It’s the biggest question in the world right now: is Covid-19 a deadly disease that only a small fraction of our populations have so far been exposed to? Or is it a much milder pandemic that a large percentage of people have already encountered and is already on its way out?
If Professor Neil Ferguson of Imperial College is the figurehead for the first opinion, then Sunetra Gupta, Professor of Theoretical Epidemiology at the University of Oxford, is the representative of the second. Her group at Oxford produced a rival model to Ferguson’s back in March which speculated that as much as 50% of the population may already have been infected and the true Infection Fatality Rate may be as low as 0.1%.
Since then, we have seen various antibody studies around the world indicating a disappointingly small percentage of seroprevalence — the percentage of the population has the anti-Covid-19 antibody. It was starting to seem like Ferguson’s view was the one closer to the truth.
But, in her first major interview since the Oxford study was published in March, Professor Gupta is only more convinced that her original opinion was correct.
As she sees it, the antibody studies, although useful, do not indicate the true level of exposure or level of immunity. First, many of the antibody tests are “extremely unreliable” and rely on hard-to-achieve representative groups. But more important, many people who have been exposed to the virus will have other kinds of immunity that don’t show up on antibody tests — either for genetic reasons or the result of pre-existing immunities to related coronaviruses such as the common cold.
The implications of this are profound – it means that when we hear results from antibody tests (such as a forthcoming official UK Government study) the percentage who test positive for antibodies is not necessarily equal to the percentage who have immunity or resistance to the virus. The true number could be much higher.
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SubscribeI fear that in a years time when all the data has been measured this unnecessary panic that has devastated industry and commerce not to mention tangible and non-tangible damage to people’s health and well being will be shown to be nothing more than a standard virus seen over history that have blown themselves out. So much has to be learnt from this (we hope) that in any future outbreak the mass hysteria that has taken place will not be repeated based on secret models from a known unreliable source.
Mate, are you dumb or what? Look at the data! New York City has already got 0.2% of population dead! Stockholm is getting there! Even assuming herd immunity is reached would still imply an IFR of at least 0.4%. That will be 8 times what she’s saying. Do your maths people, forget the politics for a moment for fucks sake!
Sweden did pretty well.
Agreed, the cost is staggering and frightening. Just think if Mr Corbyn was spending this amount on Jobs/infrastructure the NHS. No he was told! Well this is worse both = Debt. Jeremy’s at least would have left us in work with money keeping the economy going. This will do none of that. Equally what would Labour have done with Covid19 as the advisors are the same about the same. But maybe if the NHS hadn’t suffered cuts to the bone and the pandemic emergency supplies were in place?? My maths are not perfect but this will cost us between10/20@ tax to pay back in 10/20 hrs.
The ONS data is worrying already borrowed 98% of zGDP
Very strongly suggest you read the well written article by
Rupert Beale in The Spectator:
‘Herd immunity’ is impossible without a vaccine
I saw this Oxford study coming out, I was hoping it is right as it was technically plausible at the moment. But it clearly is not any more. Current death rate in NY State is 0.15% of whole population, with NY city already over 0.2%. They are younger then average in US. Their overall mortality went up 600% above expected at one point. So assuming that 100% of population got infected (which is clearly impossible) she is still underestimating seriously. Based on the serology data from NY actual case fatality rate there is somewhere between 0.7 and 0.8%. This is not final with the challenges in antibody testing accuracy, sampling etc., but 0.05% is clearly wrong, unfortunately. Belgium, Spain, Italy, UK are also already above this mark, and it is likely under-counted. Would love her to be right, but data shows she is not and she needs to admit it, public health must come before academic ego. Agree that cost of lock-down is high and needs to be considered and balanced in the policy. In some countries, especially with younger populations it will cause more harm then Coronavirus.
Excellent comment
Percentages of what? It doesn’t mean anything to say the death rate is 0.15% in NYC.
Percentage of the population. Say there are around 8 milllion people in NYC and about 15000 deaths (search “nyc coronavirus statistics” on Google), that’s 0.19% of the population. But we know that not everyone in NYC has been infected, so the IFR must be more than that to get that number of deaths.
As already explained by Mr Wright bellow, perhaps I was not clear enough. She claims that overall case fatality rate is around 0.05%, meaning 5 out of 10.000 infected people die from COVID-19. But we see a number of places where overall number of deaths in population due to virus is already higher – NY State (0.15%), Belgium (0.08%), Spain (0.06%) etc. Clearly not everybody could be infected yet in those places, especially not with strict lockdowns in place. Combining existing deaths with serology/antibody data (people exposed to COVID-19), it appears that case fatality rate is at least 10X higher to what she suggests, more likely 15X higher (0.5-0.75%). To put it simply if everybody gets it in UK for example, 350.000 to 500.000 die.
Precisely. Her theory is readily falsified with the most basic of analysis. It’s good to have challenge in science, but one must admit when your theory no longer fits with how reality has unfolded.
Her estimate, and I believe this is a very rough estimate at that, is the average. She even says in the interview that some populations will be more susceptible, age and prevalence of heath conditions such as obesity been a key factor. This explains the higher fatality rate in western countries but also the lower fatality rate in a number of poor counties, that the virus reached earlier and have not locked down to anywhere near the same extent. Look in particular at South East Asia. High exposure, weaker lock downs but much lower reported death rates so far.
Then how do you explain New York City, with an overall death rate of over 0.2%? New York city has a relatively young population.
The fact is New York City has the highest level of virus infection so the best real-life experiment we have. Does that not make sense to humans?
This assumption is not really conclusive, because you are leaving out that people die for other reasons.
The normal fatality rate is roughly 0.1% per month.
She is talking about *additional* deaths caused by the virus. The largest part of the world by population so far has *no* significant excess death due to Sars-Cov2: China, Japan, South Korea.
Basically all South and East Asia, basically the part of the world where this started earliest and where population is most dense and where most people on earth live.
It is astounding how plain facts in Asia are ignored or excused with frankly silly excuses. I see Japan explained with the common social behaviour, Korea with contact tracing, China with falsified data etc.
This is just silly when they are not locking down and subways in tokio have been operational all the time.
There’s no doubt we have huge excess deaths in some places. But they are not the norm. I would be careful to blame the appearant exception on a virus that is obviously everywhere.
Muab is referring to Covid deaths, not overall deaths. Overall deaths are many times more that that. I suggest you look at graphs comparing the average deaths/week for the last 5 years and compare to this year’s. For New York it is at lest 3-4 times more during the outbreak, unfortunately. These are numbers speaking Florian!
Come off it! This is not the Black Death. The vast majority of the deaths are of the old, and as we say in England, the the “knackered”.
This is Darwinian Selection at its very best.
‘Bedwetters’ such as yourself should calm down. Perhaps bromide in your tea? I’m told it is most efficacious.
Today, the 24th May, is incidentally, the anniversary of the sinking of perhaps the most ‘beautiful’ warship ever built.
H.M.S. Hood. In a flash this magnificent ship was destroyed, taking all but 3 of her crew of 1418 souls to a watery grave. It was also Empire Day, as we used to say. Now that is a catastrophe, and a little emotion is tolerable.
However today’s debacle is but an inevitable consequence of prolonging lives beyond their natural span, regardless of cost or consequences.
Consummatum est.
Stockholm city mortality rate is also well above 0.1% and still going up. The same is happening in Belgium and same happened in Lombardy, Italy. . She is talking nonsense and desperately defending her paper.
The current stats clearly show that Gupta is a quack doctor. If 50% have been exposed then the same death rate applies to the other 50%. The southern hemisphere is seeing huge jumps in infections, if that cycle continues combined with politics controlling our health policies we could see a resurgence in November. I hope Gupta is not getting paid for her uneducated opinion that no one should follow.
Interesting how she never actually disagrees with Neil Fergusons’ model but instead refers to it as a worst case scenario. Furthermore, she even refutes the serology testing results, when they are the best estimate we can get.
I believe Freddie and Unherd are getting some attention with such “academics”.
Andy, a correction: the mortality rate in Stockholm is not “well above”, but still under 0.1%. 1885 deaths as of Friday in a population of 2.38 million people.
Population of Stockholm city is 974,073. I thought wikipedia was accessible to everyone.
Population of Stockholm city is 974,073.
I make it around 0.075-0.08% and that with the background of a care home pandemic. Based on the Stockholm death numbers being for the whole greater Stockholm area of 2.4m not just the city.
The average age in US may be younger, but the deaths are disproportionately in the 70+ age groups. Possibly as high as 40% or more.
It does not matter, 0.2% results by dividing by the whole population. Actually, I dont think you’ll get it, never mind.
I do not agree at all with your conclusions. Just one fatal error in your analysis is the assumption that testing for antibodies alone is not potentially an enormous underestimation of overall herd immunity, especially for this virus, and not mostly due to inaccuracies in early antibody tests (a minor factor IMO) either but to basic immunological factors of innate immunity, cell-mediated immunity — i.e. everything but humoral immunity coupled with the molecular properties of SARS-CoV-2.
Prof. is humbly (unlike most of her peers) estimating a possible IFR for entire nations — not just early hot spots of highly urbanized centers with outsize exposure to international travel, as she pointed out.
This is a unique virus and very much different than flu or even SARS and MERS or other coronaviruses. Much remains to be learned.
And epidemiology is highly nonlinear and heteregeneous. You are completely ignoring this. I thought prof. did a reasonable job of explaining nevertheless.
A reasonable comparison would be Spanish flu, which was novel and also pre-vaccine at its time. Both contagiousness and virulence of that virus were much larger than for SARS-CoV-2 — this is already clear. And the CoV has the considerable advantage (or Spanish flu had the handicap) of widespread international air travel to aid its spread. At the virological level there is just no comparison between flu and this CoV — the flu is a much more potent pathogen in every respect.
There are very serious tradeoffs to be considered, and there is no historical or experimental evidence of efficacy behind almost any of the current public policies, although R can clearly be reduced and has been temporarily and at great cost. More man-years of life (there is no such thing as lives saved — that is nonsense) will be lost due to these policies than would have died of CoV without them. That can already be predicted with confidence based upon established history in the same populations/societies.
The age-dependence curve of this virus is like nothing I have ever seen before — it is stunning. That alone is good news in terms of man-years of life at risk, but also has something to teach us about the virus-specific immunology and potential for better clinical intervention. The public reaction in the West has been largely hysterical and remains so.
In the USA we are at 0.024% deaths per capita so far, according to official CDC and census figures. To reach even 0.1% eventually would surprise me greatly, but would require that we are only 1/4 of the way through. States that are reopening are not experiencing any increase in transmission yet, and we have had many weeks to monitor already. There are just no exceptions that I am aware of.
It is THIS observation that requires explanation and incorporation into models.
I myself do expect a 2nd wave during the next coming winter, and not before. But this is unlikely to match the 1st season in magnitude even without lockdowns — all observations point to this, and it is due to intrinsic innate and adaptive immunity in the “herd” or general populace. This is characteristic of ALL respiratory virus epidemics in history.
