Was I wrong about the Covid infection fatality rate?
I was mocked at the time, but new data supports my thinking
For suggesting that the average IFR of Covid-19 might be between 0.01% and 0.05% during an early 2020 interview with UnHerd, I was mocked by large sections of the media and accused of minimising the harms of Covid-19 in service of a Right-wing libertarian agenda. My analysis was called “spurious” by the Sunday Times, and was quickly dismissed by senior MPs and the establishment press.
Data released this week by Denmark’s health registry however confirms, once again, that the age gradient in mortality from SARS-CoV-2 infection essentially resembles a cliff-face, accelerating sharply only in the ninth decade of life. The numbers come from an exercise undertaken to sift deaths from Covid-19 out of the deaths with Covid-19, which reveals an overcount of around 100% in the Danish data. This puts the average mortality risk over the last three years for those above 20 at 0.089%. Adding the under-20s reduces it further to 0.065%.
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What can we usefully infer from this data about the lethality of SARS-CoV-2?
The first point to make is that it is unhelpful to talk about an ‘average IFR’ — and this is something I should certainly have avoided doing three years ago — as this is entirely sensitive to the age structure. Commonly, the risk to the older age groups is downplayed while the risk to the majority of the population is exaggerated. Policy decisions made on the basis of an average IFR are likely to be sub-optimal, and model projections based on an average IFR are bound to carry flaws.
It is worth noting in this context that the all-important supposed IFR of 0.9% in the Imperial College model of March 2020 was anchored to data — such as from the Diamond Princess cruise ship — that was skewed towards the high-risk groups. This was the main problem with their projection, rather than any errors in the methodology.
Some of us pointed out at the time that the UK data on deaths was equally compatible with a very low IFR, had the first wave of the epidemic occurred earlier than supposed by the Imperial model. The 0.065% mortality risk from Covid-19 across the past three years in Denmark is certainly closer to 0.05% than 0.9%. In fact, summing over several years can result in an overestimate of IFR, since the numerator (the number that die from the infection) will keep growing, while the denominator (the population size) remains static.
If you count for long enough, the IFR can exceed 100% — which is clearly nonsensical. That said, three years is probably a reasonable period over which to measure the overall IFR, as a significant proportion of people are likely to have been infected over that period, and so the total population can be safely used as a denominator.
However, we also need to bear in mind that vaccines have almost certainly reduced the total number of deaths. If, for example, vaccines reduced the expected number of deaths by a half, then the IFR is actually double what has been measured here. But to obtain an average IFR of 0.9% from this data, we would require over 75% of those aged over 90 to have died from Covid-19 in the absence of vaccination and, even so, the IFR for those under 60 would remain at 0.05%.
The main lesson to be learnt here is not to quibble about the true value of the IFR but, instead, to construct a strategy that is robust to these uncertainties. Focused protection of the vulnerable population, followed by targeted vaccination, remains the only reasonable solution given the very low IFR in the majority of the population. That’s not to mention the enormous costs of lockdown.
how come a reasonably smart layman like myself could predict these figures based on calculating excess deaths from the beginning of the covid outbreak – and all the experts could not ??? Sunetra thankyou for your stand against all those corrupt ‘experts’ !!
Follow the Benjamins.
No, it has more to do with ego. People want to feel important, and when something in your bailiwick is happening they tend to exaggerate its importance and the impact of ignoring its importance. See global warming.
The Benjamins come later.
In the U.S. at least, hospitals had a significant financial incentive to list “Covid 19” as the cause of death in patients. Once it was learned that the official cause of death for people dying of cancer or in car accidents, who happened to test positive, was being listed as Covid, we all knew what was going on.
Then why are the financial standing of US hospitals in worse shape after Covid? They are in my state.
Those 2 things can be true at the same time. There was a financial incentive for any patient defined as a COVID patient (ie: a patient in ER because if a ruptured spleen, but tested positive for COVID, even without COVID symptoms, garnered ~36,000 in federal funds for the hospital). That does not mean that hospitals did well during COVID, as much of their “bread and butter” – routine surgeries, elective surgeries, regular clinics, etc were disrupted. (PS: I’m a doc in Canada with close ties to numerous physician-friends in the USA)
OK, but so what? It still doesn’t mean that cases were significantly overstated. My sister is a floor secretary in a hospital. My neighbor is an ER nurse. I have friends and fellow parishioners who are doctors, one of whom testified against a hospital that was fraudulently billing 20 years ago. All have told me they saw nothing that indicated a real overstatement of reporting of cases.
Regarding the two hundred of so people I know who tested positive for Covid, ONE died positive but apparently without symptoms (a heart attack while not taking his meds) and was counted as a Covid death, and ONE died a week after ‘recovering’ from Covid but was NOT counted as a Covid death. That’s a wash.
Both sides of this question are perfect illustrations of the problem with anecdotal evidence. We’ll probably never know how honest or dishonest the hospitals were being about “cause of death”. I’m not even sure who gets the final say.
I had three friends who work in hospitals tell me, unprompted, “…they’re writing up everything as Covid.” But whenever I asked directly other people gave me the opposite answer.
Total control of data is not possible.
Because like a lot of other businesses in America, they had ‘reduced costs’ to the point that the excess capacity of the system was basically zero. They, like so many others, were simply not prepared to handle any significant supply or demand shock, and COVID imposed both. The logical response post-pandemic should have been to increase supply directly by building more hospital, perhaps reopening some of the dozens of small town hospitals that have closed over the past two decades due to lack of public funding, giving scholarships for nurses and doctors, opening immigration for those who already possess these skills, training the national guard for pandemic response scenarios, and so on. You’ll no doubt notice no politician or leader has done or suggested any such thing, because those policies would, among other things, increase competition and make it more difficult for healthcare conglomerates and insurance companies to continue building their gigantic too big to fail oligopolies into money printing machines.
Here’s my take… I live in Portland Maine just down the street from Maine Med, the largest medical “complex” in northern New England. And a few blocks away is Mercy Hospital. During the spring 2020 lockdowns I walked every day through the parking lots of both hospitals. They were empty. Yes, we insanely rewarded hospitals to label everything covid – a stupid crime. But we cleared out all the rest. So they mis-labeled, propagated fear, and killed w respirators. At the same time my 70 year old cousin presented w cancer after being mis-diagnosed. I accompanied her to the appointment where they confirmed the terminality of her cancer. I, her closest relative in the region, had to sit outside in the car! I am still so pissed off. So here’s my final take. Our corrupt public health system, aided and abetted by our med and eds cartel, mis read the situation and then, in cahoots with Federal and State government, completely pooched what semblance of competent care might have been residual in the system. Imagine if the emphasis had been, from the outset, on focused protection of the vulnerable, AND, promotion of general population health. We could have put this thing in the rear view mirror within a short period of time and not destroyed the world’s economy with systemic, intractable, inflation of assets and now basic necessities, and destroyed a generation of young people due to lockdowns and school closures.
Of course the hospital parking lots were empty, nonessential personnel were laid off. My ER nurse neighbor two doors down had to work overtime as colleagues contracted Covid – she herself got it just in time for Easter 2020. Her husband, a physical therapist at the same hospital, was furloughed. BTW, she told me she has zero tolerance with Covid denialism, it was a horrible experience for her and she sees the sideline denials as evil.
I agree this could have been quickly put in the rearview mirror: a deep lockdown on December 1, 2019 would most likely have worked. But no one wanted to try until the evidence was stronger, and by then it was too late.
True. All 117 of us knew.
Good point on the Imperial College model. But it is important to note that the Imperial Collège modelers knew this, when they pushed their misleading model. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext
So there was no error due to lack of knowledge of the age gradient. They produced misleading guidance, at great harm to society and global health in general, for some other reason.
I hope the Sunday Times et al. someday apologize to you, Sunetra.
Excellent article and thanks to Dr. Gupta for her diligence on this issue.
My only comment is this should be a main article on Unherd, not a mini article.
I have a great many issues with the events of 2020-22; the disregard of any consequence from economic to public health, the lack of cost benefit analysis, the rise of authoritarianism, the failure to prove and quantify benefits, the reliance on a model written by a non-epidemiologist/non-software engineer with a less than stellar forecasting track-record.
However, the silencing, if not out-right smearing of experts who contradicted the prevailing wisdom was one of the most egregious. What I found particularly disturbing was if such an expert as Sunetra Gupta made a single error, it was proof that they should not be listened to. Neil Ferguson’s inability to get anything didn’t seem to cause him an issue. Even when the IC model was published to GitHub demonstrating how poorly written it was (even after Microsoft tried to make it look a bit more competent) no criticism in the mainstream media was forthcoming.
It is reassuring to see that people like Sunetra Gupta, Carl Heneghan et al, have stuck to their guns. History will look more favourably up them than the contemporary mainstream media has.
