Key takeaway for me: we must listen carefully to every single word the experts like Dr Aleman say, and take onboard how precise she was in interpreting the evidence in its proper context, how deliberative and logical her thinking is, and how she politely but firmly refused to jump to simple or broad-brush conclusions.
Over the months some clarity is emerging regarding the danger of being infected and becoming seriously ill, on one hand, and also on the effectiveness and need for shout-downs and physical distancing:
1. On being infected – many factors (perhaps 20 or more) may result in people not getting infected or staving it off [strong immune system, T-cells from other viruses, vitamin D and K2, pollution, living space etc…]
On getting seriously ill from it – these are well established, [comorbid conditions – infirmity – poor health etc..]
On Shut-downs – There are now many examples of BOTH outcomes when shutdowns did not occur – the West coast states in USA had covid-19 in early January, shutdown didn’t start until mid March, but there had been no explosion of admissions or deaths. Other places there has been. In Oregon the number of deaths per month March and April is LOWER than no-covid last year.
On physical distancing – it’s a parameter, but being indoors for sustained periods breathing the same are as a carrier seems to be the key – so why close beaches/parks etc?
Oh! Surface cleaning remember that? Sill a wild overreaction continues – spraying streets! An environmental disaster.
You raise complex issues which are generally open to debate, but I’m afraid I must point out that what has happened to date in California suggests that the situation on the West Coast is factually far more complex.
For example, the counties/cities in Southern California that opened up businesses (and stopped social distancing as much) several weeks ago following the early March “lockdown” (I use that term loosely given how different it was in California to the European measures) are now experiencing very large spikes in both confirmed cases and Covid hospital admissions.
By contrast, cities in Northern California like San Francisco have retained relatively strict measures (e.g. compulsory masking in public, hair salons/shops etc still closed) and have not experienced spikes.
California is now reversing it’s planned phased reopening, as indeed are Florida and Texas (despite being led by politicians ideologically opposed to lockdowns).
Moreover, there is plenty of evidence showing the differing variables behind infection transmission, from population density to superspreader events etc. So I’m not sure an epidemiologist looking back at January/February would be surprised to see a much slower transmission rate in rural Oregon state (population approx. 4 million; size 98,466 mi²) than in metropolitan New York City (population approx. 8 million; size 302.6 mi²).
This is all quite widely reported but I’m happy to provide links if helpful.
It is also being quite widely used as a tool to continue frightening people. Only the sensational numbers are reported to the public who will rarely want to see what’s behind them. Covid hospitalizations are for people ‘with’ covid and non necessarily admitted for or being treated ‘for’ covid. As we all know the death counts are calculated in a like way. Positive tests are reported on a speciment, not person, basis. And hospitals are being reimbursed handily for admitting covid patients. So much more goes into what those numbers are, they should not be taken at face value nor used as evidence that we must reverse the relaxation of mitigation measures.
There is certainly controversy over the way numbers are counted ‘with covid’ when there could be other co-morbidity issues. That’s what makes looking at excess deaths over a time period so important. see my reply to PB above.
Agreed, this is why there must statistically be other factors involved. The classic case is Santa Clara county, CA – autopsies in April showed 3 CV deaths at the start of Feb, meaning the virus was free to roam in an urban (but spread out and wealthy) setting for 2+ months before any shutdown at all – plenty of potential superspreader events that didn’t. I will spend a few more hours going into their numbers when I find time. Meanwhile the EXCESS DEATHS data is starting to be calculable – there’s a fairy simple BBC video https://www.bbc.com/news/av… which shows the UK, as a whole, is ten times worse than Oregon (see below) and leaves you with the alarming figure of 54% increase excess deaths* over expected.
What that doesn’t tell you is that it represents excess of 0.0007% during
*8 week period during pandemic per above that’s 2/13 of a year – if whole year was as bad (which it isn’t) times numbers by 6.5 for full year estimate. Then 945,866 – 614,854 gives 331,012 EXCESS ANNUAL deaths which is 0.0049% of population… compare this figure (calculated in the same way from Govt numbers) with Oregon’s 0.00045%.
6005 + 6146 + 6163 + 6362 + 6550 = 31,226 for an average of 6245.2
Total deaths in Oregon during Mar-Apr pandemic… 6536 (less than in 2019)
Deaths this year* 6,536, average 6,245 = excess of 291 (4.7% more than ave.) Average is 0.00148% of population, This year 0.00154 of population, excess is 0.00006%
*during the mar-apr peak period. *8 week period during pandemic per above that’s 2/13 of a year – if whole year was as bad (which it isn’t) times numbers by 6.5 for full year estimate. Then 1,891 EXCESS ANNUAL deaths which is 0.00045% of population
Don’t you find it curious that all the states (and countries) that were doing horribly now are doing terrific? You think they changed that quickly? You have been watching all the mayhem going on in those same states. What if places like NY and Italy have already infected a big proportion of their susceptible population and basically there is not that much firewood left to be able to burn (infect) ? We are not testing for T cell immunity. It could be very high in those places and we don’t know it . Certainly those states are acting like they have immunity. It has nothing to do with what measures those states are taking now if their population has reached “herd immunity” threshold. They will continue to see improvements. And these other states that initially did so well. Well they didn’t have the same proportion of their population become immune because they weren’t exposed. Now that they are relaxing lockdowns they are becoming exposed and their numbers are climbing. Watch, in another 2 or 3 weeks their numbers will drop as well as they approach T cell immunity.
The blame game is rampant in the US. Outbreaks are commonly attributed primarily to poor adherence to social distancing rules and the lack of consistent use of face masks. This type of political posturing curtails a deeper analysis of other potential causes of an outbreak. For example, southern California shares a large border with Mexico. There is extensive legal cross border traffic. Northern Mexico has been experiencing a large covid outbreak. This is a major factor in the increase in covid hospitalization rates in Southern California and surely is contributing to community spread and a surge. Many families have relatives and friends on both sides of the border. Many people are commuting to work across the border. Please consider dIgging deeper for answers and avoid the social distancing blame game.
How does your alleged factor (movement across the US border) in any way contradict the view that poor adherence to social distancing has led to an increase in infection rates in SoCal?
