Over the past two weeks, a growing number of people have questioned the dramatic measures being taken to stop the spread of Covid-19. The chorus began with John Ioannidis of Stanford, who has argued that we have under-counted cases of Covid-19, leading to an overestimation of the death rate.
Since then, Covid-19 skepticism has found a home on the right. The Federalist, the Wall Street Journal and the American Thinker have all published similar arguments.
Superficially, these arguments make sense. Many celebrities and athletes have tested positive for Covid-19, despite experiencing only mild symptoms or being asymptomatic. Most people don’t go to the doctor because they have a sore throat and a fever, ergo a dramatic undercounting of cases seemed possible.
However, the number of undiagnosed cases is not quite as dark a dark number as Dr Ioannidis and the editors of the Federalist believe. In countries that successfully contained the spread of Covid-19, you can place a ceiling on the total number of undiagnosed cases. This allows you to account for undiagnosed cases when estimating case fatality rates.
In an infectious disease, the basic reproduction number (R0) represents the number of people to whom the average infected person transmits the disease. For example, if the R0 of a disease is 10, the average person who has the disease spreads it to 10 people.
To stop the spread of a disease, you need to push the R0 below 1. You can accomplish this by finding those with the disease and placing them under quarantine. Scientists estimate that Covid-19 has an R0 of around 3. To contain Covid-19 through quarantine, you would need to detect at least two thirds of all new cases and place them under quarantine.
We know of two places that have succeeded in containing Covid-19: South Korea after 11 March and Hong Kong before 13 March. During the periods in question, the number of new cases per day remained constant. From this, one can infer that the number of contagious people not under quarantine remained the same. To maintain this equilibrium, these localities must have detected at least two thirds of all cases.
As of today, 28 March 2020, South Korea has recorded 9,478 cases, 144 deaths and 4,811 recoveries. This works out to a 1.5% fatality rate, if you divide by total cases, and a 2.9% fatality rate, if you divide by closed cases. If we adjust these numbers to reflect a two thirds detection ratio, we are left with a 1–2.9% case fatality rate, depending on whether we divide by total cases or by closed cases.
On 13 March, the number of new Covid-19 cases in Hong Kong started rising. On 12 March, Hong Kong had 131 total cases and 3 deaths, which works out to a death rate of 2.3%. Performing the same adjustment gives a death rate of 1.5%, using total cases as our denominator.
Readers should keep in mind that my estimate of the number of undetected cases represents an upper bound. We know that Covid-19 patients spread the disease to doctors, nurses and non-Covid patients. If we accounted for new infections caused by known Covid cases, it would lower our estimate of undetected cases.
Dr Ioannidis would likely attribute the reduction in R0 to social distancing and the use of masks. This wouldn’t alter our estimates by much. If social distancing and masks reduce the R0 of Covid from 3 to 2, we would lower our estimate of the Hong Kong death rate from 1.5% to 1.2%. That would still be a death rate of above 1% for a novel disease to which we have no immunity.
In his article, Ioannidis estimates that the true case fatality rate for Covid-19 could be as low as 0.05%. For that to be true, 29/30 cases in South Korea would have to go undetected, and masks plus social distancing would have to completely explain their success. One would love to believe that, but it is mathematically untenable.
The dark truth is that South Korea and Hong Kong represent best case scenarios. Their populations are healthier than America’s, and their health care systems weren’t overrun with patients. If we look at Spain and Italy, we see what a worst case scenario looks like, with official death rates of above 8–10% and older patients left to die.
Hopefully, we can dispense with the pangloss and address the issue. If we don’t figure out a solution, we will face a catastrophe similar to the Spanish flu or possibly worse. We need to find a solution to this medical and economic problem, and we need to find it soon.
13 comments
I would hate to see measures as dramatic as these go unquestioned, even if they are justified. A people that can do that are a people ready to accept oppression. In a free society, if governments can’t do this without being questioned, then good! It helps keep them honest.
