Dr Ioannidis may cause irreparable harm from recent publications. 1 , 2 Novel coronavirus, by definition, arrives without precedence and therefore the reliable data Ioannidis craves. The unshakable facts regarding the COVID‐19 consist of the number of deaths, country populations and the data set from the Diamond Princess cruise.
Ioannidis paints a picture of the virus petering out after infecting 1% of the US population and 10 000 deaths. Italy has more hospital beds per capita, a population one‐fifth the US and as of this writing over 11 500 deaths. The base transmission rate, case fatality rate and community spread remain elusive. Italian physicians with experience caring for COVID‐19 patients recommend containment strategies such as test, quarantine and isolate and mitigation techniques of social distancing and hygiene. 3
The Diamond Princess had 3711 passengers and crew with 712 (19.2%) testing positive for SARS‐CoV‐2, 331 (46.5%) asymptomatic, 381 (53.5%) symptomatic, 37 (9.7%) requiring intensive care and 9 (1.3%) died. 4 The crew and passengers had a weighted median age of 59 years old, while the US median age is 38 years old. The Diamond Princess is the only closed data set with everyone in the population tested. No measures were put in place on the ship to contain or mitigate the spread of COVID‐19 so it does not seem unreasonable to expect similar results in larger populations in the absence of accepted public health measures.
Ioannidis correctly states that misinformation and hyperbole can cause hysteria and is potentially dangerous and may lead individuals and society taking up unnecessary measures. Public health strategies of containment such as test, quarantine and isolate in combination with mitigation of social distancing and hand washing are proven and seem reasonable given the existing evidence. Other experts recognize the difficulty in obtaining reliable data but nevertheless believe the current evidence presents a compelling case for action. 5 Dr Ioannidis may underappreciate the variable incubation period and asymptomatic transmission of the highly contagious COVID‐19 virus. 6 The contrarian position seems reckless and may compel leaders to delay actions costing thousands of human lives.
REFERENCES
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