COVID-19, It Is Not the Virus That Is Killing Us
We are more than half a year in this COVID-19 situation, and it looks like we are not at the end of it yet. Is it the killer virus we expected it to be? What have we learned? Or did we learn anything at all? What are the consequences of all the measures governments have taken?
COVID-19 was first identified in China in December 2019. This is not something new, we have had more new viruses from China. There are some reasons for this, but also now this was not something out of the ordinary. Contrary to some media, it is not a new virus, coronaviruses are already around for some time.
On the 11th of March 2020, the WHO officially declared a pandemic. This sounds serious, but what does the WHO consider a pandemic? The definition of the WHO is: A pandemic is “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”. The classical definition includes nothing about population immunity, virology, or disease severity.
The only thing pandemic covers is that it is an epidemic occurring worldwide, it is not even necessary that a large number of people is affected. The other thing is that also disease severity is not included in the definition. We have our pandemics of influenza, rhino, and norovirus and we continue our daily lives without being anxious about this. The definition of a pandemic is very loose.
At the start of the pandemic, we did not know what we had to expect. We had to work with the numbers which were available at that time and make the best of it. Many countries choose to apply harsh measures to try to lessen the impact and flatten the curve. Now, we have more numbers, we know more about the infection or case fatality rate, and we know which groups of people are affected the most. People who are at risk of dying with corona are elderly, often over 80 years with comorbidity (overweight, smoker, diabetes, cardiovascular disease, lung disease, cancer), in some studies on average even two comorbidities. Important to keep in mind is that dying with the disease (association) is not the same as dying from the disease (causation). Concerning COVID-19 most mortality is because of dying WITH COVID-19, and not dying FROM COVID-19.
Case fatality rate (CFR) is the change you will die from corona if you have confirmed disease. Infection fatality rate (IFR) is the change you will die if you have an infection, but in corona, this can be without symptoms. The CFR is subject to selection bias as more severe cases are tested — generally those in the hospital settings or those with more severe symptoms. The number of infected asymptomatics is uncertain; and also not everyone who has symptoms will present for testing. Therefore, we can assume the IFR is significantly lower than the CFR.
Estimations of the IFR is around 0.28% now (September 2020). However, the considerable uncertainty over how many people have the disease, the proportion asymptomatic (and the demographics of those affected) means this IFR is likely an overestimate. Usually, we also see that during an epidemic the IFR drops. In Swine flu, the IFR ended up as 0.02%, fivefold less than the lowest estimate during the outbreak (the lowest estimate was 0.1% in the first 10 weeks of the outbreak). In Iceland, where the most testing per capita has occurred, the IFR lies somewhere between 0.03% and 0.28%. This is far from the predicted CFR of 3.2% by the WHO at the beginning of the pandemic.
Seasonal influenza has an IFR of 0.1 to 0.2 %, this suggests that COVID-19 might not be more deadly than influenza. There is however a big difference, seasonal flu has a higher IFR in developing countries, where vaccination is rare, while COVID-19 has a higher death rate in the developed world, thanks in part of more elderly populations.
By now it is obvious that COVID-19 is not the killer virus we expected it to be, and that is a good thing, but there is a caveat. In the case of COVID-19, it is not the virus that kills, it is the measures our governments have taken.
To paraphrase Ronald Reagan
In this present crisis, government is not the solution to our problem, government IS the problem. It isn’t so much that the government is ignorant, it’s just that they know so much that isn’t so.
Ronald Reagan
As a global response, a majority of countries choose for a lockdown. The lockdown could be very harsh, or more intelligent, but the result is that we will see an economic backlash which could be even worse than the Great Depression. Politicians were warned about this, but one of the mantras was that health goes for the economy. That is a false proposition, there is not one country that has bad economics but excellent health care. You can have an opinion about it or a feeling, but in real life, economics go before health care. Only when there is good economics it is possible to develop good health care.
The consequences of losing one’s business, or losing a job are not only economical but also affects our health and mental health. Involuntary job loss is associated with an up to a twice higher rate of suicide and attempted suicide. Low socioeconomic status is up to four times higher rate for suicide and attempted suicide compared to high socioeconomic status. In 2018 in the USA, there were close to 50.000 recorded suicides according to the CDC’s National Center for Health Statistics. On average, the annual U.S. suicide rate is 15 suicides per 100,000 people. If this rate goes up it will have a significant impact on mortality, and this effect is not for just a year. Another effect, but more difficult to measure, is the effect of de-socializing and dehumanizing measures of distancing and wearing face masks on mental health and the feeling of fear.
Because of the lockdowns, our supply chains have been broken. Slaughterhouses are closed. This means that millions of animals are killed and cannot be processed. Farmers have to destroy their crops because they cannot bring it to the market. This does affect the developed countries, but it is devastating for developing countries that are dependent on this food supply. According to Oxfam by the end of the year, 12,000 people per day could die from hunger linked to COVID-19, potentially more than will die from the disease itself. One hundred twenty-one million more people could be pushed to the brink of starvation this year as a result of the social and economic fallout from the pandemic including through mass unemployment, disruption to food production and supplies, and declining aid. The predictions of the World Food Program are even worse, the number of people in acute food insecurity may double by the year-end to 265 million because of the coronavirus.
The measures also have had a devastating effect on health care. The care for COVID-19 patients has spared some lives and has won some life years, but the loss of life years in other patients is much higher. Only in the Netherlands estimations are that 10.000 people will die 10 years earlier than would have been expected. This is because of delay in regular care, in cardiology the number of patients who were treated declined by 29%, in surgery this was 28% and in neurology 24%. Additionally, the screening for cancer came to a halt. The number of newly diagnosed cancer cases went down by 30%. This means that 30% of patients are not diagnosed or will be diagnosed much later and therefore have a worse outcome. Estimations for the Netherlands are that there will be a loss of 100.000 to 400.000 healthy life years (10 times more than the life years we won with the care for corona patients) This is unheard disproportional damage. In developing countries, the next five years mortality because of HIV, TBC, and malaria will rise by 10, 20, and 36 percent respectively. The Global Fund to Fight AIDS, Tuberculosis, and Malaria state that more people will die because of this than by the COVID-19 pandemic. Most recent numbers show that 85% of the HIV, 78% of TBC, and 73% of malaria health programs are disrupted by the pandemic.
It is not the virus that is killing us. It is the measures we have chosen to take and now is the time to overthink if it is worth continuing this…
Interesting links:
Why Virologists Are NOT Our New Heroes
COVID-19 is the New Cult
How To Recognize That You Are Being Brainwashed
Ausweis Bitte!!! (Pass, please!!!) Do We Really Want to Go Back There With the COVID-19 or Green Pass?
China Has Outsmarted the West, the World Is Dancing to Xi Jinping´s Tune
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