If these individuals crossing borders are (as you seem to be suggesting) in fact the cause of the significant SoCal infection spikes among the young in particular, the reason for that must be that they are not socially distancing themselves and thereby contributing to wider community spread? (I think we can all agree that viruses can’t spread if people aren’t close enough together/sharing the same space etc.)
So are you not merely singling out a particular group or groups, and alleging that they are the cause of the increased infection transmission? Which in no way undermines the point that lack of social distancing causes the infection rate to increase.
it is NOT true what you say about “very large spikes” in hospital admissions in California (for any reason including Covid-19). what is the source of your information?
Laura Creighton
3 years ago
The other thing to remember when comparing Sweden with Norway and Denmark is that the number of sick people you started with is a significant factor in how many people end up dying. So, pick a start date of March 17 — when European travel restrictions started. From here on in, everybody has to deal with however so much sickness they have inside their borders. All of the comparisons between the Nordic countries assume that proportionally the amount of travel in the 2 weeks before — when your citizens were abroad and possibly getting sick was the same for all three countries. But nothing could be further from the truth. I have been unable to obtain hard numbers from Denmark and Norway about how many residents were travelling in the prior 2 weeks, beyond a hand-waving ‘about 1%, probably’. For Sweden the answer is more than 10% of the population. The last week of February was ‘winter sport week’ for the region of Stockholm. See https://www.expressen.se/ny… but really easy to understand. This is, aside from Christmas week, the heaviest week for international travel in all of Sweden.
So what happened? People came back from the Alps, sick, and got told to isolate and were traced, and the Swedish health authorities did a great job of keeping Italian and Austrian alp strains from infecting all of Sweden. This only meant that strains from other places were the ones that we next saw Swedes getting sick with. see: https://www.thelocal.se/202…
Meanwhile the Danish and Norwegian health authorities do not credit the lockdown for their more successful strategies. They think they locked down too hard. Danish researchers believe that banning large gatherings would have been enough — https://www.thelocal.dk/202… while the Norwegian head of the their government health authorities is even more blunt about it https://www.thelocal.no/202…
about Sweden, here is a comparaison between countries where strict lockdown has been imposed https://ssrn.com/abstract=3…
m.felstead
3 years ago
great discussion and great format. i really appreciate your work and you have become for me the “thinking man’s Hugh Grant”- i hope you see that as a compliment!
Elizabeth Hart
3 years ago
Using Sweden as an example, it seems most of the population remains alive and not adversely affected ““ how can it be justifiable to disrupt society and the economy for the millions of people who it seems are unlikely to be too adversely affected by this virus in the prime of their lives?
Latest reported deaths in Sweden are 5,526 (pop. 10.23 million), with 1,428 deaths in people over 90. 2,300 deaths are reported for people in the age group 80-90. So that’s 3,728 of the deaths. Then there are reportedly 1,194 deaths in the age group 70-79. That’s 4,922 deaths across the age group 70 to over 90.There are 379 deaths reported across the ages 60-69. And 156 deaths in the age group 50-59. With a total of 69 deaths across the ages of 0-49 years. So most of the deaths are in the elderly age group 70 to 90. (Ref: The Statista website – figures above as at 10 July 2020.)
The focus now should be on finding effective treatments and strategies for the sick, i.e. generally elderly people. And recommending long-term practical preventive measures for the population generally, to reduce the prospect of the illnesses which exacerbate the effects of this virus, and enhance health, eg promoting optimum Vitamin D levels.
Thanks Helene. Re my comment above, a version of this has now been published in The BMJ Rapid Responses, see: Looking at Sweden, COVID-19 and vitamin D…https://www.bmj.com/content…
My BMJ rapid response also includes reference to studies that indicate vitamin D deficiency in Swedish nursing homes.
Absolutey right but how can you not express the truth about those trying to destroy your way of life despite this knowledge?
Rickard Gardell
3 years ago
The approach seems to make sense. The really young are active and social. The really old are in effective lockdown. The people in between these two groups are observing social distancing. At the same time in the background, herd immunity is marching on. It seems like the only logical strategy. As Sweden and many other countries were ill prepared, it made many implementation mistake. They belong in the past. Now testing is adequate, PPE is sufficient, age care facilities are better monitored and immigrant population is better informed. The deaths would be far lower if covid struck now as opposed to 4 months ago. Right now, many people are drawing conclusions from what happened 3-4 months ago, not how it is working now.
juliandodds
3 years ago
Interesting stuff and it is confirming what other scientists have been saying for some time (some of them in the UnHerd series). The key point for me was Freddie’s where he says despite lockdowns loosening widely deaths are not rising. That is an inescapable fact. Epidemics are definable by their maths and this ‘event’ never really had the maths to back up the word epidemic. It was ‘Pan’ but it never was ‘demic’. India and Pakistan are great case studies. They are densely populated and abandonned lockdowns over 2 months ago and yet their death rates are exceptionally low. The key stat for me has always been how much economic damage has been self-inflicted on each country in the form of debt and unemployment not how many (brought forward) deaths there have been. Virusses are a part of nature and we should thank this one for not killing our children and their parents.
Helene Banoun
3 years ago
I wrote a hypothesis to explain the decline of the epidemic based on the evolution of the virus against the host immune system
I’ve also been analyzing the cross-immunity data…
The 2 texts are here
EVOLUTION OF SARS-COV-2 IN RELATION TO THE HOST IMMUNE SYSTEM. http://ssrn.com/abstract=36… DOI: 10.2139/ssrn.3637909
ABSTRACT
How can we explain the temporal evolution of the pandemic?
An analysis of the curves of the epidemic at the late stage shows the evolution towards the benignity of the virus throughout the world. There is a prolonged increase in new cases with a steady decrease in severe cases and deaths.
Cross-immunity with common cold coronaviruses has been suggested. This would involve viral sequences coding for the spike protein but also and importantly for non-structural proteins that could interact with the cellular immune response (CD4+ and CD8+).
The mutations in the viral RNA sequence observed during Covid-19 also concern regions involved in the interaction of the virus with cells of the host immune system. It appears that the emerging virus has adapted to the host immune system by altering its transmissibility and/or virulence. The virus adapts by natural selection to the immune system of its host (the human population); it is the sum of these individual adaptations that produces the overall evolution of the virus during the epidemic. This hypothesis is consistent with the Theory of Evolution, which often helps to solve puzzles in biology.
