Professor John Ioannidis Reviews the Totality of the Evidence on Covid-19

This is from the latest essay on Coronavirus on the net from the distinguished Professor John Ioannidis. (I'd skip the first half of it if you are short of time.) He said, you remember, a while back that the risk to people under 65 of dying from Covid-19 were the same as dying on a very long drive to and from work. 

I can't help wondering if he is being completely candid when he says he thinks that lockdowns were initially justified because of our ignorance about the virus, since what he said back in March strongly suggested that we were overreacting.

On March 3 the World Health Organization (WHO) director-general introduced a media briefing with these distressing words: “Globally, about 3.4 percent of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1 percent of those infected.” Others spoke of a very high reproduction number, of almost no asymptomatic infections, and of the high likelihood that the virus would infect most of the global population. Many, including the team led by Neil Ferguson at Imperial College London, drew comparisons to the 1918 pandemic, which cost at least 50 million lives. These claims had a dramatic and arguably dangerous impact on public perception. Moreover, if these claims had been true, any EBM practitioner would call for swift and thoroughgoing lockdown measures. EBM is dead clear in such situations: if the risk is 50 million deaths, shutting the world for a month or two is nothing.

But it was my infectious disease side that had questions. A virus that spreads like wildfire, killing one out of thirty and infecting almost everyone in the absence of a vaccine, should have killed far more people in China and should have spread widely worldwide, perhaps with millions of fatalities, by mid-March. Hence, as I wrote in an op-ed in Stat News, I began to plead that we seek to obtain better data as quickly as possible to best inform our actions. I think lockdown was justified as an initial response, given what little we knew about this new virus, but I also think we needed better data to decide on next steps. And given what we know now, it is reasonable to consider alternatives to population-wide lockdown, even as we continue preventive hygiene measures, exercise local infection controls, focus on protecting those most at risk, and support health care systems to care for patients who are sick.
Two and a half months after COVID-19 was officially declared a pandemic, we lament a great and acute loss of life, especially in places like Lombardy and New York. Since the outbreak was detected in Wuhan in December 2019, the global death toll is estimated to be 346,000 as of this writing. But because our interventions can harm as well as help, it is not unreasonable to put this number in context.

We now know that the death toll is not comparable to that of the 1918 pandemic. We also now know that the virus has spread widely, but for the vast majority of people it is far less lethal than we thought: it kills far fewer than 3.4 percent of those who develop symptoms. Late last week the CDC adopted an estimated death rate of 0.4 percent for those who develop symptoms and acknowledged that there are many other infected people who develop no symptoms at all. These estimates will continue to improve as time goes on, but it is clear that the numbers are much lower than first feared. The exact infection fatality rate varies across populations and settings, but it appears that in most situations outside nursing homes and hospitals, it tends to be very low.