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.
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Saying that CoV-19 is not any worse than the Flu is a non-statement – which Flu?
Flu seasons vary and U.S. death rates can vary from a few thousand to 60,000 depending on the strain and how novel it is. And this probably under counts the actual deaths, just like CoV-19 deaths had been under-counted in Italy. So a really bad Flu season is nothing to sneeze at (sorry, Puns just happen).
SARS-CoV-2 is extremely novel, highly infectious, and very dangerous. There was no known immunity in the “herd”when this all started, making this a very dangerous disease unlike Flu, where there is usually some amount of at least partial immunity present. When I first extrapolated death rates (partially based on flawed China data) I came up with a maximum of 120,000 deaths in the U.S – so a really bad Flu season. I now think that number was low if we hadn’t taken steps to slow the spread down.
My wife works in a hospital in a lab and agrees – hospitals in at least some areas were set to be overrun with cases they could not properly treat had we not slowed down the spread, and the death rate would have been much higher for those cases. But delaying non-critical surgery also likely saved lives – the best place to go to catch a disease is a hospital – sorry but true. Workers just get careless over time no matter how much training you give them.
I am not happy with the damage we have done to the economy – there has to be better ways to combat pandemics, but so far no one has offered up any workable alternative. Perhaps more tightly locking down highly infected areas (no travel without antibody testing or quarantine for example) and then keeping the rest of the country working would have worked, but now we are stomping all over people’s rights (worse then the lock-down already has). There is a risk-cost to mega-cities – they are the perfect breeding grounds for infectious diseases.
Rather then complaining about what DID happen, we should focus on what SHOULD happen. How do we prepare better for a future pandemic? How can we keep from ripping the throat out of our economy while in a pandemic? We need to get through this episode, learn from our mistakes, and work on being prepared for the next wave.
Some suggestions, cleaner environments in large offices with air scrubbers that cut down on infectious particles, higher partitions that better separate workers, policies to require temperature measurements at the door and send home workers who are sick (always in force), better preparation in stockpiles and hospitals, less dependency on widely flung supply chains, localizing the manufacturing of critical goods such as drugs. There are a million things we can do…I wonder if we will do any of them?
The USA was not helped by being visited by half a million Chinese before they locked down, nor were the rest of the world.
By then it is too late for proper quarantine to work.
I posted the following note earlier on another thread, where it is in moderation.
This alleged Covid-19 pandemic is difficult to analyze, because much of the data is suspect and/or incomplete, a moving target. Regardless, it is prudent, especially for older people, to limit our exposure to this new virus – nobody should assume it is not dangerous, it is – especially to those over ~65.
I have already taken a guess as to a probable outcome, but I have little confidence in a tentative conclusion based on such poor data. In any case, we will have lots of data to analyze in a few months, and will be much wiser. In the meantime, stay safe, especially us older folks – we still have something to contribute.
Best, Allan
_________________________________
Reportedly, Sweden is not following the full lock-down model and has only moderate precautions for Covid-19. It will be interesting to see how Sweden’s full-country-scale test compares to the full lock-down, kill-the-economy model of the USA, Canada, etc.
I think we will learn much about the greater picture of contagion with this exercise. We will also see some changes is social practices.
Customary greetings like face-kissing and even handshakes will probably become much less commonplace after Covid-19 has passed.
It is interesting to me that Total Winter Deaths are ‘way down this year, despite the alleged Covid-19 pandemic.
It is also interesting that here in Calgary hospitals have deferred elective surgery to make way for the anticipated flood of Covid-19 patients, and as a result hospitals and staff are not at all busy – yet.
The big questions remain:
Is Covid-19 is really a catastrophic pandemic, or a huge over-reaction to one-more-seasonal-virus.
Was the full lock-down that has harmed our economy and financially destroyed so many young people and small businesses really necessary, or was it like swatting a fly on a glass table… with a sledgehammer?
We should know much more in a month or two. Fasten your seatbelts. Faites vos jeux.
