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May 13, 2020 - 12:45pm
Dr Natalie Dean, Assistant Professor of Biostatistics at University of Florida, has been one of the most prominent voices in the US media arguing in favour of continued lockdowns. She co-authored a piece in The New York Times which argued that a ‘herd immunity’ strategy would cost millions of lives. Freddie Sayers challenges her on how she can be so sure…
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SubscribeAll fell apart when asked about Sweden. She completely denied the truth of what has happened and put it down to some kind of randomness. I was interested till then. Any exposure to reality realised a negative response.
Welcome to Science, American Style!
I feel desperate to understand the perceived benefit of keeping the transmission rates low, presumably without regard to the ability of the health care system to manage the cases. I did not hear any mention of how low is low enough or why it’s even a primary focus when the ‘severity’ of the virus is more than manageable. If we are ultimately all going to be infected (and likely recover without issues) why do we insist on suppression of this magnitude? How is it helpful, given the collateral damage that ensues?
I wish the Swedish model or approach had been addressed more fully and I would think the interviewee who reminds us she is a scientist would address more fully and objectively the Swedish approach. That is, that in the long-term (short of a miraculous treatment or vaccine) the argument from Giesecke is that those who have locked down will see relatively higher numbers of “excess deaths” relative to Sweden. Why does she dismiss the Swedish model in fashion similar to Neil Ferguson instead of addressing it more objectively.
Previously Fauci said hydroxychlorquine not only cures corona virus (must be administered early) and even acts as a preventative. Now he is saying not to use it. Also he is on video saying masks are not good (reduce fresh air etc.), now he says not to use them. https://www.abc.net.au/news…
Australia to trial HCQ
https://jamesfetzer.org/202…
Lost in these discussions are the places that have succeeded in flattening the curve without much of a lock-down. I live in British Columbia, Canada and our first reported case was in late January. We closed schools and large gatherings in March, but shops, transit, take-out, beaches, parks, etc. all remained open. Indoors we have been zealous social distancers, but outdoors you wouldn’t notice much difference. We did close the border to non-essential travel. Small shops are asking customers to wear makes and have capacity limits. They cancelled elective surgeries to free up hospital beds, but are resuming those next week. Compared to what other countries appear to be going through it is very relaxed. We have had 132 deaths in a population of over 5 million, granted we have a large land mass, but the population density in Vancouver is similar to most European cites. Like other places the deaths are concentrated in nursing homes with a median age of death of 87. It is very possible that we just got lucky. We are not South Korea or Taiwan in terms of our testing and contract tracing, but are seeing similar results. While severe lock-downs might be necessary in some places, I believe our experience demonstrates they may not be necessary everywhere.
A few comments regarding the claims about Sweden:
1) The delay in the ICU admission data is, for most cases, at most a couple of days, and there has been a steady downgoing trend for a month now. For data, see https://www.svt.se/datajour… It would be interesting to know how long Dr. Dean thinks that a lockdown has to last in order to ensure that the “hidden momentum” (as I interpret her answer) is gone. For the number of cases, there isn’t much lag at all, maximum of 2-3 days as well, and a fraction of the new cases are because of extended testing of health care workers. The number of cases tested under the old testing criterion is going down as well. For the death toll, most of the cases are reported within ten days, but looking at the cases for more than ten days back shows a clear decay in daily deaths as well.
2) While it is true that the death toll in Sweden is higher than its neighbors, the choice of not having a lockdown may not be the explanation for that. The following report, drawing conclusions from data instead of models with questionable parameter choices, illustrates that: https://www.benjaminborn.de…
3) The state of Georgia has approximately the same population as Sweden. When I looked at the data a couple of days ago, Sweden’s death toll was 3200, while for Georgia, it was 1500. But when only considering people under 70, 500 have passed away in Georgia compared to 400 in Sweden. While there could be several explanations for this, I think it is still an interesting observation since lockdown mostly affects people at working age, losing their income and students, not getting a proper education.
