Public Health Numbers Are Being Misrepresented

Dear Editor,

The media continues to misrepresent issues to score political points.

Simple math problems explain some of the misrepresentation.

Total infected and total deaths from COVID 19 should not be used to judge policy effectiveness. Imagine there are two groups; one with 1,000 people, the other with 10 people. If a disease infects 10 percent of everybody, the larger group will have higher total infected. The US has the third largest population in the world. Rates are required to provide meaningful comparisons.

Of course, China and India both should have higher totals than the US. However, we need to compare testing effectiveness to judge rates. No test is 100 percent effective. There is a tradeoff between sensitivity (high false positives) and specificity (high false negatives). Let’s say we have two populations both totaling 100 each where everyone in both groups has the disease. If group A uses a test that results in 100 percent false negatives, all of the population will have the disease but be uncounted. If group B uses testing with 0 percent false negatives, all will be appropriately counted. Take another example of two groups with 100 each where nobody has the disease. If group A uses testing with 100 percent false positives, all will be counted as having the disease despite nobody being infected. If group B uses tests with 0 percent false positives, nobody will be incorrectly counted.

Most testing trades off false positive and false negative. Screening tests should err on low false negatives/high false positives. It is better to have high false positives, recommending those without the disease remain in isolation, than to misdiagnose patients incorrectly as not having the disease, spreading the disease. We need to study and compare false positive and false negative rates to compare rates effectively.

There are three reasons for drug trials. The two most basic are safety in general and efficacy for the intended purpose. The third is to determine what the drug does to the body/what the body does to the drug. Hydroxychloroquine has been labeled “unsafe” by biased reporters in order to portray the president/CDC negatively. For decades, it has been deemed safe for prescription by the FDA for malaria prophylaxis/treatment and other diseases. Since we know the side effects and interactions, in many ways it is safer than brand new medications with no track record. The only unknown is effectiveness against COVID 19.

Alan Burke