It’s like swatting a fly on a glass table with a sledgehammer. In the 2018-2019 flue season, there were 35,000 deaths from the flue in the US – for which they presumably had vaccines. To date, there are roughly 16,000 deaths from corona virus – say 17,000 – from the first wave of the flu season – with no vaccines. So if there are total of 18,000 deaths from all flu deaths during the second wave of the flu season starting in roughly in October, then the number of flu deaths would be on par with the flu deaths from the 2018-2019 flu season. Maybe a vaccination is just a placebo.
cinaed
The CDC estimated that there were 80,000 seasonal-flu deaths during the 2017-2018 season! And, the MSM said nothing, and no extraordinary measures were taken to suppress it.
Maybe the rest of Europe can simply emulate Hamburg?
‘This virus affects our lives in a completely exaggerated way. This bears no relation to the danger posed by the virus. And the astronomical economic damage now arising is not commensurate with the danger posed by the virus. I am convinced that corona mortality will not even make itself felt as a peak in annual mortality. So far, not a single person with no previous illnesses had died of the virus in Hamburg: everyone we have examined so far has had cancer , chronic lung disease, were heavily smokers or obese, had diabetes, or had cardiovascular disease. Covid-19 is a deadly disease only in exceptional cases.’
Professor Klaus Püschel, head of Hamburg forensic medicine
‘The Free and Hanseatic City of Hamburg had recently, contrary to the requirements of the Berlin Robert Koch Institute, started to differentiate between deaths with and with coronaviruses, which led to a decrease in Covid 19 deaths.’
Hamburger Abendblatt 02 April 2020
with and from
We simply don’t know What the Chinese flu death rate is because we don’t yet know what the denominator is.
Dr. Bendavid of Stanford is conducting an antibody test in California with the results to be announced tomorrow.
Once these results are known, we’ll have an excellent idea of how many people were infected by Chinese flu and were asymptomatic, and then we’ll know what the real denominator is and the real death rate.
In the meantime, let’s not destroy the world economy any more than it already has until we know what the actual death rate is.
By the end of March, about 60,000 Americans have died from the regular flu and about 13,000 from the Chinese flu….
Everyone just needs to wash their hands, wear masks, and people over 65 with comorbidity need to shelter in place as much as possible.
Hydroxychloroquine, Azithromycin and zinc also need to be widely prescribed to those infected with the Chinese flu as the efficacy of this drug combination is extremely promising.
We also need to restart the economy ASAP and try to fix the extensive damage already inflicted once the true death rate is knOWN, which should have been determined well before The US passed $2.2 trillion in Chinese flu spending, and committed the Fed printing another $4 trillion)
The US economy has essentially been mortally wounded, likely for no good reason.
Stay safe.
What is the difference between Covid-19 disease and ordinary flu? Ask those who have experienced this disease. I think that only such comparisons are reliable.
That’s bad statistics. It’s looking at the wrong population.
Blacks may be only one in 20 of the UK (England ad Wales?) population. But the outbreak has been first and foremost in London.
I think you will find the ethnic mix of London is far more diverse than the nation as a whole.
The following statements from Chris M’s article gave me pause to ponder:
Notice: non-COVID-19 viral pneumonia cases requiring ventilation appears as 16%, while COVID-19 respiratory-syndrome cases requiring ventilation appears as 67%, and duration of ventilation for non-COVID cases averages 3 days, while duration of ventilation for COVID cases averages 6 days (twice as long).
Might this give rise to the question whether or not the ventilation protocol for this syndrome is correct? — pointing to the possibility that the the long duration of ventilation or the ventilation protocol itself might be causing the deaths?
Being put on a ventilator carries risk:
https://www.nhlbi.nih.gov/health-topics/ventilatorventilator-support
___________________________________________________________
What Are the Risks of Being on a Ventilator? – Ventilator/Ventilator Support
Infections
One of the most serious and common risks of being on a ventilator is pneumonia. The breathing tube that’s put in your airway can allow bacteria to enter your lungs. As a result, you may develop ventilator-associated pneumonia (VAP).
The breathing tube also makes it hard for you to cough. Coughing helps clear your airways of lung irritants that can cause infections.
VAP is a major concern for people using ventilators because they’re often already very sick. Pneumonia may make it harder to treat their other disease or condition.