@Gu@unherdlimited-c93d9bdb100328f21884159bd43c20ab:disqus ICU admissions in Sweden appear to be down because fewer incoming covid patients are admitted to ICUs. Deaths per ICU session are also steadily rising. My guess is they’ve stopped intubating as many people, as is trending around the world.
https://github.com/adamaltm…
What should perhaps also have been fully disclosed by Assistant Professor Dean in this interview is that her research in recent years has apparently been funded by organizations who seem to be supporting a more prolonged lockdown strategy (including the WHO–which has received 14 percent of its funding in recent years from the Gates Foundation, whose stock portfolio includes for-profit Big Pharma stock–that apparently failed in late 2019 to prevent spread of COVID-19 to Europe and North America). According to Assistant Professor Dean’s internet posted CV: “FUNDED RESEARCH GRANTS & CONTRACTS
Principal Investigator Role
“Design and Analysis of Vaccine Trials for Emerging Infectious Disease Threats,” PI Dean,
Agency NIH/NIAID, Type R01, Period of funding 08/2018″“07/2023, Amount $3.57 million
“Vaccine Clinical Evaluation in Public Health Emergencies,” PI Dean, Agency WHO, Type
Contract, Period 07/2017″“09/2017
“Dengue Vaccine Seroprevalence Surveys,” PI Dean, Agency WHO, Type Contract, Period
08/2016″“01/2017″
So an argument perhaps could be made that she might have a vested personal economic interest in interpreting results of her research in a way that supports the political agenda of the Gates Foundation–that funds in a big way the WHO which apparently awarded her the contract for a “Vaccine Clinical Evaluation in Public Health Emergencies” July 2017 to September 2017 research study?
I believe in science, but I do not trust scientists.
They are people. Sometimes they are mistaken, sometimes dishonest, and very often biased.
“The government follows scientific advice.”
Which one?
If advice is contradictory, and evidence is scarce- follow common sense.
No one should die because there are no beds in hospitals.
Otherwise, we cannot sit locked and wait for a vaccine (perhaps it will never come) or medicine.
Dr. Dean would never prescribe a medication or treatment that was not proven to be efficacious or safe, yet she completely ignores the toxicity, morbidity and mortality risks of mass prolonged lockdown, this is the heart of the issue. The “middle ground” was entirely excluded as an option by “WHO” client states and had it not been for the conviction of doubt maintained by Sweden we would never have been able to do in situ mass clinical trials to determine the efficaciousness and safety of mass lockdowns. Dr. Dean violated her Hippocratic oath.
As I have earlier commented, SARS-CoV-2 is a WEAK pathogen in comparison to flu and other endemic viruses, by any measure one might choose. One characterizes the biology based upon the response of the bulk of the population that is ordinarily healthy — NOT based upon a limited minority susceptible to ARDS due to poor health.
This cannot be, and is not being, emphasized enough.
People should consider and compare the Spanish flu, a much more virulent pandemic, which was merely in the background as the US participated in finishing WWI. Basic human host defenses have not changed significantly since. The basic premise that this pandemic justifies any measures nearly as extraordinary as mandated lockdowns is fallacious.
The opportunity for those in industries like Dean’s is great, and the needless suffering of the rest of us including those who produce real wealth (i.e. goods and services that voluntary buyers pay for in a marketplace) will be enormous.
The problem is that people like Dean act in the interest of their livelihoods through the force of government only — they produce nothing for any marketplace, which is the ultimate test of a product. There are far too many of these livelihoods in a rich society. And they are helping to make these societies poorer very effectively and quickly now.
Also Fauci said they could experiment on viruses when it was banned in USA and funded experiments in Wuhan China.
Shhhh…we’re not supposed to know about NIH starting the plague!
How can you trust an expert when she states at 2:15, ‘this disease has very severe outcomes’! In what percent of the infected is this true?
I’d love a direct reply to this question: Is she really the best you could come up with? I’m working on a long piece arguing that the lockdowns are not medically necessary, and I want to make sure that I’ve considered the best arguments in their favour.