Furthermore, for some perspective, CDC reports CoVID-19 deaths are 8% of total from 2/1/2020 to 5/16/2020. And CoVID-19 as cause of death is almost certainly overreported in the current melee. As time goes on over coming years I would be greatly surprised if CoVID-19 does not steadily and unrelentingly decline as a percentage of cause of death — that is the default expectation, and would require extraordinary new evidence to overturn.
Prof. is still looking good as far as I am concerned, wrt predictions for IFR in USA.
The fact is New York City has the highest level of virus infection so the best real-life experiment we have. Does that not make sense to you?
Spot on: lots of good sense there, thanks.
I completely agree. I don’t understand how so many people still spout views like Gupta’s when it is so easy to disprove
For heavens sake
This covid 19 virus clearly affects the old and weak much more than the under 70s fit and healthy
Quarantine of the fit and healthy makes zero sense
This is crazy
Yes it is crazy, in Stockholm 0,01%, of people under 70, including people with underlying health problems have died of, or with covid-19. Too many, but it’s not as deadly for everyone as it is for some.
You’re so right but most people would say its to early to go out from lockdown, you will juggle with peoplw lives etc. of course as long they can stay home and get paid. Take the money from them and they will ne out on the street asking to lift the lockdown. You can’t see that in TV but it’s start happening in other countries.
It also affects BAME more. Quarantine all of them too ?
Fat people ? Diabetics ? How old ?
@Sunetra Gupta — excellent interview, thanks!
Have you looked into innate immunity?
When our innate immune system is healthy, it can prevent infection without needing to create antibodies. Flu research shows that about 80% of a healthy population cannot be infected with a flu or cold, try as you might (cold showers, infected mucus, etc).
Looking at the Diamond Princess, this is exactly what we saw: 85% of the crew was immune to the point that PCR tests were negative, and 80% of the passengers (presumably because the older passenger population has somewhat reduced immune function).
Even in a homeless shelter in New York, 60% of the homeless had no detectable SARS-Cov-2.
For COVID-19, research shows that Vitamin D levels are correlated with immunity, and Vit D affects the capability of the innate immune system.
For other enveloped viruses, research has shown elevated innate immunity based on selenium status, and we see this effect in the epidemiology.
Best wishes! I hope you replace Ferguson 🙂
Well what about New York City, with 0.2% dead, and Stockholm getting there soon?
Clearly no reply by “Team No-Lockdown”
She specifically addressed that point in the video. Did you watch it?
Remember diamond princess was quarantined within two weeks of first exposure. At a 4-5 day serial interval that’s only just over one reproduction cycle. So looked at another way 700 people were infected by one person within two reproduction cycles. This was not a freely mixing population after that two weeks. I appreciate all the imperfections of diamond princess as a study, but what it is not is evidence of innate immunity.
She clearly can’t be right that the IFR is “close to 1 in 10,000”, since 22 countries have already passed that, some by a significant margin. UK is already at at least 5 in 10,000 who have died, even if we only use the current official figure of 35,000 deaths, let alone other estimates of 50-60,000.
And to suggest that somehow it is all coming to an end because most have already had it asymptomatically seems far fetched at the very least.
She has been caught off-guard
Yes, but to be the devil’s advocate, it is often argued that the official death rates have been (inadvertently) inflated, due to the policy of including not only death from but death with covid-19.
Well, then go look at the overall deaths compared to average from previous years. They are at least 3 or 4 times higher this year during the outbreak as compared to previous years. This woman is talking nonsense, how can people not realise this I’m shocked.
Total deaths to end of 19th week of this year 259910. Corresponding 5 year average 212284. Diff of 47626 which is a year to date increase of 18.3%. This will reduce as weeks go by as the relative increase in death is diluted over time. Many of the increase in deaths in known to be from none covid reasons but the ONS are doing more research on this. Your “3 to 4 times higher ” is alarmist and clearly not correct. Such alarm peddled by a weak leader in government has just cost the country £62bn in one month. (Eng and Wales data)
Source: https://www.ons.gov.uk/peop…
Excuse me ?
https://bit.ly/3cXOpvP
The 3 or 4 times is referring during the outbreak, this is the time when virus is spreading, simple enough for you now?
Very simple indeed, Sir.
But you are wrong. The worst week so far this year for deaths is the weekending 17th April – 22351 which is just over twice the 5 year average of 10400. Looking at the whole period in which people have died of this virus weekending 20th March to WE 8 May we have just over 131000 deaths vs a five year average of 82000. That’s a 60% increase showing reducing differences weekly. Again, not all of this increase is Covid 19 related. We are killing our citizens with our “cure”.
Your link to images of graphs from various places isn’t very clear. But it does not look like showing a 3 to 4 times increase in deaths in the UK.
Check the link to the ONS that I posted previously. I think they present their data very well. Simple enough for me….
“We are killing our citizens with our cure” exactly!
Please desist from commenting or greatly increase the precision of your posts. Thanks.
Always happens. I as a young brilliant mathematics student was told be a Statistian never wrong or right just a different opinion.
IFR is based on total number of infections which we don’t know. You are quoting the CFR which is always higher than the IFR. As a significant number have least been infected but not recorded the IFR is massively smaller than the CFR.
Why agree with either they don’t know think ok well we can guess. The truth is in roughly the middle wavering around it anyway. We are like a Jury giving sentence after the opening exchanges. More evidence please.
She can still be right because the majority of the word is neither as old or as obese as western populations. No where has yet to see the same death rates in the west.
New York city has a relatively young population, yet many deaths. How difficult can it be for people to understand this is actually not a flu!
Clearly the answer remains somewhere in the middle ground. I certainly believe that the virus entered UK during the Christmas / New Year period and that we had deaths way earlier than the “first death”. It was a time of year when people were dying of flu and pneumonia; CV 19 is not all that different in how it presents and many had coughs and fevers anyway and we were not really testing for it as we had so little capacity I don’t believe the R0 was ever as high as Ferguson assumed (3-4). It therefore spread much more slowly than Gupta assumes. IFR is also not as high as Ferguson assumed – he was 0.9-1%, but clearly it is not as low as Gupta believes. There are people who were tested positive who have no detectable antibodies. We don’t know how many and can only speculate about possible reasons why. Antibody tests are unreliable, though our government now claims the test it has very recently licensed and is buying to issue free at point of delivery, does not give false positives – by definition it gives false negatives. It has been obvious to me for ages that London had developed a fairly high immunity rate as there is no way Londoners were practising better social distancing than other areas of the country. Other hard hit densely populated cities will also have decent rates of immunity. The fears about using public transport in these cities are therefore exaggerated.
I think the debate about whether we should have locked down in the first place is largely pointless and is actually becoming more of a distraction than a help. We can’t change what has happened. The important thing is to do the right thing going forwards. My view remains that we need to be lifting lockdown much more rapidly and getting the working age back to work (and why shouldn’t they enjoy a beer in a beer garden or socially distanced bar when they finish?) and kids back to school – they are not at any real risk. We should shield the most vulnerable, whilst remembering most elderly still have the capacity to make their own decisions on quality vs quantity of their own lives. Above all we need to replace irrational fear, which really is not based on the reality of personal risk, with common sense whilst being socially responsible to minimise relatively easily avoidable infections. I agree with what Prof Gupta says about death figures being the only really reliable source of data for analysis of what was happening to infection rates 2-3 weeks earlier, but that is all they should be used for. Not for MSM to delight when a new set of higher figures come out because more has been included and they can use them to tell us how bad it is and scare people more. Deaths are a sad but inevitable part of life. The excess deaths we are seeing now, about 30% of which are not directly linked to CV19 (either of or with), will largely be reversed later this year and over the next couple of years, as so many of them have just been brought forward by between a few months to a couple of years, we really cannot sacrifice the quality of life of so many for however long it takes to rebuild our economy any further, due to an obsession with a few graphs.
I’m in complete agreement with every aspect of this, perfectly summed up.
A superb comment and I agree with it fully. I was a strong advocate of an early “lockdown” (of sorts – I never agreed with home confinement in a democracy) late Feb/early March. However, having missed the boat on that it is almost as if opposition is trying to make up for it by being over cautious now. The precautionary principle is no longer in favour of a lockdown given the huge repercussions it has.
Yes, absolutely,
My perspective as an Australian and having had early lockdown which then prevented the large spread of Covid is that whilst the lockdown did save lives I am anti lockdown. You may ask why and Ill tell you. Its like the Australian government and the Australian health authorities are relishing in the power of lockdown. The power they have over the Australian public through the fear the majority have of Covid. It defies common sense. When results came out that Covid was not the killer forecast by Ferguson the narrative did not change in Australia. It was all still deadly deadly don’t walk out your door. I expected Scott Morrison, rather naively I might add, to publish the latest science with positivity. Nope its become super political hence the anti lockdown stance.First couple weeks yep lockdown fine after that well I’d rather talk my chances thanks.
I am very worried that politics took control over lock down decisions. Why else would Dominic Cummings want to be present on SAGE meetings? The history of Cummings and his methods (clever but not wise) are that of playing to the gallery, seeking the route that appeals to the many for the purpose of retaining power. The more I look at the lock down arguments the more i find them wanting. I am not an epidemiologist but i can read and understand data.
No logic, no principal, no plan – especially one to get out of it.
As has been mentioned previously
Cummings is a ‘recent convert’ to Science and, we all know how lethally dangerous converts can be!
He is also said to be a great fan of both ‘Blood an Iron’ Bismarck and Machiavelli. So perhaps the method in his madness is to reduce the country to penury in order to facilitate the draconian reforms he wishes to execute. Had this synthetic panic not occurred, he would face a stiff uphill struggle against the “invisible enemy” ie: the Civil Service.
This may prove to be the reason why he rejected the excellent advice of Sunetra Gupta for that of Neil (pants down) Ferguson and his ilk?
While we are focused on the path of the disease in our own first world countries Sunetra Gupta is looking, I think, at a wider picture. The virus passes through, it hits one continent after another. And then, having killed whom it will kill, it moves away… and, in the end dies out.
Exceptional plagues, such as the bubonic and waste born things like cholera return and persist. But this is not usual. Even the Spanish Flu made no more than two and a half visits.
We can argue stats and percentages for ever but Gupta’s evaluation is most likely to be proven correct.
I think we were heading for a no lockdown position where the measures in place on 16th March were seen as enough. Along came Neil Ferguson ((again!) look at foot and mouth, swine flu, mad cow disease etc) and spooked the decision makers into a political lockdown.
Motivation for epidemiologists to overstate risks from a virus: government funding will increase with perceived threat of virus; big pharma will finance research of new vaccine; media spotlight for scientists predicting the worst; (and for those with hard left politics) a desire to bring capitalism down.
The most disgraceful aspect of the Niall Ferguson episode was that he was not interviewed on TV to justify his behaviour. Instead of either explaining why he considered himself immune from the virus or admitting that he had been lying all along, he was allowed to slink back off to his research grants. I have some sympathy for the politicians. They decided to put the decision in the hands of ‘the science’ and then found that there are many versions of ‘the science’.
Don’t you have to look at excess deaths over the, say, January – June time frame to get an idea of the deaths FROM as opposed to WITH covid. Two other interesting observations: 1. Sweden had more deaths in April 1993 and April 2000 than in April 2020. I don’t remember a lockdown/social distancing talk then? People just got on with their normal lives, no media panic etc(2 bad influenza A years).
