Dr. Ferrer — Clarify the Risk and Protect the Vulnerable
By Joseph P. Charney
The death rate from Covid-19 is recorded as 4.7 percent in the Pasadena Star News and other local papers. From that we conclude that Angelenos have about a one in twenty chance of dying if they catch the virus.
While a frightening statistic, it has been proven false by LA County Public Health. But that information is nowhere to be found on the Public Health website. So why doesn’t the site clarify this essential information?
On April 10th, County scientists joined with USC to test for Covid-19 antibodies in the County population in order to shed light on the true mortality of the disease as well as the efficacy of social distancing. Health officials and researchers said that the results of “serological testing” could paint the most complete picture yet of the sweep of the pandemic in the nation’s most populous county.
“Is it 1% of our population? Is it 10% of our population? That’s the difference between 80,000 adults and 800,000 adults. We have no idea,” said Dr. Paul Simon, chief science officer of the Los Angeles County Department of Public Health, and involved in the study.
On April 20th, the results from this first study came in. Dr. Barbara Ferrer, head of LA County’s Department of Public Health announced:
“Although I report every day that we have thousands of people that have tested positive, the serology testing lets us know that we have hundreds of thousands of people that have already developed antibodies to the virus — because at some point in time, over the last couple of months, they have in fact been infected with COVID-19”.
Ferrer said the study suggests that the number of people in the County with past or current infections is 28 to 55 times higher than the number of confirmed cases found through testing for current infections.
In May, additional anti-body testing confirmed the findings that there are hundreds of thousands of additional cases of Covid that are not considered when determining mortality rate.
Anti-body presence means that you had the virus. It also means that at a minimum, the mortality rate displayed in our newspapers should be amended or at a minimum explained on the County Public Health site. The County has a responsibility to distribute this information and apprise Angelenos of their real statistical risk. That risk has gone down by at least a factor of ten if not far more.
Reducing the fear of our healthier demographic in no way diminishes Public Health’s responsibility to protect the most vulnerable members of the population. Ninety-two percent of those killed by the virus in our County were either elderly and/or had underlying conditions. By the end of February, health officials recognized this vulnerable population was concentrated in long-term elderly facilities and had to be protected. Nevertheless on April 22 Barbara Ferrer had to apologize for failing to effectively protect those in these facilities and pronounced a ramped up strategy to do so. She confessed that “The previous guidance, to test only those who showed symptoms, was a mistake.” She said, “We were wrong.”
Now, late in May, Ferrer has changed her mind deciding there is no longer need to test everyone in nursing homes. This reversal has provoked strong criticism:
“More people will die than necessary based on this policy,” said Dr. Michael Wasserman, president of the California Assn. of Long Term Care Medicine, which represents doctors, nurses and others working in long-term care facilities.
When fear motivates us towards objective analysis and solutions it is useful. When fear blinds, and prevents us from considering the evidence and choosing the best options it becomes a form of paralysis. It’s time to move forward with less fear and more facts.
There may be some remaining unknowns relating to the coronavirus. However, two things have been established. The mortality risk for the healthy is dramatically lower than we thought and most resources must be channelled to those we know are most vulnerable to succumbing to the disease.
We can only hope that LA County Health will do both: clarify the risk to reduce the fear and do a better job of protecting the vulnerable.