[JoshuaDavid]

> We're approaching the total death toll of World War II[3].

We're really not though. World War II killed somewhere in the ballpark of 75 million people. COVID-19 has a bit under 800,000 known deaths. Even if we say that for every person who is known to have died of covid, 5 additional people died and were recorded as deaths from other causes (and it's not that high, you can check the excess mortality stats to confirm for yourself that it couldn't possibly be that high), the number of covid deaths _still_ wouldn't even be 10% of the total number of WWII deaths.

Unless by "approaching" you mean "getting closer to because it's currently below that number and increasing" in which case the number of people killed by vending machines is also "approaching" the number of people killed by WWII.

Hyperbolic statements like this just serve to undermine trust, and trust is already in pretty short supply, especially around the pandemic. Messaging around the pandemic has had a pattern of people making whatever statements they think is most likely to get people to comply with public health guidance, even if those statements are false or misleading.

For example, there's a great deal of news lately about how COVID-19 can cause Multisystem Inflammation Syndrome (MIS-C) in children, and that 80% of children who develop MIS-C require intensive care, and that the existence of MIS-C as a possible complication of covid means you should worry more about kids getting covid. What these articles neglect to mention is that only about 300 cases of MIS-C have been observed in children, out of what is probably low-millions of children infected with covid.

When you make misleading statements in order to induce compliance through panic, it'll work the first few times, but eventually people will start noticing, and stop trusting anything you or anyone who sounds like you says, even if it's true. This is the moral of the "Boy Who Cried Wolf" story, and it's been seen again and again in real-life contexts as well (see for example how DARE actually _increases_ drug use).

Making false-but-alarming statements about public health sucks the air out of the room for true-and-alarming statements about public health, and is the moral equivalent of crying wolf except with millions of lives on the line instead of just one village.

Please stop crying wolf.

[throwawaygh]

I think he meant US deaths because his source is a list of WWII deaths by country. That is actually fairly accurate: 170K direct, he assumes ~2x if you count indirect, so ~400K which is indeed approaching total US WWII casualities (460K or so).

Even if you don't count or differently count indirect deaths, I'd still say going from 0 to 170K in 6 months with no end in sight definitely constitutes "approaching". We'll get there before this is all over, for sure.

[JoshuaDavid]

Ok, but WWII wasn't really a horrifying war because of the number of _American_ casualties. The US lost 0.35% of its population as casualties to WWII, which was pretty close to the percentage of the _world_ population, _including non-participating countries_, that died in WWII (0.33%). Russia, which _was_ a good example of a country that got hit hard by WWII, lost 15%.

By contrast, the US _is_ one of the countries hit hardest by covid -- the US has about 5x the number of deaths per capita as the world average.

It's a little less egregious if the original poster meant "US casualties in WWII vs US deaths from covid" but it's still a misleading comparison.

[throwawaygh]

I agree "US casualties in WWII vs US deaths from covid" is far more appropriate. OP forgot to say US and you were right to point this out.

Past that, at some point it's hard for me to take this sort of thing too seriously. OP probably doesn't have a copy editor for the online comments he's writing from the shitter/waiting for the coffee brewer.

It's a reasonable comparison because, sans COVID context, literally every American would answer "yes" to the question "did lots of Americans die in WWII?"

[brlewis]

When I saw the first statistic was US only I assumed the WWII statistic was also US only. Nonetheless, JoshuaDavid made a great speech. Favorited.

[quacker]

COVID-19 has a bit under 800,000 known deaths

Not disputing your overall point, but this is with preventative measures, such as lockdown, quarantine, use of masks, social distancing, etc.

I have seen various estimates with factors such as 35x the number of cases without preventative measures. Right now, there are 5.5 million cases and 172,000 deaths in the USA.

With a more conservative factor, like 15x, a quick ballpark at current ratios of cases/deaths puts that at 82.5 million cases and 2.4 million deaths without preventative measures in the USA, and more considering worldwide cases. Not as bad as WWII, but it is in the range of the Korean War (est 1.5 to 4.5 million deaths) or the Vietnam War (est 2.4 to 4.3 million deaths).

[JoshuaDavid]

I find myself doubting the 35x number, and even the 15x number. For the 35x number, there are 328M people in the US. Divide that by 35, and you get 9.3M. Under the most generous possible assumptions, with no preventative measures, 100% of the US population would get COVID, and with the current preventative measures, there will be no new COVID cases after today. Under those assumptions, there could be no more than 9.4M people who have caught COVID in the US. There are currently 5.6M people who have tested positive in the US, so that means that under the most generous possible assumptions, at least 60% of the people who were infected with COVID have to have been tested, tested positive, and had that positive test recorded in the statistics.