But if history is written by the victors, no one will know this truth in the future.
Dr Atlas explains in his book that until he arrived nobody had considered the effect of policy on society. He was demonized for advising to end lockdowns and school closures. The NIH team refused to examine data about risks. Group think consumed the world, we suffered and that continues today. Politicians nearly everywhere refused to deal with policy, afraid of the press and accused of killing grannies.
Think about two complex, conflicting things simultaneously!!??
I suspect the NIH/CDC teams all have difficulty walking and chewing gum simultaneously. Far easier to double-down and issue pronouncements.
i think ‘afraid’ is the key point here – it seems that our ‘leaders’ are mostly cowards who passively or not perpetrate ‘evil’ ie ‘that which actively works against the greater good’. Sick of pussyfooting around – these people are evil in the broader sense – and I hope they spent 27000 years in some kind of purgatory for their arrogant self serving behaviour – ooops I am getting grumpy again – not too long till 5pm tho..
In the midst of madness the sane voice is rarely heard. But history remembers them, cold comfort though it be.
Well neither the media or the health authorities are prepared to discuss their miserable performances – but the public have taken note. The pick up rates for boosters and child vaccines show that even people who don’t publicly question the narrative do privately question it.
Interesting article and so pleased that silenced people are increasingly getting a voice, but I think comments about the vaccines should have come with more than just a caveat of ‘targeted’.
I agree, and think they should carry a skull and crossbones label, haha
Covid-19 was without any reasonable doubt a product of the Bio-Defense Industry*
*DOD, haha, a semi Orwellian Ingsoc, if there ever was one.
And according to Dr Malone, who worked for these guys on exactly these kind of areas, and holds the original patents on mRNA, nano-lipid wrapped gene therapy…. The vax is totally a bio-weapon as well.
OK, Dr Gupta – you were 100% right (on most things), the vax parting shot I wonder about – maybe you could explain how you came up with that 50% number. I assume you did not use Africa as the control/placebo group, or your 50% reduction in deaths means something different to a scientist than it does to a lay person. (as in the absence of the vax uptake is coincidental with decreased covid mortality. We know very well the uptake of the vax is incidental to non-covid excess mortality.
But Doctor – the BIGGIE is the Forbidding of early treatment, forbidding of ‘off-label’ medications. Dr McCullough and his group say 85% of all covid deaths were survivable if given the Forbidden early treatment.. The masks, and the destruction of the children mental health, and education, and lifetime earnings. (and thus mental health, and health, when they grow into adulthood too, and societal pathologies associated…)
So, how about the lack of informed consent? That is a human right established by the Nuremberg Trials – and naturally the destruction of our economy, pensions, savings, and all the rest by the insane lockdown coupled with insane money printing – and this inflation death spiral.
The world needs this to be OPEN, and the guilty to be punished, and the corrupt to have their money taken back, and the entire cadre of every deep state, Social Media Boss, MSM, BBC, Education cartel, MO, Government Politician, and Health Service boss – put on a form of public trial.
But for these couple comments, I enjoyed your article.
Few will ever have the article space to present all the injustices that have happened. And no apologies from officials.
I think one of the worst decisions by the whole Health Establishment was Forbidding Early Treatment. Many doctors, who were successful with early treatment, pointed this out at the beginning of the pandemic. I still believe that suffering and death could have been prevented by early intervention. I still want to figure out, why there was no money/research available at this crucial time and only billions spent on vaccines. In my own family I saw my brother-in-law deteriorating and severely suffering in the early stages of Covid. The Covid Hotline doctors kept telling him to stay put, take painkillers and only get in touch once his breathing deteriorates and that at this point an ambulance will take him to hospital. Hey, what about medication from day one, which would prevent Covid to get out of control.
We simply cannot reach the truth in this matter of Covid fatality rates without considering its early use as a hammer (along with anything else that came to hand) by the Left to pound away at Trump and distort 2020 election procedures, and later, its weaponization by bureaucratic health elites to expand their power – something that grows metastatically out of Progressivism’s insistence that we all need oversight and assistance from powerful government agents (them, in other words) to survive. This was a political pandemic from the start. https://www.wsj.com/articles/covid-worsened-america-rage-virus-for-which-theres-no-vaccine-lockdown-vaccine-mandates-ron-desantis-stanford-masking-2670cd39?st=3xa4qesc1sqgm9u&reflink=desktopwebshare_permalink
Add to this the fact that because COVID can be asymptomatic, we don’t know, and never will know, how many people actually contracted the disease. If the death rate is calculated basically as deaths X divided by total cases Y, then Y is unknown and unknowable. We can guess, and as it seems likely everyone will eventually contract some variant of COVID at some point if they haven’t already, the most accurate calculation of COVID death rates over the long term is quite likely to be somewhere in the neighborhood of total COVID deaths/total population, and that’s an even smaller number than the ones this author is citing.
Now, just hold on. Cases are never asymptomatic by definition, which is why the case fatality rate (CFR) is much more important than the IFR which includes the asymptomatics. The IFR matters as an understanding of the overall progress of the virus through a population, but the CFR is what measures the ‘disease burden’ (a technical public health definition) of the disease on the population. The asymptomatics are immaterial to the disease burden the virus imposes on society, in fact the Covid-19 and polio IFRs are remarkably similar. And any attempt to redefine ‘disease burden’ to be based on the IFR is simply wrong for many reasons, including the fact that it would be inconsistent with past usage.
I see what you mean as ‘cases’ is defined by people who reported systems, but that’s a technical distinction. This is the exact kind of statistical scientific tiddlywinks that makes people like me skeptical of the so-called ‘experts’. I don’t really care about all the technical definitions. What people want to know is the simple odds of dying from this virus if you get it, whether you are aware of it or not, which should include asymptomatics. Polio is actually a decent comparison as it is another disease that is usually asymptomatic or minor. The problem with comparing COVID to polio is that polio, in addition to rare fatalities, also disabled and disfigured many who survived. That visible reminder caused it to have a far greater psychological impact on human beings. Further, polio was most often severe in the case of children, which again generates a far more powerful psychological response. Further, from a strictly economic perspective, a disease that imposes disabilities on the youngest members of society has a far greater total cost because those disabled by polio often required lifetime care and often could not work but had normal lifespans. COVID on the other hand, from the very beginning, and as the author points out, was always most dangerous to the very sick and the very old, to the point that one can draw wildly different numbers of deaths based on how one separates those who died of COVID from those who died of something else but also had COVID or who died as a result of COVID plus some other condition can profoundly affect the final numbers (the author mentions this as well). I’m not saying it wasn’t costly or a burden on our healthcare system. It clearly was. I’m fairly confident, however, that just letting the disease run its course would have been less costly than shutting down most of society for the better part of two years.
Then you are skeptical of that last 100+ years of public health methodology, and you want a rupture that will make it nearly impossible to compare pandemics going forward, and for really no good reason (except the desire to minimize Covid).
Long term polio and long term Covid are directly comparable, including those in middle age. While the most visible victims of polio were the very young, they were not the only ones.
“…to the point that one can draw wildly different numbers of deaths based on how one separates those…who died as a result of COVID plus some other condition…”
And this leads to another corruption of medical terminology: a co-morbidity with a Covid death still means that Covid was the killer. Covid deniers try to turn this on its head, in effect making Covid the co-morbidity when it was not.
PS But my real favorite is that the CFR was about 1.8% up to the summer of 2022. Last I looked 1.8% rounds up to 2% and not the 1% death rate that the Covid deniers claimed – neat trick, making almost half of the deaths disappear! Perhaps those mathematical ‘experts’ weren’t to be trusted either [actually my favorite were the people who claimed it was 0.018% because they couldn’t tell the difference between a percent and a ratio].
To be clear, yes, I am skeptical of the last 100+ years of public health methodology, along with a great many other things. I’m an independent thinking, critical human being who doesn’t automatically believe something because the media says it is so. I understand that precise definitions are important for decision making, but that can safely remain in the circles of those who truly understand the subtleties. The IFR is what more people would think is the ‘odds of dying from this’. But you’re right, presenting facts in such a way as to inspire the maximum amount of fear and obedience in the populace is not new, and neither is the tendency of people to use gray areas to push the final public numbers towards the place they personally think those numbers should go. These are common human failings and singling out COVID response is perhaps unfair.
“Focused protection of the vulnerable population, followed by targeted vaccination, remains the only reasonable solution . . . ”
Like most doctors and others debating the COVID-19 pandemic, the author does not seem to be aware of the very strong, causative, association between low 25-hydroxyvitamin D levels and COVID-19 severity and death. Severity also increases average levels of viral shedding and so community-wide transmission. See the graphs at: https://vitamindstopscovid.info/00-evi/#03-uk-low .
