There is understandable willingness to criticise what is happening in the US, in relation to COVID19, given the desire to criticise the moronic ideas that motivate Trump and his regime. Indeed, Trump's adoption of fake news, and claims that COVID19 did not exist and so on, have facilitated such criticism. His failure to take any action in response to it, which was also adopted by Cummings and Johnson in Britain, was idiotic and criminally negligent. However, that does not mean that the alternative was to jump on board the COVID19 moral panic that has been developed either. It doesn't remove from us the responsibility to check the actual facts and data, rather than just go along with all of the hyperbole, and nor does it mean that we have to go along with the equally idiotic policies of closing down the economy that have been developed on the back of that hyperbole.
If we look at the media coverage around the US, for example, a lot is made of the bald number of US deaths from COVID19, which stands currently at over 5,000. But, the US population is 330 million, compared to 65 million in Britain, or approximately, 5 times larger. So, per capital the number of deaths in the US is lower than in Britain. There has also been a lot of publicity about the claims that COVID19 deaths in the US could reach 100,000, but that equates to only the same number per head of population, as the predicted 20,000 deaths in the UK, a figure, which, in both cases, we are still a long, long way, fortunately, from even coming close to.
And, as I wrote the other day, we are likely to see a peak in COVID19 deaths shortly, because its likely that we already have it being spread to more than half the population, so that herd immunity will begin to prevent further spread, amongst the general population. Moreover, the vast majority of deaths and serious illness is amongst the elderly and sick, who are concentrated in care homes and hospitals, and the virus will already have taken hold in these locations, as, indeed, did MRSA, and C-Dif, in previous similar circumstances. That means a high number of deaths amongst these vulnerable populations can be expected early on, but tailing off, as the virus has less success amongst the general population. Governments that have imposed lock downs will undoubtedly claim credit for any reductions in mortality and infection rates, but these would almost certainly have fallen, anyway, as a consequence of this natural progression of the virus.
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| Each year, in the US up to 45 million people suffer from flu, with up to 810,000 being hospitalised and up to 61,000 dying. Current COVID19 look less scary when compared to that. |
And, if we look at that projected 20,000 deaths from COVID19, in the UK, even if it is achieved, it is only more or less the same as the number of deaths from “flu-like” viruses in 2018. Similarly, the 100,000 deaths projection for the US appears scary when put forward as a bald figure, but less so, when it is compared with the average 56,000 deaths a year, in the US, from flu like viruses, as detailed by the CDC. Indeed, the CDC records that between 9.3 million and 45 million people suffer from flu-like viruses in the US, with between 140,000 to 800,000 of those requiring hospital admission. Deaths vary between 12,000 and 61,000. Yet, COVID19 has been exceptional in provoking such a widespread hysteria, and closing down of the economy, whereas, in previous years, no one has blinked an eye, and has been totally oblivious to these hospital admissions and deaths due to seasonal flu! yet, COVID19 deaths of 5,000, in the US are a long way from the average 56,000 flu deaths, and reported COVID19 infections of around 210,000 is a long way even from the 9.3 million flu infections, let alone the 45 million figure that has been seen in recent years.
The criticism of Trump and his regime, as with the criticism of Johnson and his regime is that they failed to undertake rapid and efficient testing of the initially small number of people with COVID19 so as to isolate them, that they failed to provide health and social care staff with adequate PPE so as to prevent further spread of the virus amongst vulnerable groups, that they failed to trace those infected with the virus so as to isolate them, and that, having allowed the virus to spread, they failed to properly isolate the 20% of the population that is vulnerable to serious ill-health by infection, and to provide them with the resources to do so efficiently.
A look at the CDC data, shows, as does Italian data, that infections from flu have been rising in recent years, last year being an exception. But, a look at UK data shows that, of all those tested for COVID19, which is almost exclusively those that have been admitted to hospital with flu-like symptoms, only 10% have COVID19. That suggests that the real cause of the NHS being overrun is actually the other 90%, that are being admitted with flu or other flu-like viruses. The criticism of Trump, and also of Biden, is that they oppose the provision of Medicare For All, and of Johnson that the Tories have presided over ten years of austerity that has made an already inadequate NHS even more inadequate, and unfit for purpose. The idiotic policies of both, in now closing down their economies, can only make that worse because it will increase significantly the number of poverty related illnesses and deaths at the same time as destroying the economic base of society required to provide the resources and revenues required to provide adequate health and social care.
