks to dying from COVID:

  • 3x more likely to die in a car accident
  • 6x more likely to die of a drug overdose
  • 1x more likely to be murdered
  • 4x more likely to be a victim of violent crime
  • 3x more likely to die of the flu/pneumonia
  • 2x more likely to be struck by lightning in your lifetime
  • 6x more likely to be injured in a toilet-related accident in your lifetime

Despite all these things, you operated as normal your entire life. You went to work and school. You didn’t kill your grandparents with the flu when you were 16. You went to games and parties. You drive everyday and you even used to walk down dark downtown streets to go to that new cool place to eat despite the increased risk of murder. You walk in the rain and you hit the restroom. You did these things because the real chance of the worst case scenario was far too low to disrupt your life or limit your ability to live your life. That’s measuring relative risk.

But what about the rising cases? The cases?!?!?! Good God, man…THE CASES!!

The more you test, the more you find. Do you think every case of the flu is documented, researched and contact traced? Almost everyone I know sucks it up for a few days, treats the symptoms and then bam – back in the game. If we increased flu testing rate by >80x (which is what we’d have to do to align with the COVID testing) do you think we’d find more cases? Of course.

In KY, the increase in testing volume against the rise in cases looks like this:

For the record, deaths are on the graph but they are so small on a relative basis, you’d have to zoom 400x to see the line—the FLAT line. Now if you did some basic math to adjust the amount of cases for the testing volume, the graph looks like this:
And this shows that we peaked in June. Not late July when the chorus sang that old hit record,“let’s shut it all down and cancel schools because of the uncontrollable case growth”, but early June. When you were headed to the beach and optimistic about the world cases adjusted for testing volume peaked.

 

Where are the Emperor’s clothes?

Whether I’ve opened your mind or not, why is there no voice, no media outlet, no leader pushing for the transparency that can only come from context? If you think everything I’ve said is trash, shouldn’t we be pushing for some kind of larger transparency that confirms the executive orders of a limited life?

This love note has been mostly interpretation of real facts and contextual data displayed in a way that probably makes many of you very uncomfortable. Many have chosen to believe Andy is there to take care of you. But there is no politician you should trust to take care of you. That’s your job. They are not helping me make my family’s decisions, they are making decisions for my family and asking for my blind faith to boot. 

There are a small but increasing band of non-partisan and brilliant people shouting this relative risk and context argument into the void. Ethical Skeptic, JB Handley, El Gato Malo on Twitter are just a few and they go beyond the political nonsense. I despise the Republicans right now and I loathe the Democrats. We are in the worst failure of human leadership since Nero played the fiddle while his empire burned. Politicians demonstrate either remarkable ineptitude, incompetence, self-interest or all of the above. I used to think they dumb everything down because they believe we’re stupid, but it may be because–they’re stupid.

The alternative is that they want this. There is no full, contextual data that shows the relative risk of severe illness from COVID in Kentucky is worthy of the actions that have been taken. None. So, there has to be other motivations. A media industry rapidly dying has found a platform of constant crisis and panic to sell clicks into. Politicians need your fear to maximize control and power while pushing the other side into the abyss in November. It’s the Republicans. No, it’s the Democrats. It’s Civil Unrest. It’s CNN, It’s FOX. It’s a parlor game that keeps the public looking at the magician’s top hand, but the bottom hand is where the trick is. I think that magic trick involves a perfect storm of greed, ambition, misaligned financial motivations and unparalleled fraud. More to come on this soon. 

For now, try and think in terms of relative risk and ask yourself, at what point is an increased risk of dying worth reclaiming the ability to live a full life? For me, I’m there–even if it costs me my life. My Dad and Grandfather were willing to run into bullets to preserve a way of life, so I think the least I can do is have the courage to go watch my daughter play soccer without fear of impending death or being called a murderer for doing it.

And if that’s too big of a risk for you and you’re afraid of getting this, it’s ok. Just stay home.

 

All data has been complied from kycovid19.ky.gov and the CDC. The results are calculated and analyzed over a period from July, 24 2020 through August 7.