2. 800m people in Asia Pacific(excl China). Almost hardly any deaths. This is where pandemics start. Japan with 130m people and the oldest population in the world, 700 deaths. Less than UK in a bad afternoon. No lock down, restaurants open etc. Japan has a really bad flu season(probably with other viruses) in 2019 like most countries in Asia pac. Is it possible that this region has got some form of immunity?
Possibly Japan just lost its most vulnerable percent or two to last flu season? Those remaining not quite so vulnerable to new virus?
Professor Gupta’s theory is inconsistent with observed data.
Captive populations such as the crew of the french aircraft carrier Charles de Gaulle showed high rates of infection when the virus was able to spread unchecked – 45% in that case.
Serology surveillance survey results announced by the UK Health Secretary today show 17% seroprevalence in London and 5% elsewhere – the same test in the same survey. Thus even if the cross-immunity which Professor Gupta imagines exists does exist, the UK population outside London is vulnerable to 2.4x as much infection (and death) as it has already seen. This is hardly a virus “on its way out”. Stockholm/Sweden data shows the same phenomenon.
There is also the issue that this survey shows equal seroprevalence across all age ranges and for healthcare and non-healthcare workers alike. What is this strange non-susceptibility property that does not vary either with age or regular exposure to infectious pathogens? Is there any clinical evidence of it? One would think that by now with all the practical studies being done around the world that someone would have noticed this.
A further example of Gupta’s theory’s clash with observable reality is the large scale serology survey just reported in Spain, with seroprevalence rates given for 50 different states. Seroprevalence correlates with death rates. There is no sign of an antibody “signal” disappearing over time in the states affected earliest.
I agree the “strange non-susceptibility property” is pure mysticism. There is no evidence that people do not seroconvert regardless of any cold coronavirus cross protection.
A voice of reason and sanity. The government on the other hand with its BBC propaganda arm should be hung, drawn and quartered for the trillion pound knackering of the economy.
Prof Gupta is not on her own in coming to this conclusion. A Professor for a university in Tel Aviv and also one from Stanford, USA have the same opinion. We have trashed the economy for no good reason.
Sweden’s example has not been recognised as a viable response but my simple reading of Johns Hopkins data shows Sweden to have a lower death rate than the UK. I found this article a signpost to thinking about the pandemic in a different way. Thanks.
Others saying DR not good measure, as no one knows how many people have had the infection. Testing the same in each country? Having said that, 7 day rolling death per million capita (which we have decent chance of estimating without testing) 12-19May for Sweden is 6.25 compared to 5.75 UK. I think Sweden has made more of a mess of protecting the vulnerable, especially care homes, than we in UK have. So whilst being confused by this interview, I am wondering that it would have all been better, if, with benefit mostly of hindsight, we knew who was most vulnerable and acted to protect them, only…
I think you will find that Sweden now has the highest death-rate per capita in the world now. It overtook UK Spain Italy yesterday.
It only had the highest per capita death rate over one particular week. Overall it’s still well behind the UK, Spain, Italy and Belgium IIRC.
Yet Sweden is 7th highest in the world, and many times higher than the Scandinavian countries, which I think are more fair to compare due to the population density etc.
According to Worldometer just a few minutes ago, Sweden’s death rate per million is 384, whereas Spain, Italy and UK all have rates well above 500. Spain 598, Italy 537, UK 531.
How are deaths recorded ?
Yet Sweden is 7th highest in the world, and many times higher than the Scandinavian countries, which I think are more fair to compare due to the population density etc.
384 per million for Sweden; 598 in Spain; 537 Italy; 531 UK.
I’m only reporting what I read in my daily newspaper.
The Telegraph.
Its important to be clear how deaths are counted.
It’s important to be accurate and specific in what we quote from other outlets and mass media in general… what Reuters reported a few days ago is that Sweden has shown the highest rate of COVID19 deaths per capita OVER THE PREVIOUS 7 DAYS, obvious as everyone else is still in lockdown mode… full article here> https://www.reuters.com/art…
I suspect the Telegraph does not want Sweden to be looked at in a positive manner and so it has “distorted” figures to make a political point. Time to stop reading the Telegraph.
Retreat into a bubble then.
Still more MSM reports Sweden is in trouble
Sweden has the 7th highest death/capita in the world, and many times higher than the Scandinavian countries, which I think are more fair to compare due to the population density etc.
When you are making a hypothesis comparing lockdown to non-lockdown on the basis of per capita mortality, you can’t then cherry pick other criteria (i.e. population density) because that supports the conclusion you’d like to see.
If you want to compare lockdown/non-lockdown AND population density, you need to do that, comparing ALL countries with similar population density to draw your conclusion.
It seems to make a lot of sense. With a fast reaction, plenty of PPE all over, an excellent health care system, special attention to the elderly and good social distancing we would not have needed lock down probably and would thereby not have needed to close schools which kids so well need for their health. That’s one thing I personally am convinced Sweden did right. Pity we in Sweden were so slow at the reaction bit! And the PPE! And the protection of the elderly…….
No, it did not work in Sweden. Sweden has the highest death/capita in the region and 6th highest in the world. Do your research!
Unfortunately, the best solution for controlling the pandemic has become a political preference rather than a scientific discussion. I agree that lock down has been an exaggerated solution, maybe excusable to some extent given the speed of transmission. However, there is still time to plan for the summer and for next year. What about organizing a request for proposals to be discussed in an open forum? Maybe scientists (epidemiologists, immunologists, public health experts, city planners…..) could meet, discuss and select various proposals for people to vote on. It is almost unbelievable that in the year 2020 the world has not been able to find better solutions!
This doesn’t work, as “Mr Brightside” on YouTube points out. They wrote:
Freddie Sayers invites her to say whether the serological surveys could falsify either her model or Fergusson’s, and she hedges, which is worrying.
How is it obvious that not everyone (or close to it) has had the virus? Serious question.
Good question, the way I see it there are few reasons.
First diseases like this tend to stop spreading when reach 60-70% of population even if left unchecked, famous Herd Immunity effect.
Most of the world didn’t leave it unchecked, we have very strict control measures to prevent spread, and as viruses don’t go through walls it is reasonable to expect that it has drastically reduced number of infections.
Then we see big differences in reported virus mortality in “hotspots”, meaning there was a different level of exposure, e.g. Lombardy (0.15%) compared to rest of Italy (<0.04%), NY State (0.15%) compared to rest of US (~0.02%). This indicates different level of infection.
Most of the PCR test for virus are negative and antibody testing (as imperfect as they are), come back with bellow 5% positive, hotpots and especially exposed populations 20-25%.
Firstly, diseases don’t stop spreading when herd immunity is reached. If you reach herd immunity when there are 10 millions infections they can still spread it to the 30-40% of the population who are not infected.
The R-value is always decreasing from its original R Naught. So for example if R0 is 3 the R-Value will decline overtime from 3 and then herd immunity is reached when the r value is 1. It will continue to fall. If 10 million people are infectious when R drops to 0.9 they will still spread it to 9 million people who were previously unaffected. (That’s if there are at least 9 milion people still uninfected) When herd immunity is reached the virus doesn’t just magically go away. If herd immunity is the goal you would want to reach it when there are a tiny number of cases.
If you go for herd immunity there would have to be point where you slam on the breaks to prevent the overshoot.
Secondly, if you do reach herd immunity at a low number there is the issue of new previously unaffected people coming into the population. e.g New Births.
It was not particularly bright of her to plump for the value of this parameter. Plumping was the name of the game back in January or February, with appalling results. The population of the UK is a good upper bound for the infected number, certainly. But the 1 per cent sort of ratio, where very few are infected but many die are not reality either. There are proxies for the numbers infected at each stage (eg the NHS triage calls per day) that suggest the right ball park is more like 0.12% to 0.3%.
Lockdown is not a cure for the virus. If Dr Guptas model is wrong most if not all countries should have a spike when lockdown eases. None have as yet though it may be early days
The issue is not what the IFR is or what the R rate is. Its whether these draconian measures have done anything to change the total number of deceased. I work in the NHS as a Consultant and personally think they are doing nothing. The infection is perhaps reaching its end but people who have been in lockdown have almost become institutionalised and are petrified to return to normality. The media fuels this fear and so we are in limbo.What i am seeing now is patients with cancer presenting when they should have done so 8 weeks ago and will have a poor outcome. The estimate of 18,000 extra cancer deaths is an underestimate!And that is just one disease. It is not easy to figure out now what harm this paranoia and the lockdown has caused but we will in 6 months
No one said lockdown is a cure, it delays the infection. The virus is already killing over 0.2% of New York city. Referring to your 18,000 cancer deaths, they would be accelerated by the virus. Is it so difficult to apply some logic and simple arithmetics?
I understand your anguish & genuine belief that lockdown delays & squashes down the peak (while not reducing total deaths). However most evidence speaks against the puported efficacy of livkd.
Gupta must hate having her carefully phrased words reduced to the above headline and strapline.
Wow … finally an epidemiologist with her thinking cap on straight — right on the money and the right track. I am looking forward to listening to this interview.
Why is the behavior of this virus so extremely different from that of flu in children?
Why have none of the US states that have come out of lockdown seen no detectable resurgence of transmission?
Why is the virulence of this virus so paltry in comparison to that of flu in the healthy (of any age)?
Why is the incubation period of SARS-CoV-2 so long?
Why is SARS-CoV-2 viable in throat whereas SARS and MERS are not?
What is the percentage of those infected who recover without medical intervention (i.e. easily without complications) and do NOT develop antibodies?
A parsimonious hypothesis or theory, aka principle of “Occam’s Razor”, has been overwhelmingly obvious from early on, and continues to be. Obedience and conformity and infantilization in current Western liberal societies is frightening — I would go much further than Giesecke with regard to this type of conclusion.
I thought this lady sounded very thoughtful and balanced. She wasn’t saying she was right she was saying that in the absence of a full set of good data there was room for a number of scenarios but that she felt the balance of probability was that its coming to a natural end in UK. You can’t harrang her for that. With the number of cases being discovered now in London becoming so sparse, despite the obvious lack of social distancing over the last 2 weeks my money is on her and not Mr Ferguson.
Julian, the problem is she does not seem to have altered her views now we are in a much bigger second wave.
Very odd interview published on the day of release of the UK Infection Survey
report and also a Government statement that 17% of London had been infected and at least 5% of England. Some beating around the bush by Freddie Sayers. Had Prof Gupta and Freddie seen the report or not? If they had they were skirting around it in perhaps a face saving exercise?
There is something very wrong with her estimate of 0.05% – 0.1% as the UK study would put the Infection Fatality Rate for England at closer to .9-1%.
Simple empirical observation – the quantity of deaths certainly exceeds a flu that is half as fatal as a typical flu and indeed exceeds a typical flu season plus flu deaths across a whole year at least for the flu’s for the last 5 years. No issues about estimating IFR needed to refute the .05% or .1%.