See the first graph on this page, with results from research in a Boston hospital, in 2014, showing that the risk of surgical site and hospital-acquired infections is about 2.5% for people whose pre-operative 25-hydroxyvitamin D levels were 50 ng/mL 125 nmol/L or more, but rise to about 25% at 18 ng/mL 45 nmol/L, which is a typical level for most people who are not supplementing proper amounts of vitamin D3 and have not had a lot of UV-B skin exposure in the last month or two.
Those with black or brown skin, living far from the equator, on average have much lower levels, such as half of UK Asians having 10 ng/mL 25 nmol/L or less.
These normal 25-hydroxyvitamin D levels are terribly unhealthy.
There’s far more to say about this than fits in a comments section. Please read the research on vitamin D and the immune system at: https://vitamindstopscovid.info/00-evi/. If you think this is too simple to be true, or that vitamin D is just another over-hyped nutrient, then you do not understand how many types of immune system rely on 50 ng/mL 125 nmol/L circulating 25-hydroxyvitamin D to supply their intracrine signaling systems. This system, inside each cell, is crucial to the cell’s ability to respond to its changing circumstances. Most doctors and immunologists have not heard of this.
The paltry 0.015 mg 600 IU of vitamin D3 a day the UK government recommends is totally inadequate to the task of raising 25-hydroxyvitamin D levels to 50 ng/mL 125 nmol/L or more.
For 70 kg body weight, without obesity, 0.125 mg 5000 IU vitamin D3 a day will get most people’s levels to or above this, over several months. This is a gram every 22 years. Pharma-grade vitamin D3 costs about UKP2 a gram ex-factory. Where’s the profit in this, you might ask? Indeed. This is why most people have never heard of it and why some can’t imagine it to be true.
I’d love to be able to reply to this but apparently I died from AIDS in 1985 along with most of the rest of the population. Or at least, I should have done so according to the experts.
I’ve followed Sunetra Gupta (Oxford), Jay Bhattacharya ( Stamford) and Martin Kulldorf (Harvard) these last three years – signed The Great Barrington Declaration initiated by all three, whose main tenet was to focus protection, avoid lockdowns. I also met with both the latter to discuss associated covid management issues relevant to public response/behaviour in ’21 via UnHerd, as being an exemplar of the 1952 Solomon Asch experiment in social conformity – well worth looking up!
All three are the voice of educated reason and deliberation, free of any other motive other than to share knowledge so that we have the best informed action.
If at the time (2020) our governments could process what was said by all three, without the fear engendered by the ‘advisers’ with their inadequate modelling – we would arguably not have the inflation and societal disconnect we now have.
haha – – Awaiting for Approval
apostasy will not be tolerated…haha
Test test. It says 4 comments, but I see none.
Now it says 5, but I can only see mine.
Currently it says 7 comments but I only see three. That probably means some comments have been flagged so they disappear until a moderator at Unherd reviews and approves them.
J, would any be surprised that my long message is awaiting approval. I almost never go back to anything I have posted on so do not know if most, or all, or few, of my posts are deleted – but I do see the Orange letters of A for A a lot.
I have never known of an A for A comment later be passed – from what I have seen it is total. But then I don’t care – the sheep do not need worrying I suppose…
20 / 16 now.
This isn’t good for retaining subscriptions, although I guess only Unherd know the exact metrics on that front. There must surely be at least one off the shelf commenting software that doesn’t have such onerous limitations.
My guess is they’re using WordPress, or similar, which is likely extremely aggressive when it comes detecting wrong-think.
22/26 now. It seems that the original 4 are never to be seen again.
‘7 comments’ but I only see 4, perhaps the other 3 have been cancelled. These 4 seem pretty harmless. I think Unherd is gradually losing it lustre.
Yes, a number of, what looked like harmless posts that disagreed with the article, have disappeared overnight. Maybe someone wrote a nasty reply, but to remove the whole thread is not really acceptable.
Well, there is truth…but then there is The Appropriate Truth.
Lower-case truth is boring. It’s anti-sensationalistic (for the most part); it’s grounded in Reality (as in UpperCase Forever Reality). Sometimes it’s painful; always it’s accurate. It tells us pretty consistently, a bunch of stuff that the Progressive Eloi hate to hear.
So clearly The Appropriate Truth is immensely better. It’s Inclusive; it’s Diverse; and perpetually Equitable. It’s also Artisanal Truth — hand-crafted by Experts, custom-fit to tell us exactly what THEY (those who know best, what’s best for us) need us to hear. The Appropriate Truth, indeed, helps to bend that infamous ‘Arc of History’ towards Lennon’s social-justicey ‘utopia’. (Just ‘Imagine’!)
As for Covid…the trumpeted Pandemic…the Lockdown…the immolation of the world’s economy…and the advent of 10M Little Napoleons, eager to enjoy their newfound ability to tell us how to dress, where to stand, who we can see, what we can do: clearly The Appropriate Truth is the only possible solution.
The author asks, “Was I wrong?” No, of course not. Nor were hundreds of others who raised the same issues — discussed the same data — pointed to the same lower-case truths. But it was already clear that the only truth which could be allowed to see the light of day (as blessed by Fauci, NBC, CBS, CNN, and the NYTimes) was the Appropriate Truths which produced the Appropriately Compliant behavior. Everything else & Everyone else was to be shunned.
Governing hundreds of millions of unruly, freedom-seeking, happiness-pursuing human beings is so much easier when the entire nation plays ‘Simon Sez’ (and report those who don’t). Simon Sez wear a mask. Simon Sez hunker-down. Simon Sez don’t go see Grandma…douse your hand with germicide before touching your children (or letting them touch you). Simon Sez: build a virtual life in the virtual world (and if you find that depressing, well — we’ll send you some drugs!).
Yes there are all kinds of superior strategies for the inevitable next time. The question is: will any of those strategies build the same unthinking compliance that we had (and still have) this time? Simon Sez…”Nah, I don’t think so”.
Out of a population of 335 million, the U.S. counted over 1 million “death from covid” cases. My understanding is this figure is a crock, i.e., came to hospital without covid, got covid while there, died from something else entirely .. and it’s counted as a “covid” death. Because HPs got money for each covid case. We don’t have good data on exactly how many people died “from covid”. We never willl.
What if only 217,750 in the U.S. actually died from covid, that is .065% of 335 milliion, and 80% of those deaths were people 65+? or +1 or more in comorbidities? It would mean 43,550 people who – otherwise – ostensibly were healthy, died of covid. Of course the people who put us through this farce would hate it if that were the truth, because it would make everyone want to hang them that much higher.
We’re still pimping vaccines, despite the growing contingent of vaccine-injured and vaccine-related deaths mounting up, as “excess deaths” bankrupt insurance companies.
Wonder what the toll of vaccine-dead and vaccine-injured will mount up to? 5 million? .. or 50.
You are not the only country in the world. Other countries do not have the weird incentives of the for-profit US health care system – and they do not report hugely lower death tolls that I know of. Anyway, you need evidence, not just suspicion to junk all the official figures.
In the UK, a Doctor Campbell under the Freedom of Information (FOI) Act requested to the UK Govt National health Service (NHS) exactly how many people had died of COVID alone i.e. with zero comorbidities – the answer, and by law it must be released into the public forum, was less than 15,000 victims (in just less than 2 years of available data), so NO, nothing like 125,000 Covid victims!
Now the real ‘eye opener’ was that when the wonderful Dr Campbell released this data on his YouTube channel, he was immediately vilified by firstly the BBC, and then various elite Govt or quasi govt elite institutions. This proves beyond all doubt that it was all a lie!
It was all Orwellian manipulation as Boris got sight of actually becoming a dictator: I never believed a word of it. One only had to look at the feeble little wind up automaton Malter Whitty for it to become abundantly clear.
According to the WHO’s figures for the UK (‘GB’), in April 2020 weekly cases peaked at 33,506 and deaths at 6,730 – earlier, so either should be linked to far fewer cases, or many early cases went unrecorded, anyway implying a death rate at least 20%.
At the next peak, in January 2021, there were 422,763 cases in one week, with deaths peaking at 9,044 two weeks later, implying a death rate 2.14%. This was in the middle of the first deployment of vaccines to vulnerable categories, which may have reduced the death rate even allowing for latencies. However, prior to that, in November, before even the first vaccination on 8 December, there had been a peak of 3,232 deaths following a peak in cases of 175,281, a death rate of 1.84%.
To date, the average death rate is 0.87%, though this is confounded by several factors: a high proportion of people having been vaccinated; the uncertain effect of sporadic so-called ‘lockdown’ (mainly lockout) policies; and deaths continuing to roll along in waves approximately three months apart, at the same time as cases have fallen steadily though still comparable to the first figure I gave.
Should there be a question about how many cases now go unrecorded or ignored?