Either as a people too free to stop a disease in its tracks, or as a people too obedient to prevent the rise of tyranny, lives are at stake. States with too much power and authority have been known to kill people by the millions too, you know.
The important arguement is one of quantitative response. What is the cost of the response? The shutting down of the economy to “protect” us. The deaths of those who, in all likelihood have reached their expiration date anyway, or close to it, or, who have lived their lives in such a way that their health and/or medications put them at advanced risk? How many generations will now suffer due to the financial setback their families will incur from this political response of shutting down the economy? Businesses ruined, livelihoods evaporated. We are economic creatures that must labor for our nourishment. We do not go out into the fields to graze. This is an attack of government on the people and on the economy. It is a psyops of perception management. Why they are doing this I know not. There is a quantifiable value placed on human life. Somewhere around 35,000 people die each year in the U.S. From vehicle accidents. The economy is not shut down because of it. The greater value is seen in keeping the economy running. We should go out and live our lives as we normally would. Those at risk should take precautions. I am 67 years old and healthy. If a vaccine is forced on me, I would rather the live virus and let the chips fall where they may. I would rather die a man than live a sheep.
Car accidents and Coronavirus? Great example of category mistake. You have a choice whether to get in your auto; the virus doesn’t ask your permission to catch a ride in your immune system. Your suggestions are also great demonstration of how the general public is mostly completely incapable of putting together a logical argument.
Anyway, unfortunately for you Jimbobla, most of science is counter-intuitive. Your strange attempt to make sense of the situation demonstrates very clearly the limitations of plain old grandad common sense. Your way of thinking reminds me of the time six centuries ago when the Catholic Church was able to tell scientists what to think. Finally great example of community minded thinking, in the form of “bugger you mate, I’m okay”. If everyone thought like you did and reasoned that, for instance, vaccination was pointless, then TB would once again be the scourge it was 150 years ago
As for dying a man rather than a sheep, how very noble of you, but I’m afraid that a virus does not give awards for courage and valour. Ignorance truly is blissful
“but the entire world being plunged into dire poverty as a result of lockdown”
Surely this should be taken into account? I myself can’t sort this out. On the one hand we have supposed mortality rates not above the usual winter flu season, on the other hand they have emergency morgues in Spain and New York. Somehow it all seems very strange.
iirc it was reported to be at least 10x more lethal than the flu?
“iirc it was reported to be at least 10x more lethal than the flu?”
I’m no expert, but it seems to wipe out old people but next to no deaths in the young and fit.
Dear Mr. Andrews, allow me to help you sort this out. The reason that people are finding this situation so confusing is that we live in a bio-political epoch in which politics is now almost exclusively about managing human life-processes. But then, isn’t the latter what a virus is all about? Viruses are a biological life process which runs amok in the body – an expression of vital life forces which then attacks its own substance. And doesn’t the same apply to economics? Is not the latter really the human life-process writ large? Economics is basically a matter of the metabolic interaction of humans with nature, and through which human life is sustained and the species perpetuated. In which case, death by poverty and death by virus are really one and the same thing. There is a difference, too, between common influenza and this virus. For the former there are vaccines. Usually, the general public has a choice whether or not they want to get a flu vaccination before the flu season starts. Obviously those who are not vaccinated stand a greater chance of getting the flu and possibly dying if they have comorbidity or compromized immune systems. So the annual death rates from influenza are not really comparable to those from COVID-19, and probably if more people chose to be vaccinated, these common flu mortality rates could quite possibly be much lower than they are. But the same does not apply to this virus, as there is no immunity option currently available.
I also offer you the following excerpt from an article on COVID-19 that I offered Areo magazine, but which they declined to publish:
To begin with, it’s worth remembering that a virus represents the very potency of a biological process which goes on within (and indeed presupposes) life. In other words, the virus erupts as life and within life, but is already, in this living form, a pathological force, life that works to negate life. Or, to put it somewhat differently: a virus is that organic development by which life itself becomes the engine of its own destruction, just as an auto-immune disease represents the moment when the life-forces in a living body start to attack its own vital substance. In this respect, death is not something hostile to life, attacking it from without. Rather, it is already present in the form of death-directed life forces which lie ready to ambush the normal functioning of a living being, destroying it from within.
