The spy’s dilemma and the lockdown dichotomy

By Christopher Monckton of Brenchley

[Update: Good news: Boris Johnson is now out of intensive care. His prospects for recovery are, therefore, very greatly improved.]

Consider how fair-minded is our kind host. There are two very different policy positions on the handling of the Chinese-virus question: the passivist (let the population acquire “herd immunity” and hope that the virus is not much worse than the annual flu) and the activist (salus populi suprema lex: take whatever steps are needed, even if the economic cost is heavy, to ensure that healthcare systems are not overrun).

My good friend Willis Eschenbach is a protagonist of the passivist position, on the ground that the virus is not much more infectious and not much more fatal than the flu. I am a protagonist of the activist position whenever a new and fatal pathogen emerges, on the ground that until one knows more about the true case rate one must be guided by the growth rate in new cases, which, in the early stages of any uncontrolled pandemic with a population that has no immunity, is necessarily exponential.

It stands greatly to the credit of our kind host that both of these points of view are fairly reflected here, and the quality of the data and arguments being offered on both sides, not only in head postings (for instance Rud Istvan’s excellent medical postings) but also in the discussion between commenters is high. It is not unjustifiable to say that more, and more profound, information about the Chinese virus is being posted here, in a more fair-minded way, than anywhere else. This is how free speech ought to work.

Today’s post will be about how to resolve the dichotomy between the activist and passivist positions. First, the data. Precisely because the early stages of a pandemic necessarily show exponential growth, policymakers in responsible governments are guided, first and foremost, by the mean daily rate of growth in confirmed cases – i.e., cases the great majority of which are identified and reported because they are serious.

During the three weeks up to March 14, the date on which Mr Trump declared a national emergency, the global daily compound growth rate in total confirmed cases was almost 20%. Exponential growth that high, if it had been allowed to continue, could potentially have killed millions to hundreds of millions worldwide. That, above all, was the reason why governments decided, albeit with extreme reluctance and (in the UK and the US for instance, much later than they should have done) to interfere with transmission.

The problem with being late is that the lockdowns had to be much more severe than they would have been if the interventions had been more timely.

However, as our daily graphs here are demonstrating, the lockdowns are working. Of course, some countries – notably Sweden – have not introduced strict lockdowns, and yet the daily case growth rate is falling there too. That is one of the chief reasons why the passivists argue that if we too had not introduced lockdowns the numbers would have fallen just as fast and just as far.

Another reason, well reflected in a recent posting by Willis Eschenbach, is that official sources originally predicted ten times the deaths they are now predicting and that, if they had gotten the predictions right in the first place, no lockdowns would have been needed.

The excellent Dr Fauci, for instance, had predicted 200,000 deaths in the U.S., but Mr Eschenbach, on the basis of a model, considers the number may prove to be only 20,000.

Naturally, any model worth its salt will necessary look at the case growth rate at the time when the run begins. The daily case growth rate of 20% that had obtained before March 24, applied also to deaths (a lagging indicator), would have turned the cumulative 20,000 deaths up until then into 310,000 deaths by April 8 and 17 million deaths by the end of April.

As it is, by 8 April worldwide deaths were less than 90,000. And why? Because the mean daily case growth rate has been falling. Over the 15 days from March 24 to April 8, the daily mean growth rate in deaths was just 10.5%. If this lower growth rate were to be continue till the end of April, there would be 800,000 deaths by then and not 17 million. So of course current runs will be showing far lower estimates of the eventual death toll than earlier runs.

It is elementary calculations like these, based not on predictive models (which are useless in the early stages of a new pandemic) but on the observed exponential growth rates, that led governments to decide that the passivists, for the time being, would not be heeded.

The case growth rate continues to fall. Because lockdowns work, some of that decline is attributable to them. Here is today’s updated graph, showing that, for the world excluding China, whose data are unreliable, the daily mean case growth rate has fallen to less than 8%:

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Fig. 1. Mean compound daily growth rates in confirmed cases of COVID-19 infection for the world excluding China (red) and for several individual nations averaged over the successive seven-day periods ending on all dates from March 14 to April 8, 2020.

But what about deaths? Taking the world as a whole, excluding China, the daily compound growth rate in deaths has fallen to about 10.5%, while in the U.S. and U.K. it is about 16-17%. Note that the graph begins on March 23, not on March 14, and that, as with the case graph, the rates shown are weekly-smoothed rates, to iron out the often large daily fluctuations in counts.

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Fig. 2. Mean compound daily growth rates in reported COVID-19 deaths for the world excluding China (red) and for several individual nations averaged over the successive seven-day periods ending on all dates from March 23 to April 8, 2020.

Now that we have the data before us, how can the spy’s dilemma assist us in resolving the conflict between the activists and the passivists? That is an important question at present, because the passivists are justifiably impatient to end the lockdowns, for the economic damage they cause is considerable, while the activists, with no less justification, would rather be sure the case growth rate will not return to 20% if the lockdowns are lifted.

This dichotomy between two legitimate and strongly-argued positions is the spy’s dilemma. Imagine an agent in the field. He will nearly always be investigating a subject in which he has no specialist knowledge, and he will also have incomplete and potentially inadequate or even inaccurate data. How, then, can he advise his superiors sensibly?

I once gave a lecture on the spy’s dilemma to 200 trainee James Bonds at the Intelligence School of the Army of Colombia in Bogota. Using global warming as an example, I said that, as a non-specialist in climatology I had had to try to decide between two competing scientific points of view: the passivists, who thought there was nothing much to worry about, and the activists, who thought the planet itself might be at risk of destruction unless capitalism were closed down.

How was I, as a layman, to decide between the graph of the past 1000 years’ temperatures produced by the formidable atmospheric physicist Hubert Lamb, and reproduced in IPCC’s First Assessment Report, and the hokey-stick graph produced in the frankly Communist academic environment of today by Mann, Bradley and Hughes?

I began by saying that data generated by totalitarian are generally more suspect than data produced by those with no Party Line to defend. Therefore, I said, one would instinctively prefer Hubert Lamb’s graph to the hokey-stick graph. However, though evaluation of the likely reliability of source data is always desirable, it is not on its own always definitive.

I explained how Socrates, Plato and Aristotle would have resolved the two competing positions by the use of elenchus, still the most powerful technique for reaching the objective truth ever devised.

monck

Fig. 3. Hokey-cokey: Hubert Lamb’s reconstruction of the past 1000 years’ temperature (top panel, from IPCC, 1990), which shows the medieval warm period as warmer than the present and the little ice age as colder, was replaced in IPCC (2001) by Michael Mann’s infamous hokey-stick graph (bottom panel), followed by many me-too graphs that purport to abolish the medieval warm period and the little ice age.

The climate activists say that global warming goes chiefly into the oceans, causing sea level to rise. Therefore, alongside their statement that the hokey-stick graph is true we can place the new statement, with which we expect them to agree, that sea-level rise or fall is an indication of temperature rise or fall. We can then draw conclusions from that additional statement.

The simplest way to decide which of the two competing 1000-year temperature graphs is correct is to compare them both with an independent graph of the past 1000 years’ sea-level change. Only one of the two competing temperature graphs closely follows the sea-level graph. The other, very conspicuously, does not. Therefore, I said, even a non-specialist with an open and enquiring mind could reach a rational – and correct – discernment of the objective even when faced with two directly-competing expert positions, and even in a field in which he holds no qualifications: for that is what an intelligence agent in the field must do every day. For that lecture, I was awarded the Intelligence Medal of the Army of Colombia:

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How, then, should be apply the Spy’s Dilemma to the lockdown question? See how similar it is to the climate question. There are two competing scientific positions, both of them having some sound arguments in their favor. The data are manifestly incomplete, inadequate and often downright inaccurate.

For instance, the British government, comprising an unduly high fraction of innumerates, has not yet understood the importance of keeping a very careful track of how many of its confirmed cases have recovered. The reason why this matters is that, during the early stages of a pandemic, the least inaccurate way of deriving the true case fatality rate is to study the closed cases – those who have had the infection and have either recovered or died. Globally outside China, the confirmed-case fatality rate thus derived is currently about 25%. That seems very much too high, leading to the suspicion that Britain is by no means the only country whose experts have not understood the importance of keeping an accurate count of those who have recovered.

The official figures have stated for several days that only 135 of the 60,000 confirmed cases have recovered. If that were truly the case, it would be an indictment of the National Health Service. So you can expect the head of the Joint Intelligence Committee, who attends all Cabinet Office Briefings on emergencies such as this, to demand that ministers get their act together and require the health service to provide a proper daily count of those who have recovered. It is known, for instance, that of the first 2249 intensive-care cases almost 400 have recovered. Inferentially, a far larger faction of the less serious confirmed cases will have recovered by now.

In tomorrow’s daily update, I shall describe some further methods of intelligence analysis that would assist governments in deciding when and how and to what extent to bring lockdowns to an end. For now, I shall point out that the pandemic will not have reached its peak until the daily compound confirmed-case growth rate becomes negative. At present, it remains strongly positive, though trending in the right direction.

Therefore, it would not be appropriate to assume that half of all cases – let alone half of all deaths – have yet occurred. We all want the lockdowns to end, but at present it is better to wait a little longer. So keep safe.

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terry bixler
April 9, 2020 10:31 pm

There is the question of what if any treatments work. Certainly with the number of cases and the time that has elapsed there should be a glimmer of what is effective in treating the virus to “bend the curve” of total deaths.

Rob
Reply to  terry bixler
April 10, 2020 2:13 am

UK ITV nearly did an honest bit of reporting last night, a young lady was admitted to hospital suffering from covid-19, her condition was serious, because of that she was offered a position on the UK trial, (only the most serious cases are considered) she was given Hydroxychloroquine, within 1 week she was cured.

If Hydroxychloroquine is give on it`s own at the later stages of the illness it is expected to give little benefit, surprise, surprise.

https://youtu.be/iiCog70rEzU

Vuk
Reply to  Rob
April 10, 2020 4:34 am

Slowing down of the exponential rise in the UK’s hospitals’ death rate is shown here
http://www.vukcevic.co.uk/UK-COVID-19b.htm

Grg
Reply to  Vuk
April 10, 2020 6:53 am

My graph of UK data from ECDC shows growth rate flat for the last week, ie constant new cases every day: out of growth phase.
comment image

Greg
Reply to  Vuk
April 10, 2020 6:53 am

My graph of UK data from ECDC shows growth rate flat for the last week, ie constant new cases every day: out of growth phase.
comment image

Stevek
Reply to  Rob
April 10, 2020 6:31 am

Agreed. The hydro chloroquine, according to Chinese study with control group, works by not having mild cases progress into critical cases. Using it early on is what studies need to measure. I noticed Vice President Pence mention zinc in last night’s press conference combined with the hydro chloroquine. Pence is a careful, disciplined politician so I’m thinking the fact that he mentioned it means he has some inside information as to its effectiveness.

Bill_W_1984
Reply to  Stevek
April 10, 2020 8:41 am

A doctor in LA has been using zinc plus HCQ and claims it works on Covid patients. A group from Germany wrote a proposal to add zinc to trials of HCQ (for some patients) to test this. HCQ is thought to be a zinc ionophore of some sort. Other media outlets like Wash. Post, etc have found experts to come on and say there is no evidence these work. Once some trials are done, we will have a much better idea.

jorgekafkazar
Reply to  Bill_W_1984
April 10, 2020 3:47 pm

The WaPoo only chooses experts from the pool of people who espouse “Orange Man bad” as their mantra. They want the meds to fail. They want more people to die.

Rob
Reply to  Bill_W_1984
April 12, 2020 5:46 am

Bill_W_1984 said,

Other media outlets like Wash. Post, etc have found experts to come on and say there is no evidence these work.

I live in the UK and even I am aware the left don`t like President Trump.

Greg
Reply to  Rob
April 10, 2020 6:44 am

However, as our daily graphs here are demonstrating, the lockdowns are working. Of course, some countries – notably Sweden – have not introduced strict lockdowns, and yet the daily case growth rate is falling there too.

CofB continues his spurious claims and refuses to address criticism from the lower classes.

If he had any objectivity and the ability to question his own assumptions, Sweden is proof that his method does NOT show what it claims it shows.

That is one of the chief reasons why the passivists argue that if we too had not introduced lockdowns the numbers would have fallen just as fast and just as far.

Cobblers. The growth rate is NOT falling in Sweden it is still in fairly pure exponential growth. The only person fooling himself about Sweden is CofB who is totally misunderstanding his own graphs and what they show.

There was an initial burst in Sweden when case numbers were very small, this is not a reliable reference .

The growth in Sweden is at a very low level, most likely for other reasons. It is still clearly linear in the log plot ie in exponential growth, not curving over as most other countries were , even before confinement.

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It is good that WUWT let’s all sides express their case but if CofB pretends he is belligerent refusal to address criticism of the obvious flaws in his approach will resolve the “dicotomy”, I don’t see that happening.

I think I have developed a method which detects the *assumed* effects of confinement in the data, with the possible exception of France which seems skewed by exponentially increased numbers of tests. More on that late when I have a means of validating the method. Someting CofB would have been wise to do before making spurious claims he now has trouble walking back.

Monckton of Brenchley
Reply to  Greg
April 10, 2020 7:42 am

Greg is incapable of either civilized argument or rational thought. He should stop whining and start studying.

Greg Goodman
Reply to  Monckton of Brenchley
April 10, 2020 8:44 am

The above is pretty civilised and also raises rational flaws in what you present. As did my lengthy, detailed and civil reply to your comment yesterday which you have so far completely ignored.

Apparently you consider such trite and dismissive responses sufficient instead of addressing the serious blunders in your presentation.

I was studying science when you were studying classics. Though I never stop studying , thanks for the tip.

Now since you consider this spaghetti graph of a quality sufficient to present to world leaders maybe you need to stop playing around and start responding to a bit of peer review and maybe publish your methods so we can explain exactly where you are going wrong.

For now, I shall point out that the pandemic will not have reached its peak until the daily compound confirmed-case growth rate becomes negative.

Both Spain and Italy have been showing generally decreasing daily cases for at least the last 10 days. That your graph is still hovering around 5% means it will never go negative and proves you have made a blunder, yet you refuse to see it or enter into meaningful discussion to sort it out.

If we follow your advice we will on permanent house arrest, forever waiting ” a few more weeks” for your asymptotic graph to go negative ! LOL .

Perhaps you should start by defining clearly , mathematically how you are deriving your percentages.

Clyde Spencer
Reply to  Greg
April 10, 2020 10:29 am

Greg
You said, “The growth in Sweden is at a very low level, most likely for other reasons. It is still clearly linear in the log plot ie in exponential growth, not curving over as most other countries were , even before confinement.”

Sweden is NOT linear! Draw a line between days 1 and 3 to see what linear looks like. The growth rate in Sweden is not bending over as strongly as Italy or Spain. However, it has actually bent over more strongly than the Netherlands, albeit more irregularly. The slope is roughly parallel with what happened with the US and France at the same death rate! That is, it is not some obvious outlier like South Korea. The thing most unique about Sweden is that the curve is not as smooth as all the other countries. I’d say that Sweden is highly suggestive that social distancing is about as effective as lockdowns.

Greg
Reply to  Clyde Spencer
April 10, 2020 11:16 am

comment image

Clyde, Sweden was a bit bumpy at the start. This is typical when dealing with small numbers of cases and probably many other factors. You need a bit of volume before these things average out. Other countries have much bigger numbers and average out better.

You can fit a line from where they had 30 cases / day and it settles to steady rate of increase. There a little dip recently which I thought may be a sign of leveling off but it’s come back up so I’m not reading anything into it.

Spain and France on that graph are now on a downward slope: it does not look much on log scale but the numbers are down by almost a factor of 2 from the peak.

For the moment I don’t see any evidence of flattening for any reason, though their numbers are small and it is not too worrying for now. So far they seem to have made a wise choice. I would not agree that it has been “as effective” since I don’t see it doing anything.

I think I do have a way to showing the effect of confinement, more later.

Roger Knights
Reply to  Greg
April 10, 2020 8:09 pm

“Ηοw Sweden’s Coronavirus Strategy Makes Sense: And why it may not be applicable in other countries — a Swedish doctor’s perspective.”

The article is too long—a 12-minute read. But it can be skimmed.

https://medium.com/@yannis_freddy13/how-swedens-coronavirus-strategy-makes-sense-2f07f69df2f2

mc
Reply to  Rob
April 10, 2020 7:46 am

One case does not constitute evidence; it barely even counts as anecdote. The reason of course is that we don’t know–and cannot know–whether she would have been cured (and within a week) if she had not been given hydroxychloroquine. Indeed, for all we know she might have recovered faster without it.

The only reliable way to tell whether treatment X works is to do double-blind studies on large numbers of patients, where the patients who get X or a placebo are randomly chosen. Whether that’s ethical in any given situation is, of course, a different question. But in any case, an N of 1 is virtually meaningless.

PJCGucci
Reply to  mc
April 11, 2020 2:05 am

mc I fully agree with you

Rob
Reply to  mc
April 11, 2020 9:36 am

Quote UK ITV nearly did an honest bit of reporting last night, a young lady was admitted to hospital suffering from covid-19, her condition was serious, because of that she was offered a position on the UK trial, (only the most serious cases are considered) she was given Hydroxychloroquine, within 1 week she was cured. If […]

One case does not constitute evidence; it barely even counts as anecdote. The reason of course is that we don’t know–and cannot know–whether she would have been cured (and within a week) if she had not been given hydroxychloroquine. Indeed, for all we know she might have recovered faster without it.

The only reliable way to tell whether treatment X works is to do double-blind studies on large numbers of patients, where the patients who get X or a placebo are randomly chosen. Whether that’s ethical in any given situation is, of course, a different question. But in any case, an N of 1 is virtually meaningless. Quote

——————————————————————————————————

That was an example of the drug being given at the worst possible time and without the other two drugs that have been shown are needed, you know that though.

Now consider the numbers, Nigeria 220 million long time uses of chloroquine and 6 deaths, Lupus and rheumatoid Arthritis , long time uses, to my knowledge 0 deaths in this group in US.

This academic thinks it`s contracting Malaria that`s making the Nigeria population immune, I think she`s a bit off the mark here. She believes it`s the resistance to Malaria that`s protecting the population when it is obviously the drug they have taken over a long period and are still taking at the present time to protect themselves against Malaria that`s caused the resistance to Covid-19, Lupus suffers take the same drug again over long periods, the link here is chloroquine) not malaria resistance. That`s my take on it.

Quote,
The issue of resistance to malaria conferring some protection to COVID-19 is a legitimate but premature hypothesis. Reason being that an insignificant portion of individuals in malaria-endemic regions have been tested. Nigeria has tested about 4000 people representing about 0.002% of the 200 million population. You need to at least test 1% of the population, that is, two million Nigerians to start making any correlation and then test those correlations. Quote.

https://www.premiumtimesng.com/features-and-interviews/387067-feature-are-africans-immune-to-coronavirus-dr-malachy-ifeanyi-okeke.html

Reply to  mc
April 12, 2020 9:25 am

This is part of the problem that I see with the Activist path. You expect that authority is correct and always should be followed.

I for one detest your ilk assuming that I am too stupid to judge (for myself) what is the best choice among less than ideal choices. A person with secure resources easily might choose stay at home, while a self employed shopkeeper more likely would choose to continue to be open for business. Each has a different risk/reward framework.

President Trump suggested that social distancing made sense and recommended that I do it. (My wife and I have followed that advice.)

The US Constitution prohibits house arrest without due process – mandatory quarantines. And yet, when the army of socialist federal, state, and local commissars ordered me to stay at home and non-essential businesses (liquor stores are essential??!!) to close for the duration, even Mr Trump didn’t come to my defense.

Instead, the Economy has been encouraged to fall apart, while the FED and the government are bailing out the and banksters and other favorites. Most Americans are being pushed toward poverty to protect against death bu COVID-19, even though poverty also kills.

And then, those in power (or medical authority) are willing to accept the hundred thousand (or however many) deaths rather than allow “unproven” treatments to be used. If Carona Virus gets to me, it should be my choice whether to try hydroxychloroquin / azithromycin / zinc , etc and not those stupid socialists with the power over me to say I can’t have that choice.

Reply to  mc
April 12, 2020 9:28 am

This is part of the problem that I see with the Activist path. You expect that authority is correct and always should be followed.

I for one detest your ilk assuming that I am too stupid to judge (for myself) what is the best choice among less than ideal choices. A person with secure resources easily might choose stay at home, while a self employed shopkeeper more likely would choose to continue to be open for business. Each has a different risk/reward framework.

President Trump suggested that social distancing made sense and recommended that I do it. (My wife and I have followed that advice.)

The US Constitution prohibits house arrest without due process – mandatory quarantines. And yet, when the army of socialist federal, state, and local commissars ordered me to stay at home and non-essential businesses (liquor stores are essential??!!) to close for the duration, even Mr Trump didn’t come to my defense.

Instead, the Economy has been encouraged to fall apart, while the FED and the government are bailing out the banksters and other favorites. Most Americans are being pushed toward poverty to protect against death bu COVID-19, even though poverty also kills.

