My Current Location: Eswatini (formerly Swaziland)

Do the Numbers Justify Locking Down the World

Teaser: This was in April. Fast forward six months and the song remains the same

 ABSTRACT

COVID-19 has brought the world to a standstill. Governments have put their populations under house arrest and the global economy has been shut down. But is this justified by the numbers? Are the numbers of confirmed cases and the death rate any worse than the average global flu figures that have never prompted this level of panic? Evidence shows that COVID-19 can severely affect the elderly and immune compromised, but the risks to the vast majority of the population, so far has been minimal. The economic, social and political consequences of this crisis on the world’s population may be far greater than the health risks of COVID-19.

 WE HAVE HAD EPIDEMICS BEFORE

The most devastating flu epidemic in modern history was in the aftermath of the First World War, when the 1918 “Spanish Flu” killed in excess of 50 million people, including healthy children young adults and the working population. In 1957-8 an Asian avian flu pandemic (H2N2) killed an estimated 1.1 million worldwide and 116,000 in the USA. According to figures from the Centre for Disease Control (CDC), in 1968, the Hong Kong influenza (H3N2) pandemic killed 1 million worldwide and about 100,000 in the USA. As with most annual flus, the elderly and the immune compromised were the hardest hit.

In 1976 H1N1, the “swine flu” prompted a mass vaccination program of 45 million Americans with devastating consequences, despite no swine flu epidemic materialising. A direct causal relationship between the vaccine and Guillain-Barré syndrome (GBS), a debilitating autoimmune nervous-system reaction meant that during that year, the rate of GBS in Ohio was 13.3 per 1,000,000 in vaccine recipients, compared to 2.6 per 1,000,000 in non-recipients. More recently, an increased risk for GBS has occurred in patients during the six weeks following the administration of flu vaccines in the 1992–1993 and 1993–1994 flu seasons.1

Fear of another outbreak of (H1N1) occurred in 2009, is reported to have cost 284,000 lives and also triggered widespread vaccination.2

The coronaviruses, a ubiquitous species of viruses responsible for infections like the common cold, have also been responsible for recent outbreaks of global concern. SARS-COV-1 (Severe Acute Respiratory Syndrome) caused sporadic outbreaks between 2002-2004. According to the WHO, SARS-1 originated in China, affected 26 countries, and during the worst outbreak in 2003, resulted in more than 8000 cases and approximately 800 deaths. MERS (Middle East Respiratory Syndrome), hit the headlines in 2012 produced a death rate of 34% but all 2,519 cases and 866 deaths were limited to the Middle East.

In this context SARS-COV-2 the pathogen responsible for COVID-19 is a novel corona that, virologists say has never been seen before. It shares some common features with SARS-1 and MERS and was first identified in December 2019 in Wuhan, China. As of 15th April 2020, four months later, the total number of confirmed cases is almost 2 million with 127,000 deaths across 185 countries.

PANDEMIC ANNOUNCED – THE WORLD PRESSES THE PAUSE BUTTON

The media reported the first deaths in a spreading epidemic in China but when the WHO classified COVID-19 as a pandemic on March 11th, the immediate response from media across the world can only be described as frenzied hysteria. Months later this has not abated. COVID-19 continues to dominate all mainstream media on a 24/7 news cycle. Predictions have been apocalyptic with fears that tens of millions will die. Comparisons have been made with the Spanish flu of 1918 and in the face of this media hysteria, a siege mentality has been quickly adopted with panic buying, food hoarding and in the US, a sharp increase in gun sales. Populations looked to their governments for action.

On the advice of computer modelling teams, most notably Neil Ferguson’s team at Imperial College London, shocking predictions were made of the coming death rate. 500,000 deaths in the UK alone were predicted.3 All eyes were on China since the virus is thought to have originated in Wuhan, a city of 11 million people. South Korea, Taiwan and then Japan were affected and cases began to emerge in Europe. China put Wuhan under severe lockdown to try to prevent the spread of infections. Citizens were forced to stay in their homes and all non-essential businesses were closed, but the virus had already spread. In the face of huge numbers of predicted deaths, countries in Europe followed suit and imposed their own lockdowns, shut down their economies and effectively put their citizens under house arrest. A domino effect meant that within days, countries across the world had locked down.