In the cross-fire of political commentary about COVID-19, one often hears talk of a looming conflict between those economic and social measures designed to slow transmission, and the potentially catastrophic economic effects of such measures. Certain social restrictions might stop the virus dead in its tracks, but kill the economy, whereas those who baulk at crippling the economic system risk putting many millions of lives at risk.
Steve Hilton, Host and Former advisor to David Cameron, from a March 22, 2020 episode of Fox News, ‘The Next Revolution With Steve Hilton’, takes this dilemma even further: “You know that famous phrase, ‘The cure is worse than the disease’? That is exactly the territory we are hurtling towards. You think it’s just the coronavirus that kills people? This total economic shutdown will kill people. A UK study calculated that 130,000 people died avoidably from austerity there between 2012 and 2017. The years of austerity for America to pay the cost of this shutdown will be worse. Adjusting to the size of our economy, it’s over a million deaths . . . Poverty kills, despair kills. This shutdown is deadly. . . . Don’t turn a public health crisis into America’s worst catastrophe”.
Hilton poses an opposition between, on the one hand, the human cost of economic shutdown, and on the other, the mortality potentially inflicted by the virus. He then suggests that both these scenarios will lead to identical, or near-identical, outcomes – a huge loss of life. In which case, why deliberately inflict upon society a total shutdown when, all things considered, the same death toll will result with or without it? Presumably, the virus will do its destructive work and then depart, whereas a deliberately inflicted trauma, such as closing down large sectors of the economy, will leave tragic long-term consequences. The first catastrophe might now be unavoidable; the second, however, can be avoided. Or at least, so this argument goes.
I’m not in a position to verify whether Hilton’s claim about the mortality caused by economic slowdown is factually correct; what interests me is the presupposition of the argument itself. The author sets up his discussion on the basis of an opposition between two scenarios, as an ‘either-or’, but with both leading to virtually the same outcome in terms of deaths. Hilton obviously advances this argument more as a provocation than as an analysis. Yet what’s striking is that he has, quite inadvertently, stumbled on a certain truth: that, in fact, in a bio-political framework, these two terms – economics and human life – are one and the same. Karl Marx understood labour and work as a metabolic exchange with nature that reproduces and preserves the species. In this sense, Marx anticipated the demise of classical political theory, swallowed up in the modern age by the idea of political economy. The latter, arising in the late-18th century and at the dawn of our bio-political era as a sort of hybrid conceptual monster, attests to that coupling of life and power which is at the heart of the economics of mortality.
The common denominator between the virus and the economy is that both are effectively the life-process writ-large; and with the neutralization of moral, social, and metaphysical standards effected by the paradigms of bio-power, nothing remains to mediate between the economy and life but biology. Again, this situation is not limited to the COVID-19 pandemic. It prefigures a general trend. For instance, to take just a few examples: the growing prominence of issues of ethnicity and gender, the centrality of public health care as a privileged index of the functioning of economic systems, and the priority some contemporary political parties accord to maintaining the homogenous ethnic composition of states. In all of the above, there is a tendency to flatten the political into the biological. Likewise, that international political conflicts seem to constantly turn into ‘human rights crises’ can be attributed less to a proliferation of tyrannical political despots and more to sense in which people nowadays find it impossible to think of politics in anything but ontological terms (that is, as a politics of living being).
regards
Kim Halik
Melbourne, Australia
Can you summarize what you were trying to get at there?