Dr. Dean was very useful as a catalogue of the basic logical fallacies most popularly circulated, but she had no serious argument in favour of lockdowns. Do you know of anyone better? Please feel free to email me, if you can see my address via my login name.
Benjamin Turner MD, FRCSC
Canada
So i kind of agree with some of what she said but more than happy to be shown wrong. If death rate 0.3 percent and you need 80 percent of population to get infected for herd immunity that means in australia where im from we have population of 26 million so say 20 million get infected isnt 0.3 about 60000 deaths? That is an awful lot. Now i dont agree with lockdown either but what do we do?
Changing the values makes a huge difference. If the fatality rate is more like 0.1 percent then suddenly for Australia you get around 20 000 deaths, even with 80 percent infected – raising the annual number of deaths by around 12 percent.
The 80 percent is also under question, with some calculating as low as between 7 and 17 percent. If it is 17 percent, for Australia that would mean only 4420 deaths, raising annual deaths by only 2 percent.
Unfortunately we don’t know what the values will be … if you take the view that lock down only delays the inevitable (whatever the values), then lock down makes sense only when you need to protect the health care system from being overwhelmed.
About 0.8% of the world’s population die every year. So in Australia 208,000 expected to die every year. The virus would bring about 3-4 months of increased mortality for that year, presumably most of those individuals would have died in the next few years. It is a lot of mortality. vs a lot of economic and social havoc. difficult choices.
No society can do anything but slow spread of this pathogen at enormous cost (lockdowns). Gov’t doing little to nothing is optimum, and let individuals make their own decisions about isolation.
Let people mingle. Open schools. Virulence of SARS-2 is low (compared to flu), except in the older with comorbidities predisposing to endothelial injury and death (apoptosis) in microvasculature (in lung), with secondary microthrombosis (tiny blood clots).
Help elderly to self-isolate as much as possible. Get serum 25-hydroxy vit D levels up to 30 or 40 ng/mL (everyone). Consider existing cheap interventions that target the biology, such as L-glutathione in cases of pneumonia as early as possible.
These measures are not under control of governments (except to hinder), but of individuals.
I have been infected now twice by SARS-2 (age 61 1/2). The 1st time was respiratory — mild throat symptoms for less than a day and mild dry cough for 10 days. Nothing else. It was trivial, although I did not recognize symptoms as CoVID-19 at the time and thought a respiratory bug (e.g. flu) was merely trying, unsuccessfully, to get going.
I am just now almost 100% recovered from a gut infection (from meat, likely, due to big production facility outbreaks in US). I tested NEGATIVE by throat swab. I have had no respiratory symptoms whatsoever.
I have a severe form of CVID, and cannot make antibodies to any viruses (protein antigens) or bacteria (carbohydrate antigens). Would have developed T-cell / cell-mediated tissue-specific (cognate antigenic) immunity with each infection. Good to go from now on, likely.
This virus is not a lethal threat to the healthy at any age.
We must rely upon, and shepherd, our God-given (evolved) host defenses (one of which I do not even have). That is it.
Dr. Dean states (6min 25sec) that her expert estimate on the number of infected Americans thus far is 15 Million. The latest confirmed deaths due to COVID-19 in the U.S.A. are 88,199. That means the mortality rate is .58%. I am not sure whether that mortality rate warrants the extreme lockdown procedures. Perhaps there needs to be more debate?
It was great that Dr. Dean was able to explain country/state differences – “Timing & Luck”. Now we know!
Dean’s opening gambit: “what we know is …”
1. “really fast-spreading”: Oh really? What is the “serial interval”? All estimates appear much higher than that for flu. That means it spreads more slowly.
2. “really severe outcomes”: Oh? Would severity be quantified by IFR? If so, that for CoVID-19 is not obviously much higher overall than that for an average seasonal flu. And for all but the very aged it is much lower.
