COVID crisis and Serendib sanity

It’s time to restate terms of reference and redefine thresholds meriting panic

Of late, despite flashes of social media mania, there has been heartening focus here in Lanka from policy makers on evidence based COVID responses, localised interventions where needed, encouraging prudent social distancing and hygiene measures. This deserves to be supported. While I could wish for greater clarity and coherence on the tourism front (of increasing urgency to the industry and the foreign currency fortunes of the country), overall, there is some economic ignition. And this invites an overall review of the situation at large to bolster the government staying the course to sensible as well as safe recovery.

An orgy of incoherence

Each day, in ‘COVID panic land’ statements are issued that are never seemingly challenged, or even questioned, or even unpacked, or even ‘quizzed’ for minimal coherence.

First, just a canopy bit of perspective, quoting Lord Sumption, former High Court Judge in the UK, who has become a lightning rod for speaking out about the mass invalidation of civil liberties over hyped hysteria.

“COVID-19 is a serious disease, but historically it is at the bottom end of the scale. For anyone under 50 the risk of death is tiny, less than for seasonal flu. In the great majority of cases the symptoms are mild or non-existent. Our ancestors lived with far worse epidemic diseases without rushing to put their heads in a bag. In other parts of the world they still do (world-wide, tuberculosis kills many more than COVID-19).”

While there is some outrage evident in Lord Sumption’s assessment, the above statements are all factually true, and can be objectively corroborated. Relative to our ancestral experience with viruses, I will spell that out further below as well, so as to pacify the ‘here and now’ doomsayers.

Samples of mindlessness

“What if COVID never goes away?” Since it kills virtually no one in statistical terms below 60, and above 60 without comorbidities recovery rates are still highly encouraging, and since the impact on net mortality is not anywhere close to seismic on the actual numbers, the answer is, “We live with it.” Or “We end all life as we know it due to what is tantamount to a bad influenza period.”

It’s a virus, likely may not disappear. We will develop greater immunity, our hygiene habits will improve, we might get a vaccine, but we need a ‘vaccine’ against panic and the myopia of ‘risk-free’ living, which we have not imposed on ourselves in reaction to anything else in history: from terrorism to earthquakes to tuberculosis to race car driving (so from the man-made catastrophes to natural disasters, to global diseases to human hobbies).

So, the question emerges, other than the now clearly discredited ‘optics’ of warning us of millions of deaths, inflamed by modellers who have perfected the art of imperfection in their predictions (and our saying that is as ‘factual’ as it gets), and other than reality being ‘gaslighted’ by deranged and virtually unremitting media reports urging panic and paralysis upon us, what triggers this bizarre new threshold of absurd self-preservation, even when the opportunity cost is the virtual end of social and economic life as we know it? We ‘sneezed’ civilisation away?

“What if there’s a second wave?” It will, if following the patterns of virtually all viruses, be even less dangerous, immunity will be greater, we may be sane enough to protect nursing homes, and we will find the rebuilding of society a better place to focus our attention.

And why on God’s earth are we so infatuated with caseloads? A mild upward tick in Catalonia and the UK in sheer panic imposes quarantine on anyone returning from Spain? Overall net mortality is no worse than the UK (zero in the last two days, 1 and 2 August), and we are just postponing the inevitable, unless the UK is going to not only leave Europe but take leave of its senses at the same time, and operate as an ‘anti-COVID fortress’ with dwindling economic and cultural and social prospects. But by God I’m not getting a fever or a dry cough, forget number of deaths annually by influenza, pneumonia, crossing the street, diabetes, heart attacks…all acceptable ‘except’ the dread…theme music please!...scourge of ‘COVID’!

Vietnam, which marshalled its sanity and responses so remarkably and reports to date no deaths from COVID, found three residents infected in DaNang, after months of no local cases reported apparently, and in a fit of over-reaction, shut DaNang down, and evacuated the (mostly local) tourists from there. Elephant guns and mosquitoes come to mind. 

Some large multinationals have proclaimed no face-to-face meetings, even if crucially needed in local markets, until 2021! On what basis? Surely, this should be assessed locally? And if you are in a community which is recovering, now has 1,000 people gathering thresholds, or marriages of up to 500 or more taking place in Asia, and if you are a newly forming team that needs to engage, to rally, to align, to build the necessary relationships for greater virtual work to be possible in fact, why would a HQ ‘declare’ themselves a medical authority on gatherings per se, large or small, decoupled from the leadership discretion of leaders you have entrusted brands, livelihoods of your employees and hundreds of millions (or more) dollars in revenue to? And should not a ‘factual’ threshold, rather than a calendar one be established?

