How COVID-19 Picks on the Weakened

Celebrated playwright Terrence McNally passed away on March 24. As told to The New York Times by his husband Tom Kirdahy, the cause of death was “complications of the coronavirus.” McNally, 81, died on the battlefield of his body. He was a lung cancer survivor. Treatment had left him with COPD, a condition caused by accumulation of damage to delicate gas exchange tissues in the lungs. When McNally accepted a Tony Lifetime Achievement Award in 2019, he appeared on stage assisted by breathing tubes and darkly commented that the award came “not a moment too soon.” He died while infected with SARS-CoV-2. But what is it that killed him?

Understanding the role that the infection played in McNally’s death requires us to examine the epidemic as a whole. Two common measures of a pandemic are R, R-naught, and CFR, the case fatality rate. The former measures transmission of the virus—how many new infections are, on average, generated by an infected individual; the latter how many infected will die of the virus. Both statistics require an accurate count of the absolute number of people who have the virus. But getting a solid estimate of that number has been hampered by the shortage of accurate testing kits, the lack of trained technicians to perform the tests, and tests that repeatedly give different results for the same individual when they’re finally carried out.