Three out of four Americans are in semi-lockdown, some states imposing ‘shelter in place’ rules, and most countries in Europe are now in almost total lockdown. Even in Africa, where very few cases have been seen so far, lockdown and curfews have been imposed, leading to extraordinary scenes, including police beatings and deaths. South Africa, with 2,415 cases (April 15) out of a population of 48 million has enacted one of the strictest lockdowns in the world. The Health Minister stated he thought 60% of the country could become infected. So far, there have been 27 deaths in the country and 2 deaths from police violence. Kenya has approximately 216 cases with 9 deaths, and 2 people killed by police in relation to curfews. Uganda is in total lockdown with others in the process of locking down.

Manufacturing, service industries, sports and leisure and non-essential retail outlets have been closed. Entire populations have been told to stay in their homes. In most European countries the rule are stringent: you can’t walk alone on a beach, or in a park, you can only leave home to get food or medicine and you must practice social distancing, maintaining a 2m distance between yourself and the closest other person, at all times.

For many people living wage packet to wage packet their income has vanished overnight. For some parts of the world like India and countries in Africa, the huge swathes of the population who live day-to-day, hand to mouth will quickly be rendered destitute.

This response to COVID-19 is unprecedented even in wartime. The consequences are unpredictable, but by all measures currently available, they will be economically devastating, individually, nationally and globally. Many countries, including both the US and the UK have already passed Corona virus Bills containing the most restrictive laws seen in peacetime, and removing basic freedoms and civil rights overnight.4 Ghana just introduced a new law – the “Imposition of Restrictions Act” which gives the government unlimited powers for an indefinite time to impose violations of fundamental rights and freedoms, even though an existing law: The Emergency Powers Act 1994, is already in place to deal with such emergencies.5 Has the declaration of a global pandemic encouraged governments to abuse democratic rights in the name of containing the crisis?

WHAT ABOUT THOSE NUMBERS

While the global population is still anxiously trying to adjust to a world that has turned upside down, where even in the richest countries citizens are scrambling to meet their basic needs, scientists are already starting to speak out about the folly of global lockdown. The world’s most eminent epidemiologists are mystified at what they are calling a dangerous over reaction.6 They argue that there are so far no more excess deaths than would be expected at this point in the year. For example, in the flu season of 2014-15 in England and Wales alone, there were 28,300 flu related deaths, with hardly a whisper in the press. Dr Tom Jefferson of Oxford University, member of the Cochrane Collaboration and a world expert on flu related disease said in his blog in the British Medical Journal, “There does not seem to be anything special about this particular epidemic of influenza-like illness”.7

Economists like Toby Rogers PhD are warning that the number of Deaths from Despair: those deaths caused by economic collapse and the subsequent sharp rise in unemployment, where whole segments of society are plunged into poverty, civil unrest, increased mental health issues including suicide, and so on, caused by the lockdown, will far exceed anything wrought by COVID-19.8 On 28th March, the German Finance Minister committed suicide, apparently “deeply worried” about the economic fallout.9

Statistics have a history of being used to justify government actions and medical policy. Annual flu statistics are routinely used to justify the need for the flu vaccine, even though the vaccine’s efficacy varies widely every year, and has in some years been as low as 10-30%.10 It is not easy to know whether the mortality rates attributed to the flu were flu-related deaths of people with pre-existing conditions. Similarly with COVID-19, if we take the emotion out of the equation and confine ourselves simply to the numbers, it is not clear how many of the reported deaths were of people who would have died at some time this year anyway, given the fact that the vast majority of those admitted to critical care are the elderly and immune compromised.

Already, we are seeing serious consequences on the medical frontline, with a lack of resources and facilities for patients. Because of the focus on stopping the spread of infection, elders are being told to self-isolate at home sometimes with dire consequences. In the UK ambulances have been given instructions not to attend if those elders become critical. The very old are being pressured to sign Do Not Resuscitate notices.11 It is catastrophic for those individuals and their families deprived of medical help when the policy in place is based on computer modelling that does not seem to be borne out by the facts on the ground.