I don’t understand Freddie Sayers remark about a “disappointingly small percentage of seroprevalence”. If there has been over 60,000 deaths with only a little over 5% of the population in England exposed imagine what would happen if another 55-60% of the population was infected over the space of a month or so if there was a do nothing approach? As it stands with a model that is doing very well and based on confirmed cases only the projection is 51,000 deaths by August 1st. Clearly there is undercounting in care homes and the aged living at home. The bulk of any excess deaths will highly likely be due to not attributing the deaths as Covid-19.
While there may be some cross protection from cold coronaviruses it really isn’t known how much and the existing death count is inclusive of this in any case. Apart from antibody tests there isn’t much scope for population sampling using any other method. There are reliable antibody tests with good enough specificity and sensitivity to determine the numbers of people who have had the infection but it is very strange that the UK Infection Survey
report doesn’t state what the specificity and sensitivity of the test is – possibly because the swabbing is DIY?
I haven’t heard of people having had the infection not producing antibodies after 7-10 days. Where the evidence that people can get infected and not produce antibodies? Even in the case that cold coronavirus offer some protection antibodies are still produced so I don’t understand the other type of “resistance” Prof Gupta is referring to.
I also find the idea that the virus was circulating much earlier but only later there was a sudden spike very strange.
There are several other odd things about Prof Gupta’s theory but I will leave it at that.
A great woman who seems to be right about everything. Why is it that the people who are wrong about everything always gain the ear of politicians and the media?
That maybe the problem, “a great woman”.
Will anyone ever admit to that in wonderful PC Britain?
Indeed…..lucid and rational v head-line grabbing….shame our policy seems to err to the latter
Thanks for the continued constructive journalism. I do think Unherd needs to create its own video channel so that they are not compromised by YouTube.
I would subscribe to that.
I have an open mind but very uneasy about this iinterview with Prof Gupta:
“On the politics of the question, Professor Gupta is clear that she believes that lockdowns are an affront to progressive values:”
Dangerous. I am sorry, but values – progressive or otherwise – have nothing to do with epidemiology.
Her arguments did not seem to me to be based upon firm evidence. That is understandable as there is very little firm evidence, but that should not lead to a any particular view. It would be more honest to say “I don’t know”.
In fact, I think Prof Gupta does not know but being a epidemiologist she must express a view. She has chosen to express a view based upon her values and not upon her scientific understanding .
Politicians must decide, even with little or no facts. They cannot equivocate.
Politicians seem to have decided to wreck the country relying on the evidence of a known and hypocritical wrong-un, reacting as if we had an unknown bubonic plague, whereas 93% or higher of a relatively small number of deaths have occurred among those vulnerable to any winter flu epidemic. I want the British people to grow bigger gonads and for the government to be held fully accountable for an unnecessary disaster that will cost us trillions. What kind of tin-pot, cowardly, useless kingdom have we become? Donkeys led by globalist jackasses. Time for a proper political revolution to rediscover our national backbone and ensure British people and their needs are placed front and centre.
You would rather gamble with people’s lives based upon La Gupta’s values ?
Yep. This is not Ebola or the Black Plague.
Lockdown was based on the flawed model of Neil Ferguson and all the economic and medical analysis shows the deaths as a consequence of lockdown will be far higher than Covid. Wasn’t that a gamble that kills? How come people are so willing to listen Neil Ferguson who got Swine flu modelling very wrong, who got avian flu modelling very wrong who got BSE modelling very wrong and advised the government to slaughter millions of cattle, also shown to be unnecessary. Oh and by the way his model was based on bad programming and dodgy assumptions. His code has been analysed on GitHub by professional programmers. Worldometers shows quite clearly that the disease is following the normal rise and fall for a viral infection irrespective of the level of lockdown. In fact many lockdowns occurred AFTER the peak when you take incubation duration into account DUH!
I think Prof. Gupta’s hypothesis might well prove to be closer to reality than the models put forward both by Imperial and IHME. There are studies coming out showing innate immunity to SARS-CoV-2 via T-lymphocytes, which can be a clue to why there are so many asymptomatic and mild cases; in addition, it would explain why the spike in death occurred from late March while the virus had clearly arrived in Europe in December if not November 2019, a full four months before the surge in deaths. There’s also the question of why deaths are declining in a similar pattern regardless of the strictness of lockdown measures: they are declining, for example, in Sweden (no stay-at-home order but social distancing), in Switzerland (gatherings of up to 5 people always allowed, even during the closure of non-essential business and schools), in Spain (strictest shelter-in-place in Europe), in the UK (with the lockdown measures we all know about), in the US, in Italy, and so on.
Many people point to the fact that an IFR of 0.05 percent is too low. They might well be right: it is plausible it is higher in Europe and North America, because, for instance, of higher average age and more comorbidities, especially obesity. However, that doesn’t disprove Gupta’s hypothesis for three reasons. 1) Immunity, age, and comorbidities seem to be related. The vast majority of deaths have occurred in people over 65, with two or more pre-existing conditions. We tend to forget that most deaths also occurred in care homes, whose demographic consists of old and sick people. If the virus gets in there, it spreads like wildfire. This has happened all across Europe and North America, with the strictness of the lockdown measures making no difference. It is clear that the pattern of deaths as they have occurred until now is not reflective of the state of the wider population: 66 percent of deaths in Spain occurred in nursing homes, but a very low percentage of Spain’s population lives in nursing homes. 2) Related to this point, nosocomial transmission has been the greatest culprit in the covid-19 pandemic. This was evident in February, when the situation deteriorated in Codogno: people have fallen sick after catching the virus in a hospital. Again, hospital populations aren’t reflective of the wider population”they tend to have higher rates of comorbidities than what can be observed outside. Therefore, if the virus enters a hospital it spreads much more easily. 3) Many point to NYC and Lombardy to suggest a higher IFR. However, it is not entirely clear that all the Covid deaths in NYC and Lombardy have actually been caused by Covid, because a) there have been reports of incorrect early treatment, due to the novel characteristics of the illness (early intubation and ventilation might have done more harm than good); and b) there is the usual distinction of death with and from covid: a person might be positive to the PCR test, but we can’t be sure they died because of the virus (this has been said, among others, by Deborah Birx).
If not everybody who tests positive to PCR test develops antibodies, we can’t really know how many people have actually encountered the virus, and we can’t really determine at what stage of the epidemic curve we are by looking at positive PCR tests and serological results. Hospitalizations and deaths are declining, though, in spite of diverging lockdown measures. That’s the thing that needs to be looked at.
P.S. An implication, if herd thinning is already significant, is that a serious focus upon, and investment in, isolation of residents of care homes would have an outsize effect now that maybe the most susceptible have been removed, and the next-most susceptible remain. Expected summer lull should be used by governments to prepare for coming winter. There should be, arguably, no other effort by governments than this one. Incompetent as governments are, they MIGHT have some success with the low-hanging fruit.
Any other efforts will doubtless be enormously harmful to society.
Freddie, I must say that you do an excellent job in your written summaries of these interviews. After listening and before that reading, I really did not notice anything much that you failed to cover. Keep up the good work 🙂
The one thing Gupta mentions that I cannot really get my arms around is the hypothetical rapid spread early on. That spread would have been happening at least a month before data reporting (with virus/antigen testing) began is for certain IMO — not a question at all.
But how anything like one half of the population could have been exposed I cannot understand. That would imply a rate of spread much higher than that for flu, rather than much lower.
Possibly prof. has a notion that there are two different modes of spread for SARS-CoV-2, with one being a fast spread with superficial infection (in throat, for instance), and the other being a slow spread with substantial infection (in lung). That would be very interesting, but I did not hear her say this explicitly. Spread from throat could indeed be expected to be much faster than from lung.
My own likely respiratory infection in Feb. 2020 had symptoms so minor that noone would stay home from work under normal circumstances, and indeed I did not. I did not consider myself sick at the time, and thought the symptoms too trivial to be the Wuhan virus — this was before it became well known that asymptomatic infection is so common and before I knew about dry cough as a symptom of CoVID-19.
Two different modes of contagion is a very intriguing notion, methinks. Maybe this has been previously modeled epidemiologically for another respiratory disease, but I have not seen it discussed in the context of CoVID-19.
I do find the idea that transmission from throat would carry an intrinsically light viral load plausible. The throat symptoms of SARS-CoV-2 seem trivial in comparison to those of flu. It might be that with such a light initial infectious load of virus the typical immune response does not include humoral (i.e. novel antibody production). Certainly I do not think that antibodies are likely required to eliminate this virus from the body in a substantially healthy individual with very little or no symptoms — my own case is an example.
P.S. Should have clarified above, and am belatedly doing so now, that the puzzling thing to me about an early rapid and wide spread of CoVID-19 is that there had to be almost no advanced complications during this early phase of the epidemic. Otherwise this would have been noticed, especially in Europe and North America (and other areas) which were not so completely taken by surprise as China — i.e. had the forewarning of CoVID-19-specific pneumonia and so forth.
Repeated exposures to SARS, MERS and SARS-2 has always been a large risk factor for death and advanced complications in virus-naive and ordinarily healthy individuals, and notably so in young adults such as medical professionals. Those in janitorial jobs are in the same category. Predominantly the serious complications are in lung.
That is why only a model of two different transmission modes makes sense to me. Transmission from throat only would plausibly spread much more quickly than from lung, but also might plausibly carry a limited, light viral load (except in unusual so-called superspreader events such as singing/chorus gatherings) to which a much larger fraction of the population would recover easily while priming the immune system with SARS-2-specific adaptive recognition in T and/or B lymphocytes.
I am not sure why prof. did not discuss the anomaly of early stealth of the virus more explicitly, but this does get a bit deeper into human immunology of necessity.
I am no expert , but it seems to me that this lady has a good understanding of her subject.At any event we a shall not have very long to wait for an answer to the question(was Lockdown worth it) since Sweden has volunteered itself as a control.
And Sweden is now going through a big second wave…
“I think there’s a chance..”-,..”strong possibility”…”she believes…” etc.
OK so we have another theoretician’s views… nothing about countries that relaxed the rules and the results eg: S.Korea, Israel.
Also the “I think there’s a chance we might have done better by doing nothing at all,…” – well look at Brazil..
Gupta has arguments, however, hers seem no better than anyone else’s.
Oh, dear, have you seen the level of the “second wave” of infections in Israel?
A few typos in the written piece
It will be interesting to see how this unfolds but without transparency on SAGE meetings its hard to have a full debate. Personally I agree we should be out of lockdown, at least those not known to be vulnerable.
British common sense has not prevailed nor has our historic ability to pull together and deliver. we should be proud of the nightingales and front line nurses and doctors but otherwise ashamed of the stifling structural and cultural bureaucracy that has hindered PPE, testing and clear return to work, education and play guidelines. If you are old, over weight or diabetic you need to take extra care, the rest of us should be back to work
The economy has its own “R” factor and cascading business failure and unemployment will lead us to a much darker world than the 2 months of lockdown
we need a cross party 10 year industrial plan aligned with education and public sector/civil service reform – create productive jobs, educate for those jobs, cut bureaucracy – BJ should work with Starmer on this
The NHS app should be compulsory – if you can make lockdown compulsory then make the app compulsory for all our benefit – don’t do it half hearted. Eventually we will have enough tests to make “tract and trace” effective
Get masks in automatic dispensing machines at all train stations and airports – its as much a feeling of safety as a preventative measure
Even if we assume the lockdown had no impact on deaths, it was politically inescapable. Imagine the situation in early April, with no lockdown, the Government being criticised for sitting on its hands while people die, and deaths rising daily, seemingly inexorably, towards 1,000 per day. No Government would have been able to resist the calls for lockdown and there would have been no defence to the claim that it was enacted too late.