My take is that the early figures simply confirm the failure to protect vulnerable people in the early stages – or, worse, behaviour that greatly exacerbated risk. The later figures suggest that the effect of vaccination in the general population was indeed modest.
I am generally sympathetic, but these numbers need a lot of confirmation. The obvious problems are 1) how sure are we that those deaths were in fact due to COVID, 2) what proportion of the cases do we actually see. We can only count the cases we know about, of course. This is where you want a peer-reviewed reference, so you can go in and check the details of those numbers were arrived at.
Unfortunately the suspect nature of most of these figures (all of which, at this point, tend to carry heavy political weight) make reasonable analysis difficult, if not impossible.
Early on, in the Spring of 2020, there were preliminary numbers coming from a Stanford study which indicated the actual (largely asymptomatic) infection rate was hugely higher (10X? 20X? 50X) than the recorded rate….which would mean whatever IFR you chose to calculate from the known infection rate would be equally hugely overstated — assuming the Stanford results were broadly indicative.
The same uncertainty haunts us today. We say cases have steadily fallen but what that really means is that reported cases (serious enough to merit a doctor’s visit) have steadily fallen. Now that everyone has about 12 Covid test kits under the bathroom sink, who knows how many cases we actually have? or have had? At this point it might seem reasonable to conclude that the vast majority of Americans have indeed gone through at least one Covid infection… plus at least one full vaccine dose (and perhaps 2-3 boosters).
We also don’t know the impact of lockdown on transmission….or masking on transmission, or both, or neither. Multiple studies prior to Covid indicated masking was ineffective. New studies currently available indicate the same thing. We might also ask about social distancing…floating plexiglass barriers that ‘separate’ the customer from the cashier….aerosol transmission rates in closed spaces….sanitizing efforts, etc.
Additionally, we have no answers for the impact of lockdown on the wider society? What did it cost us? (in lives and dollars) What is it still costing us? Until we can answer both sets of unknowns on both sides of the equation, what have we really learned?
In the end we still have two primary unanswered questions: 1) What am I as an individual supposed to do? What makes the most sense given each individually idiosyncratic collection of age, health condition, comorbidities, vaccine status, Covid status, current living situation (am I a teacher surrounded by children? am I 80 yr. old senior citizen in a retirement community )… and 2) What is the nation supposed to do, next time round? (Or, asked differently, what are those $12B we’re pouring into the CDC actually doing?)
If past history is any guide, the odds are good that we’ll try to fight the next war using the last war’s strategies. History, of course, would also tell us that that’s a lousy strategy…but, admittedly, it’s fairly easy to assemble. (Kinda like the man looking for his lost keys under the streetlight: “Did you lose them here?” a passing stranger asks. ‘Nah…but it’s too dark way over there!”)
The MSM were largely responsible for stoking hysterical public opinion. At the time of the Wakefield MMR scandal, the typical newspaper health editor, and health correspondents, had a degree in English, History, or ‘journalism’. At the start of the pandemic, ditto. And now? Absolutely nothing has changed. Employ monkeys, and all the change you get is peanuts.
The element missed is how we managed to ensure the deaths weren’t greater. For example without the intensive care intervention our PM received he’d have v likely gone into acute respiratory failure and died. And in order to ensure he, and lots of others infected, got access to the urgent care needed we had to just about cease everything else. And to avoid that key capacity being overwhelmed we had to stop having so many arrive at hospitals. The response saved and avoided lots of additional deaths (albeit it took a while for Intensive Care doctors to work out how best to treat the infection).
A sole fixation on deaths rates can miss the point about what was necessary to keep the death rate down.
Unfortunately a compounding factor was not many in deep old age are going get access to an ITU and survive the invasive intervention necessary.
Nonetheless the death rates stayed low, as compared to what they could have been, because of the interventions.
Now it’s a separate matter and legit debate as to whether the implications of those interventions created other problems of greater consequence. But let’s not be silly and start to imagine Covid was just a bit of flu. You work in a hospital those first few weeks and you’ve never seen anything like it and hope you never will again.
40,000 excess deaths occurred in a home setting in the first year from the 1st of May 2020, only 2% of which were Covid related, Source (ONS stats) Hospital and care home deaths quickly re-established the long-term trend for death rates the excess deaths simply happened at home.
And no one said Covid was “just like flu’ in the first year it killed three times as many as the flu and was always going to. But 90% of those people were either co-morbid and or over 60.
That’s the real point of Suntera’s interventions three years ago. that the at-risk group was clearly established and so the rest of us should just have got on with our lives. Boris Johnson was comorbid he was an at-risk person who should have shielded.
The NHS was busy but it’s always in danger of falling apart at the seams every winter because it is appallingly run and far too many elderly patients are bed blocking who should be in care.
You need to stand back from your narrow view from being on the inside and all the genuine minor heroisms that some staff perform and look at in the round.
So how would shielding have worked for the millions with co-morbidities in the first few weeks of pandemic? Which co-morbidities would you have confirmed quickly? Let’s see how much you’ve really thought this through.
Do you think, like a light switch, you could have turned on some ‘shielding’ practical policy in mid March 20 and everyone understand who it covered and abide by it? Because if they didn’t we’d be overwhelmed anyway. So you are assuming it would have drawn compliant behaviour and/or been policeable.
Now come autumn/winter 20/21 and the 2nd lockdown I think a more debatable issue what role shielding could play, but was still before vaccine roll out.
(If you’d like to support a significant increase in national ITU capacity too so we have bit more resilience the next time that’d be great as well)
And finally back to key point, which I think you’ve ceded, the deaths were indeed lower because of the actions taken, albeit you’d have taken the risk on being overwhelmed and hoped people shielded. Probably hoping UK citizens acted more like Swedish etc. Understandable contention, until you or family had an RTA , had no ambulance to respond and no way hospital could admit/treat you as already overwhelmed. At which point you get v angry basic emergency services been overwhelmed by others.
The key point in all of this is the outright cancelation of debate on the issue back then. Any dissenters from the “official narrative” were mocked and derided for their views, without regard for their credentials. I can understand the complete dismissal of opinions from blogs like this, but when previously highly regarded and credentialed professionals spoke out, it became more political than scientific. That is the travesty that occurred here.
No that’s a snowflake-type cop out WT. (Sorry to use an anti-woke type phrase). It beholds folks making alternative suggestions to put some proper ‘meat on the bone’ on how it could work. Otherwise the exponents are just messing about rather than properly engaging with a national discussion we do need to have on what we could do better next time.
The GBD contention continually fails to give details on how it would work, be policed etc. It fails to engage properly. I suspect it doesn’t want to because exponents recognise it’s much more difficult when you have to think it’s operation through in more detail. Asking folks to explain further is not ‘cancelling’ them. They are cancelling themselves if they haven’t thought it through.
Mid-March 2020 was too late. It was obvious that early December 2019 was really our last chance, even at that time if attention was seriously paid.
Yes something in that, although it is with hindsight. Covid awareness v limited in Dec 19 so the Behaviourist experts may have thoughts about how much public might have engaged at that point. One for the Public Inquiry to hopefully ponder.
I had made up my mind about Covid-19 after reading the news from China in November 2019.
I think there is a great disconnect between the ideals of liberty and those of public heath for most people. It has been estimated that if a doomsday cult with a CRISPER machine rebuilds the smallpox virus (the sequences are in the public domain) and makes a determined attempt to release it there will be 80 million deaths in the US alone within a year. To avoid that will require measures that will make the Covid response look like a picnic. I personally have no problem with switching from liberty to public health and back again as events require.
No one looked to see why the mortality was so great in the nursing homes except for only blaming the virus. Had they examined the mortality figures for respiratory viruses of the previous 1.5 flu seasons they would have seen that it was relatively low, setting up a situation where you had a huge number of very vulnerable surviving into 2020 when a more virulant respiratoty virus came along.
Yep I think something in that statistically. However doesn’t detract from my point that any assessment of death rate has to also recognise how a much higher death rate was averted as a result of all the actions taken, esp in the early phases. And let’s keep using our PM as a case example as it’s v typical, and nobody can easily dismiss it. Not elderly, some marginal co-morbidities, yet hospitalised and managed on closed oxygen system – otherwise respiratory failure and death. Multiply by thousands and you have an example of what was required to stop much higher death rate.
You keep on missing the central point that in every Western Society with similar population profiles and that used the same measurement base the death rate was 3 Covid 1 Flu. That has happened in Sweden, New Zealand, Victoria Australia, UK, Italy, Spain. Despite the widely different policies in Victoria, Sweden, NZ, and UK the ratio was the same. All of those health services saved lives, of course, they did, but the social interventions were radically different and over a three-year period ended up in the same place. Old frail elderly people die and there isn’t a statistic that shows they were not the majority of deaths.
