I am posting this for anyone who is interested. I am only posting the abstract and the conclusion to keep from taking up too much space. This scholarly article points out a pretty big screw up in the early stages by the CDC, WHO and others in interchanging the terms "case fatality rate" and "infection fatality rate" while estimating future Covid deaths for the purpose of making policy. Also included is a link to the entire article:
https://www.cambridge.org/core...y_overestimation.pdf
Public health lessons learned from biases in coronavirus mortality overestimation
Ronald B. Brown, PhD
School of Public Health and Health Systems
University of Waterloo, Waterloo, ON N2L 3G1, Canada
r26brown@uwaterloo.ca
Abstract
In testimony before U.S. Congress on March 11, 2020, members of the House Oversight and
Reform Committee were informed that estimated mortality for the novel coronavirus was ten-
times higher than for seasonal influenza. Additional evidence, however, suggests the validity of
this estimation could benefit from vetting for biases and miscalculations. The main objective of
this article is to critically appraise the coronavirus mortality estimation presented to Congress.
Informational texts from the World Health Organization and the Centers for Disease Control
and Prevention are compared with coronavirus mortality calculations in Congressional
testimony. Results of this critical appraisal reveal information bias and selection bias in
coronavirus mortality overestimation, most likely caused by misclassifying an influenza
infection fatality rate as a case fatality rate. Public health lessons learned for future infectious
disease pandemics include: safeguarding against research biases that may underestimate or
overestimate an associated risk of disease and mortality; reassessing the ethics of fear-based
public health campaigns; and providing full public disclosure of adverse effects from severe
mitigation measures to contain viral transmission.
Conclusion
Sampling bias in coronavirus mortality calculations led to a ten-fold increased mortality
overestimation in March 11, 2020 U.S. Congressional testimony. This bias most likely followed
from information bias due to misclassifying a seasonal influenza infection fatality rate as a case
fatality rate, evident in a NEJM.org editorial. Evidence from the World Health Organization
confirmed that the approximate case fatality rate of the coronavirus is generally no higher than
that of seasonal influenza. By early May, 2020, mortality levels from COVID-19 were
considerably below predicted overestimations, a result which the public attributed to successful
mitigating measures to contain the spread of the novel coronavirus.
This article presented important public health lessons learned from the COVID-19 pandemic. Reliable safeguards are needed in epidemiological research to prevent seemingly minor miscalculations from developing into disasters. Sufficient organizational quality assurance procedures should be implemented in public health institutions to check, catch, and correct research biases and mistakes that underestimate or overestimate associated risks of disease and mortality. Particularly, the denominator of fatality rates should clearly define the group to whom
fatalities apply. Public health campaigns based on fear can have harmful effects, and the ethics of
such campaigns should be reevaluated. People need to have a greater voice in a transparent process that influences public health policy during an outbreak, and educational curricula should include basic research methods to teach people how to be better consumers of public health information. The public should also be fully informed of the adverse impacts on psychological well-being, human rights issues, social disruption, and economic costs associated with restrictive public health interventions during a pandemic.
In closing, nations across the globe may fearfully anticipate future waves of the coronavirus
pandemic, and look bleakly toward outbreaks of other novel viral infections with a return to
severe mitigation measures. However, well-worn advice from a famous aphorism by the poet
philosopher George Santayana should be borne in mind, which is relevant to public health
lessons learned in this article: “Those who cannot remember the past are condemned to repeat
it.”