That said, it is clearly time to ease off significantly. I suspect the teaching unions are going to look very silly come June 1st when, in some parts of the country at least, new cases will have all but disappeared.
Interesting. Surely the Swedish approach is what is being suggested here and there experience seems no worse than the UK from a fatality perspective and vastly better for their society freedom and also economy. What was it about the Swedish government and advisory dialogue that has allowed for this better outcome.
Hi Freddie Sayers, can new get someone from the ‘other side’ to comment on this discussion and that of Karol Sikora? Would welcome some contradictory views. I can’t be grasping this fully, but I tend to believe who I listened to last. So am somewhat confused. I almost, but not really, have some sympathy for those deciding what to do next….
If the virus is no more serious than the flu, why are hospitals around the world being overwhelmed with cases? That doesn’t happen during the regular flu season, in spite of flu infecting a billion people a year. As far as we know, covid has “only” infected 5 million. Even if the numbers are 10× higher, it is still much more lethal.
Better to err on the side of caution.
As for the idea that rich countries are locking down “at the expense of the poor”, that’s just nonsense. Locking down during a pandemic goes back to the 14th century, when Venice prescribes 40 days of isolation for ships entering their harbour, in case they were carrying plague. Protecting yourself by using tried and true methods is not some kind of moral lapse. What exactly is the alternative- allow the death rate to explode exponentially, overwhelming hospitals, collapsing the health care system, and dramatically increasing the final body count?
But at least you could warm yourself among the bodies of the dead by feeling good about not betraying your “progressive” values. Sounds to me like the real affront to ethics is sacrificing others so you can feel good about your politically correct persona.
Actually, lockdowns have no historical precedent. Quarantine is different from lockdown in that it separates the infected from the non-infected. A lockdown separates everybody from everybody else, whether they be infected or not. Venice practiced quarantine, not lockdown. The closest example to 2020 “lockdowns” occurred in Florence during the 17th century plague: the residents of the Tuscan capital were told to stay at home, and they did. However it was very different from today’s lockdown because it was restricted to the city of Florence: the measure did not apply to the rest of the Grand Duchy of Tuscany.
You’re wrong. As Raj Boodhoo relates in ‘Infectious Disease and Public Health – Mauritius 1810-2010’, lockdown was used in Mauritius (and, I believe, other parts of the British Empire) for the 1919 ‘Spanish’ influenza pandemic. It’s apparent in any reading of Mauritian newspapers and official documents from that period. Boodhoo clearly differentiates between what we now call ‘lockdown’ and quarantine, and what was imposed in 1919 in Port Louis and the suburban towns of Plaine Wilhems was absolutely equivalent to the 2020 UK lockdown.
Do you have any links to those sources? I have no access to that book, but I’ve had a quick Google search and it seems to me that the business shut downs etc in Mauritius during the 1919 pandemic were the result of the island being struck by deaths, rather than a preventative measures. Carlo Caduff, who has written extensively on pandemic preparedness doesn’t mention it (https://www.academia.edu/42… ), nor does this piece which focuses on Italy (https://www.e-flux.com/arch… ). In any event, I am not convinced that what was applied in specific areas or cities of a particularly hit country/territory is equivalent to a blanket stay-at-home legislation that applies to individuals in both London and the Scottish highlands at the same time and in the same way!
I think this article is dangerous.
She’s talking unproven Hypothesis on a brand new virus.
It’s not factual.
The UK is in serious dire straits and this approach could be insulting to the 35,000+ families whose loved ones have died an awful and lonely death.
Let it run amok, ‘and we will be OK’…. Who is this ‘we’ she speaks of??
It’s a Hypothesis
.. Nothing more
Freddie, I would offer my own personal case history for insight to anyone, including Prof. Gupta, for consideration of what might be going on immunologically with SARS-CoV-2.
I have CVID, and a severe case of it. This is a purely polygenic condition. Because it is rare it is epidemiologically insignificant (at population-wide scale). But it offers immunological insights to epidemiological behavior of the immunocompetent population in the face of SARS-CoV-2.
I am not capable of developing any antibodies whatsoever to a humoral antigen such as flu or SARS-CoV-2. This is based upon very thorough previous testing. I am 61 1/2 years old.
I developed an extremely mild infection in Feb. (very early on for Mass., USA — this supports Gupta’s notion of an early undetected contagion) with a few hours of symptoms in throat followed by a very mild but quite notable (i.e. unusual) dry cough for the following week and a half. And I have a local friend who developed one of the classic non-respiratory symptoms of CoVID-19 in Dec.! And I have a work colleague who had full-blown symptoms and was out sick for a full week, also in Feb. — I only found out about this more than two months later. I have almost no contact with this colleague normally, and I doubt that our two infections were linked.
Only in retrospect did I recognize that my infection very likely was the novel CoV.
Then only in the past two weeks I suffered another infection confined to gut, with no respiratory symptoms at all and a negative result from high-quality virus/RNA test. I have two other rare conditions in addition to the CVID, and these gave me complications of kidney stone blockage of ureters and pain in testis (perfectly coincident) during the week and a half that was required to fully clear the virus. It turns out that testis and renal tubules are the two most rich in ACE-2 receptors inside the body (whereas intestines and lungs are non-systemic tissues exposed to the external environment).
With the severity of my unique complications (e.g. violent dry heaves with clear fluid expelled from gut) there is really no possibility I would not have been self-reinfected in respiratory tract if I had not developed robust adaptive immunity (T cells) there from the 1st infection.
The point is that the human immunlogical system is very complex, multifaceted and robust. The importance of the humoral immune response is hugely overestimated in all fields, and especially so wrt vaccines. For the most part I completely lack this response — I simply do not have functional B cells, not even the typically partially functional B cells in most CVID patients.
For some reason that is yet to be well understood, SARS-CoV-2 does not require or stimulate a significant humoral response in many or most immunocompetent healthy people IMO. The comparison would be to flu, in which humoral response is quite important.
AMPs host-defense system is innate (i.e. not adaptive) and very important in any viral exposure of lung. Vit D adequacy is critical to function of AMPs by the way. This is all textbook material — well studied and recognized, and not really hypothetical.
The human immune response involves very wideranging signaling amongst leukocytes from both adaptive and innate immune systems — host defense is complex and robust. The role of B cells, although important, is not predominant or vital by any means.
Thank you for sharing that real life test of human immune system response to SARS-CoV-2.
If there is a fast mode of transmission from throat (but not lung) for SARS-2, and this has been an unmodelled and unsuspected epidemiological factor, this begs the question of typical cell-mediated response to SARS-2.
Once again, prof. did not bring this up explicitly unless I missed it. She did mention innate-immune response explicitly. But this is not adaptive, and hence I question whether it could contribute (on its own, without stimulation by T cells) to any buildup with time of herd resistance (my preferred term — aka herd immunity). Certainly T-cell learning could, though.
For T cells to be entirely responsible (in an individual) for adaptive immunity with no contribution by B cells, immune response to reinfections would require some cell invasion. But the required amount of cell invasion might not result in detectable symptoms. And it also might be that upon reinfection the B cells would get a second chance to develop antibodies, with the aid of signaling from T cells and other leukocytes. Hence, we might see a slow buildup of SARS-2-specific antibodies in the population only as substantial numbers of people become infected again after an initial recovery. Many or most might have no awareness of initial or subsequent exposures/infections.
Frédéric Bastiat’s 1850 essay “Ce qu’on voit et ce qu’on ne voit pas”
stresses that “that not seen” is of vital importance. And this is
probably more true in medicine than in most fields, because there is a
misguided but commonplace assumption that we “see” or know much more
than we in fact do.
ELISAs only “see” the humoral immune response.
There is no analogous technology, as far as I know, for cell-mediated
response. There ARE vaccines that are designed for cognate-antigenic
stimulation (of T cells), and I have found some companies in the US
already working on SARS-2-specific such vaccines. But no hype around
these.
Maybe national governments should be working up
a design of controlled studies in which cohorts of young, healthy
volunteers would be tested with a live-virus challenge of controlled
administration and dose. In such a study I suspect that manual-test
methods could detect previous infection or naivete wrt SARS-2 using a
wide range of immunological serum markers.
Suchstudies used to be done before the modern era of overly restrictive
IRBs, which is one of the reasons there is so little learning and
increase of knowledge of biology in medicine anymore.
On the cell mediated analogue test, yes, it’s possible to present T-lymphocytes with a processed antigen & self identification ligand. Cells take up tritiated thymidine if they’re already immune / primed to respond to that antigen. I think Prof Drosten in Germany most recently used the technique.
The Prof seems completely unaware of the Low death rate and The temporary yet string lock down policies implemented in South Korea, China, Australia, Singapore, Thailand that conspicuously were not followed in the US UK or Brazil. The former economies are recovering quicker and with a fraction of the deaths. So how would the UK be better off by doing more of what has failed?
It’s a fair challenge. It’s not certain that it would have worked anything like so well in U.K. Also, we simply had nothing like the capabilities to have done it.
U.K. pop is much older, fatter & less well than people of SK. We’re also unwilling to be ordered about by the state to the same extent.
Finally, we’re a major international travel artery. It was inevitable we’d get ‘seeded’ harder than most. NYC has similar dynamics & disadvantages. It was a surprise to me to read that the WHO did not recommend border closures & travel band in cases like this, pandemics where the infection is very easily transmitted & is of relatively low lethality. Perhaps this apparent pragmatism reflects the view that the precautions can easily be more damaging than the infection?
Looking at the bigger picture, SARS-CoV-2 has something to teach the industrialized, urbanized world.
Due primarily to an anti-evolutionary (i.e. contemporary urban) diet, tissue-specific accelerated-aging/degenerative conditions (aka “chronic disease”) such as CVD, T2DM, MetS (metabolic syndrome), obesity, hypertension, cancer, dimentia (i.e. Alzheimer’s), sarcopenia and osteopenia — many of which are associated with a large increased risk of advanced complications and death from SARS-2 infection — there is a notable minority of younger individuals unusually susceptible.
It is notable that no government has, to my knowledge, even mentioned the notion of raising vit D status (i.e. hepatic storage/reserves) in all of its population to sufficiency (marked by serum 25-hydroxy vit D of ~ 30ng/mL IMO). I think this would make more difference in the short term than vaccines and therapeutics are likely to ever make in the longer term, due to the unique molecular properties of SARS-2, and at trivial cost. Much more ambitious and even more unlikely would be a public policy to improve diet by making it more compatible with that which modern hominids have evolved and adapted to.
The modern tissue-specific accelerated-degenerative conditions that are so prevalent and taken for granted today are measures of EXTREME ill health. Nothing in any of the conventional chronic drug treatments restores the cellular function that is lost through continuance of diet that mankind is not adapted to. Although leaders and governements will not learn the lesson, individuals can and should.
