Hi Wade. Keep in mind that many things impact the case fatality rate and that rate has not and will not be constant over time. For example, right now, the global and US case fatality rate (CFR) is 3% and 2.8%, respectively. That has improved with the evolution in our treatment https://twitter.com/bigbaldbaby/status/1314585114597183488

practices and new therapies. It will be interesting to see what happens to the CFR over the fall and winter because I suspect co-infection with influenza will increase the CFR, but new therapies under development and study will become available that hopefully will decrease

mortality. But, even at 2.8%, that is about 17.5- 70 times greater than the mortality of last season’s influenza. I think the other thing why I am more concerned than others might be when you look at what to some might seem not all that alarming, is the fact that the CFR is an

average and that number would jump significantly if we removed cases in people under 40 or 50 from the denominator. For example, we have all been alarmed by President Trump’s case of COVID, because in his age group, that CFR would be between 10 and 15%. But, I want to be clear.

As a physician, I think I experience these deaths in a different way than perhaps the general public does. For the public, these are numbers and they seem low to many, and so they may not be alarmed. Most of these patients do not come in DOA (dead on arrival). Doctors, nurses and

respiratory therapists deal with these patients for days to weeks before they die. It is different when we watch people die, rather than just see mortality statistics. We see them as people rather than statistics. We hear about their lives, we learn about their families and how

much they are loved and how big a loss their death is to so many who love them. But, it is not just the deaths. We also treat many patients who survive, but we see what they went through- something we would never want to go through or have anyone we care about experience this.

The fear in a young adult’s eyes as we inform them we are going to have to put a tube down their throat to help them breath. And, after they recover, we see the long recovery and in some cases, the PTSD they suffer with. And, keep in mind, these people and those that experience

long haulers syndrome just get thrown into the category of “recovered,” so no one gives any time to thinking about the traumatic experience they have gone through, the disabling symptoms they are dealing with and the huge health care costs they are saddled with. So, I probably

haven’t stated this very well, but I hope this might help explain why care givers who take care of critically ill patients and families that have experienced this with a very ill family member might have a very different perspective on these statistics than the general public

does and why we may react with some emotion when the public or the President minimizes this health threat as something no worse than the flu or only an issue for the elderly or high risk groups or that of something of little concern because of the low mortality rates.