Main Edition
US
FR
April 22, 2021 - 3:00pm
I watched last week’s interview with Johan Giesecke and Freddie Sayers with interest — it is still a rare thing to see a conversation about Covid devoid of the usual agenda. However, I felt that there were some important issues missed by my fellow Swede and epidemiological colleague.
- Country Comparisons:
It is popular to compare the disease outcomes of different countries and attribute their differences to the pandemic strategy employed. It is important to realise though that there is often major geographical variation within countries that is not explained by different strategies since the strategy was uniform.
For example, all parts of Sweden had the same strategy, but the Covid-19 cumulative mortality in Stockholm is almost three times higher than in my own northern home region of Västerbotten. While there are regional differences unrelated to strategy, Giesecke was essentially right a year ago when he thought that differences between countries would even out over time, even though the final number will obviously differ.
For example, a year ago, the media praised Czechia for their successful lockdown measures, but now they report the highest cumulative Covid-19 mortality in the world. Their low rates a year ago was not due to pandemic strategy. Rather, Covid-19 arrived later in Czechia than in many other parts of Europe, and the rates were held down by seasonality before the disease had time to get a strong foothold.
- The “accuracy” of the Imperial College Model:
On March 16, 2020, Neil Ferguson and his colleagues at Imperial College predicted that around 500,000 in Great Britain would die from Covid-19 under a do nothing let-it-rip strategy. A significant factor in their model was their assumed overall infection fatality rate (IFR) of 0.9%. While that was one plausible estimate at the time, it would have been more scientifically appropriate to present multiple plausible values, as did the Oxford group led by Sunetra Gupta. More recent IFR estimates are about a third to half of the Imperial College model assumption. With these later numbers, the Imperial College model would instead have predicted somewhere between 165,000 and 250,000 deaths under a let-it-rip strategy.
While not part of their research report, in an email from Ferguson dated March 29, 2020, he reported on a scenario that his group ran using the Imperial College model for an “age-based cocooning” strategy, with focused protection of older high-risk people, as advocated by the Great Barrington Declaration. “Making realistic assumptions about effectiveness,” they predicted 50-60% fewer deaths relative to a let-it-rip strategy. Together with the lower IFR estimates, that would have meant somewhere between 70,000 and 125,000 total Covid-19 deaths. We can compare this to the actual April 19 cumulative UK death count of 127,524 from the implemented lockdown strategy.
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
SubscribeAnother issue not discussed was the lack of agreed standards for diagnosis of COVID19 infection, with no standardisation of the PCR cycle threshold, nor for diagnosis criteria (eg the UK “if it looks a bit like COVID19, then it is COVID19”)
It’s a pity they didn’t say, “If it looks a bit like flu, then it is flu”.
Yes, well that is just silly and ruins the argument against widespread and damaging lockdowns. Covid-19 is not influenza, the virus is an entirely different type, and it does have a significantly higher infection fatality rate.
Because they are what is called an ‘Inconvenient Truth’.
Worse than that – the NHS has been committing mass fraud “If it looks nothing like COVID19 e.g. a stroke, then it is COVID19 because that’s government policy and I’m following orders or I’ll lose my job”
Anyone who bases policy of the ‘Covid death’ stats should be put in front of a firing squad (Cause of Death: Covid with 12 comorbidities). In the case of the UK, I DO believe the ONS Deaths All Causes series. The good news is that the year 2020 came eleventh out of the last twenty years in terms of population adjusted deaths.
I always wonder how many flu deaths there would be if we test everyone for flu and concluded that any death is consequence of flu. I bet at least half of the reported cumulative deaths are not really because of covid but only “with” covid.
You don’t need to bet, Fran, the ONS publishes statistics that differentiate between dying with and dying from. Hint: the answer is not a half.
This guy seems to talk total sense. The pelicans and Sage etc will never listen to him.
Lockdown is one of the greatest crime nations ever committed against their own citizens.
Poor students have been proven to never catch up from missed school, this is why it is against the law to take a child out of school to go on holiday almost everywhere. 1/3 of children in cities in USA never even logged in to the system, they just disappeared. Now they have forgotten the building blocks of the previous year so really need to repeat the last TWO years if you want them to ever be employable. This is impossible as new children need those classrooms, and that the facilities and budgeting impossible. Dental and Medical schools, lost a year but many were just handed their degrees and sent out as what are you going to do?
Tend of thousands of business families have devoted their lives to are closed for ever!
And the citizens of the West are all weirded out, they are frightened, over compliant, surly, unsocialized, lost their rights and freedoms – and liked it, and living on government debt.
Hundreds of thousands are horribly affected by lack of health care.
National GDPs are all hugely reduced, and Gov debts doubled till they will hold back the economic health of all the younger generations. USA has 130% debt to GDP! This cannot be recovered from – wile the stock markets are at ALLTIME highs! This is where the trillions of money printed went, into the wealthy people’s stock portfolios. The Billionaires almost all became much wealthier! It also means a depression or huge recession (A Correction) inevitable, and pensions destroyed.
WFH. work from home, means the office space in cities are underused, and inner cities have been changed for ever, and suddenly, so it could not evolve. The business which supported them destroyed. The Public Transport not used enough to continue as we had it before. People leaving the cities in USA.
The retail shops closing, and most to never reopen as Bezos and his evil empire, Amazon, now all powerful, and once fully automated will mean an amazing loss of jobs. The high streets closed down, the strip malls closed.
A Billion developing and third world poor had their lives disrupted by reduced economic activity in the West, over a million of the children are expected to die from poverty as a result of Western Lockdown, to add 6 months (of misery) to a 84 year old. Pretty evil.
Freddy, I guess trying to be fair, really just attacked Sweden for not being a lock down tyrant. The lockdowns and consequent responses and spending are totally disastrous. The cure hundreds of times worse than the disease. It was a war against covid, and we lost by collateral damage. Now it time for the War trials, the Nuremberg, as it were, and the guilty who did this to us get their punishment. I think every dollar made by the Billionaires should be clawed back too, and Amazon, Facebook, Twitter, all broken up because they were the part of the enemy in this disaster.
Rioting in the streets also can be blamed on this, and it looks like it may bring a virtual civil war in USA, the Democrats using covid to divide the nation. This was a POLITICAL event, not a health one, this was not about covid, but about gov taking absolute power, and the financial disaster part of their plan.
I’d like to see some sources/data for your assertions.
The US economy will leave the Swedish economy in the dust this year. But neither that fact, nor US’s debt ratio relative to Sweden, tells us anything about how the poor will be impacted longer term (which seems to be a focus on your concerns).
The longer term structural challenges are still there, regardless of COVID. Hence it will probably always be better to be poor or a student from a disadvantaged background in Sweden than in the more laissez faire US.
However, it is perfectly plausible that the pandemic will lead to a new political settlement in the US, where the people demand a better healthcare and welfare safety net, ie the US may become slightly more like Sweden. In which case, one could argue that an acceptance for increased government intervention during the pandemic might improve the lives of the poorest.
In short, I think it’s too early to tell, but I don’t think there’s any evidence to support your frankly, and with respect, somewhat hysterical position.
Incidentally, I note lockdown sceptics have stopped going on about lockdowns causing suicides in the US, now the data in fact shows a 5% fall in US suicides in 2020.
I am prone to hysteria, seen to much to expect normality and tend to not believe the status-quo is really real.
But history teaches us that the huge events always take the people by surprise, although the evidence it was coming was so clear in hindsight. I do believe in Harry Dent’s crash theory, although he seems to be wrong again, but I think it is coming….
MMT is my reason, the theory you can print any amount you wish if you are a sovereign Bank. It is what USA is working on, and UK. (google MMT)
As far as I can understand it it is:
Central banks can print any amount of money they wish without triggering inflation because they then, later or now, can suck back up the excess by taxation.
The thing is taxation is mostly progressive, and so the top earners get taxed to pay social programs. This means tax and spend is De-Facto redistribution. So increase the spending, UBI, free health, free university, free mortgages for the low income, food stamps, what ever – then the big income earners pay it back as income tax. MMT 101.
The problems is there are not anything like enough big earners, so corporations and business and land must be taxed more – BUT that then becomes Regressive nTax, as the costs of what the businesses produce have to rise to pay the tax increase! So you raise the benefits to keep up, raise gov pensions, UBI, what ever, by printing more money, then tax the corporations more, and they have to raise their prices…….
We are far along this course, M2 (real money supply, $) has doubled since covid! From printing! 37 Trillion Fed debt in USA, and on and on – it is a house of cards!
Thanks for your reply. I’m an investor and live in California, and am very familiar with MMT. I broadly agree with your summary, but I would stress the risks do not apply to all countries equally.
The US has a huge market and the global reserve currency so has much more policy space to “print money” than eg the U.K., which is more at the mercy of the capital markets. And, as you know from Sweden (and from the US in the post war boom years), higher rates of taxation are not necessarily incompatible with income growth. Other factors, such as productivity, are potentially far more significant.
I’m not saying you’re wrong to be concerned, but I am saying there’s a lot of nuance and you should be more open to potential upside and positive outcomes that don’t fit with your opinion that lockdowns will turn out to have been a disasterous mistake, particularly when (as Giesecke admits) there is no such conclusive evidence (at least not yet — we shall have to wait and see). (Frankly, I think reasonable minds will always disagree to some extent on lockdowns, regardless of the facts that emerge over the next few years).
