After the UK government halted the lifting of lockdown with a screech of brakes, because of an increased number of cases over the last month, I’ve taken a closer interest in the official stats. It’s better than reading endless e-mails about the exact meaning of the regulations on wearing facemasks in church, but leaves me equally bemused.
There has indeed been a gentle rise in the number of “COVID positive tests,” which looks worrying. Some say the dreaded “R-number” has exceeded 1:
But this, as a number of others both here and in the US have pointed out, means virtually nothing because of the number of uncontrolled variables: increasing testing, changing sampling systems and distribution, the non-specificity of the tests, and their probable ability to detect virus fragments some time after the patient has cleared the infection. The last means that the more complete our herd immunity, and hence safety, the more likely we are to see increasing cases.
Many epidemiologists have said that the only really valuable figure is the death rate, but this too is complicated by the policy of including all who have died at any time after a positive COVID test as “COVID deaths.” Not only does this drag in those like comedian Bobby Ball, who died at the height of the epidemic from terminal cardiac failure and happened to test positive for COVID. But it also includes an unknown number who die from entirely unrelated causes, like the guy in America who was struck by lightning on a ladder, suffering horrendous and mortal injuries, but tested positive for COVID on his admission and was included in the figures. I’ll have more to say about that shortly, but note that the government site points out the policy of including all patients who have died with a positive COVID test in the figures.
Nevertheless, even if we take the fatalities at face value, the mortality in the UK population is just 7 people per 10,000 of the population, and of course 80%+ of those were in the 80+ age bracket, many of whom would have succumbed to winter infections this year anyway. Given that a new UK study has shown that for every three COVID deaths, a further two have been caused by lockdown – and that’s before we begin to reap the predictable mortality due to the coming recession – lockdown has been an unmitigated medical disaster, as I predicted in March. Lockdown has simply served to show the stupidity of relying on un-validated models for prediction, but also the questionable rationality of the government and its scientific advisers for defending the policy and even sticking with it as we move forward.
In this regard, it is now clear that cases peaked before lockdown, and so even without counter-examples like Sweden the gloomy projections of half a million deaths here were no better, and possibly worse, than reading the omens of a sheep would have been. Astoundingly, HMG still appear to be using those failed models for predicting a terrible second wave. Neither the press nor politicians are demanding explanations for this, though plenty of social media from people who are asking have been censored.
Note to Boris: every model is wrong, but some are useful. Those which make erroneous predictions an order of magnitude too great in every country they have been adopted are not useful, and should be dropped like a hot brick.
But let’s look more closely at this second wave, ie the increase in case numbers that has precipitated quarantines that have ruined people’s holidays, and the holiday industry’s livelihoods, and bans on live music that have kicked an industry already on the ground, not to mention the imposition of face muzzles by law and with little clear evidence of benefit. Oh yes, and the threat that we can’t re-open our schools unless pubs and shops (and churches?) close.
What is immediately obvious from the stats is that, despite the slight case increase having lasted over seven weeks (with a suspiciously sudden start), hospital admissions have continued to decline, on some days to single figures.
Now, given the anomalies in death records (including the impropriety of using “excess deaths,” as is done for flu deaths, because lockdown has added so many deaths on its own account), admissions for COVID are our best guide to the real situation: serious COVID-type symptoms in mid-summer are highly likely to be due to that cause.
But the continuous decline in admissions is inconsistent with a “second spike” of the same disease, since the criteria for admission have not changed, and likely fewer people are being left to die in care homes after the adverse publicity. It seems likely that if you get ill now, you will get admitted and numbered in the stats.
So fewer admissions must mean either that the virus has lost its virulence and is now working more like a vaccination program, in which case we should relax, not tighten, restrictions; or that, as many have suspected, the increased positives (largely in asymptomatic patients) have been caused by anomalies of testing, as I have discussed already.
But the other interesting observation from the data is that, whilst deaths have been dropping, as well as hospital admissions, they don’t appear to be dropping as quickly as the admissions. And that does not compute, because we have learned a lot about treatment, ventilator figures are down, and so we ought to see a lower proportion of deaths to admissions.
I’ve done some crude calculations, by totalling the admissions in England for each month from April 1, and the monthly deaths dated from a fortnight later (around the average time from admission to death). The percentage of admissions dying at the height of the epidemic in April and May was 33% and 34%, respectively. Total cases by June had already dropped dramatically (only 9,159 admissions compared to 54,145 in April), and the death rate also dropped a little, to 31%, as one might expect from more refined treatment and, perhaps, less pressure in the ITUs.
But the figures for the last full month, July, show that although there were only 3,058 admissions, there was a dramatic rise to a 55% mortality. Indeed, over the last week or so (admitting that the stats may come under revision later) there appear to have actually been more deaths than admissions, which is absurd.
Somebody with more application than me might do well to reckon the figures at a finer grain, perhaps using weekly figures, but it seems to me that the only plausible explanation is that a very high proportion of the current death figures are actually deaths from late, unrelated causes in people who, at some earlier time during the outbreak, have tested positive. Given the age distribution of the disease, this would mean that the 90% of elderly patients who survive the infection without major problems are, as one would expect, beginning to die from the usual causes of old age: heart attacks, strokes, cancer, dementia and so on.
Previous COVID infection would be more or less irrelevant to their deaths, and the implication is that the total number of deaths attributed to COVID-19 has been, and is increasingly, exaggerated. As time goes by, the COVID death figures will increase because more of the population will have survived infection by the virus (generating apocalyptic headlines, perhaps?) even as the outbreak dies away. At the same time, the way the stats are presented will increasingly downplay the non-COVID deaths precipitated by lockdown, simply by invoking a positive COVID test at any time in the past.
In other words, because of how they are counted both case numbers and deaths give a false impression of ongoing COVID problems: only hospital admissions are indicating the true picture, and that is of steady decline.
So to reflect reality we have to revise that 0.07% population mortality downwards, perhaps to 0.05% or less.
The disparity between seriousness and the political (and scientific) response is even greater when compared to previous pandemics. I mentioned back in March that the Hong Kong Flu of 1968-9 killed 80,000 in Britain, many of them young people. But the population then was only 55 million, giving a population mortality rate of 0.15%, or double that assumed of COVID-19, as well as an actual number of deaths nearly double our present one – which is worse than much of the rest of the world.
COVID-19 is scarcely the Black Death, then, where the mortality was nearly 50%, or even in the league of Spanish Flu, with a mortality ten times that of COVID. Despite that, our collective response has trashed the world economy and disrupted life more than any epidemic since the Black Death.
I understand that Frank Borman developed Hong Kong Flu whilst on the Apollo 8 Mission around the Moon, apparently catching it from Lyndon B. Johnson, the ex-President. That surely cries out for the kind of comparison often heard when our society louses up – “We put a man round the moon with Hong Kong Flu, so why can’t we have a normal church service during COVID?”
Answers on a postcard, please.