VAP is treated with antibiotics. You may need special antibiotics if the VAP is caused by bacteria that are resistant to standard treatment.
Another risk of being on a ventilator is a sinus infection. This type of infection is more common in people who have endotracheal tubes. (An endotracheal tube is put into your windpipe through your mouth or nose.) Sinus infections are treated with antibiotics.
Other Risks
Using a ventilator also can put you at risk for other problems, such as:
Pneumothorax (noo-mo-THOR-aks). This is a condition in which air leaks out of the lungs and into the space between the lungs and the chest wall. This can cause pain and shortness of breath, and it may cause one or both lungs to collapse.
Lung damage. Pushing air into the lungs with too much pressure can harm the lungs.
Oxygen toxicity. High levels of oxygen can damage the lungs.
These problems may occur because of the forced airflow or high levels of oxygen from the ventilator.
Using a ventilator also can put you at risk for blood clots and serious skin infections. These problems tend to occur in people who have certain diseases and/or who are confined to bed or a wheelchair and must remain in one position for long periods.
Another possible problem is damage to the vocal cords from the breathing tube. If you find it hard to speak or breathe after your breathing tube is removed, let your doctor know.
________________________________________________________________
Given theses normal risks of being put on a ventilator, and given the prolonged use of the ventilator on people with weakened respiratory systems already, how is it known now that the ventilators are not the problem in the treatment of this syndrome? Is the wrong protocol being used on a large scale? Are doctors expecting too much of it? At least one doctor has been asking such questions.
This stands beside the issue that other people keep raising — data quality — I too am not convinced that current data is good quality data — it has a limited view — possibly biased by other variables, which are not being taken proper account of.
I suppose that instead of going on a ventilator you could just let the patient die!
Is that your alternative?
Steve R,
I surely was not suggesting any alternative. But think about it: if the patient dies ON the ventilator, how are you distinguishing that from death off the ventilator. The ventilator really did not prevent death, did it? So, again, I am raising the question, “Could the ventilator merely delay the inevitable?” If a doctor did NOT ventilate, causing death, and ventilating caused death too, then I suppose the value of ventilating would be feeling good that an effort was made. But is this good feeling justified? [I don’t know]. Is a life being prolonged that maybe should not have been? [I don’t know — I’m raising the question.]
Supportive care is the hallmark of treatment for such conditions as have no specific cure.
The idea is to give the patient as much time as possible to overcome the infection and begin to recover.
Patients generally do not come in with the outcome of their illness stamped on their foreheads, so given that some will have the time and the strength to pull through, and some will not, the fact that many die while on a ventilator just means that everything possible was being done for them until they recovered or died.
If we attribute all deaths to Covid-19 the epidemic will never end. That would be the strategy of those who wish to prolong the misery.
Contrary to what some people think, this infection does not improve population resistance because it damages internal organs in patients.
And then there’s this:
https://pjmedia.com/trending/uh-oh-south-korea-reports-coronavirus-reactivates-in-some-patients-thought-cured/
“Immunity” might not mean what some people think it means…
900,000 were hospitalized and 80,000 died in the 2018 us flu season. Hospitals were nearly overwhelmed and supplies dangerously low.
Nothing was shut down.
“season”
Yes season. I even know what that means and the significance. Or lack thereof.
Steve Oregon should perhaps read the head posting, where he will find the clearest and most authoritative hard evidence that the Chinese virus is far more serious, and has a far heavier impact on hospital services, than flu. Does he seriously think that governments across the world have been building emergency hospitals as fast as they could if they have not worked out that this pandemic could have been – and may yet be – one of the worst of its kind?
If the pandemic had been allowed to run unchecked, the 80,000 figure he mentions would have been overtopped in the U.S. in weeks. It will probably still be overtopped in months, unless the daily case growth rate can be brought down.
BREAKING: British Prime Minister Boris Johnson moved out of intensive care as his condition has improved
https://twitter.com/AP/status/1248318773276356617
A total of 7,978 people have now died in hospital after testing positive for coronavirus, up by 881 on Wednesday.
https://www.bbc.com/news/uk-politics-52238276
I have a few comments:
1. It is one thing to claim that Covid19 is far worse than the flu. It’s another thing to say we shouldn’t compare the two. Obviously, if these people are right, we should compare the two. In fact, they do compare the two, in order to conclude that we shouldn’t compare the two.