“I note lockdown sceptics have stopped going on about lockdowns causing suicides in the US, now the data in fact shows a 5% fall in US suicides in 2020.”
I’d take that with many grains of salt.
Some suicides can be identified relatively easily due to documentation (suicide note) or cause of death (hanging or self-inflicted shooting). A drug overdose is tough to classify as purposeful suicide or unintended in the absence of a suicide note. Also, drug overdoses, along with all types of suicides, fit in a broader category of “deaths of despair” that should arguably be viewed in totality.
U.S. “unintentional injury” deaths increased by about 19k from 2019 to 2020, which was 7x the decline in suicide deaths. That was above the recent trend. Unintentional injury deaths had increased ~6k in 2019 and had actually declined by ~3k in 2018. (My understanding is that unintentional injury deaths include overdoses.)
Here are the 5 year totals for the sum of those two categories, unintentional injuries plus suicides. Unintentional injuries account for ~80% of each year’s total.
2020: 237k
2019: 221k
2018: 215k
2017: 217k
2016: 206k
( Source: https://jamanetwork.com/journals/jama/fullarticle/2778234 )
As for other explanations, U.S. traffic fatalities were – counterintuitively – up about 3k in 2020 despite fewer miles driven. ( https://www.npr.org/2021/03/05/974006735/tragic-driving-was-down-in-2020-but-traffic-fatality-rates-surged )
So traffic fatalities account for a portion of the 16k increase, though some (likely small) number of traffic fatalities could conceivably be unidentified suicides.
Here’s additional analysis providing evidence that drug overdoses – with increases above recent trends – drove the increase in reported U.S. unintentional injury deaths in 2020 – https://www.commonwealthfund.org/blog/2021/spike-drug-overdose-deaths-during-covid-19-pandemic-and-policy-options-move-forward. (I’m not aware of a solid number for U.S. calendar year 2020 drug overdose fatalities due to reporting delays.)
Here’s the latest data from The Economist:
https://www.economist.com/graphic-detail/2021/04/24/surprisingly-suicide-has-become-rarer-during-the-pandemic
Someone downvoted this?!?!
To properly interpret these statistics one needs an understanding of how they are compiled. Certainly, within the UK, a certain amount of investigation is required before a death is officially registered as a suicide and, as a result of the Covid restrictions brought in by the government, there was a large backlog of cases awaiting investigation and certification. This produced an artefactual apparent drop in suicides in the statistics, which drew fury from people I know working in the psychiatric field, when Matt Hancock tried to claim publicly that suicides had fallen.
And I acknowledge that point, and explain why it’s a woefully incomplete picture: drug overdose deaths in the U.S. increased dramatically, by far more than the decline in reported suicide deaths.
Eva, you write: “The US economy will leave the Swedish economy in the dust this year.” Maybe so, I’m not sure what that proves. Even in 2020Q4 the economic data is somewhat influenced by the vaccine rollout, which has nothing to do with lockdown strategy per se, and where the American performance was clearly superior to Sweden’s. (Sweden was handicapped by dilatory EU policy to some extent.) If we look at annual economic growth for 2020Q4 Sweden outperformed the US and most other advanced countries with a -2.1% growth rate, as opposed to the -2.4% US growth rate, all the more impressive as Sweden, much more than the US, is dependent on trade, and its economy suffered from the tough lockdown policies of its European neighbours. If you want to make a case against the Swedish light-touch lockdown strategy, you really don’t help your cause by looking at the GDP numbers.
Andrew — thanks but I think you misunderstood me. I’m not arguing in favor of lockdowns or against Swedish policy, nor was I looking at GDP one way or the other. What I said was:
I was merely suggesting — in the context of nebulous and unsubstantiated claims of “collateral damage” in both the article above and the comment I was responding to — that the economic harms from lockdowns or other social distancing policies (including those implemented in Sweden) may not be so significant in the longer term. In that regard, I was also pointing out to Sanford that there are lots of structural socio-economic factors that make life difficult for the poor (more so in the US than Sweden, of course), and I would be careful before attributing these type of social ills to Covid policy rather than unrelated longer term trends.
Ultimately, we will have to wait and see, as Giesecke himself says. I’m not advocating a particular policy, however I am allergic to unsubstantiated assertions of “collateral damage” — particularly those that do not account for the inherent/unavoidable (i.e. policy-neutral) costs of the pandemic.
Thank you for this interview and written summary. An objective account of what we’ve learned about covid and the effectiveness of lockdowns over the past year.
I am not, however, hopeful that political leaders will rely on these conclusions in future. I’m betting on more lockdowns this winter at the first hint of a rise in covid infections.
It was a terrible interview. Now, afterwards, is the time to count the costs! Freddy kept going on about Deaths, but what are they? 84 year olds, people at end of life? No mention made of normal Death rates, no talk of how 2020 is compared to all the years previous, no talk of – died of – or died with, no mention of LOST YEARS of life, as it is certain more healthy years are lost as collateral damage, than saved by this crime of lockdown.
This interview could have been on CNN, BBC, or any Lockdown apologist MSM.
You are mistaken. There’s lots of analysis of years of life lost data by Prof Sir David Spiegelhalter of Cambridge and the Royal Statistical Society, among others.
The answer: those who are dying are not all at the “end of life”, as you suggest. Rather, they typically could have expected to live another decade or so.
https://www.ft.com/content/879f2a2b-e366-47ac-b67a-8d1326d40b5e
https://www.nature.com/articles/s41598-021-83040-3
Why do people feel the need to downvote factual and relevant posts with citations to back them up? Is it the FT paywall, or just a wish for alternative facts that conform better to one’s preferred reality?
If that were true Swedish total mortality would have gone up far more than it did for 2020. Under plausible assumptions (i.e. that 2019 was not a new trend of permanently lower death rates but rather random variation in the previously stable trend), Sweden has no excess mortality at all. Where are all these people who could have lived another decade and why do they not show up in the “ground truth” stats?
Norman, you are spreading misinformation.
Latest Eurostat data shows Sweden had 7.7% excess mortality in 2020.
https://www.reuters.com/article/us-health-coronavirus-europe-mortality-idUSKBN2BG1R9
And this is backed up by the official Swedish data (Tabell 1 in the Excel file):
https://www.scb.se/om-scb/nyheter-och-pressmeddelanden/scb-publicerar-preliminar-statistik-over-doda-i-sverige/
I’ve explained this in other comments in the thread. Your number is the increase over the average of the last 4 years. That’s one of many ways to calculate the excess which is, ultimately, the deviation of the real number from a model of what was “supposed” to happen. So differing numbers here are to be expected and are not “misinformation”, which is at any rate a totally meaningless label especially when talking about COVID and government statistics.
An average of the last 4 years is an especially questionable choice of baseline because it will be very heavily affected by the record drop in 2019, implicitly creating a trend downwards where a longer term average shows no obvious trend.
A useful decade? Or a costly-to-others decade? An enjoyable decade, or merely a KBO decade, because timor mortis conturbat me?
Martin Kulldorf is dead on the money. One of the few together with Gupta and Batthacharya who have spoken with the voice of common sense all during the course of this pandemic, in sharp contrast to the prominent scientific/medical advisors to the US and UK government.
Very interesting with the in-depth reasoning around the Imperial College Model. Especially that there were a part based on “age-based cocooning” strategy.
Sweden went from 8th in per capita deaths during the epidemic wave last year, to round about 30th now. They have been overtaken by a host of European countries. I don’t ever trust cases, because as we all know, this is dependent on amount of people tested, plus the flawed PCR tests. Not that deaths are entirely accurate either, but certainly a better indicator than cases.
As Sweden’s state epidemiologist Tegnell said the other day, deaths are down in Sweden because the elderly/vulnerable have been vaccinated in decent numbers. The virtue of having a small population, even with vaccine supply issues. However, Swedish ICUs are under intense strain, full of younger, unvaccinated people.
https://www.thelocal.se/20210422/will-sweden-ease-coronavirus-restrictions-next-month-or-not/
I am puzzled by the absolute conviction about seasonality. I am in the southern hemisphere in South Africa and our 2nd wave, much worse than the first (which was in the winter), was right in the middle of summer (December / January) – in tandem with the rest of the world in the north.
But perhaps we don’t have such a big difference between summer and winter, so seasonality is not so pronounced? Yet ordinarily natural deaths here are indeed higher in winter than in summer.
Can anyone point to a study which provides clear evidence of seasonality in both the north and the south?
I am also in South Africa and to my knowledge, no one yet has explained why we saw an unseasonal epidemic wave. We are an obvious case for enthusiasts to investigate – no hard lockdown, no vaccines and a curve that nonetheless plummeted.
It is not just South Africa, other southern African countries (e.g. Namibia, Mozambique) and South American countries experienced a rise in December too (and a subsequent fall). South American countries experienced another rise in March.
“No vaccines” isn’t quite true. South Africa was a site of vaccine testing last year, and 250 000 health care workers have been vaccinated this year … albeit that’s only 0.5 percent of the population.
Also, we still have a curfew, we have to wear masks, we have to ‘”sanitise” wherever we go, it is still not possible to go to big events. Most school kids are only going to school every 2nd day and many universities have only allowed one third back on to campus, or otherwise have a hybrid model (1/3rd live lectures). Those who can are still working remotely.
I agree that lockdowns probably have little impact in the long term. It seems that it takes about 4-5 months for the virus to find its new crop of susceptible people.