Covid19: cross-immunity with other coronaviruses, immunopathological phenomena
SUMMARY
The low percentage of individuals in the population who developed symptomatic Covid-19 may be explained by cross-immunity with other coronaviruses. This phenomenon is based on cellular immunity. Humoral (antibody-mediated) immunity, on the other hand, may be partly responsible for some immunopathological phenomena.
The balance between this beneficial cellular immunity and these immunopathological phenomena could explain on the one hand the low representation of children among the sick and on the other hand the high lethality in the elderly.
In order to cope with a future pandemic, it would therefore be necessary to find out how to protect vulnerable populations on the one hand and improve the immune status of the world’s population from an overall health perspective on the other.
This is not only a health problem, but a social problem and also an economic problem such as the state of the world’s health system.
Helene, thank you – I will go and read your papers when I can put another 4 hours aside. I get slammed on youtube for suggesting this and will appreciate another source (if your paper pans out) is it peer reviewed yet?
linda
3 years ago
This is a little unrelated but I feel compelled to point it out. First, it never ceases to amaze how articulate many non-English speakers are. Their vocabulary and phrasing always puts me to shame, and English is my native language. That being said, I find Dr. Aleman’s accent here a little difficult to hear through. I usually listen to these interviews rather than watch them but I sat down here for a bit and by watching her face, the accent goes nearly away and I can understand her very well. This, to me, illustrates one of the primary problems with people wearing masks unnecessarily. They obscure expression and inhibit complete communication.
Also, this is a wonderful interview. Thank you!
Mark Bishop
3 years ago
The challenge with Covid is that there’s so much we don’t know, and it’s hard to make the right call with such incomplete and imperfect information. How much of Sweden’s performance is down to voluntary mitigation efforts? Many city dwellers headed for their holiday homes, causing already low population density to plunge (and measures of density don’t reflect specifics of Swedish society, such as high proportion of single households)? To what degree do mitigation measures reduce the viral load to which people are exposed, resulting in milder or asymptomatic cases, as opposed to fatal ones? Has the virus attenuated – and if so is it because of spread or due to seasonal factors, in the northern hemisphere at least? Will that trend reverse in the winter?
Also, the optimum strategy may depend on how confident we are that an effective vaccine will be developed, and when it will become available. If you’re a bull, you might want to lock down until you can vaccinate. If a bear, herd immunity through infection is a necessary evil and the optimum strategy is to slow the infection rate sufficiently that all can receive good treatment, while protecting the most vulnerable until the threshold is reached.
I think the point of the critique of lockdown response of government, is that we now see that the *vast* majority of those infected did not/do not need any treatment what-so-ever.
Andrew Meffan
3 years ago
Fascinating. I wonder how much the season has to do with infection rates and severity? It’s winter in NZ and Australia which now has community spread problems. Australia initially did well despite a slack lockdown but that was during a dry warm autumn. Similarly NZ had a stronger lockdown and appears to have little Covid. However we have problems with border security – quarantine being breached by people escaping for a trip to the supermarket or booze shop. No tourism, inbound or outbound and a population vulnerable should Covid start to spread. We have a shortage of airfreight for our exports and the cost is six times pre Covid levels. Sweden’s current situation may be in part due to it being summer now. Other Coronavirus illnesses such as colds are usually rare in summer. NZ has a short winter but it is cold enough that buildings are ventilated far less, in order to conserve heat. And NZ houses are poorly heated. So we typically see quite a bad Flu and cold season. It feels we are just a small slip away from a big outbreak or another debilitating lockdown. Only time will tell.
I agree and I think it would be rather stressful to always be thinking that way. Is it not better psychologically to have already been through the worst of it and be coming out the other side? I’m in Australia and we also have had very little infection. I have trying to get out as much as possible so as to still be building mine and my families immune systems. Funnily enough we were in Ireland during the 2018 bad flu system and we all caught the flu!. I am hoping that has given us some immune boosting strength even though corona is novel it is still related to other families of viruses so I hope that’s logical.
Dan Mr.
3 years ago
Sweden til now has been the poster child for the Left but decided to follow the science not scientism like the west has done.
COVID-19 would be so much easier to deal with if Hinokitiol was available.
Dan Mr.
3 years ago
As Mark Twain once wisely quoted, “it’s much earsier to fool a man than convince him he’s been fooled.” I will attempt the latter part of his quote here but I realize this will likely fall on the same deaf ears – even here.
For starters, over-run hospitals is a lie. It’s the opposite almost everywhere. 2018 flu season they were. Look folks, herd immunity is almost reached in many places around the world including Sweden. Not one healthy person has died from this world-wide. All lies from those that say otherwise. The death numbers are admittedly over-inflated with many nefarious reasons and left-benefit to do so. They want you to believe that if you died with Covid19 then you died from it. Most of you have probably already had it with harsh but quick, mild or no symptoms. Case count means nothing but the lefties are using it big time to keep you in fear mode. Covid19 is no less than a scamdemic perpetrated by the libtard, self-loathing, narcissistic, progressive, pagan left’s agenda for control over you, a lifetime of over-paid jobs and access to as much power and “free” money they can scam – no contest. Many scammers and ignorant here in Canada like doctors David Jacobs and Issac Bogosh fit into this box so beware the many boneheads in healthcare too. All institutions now have been infiltrated by the immoral goosestepping left and are completely broken. Mainstream media are now all following the lies. 80% of the population are just useful idiots supporting the lefty scam because they are often tribal in their thinking (low functioning intellectually or emotionally retarded to some degree) and the lefty virtu-signalling lies always sound good to the ignorant. They have no clue how it’s turning them into slaves. With the data in by mid-March discovering it was too late for a 15 day lockdown (if a lockdown was ever going to work) herd immunity was always the best solution as projected by the experts at Stanford U, Oxford, Carnagie-Melon and many other world-wide, in Sweden and through-out the US. You know, those without an agenda that have the balls to stand on their own two feet. All these best of the best were in agreement back in March that this is not at all harmful to the healthy – including a peer reviewed paper written by the great Lord Fauci himself published in the New England Journal of Medicine in late January. He notes that it’s looking like “nothing more than a bad flu season”. Of course we know he turned out to be a quack political hack. Sweden has reported one or no deaths in last four days as of yesterday. Contrary to the mainstream media lies that they have a higher proportion of deaths and just as bad economy. All BS lies. Just go to the CDC website for the stats. Arizona, Texas and Florida have one third the deaths of NY with three times the population. Surging cases means surging immunity towards herd immunity – nothing less. US is far from the worst in death toll by country – another perpetrated myth. Also, most deaths were over the age of 80 and with little time left (months or even weeks) given other fatal or underlying conditions. Covid deaths admittedly were over inflated as being discovered. Only 6% were under age 55. Shall i go on?