2. Does anyone believe that in the year 2020, Covid19 will kill more people in the US than the flu? Surely not. But if it doesn’t kill more this year, there will never be a year (and probably never a month) where it does kill more. By this simple measure, Covid19 can’t be as bad as the flu.
3. A lot of these numbers are pretty meaningless, because we don’t have any empirical measure of how many people have been infected with SARSCov2 and have recovered. Current tests do not identify these people. They can be identified by a serological test for antibodies. This only needs to be done for a representative sample of the population, say five hundred subjects. If ten percent of the population, or less, have been infected (including those who have recovered), then it suggests that Covid19 is a lot worse than the flu. If fifty percent have been infected, or more, then it suggests that the flu is a lot worse than Covid19. We should have an answer in a month or two.
4. Two years in the future, no one will give a toss for Covid19. It will be a historical footnote, at most like swine flu or avian flue. But everyone will be preoccupied with the ongoing world slump, deliberately created by government lockdown policies. Needless to say, the world slump will kill more people than Covid19, and more people than Colvid19 ever could have killed.
Mr Ramsay Steele does not believe that this year the Chinese virus will kill more people than the flu does. If lockdowns had not occurred, it would have done just that. In the two weeks from 7 to 21 March, the mean daily compound growth rate in deaths was 40%. Do the math.
This sums it up for me
https://twitter.com/ClimateAudit/status/1247913161979842563?s=20
along with
https://twitter.com/NikolovScience/status/1248002677834838016?s=20
Mosh and the Lord know nothing about viruses it will be proven over time I totally respect mosh for his uncovering of the president of the union of concenced scientist global warming scam but apart these people have no clue about how viruses operate
WUWT will have to seriously reconsider who can publish serious climate stuff here I think Watts Spencer ect know what they are saying Mockton and Mosh should be allowed to reply at most but not post they have beeen wrong nearly 100% are are damaging peoples lives.
Accusations without arguments are worthless and impertinent. Goodbye, Eliza.
WUWT needs to not to allow Mocktons Moshers to post here anymore at least for a couple of days they are doomsayres and havent got a clue abut how virures work please allow them back in 2 weeeks they can say what they want
You do know what the first W stands for in WUWT, right?
Create your own blog and stop telling the owner what he can and can’t do.
Eliza should know that I have carried out epidemiological modeling on behalf of HM Government: I wrote one of the earliest working models of the HIV pandemic, and predicted that if carriers were not identified and isolated at the earliest stage the virus would spread worldwide and kill tens of millions. And there was shrieking and howling when I said that, because everyone who had not actually modeled the pandemic thought they knew better. But they didn’t. Depending on whose count one relies on, there have been 30 million to 50 million deaths worldwide, and hundreds of millions more are living with the infection and being treated – expensively – for it.
The graphs in the head posting are a straightforward presentation of the available data for the territories listed. They show, like it or not, that the compound daily mean growth rate in total confirmed cases is falling, though it has a long way further to fall before we can declare the emergency to be over.
One realizes that people will be somewhat panicky and hysterical at this difficult time, and one does one’s best to make allowances. But Eliza must accept that it is the advice of such as me, rather than the opinions of such as she, that governments are heeding – and, if she would only open her mind, with very good reason.
Disagree, Eliza. There are articles posted on the site arguing the case that COVID-19 is not a danger warranting extreme measures. These articles also have comments sections. Nowt wrong with giving the mainstream argument space. This is a controversial subject – controversy is public disagreement, and here it is in all its glory.
Pretty much always true: the best solution to bad speech is more speech.
i agree dont worry be happy
Excess mortality in EU
http://www.euromomo.eu/
Most grateful to Alex for this useful confirmation that in England, France, Spain and Italy there is severe excess mortality, related to the Chinese-virus pandemic.
I’m not sure who is saying that covid-19 is no worse than the flu, in terms of how it impacts a critically ill patient or our heroes in the hospitals. I certainly don’t endorse that view. It seems like another straw man argument being advanced.