3. “responsible”: I live in Massachusetts. It is a waste of money to contact-trace late into a pandemic that has no possibility of containment (R0 = 0). Death rates are MUCH higher in Mass. than in Florida, and average age at death is 82. Almost all deaths have been in elderly, five times less in age group 70…79 than 80+, four times less in age group 60…69 (my age group) than 70…79, etc.
This is nothing but a grab but MA politicians for federal money — I know whereof I speak.
For a data statistician, Dean does not cite or use any quantification of anything. Merely subjective, unquantifiable statements.
One optimistic hypothesis that I have yet to see proposed is that SARS-CoV-2 may not generate a humoral (i.e. B-cell) response in substantially all people. If so, serological studies may underestimate the total herd resistance in a society or population.
German virologist Hendrik Streeck mentioned a larger known antigen-tested implied fraction than resulting antibody-tested fraction from his test-cohort/population, but I should read the paper to better understand this anomaly.
To me, a virus that produces no symptoms while replicating in tissues for days (e.g. throat for SARS-2) is unusual from the immunological point of view. Antibodies recruit leukocytes to an antigen — this is part of the inflammatory response which also produces symptoms. Many days of replication in cells without symptoms suggests an unusually weak antigenic humoral stimulation. The limited study of other CoVs is consistent with this suggestion or hypothesis.
But even if true, the evolving data confirms that SARS-2 spreads slowly (not fast, as Dean states — she must not pay any attention to numbers and not understand basic epidemiology at all) compared to flu and other common non-respiratory viruses (e.g. norovirus). This is unfortunate, really, and could imply that saturated herd resistance may not generate herd “immunity” by the normal measures.
Relative to other respiratory viruses the key feature of the novel virus seems to be that innate immunity plays a relatively larger role, and adaptive immunity a smaller one. It is that simple. This explains the stark difference in children between flu and SARS-2.
People need to wrap their heads around this basic fact. It means you, as an individual, are largely on your own wrt this virus. Lockdowns can only extend the time for an individual to prepare to be infected.
Dean uses a false comparative argument about “letting things go”. This is deceptive, if not fraudulent.
If anything there is wildly hyperbolic fear in the society already. Individuals will voluntarily keep transmission down, and the incremental effect of publicly-enforced lockdowns is already minimal at best, and probably significantly counterproductive on a net basis. That is because the public lockdown policies defeat the appropriate stratification of risk vs. isolation that individual choice would optimize, and reduces mingling amongst most of the population for which infection results in milder symptoms than flu, slowing buildup of adaptive (both humoral and cell-mediated) immunity.
Letting things go, as Dean puts it, would probably save lives lost to CoVID-19 and would definitely prolong life in cancer, CVD, and other chronic tissue-specific common degenerative conditions for which standard medical services are now restricted and/or being avoided by patients afraid of being infected by SARS-2. And fear of exposure is most appropriate for this minority of the population with comorbidities.
Increased deaths due to economic hardship and secondary depression, drug use, and so forth will be on the same order of magnitude as from CoVID-19, and likely more, if lockdowns continue to be overextended and used for any other purpose but to avoid hospital overload.
Wise public policy would be to open things up full-throttle in almost all of the US (with selected exceptions only in a few urban areas not significantly past peak or yet without appropriate buttressing of local pneumonia-specific hospital resources), and have a plan to throttle back only in cases of significantly underestimated velocity of new cases and hospitalizations. Dean’s opposite approach is the “irresponsible” one.
In the USA most of the tax revenue goes to the federal gov’t and then it is redistributed back to the states. This is a huge problem, but nevertheless the status quo. That results in enormous political ambition, especially by the most poorly run states, to grab for federal funds. Those in UK not intimately familiar with US politics likely cannot adequately appreciate this overriding factor. People in “industries” like Dean’s (academia, which manufactures untestable ideas) are mostly funded by the taxpayer, and the only other significant source of funding is the drug industry but it is much more demanding of a tangible RoI.
