The second wave of COVID deaths shows that the strategy of lock down has been an unmitigated disaster. For months after March last year, country after country implemented lock downs. They all failed to deal with the virus, and, as I predicted back in April last year, as soon as those lock downs were relaxed, which reality meant they had to be, the virus would simply flare up again, even more powerful, because, by dragging out its existence, as a result of “flattening the curve”, it would inevitably have time to mutate, creating new strains that would be more virulent, or more deadly. Both have now been seen, a more virulent strain having developed in Britain, and a more deadly strain in South Africa. Yet, with lock downs having already failed miserably, having been applied, in one form or another, for nearly all last year, authorities are responding, now, with calls for the same failed strategy to be used, just more extensively and harshly. That is the definition of insanity.
If we look at the data, what do we see? On the face of it, we see a significant rise in infections, hospitalisations and deaths. In reality, the data in respect of deaths is completely unreliable. What the figures show is the number of people who have died within 28 days of having received a positive COVID test. But, this is not a measure of the number of people dying from COVID. Someone could have had a positive COVID test 27 days ago, have been perfectly healthy in the intervening period, but, yesterday, whilst out riding their bike, gets hit by a bus, and is killed. They would show up in the data for people dying with COVID! In other words, this is a completely useless and misleading metric for COVID mortalities. Its as though it has been deliberately designed to grossly overstate the number of people dying from the virus. Of course, this is an extreme, though not necessarily exceptional, example of how deaths, totally unrelated to COVID, can appear in the COVID data, but, given that the vast majority of people dying with COVID are elderly people, indeed the average age of COVID deaths is 82, and above the normal life expectancy, many of those dying and recorded in the figures will be people who actually died from old age, or other co-morbidities, rather than from COVID itself specifically.
As Dr. Malcolm Kendrick has put it,
“Did someone die with COVID19, of COVID19 – or did it have absolutely nothing whatsoever to do with COVID19? Who knows? I certainly don’t, and I wrote some of the death certificates myself...
In the US, the Centre of Disease Control (CDC) found that ninety-four per cent of people who died of COVID19 ‘related deaths’ had other significant diseases (co-morbidities) This ninety-four per-cent figures would only be the co-morbidities that were known about – who knows what lurked beneath? Especially as people stopped doing post-mortems (i.e., autopsies in the US).
So yes, they had COVID19 (or at least they had a positive test – which may not be the same thing), but they were often very old, and already severely ill. Using an extreme example, someone with terminal cancer who is a week from death, catches COVID19 in hospital, and dies. What killed them? The statistics say COVID19. I say, bollocks.”
Kendrick has looked at mortality rates this year and compared them with previous years, i.e. total deaths. He found no correlation between lock downs and deaths, or between this year and previous years in relation to total deaths.
The data seems to suggest that what we are seeing is the normal increase in hospitalisations that always occurs in the Winter. Elderly people are more likely to fall ill during the Winter, and so become more vulnerable to viruses such as COVID. As Kendrick says, in years gone by, chest infections were known as “the old man's friend”, because old people in their last days, suffering from other illnesses, and just old age, if they came down with a chest infection, would quickly pass away, relatively peacefully. Today, COVID fulfils the same function, but all these deaths appear in the statistics unrelentingly as COVID deaths.
But, its not just old people. Younger people can also end up in hospital. As we were coming back from walking the dog today, one neighbour was relating how he fell over on the ice yesterday. Break a leg, and end up in hospital, and you might die from COVID. The reason being that, in the outside world, you might come into contact with particles of the virus, but in small amounts. Your body's immune system quickly destroys it. But, end up in hospital, with a load of other people carrying the virus, and your body can be invaded by it in large quantities, in a short space of time. This large viral load then overwhelms your body's immune system. It may go into overdrive to fight off the virus, which is what leads to the other complications, such as pneumonia and so on. It is these large viral loads in hospitals – and the same in care homes – that has made the NHS into a COVID super-spreader.
Some weeks ago it was identified that 25% of the people being treated for COVID, in NHS hospitals, actually contracted the virus AFTER they had gone into hospital for some other cause. That figure is undoubtedly higher today. But, this is only a figure for those being treated for COVID. We know that 80% of people with COVID are either asymptomatic or have only very mild symptoms. So we can deduce that a much larger number of people than this 25% are people who have gone into hospital, perhaps on an outpatient basis, and who have contracted COVID, there, but who have then gone, once more, into the wider world, spreading the virus as they went. That is similar to the way the NHS itself deliberately released elderly people with COVID back into care homes last year, where they spread the virus throughout the care home sector.
