Coronavirus — Minor Malady to full blown Fiasco

Coronavirus
Minor Malady to full blown Fiasco

Dr. A. K. Dragun
April 2020

Coronavirus – From a small medical concern to a full blown Fiasco

The coronavirus, SARS-CoV-2 is a killer. Lots of people are dying, and many more are hurting. Communities and countries have been shut down and some experts opine that the total lockdown should remain for 3 month, 6 months, the rest of the year or at least until the virus has been exterminated or a vaccine is found. Much of the expert medical opinion is for continuing the lockdown. Unfortunately, while medicos are good at saving lives and operating hospitals, they are not so good at running a society, an economy, or a country. By their training medicos are probably the most risk averse group of professionals in any society. Every life is precious, everyone should be saved. At a public level this perspective is the precautionary principle writ large. In this limited universe the coronavirus needs to be eliminated completely or at least a vaccine found to control the beast. Until then it is not safe to move, even slightly. Lockdown could be forever. Citizens, the economy and money are on another planet .
But a lockdown can have unintended consequences and cause great harm itself – is the cure worse than the disease?
The lockdown in most communities and countries was justified in terms of flattening the curve. The theory here is that if left to nature, the virus cycle would peak causing intense pressure on the medical system which might not be able to cope and as a consequence a larger number of people would die unnecessarily. The reasoning is then to flatten the curve with some combination of social restraints to minimise transmissions. Rather than dealing with a peak, the case load could be spread over a longer time frame to be managed efficiently within the capacity of the health system. And thus the war cry in the UK to save the NHS.
The key to this theory is that the overall case loads are effectively the same, but the death rates would be much lower where flattening is achieved. Given that the case load is managed within system capacity the prospect is that better care means fewer deaths. This perspective, which is found in the popular IHME models, is not rocket science but it should be clear that it is a theory and it is expressed in models which don’t always connect with reality.
In 2005 when the world was losing sleep over the Bird Flu pandemic there were very scary prognostications from serious quarters such as the WHO with predictions of huge human deaths. Interestingly the key expert to the UK on coronavirus very recently, Professor Neil Ferguson, commented that in his expert opinion the bird flu in 2005 could kill upwards of 200 million people worldwide and close to 709,000 in the UK . In the final event bird flu did not kill anyone in the UK, that is zero deaths, and it did not kill 200 million worldwide, with the final death toll being a mere 282. About 4,500 chickens did die though!
Clearly the SARS-CoV-2 is a different beast to the H5N1 cousin. But from the earliest days of the coronavirus epidemic, even though there were some issues with the data, the basic characteristics, impacts and risks of the Covid-19 disease were reasonably well recognised and understood. And it has to be said that most of the authorities in most countries handled the situation very badly.
Part of the dilemma of appraising the situation is the subjectivity and quality of the data. For not a lot of reason a key indicator has been Number of Cases. Unfortunately, it is not clear how these cases are determined, if it be test results or a medical examination. And Test results seem to be fraught with error as a function of very high false positive rates (up to 50%) as well as false negatives (30%). Thus, a concern for reinfection is spurious, when the likelihood was that maybe the first test was actually false positive. Otherwise the use of cases as a measure of the extent of the disease is spurious since the testing programs are generally targeted in some way or another. Reporting of the data is haphazard and there appears to be many omissions and adjustments The result is a very biased and probably error prone indicator, in terms of the false results.
It might be expected that death rates might be a better measure of the virulence and extent of the disease. But this might not be so as a function of the because/with conundrum. Also it seems that criteria for cause and for death are uncertain and have been adjusted haphazardly. Certainly the CDC guidelines do not yield much confidence for accuracy in identifying death causes, and there does not seem to be any significant oversight and review. Ultimately, the key measure for the Covid-19 disease will be the excess pneumonia related deaths when that data becomes available.
With a global perspective, the variability in death rates is not actually believable as a function of a novel disease being managed within mostly comparable quality medical systems. The death rates of 300 to 400/mill in modern quality medical systems in Europe just don’t pass the test. And in comparable systems in Australia, Japan NZ, Singapore, etc, the death rate hovers around only 2/mill. A reasonable conjecture would be that the latter category of countries actually do measure the context of Covid death more objectively, with quite stunning impacts. Rather than the global body count approaching 135,000, (17.3/mill) the real mortality of the disease might be as little as 15,500 (2/mill). The context? It is estimated that 5 million people might die of pollution each year, another 728,000 of alcohol related issues, suicides at 312,000. And the annual flu with 290,000 to 650,000.