A useful antidote was given by Channel 4 News in its brief discussion of the approach of Sweden, which has refused to succumb to the moral panic over COVID 19, and has not imposed a lock down, though it has closed schools. There appears to be no reason why Sweden should be any more favoured than any other European country, in terms of the spread of COVID19, or deaths and serious ill health from it. Yet, despite having refused to go into lock down, or to prevent normal social interaction, six months into the global spread of COVID19, it is not experiencing any disastrous increase in the number of deaths or hospitalisations. It has only 5,000 reported cases, and just 150 deaths from COVID19, and because it has not capitulated to the global hype and moral panic, its economy continues to function normally, constrained only by the fact that its neighbours have voluntarily cratered their economies, and closed borders, reducing trade as a result. Sweden's population is around 10 million, or about a sixth of the UK, so these 150 deaths are equal to about 900 deaths in Britain, but that is less than half the actual number of deaths in Britain, where lockdown has been imposed.
Denmark, Sweden's neighbour, has a population of 5 million, and has had around 80 deaths from COVID19, which is slightly higher in proportion to population than in Sweden, yet, Denmark has imposed the same kind of lock down as applied in the UK. So clearly the claims about the need for such lock downs in order to prevent COVID19 deaths are unsound. It may be the case that such lock downs slow the spread of the virus, but it is not the number of infections that should be the focus of attention, but the number of deaths and serious illness. Given that 80% of the population suffer no or only mild symptoms from COVID19, these are clearly two different things. It is quite possible for there to be large numbers of infections, but low numbers of deaths provide that you ensure that the 20% of the population at risk of serious illness or death is isolated from it. Moreover, even if it succeeds in slowing the spread it only delays the development of herd immunity, which, in the absence of a vaccine, is the only sustainable means of preventing it spreading.
That requires that those amongst this 20% of the population within the general public be enabled to effectively isolate in their own homes, and that those in that group currently in care homes and hospitals be effectively isolated from the risk of infection by staff and other patients/residents. The latter requires that staff be provided with adequate PPE, and that patients/residents have isolation wards, or private rooms to prevent infection by others. The former requires that adequate provision be made to ensure that essential supplies are delivered to the homes of those in isolation.
All of those measures require that the resources available for such provision are maximised, and that can only be done if the economy is kept running at full potential, rather than being deliberately closed down by government diktat, and the spreading of moral panic.
22 comments:
This is complacent and dangerously so.
Without working controls, cases and deaths double every two or three days. It takes at least a fortnight for controls to even begin to have an effect on infections, three weeks or more on deaths. So current US deaths of 100K are likely to be around half a million in a fortnight. A million by the middle of the week after unless the spread can be cut down. That's based on doubling every three days.
Hospitals in the hotspots, there as well as here, are already working at burnout levels. A million plus deaths and rising in a short time is no longer a minor blip even in a population of 330 million.
Britain was about a fortnight behind Italy. So far we seem nto have been going through pretty much the same stages, at pretty much the same time lag, as happened there. Perhaps Sweden has so far been "lucky". For whatever reason, they are on the same track, maybe three weeks behind Britain. To work that out don't just need the current levels of infections or deaths, but to look at the curve of how these figures are changing.
Looking at that pattern (Statistica) it looks more likely that they are indeed following the same course as everyone else. Still at the same stage we were at a month ago, Italy six weeks, with many (including those taking the political decisions) complacent that it won't happen here because its hard to grasp how quickly things snowball.
Those who have begun to grasp what's on the way doing their best to plan and prepare for the tsunami about to hit. I hope their efforts bear fruit soon. I hope they are listened too sooner rather that later, while there is still time to put in place the least economically and socially disruptive controls.