I would like to see the age profiles of those who were saved in hospitals in ICUs. They were the people that should have been there for your skills, not the bed blockers. As an Italian Doctor observed in February 2020 when discussing his ICU ward ‘everyone in here will be dead within the week’ – so why take up a bed?
And I return to the point I made to you the last time this was discussed. Deaths peaked in the UK on the 14th of April my birthday which is why I remember it. Only three weeks after Lockdown was instituted far too soon to have an impact whereas people’s natural behavior to be more cautious was already established just as even now the elderly and co-morbid are exercising more caution even without any restrictions. I have traveled extensively since leaving NZ in March 2021 and the elderly and co-morbid are largely absent. They probably do not realize it but they have bought into the Great Barrington Declaration of which Senetra was a co author and which I signed.
So, are you saying that the health service should be there only for the young and strong, because the old and weak ought shuffle off quickly to save on valuable resources? Please tell me you are not working in a hospital.
I am saying that when a new virus comes along we should accept that the frail elderly co-morbid should be allowed to die as pain-free as possible and not placed in a hospital. My mother bed blocked from October 2020 to February 2021. Shen went home to live in squalor with care and when I arrived in the UK it was obvious she had weeks to live and yet was still considered for a rehabilitation course for a week and then a cataract operation before her GP intervened and said stop this nonsense the next stent change first. She could only be moved with a hoist and the hospital in Bath even rang and asked me to pick her up from yet another emergency admission. I had to explain she was on a hoist and that was the same hospital that rang me when she was admitted and asked me what medication she was on !!!!
Mercifully an end to this madness came when her Urologist stepped in and said we should call it a day and she died peacefully between clean sheets a human being no longer a body to be pricked and prodded.
Meanwhile, the next generation down all but one suffered mental health issues dietary issues, and health issues being locked down to save her life. Bonkers.
So your passive-aggressive moral indignation is, to say the least wide of the mark. Unfortunately, policymakers take more notice of people with your opinions than my view that part of the human condition is to die with dignity.
My daughter asked me why do I engage in this it’s over but only yesterday I found out another friend’s son descended into alcoholism during lockdown. It just keeps on giving.
The dilemma about when you cease active treatment for conditions in the frail elderly is a constant and not just pertinent to the Pandemic. Each has to be an individual decision and Doctors/Families are always grappling with this. Medical sub specialisation can occasionally complicate and the holistic view gets overlooked. Good Gerontology input often vital – but national shortage in this speciality.
But the thing was we didn’t initially Lockdown to save the frail elderly. In fact they got pushed out of hospitals quickly (sometimes inappropriately) because of the influx in younger admissions.
Come Winter 20-21 the Lockdown may have been driven by the fear of giving Granny Covid. But again Granny generally didn’t make into an acute ITU anyway. ITUs become overloaded again that winter but with younger admissions.
Sorry to hear about your own family experience and condolences. My father was in a Care Home, contracted Covid (almost certainly from staff, although we bear no grievance given how difficult things were at that time) and died in late Apr 20. He may well have contracted a respiratory illness at another time and died as he was frail and so we can rationalise it but a loss is always v painful.
A thirds of patients admitted to ITUs (Note: not HDUs) typically die anyway, but we don’t give up on people because the risk is higher, esp if a chance. The v elderly can’t absorb the invasive care (mechanical ventilation) as much as anything so don’t get triaged into ITUs as much.
ITUs, and overspill ITUs including Theatre areas (as they have the kit) were full of Covid+ by start of April 20 and through the next 2-3mths. The length of ITU stay was considerable compounding the capacity problem. The age range was categorically not the v old.
Deaths peaked mid April in part because it took til then for the Lockdown to stem the tide in attendances and for Physicians to work out how best to treat the condition (e.g patients ‘proned’ (laid flat) seemed to do better so that quickly became an approach. PPE supplies had improved by then and we were better reducing cross infection (although that never went away entirely).
There was immense activity to try and manage the influx the first few wks, whilst running with far less staff due to many having Covid, or being quickly assessed as needing to work elsewhere.
So to come back to my point – the GBD principle would not have been operationally poss in the early Phases. Later it’s more plausible. GBD advocates don’t help themselves IMO by being too broad-brush in their assumption about practicality.
The GBD recipe was a non starter for the UK for the following reasons :
If you were going to really protect care home residents you would have had to ensure that all their carers and any visitors didn’t meet anyone else – that is that the care homes and their staff were kept in their own bubbles (not mixing with their families) until all the elderly inmates were vaccinated.
1.49 million people in the UK are in receipt of adult social care (private and NHS and Local authority and direct payment recipients). According to Satista about 490,000 of these are in care homes. There are 1.52 million social care workers (potential transmitters to this vulnerable population). This doesn’t include those that are being cared for by immediate family members about 13.6 million informal carers according to this paper :
COVID-19 and UK family carers: policy implications
The population at risk of severe COVID-19 (aged ≥70 years, or with an underlying health condition with a fully adjusted hazard ratio (HR) of getting severe covid of 1.13 or greater) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals.
34% of households in the UK are multigenerational – 9 million homes.
According to the Actuaries Friday report # 51 : Priority Groups 1 to 9 i.e. over 50s, Health & Care Staff, Extremely Clinically Vulnerable and “At Risk” amounts to around 31m people.
Big numbers requiring lots of financial and logistical support in a Great Barrington Declaration scenario + a massive sacrifice by direct care workers unless you chose to bribe them with what ? an average junior doctor’s salary perhaps for 1 year ? (Foundation year doctor year 2 £33,345) x 1.52 million care workers = aproximately £ 50 – 51 billion.
So that just leaves the ? millions who are still clinically vulnerable but still working and contributing to the economy and under the GBD recipe would be obliged to continue since they are not in a care home.
Oh, and incidentally, there were plenty of people on this forum in 2020 that were claiming that Covid “was just like the flu”
Yes v valid and as you say this is what GBD advocates just fail to engage with.
I have engaged and twice as many co-morbid elderly deaths would have been worth it to avoid the catastrophic consequences.
What is so sad about this was when I returned to England and sat in front of Elderly clients in their 80s in 2021, they all said the same. “Michelle I have aged 5 years I do not have much time left I need to get on with my life whatever the risks.” They were as badly affected as the young ones locked up in tenement blocks.
Thanks for your reply. Two points.
Basing an argument on the over the 50s being vulnerable when it is comorbid over 60″s that died in 92% of cases and less than 1,000 fit and healthy people under 60 had died by the end of 2020 is overegging the argument.
The just like flu argument is more nuanced. For fit and healthy active people who turn the wheels of the economy Covid even in its first iteration was just like the flu indeed 50% didn’t even present symptoms in whole community tests aboard cruise ships early on.
That’s separate from it being three times as deadly as flu to co-morbid elderly.
What characterizes responses from people like yourself is absolutely no thought is given to consequences for the welfare of 7,000,000,000 people in the round.
Nursing home covid deaths in 2020 were 20,000 10,000 people die a week in England and Wales and 170,000 died in nursing homes in 2020.
If the GBD had generated 6 times flu death rates a year for three years that would still only have been 450,000 and those elderly sacrificing the last three years of their lives would have been worth it for the catastrophic consequences of a straight lockdown. Alcoholism, broken marriages, businesses destroyed, and irreparable damage to the cognitive behavior of the Global Economy. I could write a book in answer to your points about the cost of GBD versus the most catastrophic policy decision since the officer class pushed young men over the trenches in the Great War and I speak as someone who has personally been completely unaffected and looked on at the catastrophe.
The real irony you fail to address is outside of dementia those elderly people who need care who indicate are being looked after formally or informally by 15 million people, just under a quarter of the entire population (?), have a life expectancy of three years so by the end of this year they will all have passed away. (Care home attendees or people having care have a 3-year life expectancy excepting dementia).
Finally, let us look at it now with no restrictions. Your 15 million people may all be vaccinated as well as your 1.5 million vulnerable but the former group is just as capable of getting the virus and passing it on to the most vulnerable who are still vulnerable and still dying. But that’s acceptable I suppose because they have been vaccinated.
Elaine, I fundamentally disagree with you and wrote a very long post but it has been removed. So do not think the absence of a detailed reply is because I accept your observations. I will try one remark 1.5 million need care and 15 million are involved in helping them out of a population of 70 million and a virus that is still capable of transmission and killing the frail and elderly. Your suggestions ?
The problem is, you can’t prove a counter factual. Like me saying, I’m preventing the death of 5M people by having typed this sentence. Good thing I did that! Just imagine the human tragedy if I hadn’t. (I probably should keep typing!)
Certainly there is some logic to the notion that restricting non-critical medical care to allow limited capacity to shift to critical (to the extent that’s possible) is a good thing. But to truly answer the question, you’d have to look at admissions rates, diagnostic rates, occupancy rates, discharge rates, and compare all that to medical capacity rates at hospitals and care centers nationwide. As you say, “those first few weeks” were horrific….but the Covid Panic/Lockdown continued for more than a year….long past those early horror shows.