The lockdowns are just one of the hidden and unaccounted-for costs societies pay for the extreme ill health they have come to accept unquestioningly in their populations. The lost opportunity of productivity devoted to drugs for chronic disease is another. And since the business model for pharmaceuticals is now completely dependent upon these drugs prescribed for life, any efforts to develop vaccines and other pathogen-related products are undermined and have negative RoI. Quite a mess civilization has wrought.
I think these important pieces of advice should come from physician / scientists such as Witty. Govt will look like victim blamers otherwise.
As I understand it, Prof. Gupta is making some rather large assumptions. Firstly, that the virus manifests itself in three ways: a particularly virulent form in certain urban centres; a symptomatic form which generates antibodies; and a third much milder form which is asymptomatic and does not generate antibodies. Secondly, that recovery from each of the three forms conveys immunity to the disease in almost all cases. Thirdly, that all three forms have the same characteristics in terms of infection and hence can be modelled mathematically as a single entity, except that the fatality rates are different by orders of magnitude. Under all those assumptions, then, there is a good fit with a simple SIR model with parameters described in the preprint doi:10.1101/2020.03.24.20042291.
I suggest that when you have to postulate not one but two additional and hitherto unknown forms of the disease, one of which is undetectable by conventional techniques, to make a rather simple form of model fit the data, Occam’s Razor implies that the simplest solution is that the model in question is inadequate.
In Lombardy there was an unexpected surge in the Virus that overloaded hospitals. This meant people who needed respiratory assistance risked not being able to receive it.
A similar situation had been seen in Wuhan, and later in Madrid. We now believe that he virus was circulating in Europe long before it was detected, but this was not known at the time.
This lead to a panic throughout Europe, if the events in Lombardy became commonplace then many would have died through insufficient medical facilities. All western European countries introduced national lockdowns around the same time, in the middle of March, and this was due to a fear of health systems being overloaded, not because it was thought of as being the ‘best’ solution to beat Coronavirus.
Therefore I think the most important observation in this article is that roots of the problem are they way hospital beds have been cut; we know that the NHS struggles every year to cope with the flu, we now know that we should regard seasonal flu as a mild event and have capacity for much worse. Without a lack of capacity then a lockdown may never have been considered.
There seem to be some quite unsettling assumptions both above and below the line. First, that herd immunity exists, when we don’t even know for sure that exposure to Covid-19 provides immunity or, even if it does, to what degree and for how long. Second, that older people or those with compromised immune systems, underlying health problems etc are inherently ‘disposable’ so therefore their lives don’t need/deserve to be protected. Doubtless, those of this persuasion would have pulled the plug on Stephen Hawking and other outstanding scientists, artists, politicians, business people etc who failed to accord with their ultra-Darwinian view of the human race. Third, that ‘recovery’ from Covid-19 is an end to the problem. From the personal testimony of friends and others who have been infected, it is clear that the damage it can cause is considerable, wide-ranging and ongoing. It’s really concerning to see how little attention is being paid to its longer-term effects on heart, lungs, kidney and mental health and the way different symptoms present many weeks after the initial attack.
Having just heard Prof Gupta give her views on BBC Radio 4 news today, I am unconvinced by her arguments. So much of what she says is based on speculation and theorising. Of course, there’s no harm in thinking out loud if the aim is to prompt new avenues for research. But when speculative assertions are put forward as a spuriously factual basis for public health policy it becomes potentially dangerous.
A little more humility from all scientists and advisers – especially epidemiologists, behavioural scientists and statisticians – would be in order. Some, at least, need to get off the microphone and go back to the 3 Rs – research, research, research.
Ferguson has even less research & a great deal more conjecture to craft his ‘model’, which has been proven wrong, by large margins, in every setting in which it could be tested. Why anyone would believe his second wave prognostications, I don’t know.
The model assumed no social distancing measures be introduced. Clearly this has not been the case, so how can you argue it has been “proved wrong”. Indeed, the large number of second and third waves that have been experienced all round the world were predicted by Ferguson.
that prediction turned out well for Professor Gupta
Tadaa, which prediction are you talking about? If you are referring to her suggestion made in April 2020 that 50% of the UK population had already been infected then that would seem to be a complete dud. At the time she made this prediction about 200,000 brits were recorded as having had covid 19. Now it is nearly a million. How does that square with her claim of 50% in April? Well, there is one way the two can be reconciled, and that is that immunity to Covid is very short lived, and people are being repeatedly infected, but then Prof Gupta doesn’t seem to countenance that possibility.
I would have a lot more respect for her if she modified her views when the facts changed. I see no evidence of this.
A well informed voice of reason and common sense makes a very welcome change. I wonder why Professor Sunetra Gupta is never interviewed in the MSM.
A very savvy intellect is Dr Gupta …
With necessity of lifting of lockdowns – except quarantine for the truly vulnerable – I have advocated for thenfree dispensation of nutritional supplements ( vitamins D, C, A plus zinc and selenium – all shown to have benefit to innate immune defences and to be commonly deficient especially in poor, inner city populations of colour in northern climes) to everyone
All these vitamins are freely available from healthy food and sunshine. (I don’t know about zinc and selenium). Healthy food is virtually free by all historical standards. The state should not be providing this stuff for free to stupid people. It already provides endless free stuff to stupid people.
The poor rarely eat well for various reasons.
The main reason being stupidity. I am not poor per se, but prefer to live a life that is largely devoid of mindless consumption. I can eat very healthily for about 17 pounds per week on average.
It must apparent by now that we do not need to prolong human life any more than is natural.
Darwinian Self Selection should be the order of the day.
The populous should not be spoon fed by the Nanny state. People should be free to stuff their faces with whatever they desire. They should also be taught to accept the consequences.
Charity begins and ends at home. This is not a matter for the ever grasping “invisible enemy”. (the State or Civil Service)
Just logged in to say what a pleasure it was to watch such a well conducted interview. Great questions being asked at appropriate times with Professor Gupta doing her best to answer them. How different to the mainstream media circus. Professor Gupta is a very impressive speaker- whether you agree with her or not! Thanks.
Is everything censored on here ?
Thanks Freddie, another good podcast.
However, it does raise the problems for politicians who follow the science.
Which science do/should they follow?
Following almost any science is better than following ‘values’
I think the Prof Gupta has made the mistake of thinking she was being asked about her values.
Unherd has managed to catch a valuable source of expertise and wrapped it in click-bait.
Not a good move as Unherd’s USP is to be reasoned. You can view any number of other free websites that produce this stuff.
You could argue that her position is flawed, because of confirmation bias. If you look for evidence to prove your hypothesis you’ll find it. I appreciate Iranian data is questionable, but Iran appears to be starting a second wave. I’ve also read numerous reports on community infection rates, which are fairly similar across Europe and the US so arguing the tests aren’t accurate doesn’t square with dozens of possibly inaccurate surveys coming up with broadly similar results.
The question of natural immunity is valid and pressing. Identifying why some people don’t catch it and some do in an open inquisitive way can only be a good thing, but when I read studies suggesting that being a smoker put you at less risk, I knew it would receive a dogmatic backlash. The bottom line is if we knew more, we’d be better equipped, but we aren’t.
Anyone who takes the time to educate themselves on the nature of viruses and pandemics will feel uncomfortable that so many scientists appear so sanguine about herd immunity. My biggest concern is the way in which children are almost being dismissed as irrelevant. 28 year olds were particularly vulnerable to Spanish Flu probably due to being infected by a different virus as infants in a pandemic 28 years earlier. So for children the virus may be a trojan horse, which is triggered by else something later on. As we all know the virus is ‘novel’ so no-one knows, but China seems really keen on stamping it out. I’m with them on that.
I’m not sure sanguine is the right stance. More that it’s pretty much inevitable.
What remains unclear the documentary about the truth behind COVID 19, was removed by youtube.
The documentary claimed a huge medical fraud and false data for useless antiviral drugs.
For becoming rich by rights of patent and intellectual property.
The drama is amazingly taken us for a ride perhaps.
Why two genuine virilogists were jailed in USA ? Their work stolen .
Whom do we believe, now?
I would suggest you believe anyone who has been removed by YouTube, Twitter and Facebook. I instinctively knew that Twitter and Facebook were to be avoided when they first emerged and I refused to have anything to do with them, except when paid to provide ‘content’ on their platforms for various clients. But I never imagined they would become actively evil.
I think Prof. Gupta’s hypothesis might well prove to be closer to reality than the models put forward both by Imperial and IHME. There are studies coming out showing innate immunity to SARS-CoV-2 via T-lymphocytes, which can be a clue to why there are so many asymptomatic and mild cases; in addition, it would explain why the spike in death occurred from late March while the virus had clearly arrived in Europe in December if not November 2019, a full four months before the surge in deaths. There’s also the question of why deaths are declining in a similar pattern regardless of the strictness of lockdown measures: they are declining, for example, in Sweden (no stay-at-home order but social distancing), in Switzerland (gatherings of up to 5 people always allowed, even during the closure of non-essential business and schools), in Spain (strictest shelter-in-place in Europe), in the UK (with the lockdown measures we all know about), in the US, in Italy, and so on.
Many people point to the fact that an IFR of 0.05 percent is too low. They might well be right: it is plausible it is higher in Europe and North America, because, for instance, of higher average age and more comorbidities, especially obesity. However, that doesn’t disprove Gupta’s hypothesis for three reasons. 1) Immunity, age, and comorbidities seem to be related. The vast majority of deaths have occurred in people over 65, with two or more pre-existing conditions. We tend to forget that most deaths also occurred in care homes, whose demographic consists of old and sick people. If the virus gets in there, it spreads like wildfire. This has happened all across Europe and North America, with the strictness of the lockdown measures making no difference. It is clear that the pattern of deaths as they have occurred until now is not reflective of the state of the wider population: 66 percent of deaths in Spain occurred in nursing homes, but a very low percentage of Spain’s population lives in nursing homes. 2) Related to this point, nosocomial transmission has been the greatest culprit in the covid-19 pandemic. This was evident in February, when the situation deteriorated in Codogno: people have fallen sick after catching the virus in a hospital. Again, hospital populations aren’t reflective of the wider population”they tend to have higher rates of comorbidities than what can be observed outside. Therefore, if the virus enters a hospital it spreads much more easily. 3) Many point to NYC and Lombardy to suggest a higher IFR. However, it is not entirely clear that all the Covid deaths in NYC and Lombardy have actually been caused by Covid, because a) there have been reports of incorrect early treatment, due to the novel characteristics of the illness (early intubation and ventilation might have done more harm than good); and b) there is the usual distinction of death with and from covid: a person might be positive to the PCR test, but we can’t be sure they died because of the virus (this has been said, among others, by Deborah Birx).
If not everybody who tests positive to PCR test develops antibodies, we can’t really know how many people have actually encountered the virus, and we can’t really determine at what stage of the epidemic curve we are by looking at positive PCR tests and serological results. Hospitalizations and deaths are declining, though, in spite of diverging lockdown measures. That’s the thing that needs to be looked at.
Really excellent
Michael Osterholm (US epidemiologist) stated rather
matter-of-factedly one month ago that Georgia’s ending of lockdown (and a
rather liberal one criticized even by Pres. Trump in advance) would
lead to resurgence of new infection. It has not. Osterholm was exactly
wrong, it appears.