/ENDS
David,
Unfortunately, you are spreading fake news and creating panic. You say,
"So current US deaths of 100K are likely to be around half a million in a fortnight. A million by the middle of the week after unless the spread can be cut down. That's based on doubling every three days."
But, current US deaths from COVID19 are not 100,000. They are only 5,000. You have multiplied the reality by a factor of 20!!! That is typical of the hyperbole and lack of attention to the actual data that those that are spreading fake news, and hyping up the panic have done from the start. I heard James Meadway on TV this morning claim that the mortality rate from COVID19 was 1 in 25, or 4%, that is again a massive over exaggeration, this time by a factory of 40. What Meadway is doing is comparing deaths to reported cases. But, reported cases in Britain are particularly low because of the governments abysmal performance on testing. If you only test less than 10,000 people a day, you will automatically have a ridiculously low number of confirmed cases as against the number dying.
But, even the Imperial study, based on again flawed Chinese data said the mortality rate was only 0.9%, whereas Sir Partick Vallance says its more line 0.1%. Even that figure appears to high. The other thing that Sweden does in its more accurate data is to separate out those that die actually from COVID19, as opposed to those that die with it, i.e. those that have gone into hospital with some other illness that was likely to have caused their death, but who caught COVID19 whilst in hospital. Such a case seems to be with the late Eddie Large, who went into hospital with heart failure and caught COVID19 whilst their. This seems to be typical of many of those actually dying from COVID19 in Britain.
"Hospitals in the hotspots, there as well as here, are already working at burnout levels. A million plus deaths and rising in a short time is no longer a minor blip even in a population of 330 million."
Again just more hysterical fake news. Now You have multiplied your hysteryia by a fact of 200 rather than just 20! I repeat current US deaths are 5,000 not 100,000 let alone 1 million. Please stop spreading this fake news and causing unnecessary panic. Look calmly at the facts, and analyse what is behind them.
"Britain was about a fortnight behind Italy. So far we seem nto have been going through pretty much the same stages, at pretty much the same time lag, as happened there. Perhaps Sweden has so far been "lucky". For whatever reason, they are on the same track, maybe three weeks behind Britain. To work that out don't just need the current levels of infections or deaths, but to look at the curve of how these figures are changing."
Not surprising that Britain followed the path of Italy. The cause of the pattern of deaths in Italy was infection of people in hospitals and care homes, and the same is true in Britain. In reality, the number of deaths in Italy as in Britain is not exceptional compared to the number who die each year from flu-like symptoms, many of which in previous years have also been people who had coronavirus but which was not reported as such because no one tested for it.
Claiming that Sweden has just been "lucky" is rather desperate and subjectivist. As A marxist I prefer to base my opinions and analysis on science and analysis of the data and material conditions rather than explain phenomena by "luck". The virus has been circulated around the globe now for more than six months. There is no reason why Sweden should be simply lagging behind the UK in numbers of deaths etc. But, even were that the case, so that the number of deaths in Sweden per capita matched that of Britain in a couple of weeks time, what would that show. It would show that Sweden, which had not closed down its economy, and thereby caused all of the economic, social damage that goes with it, had suffered no worse than had Britain, which has done that. In other words it would prove that the policy of closing down your economy does not, in fact, reduce the number of deaths from the virus, but it does destroy your economy, which in turn will lead to far more deaths and ill-health than does COVID19 itself.
Britain followed the path of Italy. Italy followed the path of Wuhan. Everywhere else, including Sweden, is following the same path without the appropriate combination of S.Korea style measures and lockdown when the point of crisis is being reached.
Eddie Large got the infection in hospital. Hospitals are the worst places for getting infections - in the past I've have both MRSA and C.Diff as well as a string of other bugs. Staff as well as patients get them. But there is precisely ZERO evidence in the well-studied outbreaks so far so oppose the view that the main source of infections is in the community.
You are the one approaching this subjectively. You are cherry picking individual facts (often alleged facts) which seem to fit your case. Understanding has to be based on looking at trends, and the full and rapidly expanding range of evidence available. Sweden: luck was shorthand for the random factors which meant the explosive growth in infections started slightly later in some countries than others, for reasons which currently lie beyond the reach of any available data.