Just incompetence and malevolence all around as would be expected from the con-artists currently living on top. These folks don’t give a rats ass about you. Sheeople, use your brains. Gates the greedy pig wants to bill (get it Bill) the world for 8 Billion vaccinations. What he doesn’t know or wants you to not know is that its too late for Covi0d19 and is never worth the risk over just letting your immune systems take care of it. No vaccine for the common cold yet and its an RNA virus as well. The shutdown will ultimately kill many times more as a result with businesses and lives ruined forever!! Do the simple math you idiots!! People don’t believe in God but don’t make the gov’t or yourself one and please understand that Christ not MLK launched the greatest human rights movement of all time and rightfully warned us that humans are sinners not basically good unless showed the benefits of being so. Without this training by parents the brainwashing will continue until we make Gulags great again. Thank God i won’t be here. Wew!!
The only people that needed protected was the elderly at home or in old age homes and your tyrannic gov’ts did the opposite with the lockdown or by sending Covid19 patients in to infect the rest like the evil Cuomo of NY did. Take back your freedom now or lose it forever. The Visigoths are coming over the wall and you can’t share a city nor a country with them. Start by dismantling the scumbag public unions. Especially the teachers’ union. Take your kids out of school. They could care less about your kids – no contest. They are being indoctrinated anyhow. Incorporate now and tell your employer to pay you as a contractor with no source deductions. Much more tax advantages or better yet don’t pay any, Do it now !!! The economy is going down huge and there’s no stopping it. Let it be on their terms or yours – it’s your choice.
Dan Mr.
3 years ago
You mean marked as truth – not spam.
Dan Mr.
3 years ago
For starters, over-run hospitals is a lie. It’s the opposite almost everywhere. 2018 flu season they were. Look folks, herd immunity is almost reached in many places around the world including Sweden. Not one healthy person has died from this world-wide. The death numbers are admittedly over-inflated i.e. if you died with Covid19 then you died from it. Most of you have probably already had it with harsh but quick, mild or no symptoms. Case count means nothing. With the data in by mid-March discovering it was too late for a 15 day lockdown (if a lockdown was ever going to work) herd immunity was always the best solution as projected by the experts at Stanford U, Oxford, Carnagie-Melon and many other world-wide, in Sweden and through-out the US. You know, those without an agenda that can stand on their own two feet. All these best of the best were in agreement back in March that this is not at all harmful to the healthy – including a peer reviewed paper written by the great Lord Fauci himself published in the New England Journal of Medicine in late January. He notes that it’s looking like “nothing more than a bad flu season”. Sweden has reported one or no deaths in last four days as of yesterday. Just go to the CDC website for the stats. Arizona, Texas and Florida have one third the deaths of NY with three times the population. Surging cases means surging immunity towards herd immunity – nothing less. US is far from the worst in death toll by country. Also, most deaths were over the age of 80 and with little time left (months or even weeks) given other fatal or underlying conditions. Covid deaths admittedly were over inflated as being discovered. Only 6% were under age 55.
No vaccine for the common cold yet and it’s an RNA virus as well. The shutdown will ultimately kill many times more than Covid19 as a result.
There was no reason to remove my last post. I condemned no one in particular and all the facts presented can be proved. You violate the premise of the existence of this website which is protection for open debate and free speech. Wait, there is a term for this – Moronic. Good luck but you just confirmed that your site is irrelevant. Remember, though it’s been tried many times, one can not suck a blow at the same time. Based on censoring my first post as well you just proved the argument it made. LOL
Yes, one of my previous comments was marked as spam as well and not published, possibly because I provided a link to my rapid response on The BMJ (aka The British Medical Journal). The title of my BMJ rapid response is Looking at Sweden, COVID-19 and vitamin D… The BMJ article on which I made my rapid response is titled Covid-19: Public health agencies review whether vitamin D supplements could reduce risk, and is relevant to this discussion, and there are other pertinent rapid responses to consider. It’s bizarre UnHerd marked my previous comment as spam, this deletion of comments seems to be the antithesis of what UnHerd is supposed to be about?!?!
Lee Johnson
3 years ago
10 million people in a vast country where 50% are single households
Yet, they were cast by media (especially NY Times here in the US) as insane and “murderous” when word got out that their lockdown was more suggestion than enforced statute, and we all saw pictures of full pubs and restaurants. Their neighbouring countries have cast them out, and treated them as a pariah, with many people mocking their response. We will see the data in 2-3 years. You can certainly compare large cities with very similar population densities between Sweden and US, and see who’s response caused what long-term effects. Also, I would not call Sweden a vast country by any measure.
It certainly is a journey for Sweden as a country. As a Swede I sometimes get sick of all the political correctness my country stands for and now suddenly the world believes we are killing the elderly and weak just to keep our economy going…. Never has the economy been mentioned as a factor in Sweden’s response to corona. Three factors are mentioned all the time: This virus will be around for a long time. The wellbeing of the whole community ( avoid domestic violence, keep children in school etc) Protect the risk groups
It has certainly not worked perfect so far but then as you say , let’s see in a couple of years…
Adina Jagbeck
3 years ago
Being from Sweden I am a bit disappointed that dr Aleman was asked (and answered) questions about the Swedish strategy, the situation in the wards and the current level of social distancing. I expect she does not know more then the next interested person about those things. The T-cell study she was part of is really exciting but even then there is no statistical implication as the samples were not chosen to represent the population.
Fascinating insights.
Key takeaway for me: we must listen carefully to every single word the experts like Dr Aleman say, and take onboard how precise she was in interpreting the evidence in its proper context, how deliberative and logical her thinking is, and how she politely but firmly refused to jump to simple or broad-brush conclusions.
Amen.
Over the months some clarity is emerging regarding the danger of being infected and becoming seriously ill, on one hand, and also on the effectiveness and need for shout-downs and physical distancing:
1. On being infected – many factors (perhaps 20 or more) may result in people not getting infected or staving it off [strong immune system, T-cells from other viruses, vitamin D and K2, pollution, living space etc…]
On getting seriously ill from it – these are well established, [comorbid conditions – infirmity – poor health etc..]
