In an analysis published Tuesday, Stanford\u2019s John P.A. Ioannidis \u2014 co-director of the university\u2019s Meta-Research Innovation Center and\u00a0professor of medicine, biomedical data science, statistics, and\u00a0epidemiology and population health \u2014 suggests that the response to the coronavirus pandemic may be \u201ca fiasco in the making\u201d because we are making seismic decisions based on \u201cutterly unreliable\u201d data. The data we do have, Ioannidis explains, indicates that we are likely severely overreacting.<\/span><\/p>\n \u201cThe current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco,\u201d Ioannidis writes in an opinion piece published by\u00a0STAT<\/a>\u00a0on Tuesday.<\/span><\/p>\n \u201cDraconian countermeasures have been adopted in many countries. If the pandemic dissipates \u2014 either on its own or because of these measures \u2014 short-term extreme social distancing and lockdowns may be bearable,\u201d the statistician writes. \u201cHow long, though, should measures like these be continued if the pandemic churns across the globe unabated? How can policymakers tell if they are doing more good than harm?\u201d<\/span><\/p>\n The woefully inadequate data we have so far, the meta-research specialist argues, indicates that the extreme measures taken by many countries are likely way out of line and may result in ultimately unnecessary and catastrophic consequences. Due to extremely limited testing, we are likely missing \u201cthe vast majority of infections\u201d from COVID-19, he states, thus making reported fatality rates from the World Health Organization \u201cmeaningless.\u201d<\/span><\/p>\n \u201cPatients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes,\u201d Ioannidis explains. With very limited testing in many health systems, he suggests, that \u201cselection bias\u201d may only get worse going forward.<\/span><\/p>\n Ioannidis then zooms in on the \u201cone situation\u201d where \u201can entire, closed population was tested\u201d: the Diamond Princess cruise ship\u2019s quarantined passengers. While the fatality rate was 1.0%, he points out, the population was largely elderly, the most at-risk demographic. Projected out onto the age structure of the U.S. population, he calculates, the death rate is more like 0.125%, with a range of 0.025% to 0.625% based on the sample size:<\/span><\/p>\n Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data \u2014 there were just seven deaths among the 700 infected passengers and crew \u2014 the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases \u2014 a risk factor for worse outcomes with SARS-CoV-2 infection \u2014 than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.<\/span><\/p>\n \u201cThat huge range markedly affects how severe the pandemic is and what should be done,\u201d\u00a0Ioannidis stresses. \u201cA population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It\u2019s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.\u201d<\/span><\/p>\n For those who argue that the high fatality rate among elderly people indicates that the death rate cannot be as low as 0.05%, the professor notes that \u201ceven some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates\u00a0as high as 8%<\/a><\/strong><\/span>\u00a0when they infect elderly people in nursing homes.\u201d (Read the full opinion piece here<\/a>.)<\/span><\/p>\n <\/p>\n