We’d also want to consider — as coldly and objectively as possible — to what extent fatality spikes (which are always horrific) were more the result of a sudden accumulation of ordinary death rates in a ‘sooner-than-anticipated’ and very narrow window. Were those deaths statistically ‘excess’ deaths…or were they simply ‘early’ deaths (the elderly and comorbid being extraordinarily vulnerable to the virus)?
One of the truths that the non-medical public (which is really most of us) typically forgets is that (in the United States, as a for instance) 8000 people die every single normal day. We may hear the siren in the distance, when we’re talking to our friend about Netflix…but for the families involved, those are 8000 distinct tragedies that everyone else ignores. The media talking heads do not gather at every hospital to interview the survivors, all of whom would be in tears just as real as those shed by those who were interviewed during Covid.
We tend to forget these things.
We also lose them in the public spectacle which surrounded Covid: the President’s ‘moment of silence’ for the virus-dead. And nothing for all the other thousands who died that day of ovarian cancer, car accidents, brain tumors, raging infections, Alzheimer’s, breast cancer, etc.
Yes fair points. Counter factual can’t be proved, and that means all views need to remain inquisitive on what we can learn rather than assume decisions were all correct/wrong.
The point I think we shouldn’t lose sight of is early on many Hospitals were overwhelmed and other emergency care becoming quickly compromised (let alone planned care which ceased pretty quickly). The question is what would have happened had that continued, and whether it would have continued? Nobody knows for sure.
Critically important to protect (as much as humanly possible) the only resource we possessed which could care for/treat the infected. (Like defending Field Hospitals during wartime. Without them, every wounded soldier dies).
Looking backwards (always a tricky and misleading thing to do) we might reasonably speculate that those extreme protective measures were extended far longer than a steadily increasing experience level warranted.
I would also suggest that the political need for palatable sound-bytes shaped far too much of our public policy. Very easy to say, as a for instance, that even one death is one too many — and design government action accordingly. Much more difficult to say that we’re going to see a significant increase in fatalities among the aged and unwell…and there’s not much we can do about it if we’re to keep the country vital and moving.
Generals might say that to their command. Presidents struggle saying that to the people who elect them.
Several things wrong with this article. If my original posts ever are let through, you will see what they are.
Get a life folks. You must have f**k all going on in your lives to get all het up about this.
I don’t believe we are all ‘het up’ but it was all a lie and the next ‘one’ is coming __ the next ruination of our lives perpetuated by the corrupt elite bodies like the WHO (led incidentally by someone is not even a Doctor, but merely a CCP and Bill Gates b***h)!
It will be Avian Flu, it has started, and the vaccines are already in process of being shipped around in readiness for further totalitarian lockdowns, illegal enforced vaccinations and total disruption.to life.
This is a gracious and restrained response from this lady, if indeed she has been mocked by sections of the press. She may well be right that the lethality of covid has been over estimated, but we can’t simply look at stats in a vacuum, and I’m sure she agrees on that. We’re agreed that ninety percent of fatalities took place in the seventy plus age group but ten percent of a very large number is still a large number, and threatened to overwhelm the NHS, intensive care beds, ventilators, and staff. We got lucky in that vaccines were developed so quickly, and that the first two [more lethal] varieties of covid were eclipsed by more benign varieties. An ‘abundance of caution’ is the only safe way to proceed in these circumstances. Its true that the costs of lockdown were huge, but arguably if we had locked down earlier with proper test and trace while the infection rate was low enough to make this viable, things might have worked out better. I note that her conclusion is targeted vaccination. We might have reached the same place by a different route, but here we are.
Focused protection of the vulnerable population
What does this actually mean?
It means taking measures to isolate (protect) the extremely old (vulnerable) and let the rest of the population go about its business.
As I peviously wrote in a comment that has since disappeared:
I think that if there had been a targeted lock-down of vulnerable people (i.e. the elderly and ill) then any incentive to come up with a vaccine would have been very low and these people would still be in “protective” lock-down.
You too, eh? Normally I take it with good grace, but this is really beginning to sound like certain opinions are deemed too controversial to reproduce.
I will speculate, but I think this is a result of downvoting. Many automated systems use tools (sometimes sophisticated, but often not) to determine if a post requires moderation. One such method is to identify heavily, or relatively heavily, downvoted posts. In this case, the post, and the tree of descendant posts is removed until manual moderation authorises it.
I do not know this for a fact and there may be other tools in place. However, I think the clue is whether a post is immediately pushed to pre-moderation or if it is removed. My own posts that end up in pre-moderation typically contain certain words, whereas the ones that disappear are either a result of being negative voted or a reply to one that is.
I think Unherd need to disable the negative vote system if possible. I also think people should think a bit harder about downvoting. There is a difference between a bad post and a post that one simply disagrees with.
The final possibility is that one or more people are flagging posts. If this is the case, I would like to think Unherd identifies those individuals and deals with them.
Linda, I know many young people who have been vaccinated as many as four times and had Covid at least three. Whatever the variant whatever the number of jabs each time the outcome is the same in each individual. They are rapidly coming to the conclusion that the single most important issue is not the strength of the variant or the number of jabs it is about their overall individual health status. If you got the most dangerous first variant with no vaccine and the outcome was the same as the most recent weak variant with four jabs what other conclusion can you draw?
I have young family members who got the shots and they’re sick with either Covid or some other strange thing – limb numbness, severe fatigue, vertigo, disturbed menstrual cycle – every couple of months. Husband and I remain shot and Covid-free and in fine fettle. When a pandemic is war-gamed – as this one was just three months before outbreak – there is only one obvious conclusion. That heads have not rolled for this crime against humanity is what we should now be talking about. At the top of our lungs.
The pandemic response has been, and still is, a cluster of massive crimes against humanity, most particularly avoiding ensuring that everyone has enough vitamin D to run their immune systems properly – which requires much more supplementation than the UK government advises.
In the UN definition of crimes against humanity, there is no requirement for specific intent. Much of what happened was millions of professionals doing exactly the wrong thing due to their corrupted groupthunk ineptitude: doctors, immunologists, mass medial people, vaccinologists. Tens of millions of deaths would have been largely avoided with proper vitamin D and other nutrients and full access to multiple inexpensive early treatments: https://c19early.org – without the so-called vaccines, lockdowns or masks.
See also: my article on this and the other crimes against humanity: the lab creation of SARS-CoV-2 and the suppression of debate and doctors’ independence: https://nutritionmatters.substack.com/p/the-covid-19-pandemic-response-killed .
The general health of the population in this and any other public epidemics has constantly been ignored, perhaps thinking science will safeguard people from a sloppy lifestyle. It is no accident that the deaths in the Covid-19 breakout had serious co-morbidites, a huge number of which were related to obesity. Certainly, there were some exceptions, but governments, which are mostly populated by control-freaks (why else would one want to become a politician?), such as making rules out of the exceptions. This became quite evident when the government became the one and only source of Truth in this whole affair.
Indeed, this whole idea that science will save humanity is behind the “flatten the curve” to protect the hospitals idea, since hospital capacity has constantly been reduced over the years, thinking that “science will save humanity, that with “science” we need less hospital capacity. Whatever happened to all the fever hospitals in Britain, by the way?
LH so you’ve have locked down Bojo? (Remember he needed urgent Intensive care and maybe because he’s a bit of a salad dodger). Apart from the obvious – that might have been a good outcome for us all – I think this example demonstrates the impracticality of what you are suggesting. ITUs and Hospitals weren’t full of the v elderly. They were full of likes of Bojo.
That is odd, and I am not being sarcastic, because the stats on NHS entrants and their age profile was massively skewed to the 60 plus on that dashboard they used to update every day. Over and over again it indicated that most of your admissions for Covid were comorbid elderly.
We all know you cannot use ICU on most people over 70 that’s a different point.
And as a medical professional to call Boris a salad dodger is deeply unfunny. 8% of the NHS Budget goes into treating type 2 diabetics. Chris Patton said years ago that self-harmers should be hit in the picket for taking up beds.
Not at all, the more robust younger people would have recovered with solid protection and the possibility of herd immunity arrive. A leaky vaccine has resulted in an inability to get to herd immunity.
Prevention of infection might be as simple as disinfecting mouth/nose as routine.
May I point out that ‘natural’ immunity is just as leaky as vaccine-generated immunity. People get COVID even though they have had it before, just like people get COVID even though they have been vaccinated. Herd immunity, when so few people are vulnerable that the disease can no longer spread, is unavailable in either case.
By my reckoning the old and vulnerable make up about 25% of the population – perhaps you can provide a little more detail on how this might work?