Some have argued that excess deaths this season have been no worse than seen in recent years. Some have argued that lockdown protocols have not substantially changed the number of new cases. I don’t agree with them that they have any solid evidence that social distancing has failed to flatten the curve, but it’s hard to argue that total deaths have exceeded prior flu seasons. This could be evidence of the success of social distancing, and it isn’t prudent to deny that without stronger evidence such as antibody testing.
The real question in my mind is why, given the very valid concerns that intubating cannot be done safely in a timely manner (unsafe for medical personnel due to aerosolization, unsafe for the patient due to lengthy delays while medical staff suit up), why is there so much resistance to administering a relatively benign drug, HCQ, that has had so many positive results? And why would they wait to do that until the situation deteriorates to the point where both patient and medical personnel are in dire risk? Why would they resist this option although the survival rate of those put on the ventilator is 50% or worse? Even if it only helps 10% of the patients who would otherwise die, why resist it? A patient who could get by with high flow nasal cannula oxygen therapy and proning might recover sufficiently on HCQ-Zn to avoid the need for a ventilator.
Why is common sense banned? What is the hidden agenda?
Treatment must be started very early when the lungs are not yet powdered. It seems that this is no later than 6 days after the onset of symptoms.
Perhaps you missed my rhetorical question above:
Where is it banned?
I thought this is what is happening in a lot of places?
Oh…wait…is it banned in UK?
Did we not hear they banned the export of it at the outset?
Why do that and then refuse to use it?
CMB said they have the same rules about doctor discretion for off label usage there as here in the US.
All anyone needs to do is find a doctor willing to give it to someone who asks.
This set of guidelines from Belgium was first posted way back in the fist part of March…maybe around the tenth.
So it has been almost a month if not more.
Why no revisions to guidance on something they must have given to many patients by now?
There is a new revision as of the 7th:
https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf
Sorry if my phrasing was poor and confused anybody. I didn’t mean to imply that HCQ has been banned. I meant why are policymakers not using common sense (as if common sense is a bad thing that has been banned).
Rich,
Thanks for the follow up.
You are correct, I took your meaning to be saying something you did not actually say.
And I also thought I had read that the hospitals in UK were instructed to give nothing but oxygen.
It has become more difficult than usual to be able to parse the exact details on all of this stuff, especially because so many are more or less forced to take a seat of the pants approach to so many aspects of the entire situation.
I think I can answer why many doctors may be very reluctant to jump in on a treatment that has no scientifically verifiable confirmation of efficacy, particularly since the stuff is not so innocuous as is being widely asserted.
I for one am not going to be judgmental about this…I can see it from both directions.
But I can say I have never in my life been so anxious to read the results of a clinical trial, not even back in the pre Hep C cure years when I hung on every word of every study and every possible new treatment.
There were many.
The truth was very hard to get at, regarding the chances of a cure, the possible side effects and harms and the frequency and severity thereof.
And that is not the only time.
Happy surprises are far from common when it comes to new drugs or old drugs being used to treat something new.
I cannot really think of any drugs that were pleasant surprises re the outcome of clinical trials.
Usually it is a matter of how much less effective something is than what was hoped or thought to be the case.
Often it was difficult to even discern whether of not something was helpful.
In other cases, one had to think long and hard amount how many adverse events were acceptable for a positive but unclear amount of therapeutic value.
FenPhen. Vioxx. Telepravir. Just the ones that come to mind as standouts that seemed like they were great until major harms were revealed down the road. Actually the first two were notable for not being particularly advantageous when compared to other drugs that did the same thing, in retrospect at least.
But, nothing about any experience with anything else will predict how something new will turn out. It only provides a reason for cautious optimism until direct comparisons in outcome are known for equivalent cohorts that only differ in one way of how they were treated.
I also hope very much the studies are all done very carefully with excellent protocols in place.
Poorly designed studies can and have made unclear situations even murkier.
HCQ in the doses described by Drs. Zelenko in NY and Rebout (sp?) in Paris are >2x (500 mg daily) the typical RA dose (250mg). And there are known side effects at the RA dose: retinopathy in about 25% of patients, tachycardia. So the key is your statement, “relatively benign”.