The studies here do seem to say that where there is reasonable health care, survival of the hospitalised is better when the hospitals aren’t full. (Where health care is poor this doesn’t matter so much.)
The shapes of the graphs for cases of seasonal infectious diseases for the southern hemisphere look very different than for the same diseases in the northern hemisphere. It is not a matter of — shift this over 6 months and poof, it fits. Southern hemisphere diseases typically have a wider but less steep graph, while northern hemisphere ones are steeper and less wide. But it has been many years since I studied that in school. Nobody knew why this was so then. If they have figured it out since then, I haven’t heard the news.
There is a nocebo effect (opposite of placebo) where people can be more ill if they feel expected to be. And I also think you find more of something when you specifically look for more at the same time as expecting to find more.
This doesn’t really apply to objective data such as all-cause deaths.
Seasonality is one of the most poorly understand areas of epidemiology, in fact ICL’s modelling and most others ignored it entirely. I’ve done some research to try and understand this topic better but the field is useless: there are a few papers, mostly dating back decades, but little work has been done and there are no solid theories.
One possibility raised in the 1980s is that seasonality is primarily a European/American phenomenon due to convection currents and air movements in the upper atmosphere. The theory is that warm air in South East Asia is sucked up into the atmosphere in their summer and viral particles are then transported across continents. As the air reaches Europe/USA the winter the air cools leading to a kind of viral fallout.
This theory is interesting because it can explain why lockdowns have failed. If the virus is falling on us from above, then it will be pulled into buildings via the air intakes and circulated there regardless of how much social distancing or mask wearing is done. This also explains why COVID and influenza epidemics appear to start simultaneously everywhere rather than visibly spread from place to place, why NZ/Australia have had so few cases and why even in New Zealand they keep discovering unexplained COVID cases that can’t be traced back to any foreign travellers, which isn’t possible under conventional germ theory.
However I haven’t done much further work to investigate this and there are probably problems with the theory. It’s not my job to this after all – that’s why we pay taxes to employ epidemiologists. Unfortunately except for a few (again, like the good author interviewed here), the field is in absolute denial and is stuffed with people who believe lockdowns worked, largely because the field has become totally disconnected from real data. They model, they predict, but they never check their predictions against what really happens.
I don’t want to be argumentative, Norman, but I’m not aware of the government directly employing leading epidemiologists. The leaders in the field are typically university researchers or faculty, and yes there is a lot of public money in UK university research but not exclusively, and in the US far less of course.
And, with respect, I think you are far more disconnected than the epidemiologists are. New preprints/peer-reviewed papers are being published virtually every day analysing the latest real world data and feeding it into models, including on seasonality (but the reality is the data at the moment are unclear, particularly e.g. given that cases are now spiking in spring-time Canada). And UnHerd’s favourite bogeyman, Professor Ferguson from ICL, is regularly quizzed by parliamentary committees, the media etc on the accuracy of his modelling.
Incidentally, when I read Ferguson’s March 2020 report today, I can’t help but conclude that it was a far more accurate forecast than Giesecke’s April 2020 interview on UnHerd. Take a read for yourself here:
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
Ferguson, Fauci and many others apparently have abundant time to spend telling governments what to do, unhassled by any need to handle customers or worry about income. That’s because public health as a field and not just epidemiology is awash with money from governments or sometimes the Gates Foundation, but wherever it comes from it isn’t coming from people in the market for buying correct models. Hence their laissez-faire attitude to model correctness. They are in fact government employees, in the sense that for nearly all of them their employment would evaporate if the government stopped channelling money to them via various sources. Either that or they’d all end up on the Gates payroll.
I’ve read a lot of epidemiological papers. New papers are published every day and yet virtually all the ones I’ve read were riddled with major and obvious errors that rendered them unscientific. A lot of people have noticed that academia produces a torrent of low quality or downright deceptive papers – pointing to that flood of BS as a defense against outside scrutiny is a typical academic tactic that leaves many of us distinctly unimpressed.
For example, you say that these people are every day “analysing the latest real world data and feeding it into models”. How many of these papers have you personally read, Eva, because that’s just not what I’ve seen. What I saw is that these papers routinely input very old numbers into models, or they input numbers that are the output of yet more models without making that clear, and they never seem to follow up and compare their predictions to the real world. Instead their preferred standard is something like, “our model output is similar to other models from other academics, therefore we are all correct”. Surely nobody outside academia would try to defend such reasoning.
As for being quizzed by governments, if governments could understand why these models are bad they presumably wouldn’t be using them and Ferguson would have no questions to answer. The fact that Parliament occasionally tries to ask questions and is batted away like so many flies tells us nothing useful.
Norman — I’m an investor and I can tell you the private sector actually pays epidemiologists, statisticians and other scientists handsomely (£1000+/hr) for their predictions. Particularly in the financial sector (markets are forward looking, so investors want accurate guidance — if they’d placed weight on Giesecke’s UnHerd interview in April 2020 they would have been very badly prepared; fortunately I gave more weight to Ferguson/ICL).
If you know better than all the experts, may I suggest that you could make some serious money selling your superior knowledge to the market. Send BlackRock an email today!
“This also explains why COVID and influenza epidemics appear to start simultaneously everywhere rather than visibly spread from place to place, why NZ/Australia have had so few cases and why even in New Zealand they keep discovering unexplained COVID cases that can’t be traced back to any foreign travellers, which isn’t possible under conventional germ theory.”
Maybe Béchamp was right after all, as Pasteur purportedly said on his deathbed. Béchamp regarded illness as coming from within the body not, as Pasteur suggested, from an external germ.
I was brought up understanding that uncomfortable symptoms were the result of a healthy body doing routine cleansing the more uncomfortable the symptoms, the less healthy the body.
My guess is SA locked down too early and as the effectiveness of it waned you got it big time then. Only a guess. Certainly in South America the knee jerk lockdowns in their autumn, before the virus had really gotten there, had no effect when it came to their winter. It will be interesting to see if South American countries are top of the global list of deaths per capita again in 6 months time – Brazil currently 14th with Peru 15th (over took Belgium during its winter), just behind UK at 13th.
https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&pickerSort=asc&pickerMetric=location&Metric=Confirmed+deaths&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=CHL~BEL~GBR~BRA~PER
Chile, which over took UK for a while in Sep + Oct, is currently 32nd and would seem favourite to do so again, as most countries in Europe have had a worse 2nd peak than the first. However Chile has done better than UK in vaccine roll out, so could tell us a lot about whether mass vaccination really will succeed and give us hope for a normal Christmas in 21.
https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&pickerSort=asc&pickerMetric=location&Metric=Vaccine+doses&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=CHL~BEL~GBR
Perhaps Chile’s vaccination programme would have been more successful if they hadn’t used Sinovac.
I agree totally and I do think in a few years time Covid deaths will even out in lockdown and non lockdown (controlled protection ) scenario.
Even in India as the new variant is raging, the virus/flu SEASON is now. It can typically occur from Jan-March. It’s extended a bit as Covid is more contagious , however the problem is not even that, it’s the lack of oxygen supplies & hospital beds! For now, the number of deaths compared to infections is very low!
Most of the population that was missed last season WILL get the immunity one way or another.
The solution has to be a worldwide one, otherwise we are constantly trying to put out fires with lockdown which DOESN’T work. To me GBD is the best sensible strategy that CAN be tailored worldwide.
Does the data from Israel, the UK and the US showing the success of the vaccination programme in preventing hospitalisations and deaths not suggest to you that the only solution we’ve discovered thus far is mass vaccination worldwide?
Meanwhile, I’m not aware of the GBD “shielding” strategy having worked anywhere in the world?
Eva, which countries have implemented the GBD shielding strategy? Genuine interest, not point scoring. It would by very useful comparative data, but I haven’t seen it reported anywhere.
Whilst I agree with most of that, the bit about collateral health fails to consider that nobody gets treatment for anything, if the health service collapses. Sweden had an much stronger health service to start with and was able to surge its capacity far more than UK and Sweden had its major outbreak in 1 city – Stockholm so could move patients / resources around. It was only later that significant outbreaks occurred elsewhere in Sweden, whilst Stockholm was improving – a factor of geography not policy (look at how far apart the major population centres are and what is in between them in Sweden compared to UK). UK had outbreaks pretty well everywhere in nearly all cities at the same time. UK health service came close to collapse first time round, was strengthened in between but still came close the second time round – when seasonality was very much against us and we had a higher peak. The hospitals were not full of old people the first time round, indeed a lot of the care home issue was due to old people being left in care homes / being discharged to care homes. They were even less full of old people the second time round.
So let’s look at the hospitalisation data:
https://ourworldindata.org/grapher/current-covid-hospitalizations-per-million?country=GBR~SWE
So Sweden with a stronger service had less loading both times. The no lockdown strategy was right for Sweden and indeed if Sweden had done a better job of protecting the elderly (most countries messed up there) then it would probably be 59th on the world deaths per capita ranking rather than the 29th it is currently (UK currently 13th but likely to be pushed into 17th by Brazil, Peru and Poland in the next few weeks).
Now have a closer look at that hospitalisation chart – even in the first wave everyone in hospital was tested with a reliable test. Hospitalisations peaked both times 2-3 weeks on from lockdown – the second time has nothing to do with seasonality or vaccination as the programme had hardly started and the first people vaccinated, quite rightly, were NHS staff. You can even see the minimal effect the “circuit breaker” lockdown had and how ultimately pointless the circuit breaker strategy was everywhere that tried it.
