WHY ACCEPT a certain number of deaths when we can prevent them with firm action?
That’s our response to “Grim COVID-19 predictions for NH revised downward” printed in the Union Leader, which quoted our letter dated April 5, 2020 letter and cited predictions from the state Department of Health and Human Services and Institute for Health Metrics and Evaluation (IHME) models of the COVID-19 outbreak.
Forward-looking data analyses have uncertainty built into them. But the uncertainties in these models represent actual New Hampshire lives that could potentially be saved. The number of COVID-19 cases is low in New Hampshire because just 0.5% of us have been tested. This means 99.5% (about 1,293,500 in the state) haven’t been. This lack of critical information should scare us all.
People are being denied testing and told to stay home unless they experience breathing problems. Other COVID-19 fatalities likely go uncounted for lack of testing, especially in geriatric cases and individuals with several medical conditions.
The fallacy that New Hampshire is on the right track comes down to three issues:
We don’t know actual prevalence of COVID-19 due to a lack of testing.
We aren’t therefore able to react in real-time to protect people from threats.
And the number of fatalities attributed to COVID-19 is likely inaccurate.
Jake Leon, director of communications for Health and Human Services, referred to the models changing as we learn more about the virus. That is not true. It is not the virus we are lacking information about. We have deep knowledge of coronaviruses dating back about 50 years. What we’re lacking is data from a properly conducted testing strategy across the state.
The fluctuations we are seeing in deaths are not because of an unknown pathogen, the fluctuations are due to ignorance as to the number of people with the disease here. Any model is fundamentally flawed when we have little to no testing penetration in most New Hampshire communities.
This is a disease that is transmitted by aerosol and droplets coughed or breathed by infected people who may not yet have any symptoms. Social distancing, when actually followed, is helpful. Masks or face coverings also are very effective. But we’ve hamstrung our most effective approaches by stalling at enforcing distancing measures and masks. Instead, we use a lot of public relations bandwidth in enormously ineffective pleas for the public and businesses to clean surfaces.
The new models offered by Washington’s IHME put heavier emphasis on the “…benefit of social distancing orders such as school closures, stay at home, and non-essential business closures.” While New Hampshire has taken social distancing steps, we need data from testing to know when people can go back to work and their regular lives.
IHME is trying to do the right thing by “incorporating the accuracy of predictions from the early days of its model,” but this is not the best practice in model refinement. The early models were only “more accurate” due to random chance and smaller sample sizes. In reality, with a constantly changing set of prior assumptions, this approach doesn’t pass muster.
The COVID-19 outbreak isn’t almost over now. Nor will it be in two weeks. We haven’t “almost beaten this” because we haven’t even started properly measuring it yet. We want to measure success in lives saved, not by celebrating an ongoing low death rate.