I can with a joke. Eminent journalist once asked Boris Yeltsin, “excuse Mr President, could please sum up the current situation in Russia at the moment in one word?”; “good”, replied Yeltsin. Journalist then asked another question of Yeltsin, “could you please sum up the current situation in Russia in two words?”. “Not good”, replied Yeltsin (i’m told the joke sounded better in Russian!). So, yes, can I sum up my argument in a few words? Simply this: that the boundaries between economics and death have become blurred lately. As Steve Hilton remarked, both a virus and shutting down the economy will lead to a great number of fatalities. So clearly there is not much to decide between here. In short, the current crisis is not a political but a medical problem. The issue nowadays is that everything has to be made into a political problem. But politics is not the answer to everything. If you try to make everything political, you will find that you will never be able to make the most basic decisions. That is why we have something called science. Many centuries ago, there were what were called ‘wars of religion’ (i.e. between Protestants and Catholics). These wars were the result of religion being politicized. Then people decided that only certain areas of life should be related to politics, and that religion was not one of them. The same applied to science. If you politicize science, then you will have wars over science, just as in the 15th century in Europe, there were wars over religion. So now we have the virus being politicized, and so we have, predictably, (political) wars over the virus. Do you see what I mean? Not much progress here. The problem nowadays is that it really doesn’t matter much what happens. If an asteroid fell from outerspace and hit the United States, I’m quite completely sure that it would blow up into a dispute between Republicans and Democrats (i.e., one side will say that it is a “republican” asteroid, the other that it is a “democratic” asteroid,, etc, etc.). I hope that this makes things clearer.
This article is elementary foolishness — and fatuous in lumping all skepticism as ‘Right’ (in the UK much of it’s from Spiked!, formerly Living Marxism magazine).
The issue is the mortality due actually to the new virus, NOT mortality of all those simply who have contracted the virus.
These are very different things, as is shown by the absence of any significant overall rise in mortality from all causes!
Even those who do actually die of the new virus would likely shortly have died of their co-morbid conditions in any case.
The reason why the figures from Germany are so vastly better than from elsewhere is that they are trying to count only deaths due to the new virus.
As regards the policy of ‘lockdown’, the big issue is the vast number of undetected cases. In the UK Oxford University estimate about a third of The UK population already have it; the London School of hygiene & Tropical Medicine reckon up to half! Either way, ‘lockdown’ is now useless.
The policy needs to be targeted in the ‘at risk’ group, leaving the working population to get on with … working.
The ‘at risk’ group need to self-isolate and helped by the state with their shopping so they don’t have to go anywhere they would encounter people.
Steve Moxon for President I say. He seems to have all the answers. Yes, everybody nowadays has an opinion on everything and is entitled to their opinion. “It’s remarkable how much intelligence can be invested in ignorance when there is a deep need for illusion” (Saul Bellow)
The widespread test for the COVID-19 virus is called the PCR.
Now let’s go to published official literature, and see what it reveals. Spoiler alert: the admitted holes and shortcomings of the test are devastating.
From “CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel”:
“Detection of viral RNA may not indicate the presence of infectious virus or that 2019nCoV is the causative agent for clinical symptoms.”
Translation: A positive test doesn’t guarantee that the COVID virus is causing infection at all. And, ahem, reading between the lines, maybe the COVID virus might not be in the patient’s body at all, either.
From the World Health Organization (WHO): “Coronavirus disease (COVID-19) technical guidance: Laboratory testing for 2019-nCoV in humans”:
“Several assays that detect the 2019-nCoV have been and are currently under development, both in-house and commercially. Some assays may detect only the novel virus [COVID] and some may also detect other strains (e.g. SARS-CoV) that are genetically similar.”
Translation: Some PCR tests register positive for types of coronavirus that have nothing to do with COVID—including plain old coronas that cause nothing more than a cold.
The WHO document adds this little piece: “Protocol use limitations: Optional clinical specimens for testing has [have] not yet been validated.”
Translation: We’re not sure which tissue samples to take from the patient, in order for the test to have any validity.
From the FDA: “LabCorp COVID-19RT-PCR test EUA Summary: ACCELERATED EMERGENCY USE AUTHORIZATION (EUA) SUMMARYCOVID-19 RT-PCR TEST (LABORATORY CORPORATION OF AMERICA)” [3]:
“…The SARS-CoV-2RNA [COVID virus] is generally detectable in respiratory specimens during the acute phase of infection. Positive results are indicative of the presence of SARS-CoV-2 RNA; clinical correlation with patient history and other diagnostic information is necessary to determine patient infection status…THE AGENT DETECTED MAY NOT BE THE DEFINITE CAUSE OF DISEASE (CAPS are mine). Laboratories within the United States and its territories are required to report all positive results to the appropriate public health authorities.”