And then, those in power (or medical authority) are willing to accept the hundred thousand (or however many) deaths rather than allow “unproven” treatments to be used. If Carona Virus gets to me, it should be my choice whether to try hydroxychloroquin / azithromycin / zinc , etc and not those stupid socialists with the power over me to say I can’t have that choice.

Joe Crawford
Reply to  Rob
April 10, 2020 9:28 am

Here in the U.S we seem to have progressed from a combination of Hydroxychloroquine (for the virus) with Azithromycin (for the pneumonia) to a combination of those two and Zinc. One of the early French studies was using straight chloroquine with Zinc, where the Zinc was the actual anti-viral agent and the chloroquine greatly enhanced it’s entry through the cell wall.

Of course, there is no telling where we will eventually wind up with these. Hell, I’m 77 and just finished a bout of something last weekend with temperature of 103 to 105 deg. F., achy muscles, shortness or breath, etc.,etc., even diagnosed with COVID-19 by the E.R. doctor. Just got the results of the nasal swab test this morning and it came back ‘negative’. Who knows what I had for those three short days. :<)

Clyde Spencer
Reply to  Joe Crawford
April 10, 2020 10:45 am

Joe
We are at the tail end of the seasonal flu period. With several million cases estimated for this season, for which even vaccinations did not prevent the usual deaths, the odds are that you could have had an ‘un-novel’ flu.

I know at least one advocate of HCQ who presented with flu symptoms and promptly treated himself with HCQ, and pronounced himself free of of COVID-19 in 3 days, despite never having been tested for COVID-19! Statistically, he also was as likely to have had a conventional seasonal flu. Such is the madness of our times.

Clyde Spencer
Reply to  Rob
April 10, 2020 10:06 am

Rob
What is the length of time that young, otherwise health people typically recover on their own from a viral infection? Can you prove logically, or even statistically, that she recovered because of the HCQ? This is a disease that we know has a large percentage of asymptomatic carriers and a very large percentage of survivors. The outcome of the young woman is what would be expected without co-morbidities. Attributing her ‘miraculous’ recovery to HCQ is little better than doing a rain dance and then thanking the gods for bringing rain.

I’m astounded by the large number of climate skeptics on this site who complain about poor science conducted by climastrologists, and then turn their backs on the principles of the scientific method in establishing the efficacy of medical treatments. They are willing to adopt Voodoo ‘science’ to promote a treatment that 1) may not actually work, 2) has little known about the optimum dosage and interactions with other treatments commonly used in tandem, 3) has risks greater than commonly acknowledged (Physician, first, do no harm!), 4) confounds data about natural recovery rates by attributing recovery to HCQ, and 5) sidelines research incentive on other treatments specifically intended to treat viruses.

Jeffery P
Reply to  Clyde Spencer
April 10, 2020 12:33 pm

There are studies that support the use HCQ plus Zinc. Add the Z-pack to help with the pneumonia. I will add, I don’t believe the Chinese about anything anymore, so I take what they say with a big chunky piece of salt.

However, very good evidence of the efficacy of HCQ and Z-pack protocol. Doctors aren’t stupid and if this protocol didn’t work we would know it by now and doctors would quit using it. You may believe it’s a false hope, but what’s the downside of trying if the patient is already very sick from Covid-19 and doesn’t have any conditions that preclude following the protocol,
what do they have to lose?

I would not hesitate to consult the doctor about the protocol if loved one had a serious Covid-19 infection.

harry
Reply to  terry bixler
April 10, 2020 2:58 am

Recently there was a quote from a NYC doctor that they are throwing the kitchen sink at the virus, i.e. using any medicines that might help, but they currently have no idea which ones work best.

I wonder if someone is analysing the serious/ICU/death stats to see if there are statistical differences between the US population (age normalised) and the co-morbidities of those patients.

For example, if hydroxychloroquine is effective, we should be seeing a significant departure from the expected US stats of ~200 per 100,000 of the population amongst those who have presented with serious Covid-19 symptoms.

The same statistical analysis of co-morbidities among these cases might reveal significant statistical departures of a range of chronic diseases that would provide some clues as to the positive effects of the drugs normally used to treat these co-morbidities.

In terms of “clinical trials” the current stats are probably as effective as the large numbers of patients, no prior knowledge etc. replace the need for double-blind systems and the confounding impacts of the placebo effect etc.

mark from the midwest
Reply to  harry
April 10, 2020 3:21 am

One of the problems is that so many patients, particularly older males, are in rough shape when they arrive for medical treatment. An emergency room doctor in Detroit went so far as to say “they are on death’s door when they get here.” It sounds as though hydroxychloroquine and zithromax are fairly effective as treatments in the early stages, but how do you code, (record), case by case status when you have so many medical personnel that are scrambling to do whatever they can, often do not have a full sense of the medical history of the patient, and, have no way of knowing when the true onset of the infection occurred?

harry
Reply to  mark from the midwest
April 10, 2020 5:51 am

In the case of hydroxychloroquine, if it is truly an effective treatment in the early stages, then those suffering from lupus would already be on it. And hence they should be disproportionately absent from turning up at the emergency wards.

It is normal practice to ask what medications a person is on in case they conflict with medications about to be prescribed. So I expect relatively good records are kept.

But in the end, it’s actually the opposite statistic that we are trying to arrive at, i.e. those groups that aren’t appearing in serious conditions at hospitals. They are the ones that are have current medications that are effective in reducing the action of Covid-19.

So if some very serious cases arrive and die without any prior medical history being compiled, then it won’t affect the search for effective treatment, since by definition, they aren’t being protected by the drugs they are on.

Tom in South Jersey
Reply to  harry
April 10, 2020 6:58 am

My wife was on Plaquenil for 20 years. She stopped taking it in December because her eye doctor began to notice damage to her eyes, which can be caused by long term usage. Through the years of studying autoimmune disease I’ve noticed that many seem to attack women in far greater numbers than men. Perhaps this is the reason why so many more men show up at the ER due to Covid 19.

One issue mentioned is the problem of the immune system attacking and damaging organs as a result of the virus. Most autoimmune patients are on immune suppressing medications, so perhaps this blocks the deadly cascade effect of the immune system.

Rodney Everson
Reply to  harry
April 10, 2020 9:19 am

“In the case of hydroxychloroquine, if it is truly an effective treatment in the early stages, then those suffering from lupus would already be on it. And hence they should be disproportionately absent from turning up at the emergency wards.”

I’m not sure on posting links, but a search for “Dr Oz Complications from hydroxychloroquine were trivial” should yield an article from CNS.News. In that article he claims that, working with someone with access to millions of insurance records, they have found the following:

“We’ve now run 9 million insurance records through, identified 14,000 people who are like these patients. They have lupus. They’re taking hydroxychloroquine. Zero of those patients so far have COVID-19. I don’t want to over interpret that. This is a tiny little biopsy of America…”

The reporting could be wrong, or his recitation of the numbers could be wrong, or his source could be wrong, or something else could be off, but if 14,000 people with lupus on hydroxychloroquine is the entire sample and none have Covid-19, my calculation indicates the odds of that occurring randomly are miniscule, way under .0001 percent, assuming that we already have over 450,000 confirmed cases in the U.S.

Again, if my calculations are correct, Dr. Oz doesn’t understand just how big his “tiny” sample actually is. I took 1- 450/320000 to get the portion of the population not identified as a Covid-19 case, got .9986, and took that to the 14,000th power to get the odds of picking 14,000 people and getting zero confirmed Covid-19 patients if those patients had average resistance to Covid-19. At about 6600 patients the odds drop to less then .01%. Thoughts?

Rodney Everson
Reply to  harry
April 10, 2020 9:34 am

Harry, regarding lupus, I tried to post a comment with more detail but I’m not sure it will appear. In short, Dr. Oz claims to be working with someone with access to millions of insurance records that has already examined nine million records and found 14,000 lupus patients who are on hydroxychloroquine and states that NONE of them are confirmed cases of Covid-19.

In lieu of a link search for: “Dr Oz: Complications from hydroxychloroquine” and check out the last three paragraphs of the article at cns.news.

I suspect he’s been misreported, or his numbers are off, but if not, they’ve already proved the concept that HCQ is protective, by my calculations anyway

Clyde Spencer
Reply to  harry
April 10, 2020 10:52 am

Rodney
From Cimate Etc.
The COVID-19 Global Rheumatology Alliance says no evidence of a protective effect from hydroxychloroquine against COVID-19 in a self-report survey of patients on the medication. April 4, 2020

William Astley
Reply to  harry
April 10, 2020 6:22 pm

Chloroquine and Hydroxychloroquine

https://youtu.be/U7F1cnWup9M

What we should do is take Chloroquine with low dosages of Zinc.

Chloroquine enables a small amount of Zinc to enter our cells. The Zinc ion which is Z+2 charged stops the virus from replicating as it cannot attached to a key molecule in our cell because of the Z+2 charge.

This has been proven in vitro with live virus. There is also a test that has determined the how much Zinc gets into the cell.

Taking large doses of Zinc does not work as the cell is negative charged. The Zinc needs the Chloroquine to enter the cell and only a small amount is need to stop the virus.

This is a big deal.

When we have this small amount of Zinc in our cells we are protected from the virus and can then start to get herd immunity.

The dosages of Chloroquine to get zinc into the cell is 30 mg. If low dosage Chloroquine is tolerable for say a year this would provide protection for until there is vaccine other solution.

High doses of Chloroquine are dangerous.

Chloroquine is a Zinc Ionosphere that allows a small amount of the positive zinc ion (Z+2) into our cells which are negative polarity. The positive Zinc ion stops the covid virus from replicating.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/pdf/pone.0109180.pdf

Rob
Reply to  William Astley
April 11, 2020 2:30 am

It`s safe they know it`s safe, if it does not work nothing is lost.

Oxford University UK

Biological Mechanism of Chloroquine

A number of potential mechanisms of action of CQ/HCQ against SARS-CoV-2 have been postulated. The virus is believed to enter cells by binding to a cell surface enzyme called angiotensin-converting enzyme 2 (ACE2) (16). ACE2 expression is also believed to be upregulated by infection with SARS-CoV-2 (17). Chloroquine may reduce glycosylation of ACE2, thereby preventing COVID-19 from effectively binding to host cells (18). Furthermore, Savarino et al (19) hypothesise that CQ might block the production of pro-inflammatory cytokines (such as interleukin-6), thereby blocking the pathway that subsequently leads to acute respiratory distress syndrome (ARDS). Some viruses enter host cells through endocytosis; the virus is transported within the host cell in a cell-membrane derived vesicle called an endosome, within which the virus can replicate (19). When the endosome fuses with the acidic intracellular lysosome, this leads to rupture of the endosome with the release of the viral contents (19). Chloroquine has been found to accumulate in lysosomes, interfering with this process (20). Chloroquine is also believed to raise the pH level of the endosome, which may interfere with virus entry and/or exit from host cells (6).

Side Effects of Chloroquine

Both CQ and HCQ have been in clinical use for several years, thus their safety profile is well established (18). Gastrointestinal upset has been reported with HCQ intake (21). Retinal toxicity has been described with long-term use of CQ and HCQ (22, 23), and may also be related to over-dosage of these medications (23, 24). Isolated reports of cardiomyopathy (25) and heart rhythm disturbances (26) caused by treatment with CQ have been reported. Chloroquine should be avoided in patients with porphyria (27). Both CQ and HCQ are metabolised in the liver with renal excretion of some metabolites, hence they should be prescribed with care in people with liver or renal failure (27, 28). In a letter to the editor, Risambaf et al (27) raise concerns about reports of COVID-19 causing liver and renal impairment, which may increase the risk of toxicity of CQ/HCQ when it is used to treat COVID-19.

CHLOROQUINE | Drug | BNF content published by NICE
HYDROXYCHLOROQUINE SULFATE | Drug | BNF content published by NICE

https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine-current-evidence-for-their-effectiveness-in-treating-covid-19/

Old.George
Reply to  William Astley
April 11, 2020 8:30 am

Absolute, William!
Zinc in the HCQ+ZPac+Zn it is the Zinc that is the anti-viral.
HCQ is a zinc ionophore allowing it to cell interior. There are others, some OTC. Look it up.

harry
Reply to  harry
April 10, 2020 8:37 pm

Rodney, I agree that the odds of this occurring are miniscule. On my calcs, there should have been around 400 lupus sufferers that had covid-19.

Note that I’m more interested in those that have serious symptoms rather than become infected, which seems to be the stat that you quoted, though maybe insurance records would only refer to hospitalisations. Covid-19 becomes just an annoyance if you can stop people from needing hospitalisation or dying.

Interestingly I have an autoimmune illness and was on hydroxychloroquine when I wrote my first comment, but I’ve stopped now as I have been getting one of the rare adverse effects – very bad arrhythmia after a few months of daily doses. Just stopped yesterday and so far no symptoms of ectopic heart beats.

BARRY HOFFMAN
Reply to  terry bixler
April 10, 2020 3:13 am

In war, the first knowledge necessary to defeating your enemy is knowing your enemy. To date, we’ve been behind the curve until this:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

This is why ventilators compound the problem and simple O2 doesn’t.

D. Boss
Reply to  BARRY HOFFMAN
April 10, 2020 5:25 am

YES – the “battle” has been against the wrong “enemy”. Monckton take note and shout from the rooftops.

The problem is the virus is attacking the hemoglobin, and that is why the O2 saturation is down, and why people can’t breathe – well they can breathe but can’t get enough oxygen so they feel as though they cannot breathe.

The fluid in the lungs isn’t pneumonia per se, it is the lung membranes are “opening” more to try to allow more O2 exchange – but with a dearth of hemoglobin, all that happens is too much fluid is allowed to pass into the lungs.

The dumbarse doctors (my view is they are nothing more than glorified plumbers and mechanics – who really don’t understand how the body works) don’t recognize that the patient’s oxygen exchange and transport mechanism has been decimated, so puts him on a ventilator which is then a death sentence.

They MUST start doing red blood cell counts and treat for this primary issue – and apparently ***Cloroquine is adept at performing.

everyone should be harping to anyone in authority about this – fighting the wrong battle will inevitably kill way too many needlessly.

Hypoxia is what this sneaky virus is inducing by attacking the hemoglobin.

William R. Clifton
Reply to  BARRY HOFFMAN
April 10, 2020 6:07 am

Wow! Great link which explains a lot of things. To others -Make sure you follow and read the link.

Reply to  BARRY HOFFMAN
April 10, 2020 6:31 am

I had a look at the origin site:
410
This account is under investigation or was found in violation of the Medium Rules.

Not the first time, interesting information sites are banned.
I remember the first published studies here on WUWT has been banned too.
All in concern of HCQ – ask for the intention or follow the money…

Greg
Reply to  Krishna Gans
April 10, 2020 9:27 am

Yes, the rapidly growing censorship by large platforms is becoming a serious problem.

The hypoxia thing ties in with the gender bias and smoking noted so dramatically in China. As I’ve previously commented one of the major effects of smoking addiction is that it incapacitates upto 60% of the haemaglobin which transport oxygen, by tying them permanently to CO molecules.

taz1999
Reply to  Greg
April 10, 2020 10:21 am

Also see:
https://archive.is/ONUmi#selection-211.0-272.0

peakprosperity.com

and to all the blame china crowd. China is going to do what it always does…lie. Bad data from China was and still is expected to be the normal. Note Monckton is excluding China data. Maybe if good data had come from China the outlook may have been better. US intelligence has been a failure to the US. If US intelligence was not able to get better data then the taxpayers are funding useless agencies.

Greg
Reply to  Greg
April 10, 2020 11:19 am

US intel have been too busy trying to control Trump and stop him improving relations with Russia, and make fake Russiagate files.

niceguy
Reply to  Greg
April 10, 2020 9:07 pm

Now I’m wondering if the CIA (and FBI intelligence section) are all MSNBC talking heads clones…

Tom Abbott
Reply to  Greg
April 11, 2020 7:26 am

“As I’ve previously commented one of the major effects of smoking addiction is that it incapacitates upto 60% of the haemaglobin which transport oxygen, by tying them permanently to CO molecules.”

So a person who smokes tabacco is only operating at 40 percent of his capacity?

How long does it take to clear this condition once one stops smoking?

Interesting. I used to smoke tabacco, but haven’t done so in decades. And I don’t miss it.

Tom Abbott
Reply to  Greg
April 11, 2020 7:37 am

Well, I found an answer to my question by reading that article:

“Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion.

Yes, it does look like we have been fighting the wrong fight. This is part of the learning curve.

I wonder if the blood machines they use for transplant patients wouldn’t work better in this situation, rather than ventilators?

What’s the deal with the censorship? It must be because Trump’s name appeared in the article. These people are sick (ill).

Rob
Reply to  Krishna Gans
April 12, 2020 5:37 am

Italy Finally Starts Mass Treatment with Hydroxychloroquine

It appears there is all out war against Hydroxychloroquine, Firstly because your President Trump was the first and only world leader to suggest this drug might save thousands of lives and secondly there is no financial reward for the drug company`s plus they could loose millions already spent in trying to find a yearly vaccine. Who in their right mind would allow a fast tracked vaccine to be injected into them when for $20 they could purchase a 5 day off the shelf medication that did the same thing. There is NO cash in it guys, they don`t want this medication to succeed.

The European Discovery Study, with Oxford University doing the UK leg mentioned here by Pr Christian Perronne is a shining example of collusion between this University and their close relationship with the worlds leading drug companies, read the quote below (English translation)

Quote
Pr Christian Perronne.
I refused to participate because this study provides for a group of severely ill patients who will only be treated symptomatically and will serve as control controls against four other groups who will receive antivirals. It is not ethically acceptable to me. We could perfectly well, in the situation we are in, evaluate these treatments by applying a different protocol. In addition, the hydroxychloroquine group (which was added to this study at the last minute), should be replaced by a hydroxychloroquine group plus azithromycin, the current reference treatment according to the most recent data. Finally, the protocol model chosen will not provide results for several weeks. Meanwhile, the epidemic is galloping. We are in a hurry, we are at war, we need quick assessments.
Quote.

https://www.parismatch.com/Actu/Sante/A-propos-de-la-chloroquine-et-de-l-inimaginable-penurie-des-masques-en-France-1680312

In France, Professor Christian Perronne is one of the best specialists in infectious and tropical diseases. He is also the president of the CSMT (Commission Spécialisée Maladies Transmissibles) and of the sub-section of the CNU (National Council of Universities), as well as of the French Federation of Infectious Diseases (FFI) since 2010. This man is also responsible to teach courses on infectious and tropical diseases at the University of Versailles-Saint-Quentin, while being the head of the infectiology department at the Raymond Poincaré University Hospital in Garches. Full member of the World Health Organization, he co-chairs a working group on vaccine policy in the Europe zone since 2009. Pr. Christian Perronne is also a diligent researcher and the fruits of his research have made the subject of numerous publications worldwide.

RetiredEE
Reply to  BARRY HOFFMAN
April 10, 2020 7:18 am

Observations from the front line. Perhaps the protocols should be questioned as we gain more knowledge of this virus. It is beginning to appear the pneumonia assumptions are incorrect or incomplete. The lock down may be giving us the delay needed to really understand this virus and determine what approaches are most effective. The intubation/respirator approach may not be the best and may be damaging.

https://www.medscape.com/viewarticle/928156

rickk
Reply to  RetiredEE
April 10, 2020 11:58 am

very compelling with common sense

Steven Miller
Reply to  BARRY HOFFMAN
April 10, 2020 7:38 am

From Bobby, “This is why ventilators compound the problem and simple O2 doesn’t.”

When I first became involved in emergency medical care 30 years ago we had buttons on the end of Oxygen lines that were attached to face pieces that we pushed down to fill our patient ‘s lungs. We switched to bag valves where a hand squeezes a bag to administer O2 because they give much finer control. It turned out that we were doing severe damage to some of our patient’s delicate lungs with the push button valve and causing very poor outcomes. The “iron lungs” used during the polio epidemic were no doubt far easier on lung tissue than current ventilators.

Stevek
Reply to  BARRY HOFFMAN
April 10, 2020 8:45 am

Good link.

Iron plays role in malaria and the Black Plague.

Sickle cell anemia to protect malaria. hemochromatosis mutation in response to Black Plague. Hemochromatosis disease affects iron in blood.

Gary Pearse
Reply to  BARRY HOFFMAN
April 10, 2020 9:54 am

Barry, a great read; maybe you should put this up as an article on WUWT. It should be part of the discussion. Mods, take note of Barry Hoffmans link above as an article in this wonderful series of covid ones.

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Bescrambled
Reply to  Gary Pearse
April 10, 2020 9:36 pm

Agreed with Gary…mods please promote the medium article, this should be seriously examined and tested as it seems to explain the underlying mechanism a lot better than what we are hearing today. It could also help the search for a genetic explanation as to who is more vulnerable.

kwinterkorn
Reply to  terry bixler
April 10, 2020 10:37 pm

I am a physician (MD) involved currently in a project to stand up a new hospital in a low/middle income country overseas in response to the coronavirus epidemic. The team I am working with has broad sources of information, including a consultant MD who works in ER and intensive care in one of the NYC hospitals at the epicenter of that city’s crisis. I follow WUWT because I am a skeptic at heart and like to get science right.