Is such a draconian response justified in established democracies like Europe, the UK and the US? Where are the increased numbers of mortalities compared with annual flu figures? Was the problem with overwhelmed ICU units the result of prior cost savings and closures? Even those advocating a lockdown and making the case that millions could be infected, admit that the vast majority would be asymptomatic or have only mild symptoms, so one has to ask, where is the risk?12

THE MAN WHO STOPPED THE WORLD

One of the most vocal advocates for total lockdown, and the man with responsibility for computer modelling the declared pandemic figures, has been Neil Ferguson of Imperial College, London. As an epidemiologist working in this field for years, his modelling has been used to inform and shape government policy, and has profoundly impacted the global response to COVID-19. Experts have started to question the assumptions he has made in the modelling. Are they a realistic prediction of the situation or are they a worst-case scenario based on the “Spanish Flu? And is a comparison with “Spanish Flu” valid?

Initially Ferguson and his team predicted up to 500K deaths in the UK alone, revised down to 250K deaths if lockdown was imposed. The UK government somewhat reluctantly followed his advice. After having his assumptions challenged by another computer modelling group from Oxford University, Ferguson revised his estimate down again to approximately 20K deaths, 8,300 less deaths than the 2014-15 flu epidemic, but by then the country was already into day two of the lockdown.13

Quoting Ferguson and his Imperial College report in a Reuters article on March 17th, Kate Kellend writes:

Comparing the potential impact of the COVID-19 disease epidemic with the devastating flu outbreak of 1918, Ferguson’s team said that with no mitigating measures at all, the outbreak could have caused more than half a million deaths in Britain and 2.2 million in the United States.

Even with the government’s previous plan to control the outbreak - which involved home isolation of suspect cases but did not include restrictions on wider society - could have resulted in 250,000 people dying “and health systems ... being overwhelmed many times over,” the study said.14

The report suggested two strategic choices to limit the spread of the disease:

1. Suppression (variations of total lockdown) and 2. Mitigation (use of various avoidance strategies, drugs and in the future a vaccine). Based on Ferguson’s worst-case scenarios, the UK government chose to try to suppress the virus’s spread, with apparently no exit strategy until a vaccine becomes available. According to health experts like Dr Anthony Fauci of the National Institute of Allergies and Infectious Disease (NIAID) and currently the US government spokesperson for the crisis, a vaccine could be ready in 18 months. Many of the scientists involved in the attempt to create vaccines for other corona viruses like SARS-1 warn it could take many years and even then, there is no guarantee an effective vaccine would be found. They specifically warn against any rushed, short cut approach that risks devastating consequences.

THE NUMBERS FROM ANOTHER VIEW

An article in the British journal, The Spectator, How deadly is the coronavirus? It's still far from clear: There is room for different interpretations of the data: 28 Mar 2020, took a different look at the numbers.15 The author, Dr John Lee, a retired pathologist, made the case that to evaluate how lethal a disease is, we need to look at the death rates. He writes: “Statistically, we would expect about 51,000 to die in Britain this month. At the time of writing, 422 deaths are linked to COVID-19 – so 0.8% of that expected total. On a global basis, we’d expect 14 million to die over the first three months of the year. The world’s 18,944 coronavirus deaths represent 0.14% of that total. These figures might shoot up but they are, right now, lower than other infectious diseases that we live with (such as flu). Not figures that would, in and of themselves, cause drastic global reactions.”

The author concludes that the data doesn’t support comparison with the 1918 flu epidemic and that so far, the number of deaths ascribed to COVID-19 is no different than the normal in an average flu season. According to the CDC, in the USA estimates of normal flu mortality for the current 2019-2020 season, will be between 29,000 and 59,000 deaths.16 COVID-19 deaths in the USA are currently at 26,000, less than the flu and there are signs that the curve may be flattening. There has been what looks like a significant spike in the numbers of CoVID-19 fatalities, but reporting methods of deaths in many countries are not standardised. Whether the patient died from or with COVID-19 is not clear and crucially this has the potential to skew the understanding of the virus’s lethality. Even so, we are still a long way away from the predicted numbers that have been used to justify a global shutdown. 17 18

One important fact that Dr Lee highlights is that if testing is done in hospitals only, it will overestimate the virulence of an infection. “Normally we don’t test for the flu if someone dies of bronchopneumonia or even old age, but now that COVID-19 has been made into a notifiable disease, many cases of death will now be attributable to COVID-19.”