Lockdowns as the only right solution for everywhere – utter nonsense. Circuit breaker lockdowns – a seriously flawed concept. The 2 main lockdowns in UK were sad but necessary, as when your health service collapses even more die and the economic harm is as bad if not worse because everyone is frightened for really good reasons, rather than just politicians and the media spreading false fears.
The ONS all cause deaths are interesting:
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending9april2021
Second peak much lower than first – doing much better at protecting elderly not killed first time round. Overall excess deaths are now negative (First peak advancing deaths of people who would have died this winter anyway?) and in Hospitals and Care Homes. However excess deaths in your own home are still positive – why? are people still too scared to go to hospital? do people still think they should not be a burden because hospitals are close to breaking? I don’t know, but it is the sort of question that should be being asked.
Some, in this comment column, should view the recent OECD open forum on Covid and mental health (15th April ’21) – it’s there for everyone to see – the very real societal cost to mental health engendered by lockdowns.
I agree with the main focus of Jay Bhattacharya’s conversation with John Anderson, now some four months ago, that lockdowns have essentially been about a “trading of lives” – the poorest and young paying the price – even Gupta has wryly mentioned the nature of a “middle class” luxuary associated with lockdowns.
We have, as far as I am aware, near on 700K people in rent arrears in the UK., a mixture of those that have lost jobs specifically to lockdowns in tandem with those receiving housing benefits that do not adequately reflect the rise in rent. Eviction has had to be suspended in the courts, by the government, in order to prevent an exponential rise on already dire homeless figures.
The sector of society that are paying the ‘lockdown’ price have in effect been ‘dissappeared’ in ‘Junta-esque style – no mention in main stream media /government. They have no voice – those that bear the burden most!
The question will ever be asked in years to come – “wasn’t there another way” ? yes, if people of true creativity with the brightest of minds were ever attracted into politics.
I suggest that the governments of South Korea, Australia, Taiwan, New Zealand, Singapore and Vietnam, among others in Asia, might have some helpful answers to your question “wasn’t there another way?”.
I thought the OECD forum was very interesting by the way, but it wasn’t as black or white as you perhaps suggest. https://www.oecd-forum.org/posts/oecd-forum-virtual-event-addressing-the-hidden-pandemic-the-impact-of-covid-on-mental-health
Sweden’s all cause mortality is near flat for the past decade. How many times do we need to repeat this.
You keep saying this, but it’s not true. Latest Eurostat data shows Sweden had 7.7% excess mortality in 2020. Compared with 1.5% in Denmark and 0% in Norway. But 18% in Spain.
So Sweden has less than half the excess deaths of big countries like U.K., France, Spain, but much higher than its Nordic neighbours. However, please let’s not engage in hopelessly simplistic comparisons. Populations are heterogeneous.
https://www.reuters.com/article/us-health-coronavirus-europe-mortality-idUSKBN2BG1R9
Because you post a link does not make it so. I was hoping to see a link to a graph. Further, I did not say flat, I said ‘near flat’ especially when combining 2019 (a low death year), with 2020 a pandemic year. Yes, a pandemic year.
If you need to see the excess deaths on a graph, take a look at Statistics Sweden’s official government stats at the link below (open the excel and look at Tabell 1, which includes all 2020 and available 2021 data).
Multiple sources (Eurostat, Swedish gov etc) all paint the same picture.
https://www.scb.se/om-scb/nyheter-och-pressmeddelanden/scb-publicerar-preliminar-statistik-over-doda-i-sverige/
That is a preliminary report from April of last year. It is absolutely not what the Swedish government is saying now, because for the rest of the year, there was a mortality defecit for the second and third quarter. The fourth was about even. An October report from the very same agency makes this point (in English) https://www.scb.se/en/About-us/news-and-press-releases/excess-mortality-in-sweden-is-followed-by-mortality-deficit/
They currently think that there was excess mortality in Sweden the year 2020, but not a lot — it is in line with other years in the past 20.
Laura, why are you trying to discredit the data? The Excel I gave you the link to is not preliminary for 2020 and includes all of the 2020 data, and also the mortality deficit in 2021 (albeit 2021 is preliminary data).
And the data are of course reflecting there was no flu season this winter, because Sweden’s population has been practising substantial social distancing, which was not enough to prevent Covid but did suppress the less contagious flu.
Are you denying that Covid is causing a public health crisis in Sweden (which manifests itself, inter alia, in hospitalisations and excess death)? That is certainly not what the data suggest or indeed what the Swedish government is saying right now. See, e.g., https://www.thelocal.se/20210422/will-sweden-ease-coronavirus-restrictions-next-month-or-not/
I am in no way a denier of anything. I am at the forefront of hospital reform, where I sit, saying that we need more redundancy and more icu units.
What I am saying is that the report you link to is not what SCB is saying right now, which I know for the simple fact that I talk with them all the time. SCB thinks that there has been a small but significant amount of excess mortality in 2020 — and if people hadn’t started to die in larger numbers in December — they would have been talking about a small “and we have no clue if it is significant” fewer number of deaths in 2020.
You link to the report where they said, in April something to the effect of — Holy Smokes! So many People died in March and Early April! Which is true. But then you wait a year and see if those deaths were *in addition* to those that were expected to die all year, or whether those deaths displaced those who were expected to die of other causes.
All you do is ‘wait and see’. If your deaths every month are about what is expected, then the March and April catastrophe are in addition to the normal deaths expected for this year. If, instead, you have month after month of lower than expected deaths, then many of the people who died in March or April are the people our models expected to be around to die in those months.
The second is what turned out to be the case, which is what SCB said. https://www.scb.se/en/About-us/news-and-press-releases/excess-mortality-in-sweden-is-followed-by-mortality-deficit/
I made very clear I was providing the link to the Excel, which is up to date. The fact that the updated Excel was embedded to an old press release is irrelevant.
I’m glad, however, we can at least agree on the objective fact that there were excess deaths. That’s a start. But now you raise the issue of displaced mortality and years of life lost. The fact that some elderly people did die prematurely in the pandemic as a result of Covid (and therefore aren’t dying now) does not mean that this is most of the people being killed by Covid / does not mean there is not substantial premature death (in the UK, displaced mortality looks to be only around 5-15%, see Prof Spiegelhalter’s analysis at the link below). I have already cited and given links to research on the years of life lost issue and I certainly cannot add to what a world leading statistician like Professor Spiegelhalter of Cambridge and the Royal Statistical Society says on the subject!
https://twitter.com/d_spiegel/status/1378995410262503427
There’s another way of looking at it.
Actual, deaths in Sweden since 2010 are:
2010 90,487
2011 89,938
2012 91,938
2013 90,402
2014 88,976
2015 90,907
2016 90,982
2017 91,972
2018 92,185
2019 88,766
2020 97,941
If one adds in a population growth to account for the ever increasing population, one finds that 2020 is not in the top three (for instance 2010 goes from 90,487 to 97,328 when population is normalised to the 2020 current level).
Source ; https://www.statista.com/statistics/525353/sweden-number-of-deaths/
Statistics Sweden disagrees with the Eurostat data calculation. So does the European Center for Disease prevention and control. And independent cohort study evaluations — for instance (let us see if I can post a link here: https://www.medrxiv.org/content/10.1101/2020.11.11.20229708v1.full ) which was funded by the Norwegian government — which expected to find that Norway did significantly better than Sweden — did not find a significant difference.
Laura, you are spreading misinformation. Statistics Sweden’s official statistics also show substantial excess deaths in Sweden in 2020 (open the excel, which includes 2021 data, and look at Tabell 1):
https://www.scb.se/om-scb/nyheter-och-pressmeddelanden/scb-publicerar-preliminar-statistik-over-doda-i-sverige/
No, you are the one with obsolete information.
You are spreading misinformation, Laura. The link you provided also contains exactly the same Excel I linked, which includes the latest data, dated 19th April 2021! It is stated to be only preliminary for 2021, not 2020. It clearly shows significant excess deaths in 2020.
What is your agenda?
I have no agenda, unless ‘more redundancies in health care’ counts. But I had this from long before COVID, ask anybody in the know around here. I just talk with scb freguently enough, for various matters, and know that they do not think that Sweden had significant excess mortality for 2020.
We can’t cross-examine your SCB colleagues here on what they think and why they hold the opinions they do, but at least we could finally agree that the Excel I linked does in fact contain the latest official Swedish data and as a purely factual matter clearly shows material excess deaths in 2020.
If you find any sources (in addition to the Nature article I linked) on years of life lost in Sweden to Covid, please do share. I’m keen to learn more about that!
Excess mortality depends a lot on your assumptions as to the correct baseline, which shouldn’t in theory matter for COVID but because the numbers are so tiny end up mattering a lot.
If you do age and population growth correction then Sweden has mortality similar to 2012. That’s fine. Nothing special happened there in 2012 – this mortality rate is perfectly acceptable. Nobody thought there was any emergency back then.
But 2019 had the lowest death toll on record despite high levels of immigration and an aging population. If you’re willing to make the quite small assumption that 2019 was an aberration rather than a new trend of permanently lower death, then 2020 was just reversion to the mean and in that case Sweden had no excess death, because 2017+2018 == 2019+2020. Averaging over two year intervals makes COVID disappear entirely, which shouldn’t be possible if it was genuinely as deadly as the modellers forecast.
We’re not discussing what mortality rate you consider acceptable, Norman. We’re simply discussing the statistical existence of excess deaths. All the reliable data sources I’ve seen show material excess deaths in Sweden.