On Shut-downs – There are now many examples of BOTH outcomes when shutdowns did not occur – the West coast states in USA had covid-19 in early January, shutdown didn’t start until mid March, but there had been no explosion of admissions or deaths. Other places there has been. In Oregon the number of deaths per month March and April is LOWER than no-covid last year.
On physical distancing – it’s a parameter, but being indoors for sustained periods breathing the same are as a carrier seems to be the key – so why close beaches/parks etc?
Oh! Surface cleaning remember that? Sill a wild overreaction continues – spraying streets! An environmental disaster.
You raise complex issues which are generally open to debate, but I’m afraid I must point out that what has happened to date in California suggests that the situation on the West Coast is factually far more complex.
For example, the counties/cities in Southern California that opened up businesses (and stopped social distancing as much) several weeks ago following the early March “lockdown” (I use that term loosely given how different it was in California to the European measures) are now experiencing very large spikes in both confirmed cases and Covid hospital admissions.
By contrast, cities in Northern California like San Francisco have retained relatively strict measures (e.g. compulsory masking in public, hair salons/shops etc still closed) and have not experienced spikes.
California is now reversing it’s planned phased reopening, as indeed are Florida and Texas (despite being led by politicians ideologically opposed to lockdowns).
Moreover, there is plenty of evidence showing the differing variables behind infection transmission, from population density to superspreader events etc. So I’m not sure an epidemiologist looking back at January/February would be surprised to see a much slower transmission rate in rural Oregon state (population approx. 4 million; size 98,466 mi²) than in metropolitan New York City (population approx. 8 million; size 302.6 mi²).
This is all quite widely reported but I’m happy to provide links if helpful.
It is also being quite widely used as a tool to continue frightening people. Only the sensational numbers are reported to the public who will rarely want to see what’s behind them. Covid hospitalizations are for people ‘with’ covid and non necessarily admitted for or being treated ‘for’ covid. As we all know the death counts are calculated in a like way. Positive tests are reported on a speciment, not person, basis. And hospitals are being reimbursed handily for admitting covid patients. So much more goes into what those numbers are, they should not be taken at face value nor used as evidence that we must reverse the relaxation of mitigation measures.
There is certainly controversy over the way numbers are counted ‘with covid’ when there could be other co-morbidity issues. That’s what makes looking at excess deaths over a time period so important. see my reply to PB above.
Agreed, this is why there must statistically be other factors involved. The classic case is Santa Clara county, CA – autopsies in April showed 3 CV deaths at the start of Feb, meaning the virus was free to roam in an urban (but spread out and wealthy) setting for 2+ months before any shutdown at all – plenty of potential superspreader events that didn’t. I will spend a few more hours going into their numbers when I find time. Meanwhile the EXCESS DEATHS data is starting to be calculable – there’s a fairy simple BBC video https://www.bbc.com/news/av… which shows the UK, as a whole, is ten times worse than Oregon (see below) and leaves you with the alarming figure of 54% increase excess deaths* over expected.
What that doesn’t tell you is that it represents excess of 0.0007% during
*8 week period during pandemic per above
that’s 2/13 of a year – if whole year was as bad (which it isn’t) times numbers by 6.5 for full year estimate. Then 945,866 – 614,854 gives 331,012 EXCESS ANNUAL deaths which is 0.0049% of population… compare this figure (calculated in the same way from Govt numbers) with Oregon’s 0.00045%.
Here is the data :
Looking at Oregon – 2019 pop. 4,217,737
https://www.oregon.gov/oha/…
Mar+Apr 2015 + 2016 + 2017 + 2018 + 2019 / 5
6005 + 6146 + 6163 + 6362 + 6550 = 31,226 for an average of 6245.2
Total deaths in Oregon during Mar-Apr pandemic… 6536 (less than in 2019)
Deaths this year* 6,536, average 6,245 = excess of 291 (4.7% more than ave.)
Average is 0.00148% of population, This year 0.00154 of population, excess is 0.00006%
*during the mar-apr peak period. *8 week period during pandemic per above
that’s 2/13 of a year – if whole year was as bad (which it isn’t) times numbers by 6.5 for full year estimate. Then 1,891 EXCESS ANNUAL deaths which is 0.00045% of population
Don’t you find it curious that all the states (and countries) that were doing horribly now are doing terrific? You think they changed that quickly? You have been watching all the mayhem going on in those same states. What if places like NY and Italy have already infected a big proportion of their susceptible population and basically there is not that much firewood left to be able to burn (infect) ? We are not testing for T cell immunity. It could be very high in those places and we don’t know it . Certainly those states are acting like they have immunity. It has nothing to do with what measures those states are taking now if their population has reached “herd immunity” threshold. They will continue to see improvements. And these other states that initially did so well. Well they didn’t have the same proportion of their population become immune because they weren’t exposed. Now that they are relaxing lockdowns they are becoming exposed and their numbers are climbing. Watch, in another 2 or 3 weeks their numbers will drop as well as they approach T cell immunity.
The blame game is rampant in the US. Outbreaks are commonly attributed primarily to poor adherence to social distancing rules and the lack of consistent use of face masks. This type of political posturing curtails a deeper analysis of other potential causes of an outbreak. For example, southern California shares a large border with Mexico. There is extensive legal cross border traffic. Northern Mexico has been experiencing a large covid outbreak. This is a major factor in the increase in covid hospitalization rates in Southern California and surely is contributing to community spread and a surge. Many families have relatives and friends on both sides of the border. Many people are commuting to work across the border. Please consider dIgging deeper for answers and avoid the social distancing blame game.
How does your alleged factor (movement across the US border) in any way contradict the view that poor adherence to social distancing has led to an increase in infection rates in SoCal?
If these individuals crossing borders are (as you seem to be suggesting) in fact the cause of the significant SoCal infection spikes among the young in particular, the reason for that must be that they are not socially distancing themselves and thereby contributing to wider community spread? (I think we can all agree that viruses can’t spread if people aren’t close enough together/sharing the same space etc.)