In this week's Weekly Worker, Stan Keable relates the tragic story of his brother Robin, who after having a fall at home, was taken into hospital, where he contracted COVID, from which he subsequently died. So, on the one hand, we have large numbers of deaths being attributed to COVID, when, in reality, they are nothing of the kind, and on the other hand, we have large numbers of people being ill for other reasons, who, on going into hospital, then contract COVID, from which they die. In respect of these latter cases, its quite clear that the real culprit is the completely inadequate nature of the NHS. Nearly a year after the virus began to spread, the NHS still has not set up isolation hospitals or isolation wards of hospitals, leaving patients suffering from even minor ailments lying in beds cheek by jowl with COVID patients. This is a step back even from the medical knowledge and practice of the late 19th century.
Lockdown is not a strategy but a tactic: as I see it there are essentially three possible strategies (other than doing nothing) for dealing with an infectious disease like Covid.
ReplyDelete1) "Flatten the curve" to keep case rates just low enough for the health care system to cope with. This was the stated rationale for Europe's initial March lockdowns.
2) "Contain the virus with test and trace": this was the approach in South Korea from the start, and was also the plan which most European countries eventually adopted as their lockdown exit strategy.
3) "Eradicate the virus completely": the approach of the Chinese-speaking countries, the Indochinese peninsula, Australia and New Zealand.
None of those strategies have worked. Flattening he curve simply imposed the health burden for longer, destroyed the economy on which health and other services depend, and enabled the virus to mutate. By not destroying the virus, and by encouraging its mutation, it simply means that as soon as lockdowns are relaxed, it flares again.
ReplyDeleteTest and trace is essentially no different to lock down, except it has less effect on the economy. Its potential applications are very limited. Its purpose in Britain has been simply as a diversion whilst they hoped for vaccinations to save them. Its interesting that in the last month or so, test and trace which is all they could talk about has disappeared from the narrative.
Eradication is impossible as with all other coronaviruses. China is seeing a surge in new infections in Hubei. for example.
The only realistic strategy, as it has always been is 4) Focused protection of the 20% of the population actually at risk, by locking them down, and providing the required support they need. That means the 80% of the population not at risk would have continued life as normal, and the meaningless discussion and panic over infections would have disappeared. Isolating the 20% would have meant there would have been few hospitalisations, and even fewer deaths, meaning that the healthcare system could have continued to treat all of the other seriously ill people with other diseases, such as the tens of thousands with cancer, who have been sidelined, despite the fact that more people die from cancer every year than have died from COVID. The economy would not have been trashed. The 80% would have quickly obtained herd immunity so that although the virus would not be eliminated, its ability to cause widespread infection would be removed.
As its likely to be only in the second half of this year that vaccines are rolled out to the majority, it remains the only immediate solution, combined with focusing the vaccines on the 20%.
Do you have a link re a surge in infections in Hubei? Or did you mistype Hubei (Wuhan's province) when you actually meant Hebei (Shijiazhuang's province)?
ReplyDeleteAs for my analysis of strategies, what fundamentally defines them is "what stops the pandemic?"
In the case of strategy 1 (flatten the curve) the pandemic is stopped by natural herd immunity.
In the case of strategy 2 (contain with test and trace), the pandemic is stopped only by vaccination.
In the case of strategy 3, the pandemic is obviously stopped by the eradication of the virus.
While vaccination is only absolutely necessary to end the pandemic if strategy 2 is pursued, it is still important for the other strategies. For strategy 1 it creates a herd immunity more robust than that resulting from natural infection, while for strategy 3 it is necessary in order to allow borders to be reopened (as well as to end the periodic lockdowns that result from the inevitable imperfection of border quarantine).
Lockdowns and test-and-trace are both tactics aimed at reducing the infection rate: test-and-trace is less economically damaging of course, but also requires that case numbers are already quite low: hence the general European plan of using lockdowns to reduce case numbers to the point where test-and-trace could take over.
Focused protection is also a tactic, but one aimed at reducing the IFR rather than the infection rate. It is useful under all strategies as a way of reducing deaths, but under strategy 1 (which implies that a majority of the population be infected at some point) it is really vital to reduce deaths from vulnerable groups. It also has economic benefit under this strategy as it reduces the amount of curve-flattening you need to do, meaning both less time under lockdown and potentially faster herd immunity.
You clearly support strategy 1 plus focused protection (and clearly think that it could have obviated the need for lockdowns at all, which I'd dispute – I'd argue that Sweden could get away with it but the UK probably couldn't because its population was in a poorer state of general health), while those who oppose it clearly think that focused protection can never be good enough to avoid an unacceptable death toll if enough of the population is infected to lead to herd immunity.