Shielding people who are vulnerable to infection, while allowing everyone else to live as normal.
How many in UK pop would you deem to have been vulnerable in early phases?
How many million?
How practical for them to all Lock down whilst others didn’t, and how enforceable? Policemen out with tape measures doing BMI measurements?
And if the ‘at risk’ then non compliant and health services overwhelmed anyway, what would you have done then?
Exactly the same proportion as are vulnerable to flu which kills 20/25 K a year except Covid killed 75 K a year. Just as in New Zealand 500 die of flu each year and now, having played catch up, 1,500 have died of Covid on an annualized basis.
Why can’t you see that the same people are vulnerable it’s a respiratory illness. Take out the co-morbid and elderly and the rest are outliers that you can not make policy over without the tail wagging the dog.
And how will this be done….?
Oh, and what universe uses a definition of IFR that goes over 100% if you keep counting? That is like saying that the death rate for influenza – or the common cold? – would go to 100%+ if you counted long enough. Surely the IFR is the number of COVID deaths divided by the number of COVID infections, not the total number of deaths (1 per person, or 100%) divided by the number of people who get COVID.
I had always thought the Dr Gupta was a knowledgable and serious person (if possibly misguided), but I find it very hard to believe that of someone who presents IFR in this manner.
You are welcome to vote me down. But could one of you please explain to me what kind of sensible definition of IFR can lead to a fatality rate of over 100%? If I have made an elementary mistake surely it should be easy to point out.
Any death rate from any disease will eventually reach 100% if taken over a long enough period of time.
That bothers me too.
I think the only way a fatality rate of more than 100% could arise is because the population is not a constant – people are constantly being born and dying so, in principle, if the calculation is done over very many years, more than the population at any one time is included in the calculation.
I think Dr Gupta was just trying to make the point that leaving the calculation open for several years means that the IFR creeps up. We don’t normally look at death rates for a particular illness (‘flu, for example) in that way – we normally focus on a single year, comparing one season with others.
“I think the only way a fatality rate of more than 100% could arise is because the population is not a constant – people are constantly being born…”
But even that does not make sense. No, this exercise is just another attempt to re-define long standing statistical methods to understate Covid.
@ Will Rolf, Peter Steven
Thanks. But I do not think there can be any sensible explanation. Googling around, I found this definition of the IFR: “The proportion of people infected with SARS-CoV-2 who die from COVID-19 “. That makes sense – it is the probability for someone who is infected with COVID to die from it. And it must be equal to the number of people who die from COVID 19 divided by the number of COVID infections in the population. So, if you die from a car accident while infected, it does not count towards the IFR. And if you die from COVID on your third infection, that gives an IFR for your individual case of 33%.
Now, there may be problems with various ways of *estimating* the IFR, but any definition that allows for over 100% has to be nonsense. If, say, you divide the number of people who die *over a period of 150 years* bythe number of people who *have ever had* toothache, you will indeed get over 100%. But clearly the number you get is nonsense and does not say anything about the dangers of getting toothache – or anything else.
I must admit I was shocked that someone who claims to be an expert on medicine can claim to be getting an IFR over 100%. It makes you very much doubt her competence, or her honesty, or both.
I’m happy to admit I don’t understand Gupta’s figures, I’m surprised so many here apparently do.
No question, her description of IFR > 100% is sloppy and seriously misleading. As she describes it “summing over several years can result in an overestimate of IFR, since the numerator (the number that die from the infection) will keep growing, while the denominator (the population size) remains static.”
The denominator, of course, cannot be ‘the population size’ unless you also assume that eventually everyone will be infected. But that logic can also be extended to deaths if we equally say everyone will eventually die. So yes, in a very crude way, it would be truthful to say that everyone will sooner or later catch Covid…and subsequently, sooner or later, die. But that’s not what IFR is intended to measure. Rather it’s (as many have already noted) fatalities as the numerator and ‘current’ infections as the denominator. It’s a timebound measure.
The key point here would also seem to be that it is a loosey-goosey kind of measure. If we say that over the last 3 years, Country X has recorded 1M infections and 1000 deaths from infection…then we might say the IFR was .1%. BUT if 700 of those deaths were in the first year…against an infection count of 200K, then the first year IFR was .35% … and the IFR for the last two years is only .04%.
The problem, of course, is that these different kill-rates prompt different medical & social policies.
And even the data itself is muddied by different counts from different sources using different constraints & measurement systems. Lots of cooks in lots of kitchens with varying agendas and hugely different skill levels.
As you say in an earlier point: “the only way to get steady improvement in safety procedures is to stop apportioning blame”. And this is true — to a point. That point being: if there is no recognition of blame, of fault, of error (and these are all slightly different things) then it becomes increasingly difficult to look at the ‘objective facts’ of the matter with any clarity or reason.
If we, as a for instance, continually insist that “knowing what we knew at the time, we made the ‘best decision possible'”… then some fundamental problems with ‘how’ we ‘knew’ anything at any time become unreachable and therefore not correctable.
I’ve also heard many say, over the last few years: better to have done something (given the horrors we were seeing in the hospital corridors of Italy) than do nothing. But that, too, is wrong if what you choose to do intensifies or extends the problem: like throwing a bucket of water on a grease fire. The intuitively ‘obvious’ solution can be one of the worst solutions if we act out of panic (and the need to demonstrate ‘leadership’). The flip side, of course, is also true: analysis paralysis is a very real thing can can produce equally dangerous and damaging outcomes.
Best to begin my removing the ego…but we have yet to figure out exactly how that might be done.
That all rather makes sense.
Just one thing: As long as we are discussing in terms of who was right and who was wrong we will never get to the point. I actually do think that “knowing what we knew at the time, we probably made the ‘best decision possible’”, but I am happy to drop that argument. It is the Barringtoners and anti-vaxxers and vitamin-D’ers who keep refighting the old battles in order to prove that they were obviously right all along. If we start out by asking what we should do next time, what parameters should guide our decision (the next pandemic will be different in many ways) and how we should get hold of that information in time, then we can get somewhere. Quite possibly we may then find out that the new and improved protocol would have meant handling COVID differently – in hindsight. I shall have no objections if that is the case – but I shall still dismiss out of hand the large group of people who shout that it is completely obvious they were right at the time, and that those who thought otherwise should be tried for crimes aganst humanity.
I can agree with that.
The problem, of course, is the very human problem — the ego problem — of believing one is right (was right!) and ignored. Inevitably this yields the nursery rhyme reaction: for want of that nail (that I TOLD PEOPLE ABOUT AT THE TIME), the shoe was lost, for want of the shoe, the horse was lost, etc.
Having spent significant time on both sides of similar debates [I told you this was the wrong thing to do but you did it anyway!!!! And now — see what’s happened!!] I completely understand the Barrington Reaction. (I sympathize with it, in fact.) And, unfortunately, I also understand the Fauci/CDC kind of argument that says: ‘Eyes Wide Open — we did the best we could…the best anyone could have done.’ I’ve said the same myself. I suspect we all have.
Pushing this a bit further….
The temptation (and honestly this begins to seem to be a very Mephistophelean temptation) to believe that one’s leadership position somehow ‘guarantees’ that one’s proposed solutions really are the optimal/best possible solutions because, after all, I AM THE LEADER…is overwhelmingly seductive. We see it everywhere.
And I think that’s exactly why — in my experience anyway — I’ve never (literally NEVER) heard any leader in any endeavor EVER say, “You know, that was a stupid decision we made..and we made it when evidence was available to us that a better solution could be had…and we consciously and deliberately ignored it.” We obviously know that has happened, time & again; it’s just never acknowledged. Hurts too much to even think about saying it.
We agree about many things, but it sounds like – deep down and indirectly put – we disagree about one thing. You seem to think that the people in charge of COVID policy should be saying “that was a stupid decision we made..and we made it when evidence was available to us that a better solution could be had…and we consciously and deliberately ignored it“. And I disagree. Anyway, the idea that the other side should – up front and before discussion can start – admit that they were wrong and culpable and the other side was right all along, makes it impossible to have a sensible discussion, let alone to try to learn anything for the next time.
If you think you know what all the right answers are (and your other posts suggest so), why not drop the blame game and the talk about ‘the Eloi’ and their ‘Appropriate Truth’ and present your strategies, together with some convincing proof that they will work? You might even convince somebody.
No…not at all…I’m saying we can’t begin any kind of reliable post-mortem by saying: ‘knowing what we knew at the time we made the best possible decisions.’
Simply put — that can’t be true. But it is, always what is said. And, unfortunately, almost always believed…and then, as per many of your post, fervently defended.
I’m not saying “the other side”…I’m saying the ‘winning side’. I’m saying whichever ‘side’ sets the policy (whatever it happens to be) is exactly the side which must be willing to acknowledge — during subsequent outcome analysis that their understanding was imperfect and their execution flawed. Without that acceptance and understanding, improvement is not possible.