It’s depressing that a discussion on policy on UnHerd so often seems to veer towards Covid denialism.
See, e.g., Sweden’s official government statistics for 2020 and (preliminary) 2021 (open the excel and look at Tabell 1): https://www.scb.se/om-scb/nyheter-och-pressmeddelanden/scb-publicerar-preliminar-statistik-over-doda-i-sverige/
Thanks Eva. Your contributions to this article have kept me reading them today.
As you say, it’s fair enough to have a debate about the comparative damage caused by locking down vs alternatives but people need to have facts in their mind and not just anti-lockdown reactions.
These things should be obvious but I will spell them out anyway: my comment about acceptability is not a personal statement of what is acceptable but an obvious observation about how Sweden reacted to its mortality levels in 2012. There was no reaction, therefore, the Swedish government and people felt there was nothing unusual or unacceptable about those mortality rates. If 2020 is equal to 2012, only eight years earlier, it cannot possibly be argued with any seriousness that there was some sort of major death wave in 2020. Yet such a massive wave was predicted, hence, the model predictions were wrong, which is what everyone except you seems to be able to accept.
W.R.T. the “statistical existence” of excess deaths, what I’m trying to explain to you is that such existence is by definition relative to another model prediction, and thus you can calculate a wide range of values based on that model’s assumptions of what should have happened in a COVID-free world. The number you keep throwing around is a relative change to a model prediction that is very optimistic – it essentially assumes that 2019 represented a step change in the longevity of Swedes despite the absence of any obvious major medical breakthrough that year. It might be true, but under other perfectly reasonable assumptions, the “statistical existence” of excess death vanishes entirely. It won’t be easy to tell for another few years.
At any rate, whilst interesting this argument is ultimately pointless – regardless of how you calculate relative change to a model baseline, Sweden’s absolute age adjusted mortality makes it clear that COVID was not the major threat it was painted to be, at least not in the Nordics. Far more useful to ask is therefore why not, what went wrong with the predictions and how can we stop it happening again? Trying to claim the predictions were correct is just delusional at this point. Sweden was supposed to have 90,000 deaths from COVID alone by May, it had 98,000 deaths in the entire year.
“Sweden was supposed to have 90,000 deaths from COVID alone by May”. In what scenario? Please send a link to the report that says this. I’m not aware of any model that forecast a single outcome, but absolutely willing to accept I’m wrong!
Actual, deaths in Sweden since 2010 are:
2010 90,487
2011 89,938
2012 91,938
2013 90,402
2014 88,976
2015 90,907
2016 90,982
2017 91,972
2018 92,185
2019 88,766
2020 97,941
To calculate the death rate (and hence excess death numbers) you need to input growing population numbers which I can’t find anywhere.
I have my doubts as to how well a protective cocooning of the elderly would have worked. Online sources such as this one indicate that lockdown scepticism is just as prevalent amongst older people, many of whom are understandably determined to live their remaining active years to the full.
The way covid was handled (and is still being handled) by the west (lockdowns etc) is due to a number of failures:
Hence the covid pandemic could/should be considered to be an illness of our society… the virus found the right circumstances to create havoc…
It is possible to consider that if these factors were not present that covid would indeed not be much worse than flu and other causes for pneumonia and death …. but I don’t hold my breath to see things changing quickly soon..
How can he claim that “delayed cancer screenings” are a collateral damage effect of lockdowns? The NHS was converting whole floors of hospitals to cope with Covid, and in India you simply can’t get into a hospital for anything because the disease has been allowed to rip. Delayed cancer screenings are more a consequence of refusing to follow lockdown advice, as Boris Johnson did when he refused to follow SAGE advice on a two week circuit breaker in September 2020 when the disease was beginnning to get going, and instead delayed until the end of October when the disease was rising vertiginously. Johnson’s response was about as wise as a factory foreman who says that he can’t spare the time to investigate a fire in a corner of the factory because there’s an important order to be manufactured and shipped out. Or to quote Dominic Cummings, Johnson falls “below the standards of competence ….. the country deserves”.
You rightly point out one of the lockdown sceptics’ most illogical arguments: that it was lockdowns that prevented routine healthcare, rather than the problem being ICU wards and nurses being taken up by Covid patients.
I’m also perplexed by the failure to understand that physical beds in a Nightingale hospital are useless if you don’t have the doctors and nurses to staff them. New ICU nurses cannot be trained overnight.
The majority of Swedes engaged in stringent social distancing without a formal lockdown, and I am certainly open to the idea that could have worked in the U.K., except that the difference in scale presumably plays a role when it comes to healthcare, ie Sweden’s total population is similar to London’s, and its largest city Stockholm isn’t even a million. As we see in India today (several Delhi hospitals have run out of oxygen) scale is a challenge when it comes to effectively allocating resources.
Of course, non-locked down Sweden has had to postpone and ration treatments too during COVID spikes, and took an extreme step to reduce pressure on hospitals by refusing to admit elderly Covid patients in the first wave. See, eg:
https://www.thelocal.se/20210109/hospitals-in-sweden-forced-to-delay-necessary-operations/
https://www.thelocal.se/20200807/fact-check-how-many-covid-19-patients-in-swedens-care-homes-received-hospital-treatment/
I criticised Unherd the other day for continuing to bother listening to a word Giesecke says, he having been proven to be such an unreliable and misleading “authority”. Well with Kulldorff, they surpass this! Who in their right mind cares what Kulldorff thinks about what Giesecke says. Will we get Piers Corbyn’s critique of David Icke next? Why is it so difficult for Unherd to recognise the scientific consensus and interview people who pivot around that? Why does it choose to major on total charlatans? Is it because its readership is so whacky they can’t cope with mainstream thinking except to irrationally reject it on cherry-picked evidence? Well judging by the comments, yes.
Is Paul Marshall’s hedge fund business like this – an echo chamber peopled by nodding dogs? Well at least that one makes money – for the moment. I guess I shouldn’t begrudge him a hobby. Second Life might be more rooted in reality though.
“The claim that the spring and summer decline in cases was due to lockdowns has been thoroughly debunked, though many people still thought so back in October last year.”
”Thoroughly debunked” – links to one paper looking at ten countries including Sweden and South Korea, which did not have mandatory lock downs. The issues with regard to Sweden as a comparator have been widely debated and South Korea, did not need to lockdown because it controlled the pandemic by very aggressive contact tracing etc. The study did not include other countries which strictly enforced lockdowns, eg Australia and NZ or those which did not at all eg Brazil, Mexico. Comparing countries is fraught with difficulties (see Unherd article re Sweden and other Scandinavian countries for just a few issues – there are too many other confounders to number). By all means say that there is some evidence (I would say very weak) that lockdowns do not work but do not over egg the evidence. “Thoroughly debunked” undermines Dr Kulldorff’s credibility as a serious commentator.
Not convinced, the Imperial model underestimated deaths from the lockdown scenario we’ve actually implemented. If this is a general tendency to overestimate the efficacy of NPIs, then we shouldn’t compare the actual figure to the modelled figure for “focussed protection” without allowing for that.
Any sources to back up these claims on IFR and collateral damage?
Prof Sir David Spiegelhalter of Cambridge and the Royal Statistical Society has said the UK’s IFR (based on ONS data) is 0.9%, which is the guess the Imperial College model used.
And isnt Giesecke’s point that we won’t know about collateral damage for a few years, but he thinks it will be higher than benefits of stringent measures?
https://mobile.twitter.com/d_spiegel/status/1295287225639481349?lang=en
The lower IFR estimates come from a range of studies. The Ioannidis paper is a meta-study that calculated such a value range, median of 0.2%. However, the abstract shows us the problem with trying to do epidemiology of any form on such a disease (which is one reason I believe the field is basically fraudulent, despite the presence of a very few intellectually honest people like Kuldorff):
These numbers vary so dramatically you can get every possible policy out of using them, from do nothing at all all the way to “lockdown isn’t drastic enough for this”. The uncertainty intervals on these figures are so high that no conclusions can actually be drawn. Even so, it was apparent very early on that IFRs for those who aren’t elderly are so much lower that it cannot possibly have ever justified anything except focused protection – a whole planet of people were collectively imprisoned for a year and counting for an IFR to them of a median 0.05%!
ICL got different numbers because it was made in Jan 2020 and even then was not the best available data – it was based on a tiny dataset of Wuhan evacuees vs the Diamond Princess sample which gave a lower IFR. Epidemiologists know perfectly well that observed IFRs fall with time due to the discovery of previously missed low severity cases, so it would have been sensible to apply some sort of discount rate to it, but no such rate gets used in the field as far as I can tell.
I started to realise epidemiology couldn’t be trusted as a field when I kept reading papers being published in October that were still citing the ICL IFR figure from January as if it were established fact. If even I, a outsider layman, understand that the sample size ICL used was far too small to be reliable and that observed IFRs fall with time, why couldn’t these researchers who were paid to do it full time? The only obvious explanations are all terrible and involve massive groupthink or open fraud.
Norman, with the greatest respect, I recommend you read Prof Sir David Spiegelhalter’s book The Art of Statistics.
It appears to me that because you are personally unaware of the extensive data and literature on the issue, and furthermore you don’t like the opinions you read, you arrive at the conclusion that the field is full of frauds or perhaps even is beyond comprehension. I can’t tell if this is extreme subjectivity or nihilism or something else.
