Those two ER doctors are actually dangerously wrong

By now you have probably seen or heard about the video by two ER doctors who allegedly demonstrate with “facts” and “science” that COVID-19 is actually less of a threat than flu and that we must reopen the country right away. This, they say (of themselves) “as scientific minds who read this stuff every day” and who have been on the front lines of the battle. The purpose of this article is to show you they are dangerously incorrect and not nearly as reliable as many people have taken them to be.

I have had several people and friends send me this video or post it themselves. I have seen the same claims numerous times, such as an excerpted clip titled, “This ER Doctor just NUKED Fauci’s Pandemic Fraud.” I am as contrarian, anti-establishment, and alternate health and news as many of you, but these guys are sloppy with their stats and misleading in how they present themselves.

In the interest of not repeating too much that has already been said, several people have already made appropriate criticisms. The incomparable and tireless private researcher Valerie Jacobsen, who also has a background in nursing, wrote a piece on it called “The Fallacy of Free Extrapolation.” This same fallacy, sometimes called the fallacy of unwarranted extrapolation, is also discussed in this medical research paper. The essential error that she and others point out is that the doctor duo calculate an infection rate for COVID-19 based only on tested individuals, then extrapolate that percentage to the whole general population of their state to calculate the mortality rate. Here’s why that is badly wrong.

The sample of tested individuals is going to produce a high rate that is not representative of the whole population. After all, tests are scarce, and who gets prioritized for testing? People who feel sick or show symptoms. In fact, there’s an article specifically talking about testing in Kern County, California—the same county these two doctors are referencing. It says,

“Five groups that should be tested: those that are high risk with symptoms of COVID-19, residents of staff of long term facilities with symptoms, those of high risk of severe infection with symptoms, those at correctional facilities with symptoms, and finally health care personal with symptoms should be tested,” said Matt Constantine, director for the Kern County Public Health Department.

In short, only people with symptoms already were recommended for testing. This selection bias of a non-randomized sample group is a pitfall well known to researchers and will certainly skew that particular sample greatly in the direction of infections.

So, to repeat, the 12% infection number they derived from this is not representative of the total population. Though it is correct in its own context, it is way artificially high for the general population.

And that is crucial, because that number will in turn produce the illusion that COVID-19 is way less deadly than officials have said. When that number is artificially extrapolated for the general population as they do, the next step of math will result in an artificially low mortality rate. Of course, the higher number infected overall is going to drive the percentage of fatalities way down; when in reality, getting the number of infected back down to a realistic number will result in the mortality rate rising back to where most other experts say it is now.

But then these two doctors also do the same thing with statistics in New York. Again, it’s misleading.

This statistical fallacy is not just misleading, it is dangerous. Giving people the impression that a disease is less deadly than the seasonal flu when in reality it is more dangerous, and then rushing everyone back into that environment, is going to have the very results the various quarantine efforts were meant to prevent.

This is why it is not only people like me and bloggers like Valerie, but other educated observers like this guy, and this guy, and the whole American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM) jointly, and by now many others are all also saying it. That joint statement is far less kind in its condemnation:

These reckless and untested musings do not speak for medical societies and are inconsistent with current science and epidemiology regarding COVID-19. As owners of local urgent care clinics, it appears these two individuals are releasing biased, non-peer reviewed data to advance their personal financial interests without regard for the public’s health.

The latter part of the statement goes to my point that these guys are not entirely up front in presenting themselves. They do briefly mention they are “entrepreneurs,” but focus entirely on their status as highly educated and experienced scientists and doctors studied in immunology and epidemiology. In reality, they have a tremendous financial interest at stake. They are not general “ER Doctors” as some have presented them. They are two businessmen primarily who own urgent care clinics and are currently losing lots of revenue due to the shutdown.

I highly sympathize with that problem. It is certainly not wrong to be concerned about one’s financial interests. But it is highly questionable not to be forthright about your businessman’s hat while wearing your doctor’s coat of authority and trying to influence policy in the interest of the businessman. That is what the medical world and many others generally call a conflict of interest.

Even if this problem did not exist, for them, though, the sloppy use of statistics is irresponsible and misleading. For this reason, sharing their piece uncritically with laud and praise, especially for their alleged “science” and expertise, should be avoided.

I am not entirely certain that the shutdowns were done well. I am sure, however, that I have yet to see any solid, credible evidence that the official mortality numbers are truly faked or wrong, despite many claims to the contrary. I have also not seen much if any attempt to calculate, or even consider, what the full social and economic toll would have been had this disease with its actual mortality rate as it is were allowed to spread unchecked. I grant that 22 million unemployed, etc., now is a staggering cost (especially if it holds after the shutdown and recession or depression occurs), but we currently have no solid and credible way of comparing even this to what would have happened. To suggest that it would not have been also massively devastating has not yet been shown in any credible or solid way—least of all this interview of these two urgent care businessmen.

I know that videos like these can be compelling, but we are all also prone to confirmation bias. These guys are wrong, and I hate seeing people, especially friends, misled by science-falsely-so-called.