Here is my take on the argument between Lord M and Willis, both of whose writings I value greatly:

This new virus mutation is more contagious than usual influenza. It is both more and less deadly. Covid-19 is more deadly for elderly with comorbidies, especially diabetes, COPD (esp if still smoking), and obesity (independently of its relationship with diabetes, morbid obesity seriously compromises breathing mechanics—-so any pneumonia is thereby more dangerous for the obese). Yet Covid-19 seems to be less deadly than many influenza variants in young adults and children.

My instincts have been on Willis’s side of the argument…but here instincts can be wrong. It is true that poverty itself kills, via many pathways, and so prolonged lockdown of the economy will lead to deaths, as our great wealth is consumed and not replaced.

Willis demonstrates well the usual bell-shaped curve documenting the rise and fall of most epidemics. Usual, but not necessarily true in all cases. If there is a key change arising in the midst of an epidemic the course can change. For example, there has been an ebola epidemic in the Congo this last year or so. Why is this not big news, like the ebola epidemic in Sierra Leone about six years ago?

Answer: because there is now an effective vaccine for ebola. The current epidemic began like others, but soon the international health community brought in the new vaccine, applied it extensively through contact tracing and what is called “ring vaccination” (vaccinate all contacts of cases, then vaccinate the contacts of the contacts). It works. There is still Ebola in the Congo. But it is not spreading out of control. So nobody in the media cares to write or show video about. This is a great story: a triumph over a terrible disease. It might almost make you feel good about humanity, if you take time to think about it.

So the novel coronavirus has spread in our totally non-immune population in the usual exponential growth pattern. It will burn out, even if nothing is done. Many at high risk will die. Some at low risk will die. Finally herd immunity will stifle the epidemic….until the next aggressive mutation. So why intervene to “flatten the curve”?—-Because there is a reasonable chance that conditions will change and fewer will die:

1. A vaccine will not become available in time to make a difference… except to stop a second wave next flu/cold season perhaps, but

2. Most flu’s, colds, and prior coronaviruses are seasonal, for several reasons, probably due to some combination of temperature, humidity, sunshine, people crowding indoors breathing each other’s air… We are nearly into Spring and the end of the flu season. Delaying cases for a month or two with social distancing, lockdowns, and handwashing may put off cases until next flu season, by which time vaccines or advanced anti-virals may help.

The current virus has shown up in numbers in a few warm weather spots, but by and large the vast preponderance has been in wintry places. Maybe that’s only coincidence of some other factors. Maybe it is true seasonality. We will soon know.

3. There are literally dozens of therapies under rigorous study. Most well known are the old malaria/anti-inflammatory drugs chloroquine and hydroxychloroquine. There are many new “designer“ antivirals and anti-inflammation drugs under study. Zinc, too, has a well-established role in a variety of viral infections and may help here.

Key understanding: this viral pneumonia has at least two major destructive process at work in the serious cases. First the virus kills or damages many cells, especially in the lungs. Secondly, For some, the patient’s immune system does well, kills the virus, and the patient gets minimally ill. But in others, the patient’s immune system overreacts and spins out of control (“cytokine storm”) and a series off destructive changes follow that can get far worse than the original damage from the virus.

So treatment with drugs that slow down or eradicate the virus, if given early, may arrest the disease before the destructive immune-mediated phase gets going. Given later, the patient may not benefit; the patient may die from the immune system issues; but at least the patient may be less contagious with the virus suppressed, and healthcare givers may be saved.

But even as the immune system spins out of control, immune-suppressing or modulating drugs may still benefit the patient. Interestingly, hydroxychloroquine has been in the past demonstrated as both anti-viral (with activity vs coronaviruses) and anti-inflammatory ((hence its common use in arthritis). Various combinations of antivirals and anti-inflammatory drugs are being tested in many different doses in the hospitals of the world.

And if one or more of such regimes are highly effective in either preventing progression from moderate to severe disease or even reversing disease, then delaying cases will mean lowering the total death totals.

Think of how our anti-bacterial drugs have changed the course of pneumococcal pneumonia epidemics. Or how antiretrovirals have massively decreased the death toll of HIV-AIDS. How anti-TB antibiotics changed TB from being the number one killer of humans just since the 1950’s.

Delaying the curve to give time for the season to change and healthcare to try to help is worth a lot of cost. Re-opening the economy as soon as reasonable, based on data and evolving treatments is very important, too.

So Lord M and Willis make good points. Which is why I get good science here at WUWT

JohnM
April 9, 2020 10:37 pm

From the PHE dashboard on NHS figures. Hardly surprising, since the people collating the stats don’t work weekends. Most non-clinical NHS staff are keeping clear of the frontline, by policy. Staffing levels in London are quite low; nobody wants to go on the tube, or a bus, if they can avoid doing so.

“Previous updates of the dashboard included a number of patients recovered. This figure was the
number of people discharged from NHS clinical services in England following a positive test result for
COVID-19 and was provided by NHS services. This statistic has proved difficult to assemble and a
replacement indicator is being developed”

Rocketscientist
April 9, 2020 10:44 pm

In early stages of almost every unknown event much “data free analysis” gets proffered. As the data arrives we will be better able to assess this event. I would very much like to see better testing.
In the meanwhile I applaud the discourse.

Tim Bidie
April 9, 2020 10:51 pm

Let’s cut to the chase here:

The medical profession has known for some time that the common cold, rhinovirus/coronavirus infections, is a bigger killer of old people than influenza:

‘Rhinoviruses and coronaviruses cause the majority of common colds and play a part in more serious respiratory illnesses that lead to increased morbidity and mortality. Patients who are infants or elderly, have asthma or chronic obstructive pulmonary disease (COPD), or are immunosuppressed have increased frequency of rhinovirus-related respiratory complications.’

‘Rhinovirus and coronavirus infections.’ NCBI/NIH April 2007

‘Unexpectedly Higher Morbidity and Mortality of Hospitalized Elderly Patients Associated with Rhinovirus Compared with Influenza Virus Respiratory Tract Infection’

International Journal of Molecular Sciences Feb 2017

The health services should have been better prepared. In many countries, including some OECD nations (to their shame) they were not, and the reasons for that, will, (not very) hopefully, be looked at in some detail with swingeing reform to follow. This has been an absolute shambles.

Because the message has been clear for a while now: the elderly, medically vulnerable, need protecting from the common cold even more than they do from flu, not just this year but every year.

The rest of us need to get back to work.

Mike From Au
April 9, 2020 11:03 pm

‘Herd immunity’ is a fundamental medical/immunological principal and not a political stance whatsoever, although it is being interpreted as such.

Reply to  Mike From Au
April 10, 2020 12:19 am

It is misleading: Herd immunity is and always was the endpoint. It is the deaths in between we are trying to control.

The pandemic is a case of ‘we know the models are (broadly) correct, but we don’t know what data to plug into them’.

With climate science the models are not even correct.

Ken Irwin
Reply to  Leo Smith
April 10, 2020 2:01 am

We can’t combat the virus by hiding away – the herd immunity will never occur and at the end of each lockdown the epidemic will simply start up again.

USA got from 1 to where it is in just 80 days. If we end lockdown with just one infectious person remaining, we will be back where we started in no time.

Or will we ?

It depends on how many have acquired immunity – but we still do not have a reliable test for that.

What to do ? – Keep the lockdown in place whilst we pray for the miracle of a vaccine or an accurate antibody test.

I fear that will kill far more than the disease.

The only option is to release the lockdown restrictions in phases and monitor the “curves” – from this data we should be able to infer the progress of the herd immunity.

Holding or reversing the relaxation at any significant upward trend change.

Continue in this fashion until the epidemic blows itself out as herd immunity is achieved or the miracle of a vaccine or immunity test occurs.

Even with an immunity test we would still need to follow a phased relaxation of lockdown based on the data – so we might as well get started.

We can’t hide in place until we die. That’s just stupid.

Mike From Au
Reply to  Leo Smith
April 10, 2020 2:30 am

My point is ‘herd immunity’ is not a political stance sir.

Herd immunity is a fundamental medical/immunological principal.

For example, my dim view of polarising the subject is to assume there are only one of two theories. Distancing or not to distance.

Christopher only has two categories.

Some further errata:
https://www.youtube.com/watch?v=XgXWqFUs8c4
“COVID-19: WHO Benefits? And Epidemiology Lesson”

Rich Davis
Reply to  Mike From Au
April 10, 2020 4:13 am

You have identified my objection well. Not only does CMoB portray the world in the binary black or white of his two categories, but he is unfairly stating WE’s position. Willis has not to my recollection ever stated that covid-19 is no more infectious than an ordinary flu. Neither has he proposed to do nothing. WE objects to the interventions that collapse the economy without providing sufficient benefit to justify the harm. It is like regulations to reduce lead in drinking water to below the limits of measurement, and failing to do so, eschewing the use of water.

Much as the world economies do not include any examples of pure communism or unbridled capitalism (because every government recognizes that the best approach lies somewhere on the spectrum between those extremes), virtue stands in the middle ground between the abstract categories of “activist” and “passivist”.

In medio stat virtus

Environment Skeptic
Reply to  Rich Davis
April 10, 2020 5:03 am

Primum non nocere
(do no harm)

Logic and Reason
Reply to  Rich Davis
April 10, 2020 5:27 am

There is another point being left out. If you are part of the 25% of the population who is forced from their job because they are deemed ‘unessential’, this is a game of would you rather.
Would you rather have a 100% chance of poverty or a .001% chance of death?
(keep in mind that the flattening of the curve does not lower the risk of exposure, it only stretches it out over a longer period of time, so the death rate difference is just the difference of hospital overload)

Mike From Au
Reply to  Rich Davis
April 10, 2020 6:08 am

Thank you kindly, i agree with the precept.
In medio stat virtus
(Virtue stands in the middle)

Mike From Au
Reply to  Rich Davis
April 10, 2020 6:19 am

My apology. The two identities “Mike from Au” and “Environment Skeptic” are one and the same email address and the result of exuberant auto-fill and not a spelling checker mistake this occasion.

Monckton of Brenchley
Reply to  Rich Davis
April 10, 2020 7:59 am

In response to Rich Davis, whether he or anyone likes it or not the choice faced by governments lies between locking down or not locking down.

For six weeks the debate between the do-little merchants and the lockdown advocates raged among the medico-scientific advisors to HM Government. In the end, the lockdowners prevailed. They did so because the transmission of the pandemic was exponential, and was growing at a daily compound rate of almost 20%. In the absence of lockdowns or a prophylactic, palliative or cure, there was no way to bring that rate down in the early stages except by direct interference with the person-to-person contact ratio.

In countries such as Sweden, with a low urban population density, the person-to-person contact ratio is a lot lower than in cities such as London, Paris, Milan, Madrid or New York. Accordingly, Sweden could take – and did take – the decision to risk not locking the country down. We could not take that risk, or our hospitals and health systems would have collapsed, leading to social breakdown and widespread disorder, the economic consequences of which would have been far worse than those of a lockdown.

There is nothing black and white about any of this. The head postings in this series have very fairly reflected and discussed, the uncertainties in the data, the counterexamples such as Sweden, Taiwan and South Korea, and the variety of approaches that might be taken.

Like it or not, the activist side in this debate has prevailed with most governments, and has prevailed with very good reason. Governments cannot be so irresponsible as to assume, in the absence of far better data than are currently available, that “herd immunity”, as it is called, would have been acquired without massive loss of life. They had to take precautions and then wait and see.

We are in the wait-and-see phase at present, the precautions having been taken. The daily lockdown benchmark graphs show that inexorably, if too slowly for comfort, the daily compound growth rate both in infections and now, at last, in deaths is beginning to decline.

Nevertheless, severe excess mortality is already evident in the European countries most affected by the pandemic, and also in cities such as New York. That excess mortality would have been considerably worse without the interventions that have been put in place by governments, with the overwhelming support of their peoples.

That support will not, of course, endure indefinitely. For the time being, however, it remains strong, because, as the graphs show, the case-growth and death-growth rates are fortunately declining. Long and fast may that decline continue.

Responsible governments can’t just sit on their hands while their health services collapse under the weight of patients requiring advanced, prolonged intensive-care interventions. If you were fighting for people’s lives in an overcrowded hospital overwhelmed with patients and short of everything from staff to beds to ventilators to personal protective equipment to testing kits, rather than reflecting upon these matters from a comfortable armchair at a safe distance, you might well come to a different view. In doing so, you would be beginning to think like a responsible government.

Monckton of Brenchley
Reply to  Rich Davis
April 10, 2020 8:23 am

As a Classicist, I am of course familiar with the axiom “panta metrios” – all things in moderation. However, true virtue does not necessarily consist in standing safely on the middle ground. Sometimes, hard decisions have to be taken, as anyone who has worked at a senior level in government will know.

Governments could not and – like it or not – did not take the risk of allowing millions to die when sensible precautions could buy them time to find a way out of the crisis. Those precautions are rightly under constant review and, when it is safe to lift them, they will be lifted.

Rich Davis
Reply to  Rich Davis
April 10, 2020 9:32 am

Thank you for your thoughtful response. As it happens I have argued most of the same points as you have regarding the prudence of taking action in the absence of critical facts.

Where we differ is on the degree of action that is in fact prudent. Thus a continuous spectrum of possible interventions rather than a binary choice of lockdown or not.

How you can reconcile there being nothing black and white about your rhetoric with your claim that I must acknowledge that governments face a choice of locking down or not, completely eludes me.

Governments face a range of decisions. Whether to close schools, whether to ban large gatherings, whether to enforce a strict quarantine on vulnerable populations who have not yet been infected, etc. Also whether to risk the use of unproven but anecdotally promising treatments. Any of these questions might have been answered either way to craft a concrete policy. Each decision carries with it an unknown benefit and a cost. For Willis to argue that some interventions will not provide enough benefit to be justified is in my view entirely reasonable. There are interventions which western governments have not undertaken. Infected persons have not been strictly quarantined for example.

To segment your interlocutors into two classes is unreasonable. In reality neither you nor Willis represent the possible extreme views. You are both occupying middle ground and are disputing what is prudent. I stand with Rud Istvan in between you.

None of us has the benefit of the data that should eventually inform us all as to which choices would have been optimal (not to say most prudent because often we must choose a path that is predictably suboptimal when we lack data to justify the risky choice that is predictably more likely to be optimal but also apparently more dangerous if our expectations prove mistaken).

Wishing you good health and a blessed Easter

Clyde Spencer
Reply to  Rich Davis
April 10, 2020 10:59 am

Mike
Obviously, you are a fan of Aristotle, who defined virtue as the arithmetic mean of two opposite vices.

Clyde Spencer
Reply to  Rich Davis
April 10, 2020 11:15 am

Christopher,
You claimed, “… the choice faced by governments lies between locking down or not locking down.” That is a false dichotomy. There is a middle ground. There almost always is. The middle ground is to accept some increased casualties to save the world economies by using isolationing. We in the US accept miscalculations in the concoctions of the annual flu vaccines and nary a peep is heard from the media or politicians when there are 80,000 deaths, as happened in the 2017-2018 season! It is not unreasonable to ask white collar workers to wear surgical masks just as people in the construction industry often wear dust masks. We could stagger work hours or days to reduce the number of people in a workplace, but keep the business open. We could require workers to wash their hands at every mandated work break. Thinking out of the box would reveal that there are more options than the two extremes you present.

Incidentally, should you think that I’m being callous out of self-interest, I’m retired so I’m not trying to save my job. At the same time, I’m at high risk of dying from the virus should I catch it. So, I’m trying to be objective about what is best for society.

Clyde Spencer
Reply to  Rich Davis
April 10, 2020 11:20 am

Christopher
You said, “Sometimes, hard decisions have to be taken, …” As any experienced general knows all too well! Avoiding loss of life at any cost does not win wars.

Scissor
Reply to  Mike From Au
April 10, 2020 6:23 am

What a great video with a balanced and knowledgeable speaker. Here’s a great quote from it: “We should not commit suicide to avoid death.”

taz1999
Reply to  Scissor
April 10, 2020 10:03 am

Logic and Reason

I can recover from poverty

whiten
Reply to  Leo Smith
April 10, 2020 2:53 am

Leo Smith
April 10, 2020 at 12:19 am

Contrary to what you say, herd immunity is the fundamental initial point.
And you will not know what data to plug in how to have an initial approach on validation
of the input in these models if herd immunity is ignored.

Is due to relying in the observed parameters of herd immunity and it’s response to a new disease
that actually stands as the proper foundations of the medical response and the validation of the input in the medical models of any given disease.

You see, if a new full blown disease in proper global pandemic with a very high epidemic vector, that does not “touch” children, has to be considered as soft or mild.
Meaning that the herd immunity response is quite good and efficient even in the first stage, before even being upgraded to a better one.

Where the input in the models as it stood in consideration of ignoring such condition happens to be very wrong and invalid.

Is the observation of such herd immunity parameter that enforces the actual reality that a full blown global pandemic of the disease follows a full blown pandemic infection in the consideration of definitely more than one cycle of the infection.
This is the first full blown global pandemic disease cycle, but not the first cycle for the infection.

You see any way we address this novel virus, it happens to be a proper nobel virus also.
There is no virus there that we know of before this one, that ever went or gone full global pandemic as this virus has done…
especially when considering in this case the impossibility that it went from zero to hero in maters of weeks or max a single season.

A soft mild virus, is a very “lazy” virus… which does no go from zero to hero in maters of few weeks or a single cycle… and definitely one that only herd immunity upgrade to it is the most and first proper efficient response to it during the full blown disease cycle(s) or period(s).

The rest of the further responses simply bettering the odds on top of it, where isolation of populations does not make sense.
Where the “flattening of the curve” actually in some special situation may achieve flattening of the curve of herd immune response adjustment to the condition in the very first stage of disease blow,
which could spike the curve of severity and fatality in some special situation and lead to more unnecessary confusion and panic.

Herd immunity is a fundamental condition not to be ignored.
That condition has being fully ignored in this case, especially in the part of modeling the possible impact… a total gross negligence and a gross diminishment of responsibility, bordering criminal.

cheers

Rob
Reply to  whiten
April 10, 2020 3:17 am

Watch Sweden, no lockdown there I believe, if there is a second wave Sweden should not see one, we will see.

Scissor
Reply to  Rob
April 10, 2020 6:34 am

It’s great that Sweden is doing this experiment. It may turn out that the leadership of Sweden in this regard made the best decisions.

If China had been open and honest, then this pandemic would likely not have happened.

harry
Reply to  Rob
April 10, 2020 6:35 am

Sweden looks terrible.
40% the population of Australia, 544 deaths versus 53. 544 new cases versus 51.
77 new deaths versus 2. 40 times the death rate per million people (high than even the US) and they are only testing at 40% the rate of Australia, so likely even more infections.

GregK
Reply to  Rob
April 10, 2020 7:37 am

Sweden popln about 10 million
5416 tests per million
9685 identified infections 870 dead
no lockdown, “relaxed” restrictions

Australia popln about 25 million
13269 tests per million
6203 identified infections 53 dead
Not total lockdown but fairly stringent restrictions

An interesting experiment. We will see….

Monckton of Brenchley
Reply to  Rob
April 10, 2020 8:30 am

In global terms, Sweden does not yet look terrible, as some are suggesting. Because it has a lower population density in Stockholm than, say, London, Birmingham, Manchester, Sheffield, Leeds or Glasgow, it has a lower mean person-to-person contact rate than those cities, so it can perhaps (the jury is still out) avoid lockdown.

But the fact that countries with lower population densities can avoid lockdowns – for now, at any rate – does not imply that it would have been safe to avoid lockdowns in London or New York. The best medico-scientific and epidemiological advice was to the effect that lockdowns could not be safely avoided in these cities. On the data, that advice, rather than that of the do-little merchants, was appropriat and proportional.

Rodney Everson
Reply to  Rob
April 10, 2020 10:16 am

Watch Sweden and Israel and compare the two. Sweden should be sending someone to Israel to find out how they are treating their confirmed cases. The two countries have approximately the same populations, but Israel’s Covid-19 patients are faring far better.

Sweden: 9,685 cases; 870 deaths; 749 serious/critical
Israel: 10,095 cases; 95 deaths; 164 serious/critical

If Sweden could get the treatment results that Israel is achieving, they might well avoid overwhelming their healthcare system, keep their economy going, and achieve herd immunity more rapidly than any other country.

My thinking is that they should be testing more and prescribing the hydroxy/zithro/zinc combination to anyone testing positive who starts experiencing worsening symptoms. Let the rest become infected and let them recover without treatment if they never experience symptoms, or if they are mild. It would be interesting to know if Israel is using that drug combination. Whatever they’re using it appears to be working.

Monckton of Brenchley
Reply to  whiten
April 10, 2020 8:26 am

In response to “Whiten”, herd immunity is not being forgotten; but, by the same token, it is not a fundamental principle either. With smallpox, for instance, there was no population-wide immunity, but determined measures worldwide succeeded in eradicating it.