The point Spiegelhalter was making is that it is quite remarkable that ICL picked an IFR (on the basis of very little real world data at the time) that turned out to be so accurate when the real world data was analysed almost a year later.
Quite evidently, reasonable minds can disagree on what policies should be pursued. It’s very hard to have that discussion, however, if one refuses to acknowledge the likely costs involved.
I just quoted you a meta-study in which lots of other studies gave a far lower IFR. Why do you think that IFR is accurate when it so obviously isn’t? I don’t understand why you keep repeating this claim that Ferguson’s predictions were correct. ICL themselves calculated in the region of 90,000 extra deaths from COVID alone for Sweden if there weren’t severe lockdowns, a number very similar to what a Swedish team got when they applied the Ferguson model paper parameterised for the Swedish population. They justified this figure with statements to the effect of, if you assume a highly infectious disease will infect ~70% of the population and it kills 0.9% of them then you get a big number and thus arguments about the precision of their models are missing the point.
Yet no such thing even came close to happening. These predictions weren’t 10% wrong, they were wrong by a whole order of magnitude. The data is there. I really struggle to understand your loyalty to these predictions when you are yourself quoting SCB’s mortality stats elsewhere, which show nothing even close to what the simple (population*high IFR) calculation generated.
You are spreading misinformation, Norman.
Ferguson never made that forecast for Sweden, as he and ICL have stated publicly many times, eg https://mobile.twitter.com/imperialcollege/status/1307693797074178049?lang=en
You appear to give more weight to opinions on IFR outside the mainstream, and that’s your choice (you have expressed your intellectual contempt for the field so that doesn’t surprise me). As a layperson, the rational choice for me is to give greater weight to the consensus among the scientific community, while always being aware of course that no one is infallible. I must be open to changing my views if/when the facts change, as indeed Giesecke and pretty much everyone has had to some extent over the past year!
According Public Health England, COVID-19 was no longer considered to be a high consequence infectious disease (HCID) in the UK as of 19 March 2020, that’s March last year, and mortality rates were ‘low overall’.
COVID-19 wasn’t even mentioned in subsequent PHE HCID summaries…
What exactly is the ’emergency’ that has justified putting the world into lockdowns, and particularly the enactment of ’emergency’ laws that have interfered with freedom of movement and association, and have set us on the way to becoming authoritarian states?
I’m most curious, Elizabeth: are you not aware of anything that has happened since 19 March 2020 that might provide a different context to the (still true) fact that mortality rates for Covid are “low overall”?
I provided hyperlinks in my previous comment. It’s interesting that in January 2020 COVID-19 was classified as a high consequence infectious disease. But this was downgraded as of 19 March 2020, i.e. “COVID-19 is no longer considered to be a high consequence infectious disease (HCID) in the UK”, and the mortality rate was “low overall”.
I kept a copy which was updated as at June 2020, with no change to that advice.
It has now been updated again at 22 April 2021, and I notice some extra statements have been added, i.e. “There are many diseases which can cause serious illness which are not classified as HCIDs” and “The World Health Organization (WHO) continues to consider COVID-19 as a Public Health Emergency of International Concern (PHEIC), therefore the need to have a national, coordinated response remains and this is being met by the government’s COVID-19 response“.
These are interesting additions…
Why are they interesting additions? What’s the relevance of all this in your eyes?
To elaborate on the question I put to you above, do you not think it is relevant that after 19 March 2020 it quickly became apparent that Covid is highly contagious and therefore, even with a low mortality rate, it would (and in fact did) hospitalise and kill a significant number of people, with the systemic consequences all over the world that we have since witnessed? So it would obviously be wrong to label covid a disease of low consequence in light of all that, no?
Can you please spell out what you mean Eva?
I’ll say it again, according to Public Health England, COVID-19 was no longer considered to be a high consequence infectious disease (HCID) in the UK as of 19 March 2020, and mortality rates were ‘low overall’.
It does not appear that this advice has changed since March last year?
It seems to me there is something not adding up here?
Regarding collateral damage, here’s some interesting (and uplifting) new data in The Economist on suicide during the pandemic:
https://www.economist.com/graphic-detail/2021/04/24/surprisingly-suicide-has-become-rarer-during-the-pandemic
Why on earth did someone downvote this?!?! It’s purely factual and good news!
Do you personally really believe that suicide has become rarer during the pandemic?
Of course it might just be that suicides have been counted as Covid deaths instead!
Do I “personally believe”? I follow the scientific method and therefore place trust in empirical evidence, not anecdote, and I give weight to expertise and reputable sources. Until an authoritative source provides evidence to the contrary, I accept the evidence The Economist has presented.
While your cynicism is no doubt appropriate in certain dictatorships and less developed countries around the world, it is overblown (and frankly irrational) in countries that have establish research universities, independent national statistics agencies, and a free press.
I also follow the scientific method and, with the wisdom of using it as just one of many tools, have come to different conclusions from you. There is no need to be so rude.
I’m not aware of having come to any firm conclusions. I just shared some factual information. And I apologise for taking literally your comment on suicides being counted as COVID deaths if that is not what you meant; unfortunately, so many comments on UnHerd flirt with outright Covid denialism (under the pretence/delusion of being “sceptical”) that sometimes it is hard to know!
Lockdown protest happening in London right now: https://www.youtube.com/watch?v=T7Jg6koGE-g
Thanks for that link. The march was massive but not mentioned on BBC News of course!
Also see this link showing police confrontation with crowds, after hours of peaceful demonstration.
https://www.youtube.com/watch?v=DPK6gqEEY5w&t=128s
Some comments which sum up the situation:
”Police created this for the MSM headlines to detract from 7 hours of peaceful protest.”
“Beautiful day ruined by heavy handed police.”
”It was disgraceful of the police… what ever little respect they had left is gone.”
The ‘police’ did everything they could to get people to be upset so MSM can get their pictures.”
”Never a bother until they interfere. All done for msm to film and make it look like a violent protest.”
Etc…
Shame on them (the police) indeed!
Except that it was: https://www.bbc.com/news/uk-england-london-56878486
Elizabeth Hart’s point exactly!
Healthcare system collapse happening in India right now:
https://www.bbc.com/news/world-asia-india-56881083
What is really going on?
Let’s say India’s population is 1,390,885,000
Death rate is 7.3/1,000 population
That would be 10,153,460 deaths per year, is that correct?
If so, there would be 27,817 deaths per day?
So deaths attributed to Covid would have to be considered in that context.
Again what is really going on?
Is the hospital system being overwhelmed? Aren’t hospital systems always being overwhelmed?
Here in Adelaide, Australia, the hospitals always seem to be under pressure.
What seems to be putting pressure on hospitals?
Is it old people? The baby boomers are now the old people and there’s a lot of them. And as they age they’re going to clog up the hospital system.
So now we’re being told that to protect the hospitals from being overwhelmed, and to protect the old people, we have to try and prevent all people from getting sick with diseases such as ‘Covid-19’ by social distancing, masking, forbidding travel, lockdowns etc.
Even though most people aren’t likely to get seriously ill with Covid-19…everybody’s lives have to be upended…
In other words, society and the economy has to be shut down to stop overwhelming the hospitals…with old people…
Putting vaccines aside for the moment, if we were living in an ideal society which was really trying to address the situation in the best interests of all, what should we be doing?
Your ignorance is shameful.
There is a quantitative difference between the impact of a heavy flu season on Adelaide’s hospitals and what has happened in ICUs in Europe and the Americas, and now India, during the pandemic.
Even though risk is low in younger age groups, absolute numbers are obviously a function of how widespread the virus is spreading, and there are systemic consequences once healthcare systems are overwhelmed. Young people, including babies and children, are dying in material numbers in places where healthcare is overwhelmed, such as Brazil. https://www.forbes.com/sites/joewalsh/2021/03/26/more-young-people-are-dying-of-covid-in-brazil-heres-why/?sh=2dfbfe0a7b3e
These are empirically verifiable facts. One can be opposed to lockdowns and still acknowledge reality.
Eva, I’m raising an important issue.
Hospital systems seem to be under pressure everywhere, and the problem is not being addressed.
See for example this article in The Guardian, published in March 2018: Watching Hospital is chilling. Just how bad can NHS underfunding get?
This is the fundamental problem that has to be addressed.
The idea that younger people have to curtail their lives to avoid over-burdening the hospital system is insane, and obviously not workable in India or anywhere else for that matter.
Also see this BBC article published in May 2018, 10 charts that show why the NHS is in trouble, which includes reference to the impact of ageing people on the health system.
Note: “The average 65-year-old costs the NHS 2.5 times more than the average 30-year-old. An 85-year-old costs more than five times as much.”
This is the reality, the elephant in the room.
Also consider: Obesity putting strain on NHS as weight-related admissions rise, published in April 2018.
An ageing population, and general health issues such as obesity, are piling pressure on health systems, and viruses such as SARS-CoV-2 and flus obviously add to the load.
This is well-known. So why aren’t health systems being adapted to respond to these well-known problems?
More should be done about tackling obesity for example, encouraging people to take responsibility for their own health with diet and exercise. This would have massive impact on improving both mental and physical health overall.
Instead, it seems everyone expects a magic pill or injection to correct all our ills. We have to change this thinking, which is fostered by vested interests.
Look at the Covid-19 vaccine response – it takes my breath away! Over 30 million people reportedly vaccinated with the first dose in the UK now, and there’s the second dose, and the ‘booster’, and annual revaccination mooted thereafter.