Did you actually check the current per capita death rate from C-19 in Sweden. It doesn't seem so. Current deaths in Sweden are twice what they were in Britain a fortnight ago, with a population less that one sixth of the size.
Per capita death rates in Sweden now match the ones in Britain just about a week ago.
The point is that Sweden has not suffered any greater mortality, despite not locking down, and the fact is that morality rates are not the kind of hysterical levels that you were presenting of millions, or even hundreds of thousands of deaths, with your purveying of fake news. Those kinds of hysterical numbers were based on predictions by Imperial, whose mortality rates were based on false data about reported cases, not infections.
Its not the first time Imperial have done this, and been wrong. In 2009 they had forecast that billions would be infected with swine flu and there would be millions of fatalities. The swine flu ended up with a relatively low fatality rate of 0.02%. Current predictions for mortality rates from COVID19 are now down to around 0.05%, and they will probably end up lower still when all the data is in.
There is every reason to support the view that the majority of infections, and certainly of deaths is from people being infected in hospitals and in care. That information was well known in relation to Italy some weeks ago! Again you are, unfortunately spreading fake news and disinformation.
Likely the Swedish health care system is better geared up to coping with this. But no health care system anywhere can cope with cases doubling every few days, with no end in sight where the rate of growth of new cases begins to taper off.
Similarly with your repeated comparisons with flu. By the method you applied with Eddie Large, there are no flu deaths either - just people who die of pre-existing conditions who just happen to have flu as well. The real comparison is that bad as the flu deaths are, they are a steady stream thoughout the colder months of the year, not at a higher rate in a massive crescendo in a few weeks.
Likely the Swedish health care system is better geared up to coping with this. But no health care system anywhere can cope with cases doubling every few days, with no end in sight where the rate of growth of new cases begins to taper off.
Similarly with your repeated comparisons with flu. By the method you applied with Eddie Large, there are no flu deaths either - just people who die of pre-existing conditions who just happen to have flu as well. The real comparison is that bad as the flu deaths are, they are a steady stream thoughout the colder months of the year, not at a higher rate in a massive crescendo in a few weeks.
Containment until a vaccine can be developed to achieve herd immunity is the only strategy which has evidence that it might work anywhere in the world. The sooner it is started, and the higher the resources put into South Korea style measures, the lower (but still massive) the economic cost of coming through the crisis.
Your point about death rates in Sweden already answered by comment in moderation.
The Imperial team predictions about Swine flu were about an epidemic which was fortunately smaller scale because as they evidence came in it proved to be less infectious than C-19. It is a fact about exponential growth that even a slight inaccuracy in the growth rate used in the model has very big effects on forecast results.
The Oxford team are a set of biology maths wonks. They don't include any epidemiologists. The assumptions fed into their model are what they "believe" to be true, are all implausible in the light of all the evidence coming out from around the world, and lead to conclusions at variance with what is happening.
Imperial have a multi-disciplinary team including epidemiologists, drawing on what seems to be the most reliable research from around the world. With the benefit of hindsight they will doubtless prove not to have got things spot on, but for the moment reality seems to be matching their expectations, not Oxford.
I don't know where you are getting a figure of a death ratio of 0.05% (1 in 2,000). The latest figures I am picking up (today) are somewhere around 1% (1 in a hundred).
As to talk of millions of deaths without immediate effective containment measures being hysterical, fake news, based on false data, your rhetoric (truly hysterical) doesn't cut it, doesn't even begin to undermine my case.
Based on dodgy Imperial data about reported cases - no. Based on data from every country I could get my hands on about the rapidly accelerating death rates everywhere without containment.
Three days for rates to double is what has been happening in Britain. US currently running at 4 days - so if growth were still let rip deaths rising to half a million would be postponed all the way back to three and a half weeks from now.
If you think I got the sums wrong about the way things spin out of control fast, check the maths. I triple checked. That is how exponential growth works.