SIR — I had not heard of this name, but I
would think the elements fundamental to any epidemiological model, as
would be a large number of heterogeneous slices of demographic and
environmental factors. Biological/immunological factors should be added
henceforth, and serum 25-hydroxy vit D must be only one of them for
respiratory infections. Biomarkers for clotting is another obvious one
wrt SARS-CoV-2, SARS and MERS and probably all other viruses that
significantly infect lung which would include flu. Whole-body insulin
resistance should be another. This is easily and broadly available as
ratio of serum VHDL/HDL. And so forth … I could add more to the list.
However, comorbidities (e.g. obesity and CVD) must NOT be included —
this would be confounding, and ruinous. Obesity without insulin
resistance is common, although there is substantial correlation. Same
for CVD with insulin resistance but without excessive susceptibility to
clotting.
But I like the “R”, apparently
standing for “removed” especially. I have been thinking about thinning
of the herd, which Giesecke has occasionally mentioned. This is another
negative feedback, but it would likely only be significant at this time
if the IFR turns out to be quite low. The lower the IFR actually is, the
more significant the “removed due to death” (rather than due to
recovery) factor would be — in other words, natural (aka Darwinian)
selection.
It would be interesting to know the actual
mathematical quantities in the Oxford SIR model that seem at least
consistent with the limited publicly reported or known data now. I
wonder if, at least for the lowest consistent IFR and population figures
and so forth, deaths could already be a significant accrued negative
feedback on the epidemic. This would actually be a reduction in R0
(and not only R) that decreases with time.
Probably too politically incorrect and too early yet for the professor to discuss. Too bad.
Meanwhile, I search in vain for the much more prevalent Osterholm-like predictors
to reappear and offer any ideas as to why their forecasts have been so
wrong.
Please ‘physical distancing’ not ‘social distancing’ as recemmended by the WHO
‘Effectively we used to live in a state approximating lockdown 100 years ago, and that was what created the conditions for the Spanish Flu to come in and kill 50m people.” Please explain how people lived in lockdown 100 years ago. I am baffled!
She may already know Rupert Beale and regrets the position she has taken
Rupert Beale in the Spectator:
‘Herd immunity’ is impossible without a vaccine
Must admit that was one of the least convincing articles on Covid I’ve read in that magazine and judging by the comments most of the Speccie readership agree with me.
P.S. The figure of 0.024% I calculated is based upon official CDC numbers through 5/16. So there is a lag of about one week, it appears, before CDC deaths due to CoVID-19 are made available.
A different figure of 94,150 total through 5/22 is also reported by CDC, and I believe that this is a figure derived using a looser definition than “excess deaths due to CoVID-19”. While I suspect that even the more formal figure is likely an overcount, the 94k figure is the one that people will see reported in the mainstream press.
Using this number for the numerator results in 0.030% calculated deaths per capita so far, and a minimum bound for IFR in USA.
Even with this more liberal interpretation of CoVID-19 deaths the US could still be only 30% of the way through the pandemic as a nation without ultimately exceeding 0.1% expected realized fatality per capita.
IFR determined with some degree of certainty and accuracy in the fullness of time, likely several years from now, would be higher than deaths per capita due to the fraction of population that might never be infected. I doubt this fraction will exceed 1/3 of population at most, and likely it will be very much less.
It is going to take one heck of a 2nd season, or 2nd wave if CoVID-19 proves not to be seasonal like flu (which I very much doubt), and beyond to achieve more than 1 in 1000 deaths per capita in US. There is no sign of this yet in even a single state, as far as I can tell. None whatsoever. Lots of predictions of such, but no realizations of those calls despite unwindings of lockdowns (to various degrees so far).
Just as prof. mentioned the predictable shape of the epidemic deaths with time seem uniform amongst different countries despite widely varying suppression/lockdown policies and implementations, so it is amongst the states in USA. Per capita magnitudes vary quite a bit, but shapes (i.e. durations from inception to peaks through declines to well below peaks) do not.
China had the earliest epidemic that was not suppressed at all before peaking. The CCP’s reported figures are bogus of course, but some idea of the shape of the epidemic curve can nevertheless be inferred from Wuhan itself. Wuhan’s epidemic might still be dribbling on at a low level were it not for, or maybe is so despite, extreme lockdown measures not feasible in free and open countries, but there is little question that the epidemic had largely followed its natural course in Wuhan before the CCP woke up in late Jan. and realized it could no longer sustain its fraud of concealing the epidemic from the world.
There are many professors around the world whose opinions are in line with Sunetra Gupta and a fair number of these work with patients. So presumably if their methods of interpretation is wrong they have had lots of dead patients ? Whereas Neil Ferguson has a qualification in physics and has only ever had patients inside a mathematical model!
I see some dodgy figure manipulation going on from day 1. First of all you cannot use a CFR (case fatality rate) to infer anything it is too crude and far too biased. The only reasonable measure is an IFR based on infected populations. The media keeps comparing a Covid CFR to a Flu IFR which is just plain wrong. An IFR requires large random sampling and then an extrapolation (unless you test the whole population, which is impractical). You cannot then infer a number of deaths with an assumed 100% infection of a population as some defenders of lockdown do. This never happens even with quite virulent viruses like smallpox, except in isolated pockets (ironically). Also an IFR varies between age groups. If the IFR differs hugely between easily identified populations then protect the vulnerable and allow herd immunity from millions of years of the evolution of the human immune response to kick in with the rest. Reminder : We evolved in social groups and so did our immune system. We give nature a helping hand by using our technology to detect the vulnerable but fighting against nature with mass quarantining of the healthy will simply come back to bite us, hard.
There has never been a test to see how lockdown/social distancing works and whether it is effective or not. To infer it works because an infection rate falls is nonsense. There has never ever been in the history of the human population a virus that doesn’t rise, peak and then fall. The closest you can come to is to compare infections between populations with different levels of lockdown/social distancing. And there folks is where politics kicks in ……
FYI if Flu has an IFR of 0.1% then this implies 0.1% of the population dies from flu every year if we don’t social distance which would mean 16,000 dead children every year from flu. The same dodgy maths is used to prove how deadly Covid is.
The Gupta view looks realistic to me. It appears to be
accepted that some, perhaps many, people are, for unknown reasons, able to shrug off the Coronavirus, in some cases hardly aware that they have been infected, whereas the Ferguson model seems likely to be an extrapolation based
on the assumption that if you catch the virus you will be subject to the CFR (case fatality rate) observed in those who report sick with it, and on the estimated reproduction rate of the disease as an indication of the disease’s tendency to spread through the population. Perhaps Ferguson’s model does not include an estimate of those whose immune systems can cope without having previously been infected. Initially they are a dangerous vector, since they are infective for a period without reporting sick, but eventually they should acquire immunity that has a downward effect on the Covid’s reproduction rate by reducing the percentage of susceptible people in an infected person’s
total contacts, even to the point where the epidemic fizzles out.
This use of modelling by Ferguson reminds me of the models that were used to predict the economic effects of Brexit. Models are useful to extrapolate the effects of assumptions ““ for sensitivity analysis ““ but their apparent predictions are nothing more than expressions of the assumptions on which they are based. Their computational power seems somehow to distract attention from the key issue of the accuracy of the assumptions on which the model is based and of the data fed into it.
We shall see whether Gupta is right in due course, though I wonder whether we shall ever know the case fatality rate calculated to include in the denominator those whose immune systems are fully able to cope with the Coronavirus. Her view seems to describe the course of previous epidemics/pandemics, although the most lethal viruses may kill such a high proportion of those who come into contact with them that the development
of immunity by members of the population whose immune systems can cope may be an insignificant factor, and Fergusons model may be more representative of such cases. She is right about the cost of the lockdown, which I fear has yet to be fully appreciated.
I should think that one very interesting question is why some people’s immune systems can cope well, while other immune systems cannot. Perhaps an understanding of that could lead to a test to show whether an immune system will cope well with an infection even before it has been primed by previous contact with the bug that causes it, or by a vaccine, which would probably be at least as useful as an antibody test for the purpose of releasing people from lockdown, estimating what the case fatality rate for a disease is likely to be, and perhaps also lead to an understanding of why immune systems tend to become less effective with age, or are associated with certain diseases that do not appear to be related to infections. There could be a range of factors, such as previous infections by other diseases, or even dietary factors such as vitamin or mineral deficiencies. Perhaps herds evolve with different types of immune systems amongst their members, and perhaps there is survival value for the herd in doing so, a diversity of systems allowing the herd to develop immunity to a wider range of threats. It would hardly be surprising to find such diversity if, as I understand to be so, there are a number of elements already known to exist in a healthy immune system, and if an immune system can never be sufficiently comprehensive to deal with every new challenge.
Epidemiology will get a boost from the pandemic and the prevalence hitherto of air travel. Let’s hope that also the immune system will give up some of its precious secrets to the study of the current pandemic.
JPMorgan says basically the lockup was stuff up.
https://jamesfetzer.org/202…
In her article Professor Gupta remains clear and succinct in her message concerning higher levels of immunity and lower case fatality rates than we might currently expect. In addition the view virus is and has undoubtedly been on it’s way out fits with the clinical picture seen locally.
From my own experience within general practice, it is likely that more people have had the illness, developed immunity and are less likely to die from it , than current figures show. Also the number of new cases we have been seeing in the community and admitted to hospital have plummeted over the last 4 weeks to single figures daily.
I have direct experience of the current antigen test’s 75% sensitivity , missing up to 1 in 4 tested. For example, I have seen couples who live together displaying the same Covid 19 like symptoms, at the same time, where one tests positive , whilst the other tests negative.
Also in the initial stages of the outbreak ,GPs like myself, kept the majority of sufferers at home. Sending only the most seriously ill to hospital, where they would have been tested and included in the current figures, whilst leaving all those at home excluded . As a result of this approach , most infected people seen by GPs early on, have not yet been tested and are therefore not incorporated into the infection, immunity or case fatality statistics.
In addition , I am convinced based on my own personal (and also those of my colleagues) clinical experience that we have seen patients with Covid 19 symptoms from the 1st of December 2019 ,through Christmas and into January 2020.
The first cases I saw were in a group of 25 individuals, of which 22 became ill, with symptoms ( fever, persistent dry cough, loss of smell and taste, shortness of breath and low oxygen saturations ), identical to those we now use to diagnose Covid 19. They had all attended the same party on the 30th of November 2019.
Recently, I have been able to assess a total of 37 patients ( I suspected of having Covid19 before February) using the a finger p***k Covid19 antibody test – 12 from the party and the rest – from patients who also exhibited Covd19 symptoms in December and January. 72.9%
of those I have tested ie 27 out of 37, have tested positive for Covid 19 IgG antibodies.
The current government epidemiology model doesn’t support these tentative results, which are much more in keeping with Dr Gupta’s views and suggests the current epidemiology model might require rethinking .
The Corona virus may have been in this country from early December . This, with the approaches implemented early on in the outbreak, may mean that we may have significantly higher levels of infection (and therefore immunity) , with substantially lower case fatality than currently estimated.
Clearly there are some obvious caveats for these results which do not fit the government’s current model.