George,
ReplyDeleteI'd taken it from recent TV reports. Must admit I didn't read to carefully. It could be Hebei.
In terms of strategies, and stopping the virus. The question is do they, and in what time scale. I'd argue 1) does not stop the virus, and does not create herd immunity. Rather it delays it. The time required hen for herd immunity is pushed out so far that the economy would have collapsed, and the strategy with it.
With 2) again, it doesn't stop the virus. Its not workable in most cases, because of asymptomatic transmission, and simple logistics.
With 3), its not going to happen.
In all cases, the only real solution comes from vaccination, which is why all hopes have been placed on it. I'm not sure that vaccination does provide more robust immunity. It does for the vulnerable 20%, who can't risk natural infection, but for the other 80%, not only is vaccination extremely expensive, but its not clear that its better than natural immunity regularly topped up by contact with the virus.
Lockdowns don't reduce high numbers to low numbers to allow test and trace to work, because the level of asymptomatic disease is so high that no one knows the real figures. I suspect the actual number who have now been infected is probably in excess of 20 million, and at any one time, we probably have around 1-2 million people actually carrying the virus. The official reported new infections are around 50,000 per day, meaning the real number is between 5-10 times that.
I don't agree with strategy 1, because I think that you need a hyperbolic curve of infections, so as to get herd immunity quickly. I believe that FP is the correct approach. The government should have said, these households are vulnerable, you must lockdown, and self isolate. That is quite easy, because its restricted to those over 60, the bulk of whom are retired. Peer group pressure, and the media should have been used as the main means of achieving that. But, it can only work if a) the state provides the support required to facilitate such self-isolation, and/or other collectives - TRA's, extended families - do so, and b) the period required for such self-isolation is kept as short as possible, which is why rapid herd immunity via high rates of infection is required.
The labour movement should have put its effort into a) building the collectives required to enable such self-isolation of the vulnerable, and b) pressing the government to provide the financial and strategic support for its implementation. But, as with most things, without vaccines it would have to have been an international effort, which again shows why such things need to be implemented on at least an EU wide basis.
The opposition to herd immunity is hypocritical, and opportunist posturing. Every year more people die from smoking related illness; every year around 8,000 die from flu despite vaccines, and in a bad year anything from 20,000-50,000. The real reason for the high death rate is not a high infection rate, but the abysmal performance of the NHS and Care Homes, where most of these deaths have occurred, where most of the infections have occurred, and all of which were wholly avoidable. It amounts to manslaughter by corporate negligence, and when this is over an inquiry should be launched to bring those responsible to book, but I can pretty much guarantee the medical-industrial complex will whitewash the entire affair, hence all of the preparatory social conditioning via the weekly dose of clap for the NHS.
Unless your focused protection is really good, then a policy which doesn't contain the virus at all for non-vulnerable groups would almost certainly overwhelm the health care system and cause vast numbers of avoidable deaths (many of which won't even be from the virus). The vast majority of people wouldn't regard that as acceptable.
ReplyDeleteWhat I'm describing as strategy 1 would (for most European countries) have meant a short lockdown last spring, then adjusting the level of restrictions up or down to keep infection rates just below the limit which the health care system can handle. It doesn't look like any European country actually tried that though: they pretty much all succumbed to the moral panic surrounding "herd immunity" and switched to strategy 2 during the spring lockdown.
Australia and New Zealand instead switched to strategy 3 (most likely because they correctly realized how awful and precarious low-Covid living would actually be), but Europeans (most likely also correctly) regarded that as impossible for them, due to the much higher starting case count and inability to fully seal borders.
Now that vaccines are here, I now regard the eradication strategy as the correct one for those countries fortunate enough to have enough control over their borders for this strategy to have a chance of working.
Any strategy of focused protection is going to be better than what currently exists, where the vulnerable have not been protected at all, and where the attention was put instead on the impossible task of isolating the entire population one from another! The large majority o deaths have been of elderly people in care homes, or in hospitals, most of them infected with the virus either in hospitals or else as a result of people who had been infected in hospital, being returned to care homes. Just having prevent that would have reduced the current number of deaths from COVID by about 70%. It would have had a similar effect on reducing the amount of serious illness, and so demands on the NHS.
ReplyDeleteSo, on the contrary, even a 50% effective FP strategy would have reduced the actual number of deaths from COVID by around 30%, and with a similar reduction in the number of severe illness, and demand on the NHS. It would have more quickly developed herd immunity, and so more quickly created conditions in which such a lock down of the vulnerable would be lifted. The reason that the current lockdowns are crumbling is because everyone now knows they were lied to on several fronts by the government, and its advisors. The virus does not affect everyone equally, but is specific to the elderly. The lock down did not stop the virus, but made it worse, and simply prolonged the agony, and so on.