Crikey…all that money and resources on a response to one virus which isn’t a serious threat to most people.
There needs to be a rethink…BIG TIME!
If you are unable to distinguish between differing degrees of “pressure” on healthcare systems — i.e. if you cannot process that there is a material quantitative difference in hospitalisations (in all age ranges) between, say, seasonal flu as compared with Covid — then it will be very difficult to have a rational policy debate with you. (See, e.g., https://www.ft.com/video/0cd6f9f9-664e-40f9-bad4-dde59d7c746c)
I will, however, try: What is your policy solution when the healthcare system is unable to cope with the sheer number of Covid patients, as is the reality in parts of Brazil and India right now?
Are you saying that people over a certain age (or perhaps, weight?) should be barred from hospitals, so there is capacity for people under a certain age to be treated (for Covid and for other routine/non-Covid care)?
I’m asking that question neutrally, as I accept there could be a moral argument in support of such a policy (indeed, the Swedes deliberately did not admit many care home residents to hospital during their first wave in spring 2020). But I’d like to understand what you think the costs would be in practice right now with the population we have in reality (and not the preternaturally young, slim, healthy population in your counterfactual scenario).
Eva, judging by your antagonistic tone, I really don’t think you’re interested in having ‘a rational policy debate’ on the matter…
I’m saying there are obvious problems in the system which have been known for years, including that new problems can arise. How is this going to be addressed in future?
I’m questioning what is happening now, i.e. a mass population COVID-19 vaccination response around the entire globe.
Literally billions of people are going to be vaccinated against a virus which isn’t currently posing a threat to them. This is already costing billions of dollars in testing, vaccinating, masks, apps, and of course the costs of upending society and the economy.
There has been a grossly disproportionate and ill-targeted response to SARS-CoV-2/COVID-19, which appears to have been controlled by vested interests, e.g. the Bill & Melinda Gates Foundation, the BMGF-founded Gavi Alliance, and vaccine producing countries such as the UK, US, Germany etc. These parties are the main contributors to the WHO, which appears to be a front for the vaccine industry.
This rushed experimental vaccine response is terrifying, we have no idea of the long-term consequences, and the cumulative effects with ever-increasing vaccination schedules.
Again, there needs to be a rethink…BIG TIME!
I’m not being antagonistic, Elizabeth. I’m merely asking you to explain your opinions, which are based on the fundamentally incorrect assumptions that the Covid pandemic is not putting out-of-the-ordinary pressure on hospitals and does not have the potential to completely overwhelm healthcare systems (despite this having actually happened in several places).
Your statement that “Literally billions of people are going to be vaccinated against a virus which isn’t currently posing a threat to them” fails to comprehend that we do not only face risks to our personal health, but that we are also affected by systemic risks, such as the collapse of the healthcare system.
You seem completely unable to comprehend the systemic consequences of the pandemic that have been plain to see for at least the past 12 months, and are evident in extremis at the moment in India and Brazil.
Moreover, the real world data from Israel, the UK and the US demonstrates that the only way we have found so far to get the pandemic under control (i.e. prevent hospitalisations and deaths) is through vaccination. Again, this is a verifiable fact. If you want Australia/Asia to remain locked down to the outside world and for Europe/the Americas to continue to go through waves of the pandemic, then I accept that’s a choice. But that would seem to be a rather high cost option compared to the way out being offered by the vaccine, again as demonstrated by the real world data from Israel, the UK and the US.
I must therefore conclude that you are one of the extreme fringe, sadly all too prevalent on UnHerd, who refuse to accept the reality that there is a pandemic that has certain unavoidable costs regardless of whether or not governments take action (see, e.g. Brazil), and who refuse to engage in a fact-based discussion about what our practical options are in the world as it is and not as you wish it to be.
Eva, I haven’t said “the Covid pandemic is not putting out-of-the-ordinary pressure on hospitals and does not have the potential to completely overwhelm healthcare systems”.
I’m saying there are problems with the healthcare system(s), and mass vaccinating billions of people who aren’t currently at serious risk of SARS-CoV-2/COVID-19 is not the way to deal with the situation.
Have you looked at a vaccination schedule lately? Have a look at the NHS schedule for instance – how many of these vaccines have you had, the 6-in-1 shot for example?
Children in particular are receiving an ever-increasing vaccine load, including revaccinations, (and adults are increasingly in the frame for more vaccinations, e.g. flu, shingles, pneumococcal, dtaps). And now even children are being set up for COVID-19 vaccination for life, and they’re not currently at risk of COVID-19!
This is a juggernaut out of control. It has to be stopped and objective and independent critical thought applied to the situation.
A major problem is that the area of infectious diseases has been colonised by the vaccine industry, with vaccine products apparently being the go to response, e.g. in the UK which is developing its vaccine industry, particularly on the back of COVID-19.
Consider for example that Andrew Pollard, the lead investigator on the Oxford/AstraZeneca vaccine trials, is also the Chair of the UK Joint Committee on Vaccination and Immunisation. This is wrong, this system is wrong, we cannot keep loading people with vaccines for every ailment, particularly when many do not need them.
Ok, so actually you are motivated by an entirely separate issue: anti-vaccination.
One must take a rational approach to costs and benefits. It requires a decent grasp of basic statistics (you continue to ignore the statistically significant risk of COVID to children in Brazil that I flagged to you), but a little history wouldn’t go amiss either: barely 100 years ago children were dying in huge numbers from diseases that they are now successfully inoculated against. The new Covid vaccines are subject to rigorous independent safety checks by multiple agencies and institutions around the world, hence the recent restrictions on AZ and J&J use on certain groups, and the variation in policies between different countries’ regulators, which made independent decisions based on their own risk assessments in their particular circumstances. And real world data from Israel, the U.K. and US offers compelling evidence the benefits far outweigh the risks in terms of lives saved.
Again, you offer no rational alternative but to continue the status quo of hospitalisations, deaths (and in extreme cases, total healthcare collapse), or the Asian/Oz/NZ approach of sealing off to the outside world.
Are you saying people shouldn’t question ever-increasing vaccination schedules, schedules which are awash with serious conflicts of interest?
7.8 billion people are being set up for Covid vaccination for life.
Who made this decision?
This is what needs to be tracked back now, how has this all eventuated?
I don’t think you will be the final arbiter of this matter Eva Rostova…
In democracies, it is our elected governments and expert regulatory agencies (under the watchful eye of independent courts) that are making these decisions based on the best available data, Elizabeth. It’s no big secret. It’s how the modern world works.
The cost/benefit of vaccines is empirically researched and questioned constantly, as I pointed out with AZ and J&J, so obviously I agree the issue should be scrutinised closely, as it in fact is. Your definition of conflict of interest appears to be so broad that no one with commercial vaccine experience could play a role in testing or regulation, which would exclude important expertise. In any event, there are plenty of individuals involved in vaccine analysis and regulation who have absolutely no commercial interest in the field, including world class statisticians like Prof Sir David Spiegelhalter at Cambridge and the Royal Statistical Society. Plus we have eager plaintiff lawyers who will sue pharmaceutical companies on a no win no fee basis at the first sign of trouble (though in the case of Covid vaccines, the manufacturers have protection from negligence claims). In short, there’s a complex web of regulatory and legal accountability to ensure vaccines are safe under a socially acceptable standard, and that they are discontinued if they are not.
And I’m not seeking to be the judge of anything. I was merely flagging the factual inaccuracies apparently underpinning your opinions, and asking you questions about what you think we should do in practice given the unavoidable systemic costs of the pandemic. You didn’t answer them.
It’s very easy to be opposed to something, whether that’s lockdowns or vaccinations or whatever. It’s rather more challenging to propose practical alternatives that are grounded in reality and acknowledge all the costs that result from a policy decision one way or another.
“…expert regulatory agencies”. Really? Just how ‘expert’ are they I wonder? Or do they basically rubber-stamp manufacturers’ data? And who pays the ‘regulators’ for their ‘regulation’…why it’s the very industry they ‘regulate’, they’re awash with conflicts of interest. See for example the TGA in Australia.
Seriously, who lobotomised Johan?! Cut his brains out and chopped his balls off.
He modified his opinions in light of new facts/evidence gathered over the course of 12 months.
That is the sign of having a brain and the guts to admit he was wrong on some key epidemiological points.
He has to go along with the mob. He knows time will prove him right, but now there are so many different statistics which can be used that any argument may be won, and so the lock down side able to squash any dissenters as they rule the agenda.
Things like what is a case? Testing is all over the place in methodology and rates and sensitivities… Deaths are “With – or – Of” covid, who counts the same?
No one knows how much the youth have been hurt, education, socializing, job prospects, mental health, lack of preventive health.
No one knows how the businesses will survive. No one knows how many people will fold once the covid pay ceases, and how many Zombie corporations will fail. Will the retail places, the high streets and malls dissappear leaving us to sit at home alone and await Amazon packages instead of the bustling community?
It is unknown if the inner cities will survive as they were, or if all the WFH, work from home, will mean the white collar jobs will offshore, or become gig work without benefits and pensions and NHS contributions and so on. Maybe this killed the middle classes?
These need answering, not just Freddie’s Dead Count he used for every discussion point. He just worried about the body count when that is the smallest issue, it is if society has been killed that needs study.
and Sanford is doing a great job expressing well informed OUTRAGE FOR US ALL !