We surely cannot manically shut down whole communities when infection rates and lethality rates show a serious but statistically modest viral challenge. But the economic meltdown, psychological impacts, social disruption, while not reducible to lab results, are every bit as palpable, arguably more devastating in the medium to longer term, and will not recover if societies and economies are being turned ‘on’ and ‘off’ by every ‘spasm’ of control fetishism.

And the ‘facts’ keep rolling in

Just taking the ‘florid’ Floridian over-reaction, a cursory look at 25 July shows 124 deaths reported, of which only one, only one I reiterate, took place that day! The rest were merrily backfilled from 28 May cumulatively! Should this not be taken as scandalously distorting? No, just another day in the ‘porn media’ sweepstakes. As I write (2 August), hospital capacity in Florida is greater than it was on 2 July, despite 300,000 tests administered since.

We also hear from numerous studies, including from Professor Francois Balloux in a pre-print, reconfirming evidence that 8 out of 10 who never had COVID-19 seem to have an immune response triggered by T-cells based on prior exposure to other illness, including the common cold. That would argue for an affinity between this coronavirus and other more common strains, rather than this being a world ravaging contagion unlike any seen before. One wonders if we never encountered a virus prior to 2020.

Hot on the heels of that, ‘The Wall Street Journal’ reported: Flu wiped out in Southern Hemisphere virtually, from reports. As an example, Chile had recorded as of the time of the article going to print, 1134 respiratory illnesses compared to 20,949 last year. Could it be that people diagnosed with flu or influenza are being “tagged” as COVID-19, particularly those who die, hence the cases of flu and influenza seem to be on a precipitous decline?

As the plummeting numbers of seasonal respiratory viral infections from Argentina to South Africa to New Zealand continue to confound, the myopic are congratulating draconian COVID containment measures for this positive by-product, ignoring the far more likely rationale that these are still there, ‘baked’ into the COVID numbers. After all, other than via notoriously fallible tests, based on the symptoms, how could you know?

Once more a plea for perspective

Despite only 2% of DC’s hospital capacity being utilised, school has been cancelled for the Fall due to the demands by the teacher’s union, with overwhelming global evidence of school openings being unconnected with any spikes thereafter, children not being at risk by and large (statistically being far more likely to be killed riding over to school, and over 9 times as statistically likely to drown – source CDC – than from deaths ‘ascribed’ to COVID), we have to more than wonder. Specifically, 138 COVID ‘ascribed’ deaths in that age group versus 995 from drowning in an average year, 4,000 in auto accidents for school age kids and teens over a similar period.

The Lancet has now also weighed in that lockdowns don’t work, in a country by country analysis. But we already knew that! Just compare Japan to Belgium! Compare Taiwan to the UK. And we’ll get to Sweden, as fatality numbers plummet, and it was the only Western country to have grown economically last quarter (Taiwan grew first quarter 2020 too). But for some reason we should insist rather that our ‘poster children’ for COVID rectitude should be the shattered economies with no viral ‘breakthrough’ to show for it? Virtually all of Europe has said, no hardcore lockdowns going forward, localised restrictions, prudent, evidence-based reactions, and following key elements of the Swedish model, would be the essential playbook.

As a percentage of the global population, even with all the likely ‘mis-stated’ COVID fatalities, taking the numbers as gospel, we come in at .0052%. Swine Flu (2009-10) was .0029%, HIV .565%, Hong Kong flu of 1968 also much higher at .027%, Asian Flu of 1957/58 still higher at .070%, the Spanish flu of 1918 a ravaging 2.73%. The global economy persevered, the world progressed and moved on to fresh prosperity through all of these. Just yesterday we read the sheer collapse of GDP in the US has eliminated the last five years of growth in one fell swoop in a matter of months.

For those who relish historical comparisons, the true pandemic ‘terrors’ were the Black Death of 1347-51 with 42.11% as a percentage of global population and the Plague of Justinian 541-542 with 28.51%. Doubtless the rudimentary understanding of medicine in those eras was a sharp contributing factor to the exponential growth of the respective contagions.

The perpetuation of fraudulent panic-mongering

Though mass congested protests are seemingly of no ‘superspreader’ concern through some unexplained medical voodoo (pandering for political advantage being one of the ‘vaccines’ against public health nostrums it seems), when ‘panic’ seemed on the wane, mainstream media stopped tracking ‘deaths’ (despite even those being periodically miscounted as per the CDC or back-filled), and decided that all ‘infections’ past or present would now be anointed ‘new cases’. And voila, the floodgates are open once more via some linguistic legerdemain. Not sick? No problem! No symptoms? Easy. Symptoms which could be mild and seasonal? You dare not make light! Not dying? Give it time…stop society!  Then came the mask mandates. We all know about them, so let me simply make the point that they are far from settled science, and they are downright dangerous when exercising, as the deaths of several Chinese students while running a race during PE with these contraptions heart-breakingly revealed.