So are you not merely singling out a particular group or groups, and alleging that they are the cause of the increased infection transmission? Which in no way undermines the point that lack of social distancing causes the infection rate to increase.
it is NOT true what you say about “very large spikes” in hospital admissions in California (for any reason including Covid-19). what is the source of your information?
The other thing to remember when comparing Sweden with Norway and Denmark is that the number of sick people you started with is a significant factor in how many people end up dying. So, pick a start date of March 17 — when European travel restrictions started. From here on in, everybody has to deal with however so much sickness they have inside their borders. All of the comparisons between the Nordic countries assume that proportionally the amount of travel in the 2 weeks before — when your citizens were abroad and possibly getting sick was the same for all three countries. But nothing could be further from the truth. I have been unable to obtain hard numbers from Denmark and Norway about how many residents were travelling in the prior 2 weeks, beyond a hand-waving ‘about 1%, probably’. For Sweden the answer is more than 10% of the population. The last week of February was ‘winter sport week’ for the region of Stockholm. See https://www.expressen.se/ny… but really easy to understand. This is, aside from Christmas week, the heaviest week for international travel in all of Sweden.
So what happened? People came back from the Alps, sick, and got told to isolate and were traced, and the Swedish health authorities did a great job of keeping Italian and Austrian alp strains from infecting all of Sweden. This only meant that strains from other places were the ones that we next saw Swedes getting sick with. see: https://www.thelocal.se/202…
Meanwhile the Danish and Norwegian health authorities do not credit the lockdown for their more successful strategies. They think they locked down too hard. Danish researchers believe that banning large gatherings would have been enough — https://www.thelocal.dk/202… while the Norwegian head of the their government health authorities is even more blunt about it https://www.thelocal.no/202…
about Sweden, here is a comparaison between countries where strict lockdown has been imposed
https://ssrn.com/abstract=3…
great discussion and great format. i really appreciate your work and you have become for me the “thinking man’s Hugh Grant”- i hope you see that as a compliment!
Using Sweden as an example, it seems most of the population remains alive and not adversely affected ““ how can it be justifiable to disrupt society and the economy for the millions of people who it seems are unlikely to be too adversely affected by this virus in the prime of their lives?
Latest reported deaths in Sweden are 5,526 (pop. 10.23 million), with 1,428 deaths in people over 90. 2,300 deaths are reported for people in the age group 80-90. So that’s 3,728 of the deaths. Then there are reportedly 1,194 deaths in the age group 70-79. That’s 4,922 deaths across the age group 70 to over 90. There are 379 deaths reported across the ages 60-69. And 156 deaths in the age group 50-59. With a total of 69 deaths across the ages of 0-49 years. So most of the deaths are in the elderly age group 70 to 90.
(Ref: The Statista website – figures above as at 10 July 2020.)
The focus now should be on finding effective treatments and strategies for the sick, i.e. generally elderly people. And recommending long-term practical preventive measures for the population generally, to reduce the prospect of the illnesses which exacerbate the effects of this virus, and enhance health, eg promoting optimum Vitamin D levels.
about Sweden
https://ssrn.com/abstract=3…
Thanks Helene. Re my comment above, a version of this has now been published in The BMJ Rapid Responses, see: Looking at Sweden, COVID-19 and vitamin D… https://www.bmj.com/content…
My BMJ rapid response also includes reference to studies that indicate vitamin D deficiency in Swedish nursing homes.
Absolutey right but how can you not express the truth about those trying to destroy your way of life despite this knowledge?
The approach seems to make sense. The really young are active and social. The really old are in effective lockdown. The people in between these two groups are observing social distancing. At the same time in the background, herd immunity is marching on. It seems like the only logical strategy. As Sweden and many other countries were ill prepared, it made many implementation mistake. They belong in the past. Now testing is adequate, PPE is sufficient, age care facilities are better monitored and immigrant population is better informed. The deaths would be far lower if covid struck now as opposed to 4 months ago. Right now, many people are drawing conclusions from what happened 3-4 months ago, not how it is working now.
Interesting stuff and it is confirming what other scientists have been saying for some time (some of them in the UnHerd series). The key point for me was Freddie’s where he says despite lockdowns loosening widely deaths are not rising. That is an inescapable fact. Epidemics are definable by their maths and this ‘event’ never really had the maths to back up the word epidemic. It was ‘Pan’ but it never was ‘demic’. India and Pakistan are great case studies. They are densely populated and abandonned lockdowns over 2 months ago and yet their death rates are exceptionally low. The key stat for me has always been how much economic damage has been self-inflicted on each country in the form of debt and unemployment not how many (brought forward) deaths there have been. Virusses are a part of nature and we should thank this one for not killing our children and their parents.
I wrote a hypothesis to explain the decline of the epidemic based on the evolution of the virus against the host immune system
I’ve also been analyzing the cross-immunity data…
The 2 texts are here
EVOLUTION OF SARS-COV-2 IN RELATION TO THE HOST IMMUNE SYSTEM.
http://ssrn.com/abstract=36…
DOI: 10.2139/ssrn.3637909
ABSTRACT
How can we explain the temporal evolution of the pandemic?
An analysis of the curves of the epidemic at the late stage shows the evolution towards the benignity of the virus throughout the world. There is a prolonged increase in new cases with a steady decrease in severe cases and deaths.
Cross-immunity with common cold coronaviruses has been suggested. This would involve viral sequences coding for the spike protein but also and importantly for non-structural proteins that could interact with the cellular immune response (CD4+ and CD8+).
The mutations in the viral RNA sequence observed during Covid-19 also concern regions involved in the interaction of the virus with cells of the host immune system. It appears that the emerging virus has adapted to the host immune system by altering its transmissibility and/or virulence. The virus adapts by natural selection to the immune system of its host (the human population); it is the sum of these individual adaptations that produces the overall evolution of the virus during the epidemic. This hypothesis is consistent with the Theory of Evolution, which often helps to solve puzzles in biology.
https://www.researchgate.ne…
Covid19: cross-immunity with other coronaviruses, immunopathological phenomena
SUMMARY
The low percentage of individuals in the population who developed symptomatic Covid-19 may be explained by cross-immunity with other coronaviruses. This phenomenon is based on cellular immunity. Humoral (antibody-mediated) immunity, on the other hand, may be partly responsible for some immunopathological phenomena.
The balance between this beneficial cellular immunity and these immunopathological phenomena could explain on the one hand the low representation of children among the sick and on the other hand the high lethality in the elderly.