So, where then did you get your fact that deaths in the US are already 100,000, when in fact, the figure is just 5,000. Even if we use your dodgy methodology of projection, reminiscent of Malthus, in place of your claim that deaths would then reach 1 million in a fortnight, the figure would be 50,000. That would still put US COVID deaths below flu deaths in a bad year. It seems that not only are you cherry picking "facts", but the facts you cherry pick are not even facts at all, but simply fake news which you repeat ad nauseum, and refuse to retract, when they are exposed!
" Sweden: luck was shorthand for the random factors which meant the explosive growth in infections started slightly later in some countries than others, for reasons which currently lie beyond the reach of any available data."
"Per capita death rates in Sweden now match the ones in Britain just about a week ago."
So what? If I could pick my lottery numbers having had sight of what they were in advance I could win every time! I checked Sweden's per capital mortality rate now as against UK now, which is the relevant comparison, and Sweden's is less than half that in the UK. Also I compared it against Denmark, which removes your objection, and the per capita rate in Sweden was again lower.
So, why is the mortality rate in Sweden lower than its neighbour Denmark, which has followed the same policy of UK of closing everything down?
"with no end in sight where the rate of growth of new cases begins to taper off."
Pure Malthusian catastrophism based upon unsound projections.
"By the method you applied with Eddie Large, there are no flu deaths either - just people who die of pre-existing conditions who just happen to have flu as well."
Not true. People die just from having the flu, just as some people die just from having coronavirus infections. Sweden's data distinguishes between the two, UK data doesn't, nor did Italy's, nor China's. UK doctors themselves admit that most of those dying "with" corononavirus in the UK would have died also without it, because they were suffering from other serious conditions, such as heart failure, and because of their age.
"The real comparison is that bad as the flu deaths are, they are a steady stream thoughout the colder months of the year, not at a higher rate in a massive crescendo in a few weeks."
The word "massive" is again loaded and hysterical. Current UK deaths from COVID19, amount to just 5000, as against average annual deaths of 500,000. By comparison deaths in recent years have risen as high as 623,000, a rise of more than 25% as against the average. "Crescendo" or not this rise in deaths should be more than manageable, and there seems to be evidence that, in fact, excess deaths are slightly down on the average.
Containment has not worked anywhere, as China now illustrates, and it is simply ludicrous to think you can keep economies locked down, and not producing for another 18 months waiting for a vaccine, which by then will be out of date to deal with the next strain of coronavirus that will be circulating in the community.
"The Imperial team predictions about Swine flu were about an epidemic which was fortunately smaller scale because as they evidence came in it proved to be less infectious than C-19."
It wasn't less infectious, it simply didn't cause the deaths predicted,and the same is true of Imperial's COVID19 predictions. Your would think that the experience of making these wild predictions based on worst case scenarios would be a lesson to you, but no, you continue to spread malthusian catastrophism, fake news and hysterical claims willy-nilly based upon unsupportable evidence.
"I don't know where you are getting a figure of a death ratio of 0.05% (1 in 2,000). The latest figures I am picking up (today) are somewhere around 1% (1 in a hundred)."
That is based on "reported" cases rather than actual infections. Its the same error that Imperial made. Even Vallance admitted over a week ago that mortality rates were only 1:1000, but again you prefer to spread worst case, hysterical projections based on proven false data.
"As to talk of millions of deaths without immediate effective containment measures being hysterical, fake news, based on false data, your rhetoric (truly hysterical) doesn't cut it, doesn't even begin to undermine my case."
Really, so we are to take you serious when you continue to claim that current deaths ion the US, are 100,000 and headed to 1 million in just over a week, when in fact the real current figure is around 5,000!!!!!
Correction: UK deaths from COVID19 3600, not 5,000, which emphasis even more that it is a mere blip compared to annual deaths of 500,000, and as many as 623,000.
Further data. 20% of the global population were infected with swine Flu in 2009/10. The gross exaggeration of the projected number of deaths given by by Imperial was not due to lack of infections, but by the fact that the mortality rate from it was just 0.02%, and the mortality rate from COVID19 will probably turn out to be about the same.