An estimate of five times as many deaths with release of lockdowns is absurd — the data indicate a ratio of more like one. Deaths will be pushed a bit sooner without lockdowns, but totals would be the same over a year, let’s say.
Dean merely betrays her conflict of interest or her incompetence (I suspect a combination of both) by suggesting a resulting differential of a factor of five. And she mentions absolutely nothing about the molecular biology or immunology specific to the novel virus.
Self-acclaimed “experts” are always nothing but “key opinion” makers (those most well known, such as Fauci, can be called key opinion “leaders”, but they merely market untested ideas for interest groups including government). These experts ALWAYS know NOT what they are talking about. They either try to sway public opinion about issues that are not yet well understood by anyone (as in this case) or propagandize to sway public opinion toward a misunderstanding or falsehood to benefit an interest group.
P.S. In addition to the growing herd resistance from the adaptive immune system, there is another negative feedback from the innate immune system that grows with thinning of the herd. This will, in the fullness of time once a lookback upon accumulated data can be thoroughly analyzed, be a bigger factor for SARS-CoV-2 than for other novel viruses because of its molecular charateristics. Innate immunity clearly plays an outsize role for this virus. Interventions such as L-glutathione and IV vit C might prove very effective but may be suppressed by powerful interests. Vaccines are not likely to be as effective as for other viruses, and antivirals are unselective and just do not work very well in general.
This Italian politician wants Bill Gates in jail.
https://youtu.be/QnsYcsCjLWI
This interview really misses a ton of elephants in the room:
FL is suburban sprawl. Our public transport is terrible and almost everyone has a car. It’s just not going to spread nearly as quickly in FL as it will in the UK, Europe, or NYC. Ferguson’s model for the U.S. was wildly pessimistic for this reason, though his projections for the UK look optimistic (given the social distancing measures adopted).
The lockdowns themselves don’t appear to be the main driver of the economic damage. Sweden’s economy is not exactly doing great. Sure it’s better than more-locked-down countries, but in theory successful contact tracing should restore people’s confidence much more quickly than a herd immunity strategy. I’m watching data out of New Zealand to see how quickly it recovers.
Reading the contact tracing studies, some infected people just seem to be a lot more contagious than others. There’s lots of randomness here, which is why household transmission rates are so low. This makes the disease more likely spread in large crowds, and less likely to spread from personal one-on-one contacts. It also means some areas have just gotten lucky, without super-spreading events.
Most importantly, you don’t need to be anti-lockdown to realize they’re way over-done for most of the U.S.! We aren’t Italy or Spain. Our country is far more spread out. Mass gatherings are probably going to be a very bad idea for a while, but that doesn’t mean people can’t participate in many smaller (outdoor) economic and social activities. People can be safely going to beaches, hiking, etc.
This lady is cringeworthy — a good example of the collapse of the so-called “expert” class. She cannot quite manage to conceal her dark hope that Sweden will be judged a failure. A true scientist would be fascinated by the contrast offered between the Swedish way and everybody else’s. Why are all these smug liberals so eager to lock everybody up and throw away the key? It’s like a scary story for children.
Thanks for one more brilliant interview. The experts being interwied have a high knowledge standard.
The problem as i see it is the challenge to mix medical thruts, with economical realities. We need smart polticians for that. The scientist can make scientific knowledge, but not predict the consequences of a evonomic/financial recession or depression which also i a very dangerous situation with increased risk for conflicts, poverty and financial collapses. We can see now that is Trump in US distancing from dr Fauci and now focus on the economy.
This strong split beteeen medicine and economy is also very dangerous in my mind.
We need a balance between science and economic realities and in my opinion we need good political leaders to do that.
The politicization of science is now complete in the U.S. How can we choose a balance point when even Joe Biden, a candidate for President, said he chooses truth over facts? That’s just the short form of tell a lie long enough and loud enough and everyone will believe it to be the truth. We’ve moved from liberty to statism in every facet of life in the U.S.