Common Sense Diagnoses

Common Sense Diagnoses March 15, 2020

I’m not a physician and I’m not an epidemiologist, but I do sometimes teach logic.

I am seeing stories come in from various US states of people who should not be in ICU ending up in ICU for a mysterious respiratory ailment.  It tests negative for the flu and the like, it presents as if it might be COVID-19, but since testing is very limited, COVID-19 status cannot be known one way or another.

So let’s think through this:

  • Either we have more COVID-19 cases, affecting more younger, healthier people than we are inclined to suspect, or . . .
  • We have a different cause, or causes, of severe respiratory symptoms affecting more, younger, healthier people than we are inclined to suspect.

Perhaps we should be tracking these idiopathic cases of respiratory distress by age and co-morbidity?  And then we could begin to understand whether these anecdotes are anomalies, and whether there is any pattern to them that deserves closer inspection?

Right now the flow of such incidents is low.  We could be looking at availability bias causing us to infer COVID-19 when in fact these incidents are part of the normal rate of idiopathic respiratory disease, now made more alarming because our anxieties are heightened.  Or we might be looking at a worse outbreak of COVID-19 than we realize, or we might be looking at some other cause of an increase in respiratory illness.

We can’t make good decisions until we study the data.  We absolutely have the technical capability to track and analyse this data at a very detailed level.  We can use this information to make rational public health decisions even with existing limitations on COVID-19 testing.

So let’s do that?  Yes?  Please?

File:SECRETARIES OF WAR - NARA - 515364.jpg

Artwork: Four women in civilian clothing with ID badges, posed for US World War II poster “Secretaries of War”, courtesy of Wikimedia, Public Domain.

 

 


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