Indeed the WHO has now changed its coding definition so that a death where the patient is suspected of having COVID-19, even if a test is inconclusive or not available, will be recorded as a COVID-19 death, regardless of any co-morbidities the patient may have had, including for example terminal cancer.19

It doesn’t take a mathematician, or an epidemiologist, to know that just this change alone will skew the death rate, and increase the apparent lethality of this virus.

The high death rate in Italy, which put the world on red alert, has been investigated by Italy’s Higher Institute of Health. They found that 88% of deaths recorded as COVID-19 deaths were in patients with one, two and in some cases more than 3 pre-existing conditions.20 While devastating for the loved ones of those involved, the distinction is crucial if we are looking at Italy’s experience to predict future death rates.

Sudden overnight surges in death counts continue to shock the public but on investigation are an accumulation of recorded deaths, which have not yet been entered into the data set. Whilst the media keeps us focused on constantly updated numbers of confirmed cases and deaths, the temptation is to think this indicates the actual fatality rate, the flames of fear are fanned and it’s all too easy to lose perspective.

The entire world’s attention and resources is now dominated by what those numbers say.

In his Spectator article, Dr Lee states: “If we take drastic measures to reduce the incidence of Covid-19, it follows that the deaths will also go down. We risk being convinced that we have averted something that was never really going to be as severe as we feared. This unusual way of reporting Covid-19 deaths explains the clear finding that most of its victims have underlying conditions, and would normally be susceptible to other seasonal viruses, which are virtually never recorded as a specific cause of death.”

“Let us also consider the Covid-19 graphs, showing an exponential rise in cases and deaths. They can look alarming. But if we tracked flu or other seasonal viruses in the same way, we would also see an exponential increase. We would also see some countries behind others, and striking fatality rates. The United States Centre for Disease Control (CDC), for example, publishes weekly estimates of flu cases. The latest figures show that since September (2019), flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar.”

So, it must beg the question, in terms of the number of cases and the death rate, is COVID-19 really that different to an average flu outbreak? According to the WHO the common flu causes up to 5 million cases of severe illness, requiring hospitalisation and kills up to 650,000 people globally every year.21 The WHO, has reported that the COVID-19 coronavirus spreads more slowly than the flu, but appears to have a higher mortality rate.22 23

Perhaps the peak of cases seems more extreme but the overall numbers are still not significantly different. This should surely mean questions must be asked about the dramatic actions taken by governments that have already precipitated extreme hardship, social instability and political restrictions on freedom of movement. This is particularly true in developing nations such as India and much of Africa, where levels of infection are currently low. The challenges and consequences of social isolation and lack of social security in countries where the vast majority of the population relies on a daily wage, make any kind of lockdown devastating.

Some African countries like Tanzania are refusing to impose a lockdown, supported by the World Bank. An article in the Mail and Guardian in South Africa on April 8th, pointed out that in a predominantly young population the risk of COVID-19 is very small, whereas the health risks due to social and economic hardship are huge. The latter may far surpass the former. 24

HOWEVER YOU LOOK AT IT THE NUMBERS STILL DON’T ADD UP

On 26th March, in an editorial published in the prestigious New England Journal of Medicine, Dr Fauci, discussed the death rate of COVID-19 saying: “If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza, which has a case fatality rate of approximately 0.1%.”25

And yet nine days later in a press conference with President Trump, Dr Fauci, insisted that all states in the USA needed to institute a full lockdown, even though many of them at that time had mostly single figure death rates.