For the 35x number to be true, all of the following have to be true. Those assumptions are, with maximum generosity

1: With no preventative measures, at least 60% of the US population would be infected with COVID-19 (assumes no further infections after today and that 100% of people infected, including asymptomatic people, have tested positive for COVID-19).

2: At least 60% of the people in the US who will be infected with COVID-19 have already been infected with COVID-19 (assumes 100% of the population would be infected without preventative measures, and that 100% of people infected, including asymptomatic people, have tested positive for COVID-19).

3: At least 60% of the people in the US who have been infected with COVID-19, including asymptomatic people, have tested positive (assumes no further infections after today and 100% of the population would be infected without preventative measures).

Note that while "all of the following are true" is _necessary_ for the 35x number to be true, they're not _sufficient_ -- evenly distributing the burden, change all of the "60%"s to "84%"s to get an example of what a world where the 35x number is accurate.

Going in order on my objections to those assumptions, and what I think more realistic numbers look like:

> 1: With no preventative measures, at least 60% of the US population would be infected with COVID-19:

The R0 of COVID-19 is probably between 2.79 and 3.28[1]. We'll go with the higher of these two numbers (3.28) for our upper bound. That means each infected person, in a population with no infected people, will spread the disease to 3.28 other people. In a world of uncontrolled spread, the spread stops when the average infected person comes in contact with less than one person who is susceptible to the disease, so once 1 - 1/3.28 (~70%) of the population has been infected, the spread stops. This gives us an upper bound of 70% for what fraction of the population gets infected.

In real life, that R0 is made up of some people who will spread the disease to an average of 50 people, and others who will spread it to an average of 0.1 people. People who are likely to spread COVID widely are more likely to be the people spreading the disease and are also more likely to be the people infected people "try to" spread the disease to -- a cashier who interacts with 1000 customers a day has 1000 chances to catch COVID from one of their customers, and 1000 chances to pass it on, so they're likely to be infected early on. The people most likely to catch COVID will, in the long term, be the most likely to be immune, lowering the effective rate of spread much more rapidly than the naive model would predict. Estimates for the actual herd immunity levels vary, but as a lower bound let's go with the number Gomes et. al. come up with[2] and say 10% is our lower bound.

Being very rigorous and scientific, let's split the difference between our upper and lower bounds and say 35% of the population would get COVID-19 if the spread was uncontrolled.

Moving on:

> 2: At least 60% of the people in the US who will be infected with COVID-19 have already been infected with COVID-19

Assuming no third wave, cases per day will continue to trend down over time. Currently, it looks like cases per day are decreasing by something like 0.5% per day, and there are about 50,000 cases per day currently in the US. If that trend continues, we end up at about 15M total positive tests. If the trend accelerates to about a 1.2% per day decrease in positive tests, we do end up with only about 9.5M positive tests, so "60% of the positive tests that will happen, in total, have already happened" is not _completely_ outside the realm of possibility. On the other hand, if there _is_ a third wave, we're gonna end up with more than 15M positive tests.

I'll use the "no third wave, 0.5% decrease per day" estimate of 15M positive tests when all is said and done.

> 3: At least 60% of the people in the US who have been infected with COVID-19, including asymptomatic people, have tested positive

This one seems extremely implausible to me. Tests are fairly hard to come by, expensive, and discouraged for people who have not been in contact with someone known to have COVID-19, at least in the US. Furthermore, a significant fraction of cases are either asymptomatic or very mild, and those people are unlikely to be tested. It's hard to get an exact estimate of the fraction of total cases that are tested, but several researchers have taken a crack at it (example[3]), and estimate that between 3 on the low end and 24(!) times as many people have been infected as have tested positive.

We'll go with a factor of 5, because that's a nice round number on the low end of the range and really the 24 number sounds pretty implausible. Maybe back in April when tests were in very short supply, but certainly not now.

Putting all these numbers together, we get

5.6M * 5 = 28M people in the US have caught COVID-19 so far. 15M * 5 = 75M people in the US will catch COVID-19 when all is said and done. 328M * 0.35 = 115M people in the US would have caught COVID-19 if the spread was left unchecked.

So by a back-of-the-envelope calculation, we should expect the precautions have decreased the spread by a factor of 115M / 75M ~= 1.5, with a fairly wide margin of uncertainty (but I'd say almost certainly not higher than ~3 or lower than ~1). Certainly not a factor of 35 or even a factor of 12.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073717/ [2] https://www.medrxiv.org/content/medrxiv/early/2020/05/21/202... [3] https://jamanetwork.com/journals/jamainternalmedicine/fullar...