With the present pandemic, the problem was to prevent mass death and disease occurring all at one time, swamping healthcare services – as has already happened in New York and in several UK hospital systems – and eventually threatening social order.

Responsible governments cannot afford to be ideological. They have to act on such evidence as is available, and it was quite plain that this virus was dangerous enough to require very careful handling. There’s no point in being doctrinaire: one must think.

whiten
Reply to  Monckton of Brenchley
April 10, 2020 9:53 am

Monckton of Brenchley
April 10, 2020 at 8:26 am
—————
Thank you for your reply.

I am sorry to put it so plainly.
I have no time or means to waste in consideration of telling you how wrong your approach to herd immunity is.

I will simply restate, that it, happens to be the main fundamental initial principle in consideration of any disease response… period.
You like it or not that is what it happens to be.
End of discussion at this point, regardless of what you know or you do not know, regardless of what you believe or not.

But, you see, you happen to be equally perverse in implication of social order.
Without the proposition of law and order, there is no any means of social order to even be contemplated.

Outside the means of crime and punishment, law and order happens to be just a figment of imagination… social order just a ghost.

Crime without punishment happens to fuel a strong forcing incentive for more and more crime, leading to the proposition of a new normal,
crime and reward, the very epitome of social collapse and social destruction,
far far much worse than social disorder.

Crime and reward is actually the main threat to your beloved society that you seem to care so much, at this very point in time…
the very self destructive incentive there flourishing as we speak, due to the fearmongering panic gone global, purely insane.

Mutating from law and order to crime and reward, has only one outcome in consideration of social civility… very clearly shown in our civic history…
unnecessary destruction and death and murder to incomprehensible amount.

Hopefully you understand this point… hopefully.

cheers

rickk
Reply to  Leo Smith
April 10, 2020 12:09 pm

Not misleading at all. The young and middle aged, for the most part, come through with only minor discomfort (of course bad luck happens some unfortunates). These are the members of the herd we want. We also want to protect the frail and the elderly and all the retirement homes need to be closed to visitors (with increased screening of employees). Question: why is the west coast (CA, Wash) so quite wrt to this Wuhan virus yet NY and NJ are completely overwhelmed – if you believe the newly reported Stanford hypothesis – it’s herd immunity – as this virus was introduced gradually over Nov-Dec 2019 – seems plausible

Richard M
Reply to  rickk
April 11, 2020 1:07 pm

Another explanation for why the west coast has had a slower infection rate is the difference in mass transit. Mass transit the fastest way to spread a virus. If this is true then the infection will continue to spread at about the current rate for much longer on the west coast.

Lance Wallace
April 9, 2020 11:13 pm

I’m worried about Africa. The virus is only now getting there, but will it rage through the continent? 1900 cases in South Africa, but only 800 cases in Cameroon, 400 in Ivory Coast, Burkina Faso, etc. as of today. How high will it go?

Reply to  Lance Wallace
April 10, 2020 12:21 am

Me too. I have family there.
And it is their winter, on the way.
It could rip through the townships in SA as badly as did HIV.

Rob
Reply to  Lance Wallace
April 10, 2020 3:12 am

Malaria and Chloroquine.

As of the 9th April only 8 deaths in Nigeria out of a population of over 220 million, the population is mainly poor. Nigeria has the largest death rate from Malaria in the world, the only affordable drug that works against Malaria is Chloroquine. China is Nigeria’s main trading partner. ( 8 DEATHS ).

Lupus, rheumatoid Arthritis and Hydroxychloroquine.

None of my lupus patients have developed covid, which is quite remarkable,” Dr. Daniel Wallace, a rheumatologist at Cedars-Sinai Hospital in Los Angeles, said in a teleconference for the Lupus Research Alliance.

Dr Wallace said that of around 1,000 patients with coronavirus that have showed up at his hospital network, “one has had lupus.”
“It may be that the drugs that these patients are taking provides them with type of protection. I find this rather interesting and I can’t quite explain it,” Dr Wallace said.
Dr. Peggy Crow, the chief of rheumatology at the Hospital for Special Surgery in New York, echoed Dr Wallace’s observations.

Dr Wallace is one of the worlds foremost experts in these fields.

There is an ongoing trial in the UK, Hydroxychloroquine is included ( thank you President Trump for that), my understanding is that this drug will be used on it`s own and at the later stages of the illness. The best results being seen around the world are when the drug is used with an antibiotic and zink sulfate. I believe the intention of the oxford trail is to undermine the efficacy of this drug because there is NO drug company profit in it.

Oxford University has a history of having close links with drug companies, they hold all the data from drug company Statin trails and up to this time have not released any of that data to enable independent researches verify drug company dodgy Statin results. Oxford have been paid millions by these companies.

Thousand are dying in the UK, recoveries are rare, we get I believe, oxygen and paracetamol, bit stone age I`d say.

harry
Reply to  Rob
April 10, 2020 6:30 am

“Dr Wallace said that of around 1,000 patients with coronavirus that have showed up at his hospital network, “one has had lupus.””

Given that lupus incidence in the US is somewhere around 100 per 100,000 (various ranges for males females and different ethnicities), 1 patient in 1000 seems about right. The numbers are too small to draw conclusions, even if the age demographic of serious covid-19 cases might push the stats up a little. You’d need to study the 100,000+ serious US cases.

Stevek
Reply to  harry
April 10, 2020 6:40 am

Another issue is how often do the lupus patients take the drug. My understanding is that many people do not take medication as prescribed so just because a person has lupus and takes hydro chloroquine it doesn’t mean they were actually taking the drug at the time of infection. Lupus my understanding is a disease that flares up at different periods so it could be patients only taking the drug during a flare up.

old white guy
Reply to  Lance Wallace
April 10, 2020 5:31 am

When 3,177,204 die it will have reached the annual deaths from the seasonal flu world wise.

Scissor
Reply to  old white guy
April 10, 2020 6:48 am

My opinion doesn’t mean anything, as I am just looking at eyeball projections of the data, but it appears that the global trend in both cases and deaths have favorably moved off their exponential trends.

Extending the current death trend, gets to around 1 million globally on this round. There is a lot of uncertainly around this projection because the divergence of deaths off the exponential is just developing. So, 3 million is possible, but so is less than 1 million.

mcswell
Reply to  old white guy
April 10, 2020 7:54 am

Where does that number come from? The numbers I’ve seen are at least an order of magnitude lower.

Monckton of Brenchley
Reply to  old white guy
April 10, 2020 8:39 am

Old White Guy makes a good point. At present, 100,000 have died worldwide. Given that the present daily growth rate in Chinese-virus deaths is 9.2%, and assuming that that will halve in the coming weeks as lockdowns take effect, at a mean 4.6% daily death growth rate there will be 3.2 million deaths by eight or nine weeks from now. If the daily death growth rate falls fast, that will take some weeks longer.

It is already more than likely, therefore, that in little more than half a year the deaths from the Chinese virus will exceed the global flu deaths in a full year.

ozspeaksup
Reply to  Lance Wallace
April 10, 2020 6:07 am

africa and india are just kicking off counts are dodgy as usual due to such little health care for many
indonesias looking like rising fast also and they have NOT banned the pilgrimages by Muslims back home before ramadan
I dont think they would be able to enforce it anyway

Fabio Capezzuoli
Reply to  ozspeaksup
April 10, 2020 8:31 am

“indonesias looking like rising fast also and they have NOT banned the pilgrimages by Muslims back home before ramadan”

Correct, but the president announced a campaign to persuade people NOT to return home and other actions are being considered. I know almost for a fact that Indonesian numbers are unreliable, but at least they’re trying.

DMacKenzie
Reply to  Lance Wallace
April 10, 2020 8:21 am

There are so many diseases that take lives in Africa that assuming they reach the .03% mortality rate of Italy, Spain, and Iran, it will hardly make a bump on the annual 1% death rate. Epidemics only occur in Western countries, for the 3rd world it is just normal life. /s

ironargonaut
April 9, 2020 11:17 pm

“The excellent Dr Fauci, for instance, had predicted 200,000 deaths in the U.S.”
And now…
In an interview with ABC News’ “This Week,” Fauci said the figure, as reported by the New York Times, of as many as 200,000 to 1.7 million people could die from the fast-spreading virus is “unlikely” if the nation does what it’s doing now.

The staggering death rate is “possible,” he said of the figures reported by the Times.

“A model’s only as good as the assumptions you put in there,” he said.

“It is unlikely if we do the kinds of things we’re outlining right now,” he said, adding: “I don’t think it’ll be that worst-case [scenario]. What we’re doing will have an effect.”

Notice how he says models are only as good as the assumptions, same as climate science models. So I guess he and Willis think alike, at least in some ways.

Tom Abbott
Reply to  ironargonaut
April 11, 2020 8:32 am

I think Dr. Fauci and Dr. Birx are being unfairly vilified about these virus computer models.

You have an unknown disease, so you have to start out with assumptions, not data. Then, as things develop, you acquire data and feed that data into the initial model and that data causes the model output to change. And so on and so on. There’s no conspriacy here.

I think Dr. Birx said they were looking at something like six different virus models, and were looking at them every day, and apparently the six models she is looking at are pretty much in agreement, and they all had to make initial assumptions about the disease before they had any information about it. So if you want to fault Dr. Fauci and Dr. Brix, then you are faulting a lot of other experts in the field, too, because they all handle their models the same way: No data at first, just assumptions, then modify the model when data is available.

The difference between the virus computer models and the human-caused climate change computer models, is the virus computer models incorporate actual data as it becomes available, while the climate models are just guesses and dishonest manipulation all the way down.

ren
April 9, 2020 11:32 pm

Vaccination with plasma with antibodies is effective during the first three days of symptoms. It inhibits the development of inflammation. In severe cases it will not be effective.

Michael Carter
April 9, 2020 11:33 pm

Completely off-topic, but today I was thinking about aircraft pilots. Thousands, possibly within the hundreds of, without work. This is a profession built upon a child’s dreams. They know nothing else and have thought of nothing else as a profession for years. Think for a moment of the young pilots who have just completed training and/or may have just landed a job

Furthermore, all pilots need to keep up their flying hours to retain their licenses

It must be devastating

Sorry, but no. I believe that while the debate may rage for years the general consensus will eventually tilt toward the passivist approach

No doubt, the lockdowns are working to flatten the curve. But we are not even at Churchill’s “end of the beginning”. Policy makers WILL be responsible for the suffering to come through an economic virus that will persist long after the outbreak wains

IMO

M

Monckton of Brenchley
Reply to  Michael Carter
April 10, 2020 8:43 am

Mr Carter is, of course right: eventually, the lockdowns will be brought to an end. No one wants to leave them in place indefinitely.

But one needs a mature, responsible strategy for ending them. The first step is to develop an antibody test. Without that, the true prevalence rate, and the true rate at which general immunity is being acquired, cannot be known.

In view of the immediate menace to healthcare systems worldwide, responsible governments could not simply assume that all would be well. Already, hospitals are overwhelmed in many places. Lockdowns buy time for building up necessary hospital capacity, and they allow a breathing space to develop an exit strategy that does not involve swamping the hospitals and morgues, digging mass graves in New York, etc., etc.

rickk
Reply to  Monckton of Brenchley
April 10, 2020 12:16 pm

Unsure of such a blanket statement of ‘overwhelmed in many places’. Case in point, California and Washington are rather attenuated wrt to covid 19 – which cannot be explained by lock-downs.

Robert of Texas
Reply to  Monckton of Brenchley
April 10, 2020 4:32 pm

“But one needs a mature, responsible strategy for ending them.”

The problem with this statement is it assumes their *IS* a mature, responsible strategy for ending them. I am not convinced their will be. Anything that involves people and their emotions is highly unpredictable and prone to unintended side-effects.

Take ending the war in the Middle East as an example of this…it was easy to get into the war, and to even overcome certain entrenched governments, but getting out of the war seems very protracted and difficult.

I kind of suspect that ending the lock downs will be messy and prone to a lot of unintended side-effects. Once people have lost their jobs, it won’t be a simple matter of them just being rehired – there has to be demand, and that requires people who feel wealthy enough to purchase, and that requires jobs.

I think the plan to end the lock downs, just like any war plan, will last right up to the first battle. We need to be prepared to evolve our plans very quickly.

JBW
Reply to  Michael Carter
April 10, 2020 8:49 am

Back in the ’70’s we had the oil crisis. Many pilots from the corporations (BOAC/BEA now BA) were stood down and new cadets joined the company but were redeployed in jobs such as cabin crew. My course was suspended and when we finally were finished we were told to go away for three years. Even after 3 years we were only offered non flying jobs. So not a totally new situation.
Most of us survived to complete an aviation career.

WTH
April 9, 2020 11:37 pm

So, let’s remember normal flu season has low deaths due to VACCINATION. The old and the compromised are normally vaccinated and there is a reasonable degree of herd immunity. So any comparison of COVID-19 with the flu season should take this into consideration.

Lockdown will be effective based on a) border movements being greatly restricted for the foreseeable future and b) a vaccine is developed. If not then there will be a second and possibly third wave requiring future lockdowns. At some stage the economic aspects will need to be factored in. Every Government make such decisions every year such as capping the amount of money for drugs and healthcare, there is a trade off.

While I support a lockdown assuming the above, I have a slight concern that we could win the battle but lose the war. This is a low probability but if the world economy spiraled into a great depression, then there will be more deaths from this than COVID-19

Mike Dubrasich
April 9, 2020 11:38 pm

Because lockdowns work, some of that decline is attributable to them.

That is a bold statement without proof. Implicit in the contention is that “lockdowns” are an actual thing, that people are actually sequestering in their homes in obedience to government dictates.

My observations are limited to my community. My state is under “lockdown”. Schools are indeed closed here, but nothing else appears to be. The roads are busy, people are going about, stores are open, and construction, logging, farming and other businesses are proceeding much as usual. Very few shoppers are even wearing masks. Apparently nobody heard about the lockdown or else they don’t care and are simply ignoring it. The Governor can issue edicts, but people around here figure it applies to somebody else, not them.

The cumulative death count from (alleged to be from) the Terrible Virus is 40 poor souls in a state with 4 million residents. That’s one death per 100,000 people. Our normal background death rate is something around 100 per day. I can’t say when the viral mortality “peak” will be, or if it has already come and gone.

Do lockdowns work if they are virtual lockdowns in edict only and not in reality? Correlation is not causation, especially when the correlate is imaginary.

Chaswarnertoo
Reply to  Mike Dubrasich
April 10, 2020 12:06 am

Sweden and Japan show lockdowns don’t work and don’t matter.

JohnM
Reply to  Chaswarnertoo
April 10, 2020 2:50 am
ozspeaksup
Reply to  Chaswarnertoo
April 10, 2020 6:11 am

well Japan is Now locking down as the toll rises
swedens got high 9ks and around 900 dead and not many recovered yet

Joey
Reply to  Chaswarnertoo
April 10, 2020 8:41 am

Iceland has the highest testing rate in the world….over 10% of their entire population. It also has among the highest infection rates in the world (over twice that of Italy)….and the lowest death rates in the world (about 1/17 that of Italy). Iceland has not locked down. It does contact tracing, quarantine of the infected and has banned gatherings of more than 100 people.

Monckton of Brenchley
Reply to  Chaswarnertoo
April 10, 2020 8:49 am

Chaswarnertoo is incorrect. Sweden decided not to go for lockdown because the person-to-person contact rate in a country whose urban population is not as densely-packed as it is in London or New York is a great deal lower than in those countries.

As for Japan, that is a unique society where individuals take far more personal responsibility than is usual in the West. They wear masks willingly, and they do not need to be told to lock down because they can be trusted to use their common sense.

In Britain, alas, common sense could not be relied upon, Long after it was apparent that mass gatherings were unsafe, the Cheltenham Racing Festival went ahead and tens of thousands attended. Result: a cluster of new cases and deaths that would not have happened in Japan.

Lockdowns work for well-understood epidemiological reasons, and only an ideologue would attempt – futilely – to suggest otherwise.

Rodney Everson
Reply to  Monckton of Brenchley
April 10, 2020 10:34 am

If you look at Japan’s confirmed cases graph, you will be able to detect a flattening of new cases (compared to the expected exponential growth rate) right up until they decided to cancel the 2020 Summer Olympics.

In other words, they were almost certainly suppressing the numbers until that point. After the initial infections were noted in late February to early March, cases were flat to declining from early March until March 25th, when they started rising at the exponential rate typical of other countries. The announcement to postpone was made on or about March 24th.

And, given Japan’s density, and its older population, the next few weeks are probably going to be hard.

PMHinSC
Reply to  Monckton of Brenchley
April 10, 2020 11:13 am

Monckton of Brenchley April 10,2020 at 8.49 am
“Lockdowns work for well-understood epidemiological reasons,…”

In what context do they “work?” Lockdown’s were sold based on “flattening the curve,” which reduces the hospital load. They were not sold as a primary means of reducing the number of deaths. With perhaps some exceptions, in the US the hospital load is less than predicted. So, is that because the lockdowns have worked, or it that because the number of hospitalizations were over predicted?

ren
Reply to  Mike Dubrasich
April 10, 2020 12:09 am

Therefore, outbreaks suddenly appear in areas of high population density. Often, hospitals unaware of the speed of infection are the source of a large number of infections. In the summer the virus will calm down, in the autumn new outbreaks in large agglomerations will appear.

Monckton of Brenchley
Reply to  ren
April 10, 2020 8:51 am

Ren is, as always, concise and informative. His contributions here are most distingusihed, most helpful and most welcome.

It is not yet clear that the virus will calm down in the northern-hemisphere summer and, even if it did, there is still the southern-hemisphere winter to come.

Governments, therefore, could not take the chance of assuming that in the summer the infection would disappear. If this virus behaves like other coronaviridae, that may well happen: but we do not know.

Erny72
Reply to  Mike Dubrasich
April 10, 2020 4:52 am

Hi Mike,
More or less the same observaation for Norway, where we’re held as a shining example for the rapid implementation of a ‘full lockdown’. Not that you would much notice when you walk to the shops and notice everyone else out walking to the shops or indeed just out for a walk. Masks are conspicuous by their total absence (except when arriving at a hospital, which I’ve had cause to visit for reasons entirely unrelated to wuhan flu). Traffic is lighter than normal, but not as light as a ‘lockdown’ would imply.
So depsite life apparently going on as normal, other than kids being home or video conference schooled office workers ‘working’ from home if they can and confirmed cases being tracked by their mobile telephone signal and threatened with substantial fines for breach of quarantine, rate of unemployment has approximately doubled. And there is no chance of anything like herd immunity being achieved before the inevitable second wave next autumn.
There is still toilet paper on the shelves of the shops though, as the closest thing to ‘panic buying’ is the longer lines before the cashiers at the Vinmonopolet.
Let’s see what this ‘lockdown’ really achives, especially when income taxes are adjusted at the next national budget.

Scissor
Reply to  Mike Dubrasich
April 10, 2020 6:55 am

The word “some” makes the statement true, but we will not ever know what “some” is and some may not even be significant.

In Colorado, all ski resorts have been closed by order of the governor. Normally, there are several deaths/season because of the inherent risks associated with skiing. Certainly, closing the resorts will cause “some” reduction in ski deaths.

But what is the cost? Using some of the logic that is being used for the lockdowns, it could be argued that ski resorts should never be reopened.

Monckton of Brenchley
Reply to  Scissor
April 10, 2020 8:54 am

Scissor is wrong. The reason for lockdowns is to prevent the entire healthcare system from collapsing under the strain of a sudden influx of patients requiring more advanced intensive care, for longer, than normal viral-pneumonia patients, and with a less happy outcome on average.

Doctors and nurses here in the UK are begging people to adhere to the lockdowns, so as to ease the inexorably mounting pressure on the hospitals and their intensive-care units.

Scissor
Reply to  Monckton of Brenchley
April 10, 2020 5:06 pm

I was responding to Mr Dubrasich’s quote of your statement, “Because lockdowns work, some of that decline is attributable to them.”

I would agree with that statement because some is not precise. I did not dispute the intention of the lockdowns.

Monckton of Brenchley
Reply to  Mike Dubrasich
April 10, 2020 8:45 am

In response to Mr Dubrasich, it is remarkably easy to establish that lockdowns work. One takes the cellphone data from before the lockdown and from after it, and from that one can derive a not unreliable estimate of the change in the mean person-to-person contact rate as a consequence of the lockdown. The product of that contact rate and the infectivity of the pathogen is the infection rate per unit of time (usually days), known as R_0.

It is thus simple to calculate that lockdowns are working, and to show just how well they are working to delay the rate of infection and eventual death that would otherwise have occurred.

KcTaz
Reply to  Monckton of Brenchley
April 10, 2020 11:18 am

I am just curious. Are cell phones really so ingrained into the world’s culture that no one would go out and just leave theirs at home, thus, preventing authorities from knowing they’ve left their house?

KcTaz
Reply to  Monckton of Brenchley
April 10, 2020 11:23 am

I am curious. Are cell phones really so ingrained in the world’s culture than no one would ever just go out and leave their phone at home, thus, preventing tracking by the authorites?