In the same week, Bill Gates, founder of the Bill and Melinda Gate Foundation (a group that has invested billions of dollars in vaccine research, vaccine companies and donations to the WHO) gave an interview to CBS This Morning’s Anthony Mason. Gates said that all US states should be made to impose a lockdown and when asked when it would be possible to open them up again, said “….activities like mass gatherings, may be, in a certain sense more optional. And so until you’re widely vaccinated those [activities] may not come back at all”.26

The predicted time until a viable vaccine becomes available is 18 months at the earliest. Neil Ferguson and his team at Imperial College London, suggests that lockdown might need to become a cyclical on off routine, driven by the number of daily cases admitted to ICU. Lockdown could be lifted, but if admissions to ICU rose above a certain number, he suggests 100 per day, lockdown would be reintroduced. How this would be managed by businesses, educational institutions, communities, families and individuals, does not seem to figure into his equations.

News outlets are already conditioning us to the prospect of living through the greatest economic collapse in the history of humanity. MIT’s Technology Review published a depressing look into the immediate future titled: We’re Not Going Back to Normal, where intermittent lockdowns and restrictions become a way of life.27 Talking about what life would look like after a pandemic, Bill Gates’ reiterated his idea for a digital certificate: “Eventually we will have some digital certificates to show who has recovered or been tested recently, or when we have a vaccine, who has received it.” and that this certificate would be needed, for example to travel.28

HOW HAS HUMANITY MADE IT THIS FAR?

Dr. Fauci, recently told a Senate Subcommittee that over 80% of the people who get infected by the coronavirus “spontaneously recover” without any medical intervention.29 When 60-80% of people have developed antibodies to COVID-19 and therefore natural immunity, a natural herd immunity would be achieved in the population, and in the process the virus itself becomes less virulent and therefore less of a risk for the vulnerable members of the group. Corona viruses are ubiquitous, like the flu, we can’t avoid them, so it seems more advantageous to gain natural immunity rather than rely on the promise of an ongoing series of vaccines.

The question now, having embarked on the suppression strategy with total lockdown, is when it is safe to lift it? What happens to the virus when it is prevented from spreading through a population, most of whom would be largely unaffected by it. Warnings are already being issued about the risk of a resurgence if lockdown is lifted, or another wave of COVID-19 in the Autumn, since the population has not been allowed to gain immunity. Is lockdown to be imposed again ad infinitum?

How do those who have engineered this situation propose to deal with 7 billion people unable to work or socialise or live any kind of normal life until the possibility of a vaccine arrives? And even then, there is no guarantee the vaccine will work. Will it be safe and should everyone be forced to take it?

In the UK, the Chief Scientific adviser, Sir Patrick Vallance, initially argued for allowing natural herd immunity to develop, but Ferguson pressed his alarming predictions of the potential death rate. The idea of herd immunity was also widely criticised by pro-vaccine advocates and the idea disappeared from the conversation as universal lockdown was imposed, despite the possibility of economic collapse with all its ramifications.

History tells us we can’t simply suppress illnesses. We have to work with nature, not try to suppress it. A healthy immunity is the key to protection. Viruses will continually be with us and we can’t simply avoid them. The illusion of a vaccine for every disease has made the concept of natural herd immunity unpopular, but naturally acquired immunity offers the potential of lifelong immunity to similar viruses, whereas vaccines at best can only give temporary immunity to specific viruses. In a number of the most commonly used vaccines, including childhood vaccines such as measles, mumps and rubella, the length of conferred immunity is variable or unknown, so that boosters are recommended for adults. Given, the pervasive nature of viruses like the SARS-cov-2 responsible for COVID-19, the best protection would seem to be natural immunity for the young and fit and some form of isolation and protection for the aged and vulnerable.

In the face of what is being declared a global emergency, health departments in every country should be empowering their populations with information on how to support their immune systems. Yet incredibly so far, their messaging has focused only on avoiding contact with the virus, inciting more fear and helplessness, both of which are scientifically proven to depress the immune system.