The antibody test that I have used is not 100% accurate. Neither is the PHE approved test.
In addition in my experience antibody levels dramatically reduce after the first 6,-8 weeks. However even low levels of antibodies seems to confer ongoing protection against the infection in those who demonstrated this Covid 19 like illness.
The patients I have diagnosed and tested might all have had a second asymptomatic Covid19 illness before I was able to test them , with the earlier infection being normal seasonal flu. However , if so it would represent a remarkable coincidence to have so many patients infected twice in such a short space of time.
Finally my clinical diagnosis might be wrong, although I’m still using the same criteria that all GPs use to diagnose current potential Covid19 patients.
Despite these caveats I believe the evidence of testing I have undertaken in the community to date , points to a situation akin to Professor Gupta’s model.
We could be in a situation where we can be more optimistic about the future approach to this pandemic and the unlocking of the country.
Indeed I wonder could this current waning pandemic even be the second wave , with a first wave much earlier than we have been aware of.
Remaining in a state of lockdown is extremely dangerous from the point of view of the vulnerability of the entire population to new pathogens. Effectively we used to live in a state approximating lockdown 100 years ago, and that was what created the conditions for the Spanish Flu to come in and kill 50m people.” We would do well to pay attention to that comment
… possibly because it is quite untrue. The Spanish Flu broke out during the First World War, when millions of men had been sent abroad into crowded and unsanitary trenches, coming back home on leave on crowded ferries and crowded trains: when women had been taken out of their homes to work long hours in crowded factories, and children were going to school classes of thirty or forty in a room. More or less the complete opposite of lockdown.
We can’t really compare 2020 to 1918-19, when antibiotics had not been discovered. I wondering how many victims of Spanish flu actually died because of a bacterial infection that happened after they got infected with the flu virus. I’m quite frankly more worried about antibiotic resistance than Covid-19!
According to UNICEF, 22,000 children die each day due to poverty. 8 million a year, entirely preventable deaths. That dwarfs any death toll from Covid-19. So, why aren’t we doing more about child health and poverty, given the vast trillions we have pumped into tackling Covid-19 ?
Comparisons between countries are rather puzzling, and I think the reason is because this virus is mainly a problem of megacities. London for example has far more deaths per capita than the Highlands and Islands, despite identical policies.Less than 10% of all deaths in UK rural areas in the last three months have a connection to covid, whilst in big cities like Milan, London or New York, around 50% of all deaths are covid-connected.
We now believe, by the way, that at least 1600 individuals with Covid-19 entered the UK from abroad in January or February and passed it to others – family members, colleagues, etc, nearly all young and asymptomatic travelers (esp skiers) , very few of whom were Chinese, meaning that even if harsh measures had been taken a couple of weeks earlier , it would have made little difference. Sure, maybe they thought they had a cold or something, but in late winter millions of us had colds.
London and the UK did lockdown, as did New York: but far more people appear to have antibodies in London and New York than in Stockholm: so the virus clearly ripped through a larger proportion of people in the megacities very early on – probably in February and early March, by which time much of the damage was already done. But then, London and New York have populations some ten times larger than Stockholm, creating far more opportunities for community transmission on public transport and workplaces etc.
The other thing to bear in mind is whether in fact, Covid-19 was the primary cause of death or merely a contributor: it is very apparent that the highest risk of fatality is in those aged groups who are already at high risk of dying from cancer, heart disease, dementia, lung disease, and so on. We also know that nearly all deaths were of those with pre-existing conditions. So its perfectly reasonable to ask whether in fact these were mostly people who would have died anyway in the next 12 months or so, and we will only know that after 12 months or so has passed. Take those over 90, for example: In 2014 to 2016, life expectancy in the UK at age 90 was 4.0 years for males and 4.6 years for females. Yet 90% of 90+ year old people in Spain survived Covid-19!
I suppose the other thing about all this soul searching is that it tends to focus on just one infection, Covid-19, but there are many, many other diseases out there that kill many people worldwide. More disturbingly, many of them kill children and babies. I don’t know about you, but given the rather horrible choice to save either the life of a 2 year old or a Ninety year old with heart disease, I think most of us would choose the child, on the instinctive basis of life expectancy: also called “Quality Adjusted Life Year” or QUALY.
In the United Kingdom, the National Institute for Health and Care Excellence, which advises on the use of health technologies within the National Health Service, has since at least 2013 used “£ per QALY” to evaluate their utility.
Sweden is now having a major second wave, and has imposed further restrictions.
CAN WE PLEASE GET ANOTHER INTERVIEW WITH Professor Gupta. I like the clam and professional way she presents her case and it would be good to get an update to see where the data is leading her now! Thank you!
Shame that Gupta chose to lard her comments with political posturing that would undermine any scientific credibility. Nevertheless, other epidemiologists consider higher infection rates possible. Two recent French studies say this may mean that herd immunity may be approached after second wave. That may still involve greater death and damage than the first though, depending on how well things are managed now. This is not the time to treat response to CoVid as a matter of standpoint or disposition, lack of respect for external realities is responsible for most of the damage so far.
Excellent!
“Asked what her updated estimate for the Infection Fatality Rate is, Professor Gupta says, “I think that the epidemic has largely come and is on its way out in this country so I think it would be definitely less than 1 in 1000 and probably closer to 1 in 10,000.” That would be somewhere between 0.1% and 0.01%.”
We’re already at 0.0521% in this country, so Infection Mortality Rate must be even higher. Oxford, you say?
You might be assuming every death with covid19 was killed by the virus. I don’t think that’s a safe assumption.
I think it’s problematic to assume that, no matter what the evidence or
logic, governments really want to lift the lockdown now. This is
evidenced in part by the imposition of more stringent mitigation
measures even as they appear unnecessary and not useful. There is
significant foot dragging under the guise of protecting the public at
all costs (though ironically only against a single threat) even when the
monster under the bed has been vanquished. As long as there are
federal dollars to spend and the possibility of garnering more, the foot
dragging will continue. Milking the cow for all it’s worth if you
will. Additionally, social manipulation such as the University of
California’s announcement it was eliminating standardized testing for
admission in order to equalize access, is becoming brazen. The
elimination was first decided on as a temporary measure as a result of
the coronavirus impacting entering students’ final year or two of high
school but it was suddently enacted without reference to the virus at
all and appears to be permanent.
Osterholm’s reasoning is easy enough to find online. But simply put,
he claimed (about a month ago) that no more than 5% of the US population
had yet been infected or exposed, and no less than 70% would be
required for significant herd immunity. Hence, he said, the epidemic has
a long way to go.
Furthermore, he stated that “this
is a highly infectious virus”. It is not — it is mildly infectious, and
much less infectious than flu according to early research estimates —
the quantitative value for rate of spread is inversely proportional to
the serial interval (SI). SI is known for flu, and all evidence so far
for CoV-2 indicates a much higher SI. CoV-2 is only highly infectious in
comparison to its cousins SARS (-classic) and MERS which were easily
contained well short of pandemic status.
I don’t know
what gives Osterholm his reputation or credentials. He just seems to be
another prognosticator who says much more than he should, and much too
early.
As for 5%, this is probably too low for reasons
prof. described well enough. I would add that 70% is likely much too
high for a virus which quitely observedly is more strongly responded to
with innate and non-humoral adaptive host defenses, in comparison to
flu. I think that the 70% figure probably is correct for, and derived
from, flu alone. This virus is very much different than flu,
biologically and epidemiologically. Its only similarity is that it isn’t
very pathogenic, but even that is a false comparison because
pathogenicity of flu is much suppressed by vaccination and long history
(i.e. it is not novel) compared to its intrinsic potential (reflected in
the Spanish flu), while CoV-2 is at its peak of potential now and
hereafter it will be all downhill, making CoV-2 most probably much less
important than flu within a few years.
Prof. seems to have some clue about immunology and biology, and Osterholm just totally ignores it after a long career in epidemiology.
Added
to the utterances of key opinion makers (KOMs) like Fauci (in US) who
has enormous conflicts of interests, the so-called experts (who are
clueless — that is why I call them KOMs — professional propagandists
working for vested institutional interests) have hugely perverted public
opinion towards confusion, fear and hysteria. Fauci is nothing short of
a clown as amateur epidemiologist, but has an attraction to the camera
as an insect to light. He is not really a virologist either IMO — he is
a corrupted paymaster distributing the taxpayers’ money to those doing
“research” on vaccines and drugs, with almost total personal control of
funding in these fields in the USA. Like Walter Willett and so many
others he derives his power in large part by playing to useful idiots in
the press, who are only too happy to point to an “expert” and make easy
copy without doing any investigative journalism whatsoever. Characters
like Willett and Fauci use their power to viciously suppress bona fide
research and researchers, but that is another story. It is very helpful
for such people to lack knowledge of science, as they always do.
For
example, Fauci insisted on a widely viewed TV show on March 8 that
“Right now, in the United States, people should not be walking around
with masks.” Looking back, this was almost perfectly coincident with the
peak of infection in NYC where Fauci is from, and which dominated
policy even at the federal level at the time due to a mild and brief
crisis in its hospitals.
Of course, there is no
evidence that masks make much of any difference anyway, especially at
the absolute peak of a new epidemic in a place like NYC. But of course,
Fauci now supports almost universal adoption of masks in public.
I think it’s problematic to assume that, no matter what the evidence or
logic, governments really want to lift the lockdown now. This is
evidenced in part by the imposition of more stringent mitigation
measures even as they appear unnecessaryand not useful. There is
significant foot dragging under the guise of protecting the public at
all costs (though ironically only against a single threat) even when the
monster under the bed has been vanquished. As long as there are
federal dollars to spend and the possibility of garnering more, the foot
dragging will continue. Milking the cow for all it’s worth if you
will. Additionally, social manipulation such as the University of
California’s announcement it was eliminating standardized testing for
admission in order to equalize access, is becoming brazen. The
elimination was first decided on as a temporary measure as a result of
the coronavirus impacting entering students’ final year or two of high
school but it was suddently enacted without reference to the virus at
all and appears to be permanent.
In what sense did we “live in a state approximating lockdown 100 years ago”? Although it’s true that there was less international travel that would not have effected how a disease spread through Britain once the pathogen had arrived.
Really? A century ago very few people had a car, or time & money to go anywhere except to work (most walked or cycled, a few took trains). I expect this made national spreading slower than today, but similar to where we are under (leaky) lockdown.
Does C-19 really exist? Seems that all relevant data is kept with the controlling elite, if I understand correctly.
‘A New Pandemic? Two Trailblazing COVID-19 Researchers Dead in a Month ‘
“……………….”The current state of much of the Wuhan pneumonia virus (COVID-19) research shows a regrettable lack of data sharing and considerable analytical obfuscation,” Nekrutenko and Kosakovsky Pond wrote. “This impedes global research cooperation, which is essential for tackling public health emergencies, and requires unimpeded access to data, analysis tools, and computational infrastructure.”…………………………..’
https://www.strategic-cultu…
Here in Canada there is federal government panic and severe lockdowns. Yet the death rate is 0.03 % of the population and about 70% are in care home of people over 65 who have other medical conditions. It is the so called health experts who lead the panic.