2017 Influenza/Pneumonia Deaths vs. Diamond Princess
Background
COVID-19 attacked the Diamond Princess cruise ship on 20 Jan 2020, when an infected index case boarded and -- after testing 13% of the ship, 172 (5%) were found positive by 9 Feb 2020 [1] -- the overall figures resulted in 712 infections (19%) from the 3711 people who were on board.
Quarantine in cabins lasted more than 14 days, by which time vitamin D levels are approximately cut in half (we need sun to keep our D levels up). This is an important aspect to understanding disease severity.
Illness outcome if deficient in vitamin D
When D is low, chance of upper respiratory tract infection is 90% higher [2]*, and a reasonable assumption is that chance of death once infected is also factored up by the same factor of 1.9 -- resulting in overall death chances 3.61 (1.9 * 1.9) higher when deficient in vitamin D.
The National Vital Statistics Report (NVSR) shows the death rate from influenza and pneumonia as stratified by age bracket [page 31 at Reference 3], and I used the most recent numbers from 2017.
Under the admittedly-questionable assumption that vitamin D deficiency wasn't a big factor in those deaths, you can multiply the age-specific death rates by 3.61 to see the expected death rates when deficient in vitamin D.
People under 25 are almost immune to COVID-19, so you can just take ages 25 and up.
Expectations applied to Diamond Princess
When applied to the population age structure on board the Diamond Princess, you get these results (interpolation for age bracket cuttoffs on Diamond Princess, reported differently from NVSR, resulted in taking half from group above and below):
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Age ......... Persons ... D-deficient death rate ... Expected Deaths
25-34 ........ 387.5 ............ 0.00003 ...................... 0.011625
35-44 ........ 381 ............... 0.00007 ...................... 0.02667
45-54 ........ 366 ............... 0.00017 ...................... 0.06222
55-64 ........ 660.5 ............ 0.00043 ...................... 0.280415
65-74 ........ 969* .............. 0.00107 ...................... 1.03683
75-84 ........ 687.5* ........... 0.00339 ...................... 2.300115
85+ ........... 119* .............. 0.01355 ...................... 1.61245
Total Expected Deaths after vitamin D-depleting quarantine: 5.3
*Note how 48% of the passengers were elderly (65+), which is 3 times more than is found in the US population overall. Also note how 1.3% (13 of every 1000) of all people aged 85 and up, die from flu when deficient in vitamin D.
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Ramifications
If people like Tony Fauci were correct when they said that COVID-19 is 10 times worse than flu, then there should have been 53 deaths on board the Diamond Princess cruise ship -- where it is assumed that everyone was forced, via quarantine, into a condition of vitamin D deficiency.
The numbers show that COVID-19 is not even anywhere close to being 10 times worse than flu. In fact, they indicate that COVID-19 is not even twice as bad as flu.
Because almost all infections were discovered by just after the end of quarantine, or by 23 Feb 2020 [4], and because almost all COVID deaths occur within 29.5 days of symptom onset [5] -- a count of deaths up to, but not including, the last week of March will reveal the total deaths from infection while on board.
Deaths occurring in the last week of March, or even later, will not be properly suspected as being deaths from infection while on board, because COVID-19 kills people quicker than that (it doesn't take 6 weeks to kill you).
The last death which can be properly suspected as to be resulting from infection on board the Diamond Princess was reported on 21 Mar 2020, resulting in a total of 8 deaths out of 3711 passengers on board [6].
Conclusion
If COVID-19 was even twice as bad as flu, then about 11.6 deaths (5.3 * 2) would have been expected. Empirical results here (8 total deaths) show that COVID-19 is not even twice as bad as flu.
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*For those with low D status, absolute risk reduction (ARR) from frequent D supplementation was at least 25% (0.25), derived from the number-needed-to-treat (NNT) = 4 in the study.
Supplementary material to the study (Cates plot with smiley faces; Figure S4) indicate that the subgroup analysis found 60% infection incidence in controls, and 31% in those treated with frequent-dose vitamin D -- indicating a factor of at least 1.9 (at least 90% difference in relative risk).
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Reference
[1] Descriptive study of COVID-19 outbreak among passengers and crew on Diamond Princess cruise ship, Yokohama Port, Japan, 20 January to 9 February 2020. Available: eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.23.2000272
[2] Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. See Figure S4 in Supplementary Material; showing 60% get sick when low in D; but only 31% when taking frequent doses of D. Available: pubmed.ncbi.nlm.nih.gov/30675873/
[3] National Vital Statistics Report [Page 31 shows flu/pneumonia]. Available: cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf
[4] Chronology of COVID-19 Cases on the Diamond Princess Cruise Ship and Ethical Considerations: A Report From Japan. Available: pubmed.ncbi.nlm.nih.gov/32207674/
[5] Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data. Available: medrxiv.org/content/10.1101/2020.01.26.20018754v2
[6] 70-year-old Canadian man who was on Diamond Princess cruise ship dies. Available: mainichi.jp/english/articles/20200321/p2g/00m/0na/050000c
Image: Titanic, 1912
Page URL: commons.wikimedia.org/wiki/File:RMS_Titanic_3.jpg
Attribution: F.G.O. Stuart (1843-1923) / Public domain