At a global level it is the case that in the order of 162,000 people die each day. That is the nature of humanity . In Europe in the 2017-8 influenza season, 150,000 died in Europe as a consequence, while comparatively about 90,000 have died so far because/with Covid-19. AND within the window of Covid-19 an average of 1,712 people have died each day (maybe about 0.1% of daily deaths). In reality the Covid-19 deaths might be as few as 182/day (at 2/mill). And the global economy has been put into reverse! Sad but true. A total fiasco.
From the earliest mortality statistics out of Wuhan it was clear that the disease impacted the elderly the infirm and the immunocompromised to a horrible degree. And most significantly there was little evidence of mortality impact with healthy people and with people younger than 60. So what was the expert advice? In January 2020 is was … “low risk” & good health practices”. On the 4th March, with 3089 cases and 107 deaths, the Italian Government in its wisdom closed its school system and sent the kids home – to the elderly and often infirm grandparents (since the parents still were working & there is considerable intergenerational family mixing in Italy).
And the rest is history. Old and infirm dying in large numbers in Italy, Spain, France, the UK and now the US. In Italy, with amongst the oldest age profile, the average age of apparent covid-19 death was 76 to 79 and numerous co-morbidities were identified. The lead Italian medical advisor identified the accounting of death problem as because of? or with? covid-19. The death statistics in New York City replicate what is seen in Italy, China and elsewhere. Lots of the elderly, and lots of associated illnesses. The NYC data from 11th April show that 71% of the deaths were over 65 and of all the deaths only 2% did not seem to have an underlying health condition.
In NYC only 3 individuals younger than 17 died because/with Covid-19 and each had an underlying condition, and only 0.4% of those who died were 18-40 and appeared to have no underlying condition. Not rocket science then — a blind pensioner could see that the Covid-19 had serious risk consequences for the elderly and the infirm.
Is it too much to suggest that given the clarity of the coronavirus problem, that special management arrangements should be made specifically for that small group of at risk individuals. Isolate, quarantine, and protect, pretty simple stuff really. And yet in the middle of April experts are opining that in the future it might be a good strategy to identify vulnerable cohorts! Really, where have they been?
But what have most of the experts suggested? And what do the authorities/politicians race to do? Complete community and country lockdown. No one moves on pain of fines, arrest or worse.
And what happens? Economies go into meltdown. The OECD estimates that most countries are on track to lose 20% to 30% of their GDPs – back to 2006! And this is early days, many experts are emphatic that 6 months, a year, or until the virus is wiped out or until a vaccine is found. Don’t move. No work, no business, and inevitably, no economy.
And then there are the unintended impacts. While the conventional epidemiological modelling can demonstrate a theoretical pathway to better manage a healthcare system in times of crisis, such an approach is unable to tell what else could happen in the health system and in the economy.
Thankfully, one government at least seems to be cognisant that the Covid-19 problem is not one sided . The government of the UK has identified that very many more people could die with the lockdown than without. Following on from the Ferguson modelling where it was estimated that near 20,000 people could die in the UK because/with Covid-19, the government has also modelled that as many as 150,000 could die indirectly because of the lockdown . The UK Chief Medical Officer, Chris Whitty, an expert, identifies up to 150,000 avoidable deaths caused by the lockdown. Whitty has identified areas of concern being; the downgrading of other medical services, cancer treatments, mental health care, emergency visits and care, organ replacement, normal vaccination and the treatment of a melange of other normal ailments. Not to mention increased rates of suicide, which have already been recognised in some US jurisdictions. But the UK lost the plot it didn’t protect the vulnerable cohort, or the PM.
And then there is the economy, with nothing happening. No surplus being generated. No capacity to continue to fund healthcare and all the welfare services which are now being activated. What happens to bankrupt businesses, and their owners? No magic pudding.
The dilemma when dealing with an ongoing and relatively unknown problem such as the SARS-CoV-2 is the uncertainty. Is this virus more dangerous, worse and possibly lingering more than ever before?
Sadly the main stream media with a proclivity for despair and doom may have over sold the so called pandemic. The constantly on and in your face social media also makes developing circumstance immediate and horrifying beyond reason. Clearly, the MSM has been more motivated by gotcha moments than providing a helpful public service. It would be true to say that most people alive today have not lived thru a crisis or trauma anywhere vaguely serious. The Covid-19 pandemic, might be the crisis the new generations had to have. In the broad sweep of history with plagues famines, tyrants and depressions, this is OUR pandemic.
We can now take OUR place in the long wonderful history of human suffering!
Or maybe not.
Apart from of a very small cohort of elderly and infirmed victims, the Covid-19 is remarkably benign for the vast bulk of the community. This is NOT a #metoo situation. In the early days of the pandemic, a woke “joke” circulated that Covid-19 was a boomer remover . While there might be some morbid truth to the #boomerremover, the significance of the disease is not so much the mortality, which will ultimately be found to be trivial compared to a multitude of pandemics and disasters throughout history, but on the response to the pandemic.