“Mob” means a violent crowd, so not an accurate word to use to describe all those expert epidemiologists, virologists, doctors and statisticians, the vast majority of whom do still think the evidence supports the use of lockdowns in certain circumstances.
Giesecke has merely followed the evidence, which has led him closer to the scientific mainstream, albeit he still maintains his concern that collateral damage of lockdowns will be higher than benefits (we will have to wait and see, as so far there’s no clear evidence of that, as he concedes). He’s still a bit of an outlier, but of course he’s now far more reasonable than he was a year ago when he said Covid was no worse than the flu and would be over in a few weeks.
The deaths “with” or “of” issue is a red herring, because we have accurate excess death data for most advanced countries.
And, as I’ve suggested to you elsewhere, the US economy is roaring back, suggesting that vaccinated societies may well bounce back far stronger than after the Global Financial Crisis.
Moreover, your complaints re: Amazon and gig workers etc are structural socioeconomic trends which long pre-date the pandemic. Such structural trends may well have been accelerated by the pandemic (indeed it is probably a reason why advanced economies were able to rapidly adapt and have increasingly proved “immune” to social distancing/lockdowns; Amazon et al are beneficiaries of socially-distanced commerce), but it is rather unconvincing to suggest that the pandemic or policy responses thereto are the cause.
I’m unhappy that you continually get downvoted for expressing unpopular (on this site) but well argued positions. Personally I’m with the Unherd majority and don’t agree with most of what you say, but from your posts as well as those on the other side, as it were, I’m beginning to get a sense that a proper debate is imminent, and long overdue. People are starting to moderate their opinions and seek somecommon ground, I hope. Maybe I’m just naive.
No Giesecke modified his opinion because he has lost all moral courage to stand for what’s correct. I encourage you to look at the deaths per million curves for the US, Germany and Sweden from October 2020 until the present (i.e. the second season of COVID 19 where it was already established and endemic and where it is clearly seasonal). You will see that those curves are completely superimposable quantitatively. i.e. it doesn’t matter what one does, lockdown vs no lockdown, mask mandates vs no mask mandates, the end result is the same. Not really very surprising given that most transmission occurs in the home, in hospitals and in nursing homes. You will also see that, for example, France, Italy, and Austria peaked earlier. Similarly for the U.K. And incidentally the excess deaths in the UK right now are below the 5 year average for this time of year.
Giesecke was wrong on IFR, herd immunity, and that there wouldn’t be a second wave — three rather fundamental errors for an epidemiologist to make in a pandemic! We know this to be true because we now have 12+ months of data. For him to admit his major errors is not a lack of moral courage; if anything it’s the opposite.
Quite evidently, neither you nor I are epidemiologists. It is, however, quite simple that Covid cannot spread if there is sufficient social distance between people. A wise man would give greater weight to the consensus of the vast majority of experts — which is based on that 12+ months of real world data — while of course keeping an open mind that the tiny minority of GBD/Ioannidis types may be right on certain points.
Regardless, if you want to make superficial observations on the (non-)effect of policy, take a look at, say, India or Brazil, or compare Los Angeles versus San Francisco, and you’ll realise the futility of simplistic analysis. This is a hugely complex issue. One has to account for e.g. population homogeneity and differing healthcare capacities, as Giesecke says.
And how can you possibly be surprised that after a period of high excess deaths pre-vaccine, the UK now has lower excess deaths post-vaccine? As Prof Sir David Spiegelhalter of Cambridge and the Royal Statistical Society has carefully explained, this is because some people who would have died this year were killed prematurely by Covid last year; that does not change the fact, however, that average years of life lost to Covid is around a decade, i.e. most of those who die from Covid could have expected to live a lot longer and were not, contrary to a popular Covid-denier lie, on death’s door anyway.
See Spiegelhalter’s op-ed on the issue here:
https://www.theguardian.com/theobserver/commentisfree/2021/apr/04/how-is-it-possible-that-the-number-of-deaths-is-now-so-low
Quoting the Guardian just won’t cut it. Unfortunately, the Guardian, like so many newspapers, is terrible at accurately reporting anything remotely scientific or medical.
As for the 2nd wave, what he failed to realize but many did, including myself from the get go, is that COVID-19 was seasonal. It didn’t appear to be so at first because of the time it actually came to the US, UK and Europe. But from here on out it will recur every flu season (i.e. October through April).
And Sir David Spiegelhalter is entirely wrong. The majority who died were not only over 80 but more importantly had many co-existing co-morbidities (often end-stage).
And while I’m not an epidemiologist I’m both an MD and PhD, and there is nothing hard in terms of understanding the epidemiology of COVID-19.
Incidentally, COVID-19 is not all that easy to catch if one doesn’t do anything stupid. It takes about 15-20 min of direct face to face continuous conversation between 2 people for transmission to occur. In poorly ventilated crowded indoor settings, spread may occur across a room via aerosols as the viral particles are not dispersed. But in any reasonably ventilated indoor setting and in any setting outside the risks are very small indeed.
I’m not quoting the Guardian! I cited an op-ed in the Guardian by one of the world’s leading statisticians, Prof Spiegelhalter. It has nothing to do with Guardian journalism. With respect Johann, that was a remarkably ignorant statement to make.
I agree there is nothing hard about understanding basic epidemiology or statistics (including your point about transmission, which has been well established for many months now) — but at the same time there are lots of complexities and nuance, which is where deep expertise is required. You’ll forgive me if I give far less weight to the views of a MD and PhD compared with the opinions of a chaired Cambridge statistics professor and president of the Royal Statistical Society. However, I’d welcome you to cite equivalently authoritative sources in support of your bald contention that Spiegelhalter “is entirely wrong”.
Well, in Sweden at any rate we *know* that the people who died in nursing homes did not have ‘around a decade’ of life to look forward to. You aren’t admitted to such places unless you have dementia, or are so ill that you cannot continue to live at home with dedicated long term home care coming to visit you several times a week, and doing your shopping, cleaning, etc.
The people without dementia rarely live more than a year in the institional health care. It’s been going up a little over the decade, but not to a large extent. Here’s a report that analyses this for ‘people who died November 2015’ — so before covid thus nobody has any public health axe to grind here. It’s a policy paper to be used in figuring out how many long term home health care people we will need to hire, and how many nursing hospitals we will need to build to go with our projected demographic of elderly people. https://www.sciencedirect.com/science/article/pii/S1525861020300281
Laura, I of course agree with you that a lot of people in Swedish homes are towards the end of life. I disagree with you, however, that such information helps us calculate years of life lost during the pandemic.
There’s a lot of research on the YLL data, but I’m afraid I don’t know of any Swedish-specific studies. However, see e.g. https://www.nature.com/articles/s41598-021-83040-3
Of course the information we have on the life expectancy of the people on the homes is very much relevant is calculating the years of life lost during the pandemic. Are you silly or what? We already know the life expectancy of *every one of these people* before the pandemic. It’s one of the few places where we do have unfalsifiable, data.
Or do they not do that wherever it is where you live? alternative explanation to sillyness.
I should have been clearer and said “overall” years of life lost. If mortality displacement is only happening among a small minority (eg in care homes) then it’s not going to have a big impact on overall years of life lost. This is what appears to have happened in the U.K. (see link below to Prof Spiegelhalter’s analysis) and from the Nature article I gave to you in my comment above it appears to be the case in Sweden too.
https://mobile.twitter.com/d_spiegel/status/1378995410262503427
Eva you are doing a great job bringing informed balance to all discussions-Unherd needs you ! plz carry on
I agree!
Thanks. I think reasonable minds can fundamentally disagree on Covid policy (and probably always will!), and I’m very relaxed about that. What troubles me are the “alternative facts” in comments that veer into Covid denialism. We can’t have a rational policy debate if we can’t agree on the basics, such as the fact there is a pandemic and that it has certain costs.
Thanks Eva. Your contributions to this article have kept me reading them today.
As you say, it’s fair enough to have a debate about the comparative damage caused by locking down vs alternatives but people need to have facts in their mind and not just knee jerk reactions.
Sorry Eva but nobody here is introducing alternative facts. They are pointing out actual, true facts that you keep either ignoring or goal-switching on. For instance you introduce a “fact” of an IFR of 0.9 and when people point out that you’re using obsolete numbers you fall back on appeals to individual academics, rather than addressing the point more directly (e.g. why are all those other IFR studies wrong?).
Fundamentally this debate is happening (or trying to happen) because epidemiological “experts” have spent the last year making predictions that were later falsified by data. Your debating tactic is mostly to just keep insisting, without presenting much in the way of evidence, that in fact they weren’t wrong at all and everyone who presents data or arguments to the contrary isn’t qualified to have an opinion and so should stop spreading “misinformation” and “denialism”. That’s not a good way to win any arguments.
Norman — As a layperson, I have to give more weight to the views of the most highly qualified and credentialed; it is not a simplistic “she’s right vs he’s wrong” assessment. I’m keen to learn, but the burden is on you as the person questioning the scientific consensus to provide compelling evidence why Spiegelhalter’s numbers are “obsolete”.
Please would you therefore cite and provide a link to authoritative evidence showing ICL/Prof Spiegelhalter are wrong/too high on IFR.
I’ve already sent you the link to the March 2020 Imperial paper that used the 0.9% IFR assumption, which I guess is background context to our conversation. And here is Spiegelhalter’s Sept 2020 BMJ paper addressing risk/IFR:
https://www.bmj.com/content/370/bmj.m3259