Translation: On the one hand, we claim the test can “generally” detect the presence of the COVID virus in a patient. But we admit that “the agent detected” on the test, by which we mean COVID, “may not be the definite cause of disease.” We also admit that, unless the patient has an acute infection, we can’t find COVID. Therefore, the idea of “asymptomatic patients” confirmed by the test is nonsense. And even though a positive test for COVID may not indicate the actual cause of disease, all positive tests must be reported—and they will be counted as “COVID cases.” Regardless.
From a manufacturer of PCR test kit elements, Creative Diagnostics, “SARS-CoV-2 Coronavirus Multiplex RT-qPCR Kit”:
“Regulatory status: For research use only, not for use in diagnostic procedures.”
Translation: Don’t use the test result alone to diagnose infection or disease. Oops.
“non-specific interference of Influenza A Virus (H1N1), Influenza B Virus (Yamagata), Respiratory Syncytial Virus (type B), Respiratory Adenovirus (type 3, type 7), Parainfluenza Virus (type 2), Mycoplasma Pneumoniae, Chlamydia Pneumoniae, etc.”
Translation: Although this company states the test can detect COVID, it also states the test can read FALSELY positive if the patient has one of a number of other irrelevant viruses in his body. What is the test proving, then? Who knows? Flip a coin.
“Application Qualitative”
Translation: This clearly means the test is not suited to detect how much virus is in the patient’s body.
“The detection result of this product is only for clinical reference, and it should not be used as the only evidence for clinical diagnosis and treatment. The clinical management of patients should be considered in combination with their symptoms/signs, history, other laboratory tests and treatment responses. The detection results should not be directly used as the evidence for clinical diagnosis, and are only for the reference of clinicians.”
Translation: Don’t use the test as the exclusive basis for diagnosing a person with COVID. And yet, this is exactly what health authorities are doing all over the world. All positive tests must be reported to government agencies, and they are counted as COVID cases.”
Those quotes, from official government and testing sources, torpedo the whole “scientific” basis of the test.
And now, I’ll add another, lethal blow: the test has never been validated properly as an instrument to detect disease. Even assuming it can detect the presence of the COVID virus in a patient, it doesn’t show HOW MUCH virus is in the body. And that is key, because in order to even begin talking about actual illness in the real world, not in a lab, the patient would need to have millions and millions of the virus actively replicating in his body.
Proponents of the test assert that it CAN measure how much virus is in the body. To which I reply: prove it.
Prove it in a way it should have been proven decades ago—but never was.
Take five hundred people and remove tissue samples from them. The people who take the samples do NOT do the test. The testers will never know who the patients are and what condition they’re in.
The testers run their PCR on the tissue samples. In each case, they say which virus they found and HOW MUCH of it they found.
“All right, in patients 24, 46, 65, 76, 87, and 93 we found a great deal of virus.”
Now we un-blind those patients. They should all be sick, because they have so much virus replicating in their bodies. Are they sick? Are they running marathons? Let’s find out.
This OBVIOUS vetting of the test has never been done. That is an enormous scandal. Where are the controlled test results in 500 patients, a thousand patients? Nowhere.
The test is an unproven fraud.
And, therefore, the COVID pandemic, which is supposed to be based on that test, is also a fraud.
“But…but…what about all the sick and dying people…why are they sick?”
A NUMBER of conditions—none involving COVID, and most involving old traditional diseases–are making people sick.
What has happened to the quality of Areo? The one most persuasive argument against skepticism is the fact that the markets tumbled precipitously long before most people knew their n95 respirator from their ventilator. Now it looks like the markets were predicting not a terrible death toll from a pandemic but the entire world being plunged into dire poverty as a result of lockdown.