The Norwegian health authorities, not noted for their reckless or libertine ways (and with some of the best COVID stats in Europe), doubled down recently on their recommendation for those without symptoms not to wear face masks, arguing the number of infections in Norway made them moot. 

Taking the most optimistic efficacy number, medical masks prevent roughly 40% of infections. 200,000 would have to wear them to prevent one new infection per week in Norway. As the agency wrote, “The number of people who experience undesirable effects (difficulty breathing, communicating when that is critical, or dropping other hygienic prudence being given a false sense of security) is likely to be much larger than the number of infections prevented.”

They concede that in congested community settings, public transport, etc., there ‘might’ be some benefit, but again largely with medical masks. They note even then, “However, study results vary greatly.” This meshes with the recent conclusion from the Dutch government indicating they will not require universal mask wearing as effectiveness of overall ‘masking’ has not been demonstrated to their empirical satisfaction. 

Oxford University points out that no government should be able to mandate this usurpation of civil liberties for something that is not ‘settled science’ by any stretch of the imagination, based on observational assertions. The suggestion is that ‘liberties’ are not to be trifled with, or annulled absent overwhelming ‘evidence’ not assertion.

The great lockdown lacuna

There was a gaping policy hole that ‘lockdown’ sought to furtively fill, the pseudo-scientific reflexive obeisance to untested modelling. 

From the reliably inaccurate doomsday prognosticator Neil Ferguson had come the ‘second Spanish flu’ (which had led to 50 million deaths when the world’s population was a fraction of today’s, roughly 1.7 billion, one third of which became infected) prediction re COVID, predicting 500,000 deaths in the UK alone, and if Sweden continued its flirtation with disaster, ‘at least’ 80,000+ there. Since Sweden has less than 6,000 deaths with no lockdown and 75% of those were from nursing home cases which they tragically mismanaged, and as we have countries that have not locked down, which have not produced such torrents of mortality, perhaps we can leave the modellers alone at last?

Even by the end of February, the Diamond Princess Cruise Ship provided a perfect sample to extrapolate from. And this was evidence-based, not model-based. 3711 passengers and crew, quarantined after a virus outbreak, with an average age of 58 were repeatedly tested. There were 705 cases (19% infection rate), 6 deaths (case fatality rate of 1%) by the end of March, eventually 14 in total, compared to the 116 that the Imperial model would have predicted. Over half the cases were ‘asymptomatic’, which if you take it at face value, meant many more were infected or ‘had’ been infected and the tests were picking up residue of the virus (which we are told can be detected for up to two months after it is no longer ‘live’). Either way the mortality rate would then resemble ‘severe seasonal influenza’ as a saner version of Anthony Fauci had himself written earlier in the New England Journal of Medicine.

Almost all the deaths on the Diamond Princess were in the over 70 age group. Later the USS Theodore Roosevelt produced one death and three hospitalised cases out of 1,156 infections (much younger and healthier profile of course), no deaths out of 1,046 cases on the Charles de Gaulle either, and this pattern continued to repeat.

WHO itself had added to the panic due to a rookie computational error, asserting the population mortality risk to be 3.8%. They arrived at this by taking the then known Chinese deaths and dividing them by the number of confirmed cases, ignoring that likely only a small proportion of infected people had been tested, asymptomatic cases were likely not represented, and those who went in for testing were inevitably those with serious symptoms. This evident computational distortion contributed also to the policy errors relating to both hospital capacity and nursing home fatalities. Deaths in care homes are now estimated to have accounted for half of all COVID-related mortality. When it was suggested, looking at 96% of Italian mortalities for example, coming from the elderly with comorbidities, that we isolate the vulnerable, and not shut down the planet, people said it was ‘unrealistic’ and ‘had never been done’. As if closing down the world, putting the wider economy into enforced seizure with no possible available longer-term financial hedge by which to recover livelihoods and industries, was a sane alternative?

For perspective, 650,000 COVID deaths globally pale next to 33.4 million deaths to date roughly in 2020 overall, and for most of the population (under 65 with no pre-existing conditions), normal influenza, road accidents, suicides, and a host of other causes of death (TB, cancer, hypertension, diabetes) are statistically far more significant. But the newness of COVID and the frenzied, fevered, unrelenting media hype have stripped most people’s critical faculties of any proportionality on that front it seems.

Though Stockholm with 2.5 times the population density of New York State outperformed NY State on virtually any COVID metric you care to name overall and at their respective peaks, and therefore still has a relatively open economy today, far more so than NY State, when facts made it evident the virus had all but disappeared from Sweden, there was from the media enablers and all the governments who had clung feverishly to the ‘lockdown’ mania, not a word, just deafening silence. 