This is true if we’re talking about the Pandemic, or Vietnam, or Marine operations near the Yalu River, or strategic oil reserves, or the Griswold’s family vacation.
To begin the other way (the best decision made given what we knew) is to close off entirely avenues of inquiry that may well prove critical.
If we are to — as you say (and as I agree) — ‘have a sensible discussion’ that produces productive / superior solutions, we must begin with the acknowledgement that NOTHING is perfect (we flawed human beings the furthest thing from it). This means we must begin by agreeing that the nation’s Pandemic Policy was flawed…that errors were made…and that the calculations about social impact were not inclusive enough to fully consider the costs and impacts of the ‘solutions’ pursued.
We distinctly cannot begin by insisting everything which was done was right. Equally we cannot begin by insisting that everything which was done was wrong.
We fail if we can’t get by either ego-hurdle. If we can, then yes, we might indeed convince someone (particularly those charged with public policy) there is a better way.
No. You are being tricky here. Saying that ‘nothing is perfect’ does not mean that the COVID policy we used was flawed, or that there was a significantly better alternative. That is exactly what we need to figure out. Nobody is trying to close off any avenues – we are just demanding that you provide some evidence before asking us to acknowledge that your way would have been better. And as long as you are talking about ‘solutions’ (in inverted commas), and the Appropriate Truth and “… we made it when evidence was available to us that a better solution could be had…and we consciously and deliberately ignored it“, you are not past the ego-hurdle yourself.
How about beginning by saying (just for the argument) that both sides were acting in good faith in an urgent situation with not enough information? Then present what you think should have been done differently, with detail and evidence on how it would have worked, and what the consequencs would have been – and we can weigh the alternatives. Once you have convinced people on that, move on to what information is needed to decide for that course of action, which will give us a blueprint for how to decide next time, and what we should have done with hindsight. And only then we can start looking at whether people should have known enough to opt for your solution already at the time, and why they did not do it.
It is amazing how the Barringtoners keep insisting on having been right, right from the start even though (as Dr Guptra partly admits) there were not enough data then and everybody were giving guestimates. She says herself that giving average IFR values made no sense (it was just the only thing possible with the first limited data), so why bother fighting to prove that her own IFR guesses were the right ones? How about dropping the fight to be proved right, and concentrating on a general approach to dealing with new unknown pathogens? As the airline industry knows, the only way to get steady improvement in safety procedures is to stop apportioning blame.
As for ‘Focused protection of the vulnerable population, followed by targeted vaccination,’ there is still no reason to think it would have actually worked. One commenter here quoted Swedish data saying that old people living in care homes or alone were *more* hit by COVID, because they had to see health personnel, and there was an epidemic among health personnel. The idea of effectively isolating those people in the middle of a raging pandemic – that no one is trying to limit – with not enough tests, not enough PPE, and asymptomatic transmission, would seem to be no better than a pious hope.
Finally, if there are new and important data out of Denmark, could Dr. Gupta link to an official source, rather than to a partisan Twitter thread?
Who’s paying you RF?
Whenever I peer round the departure area at Stansted Airport, my first thought is ” Covid was not nearly lethal enough”…..
I also think that if there had been a targeted lock down of vulnerable people (i.e. the elderly and ill) then any incentive to come up with a vaccine would have been very low and these people would still be in “protective” lock-down.
Lockdowns caused huge government overreach. People lost jobs or were made to take an experimental injection. Fines were doled out, people died alone, and the economy is still suffering. Being wrong is one thing; insisting that, despite facts to the contrary, ‘the established science’ is infallible and nay-sayers must be punished is quite another.
Surely, even you can see that is wrong?
Another example of someone who doesn’t appear in the data is my youngest son. He spent his last two years of high school in lockdown, learning at the dining table. With his innate grasp of maths and his high university enrollment score, he entered a top course. The university, seeing the financial benefits of offering first year courses online, never became for him what it was for me and my other children. After only one year he quit, never having met a human and never learning much of anything. Half a year later he is still floundering.
Rasmus, I’ve heard this kind of fallacious response to focused protection so often that it’s become tiresome. You say focused protection would have been very difficult to successfully implement amid asymptomatic transmission and few tests etc… so tell me, how is locking down *the entire population* any “easier” to implement? And if there continues to be asymptomatic transmission even in a lockdown context, surely care home workers are still susceptible to asymptomatically contracting and passing the virus on to care home residents?
You also fail to address the point that in judging alternative policies, we should be assessing the comparative net human benefit of each policy. I suspect you’re one of the many people who fails to take the indirect humanitarian devastation wrought by lockdowns on the very poorest in the poorest nations into account in a comparative cost-benefit analysis. The UN estimated that upward of 70 million additional people were pushed back into absolute poverty by the pandemic policy responses; millions of children pushed into malnutrition territory; millions of children in the poorest nations who missed out on basic vaccinations they would otherwise have received. This is a *tens of millions of deaths* accounting on the lockdown ledger that never seems to be registered by supporters of lockdown/reflexive critics of focused protection.
Focused protection posed practical challenges, yes. But had we marshalled the national energies, resources and efforts of our public officials and health apparatuses to this challenge instead of demonising it out of the blocks; and applied some creative thinking; we could well have overcome those challenges and achieved robust focused protection. Protection which, by focusing on the most vulnerable, would deliver far more protective bang for the public buck than this monstrous, blunt, draconian, scientifically unprecedented cycles of national lockdowns approach – an approach which never had a viable exit strategy, and whose record in actually saving lives in the long run is dubious at best, while the humanitarian, economic and political damage it has precipitated is vast and undeniable.
You are quite right on the principle that all policies should be evaluated with both costs and benefits – and this is not easy. I do not claim to know what the final balance sheet will be, maybe we will never know for sure. I will say that your numbers for ‘tens of millions of lockdown deaths’ are
pure tendentious guesswork extremely uncertain and lacking in solid evidential backing; they might be true, but so might a lot of very different numbers. But I will say that you cannot honestly advocate for a policy of ‘focused protection’ unless there is evidence that it might actually work. Claiming that we could have made it work with “the national energies, resources and efforts of our public officials and health apparatuses” and “some creative thinking” is not just speculation. It is wishful thinking.
The original choice was between trying to minimise human contact across the board (thorough lockdown) to keep everybody from getting the virus. With less virus about it would be easier to avoid getting it, and at worst it would delay infections, ‘flatten the curve’ as they say, giving time to get medical procedures and vaccines, and keeping the hospitals from being overwhelmed. And the Barrington alternative: Do *nothing* to reduce transmission, let the virus run riot till we got to herd immunity, and keep the vulnerable in a protected bubble in the meantime. And even apart from the problem of overwhelming the hospitals, I just cannot see how that could be made to work. First, where do you make the cut-off? if you protect the over-80’s, the 70-year-olds will still get quite a lot of deaths, as will the diabetics and other people with health conditions. How many millions will those bubbles hold? Second, vulnerable people need carers. Do you prevent not only the vulnerable but also their carers from seeing their family or everyone else for months an years on end, to protect the bubble? Realistically the bubbles will be leaky, and when *everyone* outside them gets sick, the bubbles will not hold.
If you think that lockdowns are unacceptable, on principle or because of the damage they cause outweigh the benefits, that is actually a perfectly defensible position. But the honest way of putting it is to say ‘we cannot stop the pandemic – it will run, and the vulnerable will die, and it cannot be helped because the alternatives are worse‘. Not ‘we will pretend to protect you, even though we have no reason to think it will help‘.
For once I agree with you on covid or rather your last few sentences.
Just quick look at ONS data shows who was vulnerable to covid and who was not.
Advocates of lockdowns should explain why people in food production, distribution and retail were somehow not immune to covid?
If it was safe for them to work why not for others?
You are surely aware of Australian documents from January 2021, presenting true picture of so called vaccine trials.
Vaccines were fraud perpetrated by medical profession and pushed onto population by government and MSM.
What about excess deaths after supposed success of vaccination campaign?
Surely they are either due to vaccines or lack of medical care during lockdowns.
And many of those dead were much younger than 80 plus old obese, diabetic with multiple comorbidities, who constitute 92% of so called victims of covid.
I gather that the Barringtoners are insisting that they had a right to be heard and not discredited by the authorities and their MSM lackeys. The quick take down of these incredibly well regarded experts served as notice to anyone else daring to offer alternative viewpoints.
Winner winner, chicken dinner!
Also, from the viewpoint of the ‘disease burden’ on society, it is not the IFR that matters, but rather the CFR (case fatality rate). Asymptomatics do not get hospitalized, they do not miss work, and they do not die. This focus on IFR is simply silly outside of academic questions related to transmissibility.
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