Robber
April 9, 2020 11:46 pm

In Australia, 85 new cases of Covid19 were reported on April 9, compared to a peak on March 28 of 460 new cases.
7 day rolling average of new cases is down from peak of 376 to 139. First week of March the average was just 7.
Total number of confirmed cases 6,100 with 3,000 reported as recovered and 51 deaths.
Interestingly, across the ditch in NZ that went into total lock down 15 days ago, new cases also peaked on March 28 at 146, latest count 29. The initial level 4 period is due to end on April 23.
We are rapidly exterminating this virus in Australia and NZ.

Michael Carter
Reply to  Robber
April 10, 2020 12:45 am

Note the low de..th:cases ratio in all southern hemisphere countries. Can this be to do with our high exposed to sun for 6 months? What will happen down-under in 2 months time?

The fat lady has not even arrived backstage yet

Zig Zag Wanderer
Reply to  Michael Carter
April 10, 2020 1:26 am

For one, I’ll be skipping off to hot, sunny Europe if they let me. I’m not keen on sitting through a flu season down here with that covid 19 to worry about as well.

David Hood
Reply to  Michael Carter
April 10, 2020 3:24 am

No – stupid correlation.
I see absolutely NO connection (NB – I live in NZ) that can’t be then argued the other way from ANY country in any other part of the world still having relatively mild to warm weather – and hence exposure to UV.
Don’t get me wrong – expose away, but to think this is the panacea to the problem, is a bit like those thinking 5G was the cause.

Peter Kerr
Reply to  Michael Carter
April 10, 2020 5:34 am

Vitamin D supplements when we get less sun in winter (between 3000 and 5000 IU per day) does the trick for flu; maybe for covid19 too? Worth a try.

Steven Mosher
Reply to  Peter Kerr
April 10, 2020 8:09 am

get a vitamin d shot.

Monckton of Brenchley
Reply to  Peter Kerr
April 10, 2020 8:56 am

Mr Kerr’s Vitamin D3 dosage seems a little high. The most recent major meta-analysis – Martineau et al. 2017 – suggested that 1000 AU daily (which I have been taking for years) will be enough.

Richard from Brooklyn (south)
Reply to  Robber
April 10, 2020 2:09 pm

Just to correct the NZ figure for infections (tested and probable combined). March 28 was 83 with the highest the day before at 85. We went hard and early. 2 deaths, both elderly, 93 yo and another woman in her 70’s.
I note with interest that with recent a big increase in testing (once capability increased) there was not the expected increase in positive cases.
Lockdown is taken seriously. Streets deserted. People only out for social distanced exercise or grocery shopping. Essential workers can work but all take precautions.
We are looking like going from level 4 to 3 in a couple of weeks. Border restrictions have just been increased (all arrivals in controlled acommodation for 2 weeks).
Time will tell but we may have gotten on top of this. Watch this space.
Lord M of B may wish to look at our process and results as an argument to aid his ‘take action’ approach.
Our population is a smidge under 5 million.

mikebartnz
April 9, 2020 11:52 pm

There is the trouble that by isolating this same virus could come back and bite us on the arse and create the same situation again. Frankly I don’t know why so many are trying to disprove Darwin’s theory.

Snape
Reply to  mikebartnz
April 10, 2020 1:00 am

“There is the trouble that by isolating this same virus could come back and bite us on the arse and create the same situation again.”

That is my worry too. What if the virus starts to spread all over again after social distancing measures are lifted?

The economy can’t handle these quarantines much longer.

John McCabe
Reply to  Snape
April 10, 2020 2:48 am

This is one reason why I think South Korea should be worried. It’s all very well being the ‘gold standard’ of stopping the virus in its tracks, but they will need to continue to be super-vigilant until a cure or vaccine is developed, as “herd immunity” is unlikely to be developed naturally there.

Monckton of Brenchley
Reply to  John McCabe
April 10, 2020 8:59 am

In response to those who think that South Korea has managed the pandemic incorrectly, its approach has managed to allow it – thus far, at any rate – to avoid a lockdown. That in itself is worthwhile.

The population will gradually acquire immunity, but, thanks to the beautifully targeted and excellently implemented approach of the South Koreans, the economic damage along the way will be minimal.

If only we had had the same foresight, we could perhaps have avoided lockdowns too. But we didn’t.

PJF
Reply to  Monckton of Brenchley
April 10, 2020 9:38 am

The population will gradually acquire immunity…

The population of South Korea is approx. 52 million. It has approx. 10,000 confirmed cases (20,000 suspected) and the rate of new infections is dropping. They will never achieve immunity unless their policy of containing the virus fails.

Thingadonta
April 9, 2020 11:53 pm

This virus likes to exploit complacency. It arrives in a place, spreads silently for several weeks amongst the more immune and then starts killing. That’s what got governments panicky. It fools everyone.

It is a very subversive pathogen, it interferes with the innate immune system to ensure no symptoms show for 5 days, so it can spread to others. It has a lot of natural selection behind it, as not even a bat would hang next to another bat that is obviously sick. (Yes I know most bats are immune and non symptomatic, but not likely when this first virus swept through them as well).

This subversive aspect about lockdowns makes decisions more difficult.

commieBob
April 9, 2020 11:56 pm

It’s easy to get buried under a blizzard of facts and be unable to make a decision. It’s a signal to noise problem. With anything remotely political, much of the noise is man made interference.

The trick is to find a ‘tell’ that you can tune into that will shine through the noise. My favorite example:

I knew we were losing the war because all our great victories kept getting closer to Berlin.

On the simple question of whether the current coronavirus is worse than the annual flu, my ‘tell’ is Ecuador. As far as I can ascertain, Ecuador copes with the annual flu. On the other hand, it is overwhelmed by this year’s coronavirus. link You can spout the official numbers all you want but it is obvious that they understate the actual number of deaths by as much as an order of magnitude. You could argue that the government’s actions actually made the problem worse, and I would agree. In spite of that, the fact still shines through that Ecuador does not usually see this many deaths by a long shot.

ren
Reply to  commieBob
April 10, 2020 12:14 am

The damage SARS-Cov-2 does to the human body is more like biological weapons than ordinary flu.

kendo2016
Reply to  ren
April 10, 2020 3:45 am

The idea that this virus is/was developed as a bio weapon appears to be being dismissed/covered up by main stream media . However ,one must ask why was such intense research was being carried out at Wuhan by Zheng li Shi &others, see Nature magazine 30 oct 2013.(she is known locally as ‘batwoman ‘I have read .)She recently retired I believe .
What was the purpose of the research ?just for academic information , or to see how this could be used in bio warfare & possibly modified in any way ?
In any event ,the spread has been very rapid &devastating world wide ,affecting both northern & southern hemispheres.Was this an experimenrt that went wrong ?Will we be told ….eventually ?

kendo2016
Reply to  kendo2016
April 10, 2020 5:28 am

In any event ,China has now iearned how to cripple the Western economic ,& social structure ,whether by design ,or accident. I have just heard ,China is now mostly back open for business .
Something fishy ,Beijing not affected ,no lockdown ,Shanghai,no lockdown .They are open .Do they have a vaccine? Not a single Chinese leader has been affected,or military commander have tested positive ,but leaders in UK ,Spain, Canada Prince Charles & others & thousands more . as those cities are much closer to Wuhan than European cities ,Is this simply good luck ,coincidence ,, or careful planning ?

GregK
Reply to  kendo2016
April 10, 2020 5:43 pm

“In any event ,China has now iearned how to cripple the Western economic ,& social structure ,whether by design or accident. ”

And its own.
Not a lot of production in Wuhan for the last couple of months

Biological warfare has so far been horrific but generally ineffective
https://wwwnc.cdc.gov/eid/article/8/9/01-0536_article

An exception being the effects of Europeaan diseases on the native people of the Americas and Australia which was for the most part inadvertant

Tom Abbott
Reply to  kendo2016
April 12, 2020 6:46 am

“In any event ,China has now iearned how to cripple the Western economic ,& social structure ,whether by design ,or accident.”

I would look at it differently. China’s leaders didn’t hit us hard enough, not that I think they released the virus into their own population on purpose, although I do think they purposely allowed the infection to travel all over the world, probably thinking that if China is going to suffer greatly over the virus, that they shouldn’t be the only one. China’s leaders don’t want to be the only ones suffering, they want to share.

So, for whatever reason, the Chinese leadership unleashed this plague on the world. Remember: China shut down air traffic between Wuhan and the rest of China on Jan. 24, but they continued to allow international flights long after that, and when Trump put the China travel ban in effect on Jan 31, the Chinese were complaining and putting pressure on other nations not to follow the U.S. lead.\
And although the Wuhan virus hit the world hard, it appears that we might get our economy up and running quickly enough to minimize the economic damage, and on top of that, we have learned our lessons about pandemics. When this Wuhan virus pandemic is over, the United States will have the capacity to do massive testing anytime a new virus pops up, and from the way our medical community is handling this crisis, I would say, with adeqate supplies, they, and a pandemic plan, can handle anything the Chinese leadership can throw at us.

What doesn’t kill you, makes you stronger. I think that is the case here.

Tim Bidie
Reply to  commieBob
April 10, 2020 2:42 am

The disadvantaged in Ecuador do not cope well with influenza epidemics either, mainly due to housing conditions:

‘This work found that a part of the housings that do not comply with temperature and relative humidity standards in the interior are built with inappropriate materials so that the well-being of their inhabitants is affected. In addition, an increased rate of influenza spreading, in combination with overcrowding, converts these housings in origin of spreading diseases.

In addition, the analysis shows that the socioeconomic status of people and an absence of laws that regulate the hygiene in the housings (social housing mainly) will negatively impact the health and economic situation of Ecuadorians.’

‘Spatiotemporal Analysis of Influenza Morbidity and Its Association with Climatic and Housing Conditions in Ecuador’ Journal of Environmental and Public Health 23 Nov 2019

icisil
Reply to  commieBob
April 10, 2020 3:46 am

You’re ignoring several factors that exacerbate the problem. Prices have shot up due to the lockdown, which is devastating to an already poor, malnourished population; people are going door to door begging for money. The collapse in oil prices has devastated the government’s ability to respond; “about 50 percent of the country’s export earnings and about one-third of all tax revenues” come from oil.

The clues are all there in your article, but virus-porn junkies never see them because they are so infatuated with corona-chan and her charms.

commieBob
Reply to  icisil
April 10, 2020 5:32 am

The things that exacerbate the problem also exacerbate the problems of dealing with regular influenza.

Does Ecuador have influenza? Yes it does and the hospitalization rate in some parts of the country are quite high. link

So, back to my original assertion. The country copes with regular influenza and has not coped with this year’s coronavirus and the difference is not small. Based on that, people will have a very hard time convincing me that this year’s coronavirus is less of a problem than the regular flu.

icisil
Reply to  commieBob
April 10, 2020 6:18 am

You can’t compare Ecuador’s past coping with influenza with the current situation because the economy was not shut down in those times, nor had the oil market collapsed. But those are just two factors I mentioned. I’m quite sure there are more; there always are.

commieBob
Reply to  icisil
April 10, 2020 8:22 am

Right. That totally explains why the undertakers are overwhelmed and they have to resort to cardboard box caskets. /sarc

icisil
Reply to  icisil
April 10, 2020 9:17 am

I think you’re missing the point that a normally malnourished population becomes more at risk of disease and dying from same when they can’t buy enough food because the economy has collapsed due to lockdown. Covid didn’t create that economic situation, the reaction to it did.

commieBob
Reply to  icisil
April 10, 2020 11:25 am

Ecuador has an ongoing problem with malnutrition. link Is there any evidence that it’s become much worse? I keep patiently offering data and you lazily keep offering speculation.

icisil
Reply to  icisil
April 10, 2020 12:41 pm

Yes, if you will carefully read the article you linked to, food is more expensive, which means poor people eat less. They are going door to door begging for food.

Like many Guayaquil residents who work in the informal economy, without benefits or job security, Ms. Frías, a house cleaner, lost her ability to earn a living when the quarantine was imposed. At the same time, shortages caused by the lockdown made food prices shoot up.
Residents say the price of potatoes, a national staple, has soared in Guayaquil in recent weeks: A dollar used to fetch five pounds of potatoes. Now it buys just one
.

Some are going door to door, begging for food.

Barry Hoffman
Reply to  commieBob
April 10, 2020 11:21 am

Quito, Ecuador is at altitude 9000 feet. Lower O2 concentration. I would suspect greater vulnerability to O2 deprivation from the disease and organ distress.

Chaswarnertoo
April 10, 2020 12:00 am

Spending much less on more intensive care beds would seem a more sensible activist position. Kung flu is not the Black Death.

Zig Zag Wanderer
Reply to  Chaswarnertoo
April 10, 2020 1:29 am

A good idea, but you also need healthcare workers. I’m not sure if a solution, but imagine what $2 trillion could do for the USA healthcare system, for example.

The benefits could be permanent, too.

Monckton of Brenchley
Reply to  Chaswarnertoo
April 10, 2020 9:04 am

Chaswarnertoo, who has a gift for getting just about everything flat-out wrong, is again incorrect. Our Prime Minister needed intensive care, and so did thousands of others. In civilized countries, simply leaving them to die for lack of intensive-care beds is not regarded as the default option.

That is why Britain has built a dozen new temporary hospitals with vast capacities, and will build more as needed. To leave the gravely ill and dying uncared-for is a repellent approach not acceptable in a civilized society.

Zig Zag Wanderer
Reply to  Monckton of Brenchley
April 10, 2020 1:07 pm

That was not what he said. Classic straw man argument. I expected better from you.

He suggested spending on healthcare to cover the infected, instead of paying people not to work. IMO, that, coupled with sensible physical distancing and increased general hygiene, could have as much or more benefits than shutting down the world’s economies.

High Treason
April 10, 2020 12:02 am

I am a passivist on COVID 19. Viruses can never be eliminated and worse still, mutate. How much crossover immunity comes from a vaccine and how much from the immune system training itself. Personally, I prefer my own immune system.

Thus far, the vast majority of deaths have been those with significant comorbidities- people living on borrowed time. These people die in the the thousands each year of the seasonal flu. Here in Australia, for 800-3,000 medically compromised people annually, the flu is their last straw. To destroy the economy and give the State the taste of total police state power to try and prevent inevitable deaths is insane. We have had just 52 deaths since March 2. This is within normal range for seasonal flu at this stage of the year.

As for the dismissing of hydroxychloroquine, this is suspicious to say the least. How convenient is it that those that bang the drums of universal vaccines are the ones bagging what is a simple and cheap cure. How about Bill Gates- he has been demanding universal vaccination at the same time as proclaiming there are too many humans. What a massive inconsistency. Is there a hidden and sinister agenda to his calls for vaccination instead of a simple medicine? Time for precautionary principle- if there is a risk that untested vaccines could cause harm to the 98% of the population that can handle the virus, then ditch compulsory vaccination.

Why has nobody even mentioned ozone as a means of reducing transmission and initial viral dosage? Ozone at about .02ppm will kill around 90% of viruses. This level is safe for all day exposure. How ironic that it is typically produced by corona discharge. I have used ozone in my work and on myself for eye infections. It kills bacteria instantly. Superficial eye infections were fixed in 30 seconds. A single ozone molecule punches a hole in non mammalian cells. It is only an issue for single cell thickness mammalian cells such as lungs.

As or Faucci, he is on the board of the Gates foundation. Massive conflict of interest. I would listen to what Fauci says and do the exact opposite- just like the predictions of catastrophic anthropogenic global warming. The predictions of warmists are consistently totally inaccurate, so doing the exact opposite will be a good starting point.

If I am offered the opportunity to get natural immunity, I am tempted to take it.

Petit_Barde
April 10, 2020 12:23 am

OT but related to SARS-COV-2 :

– it seems that one of the biggest health scandal is on the way (at least) in France.

Article in French :

https://www.marianne.net/politique/ambiguite-gouvernementale-liens-d-interets-au-sommet-de-l-etat-enquete-sur-la-guerre

Reply to  Petit_Barde
April 10, 2020 4:39 am

Have you any idea what the reasons are to act against the Marseille studies from Raoult ?
Are personal animosities the main reason ?

Rich Davis
Reply to  Krishna Gans
April 10, 2020 5:24 am

If I understand the article correctly, the controversy relates to several people in the French government having financial ties to the pharmaceutical company Gilead which makes remdesivir, a drug also being evaluated to treat covid-19. The allegation is that they place restrictions on HCQ-azithromycin treatment that only allows use for the patients too far advanced in the disease to be helped, so that negative results will naturally ensue, making it seem that the much more expensive remdesivir treatment is the only choice.

Reply to  Rich Davis
April 10, 2020 6:41 am

But at least the published the permit to use in general, finally.

JoeShaw
Reply to  Petit_Barde
April 10, 2020 8:56 am

It would be helpful to summarize at least the key points of the article for those of us who don’t read French.

Cheers

Ben Vorlich
April 10, 2020 12:30 am

How does the mortality rate for those infected by CV19 compare with the post-war Sain and Hong-Kong Flu pandemics?

Hivemind
April 10, 2020 12:36 am

“… if the economic cost is heavy”. Heavy isn’t the word for it. Catastrophic is barely adequate. Unemployment in Australia, the UK & US doubled and then redoubled. Most countries of the world show no improvement in the infection rate beyond natural burn-out that you would get without this lunatic measure. What worked in China wasn’t “social isolation”, it was a genuine quarantine.

Thingadonta
April 10, 2020 12:42 am

I read a few days ago that the lockdown in Italy had already saved an estimated 30,000 deaths. If true, hard to argue against.

Sure, these might get it again when the lockdowns end, creating new surges, but by then there will be more herd immunity, lowering the death rate each time new outbreaks occur. This will likely go on for months to years but overall, far less will die.

I’m not a fan of the just like flu argument. The simple fact that the overall deaths are not that much more then seasonal flu at present is largely due to the lockdowns, at least in cooler climates. Current flu strains don’t do what happened in Lombardy, Wuhan and New York. We also don’t know yet what will happen in warmer climates where the virus might not transmit so easily. If it doesn’t we are lucky, there isn’t many ventilators in tropical developing nations.

richard
Reply to  Thingadonta
April 10, 2020 1:47 am

hmm.. swap the words flu for Corona- no difference-
In Spain, flu collapses hospitals almost every year.

In 2017 the Spanish-language Huffington Post site asked “Why does the flu mean collapse in Spanish hospitals?”.

In the 2017/18 flu season, hospitals all over the country were in a state of collapse.

Last March, hospitals were at over 200% patient capacity.

In 2015 patients were sleeping in corridors.

Even in January this year, before the coronavirus had impacted Europe, nurses were complaining that the flu season was stretching healthcare to breaking point.

Ben Vorlich
Reply to  richard
April 10, 2020 3:28 am

Similar for the NHS, except nobody comments in the press, perhaps because it’s October before numbers are publishef

Rob
Reply to  Ben Vorlich
April 10, 2020 5:36 am

Ben Vorlich said Quote Similar for the NHS, except nobody comments in the press, perhaps because it’s October before numbers are published Quote.

https://www.telegraph.co.uk/news/2018/11/30/winter-deaths-hit-highest-level-40-years-experts-blame-ineffective/

Ben Vorlich
Reply to  Rob
April 10, 2020 11:12 am

Rob,
Dated 30th November, no longer News 6 months after the event.

Perhaps one benefit of this pandemic will be people will not go to A&E as readily as they did before .

icisil
Reply to  richard
April 10, 2020 3:49 am

Same in Italy. ICUs are normally at 85-90% capacity every year. The system collapsed during the 2017-2018 flu outbreak.

CptTrips
Reply to  Thingadonta
April 10, 2020 12:33 pm

Hard to argue against? I’ll take a crack at it.

Let’s start out with the fact that we are all going to die. It is inevitable. Thus we cannot prevent deaths, only postpone their occurrence. Next we’ll add in the idea that since we are mortal, the only inherent and valuable property we own is our time alive. It is our effort, or how we choose to use our time, that provides all value to everything around us.

Based on those simple ideas lets analyze your 30,000 statistical people. Based on the death profiles of COVID, these are elderly people with chronic diseases, and as such do not have a large remaining lifespan. So the question is, how long on average will our 30,000 live on after we have “saved” them? 1 year? 5 years? 10 years? I think most people would put that number closer to 1 than to 10, so what you have purchased them is somewhere between 30,000 and 300,000 man years.

Now, what did you pay for that? You denied 60 million people free use of their time for 1 month. Time they could have spent working, playing, or cowering in a corner in fear of the dreaded COVID-19, but it would be their choice. By denying them that choice, that time no longer belongs to them which means you took it from them. That gives you 1/12 * 60,000,000 = 5,000,000 man years taken from the population to give at most 300,000 and as little as 30,000 back. That’s a pretty hefty tax.

thingadonta
Reply to  CptTrips
April 10, 2020 4:34 pm

Amongst other things, one also has the issue that overwhelmed hospitals with a short term high death rate means other patients die or get poor treatment for other issues, because resources are stretched. Elective surgeries are cancelled, heart attack and stroke victims dont get proper treatment. etc etc.