In order to cope with a future pandemic, it would therefore be necessary to find out how to protect vulnerable populations on the one hand and improve the immune status of the world’s population from an overall health perspective on the other.
This is not only a health problem, but a social problem and also an economic problem such as the state of the world’s health system.
Helene, thank you – I will go and read your papers when I can put another 4 hours aside. I get slammed on youtube for suggesting this and will appreciate another source (if your paper pans out) is it peer reviewed yet?
This is a little unrelated but I feel compelled to point it out. First, it never ceases to amaze how articulate many non-English speakers are. Their vocabulary and phrasing always puts me to shame, and English is my native language. That being said, I find Dr. Aleman’s accent here a little difficult to hear through. I usually listen to these interviews rather than watch them but I sat down here for a bit and by watching her face, the accent goes nearly away and I can understand her very well. This, to me, illustrates one of the primary problems with people wearing masks unnecessarily. They obscure expression and inhibit complete communication.
Also, this is a wonderful interview. Thank you!
The challenge with Covid is that there’s so much we don’t know, and it’s hard to make the right call with such incomplete and imperfect information. How much of Sweden’s performance is down to voluntary mitigation efforts? Many city dwellers headed for their holiday homes, causing already low population density to plunge (and measures of density don’t reflect specifics of Swedish society, such as high proportion of single households)? To what degree do mitigation measures reduce the viral load to which people are exposed, resulting in milder or asymptomatic cases, as opposed to fatal ones? Has the virus attenuated – and if so is it because of spread or due to seasonal factors, in the northern hemisphere at least? Will that trend reverse in the winter?
Also, the optimum strategy may depend on how confident we are that an effective vaccine will be developed, and when it will become available. If you’re a bull, you might want to lock down until you can vaccinate. If a bear, herd immunity through infection is a necessary evil and the optimum strategy is to slow the infection rate sufficiently that all can receive good treatment, while protecting the most vulnerable until the threshold is reached.
I think the point of the critique of lockdown response of government, is that we now see that the *vast* majority of those infected did not/do not need any treatment what-so-ever.
Fascinating.
I wonder how much the season has to do with infection rates and severity?
It’s winter in NZ and Australia which now has community spread problems. Australia initially did well despite a slack lockdown but that was during a dry warm autumn. Similarly NZ had a stronger lockdown and appears to have little Covid. However we have problems with border security – quarantine being breached by people escaping for a trip to the supermarket or booze shop. No tourism, inbound or outbound and a population vulnerable should Covid start to spread. We have a shortage of airfreight for our exports and the cost is six times pre Covid levels.
Sweden’s current situation may be in part due to it being summer now. Other Coronavirus illnesses such as colds are usually rare in summer.
NZ has a short winter but it is cold enough that buildings are ventilated far less, in order to conserve heat. And NZ houses are poorly heated. So we typically see quite a bad Flu and cold season. It feels we are just a small slip away from a big outbreak or another debilitating lockdown.
Only time will tell.
I agree and I think it would be rather stressful to always be thinking that way. Is it not better psychologically to have already been through the worst of it and be coming out the other side?
I’m in Australia and we also have had very little infection. I have trying to get out as much as possible so as to still be building mine and my families immune systems. Funnily enough we were in Ireland during the 2018 bad flu system and we all caught the flu!. I am hoping that has given us some immune boosting strength even though corona is novel it is still related to other families of viruses so I hope that’s logical.
Sweden til now has been the poster child for the Left but decided to follow the science not scientism like the west has done.
A world permanently without hugs (sigh).
Seems to me there are other factors which were not mentioned. First, is the general health of the population better than average – reflecting diet, exercise, time spent in nature, swimming in clean water, taking saunas etc? All of which boost immunity.
Second, did people act on advice (mainly online/alternative) to take Vit. C & D and/or other natural immune-boosting remedies?
Atmospheric pollution has been seen to be a major factor in disease severity and mortality, for example in Italy and Wuhan. Sweden is probably one of the cleanest countries in Europe in this respect and has few large centres of population.
Mental attitude is also important. I seems likely that there was less fear in the population – the result of less of the kind of disgusting fear-mongering by politicians and the media that has blighted Britain in particular.
The T-cell connection is very interesting. I would highly recommend the article by Dr. Pascal Sacré on coronavirus test procedures at: https://fort-russ.com/2020/…
COVID-19 would be so much easier to deal with if Hinokitiol was available.
As Mark Twain once wisely quoted, “it’s much earsier to fool a man than convince him he’s been fooled.” I will attempt the latter part of his quote here but I realize this will likely fall on the same deaf ears – even here.
For starters, over-run hospitals is a lie. It’s the opposite almost everywhere. 2018 flu season they were. Look folks, herd immunity is almost reached in many places around the world including Sweden. Not one healthy person has died from this world-wide. All lies from those that say otherwise. The death numbers are admittedly over-inflated with many nefarious reasons and left-benefit to do so. They want you to believe that if you died with Covid19 then you died from it. Most of you have probably already had it with harsh but quick, mild or no symptoms. Case count means nothing but the lefties are using it big time to keep you in fear mode. Covid19 is no less than a scamdemic perpetrated by the libtard, self-loathing, narcissistic, progressive, pagan left’s agenda for control over you, a lifetime of over-paid jobs and access to as much power and “free” money they can scam – no contest. Many scammers and ignorant here in Canada like doctors David Jacobs and Issac Bogosh fit into this box so beware the many boneheads in healthcare too. All institutions now have been infiltrated by the immoral goosestepping left and are completely broken. Mainstream media are now all following the lies. 80% of the population are just useful idiots supporting the lefty scam because they are often tribal in their thinking (low functioning intellectually or emotionally retarded to some degree) and the lefty virtu-signalling lies always sound good to the ignorant. They have no clue how it’s turning them into slaves. With the data in by mid-March discovering it was too late for a 15 day lockdown (if a lockdown was ever going to work) herd immunity was always the best solution as projected by the experts at Stanford U, Oxford, Carnagie-Melon and many other world-wide, in Sweden and through-out the US. You know, those without an agenda that have the balls to stand on their own two feet. All these best of the best were in agreement back in March that this is not at all harmful to the healthy – including a peer reviewed paper written by the great Lord Fauci himself published in the New England Journal of Medicine in late January. He notes that it’s looking like “nothing more than a bad flu season”. Of course we know he turned out to be a quack political hack. Sweden has reported one or no deaths in last four days as of yesterday. Contrary to the mainstream media lies that they have a higher proportion of deaths and just as bad economy. All BS lies. Just go to the CDC website for the stats. Arizona, Texas and Florida have one third the deaths of NY with three times the population. Surging cases means surging immunity towards herd immunity – nothing less. US is far from the worst in death toll by country – another perpetrated myth. Also, most deaths were over the age of 80 and with little time left (months or even weeks) given other fatal or underlying conditions. Covid deaths admittedly were over inflated as being discovered. Only 6% were under age 55. Shall i go on?
