But is it really no worse than flu?

By Christopher Monckton of Brenchley

Some commenters responding to this daily series providing some information about the Chinese virus have repeated what seems to have become something of a mantra among libertarians who, understandably, dislike the idea of widespread lockdowns, with the loss of freedom and the economic damage that they entail. That mantra is that the Chinese virus is no more infections or no more fatal than flu, and that if we had allowed everyone to acquire immunity by catching the infection and throwing it off all would be well.

Look at today’s graph. Though the downtrend in the daily compound growth rate in total confirmed cases now appears well established, that growth rate is still very high, averaging around 8% globally outside China and occupied Tibet, where the numbers are unreliable.

The red curve shows the case growth rate for the world excluding China. If the 8% daily growth rate were to continue, yesterday’s 1,430,919 confirmed cases (many of which tend to be those serious enough to have come to the authorities’ attention, since testing is still occurring on a tiny scale in most countries) would have risen to nearly 8 million by the end of April, and more than 80 million by the end of May.

It is important, therefore, to ensure that the now well established downtrend is maintained. That is why, for the time being, governments will be keeping lockdowns in place. It would be irresponsible to do otherwise.

Of course, one might legitimately argue that, if the Chinese virus were really no worse than flu, the crippling social and economic cost of lockdowns would be unjustifiable.

But governments cannot afford to make policy on the assumption, perhaps a little too carelessly made by some commenters here, that the virus is no more dangerous and no more infectious than flu.

Here, then, to help us to begin to answer that important question, are some tolerably reliable, real-world data. I am grateful to the Intensive Care National Audit and Research Center in London for having made details from its Case Mix Programme Database available. The Case Mix Programme is the national clinical audit of patient outcomes from adult critical care.

The Center has recently issued a report on all confirmed UK cases reported to it up to midday on 3 April, just a few days ago. Critical care units notify the Center as soon as they have admitted any patient with confirmed Chinese virus, together with demographics, initial physiological state, organ support and eventual outcome.

The report concerns 2249 patients, whose mean age at admission was 60 years, compared with 58 years for 4759 patients with non-COVID-19 viral pneumonia, most of them caused by flu, over the three complete years 2017-2019.

Of the 2249 patients, 346 (15%) have died, 344 (15%) have been discharged alive, and 1559 (69%) are still in critical care. The case fatality rate, as a fraction of all closed cases admitted to intensive care, is thus a little over 50%, compared with only 22% for the non-COVID viral pneumonias of the past three years. In each age-group (under 50, 50-69 and 70+), the percentage of patients admitted to critical care with the Chinese virus and subsequently dying in hospital is at least twice the percentage of critical-care patients with other viral pneumonias over the previous three years.

Among those requiring ventilation, two-thirds die by the end of their critical care and only one-third survive. Therefore, the case fatality rate for closed cases where ventilation was required is more than 67%, compared with only 16% for non-COVID viral pneumonia cases requiring ventilation.

Worse, advanced respiratory support for Chinese-virus cases is typically maintained for between 4 and 9 days (average 6 days), while it is not needed at all in non-COVID-19 viral-pneumonia cases, which require only basic respiratory support, and require it only for 2-4 days (average 3 days). The data are similar for cardiovascular support, and for renal support. The Chinese-virus cases tend to require advanced rather than basic support, and to require it for twice as long. And yet, even after all that extra care, the case fatality rate is many times higher than for non-COVID viral pneumonias.

On the assumption that about half of all this year’s critical cases of seasonal viral pneumonia would have occurred by now, and making no allowance for any further exponential growth in Chinese-virus cases in intensive care, and assuming that the summer will stop the virus causing critical cases (an assumption that the authorities, rightly, do not regard themselves as being in any position to make yet), there are approximately three times as many serious Chinese-virus cases than all other viral pneumonias combined, including those caused by flu, in a typical year, and at least twice as many of these will die than with other serious viral pneumonia cases.

Thus, the Chinese virus is six times more fatal than pre-existing viral pneumonias, including those caused by flu.

In the past three years, some 46% of viral-pneumonia cases were female and 54% male. With the Chinese virus, however, only 27% are female and 63% are male.

The report also considers ethnicity. About four-fifths of the UK population is White, but only two-thirds of the critical cases to date are Whites. Blacks, in particular, are three times over-represented in intensive care: they represent one case in seven, but are only one in 20 of the population.

Body mass index was also studied, but the number of cases in the below-normal, normal, overweight, obese and morbidly obese categories is not far out of line with the general population, two-thirds of whom are overweight or obese. Some 72% of intensive-care Chinese-virus cases are overweight or obese.

Interestingly, the number of cases with cardiovascular, respiratory, renal, hepatic, cancerous or immunocompromised comorbidities was quite small. In all these categories, it was less than for the usual viral pneumonias over the past three years.

In the past three years, non-COVID viral pneumonias have put 43% of patients on to ventilators within the first 24 hours. The Chinese virus, however, is worse: it puts 63% on to ventilators within the first 24 hours. Therefore, governments planning hospital capacity for Chinese-virus cases must make extra allowance for the greater demands, both in advanced rather than basic care and in days of treatment, than other viral-pneumonia cases.

The doctor through whom I came upon these figures, who has himself suffered with the Chinese virus and has recovered, is very angry that for political reasons those who understandably dislike lockdowns have been maintaining, contrary to the evidence, that the Chinese virus is “no worse than flu”.

Be in no doubt. This disease is a lot worse than flu. It puts more people into intensive care, where they require costlier and more advanced treatment, where they will be in intensive care for twice the time required by other viral pneumonia-patients, and where they are more than twice as likely to die as those other patients.

So don’t dismiss it lightly. Not any more. Wash hands often. Wear full-face masks when out of doors or away from home. Take Vitamin D3 daily. Be safe.