Further data: The Imperial study in 2009 projected that a third of the world would eventually be infected with Swine Flu. That projection was probably about right for the total infection eventually. Put against the actual number infected of 20% in the first year, it is clearly NOT the reason, as you claimed for their projection of billions of deaths being so wildly inaccurate. The reason they were out by several billion deaths is that they projected the mortality rate to be up to 1.4%, whereas the actual mortality rate was 0.02%.
The same is happening again now with COVID10.
And, its not the only such Malthusian scare story of recent years. We had the same with Bird Flu, and as Doctor Wolgang Wobarg put it, its not just flocks of birds that are waiting for that particularly projected catastrophe to eventually arrive! All of these malthusian scare stories of imminent catastrophe are of a kind we have seen for over 200 years.
More than 40 years ago, I was being told that oil was about to run out, for example. Today the world is awash in the stuff, and its price has dropped to low levels never seen before in history!
Yet further data - the Imperial projections in swine flu were made because they were in the early stages of the epidemic, when evidence was still being gathered, not with the benefit of hindsight.
Evidence gathering for C-19 might only date back to the start of the year, but there has sadly been a mass of opportunity to gather evidence. All relevant medical and scientific disciplines are effectively working full time on it. Hindsight will show that even the best were not dead on. But the most gold standard studies from around the world are all turning in results in similar ranges.
Case mortality rates (number of deaths among those who show symptoms) seem to be running at about 1% in places which are making best efforts at recording all cases (ie everyone with symptoms).
When account is taken of those infected but no symptoms (not counted as cases in the statistics) that may bring down mortality to 0.2% - still ten times the figure you assert.
Still nothing from you about where the current events are a better match to the Oxford forecasts than the Imperial ones. Also not a word about how much better the track record of the Oxford group has been in previous epidemics than Imperial.
David,
Pretty much every expert thinks that the comparisons between countries are faulty because different methodologies are used so its comparing apples and oranges.
The Imperial data was wrong in relation to Swine Flu, because their methodology for determining likely mortality rates was wrong. That methodology was based on previous data and outbreaks. It was not lack of data that was the problem but a faulty methodology, and the same mistake is happening again.
"Case mortality rates (number of deaths among those who show symptoms) seem to be running at about 1% in places which are making best efforts at recording all cases (ie everyone with symptoms)."
Precisely!!! Mortality rates are being measured against RECORDED CASES, but we all know that recorded cases are only a tiny fraction of total number of people infected, because 80% of infections are asymptomatic!!! And, of the other 20%, many people do not report their infection either, because although they have symptoms, they are not severe enough to go to hospital, they put it down to flu and so on. So, 10% or less of people who are infected actually get reported as having been infected with COVID19, so the ACTUAL mortality rate is less than a tenth of what the mortality rate is measured against reported cases.
The Imperial data is further flawed, because they calculated it on the basis of Chinese data, but the Chinese do not count anyone who has had COVID19, and recovered as being infected! So, their mortality rate as against those who have actually been infected is even more inflated than the UK data which is at least based on those that have been tested and proved positive. The UK data is flawed because only those ill enough to go to hospital are tested - and of those some people have been tested multiple times, so its not even a measure of the actual number of people tested, but only of tests - the actual number of people infected in Britain, if you take the general assumptions about infection rates being 1 person infected 3 others, means that the total number of infections is at least ten times the number of people tested, and now because of the abysmal number of tests done, is probably more like 20-30 times that number. That is why the actual mortality rate as against those infected is likely to be less than 0.05%, and will probably turn out about the same as Swine Flu at 0.02%.
"Still nothing from you about where the current events are a better match to the Oxford forecasts than the Imperial ones. Also not a word about how much better the track record of the Oxford group has been in previous epidemics than Imperial."
Well we still have not seen the deaths rising into tens of thousands in Britain, let alone the hundreds of thousands that you and the Imperial predictions would lead us to believe should have occurred, have we? Rather we have deaths running at only about half the average seasonal flu deaths, and about a fifth to a quarter of the flu deaths in 2018 of 17,000.
I'm still waiting for you to retract your hysterical claim that deaths in the US were already 100,000 headed to 1 million, as opposed to the fact that they are 5,000 and headed to nowhere near 1 million.
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