There are studies happening right now in NYC: 1100 patients. 1/3 HQC, 1/3 HQC plus azithromyin, 1/3 HQC plus zinc gluconate. We will know results in a few days. That is good medical common sense. There is no hidden agenda.
I have high confidence the US economy will reopen May 1. Two reasons. First, the curve was bent in places like NYC to meet all the emergency measures like Javits Center and USNS Comfort. It still needs to be in Detroit. Worked many other places so far like south Florida and LA. Some, but not all, state governors over-reacted. Second, it appears likely that there will be at least one therapy, HQC plus something, and possibly two with remdesivir.
And, as posted in a comment to Willis, the economic cost is not nearly as high has posited. Look up the California GDP composition (Wiki has a nice chart from BEA data). Most of the sectors will not only bounce back, they will with minimal net losses by yearend. These include finance, insurance, real estate, government, manufacturing, most agriculture, infotech, construction… Only two won’t: travel and entertainment (airlines, restaurants, movies), and some professional services (beauty parlors, cleaning services). Other professional services just have deferred demand (tax prep, legal) so no big net loss by yearend. So the true economic cost of a brief shutdown (45 days) is relatively small.
Put differently, 16 million temporarily unemployed out of ~160 million is ~10% for 45 days, covered at least partly by unemployment insurance and the CARES PPP.
Temporary pain? Yes. Unbearable? No, compared to images of body bags stacked high into refrigerated trucks using fork lifts like in NYC right now.
Thanks for your reply. Do you mean Didier Raoult?
You are far more qualified to comment than I am, to be sure. But I would like to opine anyway, that if I were several days into symptoms with shortness of breath and a positive covid test, I would make the informed decision to request HCQ-Zn therapy without hesitation. Maybe I am mistaken, but retinopathy is reversible after ending treatment. Tachycardia is obviously a risk in a patient with hypoxia as I’d likely be, but if I’m not mistaken there are meds to mitigate that as well. In any case, dead people generally need not be overly concerned with visual accuity I’d guess and don’t suffer from a rapid heartrate either.
As for agendas let me be explicit lest I’m misunderstood on that as well. I believe it’s abundantly apparent that many Trump opponents care more about not letting it appear that Trump championed a life-saving therapy than they are concerned about people dying. I do not imply that “big pharma” wants to quash this to push profitable alternatives.
I’m on the same page as you on the lockdowns. Not a depression if we reopen in May. Clearly was prudent approach.
We won’t know until there is time to perform full autopsies and viral-testing on their bodies as to the exact cause of death — whether they died of Covid-19 or any one of the influenzas or a combination of many viruses and bacterial respiratory infections. The subsequent testing of past influenza deaths shows that despite declarations on death certificates, the actuality of cause of death is far different. John Ioannidis made this point recently here.
There is no doubt that Covid-19 is very serious for older folks (like me and my wife) in general — as all all the other influenzas — and particularly for those with co-morbidities such as high blood pressure, heart problems, lung problems and obesity (especially, combinations of “all of the above”).
In the US, according to a study just released by the CDC over 89% of all adult Covid-19 hospitalizations are of those with one or more co-morbidities – those with undelying conditions.
As Monckton points out, ventilators are not a cure, and for MOST, they do not result in a saved life. Far more than 50% requiring a ventilator die anyway.
36 of the 50 US states have infection rates of LESS THAN 1 per 100,000.
Covid-10 is NASTY for old folks — and can carry away seemingly healthy younger people, but not very many.
We will not know, really, until the smoke clears — probably months to a year before we have anything but preliminary numbers. There is great danger in forming opinions or making pronouncements based on these preliminary numbers — we really have no idea how many people have been infected with Covid-19 — thus both hospitalization and mortality rates are unknown.
The symptoms to look out for are cough — fever/chills — and shortness of breath. (often found in common flus as well)
Note: What is not on the list is: Runny Nose — Sore Muscles — Headache — and intestinal problems (Diarrhea or vomiting). These are all common flu symptoms though. The common flu has carried away 24,000 – 63,000 Americans so far this flu season. Covid-19 about 16,000 so far.