10-15% or ‘cases’ (notwithstanding the number is lower here due to non-test confirmed cases) dont die, but get seriously sick. This is alot of people. 5% require intensive care but dont die. This is also alot of people. Im sure one can think of other entaglements.

Bair Polaire
April 10, 2020 12:47 am

I wonder why a falling growth rate of cases is always considered to be a proof for the lock downs to work. Any outbreak follows a Gompertz-curve: exponential at the beginning, than linear, then diminishing. The growth rate of a Gompertz-curve is always falling. (Because everyday there are less potential victims that can be infected.) Exactly like what we see in the graphs above.

The relevant question therefore must be: do we beat the falling growth rate of a Gompertz-curve fitted to the initial outbreak. Only then can we say the lock downs have an effect.

I have not yet seen such an analysis.

suffolkboy
Reply to  Bair Polaire
April 10, 2020 2:23 am

There can’t be such an analysis during the initial outbreak because neither the Gompertz curve nor the Farr curve nor any sigmoid curve is distinguishable from a simple exponential during that time, so the only things you can measure are rate of doubling and current value. (And your heart rate when the doubling comes out as 3.1 days.) It’s only when you can start spotting a deviation from that initial exponential that you can begin making a stab at the extra parameters, notably peak value and timing of the peak. In my view in the UK we reached that moment around the first week of April. However, the random uncertainty of chance in collecting these figures is eclipsed by the consistent confusion about how the numbers are counted and by the political posturing and public hysteria. However, even if we could get a reliable figure for these parameters, especially timing, the question of attribution remains: do lockdowns have any significant effect? My view is that the jury should still be out, whatever the police constables, experts, politicians, poets, blog-bullies, armchair epidemiologists and newspapers may say.

Fortunately, I am not a Columbian spy so I don’t have to make a judgement call on whether to spend a trillion pounds on a project that may turn out to be the equivalent of spreading white powder around Trafalgar Square to keep the elephant population down, only to find out after a year that the powder is economically toxic and that the secret model of projected elephant population I used had a hockey-stick accidentally baked in.

Monckton of Brenchley
Reply to  suffolkboy
April 10, 2020 9:17 am

Suffolkboy has made various guesses. He may or may not be right, but he is probably wrong. A new and currently-incurable pandemic necessarily follows an exponential curve until enough of the population have been infected to begin to reduce the number of susceptibles appreciably.

So let us do the math. It isn’t difficult. There have been 1.6 million confirmed cases so far, most of these being quite serious cases, which is why they have come to official attention. Suppose that for every confirmed case there are as many as 100 unreported cases, because people showed few or no symptoms. Then there would in truth have been 160 million infections. But that is only 2% of the global population, leaving 98% still susceptible.

Therefore, the deviation of the logistic from the strictly exponential curve that prevails at the outset of a pandemic would not be expected yet.

Suppose there are 1000 unreported cases for every confirmed case. Then 80% are still susceptible, leaving very little room for deviation from the exponential curve.

The fact that we don’t know to within three orders of magnitude how many are infected means that anyone saying the peak has been reached is saying so on inadequate evidence.

Therefore, though Suffolkboy may be right, he is probably wrong. Either way, responsible government’s can’t indulge in that kind of optimistic guesswork. They can hope for the ebst, as we all do, but – like it or not – they must prepare for the worst, and such preparation unfortunately comes at great cost.

Rich Davis
Reply to  Bair Polaire
April 10, 2020 5:55 am

How would that be possible? Different countries, even if their initial rates are identical, would be unlikely to have the same response over time due to many factors including population density and cultural norms (bowing at a distance vs embracing and kissing cheeks for example). That means that it’s not a valid test to compare lockdown countries against non-lockdown countries.

If country A has 20% growth rate initially due to multiple asymptomatic super-spreaders despite a culture that is formal and “low touch”, while country B has the same rate from fewer initial patients but greater interpersonal contact due to cultural differences involving smaller personal space and less fastidious hygiene, country A will follow a lower curve than country B. If country A locks down and country B does not, in comparing the two as if a comparison of lockdown vs no lockdown, locked down country A will appear to be highly effective, mostly owing to the cultural differences. But if country B locks down and A does not, (think B-France vs A-Japan), then your comparison will likely “prove” that lockdown is counterproductive. Both conclusions are wrong. Different countries are not interchangeable test subjects.

It’s not possible, but you would need to test lockdown vs no lockdown on the same population with the same virus. Only if you have access to multiple instances of the multiverse could you run that experiment.

Monckton of Brenchley
Reply to  Rich Davis
April 10, 2020 9:20 am

Rich Davis makes an excellent point. Population densities – in particular the urban ones, where the mean person-to-person contact rate is highest and infections spread fastest – vary greatly. Stockholm is a whole lot less densely packed than London or New York.

The Swedes, therefore, have gotten away without a lockdown so far, and long may that continue. But if Britain or New York had gone down the same route, our far greater urban population density would have led to mass deaths and the collapse of the hospital system. The Government, rightly, was not willing to expose the population to so grave a risk.

ren
April 10, 2020 12:59 am

It seems that the body of people over 50 does not recognize the virus from the moment of infection and then reacts too violently. This leads to the destruction of lung cells and other organs that have ACE2 receptors.

“The ACE2 receptor is found pretty abundantly through a lot of our organs,” says Panagis Galiatsatos, a pulmonologist at Johns Hopkins Bayview Medical Center. They’re on cells on the tongue, and along our esophagus. They’re on cells in the kidneys and heart, and the end of our gastrointestinal tract—which is why stomach symptoms, like loss of appetite and diarrhea have been observed.

Most worryingly, ACE2 receptors appear on cells in the most delicate part of the lungs: the alveoli. They’re responsible for the vital gas exchange of taking in oxygen and releasing carbon dioxide. Damage to these cells is what causes some of the most common symptoms of the virus, like shortness of breath. Coughing is a result of the lungs trying to expel the infection.”
https://qz.com/1822554/how-the-coronavirus-tricks-cells-into-a-full-body-invasion/

ren
Reply to  ren
April 10, 2020 2:07 am

Plasma vaccine with antibodies to people at risk, in particular medical personnel and people treated for hypertension.

icisil
Reply to  ren
April 10, 2020 4:11 am

That may be because those patients are hypertensive and/or diabetic and taking ACE inhibitors (ACEi) and/or ARBs as treatment. Those drugs inhibit ACE expression, but not ACE2 expression. ACE and ACE2 act in a counter-regulatory manner – ACE promotes inflammatory responses against oxidative stressors, and ACE2 promotes factors that dampen inflammation.

I have read that when a patient is put under care at a hospital, ACEi/ARB treatment stops. If this is true, ACE expression will begin to increase. We all know what happens when some regulatory component of a system in balance is suppressed and then released: it swings back hard and overshoots. So I’m wondering if there is an inflammatory over-response by ACE when it suddenly detects a lot of infected lung cells creating a cytokine storm situation.

icisil
Reply to  icisil
April 10, 2020 5:20 am

I’m reading something by an MD that says ACE inhibitors (ACEi) lower PAI-1 (plasminogen activator inhibitor-1). Elevated PAI-1 is a risk factor for thrombosis and atherosclerosis. This MD is speculating that cessation of ACEi treatment upon hospital admittance is causing elevated PAI-1, which causes a thrombosis cascade that typically appears in days 10-14 of illness.

Reply to  icisil
April 10, 2020 6:47 am

Yes, you have to decline the treatmen slowly over a longer time.

Wim Röst
April 10, 2020 1:01 am

Key for bending the curves is Social Distancing. You can oblige people (lockdown) or use ‘softer methods’ like in Sweden or the Netherlands which is sometimes called ‘an intelligent lockdown’. The effectiveness in ‘bringing down the curves’ however comes from REAL social distancing.

A lot of rules and ‘advices’ in Sweden and the Netherlands are the same, but there are important differences as well. Main differences between the Netherlands and Sweden are that in Sweden ALL shops, bars and schools are open (in the Netherlands supermarkets are open but most other shops, bars ad schools are closed) and that in Sweden social distancing is not prohibited to 1.5 meter like in the Netherlands. In Sweden meetings of more than 50 people are forbidden while in the Netherlands you may not meet with more than two other people – and you still have to keep 1.5 meter distance. And what is the result of those differences?

Sweden had its first 100 deaths on March 25 and the Netherlands on March 20, indicating that the Netherlands were some 5 days ahead of Sweden. The last four days Sweden nearly doubled its number of deaths: from 401 (April 5) to 793 (April 9), a rise of 98%. Looking five days back for the Netherlands, the death toll rose from 1039 (March 31) to 1641 (April 4), a rise of 58% which makes a considerable difference.

Stockholm, the capital, is the epicenter of the outbreak in Sweden. That’s where social gathering is most intense (meetings, bars etc.). And it’s also the place with the most international contacts and where most people are moving and are having meetings.

Social distancing (or the lack of social distancing) is the key. Perhaps the prohibition of ‘social contacts’ like family visits, parties and contacts in restaurants have to be continued longer than an economic lockdown, given the damage of the last one for the economy.

In public transport good face masks should become obliged when many people again close together have to be transported to working places. Someone will have to produce them.

Data:
https://www.worldometers.info/coronavirus/country/sweden/
https://www.worldometers.info/coronavirus/country/netherlands/

kribaez
April 10, 2020 1:05 am

Lord Monckton,
I don’t doubt that the lockdowns are doing “something”, but the way you are examining the data will tell you nothing about quantification of that something. The technical term in engineering is “turd-polishing”.

In almost every country, with a few exceptions, the growth rates in reported cases are a strong function of testing capacity and testing policy. In the UK for example – the worst in Europe in terms of build of testing capacity, the daily additions of cases have been determined throughout almost entirely by testing capacity and not by any underlying growth in infections. Even in countries which have managed to develop a high testing capacity fairly rapidly, mixing high density urban population samples with samples from rural communities gives a completely misleading impression of the depth of infection, as does adding statistics from outbreak areas to areas which are still relatively untouched. The cases and the deaths reported as a percentage of the population of Bergamo province in northern Italy are an order of magnitude worse than national statistics for Italy. Even then, the epidemiology unit of the University of Milan recently reported estimated minimum number of infections in Italy of 5mm people (with upside estimate of 20mm people) when the reported confirmed tested case number was just over 100,000 !

In New York, from 4th March to 16th March, the test results were mainly at 100% positive (capacity limited). After that date, as test capacity was added, the test results dropped for one day to 9% positive and then climbed to between 40 and 50% positive over the last 10 days. Case numbers are still increasing on a daily basis, but a semilog plot of cases against time shows a continuous curve – no clear evidence of constant exponential growth anywhere. So tell me, how many people are infected today in New York? What would that number be without the lockdown? I really don’t know, but I am absolutely certain that it requires a detailed granular analysis to abstract anything remotely sensible from the data available. Your semilog analysis is just far too naive to inform decisions which will save or wreck many lives.

PaulH
Reply to  kribaez
April 10, 2020 8:41 am

I know it’s a subtle point, but these graphics are based on “reported cases” not actual cases. It seems to me (I could be wrong) that the reported number will never be “real-time” so might sudden bumps in the graph’s line be attributed to a bump in the number of paperwork reports? Just a thought.

richard
April 10, 2020 1:06 am

So the death rates are 133 ,000 for flu this year and 95,000 for Corona. I guess flu is at its most lethal in the countries experiencing winter.

The problem is cases being attributed to Corona when they died of something else- ”

“In a world first, the Swedish government has announced that it is going to officially distinguish between deaths „by“ and deaths „with“ the coronavirus, which should lead to a reduction in reported deaths. Meanwhile, for some reason, international pressure on Sweden to abandon its liberal strategy is steadily increasing.
The Hamburg health authority now has test-positive deaths examined by forensic medicine in order to count only „real“ corona deaths. As a result, the number of deaths has already been reduced by up to 50% compared to the official figures of the Robert Koch Institute”

JohnM
Reply to  richard
April 10, 2020 2:56 am

Given that THE virus kills nobody, it is the bodies over- reaction to it that does the deed, we can easily get the “deaths from SARS-CoV-2” down to zero in no time at all…

RockyRoad
April 10, 2020 1:08 am

Yes, Mann’s primary contribution to “climate science” is the Hokey Stick, which ironically destroys his reputation as a scientists and puts him in the deserving company of charlatans and shysters! Quackery has delivered its just rewards once again!

richard
April 10, 2020 1:13 am

Countries with no lock down, Sweden , South Korean and Japan saw no long term exponential growth.

Indeed Japan is sitting at 5,530 cases and 99 deaths ( that will change today) in one of the most densely packed countries in the world.

Petit_Barde
April 10, 2020 1:14 am

With respect to the lockdown :

– without lockdown, according to the data available for the countries which did not impose it, the epidemy is over in about a month,
– with lockdown, it takes at best some 4 to 5 weeks but those who imposed a lockdown will face soon or later a second wave.

With respect to the death ratio, most of the countries which imposed the lockdown are still facing the worst death toll. But the death toll vary a lot between countries which adopted the same strategies so the containment seems not to be significant with respect to observed death tolls.

The only actual difference is that those who imposed containment have destroyed their economy.

richard
Reply to  Petit_Barde
April 10, 2020 4:19 am

with lockdown we can expect another bought later in the year.

richard
April 10, 2020 1:15 am

“The two Stanford professors of medicine, Dr. Eran Bendavid and Dr. Jay Bhattacharya, explain in an article that the lethality of Covid19 is overestimated by several orders of magnitude and is probably even in Italy only at 0.01% to 0.06% and thus below that of influenza. The reason for this overestimation is the greatly underestimated number of people already infected (without symptoms). As an example, the fully tested Italian community of Vo is mentioned, which showed 50 to 75% symptom-free test-positive persons”

Reply to  richard
April 10, 2020 3:05 am

In Germany they used the region around Heinsberg as open living laboratory.
They found the death rate to be at 0.375%

kribaez
Reply to  Krishna Gans
April 10, 2020 5:43 am

Krishna,
Just for information, that is not a Case Fatality Rate (CFR). It is an estimate of the overall population mortality rate – 44 deaths out of a population of 12,000 people in a town which was hard hit by COVID-19.

Reply to  kribaez
April 10, 2020 7:08 am

And, at least, the studies there are seen as doubtful now.

Ron
Reply to  Krishna Gans
April 10, 2020 7:22 am

The antidbody test used in this study is most likely flawed (no neurtalization steps included) and detects also harmless cold corona viruses therefore leading to a way too low calculated lethality rate. Other critiques of the study point out that it doesn’t distinguish between people of one household or unrelated ones as well as it does not give any age distribution of the people tested (yet).

richard
April 10, 2020 1:18 am

and on and on it goes. It seems there are those trying to circle the wagons and prop up the myth that lock down was necessary.-

“Italy: The renowned Italian virologist Giulio Tarro argues that the mortality rate of Covid19 is below 1% even in Italy and is therefore comparable to influenza. The higher values only arise because no distinction is made between deaths with and by Covid19 and because the number of (symptom-free) infected persons is greatly underestimated”

mcswell
Reply to  richard
April 10, 2020 7:58 am

So why are the Italian hospitals overflowing, when they weren’t before? Are you saying there’s some other disease that’s suddenly broken out?

whiten
April 10, 2020 1:21 am

One of the meanings for “moron”:

A layman believing to be a spy and also acting upon that believe.
The (moronic) layman dilemma on “to be or not to be a spy”… (like James Bond)

Another one:

Shoot first and ask questions later, in the face of “first do not do harm”.

Another one:

Claiming and telling others that Socrates was a layman and a spy… or kinda of a James Bond like character.
Making Socrates look like a person who would have surrendered his life and his freedom to death…
or to whomever there in the prospect of death….. hilarious. (the very antithesis of Socrates)

Or another:

Free speech consist as a tool or a platform for validation of the ciceronian expression as truth.

and the list goes on and on.

Oh another one:

Believing and strongly advising and “teaching” that a layman approach to matters in consideration of science should be by the means of a political method.

And as always a moron will fail to understand the proposition of:
“free speech is a bitch” (one we cannot do without)

A question here:

“How should one be called or addressed when and where, one keeps feverishly playing and propagating the beauty of the cold war rules from the “bible” of cold war, in the case of a real unraveling happening
“hot” global war?!”

Could this act be considered as fair or just!

cheers

cheers

Alex
April 10, 2020 1:24 am

Thank you for the Fig. of Grinstead 2009. Never seen it before. Very illustrative!

Concerning the “exponential growth”. Actually, it is the logistic function
0.5*(1+tanh(T/rate)).
It is exponential at the very beginning only. Then it saturates.

This is the simplest model and the most reliable one.

BTW, the Germans are now claiming, the number of detected infections saturated not because of “lockdowns”, but because the testing capacity is reached.

suffolkboy
April 10, 2020 1:30 am

“For now, I shall point out that the pandemic will not have reached its peak until the daily compound confirmed-case growth rate becomes negative. At present, it remains strongly positive, though trending in the right direction.”

I respectfully disagree.

What does Farr’s Law[1] say about the matter?

I have been tracking (I know not why) figures from ArcCIS[2] since early March. (These, very conveniently, are presented as an Excel spreadsheet with daily new and cumulative cases and deaths, which I do not deal with here.) In particular I have been focussing on the cumulative figures rather than the “noisy” daily figures in order to comprehend what others are talking about. I was particularly interested in seeing how Farr’s Law worked in practice as an epidemic progressed. I dismiss as a side issue for the moment whether Farr’s bell-curve is a classical statistical exponential exp(-x²) or sech²(x) for the probability density function (PDF). Either way results, by integration (yielding erfc or tanh respectively), in a cumulative figure which is an S-shape, being asymptotic at both extremes and with a point of inflection in the middle, which I dub the “critical point”, and is the point at which the total number of cases is half the ultimate number . I chose the sech²(x) . I then focussed on trying to get the correct parameters (both the magnitude and timing of the peak of the curve) to fit Farr’s Law. As expected, I could not do this initially because the initial exponential rate of rise because obviously an exponential has no peak and had an alarming rate of doubling every 3.1 days. I awaited the point at which the actual data significantly deviated from a simple exponential. Until then one could not establish if this was going to be a high peak in the distant future or a low peak the following week. I was surprised at the remarkably good fit of the data to a smooth curve, and was delighted (and relieved) when, sure enough, the actual data began to drop below the exponential. By 1st April the “doubling period had grown to 5 days and by 8th April it was up to 10 days. This enabled me very tentatively to place the “critical point” at 5th April, which would enable a guess of the final number to be twice what it was on that date, giving a ball-park of 80,000 as the “ultimate” confirmed cases in the UK. I was greatly (and I hope not temporarily) delighted to conclude that we were already at, or even had just passed, the critical point

I seem to differ from from Christopher Monckton somewhat not in basic approach but whether we have reached “the peak”. There may be minor communication issues here: what does “the pandemic will not have reached its peak until the daily compound confirmed-case growth becomes negative” mean? I think he is referring to what I called the critical point: the point where the (smoothed) daily new case count starts going down, or, equivalently, where the (smoothed) cumulative total goes through a point of inflexion, or, again equivalently, when the second derivative of the cumulative total goes negative (“the curve bends down”). Either way, I think we in the UK have now reached peak daily new case, but he does not. However, I agree that the matters he raises about collecting statistics, different ways of counting and especially counting the number of recoveries are major issues.

Quite separately, I am not convinced that lockdown is a good idea or even that it had any significant effect on the present state of the epidemic, and that the cure is worse than the disorder, but that is for future discussion.

Finally the simple exponential model is amenable to simple interpretation. During the initial explosive exponential phase the total number of uninfected but susceptible hosts is relatively unchanged, but during the later stage (say, after half the possible number have been infected) the virus begins to run out of susceptible hosts. One does not know in advance what proportion of the total population is susceptible. Obviously, Neil Ferguson’s full-time study of this will have yielded a more sophisticated and, we hope, reliable model of how this pandemic will develop or decay, but we shall have wait until that model, code, data and test results are published before we can comment on it.

[1] William Farr: https://en.wikipedia.org/wiki/William_Farr (1840)
[2] Daily Confirmed Cases: https://www.arcgis.com/home/item.html?id=e5fd11150d274bebaaf8fe2a7a2bda11
(2020)

Reply to  suffolkboy
April 10, 2020 3:59 am

suffolkboy, thank you for your very apt and lucid comment. I too am trying make as much sense out of all this as I can. The way I thought of to test whether Farr’s Law (S shaped cumulative cases function, with symmetrical curves at the two ends) applies was to look at the countries which are nearest to over the epidemic.

South Korea seems to go for a while as if it is going to be symmetrical, but instead around March 10th settles into a fairly constant linear upward trend. Presumably this is due to increased roll-out of testing? Or could it be that the virus is expanding into parts of the country it hasn’t reached before?

The Faeroe Islands gives something very close to a Farr’s Law curve. It’s such a small population that the virus seems to have gone straight through them all before anybody could do anything. They have tested 11% of their population now, so their figures are going to be as good as anyone’s. Furthermore, they haven’t had a single death yet! Iceland is on a similar path (9.5% of the population tested, 6 deaths), but the straightening-out of the cumulative cases curve isn’t clear yet. Why the death toll in Iceland and the Faeroes is so low, in comparison to other small isolated places like San Marino and Andorra, which are among the very worst, is an interesting question.