The UK government said last Spring it would be a short lockdown, but it dragged on for months, and still didn't work. They then followed your Strategy 1, by introducing the tier system, that did indeed end in tears, and yet another lockdown, showing that the original lockdown had been a complete failure.
You seem to have a fetish about wanting to seal borders. Vaccines change the situation for all countries whether able to seal borders or not. If you vaccinate the vulnerable section of the population, i.e. about 20% in each country, then it does not matter whether you seal borders or not. You will prevent that 20% from becoming seriously ill or dying. It doesn't matter if everyone coming into the country has COVID, because they would then only infect people who are not going to be ill from it, and within a short time, most of them would, in any case be immune to it, as a result of herd immunity.
For the same reason I have no interest in all the media hype and moral panic about rule breaking by people. As a vulnerable person, my only concern is with my own behaviour, my own self isolation from any potential carrier. I have no concern whether other potential carriers spread the virus amongst themselves as a result of rule-breaking. Indeed, as such behaviour hastens the spread of the virus, and so herd immunity, I am all in favour of it. The only other people I have concern for is other vulnerable people. For those who like me, can achieve it, the answer is simple, rather than concerning yourself with the behaviour of others, look to your own. Self-isolate, so as not to put yourself at risk of contracting the virus. For those that can't, its up to all of us to pressure the state to enable them to do so, for those who can they should set up TRA's, and other such collective bodies to enable the vulnerable in their midst to be able to self isolate.
As I've said before, its like my son and his nut allergy. We expect the government to insist on proper allergy information on food packaging, we facilitate him in avoiding nuts, but it does not mean we have to stop eating nuts, or otherwise change our behaviour, or insist that society bans nuts. We expect the state to be working on measures to prevent such allergies in the future, and to provide responses to allergic reactions when they occur. But, that's it.
What are your thoughts on the popularity of the "zero Covid" eradication strategy among Labour MPs and activists?
DeleteDo you think it is mere virtue signalling aimed at people who are naive about what an eradication strategy would require: sealed borders plus a long and brutal lockdown like that in Melbourne, which led to Victoria's governor being dubbed "Dictator Dan" by supporters as well as opponents?
Or do you think it could be about adopting a nationalist closed-borders policy (in order to win back the nationalist working-class voters who switched to the Tories in 2019) but justifying it in a way that is less repellent to the internationalist majority of the Labour Party's voter and member base?
On the risk to different age groups and the implications for focused protection strategies, isn't it the case that independent elderly people like yourself are generally at less risk than the working-age population, precisely because of their ability to self-isolate? The risk to the elderly (as shown by data from Sweden) is overwhelmingly concentrated in those who either live in care homes or are dependent on care workers visiting them at home.
For people like the SWP, and their base amongst the teachers unions its about closing schools, as part of trying to close down the economy and cause economic catastrophe that they mindlessly beleive leads to socialist revolution. Amongst Labourites its not much better its about adopting a stance that is always whatever the government is proposing or about to do, plus a bit more, a bit more efficiently and so on. In other words pure opportunism.
ReplyDeleteThe risk to the elderly is a function of the fact that the virus targets those groups wherever they are, probably due to the reduction in their immune system capacity. The only difference as far as elderly people are concerned - apart from the natural variations in immune systems, the fact that some are healthier, fitter and so on - is then down to contact with the virus. So, I am generally fitter than many people in their thirties, which would probably mean I would have a better chance than others in their 60's, but because I have suffered throughout life with asthma, I am less likely to survive it.
This is why its people confined to Care Homes and hospitals, who have not been protected against contact with the virus where, everywhere, the vast majority of deaths have occurred. The others, as you say are the elderly in their homes dependent upon care workers coming in, who have not had proper PPE, support or contact protocols. In Care Homes and hospitals, you see workers coming down, because of a combination of - often they are themselves not very healthy, obese, and so on - and high viral loads that overwhelm immune systems. In other words, few people are affected by COVID outdoors, because they do not get enough virus for it to spread before the body kills it, if any at all. But in care homes, and hospitals, workers often without proper PPE are in constant contact with the virus in large quantities, so that large amounts of virus invades the body constantly, multiplying itself, and in a way that the body's immune system cannot cope.
The same is true where large numbers of people in one place have the virus, and they are in close contact for prolonged periods, so that those who have not already obtained immunity can have their system overwhelmed.