The WHO is carrying out nationwide trials of treatments — and we should have some preliminary data on what works (if anything) by the end of this month.
Believers and non-believers alike can join in an international day of Fasting and Prayer tomorrow on Good Friday.
There are more and more reports that an early sign is loss of sense of smell and of taste, Kip.
I think you are voicing the same sorts of feelings and thoughts I am having about jumping to conclusions.
There is no shame in uncertainty, and just saying so when more information is needed.
I think there needs to be a series of conferences of doctors all around the world to discuss working out treatment protocols based on what works best and when.
I bet there are some doctors in some of the earliest hard hit places that can help tremendously with this.
The gold standard for treatment efficacy is all cause mortality after some period of time. A longer period of time than anyone can think we can afford to wait to make some decisions on treatments.
Whatever else happens, there is an opportunity to move medical knowledge forward. That has to be the goal on an ongoing basis.
A couple of weeks ago, I saw a story about a group of ER doctors and researchers who were travelling from Wuhan to Italy to advise and assist with treatment there, to pass along the benefit of their experience.
But I have not heard anything more on that, or whether this is being done in other locations.
The Woeld Health Organization has established a treatment trial called “LinkText Here”>“Solidarity” clinical trial for COVID-19 treatments” — it is a distributed trial — very simple — doctors record the treatment tried (out of the four) or no treatment and record the result.
We’ll know something as a result in a few weeks (preliminary results scheduled for the end of April).
One or more (or none) of the treatments might be found effective.
First data is published today on Remdesivir compassionate use, article by Gilead on some 53 patients treated between February and March.
They expect to have much more data including the first clinical trials soon:
https://www.nejm.org/doi/full/10.1056/NEJMoa2007016
These results need to be looked at carefully…they may be more encouraging than a glance would indicate.
Only 18% of patients on a ventilator died.
Less than 5% of patients on just oxygen died…one out of 19.
Pure arrogance this virus is very different from flu it seems to be clustered in certain areas while other areas are hardly affected at all if this was a mutated flu virus the whole country would be affected equally .This virus had to be brought into the UK by people travelling into our major airports other wise we would not have the virus in the UK. The clusters are around the major airports and we could have stopped the virus getting into the UK.
Look at today’s graph. “… outside China and occupied Tibet, where the numbers are unreliable.”
Sorry Viscount, ALL numbers EVERYWHERE are EXTREMELY unreliable. Every last bureaucrat is lying to maintain the hype.
If you have PROOF that the “numbers” anywhere are “reliable” please provide it. Of course, I won’t believe you anyway since the vast majority of the bureaucrats are in this to INCREASE their power and control.
Note that nobody here was able to cite any medical fact more strongly established than the fact the hep B vaccine causes MS (a fact not radiation related; the relationship of radiation with cancer is perhaps even more strongly established).
Yet all these bureaucrats deny that undeniable link.
As do many commenters on WUWT.
In response to BlueCat57, no data from the Chinese Communist regime about the Chinese virus can be trusted at all. In a future posting I shall spell out some of the unprecedented manipulation of data of which the regime is guilty in the present case. Mr Xi is likely to find himself in front of the International Criminal Court on charges of crimes against humanity, together with his poodle the dreadful Ghebreyesus of the World Death Organization. See the Henry Jackson Society’s draft indictment, and numerous others like it.
The likely defects in the data from countries other than China and occupied Tibet have been discussed fairly in the head postings. Notwithstanding those shortcomings, some conclusions can be drawn from the data. Not the least of these is that, at the rate of spread that prevailed in the three weeks before Mr Trump announced a state of national emergency, there would have been very large numbers of deaths worldwide unless firm action to prevent mass loss of life had been put in place.
The image posted with this article appears to be using 1970 technology. Even if I magnify the image, I still can’t read the printing on the image.
In response to Cinead, I do supply the graphs as a .pptx file to be linked from the article, but the moderators didn’t link to the graphs today. I’m sure they will do so tomorrow: the .pptx slides are very clear indeed.
In response to Cinead, I did send the original images with the article, in the form of high-quality .pptx slides, and they ought to have been – but were not – linked so that they could be downloaded.
