GPs support Covid Plan B

26 October 2020

Registered Health Practitioners for Covid Plan B

 Statement of principles

Health is based on freedom and trust. Free human beings can decide themselves about their health.

Free societies decide in democratic discussions how to deal with their health. The NZ Bill of Rights guarantees free choice of treatment.

Fear of the pandemic makes us unfree. It makes us see vaccination and lockdowns as the only way to get back to normality.

International health data and our own experience shows that the fear engendered in the public and our patients is not proportional to the threat to their health posed by covid-19.

Therefore New Zealand’s public health and economic response to covid-19 needs reviewing. It is very likely to be more harmful than the threat posed by the virus in the medium to long term.

Doctors can help. We can develop trust through mutual respect, transparency and democratic debate. We can take action with our patients, so they are healthier and better able to fight infection, and by providing treatments if they fall ill to Covid-19.

There is nothing we have yet seen in the features of this virus that warrants it being regarded as especially dangerous above the many other viruses that are with us every day. The most practical response is the standard precautions of improving personal hygiene, physical health and improving lifestyles.

We want the public to know that the infection fatality rate of Covid-19 is currently about 0.3% once antibody levels are accounted for. The infection fatality rate of influenza, which is strongest each winter, is about 0.1%. It is also clear that the ages of people who die with Covid-19 is about the same as that from natural mortality. This information is enough to inspire us to take better care of our health, but not to drastically change our society and economy.

It is impossible to obtain information about the severity of Covid-19 infections in New Zealand, so we have had to rely on overseas research. About a third of Covid-19 positive patients have no symptoms, with about 90% of infections treated in the community, and only about 1.5% needing intensive care. In the US, almost all hospital treated cases have had other serious medical conditions and are almost all people who die with the virus are over 50 years old. Unusual or long lasting symptoms currently appear similar to a range of responses seen in other respiratory illnesses.

Doctors now have many promising treatments against Covid-19, including easily available supplements like vitamin D. Internationally, the death rate is falling, in part, because we are getting better at treating the disease.

Immune function can benefit from minimising sugar and refined starch intake, eating several servings of fruit and vegetables daily, being physically active, socially connected and having sensible sun exposure to ensure adequate levels of vitamin D, avoiding tobacco and excess alcohol.

We have identified comorbidities that make people susceptible to Covid-19, such as diabetes, hypertension and raised cholesterol. We need to treat a condition in these patients called Metabolic Syndrome, which creates immune system dysfunction.

Decision makers, when assessing health strategies, compare the economic costs of a policy to its benefits. Recent assessments by economists indicate that the costs of lockdowns in New Zealand outweigh benefits by a ratio of between 90 and 200 to one. This indicates that Covid-19 has been disproportionately treated compared to critical health issues that our patients face day-to-day.

Policies that the Government should prioritise or review are:

  • Adequate resourcing of high-quality infection control and quality care in rest homes and hospitals to prevent the spread of covid-19 to vulnerable people.
  • Abandon the use of lockdowns to contain the virus. Strong evidence now indicates that these measures are disastrous economically and do little to contain viral spread.
  • Review the requirement for managed quarantine and compulsory detention for both community and hospital cases in the light of the updated lower fatality risk of the virus. This measure leads to social isolation and undue mental distress.
  • Further limits on border travel should be urgently reviewed in the light of a cost-benefit analysis.
  • Avoid any measures that lead to social isolation in the response to contain the virus.
  • Review the requirement for compulsory diagnostic tests in the light of the lower fatality rate of the virus. We believe that patients should continue to have the right to refuse medical tests, as they do for other procedures, and that the public health risk from this virus does not warrant these rights being superseded.
  • Abandon the requirement to wear masks on public transport. We believe that the best epidemiological evidence available does not support mask wearing to reduce the risk of respiratory virus transmission.
  • We believe that the doctor-patient relationship should be safe-guarded, along with the ability for doctors to see patients in-person rather than online. Online patient consultations detract from the quality of the doctor-patient relationship and raise the risk of mis-diagnosis.

As facts about the virus become self-evident, the public is wondering whether the current measures cause more harm than good. They will wonder why authorities have been unwilling to listen to, or even allow, discussion of the facts and alternative policies. We are deeply concerned that the consequence will be a loss of faith in health services, science and bureaucracy.

Foundation Signatories:

Dr Cindy de Villiers – General Practitioner, M.B.,Ch.B

Dr Matthias Seidel – Obstetrician and Gynaecologist

Dr Anne O’Reilly – General Practitioner. MB BCh FRNZCGP

Dr Rob Maunsell – General Practitioner

Dr René de Monchy – Consultant Psychiatrist

Dr Robin Kelly – General Practitioner MRCS, LRCP, FRNZCGP

Dr Tessa Jones – Integrative medical practitioner MBChB, Dip Obs, FRNZCGP, FACNEM, FABAARM

Dr Alison Goodwin – General Practitioner, MBChB, FRNZCGP

Dr Ronald Goedeke – Director of Appearance Medicine, BSc Hons MBChB

Dr Deon Claassens – General Practitioner, MBChB, Dip. SportsMed, FRNZCGP

Shane Chafin – Pharmacist,AGPP,BCACP

Dr Ulrich Doering – General Practitioner, MBChB, Dipl O&G, FRNZCGP

Dr Samantha Bailey – Research Physician MBChB (Otago)

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.

Six months before the truth caught up with Covid19 doom-mongers

A dismaying aspect of the Western response to Covid19 is that it has been six months before some Governments and public institutions started listening a wider range of advice, and understood they must critically assess advice to decide what is in the fullest public interest.

Even then, the ‘listening’ has been piecemeal and slow. And not at all in New Zealand.

The preference for heeding the warnings of doom-mongers with the worst numbers is somewhat understandable, but it is inexcusable that leaders failed to listen to other advice, and to judge from the data for themselves.

https://www.businessinsider.com.au/boris-johnson-briefed-sw…

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

Global leaders infected each other with panic

No matter how dangerous you think Covid19 might be, this academic analysis dissects the dangerous speed and nature of the authoritarian responses by otherwise democratic governments.

Its says the political ‘global copycat response’ signals an ‘pandemic of authoritarianization’ with “the potential to unleash humanitarian crises no less devastating than COVID-19 in the long run”.

https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsaa064/5912724#207838617

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/