Rather than being significant as a major disease event, Covid-19 will be become noted as one of the most significant fiascos of all time. It will be highlighted by stunning overreaction, incompetence and public failure. Instead of taking special care with an elderly and infirm cohort, which should have been a rather simple task, politicians, experts and elites have pandered to the social media circus. Thus, with the woke meme of inclusion which has trampled over social media, everyone has to be a victim. Of course with the Covid-19 disease very few were actually victims and certainly very few younger than 60 years, but with the lockdown response, now everyone is a victim – of the lockdown.
With the lockdown, the whole economy of most countries has been thrown into hibernation. As mentioned the economic hit has been estimated to be huge and the initial impacts will be on the younger working generations.
Good intentions, unintended horrible consequences. And with the woke predilection for deplatforming, it is difficult to hear a rich diversity of views which might inform the situation more clearly.
Dreams of hiding until the virus has gone or until a vaccine is found are pipe dreams. Vaccines for the corona class of viruses are notoriously difficult to get to practicality, witness progress on the common cold. And the SARS-CoV-2 seems to be evolving rather rapidly, by the time the hint of a vaccine is developed it is likely to be irrelevant. Also, antibody testing might establish that the virus has pretty much been assimilated. It is clear that at this point in history, humanity will need to live with viruses of all sorts. Hiding and procrastinating are not solutions. Humanity needs to move on, adapt, and innovate. Grow the economy so that we might deal with unforseen risks better. Provide a good quality of life for all citizens. Humans have always lived (and died) with viruses.
The current coronavirus situation in Australia is extraordinarily positive and could provide a great lead to global community in terms of resolving the fiasco and getting back on track, quickly. Daily new cases have dropped to a trickle and active cases are reducing steadily. If it wasn’t for Australia’s humanitarian efforts in relation to stricken cruise ships, and particularly the Ruby Princess, the death rates would have been almost invisible (Death by Cruise Ship). Overall, with the statistical anomaly of the cruise ship deaths included the Australian death rate is a mere 0.95% or about 2.3 persons per million. Amongst the lowest in the world. Clearly the Australian medical system has coped magnificently, no stress here.
But IF the Covid-19 problem had been addressed for what it is and the vulnerable cohort protected appropriately from the get go the death count would have been minuscule. Apparently, only ONE person younger than 60 has passed because/with Covid-19. Ignoring the cruise ship anomaly, the death rate in reality is a ridiculously low 0.015%.
To emphasise the serious impact of the Covid-19 for the productive remainder of the Australian economy – the death rate for the disease for individuals under 60 years IS 0.015%. And for this ridiculous death rate, the economy is completely shut down! This really IS a fiasco.
The process of resolving the current logjam should be quite simple and straightforward. Kids to school, let the herd work. Get most people back to work ASAP. Remove state border controls, open up the parks and beaches (controlling these was absurd in terms of fresh air impacts on disease, CV Northern Hemisphere optimism for summer). Get the hospitals moving with their normal business, elective surgery and the like. Get the major sports happening maybe with a few crowd provisions. Maybe stagger the entertainment, restaurant, bars sector for a week or two as a matter of sensitivity to the worry warts. Get some domestic travel moving with similar provisions.
Probably the only current risk with getting rid of the lockdown would be international travel. And at this stage international travel is clearly a non event. There does not seem to be any serious reason why the national economies of either Australia or NZ should be parked. So why wait?
It is unimaginable that intellectual techno-structure of the major western countries have not figured out already that the Covid-19 pandemic is a dud. And the failure of government to communicate to the general public is glaring. Keep them ignorant and scared?
But it is difficult to explain away ineptitude and incompetence. So a pretty typical government – bureaucratic response will be to emphasise the might have been and then express serious caution for what could be. Already, political sharks are claiming to have saved thousands/millions/whatever, because of their foresightedness and others, mostly the experts who missed everything completely, are wringing their hands with worry that everything could just get worse …. In the very near future. The entreaties to sit tight until the virus is wiped out or until a vaccine is found are fairy-tale delusions.
So the political – bureaucratic – expert response will be to sit tight — this was really, really bad, and we need to have a little more time to explain away our incompetence. And at the same time the delay and controls provide a template for socialist totalitarianism, all in the cause of keeping everyone safe.
The sad facts of the so called pandemic are that it was a minor medical perturbation which was handled very badly and the vulnerable were not protected. The nature of the situation was never explained, leaving the general public in great fear. Good for MSM and gives the government to spin a fable. Subsequently, the cure, in terms of locking down communities and countries, has become a political fiasco . And now the tribulations to cover up and explain away the political fiasco will establish the foundations of an economic catastrophe.