Researchers from the University of Toronto found that whether a country was locked down or not was ‘not associated’ with the COVID-19 death rate. The noted journal Lancet cites, “Government actions such as border closures, full lockdowns, and a high rate of COVID-19 testing were not associated with statistically significant reductions in the number of critical cases or overall mortality.” They did plausibly keep, for an initial period, hospitals from being over-run, and that should certainly be evaluated in a focused way on that basis.

The bad science round up

Forcing people walking in parks to wear masks, when even the most fantastic assertions of aerosol transmissibility, which came from machines in lab settings, do not suggest in open air, a mere cough or exhalation magically can be infectiously propelled to unwitting passers-by, is moronic. Swedes and Danes and the Dutch have been enjoying social interaction in cafes and bars, but don’t let the Irish near those pubs (10 August may see that finally relaxed). As one commentator mentioned, they doubtless have an obscure Irish custom they have to be weaned off we don’t know about, that in riotous affection leads them to kiss each other’s noses and hack into each other’s throats whenever in pubs. Otherwise, what happens on ‘10 August’ that wasn’t true on ‘10 July’ seems quite inscrutable.

Melbourne has interrupted its last ‘Level 3’ Lockdown to initiate a new six-week ‘Level 4’ Lockdown (replete with overnight curfew) due to the admitted concern of 600 or so cases of what they are calling ‘community transmission’. But the ‘surge’ in deaths has been ‘7’ on the same day as the 600 cases (considered ‘recovery’ numbers in much of the planet) and still the overall COVID ascribed death count for Australia is 208 from February across the entire country! The fragility of the economy does not suggest immunity to other shocks likely to flow from these overlapping, never ending lockdowns, particularly as it’s winter there, and viruses are known at times to naturally spike over that period.

And why don’t we finish yet another round-up of our fevered over-reactions with the precarious petulance of the ‘tests’ by which these dire read-outs emerge at all?

Professor Carl Heneghan, Director of Oxford’s Centre for Evidence Based Medicine, provides a bracing corrective, indicating that at lower prevalence of the virus, ‘sensitivity’ and ‘specificity’ of the testing gets less precise. 

You start first with the ‘sensitivity’ of the test: the proportion of people who test positive out of those who actually have the virus. The second is ‘specificity’ which is the proportion who test negative, out of those who should indeed have done so. The true specificity and sensitivity of the prevailing tests are not known, admitted to by the UK’s Office for National Statistics, owing to the newness of the virus, a tripwire shared globally.

Let us take the Professor’s operating theatre of the UK and assume say 1,000 people have the virus, say .1% (current actual estimates are lower, hovering around .04%). Now, say 10,000 random people go get tested. So, 10 people will have it at the .1% infection rate, and 9990 will not. Estimates tell us 80% of those who have the virus test positive says the Professor (easily corroborated), this is the “sensitivity” and the “specificity” for those who test negative may be as high as 99.9% with the best (rare) tests.

So, on this basis, 8 people will be correctly identified, and 2 will receive a false negative. 

Of the 9990 that are actually negative, all but 10 will be correctly diagnosed as ‘negative’. But 10 will be told they have COVID-19 when they actually don’t. That gives us 18 positive tests; eight from those who have it, and 10 from those who don’t. So only 44% of the infections indicated are real. Hence, we have to say, alarmingly, the chance of accurately detecting the disease being less than 50% is fairly glaring.

This isn’t hypothetical, as current viral levels are lower than the above case study. The US Centers for Disease Control kits concede they can generate up to 30% false positives! With the top tests costing upwards of GBP 100 per test, developing countries necessarily opt for more affordable options, with tests where specificity could be as low as 95%.  Then in the 10,000 test scenario, there would be 500 false positives among the 8 genuine positives, so the false positives would far outstrip the genuine results, providing an appearance of a ‘surge’ in infections that seems mystifyingly disconnected from numbers of hospital admissions and deaths. So if at low prevalence, with false positives rising at the same time actual infections plummet, then even if COVID-19 completely disappeared (the aspired to promised land), then even with no actual positives, on the above example, 10 people would be wrongly diagnosed as positive, and the official data would obstinately still show a .1% prevalence of COVID-19! Off the current testing regimes, we may be incessantly chasing a shadow, and we may endlessly perpetuate panic and social and economic meltdown over a veritable phantom as a result. 

Therefore?

It’s time to restate terms of reference and redefine thresholds meriting panic. We must clarify actual mortality and not ‘caseloads’ as the relevant metric and compare cost/benefit trade-offs rather than allowing ourselves to be economically devastated and medically cuckolded by episodic ephemera posing as data.