Arguments are raging about treatment protocols based on “lack of double blind trials”. 30 Political decisions are preventing medical professionals from doing their jobs. Is the fear of litigation involved in banning the use of hydroxychloroquine, already found to be highly effective by groups on the frontline in France? The media are closing down discussion and social media giants are employing a level of censorship never seen before, branding even posts about the values of Vitamins C and D, long proven to be of value in fighting viruses, as “fake news”. It is hard to imagine how this makes sense in a situation that has been described as a medical crisis?

People are developing serious symptoms and some of them are dying in terrible ways, but can the global lockdown and the crashing of the global economy with all its ramifications, devastating consequences and Deaths from Despair for 7 billion people, be justified based on the numbers that are informing these decisions? As of April 15th 2020, we don’t believe so.

Richard Pitt and Carol Boyce April 17 2020

SOURCES

 1. T. Lasky et al., “Guillain-Barré Syndrome and the 1992–1993 and 1993–1994 Influenza Vaccines,” New England Journal of Medicine 339 (1998): 1797–1802.

2. J. S. Marks and T. J. Halpin, “Guillain-Barré Syndrome in Recipients of a New Jersey Influenza Vaccine,” JAMA 243, no. 42 (1980): 2490–2494.

3. https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-12-global-impact-covid-19/

4. https://publications.parliament.uk/pa/bills/lbill/58-01/110/5801110.pdf

5. https://theconversation.com/ghanas-president-has-invoked-a-tough-new-law-against-coronavirus-why-its-disquieting-135476

6. https://off-guardian.org/2020/03/24/12-experts-questioning-the-coronavirus-panic/

7. https://blogs.bmj.com/bmj/2020/03/02/tom-jefferson-covid-19-many-questions-no-clear-answers/

8. https://childrenshealthdefense.org/news/will-deaths-of-despair-outpace-deaths-from-coronavirus/

9.https://www.nydailynews.com/news/world/ny-german-finance-minister-commits-suicide-coronavirus-economy-20200329-bnrvo77ulnd7pcmwhiq5tzpexi-story.html

10. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

11. https://www.ageuk.org.uk/latest-press/articles/2020/04/age-uk-response-to-dnr-forms/

12. https://www.independent.co.uk/news/uk/politics/coronavirus-herd-immunity-lockdown-boris-johnson-graham-medley-a9447021.html

13. https://www.dailywire.com/news/epidemiologist-behind-highly-cited-coronavirus-model-admits-he-was-wrong-drastically-revises-model

14. https://www.reuters.com/article/us-health-coronavirus-britain-research/sobering-coronavirus-study-prompted-britain-to-toughen-its-approach-idUSKBN2141EP

15. https://www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think/amp

16.https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

17.https://www.euromomo.eu/index.html

18.https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths

19. https://www.who.int/classifications/icd/covid19/en/

20.https://translate.google.com/translate?hl=en&sl=auto&tl=en&u=https%3A%2F%2Fsteigan.no%2F2020%2F03%2Fitaliensk-ekspert-en-merkelig-lungebetennelse-ble-oppdaget-i-lombardia-i-november-2019%2F&sandbox=1

21. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)CDC this season flu rates

22. https://www.who.int/news-room/q-a-detail/q-a-similarities-and-differences-covid-19-and-influenza

23. https://www.itv.com/news/2020-02-06/how-does-the-wuhan-coronavirus-compare-to-seasonal-flu/

24. https://mg.co.za/analysis/2020-04-08-lockdown-is-wrong-for-africa/

25. https://www.nejm.org/doi/full/10.1056/NEJMe2002387

26. https://www.cbsnews.com/video/extended-interview-bill-gates-on-coronavirus-pandemic/

27. https://www.technologyreview.com/s/615370/coronavirus-pandemic-social-distancing-18-months/

28. https://techcrunch.com/2020/03/18/bill-gates-addresses-coronavirus-fears-and-hopes-in-ama/

29. https://www.cnsnews.com/article/national/melanie-arter/dr-fauci-80-percent-coronavirus-patients-spontaneously-recover

30. https://techstartups.com/2020/03/27/coronavirus-cure-new-results-french-study-shows-combination-hydroxychloroquine-plaquenil-azithromycin-successfully-treated-80-coronavirus-patients-significant-dr/

 

 

 


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