Category: Epidemiology

NZ data – not many tested, not many positives

A sense of perspective on NZ Covid data

(from Jefferies et al. Lancet paper. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30225-5/fulltext)

Outer circle here is proportional to NZ population, grey is those tested. Blue is those who tested positive. Hospitalised and ICU cases too small to print.

Zeroing on test positive cases (blue circle above, now below), it is not possible from paper to know how many deaths actually went to ICU, so these cells may not be mutually exclusive…

Experts changing their minds as facts against Covid19 mount

Abstract

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population’s movements, work, education, gatherings, and general activities in attempt to ‘flatten the curve’ of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. First, I explain how the initial modeling predictions induced fear and crowd-effects [i.e., groupthink]. Second, I summarize important information that has emerged relevant to the modeling, including about infection fatality rate, high-risk groups, herd immunity thresholds, and exit strategies. Third, I describe how reality started sinking in, with information on significant collateral damage due to the response to the pandemic, and information placing the number of deaths in context and perspective. Fourth, I present a cost-benefit analysis of the response to COVID-19 that finds lockdowns are far more harmful to public health than COVID-19 can be. I close with some suggestions for moving forward.

https://www.preprints.org/manuscript/202010.0330/v1

Call for data on Covid-19 health impacts

22 October 2020

New Zealand has not released any analysis about the negative health impacts of the Covid-19 elimination and lockdown policy.

This is highlighted by studies released in the UK this week which indicates that their lockdowns are responsible for thousands of deaths and new illnesses, principally as a result of delayed cancer diagnoses (see note below).

The only known study of lockdown health impacts in New Zealand was of a Dunedin primary health clinic, where referrals and tests had dropped 100% and 99% respectively. Anecdotal evidence provided to the Covid Plan B group is that referrals and tests may be down across the country by two thirds. Auckland District Health Board is also investigating after four women died during and after pregnancy this year, with three dying since alert level 3 was instituted in late March. Expected numbers of deaths are between 0 and one from previous years.

Evidence provided from affected individuals indicate illnesses and health prognosis have worsened due to delayed tests and treatment. Whether these cases represent a wider problem is not known.

Dr Simon Thornley, spokesman for Covid Plan B, said the Government’s elimination and lockdown policy was based on hope, because little analysis of the downsides of the policy has been carried out.

“If you base your rationale on discredited models and you don’t count impacts, this is not a policy based on evidence.

“This is a policy based on an assumption that the low Covid-19 impact is the result of the lockdown policy. There is no proof of that, and international studies indicate it is unlikely.

“This is also a policy continued on the assumption that there are no negative effects. But firsthand testimony in New Zealand and overseas statistics suggest this is not true. Economic analysis from the government and independent sources indicate that lockdowns are a disproportionate response to Covid-19. The effect on unemployment is now clear, with a 38% rise in adults on the jobseeker benefit since late March. Now, the impact of delayed diagnosis and under treatment of other conditions must be considered.

“We are not even trying to count what the other effects have been on health. We do not know how many people have died, had conditions or prognosis worsen because of the ways lockdown and fear have affected healthcare.

“We call on the Ministry of Health to undertake the same studies we’ve seen in the UK, and to weigh those costs against what they imagine, or count, are the benefits of the elimination strategy,” Simon Thornley says.

– ends

Deaths due to lockdown: UK

Thanks to good record keeping and research in the UK that country is now counting the cost of lockdown on health.

The Spectator reports:

A study by the London School of Hygiene and Tropical Medicine found delayed and cancelled breast cancer treatments will cause between 281 and 344 additional deaths. For colorectal cancer, there were an extra 1,445 to 1,563 deaths, lung cancer an additional 1,235 to 1372 deaths and 330 to 342 more oesophagal cancer deaths.

 

A University of Leeds study estimated that there have already been an extra 2,085 deaths from heart disease and stroke as a result of people not accessing timely medical help. A study by the University Hospital of Northern Tees reveals that the number of endoscopies — used to investigate and diagnose bowel cancer — fell to just 12 per cent of their normal level between 24 March and 31 May

 

The National Blood and Transplant Service looked at the period between 23 March and 10 May and found that, compared with the same period in 2019, the number of organ donors fell by 66 per cent and the number of transplants fell by 68 per cent. This year, 87 people died while waiting for an organ transplant, compared with 47 last year.

And in a report by the ONS, an extra 25,472 people have died at home than would otherwise be expected from the average past five years.

Pre-existing immunity is retarding Covid19

Sunetra Gupta talks about her most recent study showing preexisting resistance to Covid19, and that 15-20% sero-positivity in the population could retard Covid19 prevalence and probably already is.

She also refers to some strange behavior of people opposed to looking into these matters.

https://youtu.be/ZCnTtKM6RK8.

Immunity variations explains actual impact of Covid19

Fascinating study shows that removing homogeneity assumptions from population models, and replacing it with variations in virus susceptibility, returns data that better fits the actual impact of Covid19.

The results imply that most of the slowing and reversal of COVID-19 mortality is explained by the build-up of herd immunity.

The estimate of the herd immunity threshold depends on the value specified for the infection fatality ratio (IFR): a value of 0.3% for the IFR gives 15% for the average herd immunity threshold.

Now, compare this to the simplistic exponential models provided to governments across the world, and here in NZ.

https://www.medrxiv.org/conte…/10.1101/2020.09.26.20202267v1

The PCR test is not reliable

Sensitivity of the PCR test creates unreliability which undermines contact tracing, and destabilises policy making.

Jay Bhattacharya explains that the epidemic is too widespread for contact tracing to limit disease spread; that errors in the PCR tests substantially raise the human costs of contact tracing and render it less effective; and that contact tracing incentivises the public to mislead public health authorities.

https://inference-review.com/article/on-the-futility-of-contact-tracing

Schism regretted but made inevitable by first panicked over-reaction

A rule of thumb in public health, forgotten in the panicked responded to Covid19, was; If you don’t know the likely result of your intervention, don’t do it.

We heavily regret the schism in science and society over Covid19, but it was made inevitable by the first response of politicians and panickers. A determined self-selected group of people in each country promoted erroneous projections and large scale blunt interventions. And they stuck to that plan – refusing to consider alternative interpretations of data and alternative responses.

It was they that decided discussion, moderation and dissent would not be tolerated.

https://www.newshub.co.nz/home/world/2020/10/opinion-is-the-covid-19-cure-worse-than-the-disease-the-most-polarising-question-of-2020.html

Herd immunity variable, but it happens: Sunetra Gupta

Sunetra Gupta has written a thoughtful explanation of herd immunity.

It’s a riposte to a claim by the UK health minister that herd immunity is impossible for Covid19. In short she says individual immunity to Covid19 is unlikely to be permanent or complete, as with many similar viruses, so herd immunity is variable, but the level it occurs reduces widespread infection.

https://unherd.com/2020/10/matt-hancock-is-wrong-about-herd-immunity/

CDC study finds masks don’t stop Covid19 infection

A CDC study found that wearing a mask made no difference to catching Covid19.

71% of case-patients (ie. infected) and 74% of control-participants (not infected) reported always using cloth face coverings or other mask types when in public.

The CDC didn’t highlight this finding, but the finding that people who caught Covid19 were twice as likely to have gone out to eat or drink.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a5.htm