Is a person more likely to be insouciant, if not proficient?

 Several times in the past month I’ve been puzzled by individuals asserting the U.S. COVID-19 death rate is so low as to be inconsequential, and not warranting the measures being taken to limit infectivity.  I’ve witnessed people asserting the COVID-19 death rate is much lower than 1 percent.  In one case, a person asserted it is only 0.035 percent (a discussion among a Facebook friend and his friends), and in another case, a person asserted it was 0.02 percent (a recent video interview with a prominent Christian pastor).  Yet, when I view the available data, for example, at the Our World In Data site, I continue to see a case fatality rate in the U.S. above 3%, as shown in this chart. 

Three percent vs. 0.035 percent represents a huge difference in risk of death.  To put it another way, the current case fatality rate in the U.S. indicates that roughly 1 in 30 confirmed COVID-19 cases results in death.  What these other people are asserting is the COVID-19 risk is very much lower, killing only 1 in 3,000-4,000 people.  This is a huge difference.  With a probable death rate of 1 in 30 cases, it’s pretty clear why there are widespread calls to take precautions to avoid being infected, and minimize the probability of infecting others.  However, for those that believe the death rate from COVID-19 is 1 in 3,000 or lower, it’s easier to understand why they treat it with a cavalier attitude.  At this rate of mortality, COVID-19 would be much closer to what is observed in a typical flu season (based on CDC disease burden of influenza estimates).

A quick detour to address some caveats.  It is known that mortality varies significantly based on individual factors – age primary among them, and also a range of other health issues (comorbidities).  It is also known that an unknown number of people likely have contracted COVID-19, but with minor or no symptoms, and have not been confirmed as COVID-19 cases via testing.  If such cases were included in the case fatality rate calculation, the rate would clearly be lower.  There is a good discussion about the limitations of using the case fatality rate, which doesn’t really portray risk of death if infected on the Our World In Data site’s page on Mortality Risk of COVID-19.  Also, this analysis is only considering mortality, when it is clear that COVID-19 presents a range of other serious and longer term health issues.

So why are there people asserting such a different mortality rate than the data indicates, and consequently perceiving a much lower risk from COVID-19?  My light bulb moment came from the Facebook friend discussion thread, when a person arguing the mortality rate was 0.035 percent provided the data she was using, which was the EXACT SAME data published on the CDC site.  The only problem was that she was doing the math wrong.  A lot of people have trouble calculating percentages, and in this case, the person mistook the value 0.035 as a percentage, rather than properly as 3.5%.  That’s a big difference, and a significant one, when one is talking about something as serious as human death.  In the other case, Pastor John Macarthur of Grace Community Church in California, argues there is a 99.98% COVID-19 survival rate (in California), but what he is doing is using the crude mortality rate, which clearly underestimates the risk of death, if a person is infected.  He indicates this in an interview posted on Youtube (roughly 3 minutes in).  In this case, I feel he has selected the incorrect metric.  The best metric, which is impossible to know accurately, is the infection fatality rate, which is explained on the Our World In Data site (see link in previous paragraph).

These examples reminded me of longstanding studies which indicate that U.S. adults don’t perform particularly well on standard tests of literacy and math proficiency.  One such example is the Program for the International Assessment of Adult Competencies (PIAAC). 

Here is a chart showing U.S. performance on math (numeracy) in comparison to other countries.  This chart is gleaned from the published PIAAC report. 

A fairly critical summary article of U.S. performance on the PIAAC was published in Quartz (2016).

So it makes me wonder to what extend the lack of math proficiency is influencing some of the people who dismiss the risks of COVID-19 infection.

What do you think?  Leave a comment below.