Austria is showing a good attempt at a symmetrical curve, but if you look at the new daily cases it looks as if the right tail is going to be longer than the left. Maybe twice as long? But again, perhaps that’s due to expanded testing finding cases which wouldn’t have been found before.

What I have been trying to do is use an Excel spreadsheet to try to detect the peak in each country directly. What I do is average each day’s reading with the 3 days prior and the 3 days after. This seems to smooth the data (which seems in most countries to have a persistent “wobble” in the new case count, with a period of 5-6 days) quite well. Here is what I’ve found so far:

Spain – peaked on 29th March, now down to 75% of peak.
Italy – peaked on 23rd March, now 72% of peak.
Germany – peaked on 30th March, now 82% of peak.
Switzerland – peaked on 22nd March, now 67% of peak.
Austria – peaked on 25th March, now 40% of peak. They seem to be the country to follow.
Portugal – peaked on 31st March, now 88% of peak.
Norway – peaked on 26th March, now 56% of peak. Second best after the Austrians.

Belgium and the Netherlands are currently wobbling around what seems likely to be their peak. The UK, Sweden, Ireland and Denmark are still trending upwards, but increasingly slowly. France, I haven’t even looked at, because all their data prior to 3rd April is in essence rubbish.

As to whether it is the lockdowns that are having an effect, or the virus starting to peter out naturally (which would require an earlier entry of the virus to each country, and a much higher proportion of unreported asymptomatic and mild cases, than we’re being led to expect), I’m firmly in the agnostic camp at the moment. Evidence for the lockdowns doing it is that the time lapse from lockdown to peak seems to be varying between about 6 and 15 days. But this could simply be a result of each government deciding to impose a lockdown at much the same point in the epidemic. Hopefully, Sweden will give us some conclusive data one way or another.

On the other hand, there’s evidence from the geographical distribution of cases in the Netherlands for a much higher level of immunity in the general population than many think. Most of the “hot spots” there are in rural areas, many of them way out in the south-east of the country. The densely populated Randstad is little affected. In particular, Amsterdam and Rotterdam are showing lower cases per population even than some of the more suburban areas around them. That will need some explaining.

suffolkboy
Reply to  Neil Lock
April 10, 2020 6:45 am

Thank you for the quick response. Those are fascinating comparisons between different countries and “rurality”. What struck me was the similarity (rather than the exceptions) between the time of the “peak” between different countries.

You also mentioned asymmetry, which the Gompertz function allows for (giving three parameters) whereas the sigmoid functions give only two. I didn’t think I had the time or maths skills to work out how to fit Gompertz functions to raw so I stuck with a Farr-like symmetrical simpler case. I may have to revisit that, because if the numbers fit better to a Gompertz function the resulting asymmetry may yield quite different results for time of peak and value of peak. This will take some time.

I am agnostic about lockdown. I can see the logic (and political motivation) of delaying the peak and broadening the width in order to buy time and to avoid swamping resources. At the same time, the level of mortality is so low and the doubling time so short that it is beginning to appear that the expense of the lockdown vastly outweighs the benefit, and that the whole thing is “just another flu epidemic”.
Finally, I am optimistic about the speed of response in modern times. IMHO the perceived lack of a contingency “store” of ventilators, kit, medication and suchlike was less relevant to dealing with the problem. Instead we had modern ability to switch manufacturing and distribution to where it is needed so quickly that mattered, together with the organisational ability to construct field hospitals (royally opened!) in such a short space of time. Perhaps if the “second wave” comes in the autumn we shall be prepared. In the meantime we have significant economic bomb damage in need of repair.

nobodysknowledge
April 10, 2020 1:38 am

I wonder if there is a great underreporting of deaths from corona. Many news headlines point to this. There should be some checks against the death statistics to see how the difference between 2020 and earlier years comes out. In UK the death rate follows the common trend to March 20th, then the trends differ. Deaths of the yearly flu go down on this time of the year. Ant this decrease should be stronger with the measures that are taken this year. Statistics end up with 1000 more deaths than usual after one week, March 27th. The trend goes in the opposite direction, upwards.
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending27march2020#deaths-registered-by-week

Phil
April 10, 2020 1:44 am

There is no need to use nuclear bomb when a good howitzer will do.

ren
Reply to  Phil
April 10, 2020 2:18 am

During the first 5 days, the SARS-Cov-2 virus occupies your lungs without causing symptoms. How many people can you get infected for 5 days?

Joey
Reply to  ren
April 10, 2020 8:46 am

The real infection rate is MUCH higher than the current stats indicate….which means the death rate is much lower.

ren
April 10, 2020 1:59 am
Leif R
April 10, 2020 2:02 am

Lockdown or not is not really what drives economic fallout.

To turn the corner, the infection rate has to come down below 1.

What we try to do is to apply the pareto principle to achieve that:
-have 80% of people apply practices that prevent 80% of the contagion paths
– this basically means to convince 80% of people to maintain at least 2 meter separation from others

As for lockdown or not, that simply boils down to cultural and/or judicial traditions as to achieving the above.

The basic economic impact comes from the separation goal, not from which means is being used for achieving it.

Environment Skeptic
April 10, 2020 2:14 am

https://www.youtube.com/watch?v=XgXWqFUs8c4
“COVID-19: WHO Benefits? And Epidemiology Lesson”

Oldseadog
April 10, 2020 2:22 am

Regarding lockdowns, 15 years ago I would have agreed with Willis and just let the thing work its own way out. Now, though, I am 80, have high blood pressure which is controlled by medication with a side effect of making me susceptible to pulmonary infections, and one of my kidneys doesn’t work very well. Life is good, the grandchildren are growing and I have just bought a nearly new set of racing sails. So now i have to agree with Lord Monckton and also try to stay out of the way of the virus.

In “The fear in their eyes” by Dean Koontz, published in 1981, it says that there will appear in 2020 a virus called Wuhan 400 which will die out quite quickly and then reappear in 2030.
Make of that what you will.

icisil
Reply to  Oldseadog
April 10, 2020 4:22 am

So you’re quite fine with policy that harms everyone to possibly preserve your privileged life for a few more years? mkay…

Oldseadog
Reply to  icisil
April 10, 2020 7:52 am

Make of it what you like. Dunno about the privileged bit, though, I worked bloody hard for 39 years in uniform for what i now have.

John Endicott
Reply to  Oldseadog
April 10, 2020 8:10 am

Yes and no, Oldseadog.
The 1989 edition of Dean Koontz’s “The fear in their eyes” does have a fictional virus called Wuhan 400 from a Chinese bioweapons lab (in the 1981 edition, it’s from a Russian Lab and has a different name) but it’s symptoms and behavior (incubation time is measured in hours and is 100% fatal) do not match those of the real life Wuhan virus (incubation time is measured in days, and is only 1% to 2% fatal). However, the 2020 appearance, disappearance, reappearance in 2030 is not from Dean’s book. That comes from another book, psychic Sylvia Browne’s “End of Days”.

Oldseadog
Reply to  John Endicott
April 10, 2020 12:02 pm

I stand corrected, thanks. My information was from an apparently unreliable sourcs. Otherwise known as chronometric disfunction, or old age.

richard
April 10, 2020 2:34 am

not sure what it normally is but flights seem fairly busy in the US-

https://www.flightradar24.com/28.65,-77.3/6

JoeShaw
Reply to  richard
April 10, 2020 9:15 am

This is largely an artifact of fairly bizarre policy decision that 1) require airlines to maintain their pre-COVID flight schedules in exchange for bailout cash, and 2) require airlines to maintain gate usage metrics to avoid losing gate access in the future. Many if not most of these flights are well under capacity.

Andy
April 10, 2020 2:35 am

Lord Monckton,

Two days ago, you wrote about Boris Johnson, “on current data, he is more likely to die than not.”

You wrote that, presumably with good knowledge of whatever ‘current data’ regarding COVID-19, but with little or no data regarding Mr. Johnson himself or his health condition at the time. Surely a prerequisite. You, also, as far as I can tell, lack the medical training to make such a prognosis.

On that basis, why should I take the time to read anything you write now or in the future?

This question is asked in good faith, since I have, heretofore, been an admirer of your published work on climate issues.

Monckton of Brenchley
Reply to  Andy
April 10, 2020 3:35 am

Andy may like to read my previous head posting, which provided the data from the British intensive-care outcomes survey demonstrating that among closed intensive-care cases half had recovered and half had died. At the time when I wrote, it was known that the Prime Minister had been transferred to intensive care, but no information was available on whether he required ventilation. At the time of writing, then, the article was correct, based on the latest clinical data and on the information then available about the Prime Minister. However, the article was not posted on the day it was written and submitted (I have no control over the publication date). By the time it was posted, it had become known that the Prime Minister had not required ventilation. Now he is on the mend, thank Heavens, and that fact is recorded in the opening paragraph of today’s posting.

richard
Reply to  Monckton of Brenchley
April 10, 2020 4:23 am

1. How old were the cases?

2. How many illnesses did they already have?

3. Did they they die of something else though they had corona?

you are missing out a lot of info.

Paramenter
Reply to  Monckton of Brenchley
April 10, 2020 4:36 am

At the time when I wrote, it was known that the Prime Minister had been transferred to intensive care, but no information was available on whether he required ventilation.

As far as I remember there was immediate information that PM in conscious, not on the mechanical ventilator but ‘only’ on oxygen supply and there is no sign of pneumonia. In any case great news that he’s recovering!

I reckon one of the reasons ‘activists’ argue so ferociously is they realize ‘lockdowns’ to be effective in longer run will have to stay not one, two or three weeks but much longer, possibly months. Alternatively, lockdowns may need to be re-imposed on frequent basis, depends how disease re-occurs. So sooner or later – when gloomy economic reality bites harder – we will have to face the question how we want to live with this virus and not ruin whole countries. What if whole countries go bust and will fall under Chinese domination? I’ve heard that Italian economy will shrink by 15% in one go. So yes, save lives as economy may recover but dead ones not – until the resurrection. Still in the longer go we must have sensible exit strategies, otherwise indeed ‘cure will be worse that disease’.

Rob
Reply to  Monckton of Brenchley
April 10, 2020 11:26 am

What was his treatment, President Trump called him I believe.

ren
April 10, 2020 2:42 am

This is not to say Germany has defeated COVID-19.

Its coronavirus death rate of 1.9%, based on data collated by Reuters, is the lowest among the countries most affected and compares with 12.6% in Italy. But experts say more deaths in Germany are inevitable.

“The death rate will rise,” said Lothar Wieler, president of Germany’s Robert Koch Institute for infectious diseases.

The difference between Germany and Italy is partly statistical: Germany’s rate seems so much lower because it has tested widely. Germany has carried out more than 1.3 million tests, according to the Robert Koch Institute. It is now carrying out up to 500,000 tests a week, Drosten said. Italy has conducted more than 807,000 tests since Feb. 21, according to its Civil Protection Agency. With a few local exceptions, Italy only tests people taken to hospital with clear and severe symptoms.
https://www.reuters.com/article/us-health-coronavirus-germany-defences-i/pass-the-salt-the-minute-details-that-helped-germany-build-virus-defenses-idUSKCN21R1DB

richard
Reply to  ren
April 10, 2020 6:45 am

great- so they didn’t want a complete lock down-

“At the end of last week, the Prime Minister was beginning to wonder if the country was taking his advice too much to heart. He asked us to stay at home – and we have. At each daily press conference, medical and scientific advisers talk about the plunge in use of transport and how well rules are being observed. What they don’t say is that this was not quite in their original plan. Government modellers didn’t expect such obedience: the expected workers to carry on and at least a million pupils to be left in school by parents”

Steven Mosher
April 10, 2020 2:51 am

“In tomorrow’s daily update, I shall describe some further methods of intelligence analysis that would assist governments in deciding when and how and to what extent to bring lockdowns to an end.”

MoB.

I have been watching Korea closely (HK as well and China as I will have to return some day soon)

Korean cases have been roughly Linear. 100 cases a day, (now 50) for weeks on end.
the economy has slowed but not come to a halt.

Looked at as a process the following seems true.

1. the absolute number of cases does not matter that much as long as the health care system
can handle the load. That LOAD figure must be calculated accurately. then a safety margin
must be allowed for. Same as designing a plane. you dont design mission critical stuff
without a safety margin.

2. The cases should not overload the capacity to test and track. It is the Korean testing and tracking
that KEEPS THE GROWTH LINEAR.

3. The tracking resolution ( % of cases that can be traced to an index patient) has to be high. 80+ %

So in terms of the constraints the growth in cases over the age of 50 must be kept below the carrying
capacity of the health system. Those cases should have a separate metric

In terms of testing capacity your case growth in ALL cases must be kept below your testing capacity
In Korea for every person testing positive there are 50 people trace to test negative. You can’t
just test people with symptoms. If jane tests positive you have to test her friends, family co workers
You want to do aggressive overtesting such that your observed attack rate <5%. And if possible
test contacts etc for antibodies as well. If you can only test 1000 a day, then you cant let case
growth exceed 20 cases per day.

Epidemiolgical Resolution: 80% of cases in SK are resolved to a source. This can also be aided by
sequencing all new cases, and tracking mutations. The virus has a molecular clock. Such that
if jane tests positive you can (should be able to) identify any untraced prior infections.

so in terms of keeping the infections to linear growth at worst, you need to look at different variables
and control the process with key metrics; case growth in vulnerable classes; carrying capacity of
the local health system; trace success; novel mutation detection

Gwan
Reply to  Steven Mosher
April 10, 2020 3:56 am

I don”t agree with much that Steven Mosher writes but the New Zealand lockdown is working and as Mosh states , tracking and testing all friends ,families,and co workers of all index patients is the best policy.
New Zealand are testing and tracing and now have around 12 clusters of 10 or more people in the same location or they have been traced back to a function where they contacted the virus.
Around 1200 have tested positive, 300 recovered ,12 in hospital ,4 in intensive care and 2 deaths both elderly with underlying heath problems .
Only essential services are allowed to be undertaken during this lockdown .
Farming ,fruit and vegetable growing are still working and exports are still flowing to our ports.
Our log trade to China and Korea took a hit when the virus first appeared in China and then started moving again but has been stopped as it is not considered an essential industry .
Our tourism and restaurant sector is completely shut down and our tourism operators are in dire straits
The dilemma the government has is when do they lift the lockdown ,to soon and another wave gets away and spreads or if they hold the lockdown in place to long ,immense financial harm will result as already the costs are adding up to more than our Dairy exports $8 billion and our tourism sector earns close to that and they will be a long time getting back to that figure .
Graham

PJF
Reply to  Gwan
April 10, 2020 7:27 am

COVID-19 isn’t going away. New Zealand is essentially uninfected and has no immunity. Winter approaches. What could go wrong?

Gwan
Reply to  PJF
April 10, 2020 2:14 pm

Reply to PJF fly by comment .
Our borders are closed except for returning Kiwis and all have to self isolate for 14 days .
Tracking and testing is proceeding and nearly all cases can be traced back to functions or visitors from cruise ships .
All people over 65 are encouraged to get their flue vaccine and it is free for over 65′ s .
Our long summer continues into April and I am sure that sun exposure has many health benefits despite risk of skin cancer.
All gathering of any groups are discouraged and that includes kids kicking a ball around in the park .
New case numbers are dropping each day and all contacts of positive cases are tested .
Yes some more cases will appear but New Zealand is winning the fight against the virus.
No one is allowed to travel around the country and this Easter the police are turning people back to their homes when trying to travel to the beaches .
As I wrote in the post above our tourism sector will be decimated and will take a long time to recover as our borders are CLOSED.
Graham

JimW
April 10, 2020 2:58 am

The German comprehensive tests and results from their ‘Wuhan’ on the borders of the Netherlands show very conclusively that the death rate is 0.37% and infection is about 15% of the population.
For some reason that is nothing whatsoever to do with ‘health’ but more to do with instilling fear into populations, the normal route for dealing with a respiratory virus was ignored. That is to quickly build up herd immunity over a four week period and let it run its course and be absorbed into the family of similar viruses that humans live with and tolerate through the ages. Of course attention should be given to protect the most vulnerable whilst this happens.
The longer a lockdown lasts the worse this will get, the more deaths will happen.
Its almost as if it was planned that a vaccine and all the attendant ‘controls’ would replace natural immunity. As usual it pays to follow the money.

meiggs
Reply to  JimW
April 10, 2020 4:52 am

Where does the money path lead?

Ron
Reply to  meiggs
April 10, 2020 6:52 am

For the money path of the study…

To Armin Laschet, prime minister of the German federal state of North Rhine Westfalia and a strong advocate of a no-lockdown policy.

Death to total cases ratio of both Germany and South Korea are around 2%. Could be a coincidence and Germans around Gangelt are just more resilient than all other people in the world…

Jeffrey Larson
Reply to  meiggs
April 10, 2020 7:20 am

Bill Gates

Rob
Reply to  meiggs
April 10, 2020 11:30 am

meiggs April 10, 2020 at 4:52 am

Quote Where does the money path lead? Quote.

Not to Hydroxychloroquine that`s for sure.

richardw
April 10, 2020 2:59 am

Thank you again for your analysis, Lord Monckton.

I feel you present rather too binary a picture of the difference between the ‘activists’ and the ‘passivists.’ The choice is not between full lockdown and doing very little. As others have commented, a real and far less damaging alternative is to lift the lockdown but focus restrictions and protection on the vulnerable, with the main universal requirement being the wearing of facemasks in public places to limit the transmission of the virus by infected individuals.

Also, the primary purpose of the lockdown is to protect healthcare capacity from being overwhelmed. There is much disagreement and misinformation around about the actual load on hospitals with plenty of contradictory anecdotal accounts about both empty hospitals and overwhelmed facilities. I speak to healthcare professionals who have been saying for a couple of weeks that they are expecting the surge ‘next week.’ It’s alway ‘next week.’ I hope I’m not being overly cynical.

Unfortunately, political reputations have now become intimately entwined with the progression of the pandemic, which means that information gathering and publication may be subject to a strict political agenda. I suspect we will never know the true state of affairs.

The really massive risk is to the economy – not some abstract financial superstructure, but the survival of people’s jobs and livelihoods in the private enterprise sector. There is a massive ignorance amongst many, especially those in the public sector and with independent means, of the importance of the private sector as a source of prosperity, as well as the only external source of funding for tax revenues. If the private sector fails massively, the state will be forced to step in to control and distribute incomes and the dream of Extinction Rebellion will be realised – a society in which we can only do what we are told, rather than a free enterprise society in which we can do anything unless it is expressly forbidden. I hope I’m wrong but there is a concerted attempt by XR, supported by many in the public sector, for a departure from free enterprise in favour of state control. State control always starts optimistically but ends badly as we saw in the 20th century.

Steven Mosher
April 10, 2020 3:05 am

For people who want to question doomsday projections by the CDC and WHO
I recommend this essay

NOTE this essay was written prior to the current epidemic

https://inference-review.com/article/an-outbreak-of-epidemiological-hysteria

Steven Mosher
April 10, 2020 3:15 am

More ammunition for the “passivists”

by fumento

For folks who want relatively good arguments, I would look at what he says.

Please note, he doesn’t resort to crazy claims about the disease to make his claims.
I dont agree with everything he says, but he at least avoids crazy stupid arguments.

A good debate focuses on the best arguments of both sides

https://www.theamericanconservative.com/articles/sweden-scandinavia-michael-fumento-coronavirus/

he’s wrong here, the USA is not following the china model.
https://www.theobjectivestandard.com/2020/04/statist-responses-to-covid-19-an-interview-with-michael-fumento/

he’s wrong here, Korea did not follow Farrs law.
https://www.realclearmarkets.com/articles/2020/04/01/coronavirus_death_predictions_bring_new_meaning_to_hysteria_487977.html

Dan Hughes
April 10, 2020 3:29 am

Typo:
“How, then, should be apply the Spy’s Dilemma …”

Dodgy Geezer
April 10, 2020 3:45 am

I have a small separate dichotomy I would like to resolve.

I have been watching the Total Mortality figures, on the grounds that these will show me reality. They will be delayed, of course, but it is hard to misdiagnose death. This approach will leave me unable to contribute to any predictive conversation, but ought to give me an accurate view of what is actually happening.

European Mortality Rates come out on a Thursday, for the preceding week. Up to last week there was no major increase anywhere except in Italy and Spain. This week the UKs PHE issued their figures showing a definite uptick in deaths in England, though no change in N Ireland, Wales or Scotland. This increase in England was similar to the short peak we had in late 2019, and far below the flu deaths experienced over the preceding few years.

Later in the day the EuroMoMo stats, which are the collected European data for the same period, came out. These paint an odd picture.The points to note with these were:

1 – across Europe we are now seeing peaks corresponding to a bad flu year
2 – these peaks seem to come from just a few countries. Most are unaffected.
3 – of the 24 countries/areas tracked, 17 show no increased deaths
4 – of the 7 countries showing increases, Belgium, France and Switzerland show peaks equivalent to a flu year. The Netherlands shows a peak similar to a bad flu year.
5 – the increased mortality data seems to be mainly driven by Spain, Italy and England – these show peaks well in excess of a flu year.