Just incompetence and malevolence all around as would be expected from the con-artists currently living on top. These folks don’t give a rats ass about you. Sheeople, use your brains. Gates the greedy pig wants to bill (get it Bill) the world for 8 Billion vaccinations. What he doesn’t know or wants you to not know is that its too late for Covi0d19 and is never worth the risk over just letting your immune systems take care of it. No vaccine for the common cold yet and its an RNA virus as well. The shutdown will ultimately kill many times more as a result with businesses and lives ruined forever!! Do the simple math you idiots!! People don’t believe in God but don’t make the gov’t or yourself one and please understand that Christ not MLK launched the greatest human rights movement of all time and rightfully warned us that humans are sinners not basically good unless showed the benefits of being so. Without this training by parents the brainwashing will continue until we make Gulags great again. Thank God i won’t be here. Wew!!
Here’s a few of hundreds of studies on masks.
https://www.cidrap.umn.edu/…
https://kstp.com/coronaviru…
https://wccoradio.radio.com…
The only people that needed protected was the elderly at home or in old age homes and your tyrannic gov’ts did the opposite with the lockdown or by sending Covid19 patients in to infect the rest like the evil Cuomo of NY did. Take back your freedom now or lose it forever. The Visigoths are coming over the wall and you can’t share a city nor a country with them. Start by dismantling the scumbag public unions. Especially the teachers’ union. Take your kids out of school. They could care less about your kids – no contest. They are being indoctrinated anyhow. Incorporate now and tell your employer to pay you as a contractor with no source deductions. Much more tax advantages or better yet don’t pay any, Do it now !!! The economy is going down huge and there’s no stopping it. Let it be on their terms or yours – it’s your choice.
You mean marked as truth – not spam.
For starters, over-run hospitals is a lie. It’s the opposite almost everywhere. 2018 flu season they were. Look folks, herd immunity is almost reached in many places around the world including Sweden. Not one healthy person has died from this world-wide. The death numbers are admittedly over-inflated i.e. if you died with Covid19 then you died from it. Most of you have probably already had it with harsh but quick, mild or no symptoms. Case count means nothing. With the data in by mid-March discovering it was too late for a 15 day lockdown (if a lockdown was ever going to work) herd immunity was always the best solution as projected by the experts at Stanford U, Oxford, Carnagie-Melon and many other world-wide, in Sweden and through-out the US. You know, those without an agenda that can stand on their own two feet. All these best of the best were in agreement back in March that this is not at all harmful to the healthy – including a peer reviewed paper written by the great Lord Fauci himself published in the New England Journal of Medicine in late January. He notes that it’s looking like “nothing more than a bad flu season”. Sweden has reported one or no deaths in last four days as of yesterday. Just go to the CDC website for the stats. Arizona, Texas and Florida have one third the deaths of NY with three times the population. Surging cases means surging immunity towards herd immunity – nothing less. US is far from the worst in death toll by country. Also, most deaths were over the age of 80 and with little time left (months or even weeks) given other fatal or underlying conditions. Covid deaths admittedly were over inflated as being discovered. Only 6% were under age 55.
No vaccine for the common cold yet and it’s an RNA virus as well. The shutdown will ultimately kill many times more than Covid19 as a result.
Here’s a few of hundreds of studies on masks.
https://www.cidrap.umn.edu/…
https://kstp.com/coronaviru…
https://wccoradio.radio.com…
There was no reason to remove my last post. I condemned no one in particular and all the facts presented can be proved. You violate the premise of the existence of this website which is protection for open debate and free speech. Wait, there is a term for this – Moronic. Good luck but you just confirmed that your site is irrelevant. Remember, though it’s been tried many times, one can not suck a blow at the same time. Based on censoring my first post as well you just proved the argument it made. LOL
Yes, one of my previous comments was marked as spam as well and not published, possibly because I provided a link to my rapid response on The BMJ (aka The British Medical Journal). The title of my BMJ rapid response is Looking at Sweden, COVID-19 and vitamin D… The BMJ article on which I made my rapid response is titled Covid-19: Public health agencies review whether vitamin D supplements could reduce risk, and is relevant to this discussion, and there are other pertinent rapid responses to consider. It’s bizarre UnHerd marked my previous comment as spam, this deletion of comments seems to be the antithesis of what UnHerd is supposed to be about?!?!
10 million people in a vast country where 50% are single households
Yet, they were cast by media (especially NY Times here in the US) as insane and “murderous” when word got out that their lockdown was more suggestion than enforced statute, and we all saw pictures of full pubs and restaurants. Their neighbouring countries have cast them out, and treated them as a pariah, with many people mocking their response. We will see the data in 2-3 years. You can certainly compare large cities with very similar population densities between Sweden and US, and see who’s response caused what long-term effects. Also, I would not call Sweden a vast country by any measure.
It certainly is a journey for Sweden as a country.
As a Swede I sometimes get sick of all the political correctness my country stands for and now suddenly the world believes we are killing the elderly and weak just to keep our economy going….
Never has the economy been mentioned as a factor in Sweden’s response to corona.
Three factors are mentioned all the time:
This virus will be around for a long time.
The wellbeing of the whole community ( avoid domestic violence, keep children in school etc)
Protect the risk groups
It has certainly not worked perfect so far but then as you say , let’s see in a couple of years…
Being from Sweden I am a bit disappointed that dr Aleman was asked (and answered) questions about the Swedish strategy, the situation in the wards and the current level of social distancing. I expect she does not know more then the next interested person about those things. The T-cell study she was part of is really exciting but even then there is no statistical implication as the samples were not chosen to represent the population.