A Sense Of Proportion

I was recently called a 'pandemic denier' .... or at least of downplaying the crisis ...

Even The God Pan Was Spooked By The Pandemic .......

.... both charges I strongly denied.

I have fully recognised that Covid-19 is a world wide pandemic from the start. The definition of a pandemic is an epidemic disease that has spread over a large area. In other words that it’s “prevalent throughout an entire country, continent, or the whole world.” Of course before you can have a pandemic, you need to have the epidemic, and that's defined as a disease that is “affecting many persons at the same time, and spreading from person to person in a locality (region or community), where the disease is not permanently prevalent.” .... So Covid-19 started as an epidemic in Whuhan, China, and then became a pandemic when it spread into the wider country and world.

Of course the word Pandemic derives from the Greek pandēmos (from pan ‘all’ + dēmos ‘people’) which is rooted in the name given to the old god Pan, along with Panic and Pandemonium, both of which almost always accompany a pandemic at some point or other.

I have never denied these facts, and if you read my earlier posts on the subject, I have also never denied the serious nature of the illness, especially to any older people who contract it. But my beef on all this has always been, that we are not discussing the illness in any context. You simply can't understand the illness and its effects, if you don't understand the figures you are being given. So when they say 900+ deaths a day this week, is that really bad? Is it worse than other pandemic diseases, or in fact lower than a normal death rate for another illness that we are used to? Statistically, we would expect about 51,000 to die in Britain this month, so how many more should we expect?

So put simply, you can't understand the figures without a comparison with other similar related illnesses. The coronavirus family of illnesses includes the flu, a seasonal pandemic illness that we still can't completely stop, and have no full vaccine for. Its also an illness for which we do have comparative figures for, the rates of infections, hospitalisations, deaths and recoveries, are all known, and with which we could gauge and compare this new member of this contagious virus family. We also have the figures from the Spanish flu outbreak of 1918 - 1920, which truly was a deadly pandemic.

But, it appears that no politician, apart from a brief try by US President Donald Trump, who tweeted on March the 9th, that the coronavirus was not as perilous as the flu. “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”, has really made any effort to compare and contrast the Covid-19 death rates, with the annual Seasonal Flu death rates or the Spanish_flu pandemic.

I repeat therefore, that I am not in anyway denying Covid-19's seriousness. But it would be clearer to everyone what this all really meant (and therefore which approach to take), if we always compared the impact its having, with the annual impact of its cousin the Common Flu. 

So for what its worth a few stats: Every year, about 600,000 people in the UK die (including from seasonal flu complications). So far in the UK, at least 213,181 people have been tested for Covid-19, of whom 55,242 were positive for the virus, and 6,159 have died in coronavirus related deaths (as registered by the Office for National Statistics in England and Wales), which is just about a 1.03‬ per cent increase on the normal total average death rate.

Of those 647 coronavirus related deaths (up to the date ending the 7th April 2020), around 7% of the total were aged between 45 and 65. However the average age of the critically ill patients (admitted to ICU wards) is about 60 years. Most are men, and many have other pre-existing health conditions that have put them at increased risk, such as diabetes, heart disease, lung disease and high blood pressure, and other chronic conditions including obesity.

There are two other undiscussed factors in all this (the statistical elephants in the room). Firstly, its a fact that many, if not most of those who had those chronic underlying condition's, may well have died of one of those conditions, or even seasonal flu this year, if they hadn't been attributed as Covid-19 related deaths. A government advisor, Professor Neil Ferguson, told the Science and Technology Committee that up to two thirds of people who reportedly die from coronavirus in the next nine months, are very likely to have died this year from other underlying causes, and that experts were now expecting around 20,000 deaths attributed as Covid-19, although he said it may turn out to be a lot less.

Secondly, there is also the issue that Covid-19 coronavirus has now been made a notifiable disease, whereas the seasonal flu virus hasn't. This means that formerly when someone died of a respiratory infection in the UK, the specific cause of the infection was not usually recorded or tested for. The cause of death were just recorded as broncho-pneumonia, pneumonia, or old age etc. But if the patient had a chronic condition such as cancer, motor neurone disease, heart disease etc, then this would be recorded as the cause of death, even if the final illness was a respiratory infection such as the flu.

Now, because Covid-19 coronavirus has been made a notifiable disease (but the flu hasn't), medical staff will have to record the Covid-19 designation on the death certificate, rather than the chronic condition. This skews the figures considerably, and exaggerates Covid-19, and ignores seasonal flu, all whilst downplaying or ignoring the underlying chronic condition, which is the real killer.

This means that the actual annual death rate may not go up as much as people might expect. We will have merely swapped the recorded cause of death from something else to Covid-19. This fact is belatedly being recognised, and the Office for National Statistics is now trying to determine the proportion of reported Covid-19 deaths, that are caused specifically and solely by the coronavirus.

In the USA they do test and record seasonal flu, and for instance the Center's for Disease Control (CDC) publishes weekly estimates of flu cases. Recent figures showed that since September 2019, seasonal flu has infected over 38 million Americans, hospitalised 390,000, and killed more than 23,000. Its these figures that prompted President Trumps tweet pointing out that the USA is not locked down each winter for this condition, mainly because seasonal flu is familiar, and its existence and outcomes are accepted as being normal.

Rushed science is almost always bad science, and there are worrying signs that those initial estimates of "250,000 additional deaths" in the UK, were somewhat overly dramatic, and could join those other predictions which turned out to be wildly wrong. I cite as examples that in 1999, it was seriously suggested that BSE (mad cow disease) “could kill” half a million people in the UK. In 2003 it was said that SARS had a “25 per cent chance of killing tens of millions”. In 2009, the British government even said 65,000 “could die” of swine flu. These are because scientific advisors don't want to under predict, and so exaggerate to be safe. But the Government then acts on the inflated figures, with widespread public policy consequences.

But even with all this confusion, for most people with coronavirus, the reality is that they will recover within about a week of getting the symptoms, and will not need any further medical care, which of course is also the case with seasonal flu victims. Whether these recovery rates are lower or better than the rates for the common flu, I don't know, and nor does anyone else, because we are not being given, or even recording this highly relevant information.

Finally, I think the most telling statement of the week was when passport office staff were told by the Home Office deputy scientific adviser, Rupert Shute, that staying at home was important but "we also have to keep functioning our lives".

"You are no more at risk at the workplace as you would be in your home or at the supermarket. It is about minimising it. We are working on the assessment that 80% of us, if we haven't already, will get the virus." He added: "We cannot hide away from it forever." ... and that's probably the real truth in a nutshell. However that is very 'off message', and its partly because the pandemic has been sold to the public as a major killer, rather than as a major risk to the health service because of its rapid spread, and capacity to overwhelm that service, because hospital beds and ventilators would run out, so some would die who would have survived.

Some Groups Are Not On Message .....

I suspect that this is why there are some signs that after 3 weeks many low risk members of the public (Generation X and Millennials), are already chafing at the restrictions and breaking the isolation rules .... this disobedience could well get worse, unless very strict enforcement measures are under taken.

We are trashing the world, mainly to prevent our medical services being swamped and unable to cope, not to prevent the illness passing through the human herd like its seasonal flu cousin does every year, without any comment.

This will be my last Coronavirus post unless it turns seriously deadly .... after 3 weeks living in isolation (despite my personal views on its long-term effectiveness), as I don't want to let this virus dominate every aspect of my life.