We have heard about the problems in Italy and Spain, But in England we have the local authority reporting a small increase in deaths – well below a normal flu epidemic – while the European monitor, working off the same data, indicates that England is suffering the largest death rate in recent years by a huge margin.

What is going on? I note that the EuroMoMo data contains caveats that the data is estimated using algorithms and care should be taken in interpretation, but the discrepancy between national reporting and Euro-wide data is very large. Perhaps I am wrong, and death can indeed be misdiagnosed?

kribaez
Reply to  Dodgy Geezer
April 10, 2020 5:56 am

You get my literary gold star award for your last sentence. Pure Mark Twain. Thanks.

Sjoerd
Reply to  Dodgy Geezer
April 10, 2020 6:17 am

The Dutch peak rate has surpassed the worst flu year (2018) already. And the graph below is not showing last week yet, which was even worse.

https://www.rivm.nl/monitoring-sterftecijfers-nederland

JEHILL
Reply to  Dodgy Geezer
April 10, 2020 6:25 am

cause of death can and is, as matter a political policy, being misdiagnosed.

Scissor
Reply to  Dodgy Geezer
April 10, 2020 7:01 am

Rarely, but sometimes death can be misdiagnosed. In China, they regularly harvest live organs from “dead” prisoners for example.

However, cause of death can be misallocated.

Steven Mosher
April 10, 2020 4:05 am
Steven Mosher
April 10, 2020 4:06 am

“By mid-September, the Spanish flu was spreading like wildfire through army and naval installations in Philadelphia, but Wilmer Krusen, Philadelphia’s public health director, assured the public that the stricken soldiers were only suffering from the old-fashioned seasonal flu and it would be contained before infecting the civilian population.”

As civilian infection rates climbed day by day, Krusen refused to cancel the upcoming Liberty Loan parade scheduled for September 28. Barry writes that infectious disease experts warned Krusen that the parade, which was expected to attract several hundred thousand Philadelphians, would be “a ready-made inflammable mass for a conflagration.”

Krusen insisted that the parade must go on, since it would raise millions of dollars in war bonds, and he played down the danger of spreading the disease. On September 28, a patriotic procession of soldiers, Boy Scouts, marching bands and local dignitaries stretched two miles through downtown Philadelphia with sidewalks packed with spectators.

Just 72 hours after the parade, all 31 of Philadelphia’s hospitals were full and 2,600 people were dead by the end of the week.

PJF
Reply to  Steven Mosher
April 10, 2020 7:19 am

Other anecdotes from that pandemic show alternative outcomes. From the wiki page:

The fact that most of those who recovered from first-wave infections had become immune showed that it must have been the same strain of flu. This was most dramatically illustrated in Copenhagen, which escaped with a combined mortality rate of just 0.29% (0.02% in the first wave and 0.27% in the second wave) because of exposure to the less-lethal first wave. For the rest of the population, the second wave was far more deadly; the most vulnerable people were [. . .] adults who were young and fit.

We can be pretty certain COVID-19 will return, and the lockdowns will have ensured a large population of uninfected (by this only selectively dangerous strain) remains. Let’s hope the returning virus isn’t more generally dangerous, especially as we’ll have a lot less money for health care now that we’ve trashed our economies.

Steven Mosher
April 10, 2020 4:08 am
Steven Mosher
April 10, 2020 4:16 am

MoB

required reading

R Hatchett et al. Public health interventions and epidemic intensity during the 1918 influenza pandemic. PNAS DOI: 10.1073/pnas.0610941104 (2007)

M Bootsma and N Ferguson. The effect of public health measures on the 1918 influenza pandemic in US cities. PNAS DOI: 10.1073/pnas.0611071104 (2007)

richard
April 10, 2020 4:17 am

Will she reply-

Open Letter
Dear Chancellor,

As Emeritus of the Johannes-Gutenberg-University in Mainz and longtime director of the Institute for Medical Microbiology, I feel obliged to critically question the far-reaching restrictions on public life that we are currently taking on ourselves in order to reduce the spread of the COVID-19 virus.

It is expressly not my intention to play down the dangers of the virus or to spread a political message. However, I feel it is my duty to make a scientific contribution to putting the current data and facts into perspective – and, in addition, to ask questions that are in danger of being lost in the heated debate.

The reason for my concern lies above all in the truly unforeseeable socio-economic consequences of the drastic containment measures which are currently being applied in large parts of Europe and which are also already being practiced on a large scale in Germany.

My wish is to discuss critically – and with the necessary foresight – the advantages and disadvantages of restricting public life and the resulting long-term effects.

To this end, I am confronted with five questions which have not been answered sufficiently so far, but which are indispensable for a balanced analysis.

I would like to ask you to comment quickly and, at the same time, appeal to the Federal Government to develop strategies that effectively protect risk groups without restricting public life across the board and sow the seeds for an even more intensive polarization of society than is already taking place.

With the utmost respect,

Prof. em. Dr. med. Sucharit Bhakdi

1. Statistics
In infectiology – founded by Robert Koch himself – a traditional distinction is made between infection and disease. An illness requires a clinical manifestation. [1] Therefore, only patients with symptoms such as fever or cough should be included in the statistics as new cases.

In other words, a new infection – as measured by the COVID-19 test – does not necessarily mean that we are dealing with a newly ill patient who needs a hospital bed. However, it is currently assumed that five percent of all infected people become seriously ill and require ventilation. Projections based on this estimate suggest that the healthcare system could be overburdened.

My question: Did the projections make a distinction between symptom-free infected people and actual, sick patients – i.e. people who develop symptoms?

2. Dangerousness
A number of coronaviruses have been circulating for a long time – largely unnoticed by the media. [2] If it should turn out that the COVID-19 virus should not be ascribed a significantly higher risk potential than the already circulating corona viruses, all countermeasures would obviously become unnecessary.

The internationally recognized International Journal of Antimicrobial Agents will soon publish a paper that addresses exactly this question. Preliminary results of the study can already be seen today and lead to the conclusion that the new virus is NOT different from traditional corona viruses in terms of dangerousness. The authors express this in the title of their paper „SARS-CoV-2: Fear versus Data“. [3]

My question: How does the current workload of intensive care units with patients with diagnosed COVID-19 compare to other coronavirus infections, and to what extent will this data be taken into account in further decision-making by the federal government? In addition: Has the above study been taken into account in the planning so far? Here too, of course, „diagnosed“ means that the virus plays a decisive role in the patient’s state of illness, and not that previous illnesses play a greater role.

3. Dissemination
According to a report in the Süddeutsche Zeitung, not even the much-cited Robert Koch Institute knows exactly how much is tested for COVID-19. It is a fact, however, that a rapid increase in the number of cases has recently been observed in Germany as the volume of tests increases. [4]

It is therefore reasonable to suspect that the virus has already spread unnoticed in the healthy population. This would have two consequences: firstly, it would mean that the official death rate – on 26 March 2020, for example, there were 206 deaths from around 37,300 infections, or 0.55 percent [5] – is too high; and secondly, it would mean that it would hardly be possible to prevent the virus from spreading in the healthy population.

My question: Has there already been a random sample of the healthy general population to validate the real spread of the virus, or is this planned in the near future?

4. Mortality
The fear of a rise in the death rate in Germany (currently 0.55 percent) is currently the subject of particularly intense media attention. Many people are worried that it could shoot up like in Italy (10 percent) and Spain (7 percent) if action is not taken in time.

At the same time, the mistake is being made worldwide to report virus-related deaths as soon as it is established that the virus was present at the time of death – regardless of other factors. This violates a basic principle of infectiology: only when it is certain that an agent has played a significant role in the disease or death may a diagnosis be made. The Association of the Scientific Medical Societies of Germany expressly writes in its guidelines: „In addition to the cause of death, a causal chain must be stated, with the corresponding underlying disease in third place on the death certificate. Occasionally, four-linked causal chains must also be stated.“ [6]

At present there is no official information on whether, at least in retrospect, more critical analyses of medical records have been undertaken to determine how many deaths were actually caused by the virus.

My question: Has Germany simply followed this trend of a COVID-19 general suspicion? And: is it intended to continue this categorisation uncritically as in other countries? How, then, is a distinction to be made between genuine corona-related deaths and accidental virus presence at the time of death?

5. Comparability
The appalling situation in Italy is repeatedly used as a reference scenario. However, the true role of the virus in that country is completely unclear for many reasons – not only because points 3 and 4 above also apply here, but also because exceptional external factors exist which make these regions particularly vulnerable.

One of these factors is the increased air pollution in the north of Italy. According to WHO estimates, this situation, even without the virus, led to over 8,000 additional deaths per year in 2006 in the 13 largest cities in Italy alone. [7] The situation has not changed significantly since then. [8] Finally, it has also been shown that air pollution greatly increases the risk of viral lung diseases in very young and elderly people. [9]

Moreover, 27.4 percent of the particularly vulnerable population in this country live with young people, and in Spain as many as 33.5 percent. In Germany, the figure is only seven percent [10]. In addition, according to Prof. Dr. Reinhard Busse, head of the Department of Management in Health Care at the TU Berlin, Germany is significantly better equipped than Italy in terms of intensive care units – by a factor of about 2.5 [11].

My question: What efforts are being made to make the population aware of these elementary differences and to make people understand that scenarios like those in Italy or Spain are not realistic here?

References:
[1] Fachwörterbuch Infektionsschutz und Infektionsepidemiologie. Fachwörter – Definitionen – Interpretationen. Robert Koch-Institut, Berlin 2015. (abgerufen am 26.3.2020)

[2] Killerby et al., Human Coronavirus Circulation in the United States 2014–2017. J Clin Virol. 2018, 101, 52-56

[3] Roussel et al. SARS-CoV-2: Fear Versus Data. Int. J. Antimicrob. Agents 2020, 105947

[4] Charisius, H. Covid-19: Wie gut testet Deutschland? Süddeutsche Zeitung. (abgerufen am 27.3.2020)

[5] Johns Hopkins University, Coronavirus Resource Center. 2020. (abgerufen am 26.3.2020)

[6] S1-Leitlinie 054-001, Regeln zur Durchführung der ärztlichen Leichenschau. AWMF Online (abgerufen am 26.3.2020)

[7] Martuzzi et al. Health Impact of PM10 and Ozone in 13 Italian Cities. World Health Organization Regional Office for Europe. WHOLIS number E88700 2006

[8] European Environment Agency, Air Pollution Country Fact Sheets 2019, (abgerufen am 26.3.2020)

[9] Croft et al. The Association between Respiratory Infection and Air Pollution in the Setting of Air Quality Policy and Economic Change. Ann. Am. Thorac. Soc. 2019, 16, 321–330.

[10] United Nations, Department of Economic and Social Affairs, Population Division. Living Arrange­ments of Older Persons: A Report on an Expanded International Dataset (ST/ESA/SER.A/407). 2017

[11] Deutsches Ärzteblatt, Überlastung deutscher Krankenhäuser durch COVID-19 laut Experten unwahrscheinlich, (abgerufen am 26.3.2020)

PJF
April 10, 2020 4:28 am

In tomorrow’s daily update, I shall describe some further methods of intelligence analysis that would assist governments in deciding when and how and to what extent to bring lockdowns to an end.

I hope you include the basic one of comparing predictions with outcomes.

For example, you predicted that USS Comfort, the hospital ship sent by President Trump to NYC, would be filled to capacity (1000 beds) within days. Six days on from your prediction the ship has 53 patients on board.

The end of lockdowns is no longer a matter of medical science. It will be a political face-saving process by which governments attempt to extricate themselves from their unnecessary, economically disastrous policies without giving the game away to their abused populations. The proper end time is now, but we shall have to suffer weeks more as the justification pretence is invented. They need to flatten the enragement curve.

JEHILL
April 10, 2020 4:52 am

“Because lockdowns work, some of that decline is attributable to them.”

Are we sure about that?

We have only sequestered the high risk population? –> still alive and no immunity.

These lockdowns have neither the benefit of producing immunity at scale nor of culling the high risk populations worldwide. The Population of people still at the high risk are still alive and are static number that the virus needs worked through; virus needs work through the entire human population.

I suppose it could be argued that lockdowns drops the biological burden of viral concentration of the air you breath, but does that lower limit of viral air concentration trigger an immune response within a human body for it to begin the process of anti-body creation.

*************

And Dr. Fauci is NOT excellent – he is in fact a moron in many respects and cost people their lives:(frankly I stopped reading the article at this point as has no more credibility due to this statement).

His whole idea, “we should not be shaking hands anymore”, is an oxymoronic statement and completely anti-scientific and more of a phobia. To procreate we need to do more then shake hands. The first step in producing those types intimate bonds whether they be platonic or romantic is a shake hands. We are social creatures; we need to develop social bonds; the very existence of humanity depends upon us transmitting germs — especially new pathogens. Furthermore by his logical — no hugging; no kissing; no intercourse or sex of any kind; no sleeping in the bed also has to follow as the surface area contact only goes up from hand shaking. The lowest concentration of germs transmitted is with hand shaking; thinking of a surface area to surface area contact phenomenon.

per Dr. Fauci, “We do not have clinical studies of HCQ” — a) that is flat wrong; b) we do have both case study reviews and 65 since the drug was approved and nearly 85 years of history; c) we know of it anti-viral properties. d) most doctors in the trenches are taking prophylactically (this is under-reported).

Dr. Fauci — is a creature of the swamp and largeness of the pharmaceutical industry. His ONLY interest is in creating a drug that is profitable. He has no interest in saving lives NOW as indicated by his continual refusal of even acknowledging the case studies being conduct the world over of HCQ-zpak-zinc. He is causing harm.

john
April 10, 2020 4:56 am

Of course like AGW, the virus is now a scam money generator. Next up on the death certificates…Globull warming did it.

Minnesota Doctor Blasts ‘Ridiculous’ CDC Coronavirus Death Count Guidelines

April 9th, 2020

https://www.cryptogon.com/?p=57983

Pay VERY close attention from 3:02:
“Right now Medicare has determined that if you have a COVID-19 admission to the hospital you’ll get paid $13,000. If that COVID-19 patient goes on a ventilator, you get $39,000; three times as much. Nobody can tell me, after 35 years in the world of medicine, that sometimes those kinds of things impact on what we do.”

john
Reply to  john
April 10, 2020 5:39 am

Al Gore’s latest investments:

GuruFocus.com
February 17, 2020, 5:44 pm
Generation Investment Management, the firm founded by David Blood and former U.S. Vice President Al Gore (Trades, Portfolio), disclosed last week that its four new holdings for the fourth quarter of 2019 were Baxter International Inc. (NYSE:BAX), Illumina Inc. (NASDAQ:ILMN), Penumbra Inc. (NYSE:PEN) and CBRE Group Inc. (NYSE:CBRE).

icisil
Reply to  john
April 10, 2020 6:43 am

That’s very scary.

Old.George
April 10, 2020 4:59 am

Sweden did “lockdown.” But did so in advisory fashion. Very Libertarian: Let each individual isolate or not given the data.
I, being 76 and wanting to be 77, would have self-isolated even without the government having told me to do so.
My daughters, being 43 and 56 (both in medically-oriented professions), have not, having evaluated their risk.

Mark BLR
April 10, 2020 5:01 am

For instance, the British government, comprising an unduly high fraction of innumerates …

[ ENTER “Rendered even more jaded and cynical by the local lockdown (/ confinement)” mode … ]

My figures say that around the world 97% of “innumerate politicians” should be considered as the “standard / default / consensus” value, not as “unduly high”.

Tim Bidie
April 10, 2020 5:17 am

Rhinoviruses/coronaviruses, responsible for the common cold, have worse effects on the elderly and medically vulnerable than influenza.

That is well documented, and that is what is happening right now, aided and abetted by panic, in part induced by a surfeit of hysterical news coverage and by the lockdown removing significant percentages of key staff with childcare duties.

There are 160 rhinoviruses which infect humans which is why the common cold currently has no cure. So, unless the situation is correctly explained to the general public by responsible experts with no political or any other side, this panic is now likely probably every winter and certainly every other winter.

Time for contingency plans to be properly funded and for governments to show some leadership, get a grip, as, for example, in Sweden.

Healthcare has to be paid for and it cannot be paid for if the workforce is locked down for reasons that look increasingly illogical and ill thought through.

Robert of Ottawa
April 10, 2020 5:25 am

Well, my lord, I beg to differ. I would rename the strategies as:

1. Fatalist, where you let life go on and rely upon developing herd immunity quickly. Treat it as a bad ‘flu year.

2. Alarmist, where you shut down society and tell everyone to stay home. This is otherwise, for governments, a do nothing policy aimed at saving the health care system. But there is no other plan and the lock-down is endless. The cure is worse than the disease

3. Activist, where governments attack the propagation of the virus with an order to wear facemasks when out of home for any reason. Even home-made masks work in this case. A mask is poor self-protection, we are told; that is not the intent, it protects others. Mass and rapid deployment of testing people at congregation points; work, bridges, transport centers etc. Drug trials of promising avenues – such as quinine in this case. The cure becomes an inconvenience but it is not ruinous. See South Korea and the Czech Republic.

The best strategy is number three. Attack the virus’ propagation. Test for infection on a mass scale. Without knowing the extent of the infection, you cannot judge the effectiveness of your strategies. Isolate the infected and inform, not society. Use readily available drug therapies which show promise.

And fianlly, stop depending upon those computer models with poor and inadequate data input and built-in assumptions. The Canadian government yesterday announced an estimate there will be between 4,000 and 300,000 deaths in Canada. That is a not an estimate, that is a wild guess; they obviously have no idea. This is all reminiscent of the Global Warming models.

Rob
April 10, 2020 5:27 am

Professor Malachy Okeke held senior research and teaching positions in Norway, and was Senior Scientist, Molecular Inflammation Research Group, UiT The Arctic University of Norway, before joining American University of Nigeria, in 2018.

Professor Okeke states that the issue of resistance to malaria conferring some protection to COVID-19 is a legitimate but premature hypothesis. I believe she fails to consider that it is probably the medication (chloroquine) still taken by the majority of Nigerians that may have given them this protection. 7 deaths in a population of over 220 million as of 10th April 2020.

She believes there is a correlation between malaria resistance and COVID-19, it is probably the correlation between the medication to treat Malaria and Covid-19 that is the cause of this resistance.
We are now observing this covid-19 resistance in Lupus suffers.

Quote We will keep shouting, and screaming until our policymakers hear us and take decisive action. I am afraid that if nothing is done to counteract this misinformation of immunity, the consequences to our people in terms of infection, morbidity, and fatality will be of apocalyptic proportion!

The issue of resistance to malaria conferring some protection to COVID-19 is a legitimate but premature hypothesis. Reason being that an insignificant portion of individuals in malaria-endemic regions have been tested. Nigeria has tested about 4000 people representing about 0.002% of the 200 million population. You need to at least test 1% of the population, that is, two million Nigerians to start making any correlation and then test those correlations.

Why will we spend time investigating an unestablished correlation between malaria resistance and COVID-19 fatality when there is an established correlation between risk factors like diabetes, hypertension, asthma and COVID-19 severity? When time is of the essence and the difference between life and death, it is far better to spend resources including scientific investigation, public health intervention efforts on established correlations. Quote.

https://web.archive.org/web/20200410115608/https://www.premiumtimesng.com/features-and-interviews/387067-feature-are-africans-immune-to-coronavirus-dr-malachy-ifeanyi-okeke.html

Reply to  Rob
April 10, 2020 7:43 am

What’s about sickle cell anaemia, helping against malaria ?
https://www.newscientist.com/article/dn20450-how-sickle-cell-carriers-fend-off-malaria/
Certainly not an advantge.. ?

bonbon
April 10, 2020 5:36 am

The geopolitical virus infecting WUWT, possibly irredeemably, mutates as needed by the inmates.

The original Koontz “Eyes of Darkness” edition mentioned a virus named Gorki-400, rather fitting for the time, 1981. Later, post-Soviet, editions use Wuhan-400.

Commander Crozier of the USS Theodore Rooselvelt was fired for noting the US is not at war, while his boss Modly, since resigned, claimed there was a war with “China”. So NATO’s Stoltenberg is still fighting the last war while Modly was heading for his next. Meanwhile the crew is still unprotected with masks made of tee-shirts!

Severe symptoms of geopolitical viral infection, I would say.

It seems even Monckton’s motorcycle gear is no barrier.

icisil
Reply to  bonbon
April 10, 2020 6:24 am

Crozier was fired for going outside the chain of command to exert pressure on military command via the media.

John Endicott
Reply to  icisil
April 10, 2020 7:15 am

Exactly right. Anyone who has ever been involved with the military knows that going outside of the chain of command the way he did is a quick way to get fired/dishonorably discharged if not out right court marshalled. Doesn’t matter if you are a lowly private or the commander of one of our top ships, do it and you will be ending your career and possibly even spending time behind bars depending on what kind of information (as in classification level) you released to the press.