In the next update, I shall remind our kind hosts to put up the link.
Days pass like weeks in a crisis. Much has changed since the patient with chest pains unwittingly loosed an unseen virus to war on Lisa Ewald. The Henry Ford Health System now houses more than 700 covid-19 patients. Nearly a third of them are in critical condition. And though all staff and visitors now wear masks, nearly 750 hospital employees have tested positive for the virus. (At Beaumont Health, the largest hospital system in Detroit, the number is twice as high: Some 1,500 employees have tested positive for covid-19.)
https://www.washingtonpost.com/opinions/2020/04/07/lisa-ewald-was-soldier-who-didnt-really-have-chance-fight/?arc404=true
Most of the comments relate to water under the bridge. Now that most countries are in isolation mode none will risk releasing shackles early. Its now about lessons learnt and how to get back to prosperous economies.
Lessons learnt? Governments world wide need to stash away emergency funds to cover rainy days. Take Norway (population 5,5 mill) :
“It [Norway] has over US$1 trillion in assets, including 1.4% of global stocks and shares, making it the world’s largest sovereign wealth fund. In May 2018 it was worth about $195,000 per Norwegian citizen. It also holds portfolios of real estate and fixed-income investments.”
All (shock horror) acquired through sales of oil and gas
By Comparison the US: https://en.wikipedia.org/wiki/List_of_U.S._states_by_sovereign_wealth_funds
WUWT: Please find an economist to contribute as an author. There is a big gap in this debate
M
I wonder how many younger people are going to hospital just because they test positive and have been convinced by the media they will die. They have a little trouble breathing and convince themselves they will suffocate to death. In reality there is no major problem and going to the hospital will actually increase their chance of death by picking up a bacterial infection in hospital.
Lessons learnt? Governments world wide need to stash away emergency funds to cover rainy days. Take Norway (population 5,5 mill) :
“It [Norway] has over US$1 trillion in assets, including 1.4% of global stocks and shares, making it the world’s largest sovereign wealth fund.
This is not the economist you are looking for, but I can see a logical fault with that. Those 1.4% of global stocks and shares just took a massive (hopefully temporary) hit. That’s what tends to happen in global emergencies. Those are not the sort of funds you need to cover an emergency. Those are funds for long term returns.
Governments can always gain emergency funding: print money or borrow money. Those cover emergencies nicely. The headache comes later.
The official data is suspect and deaths in the US are overstated because of very loose guidelines from the CDC. The models are wrong and the experts here are frequently wrong, but we’re still letting them set policy (with disastrous results).
If we listened to government experts, the actual death count might match the models because these geniuses insist people should not use HCG until after it’s proven by clinical trials. These experts don’t know that 20% of our prescriptions are for off-label use. Thousands of lives saved despite expert advice.
Further, we’re setting policy without cost/benefit analysis. Nobody at the CDC will be held accountable for the egregiously disaterous state, local and federal lock down policies. The cure is worse than the disease and we can’t keep everyone at home long enough to let the infections die out.
So yes, I have yet to see any evidence this is worse than a very bad flu season. When I have facts that show it is worse, I will change my mind.
Yes, I’m a born skeptic and contrarian. I not only live in Missouri, I’m from Missouri. So show me Covid-19 is as bad as our very fallible government beaureacrat experts claim.
Let me add the data shown here does not support my belief. I will keep an open mind and if other data closely matches and supports the conclusion, then I will admit being wrong and change my opinion.
Do you think you might be biased? Just a bit? NY today is reporting 36 deaths per 100,000 people. Missouri is 2 per 100,000 people. Would you be saying the same thing if Missouri was reporting 36 deaths per 100,000 people?
If Jeffery P were to read the head posting, he would see very clear evidence that this pandemic is worse than a typical flu season. And he has failed to allow for the fact that the pandemic has not yet peaked, so that saying it is not as bad as a typical flu season is not useful.
Governments cannot afford to be so cavalier in their abuse of statistics.
Dead doctors, dead medical workers, and half a police force infect is a typical flu season.
Here’s the fact. the FLU data is the sketchy data. its the FLU data that you should not trust
because it is largely MODELLED.