Tuesday, October 13, 2020

Covid Update, by Sackerson

There is debate about strategies to deal with the coronavirus, but there is also debate about the facts. Obviously the more we test the more we are likely to find cases of infection; and then there is the question of which cases are to be regarded as serious, and in fatal cases how to decide what the main cause was. It may take a long time for experts to agree on how to interpret the data.

But it may be possible to get some indirect indication of the impact of the pandemic in England and Wales, where we now have ONS fatalities data up to Week 40 this year (2 October).

The average total of deaths from all causes in 2020 so far is 463,748; in the same period for the years 2014-2019 it was 409,438. That is, the excess mortality this year - the difference between the two - is 54,310. 

Within the weekly data, the ONS has been counting cases where Covid-19 was mentioned on the death certificate. That doesn't necessarily mean that CV was the principal cause, or even the trigger (as it were); but it's interesting to see that 52,592 certificates did mention CV, which is not far off the total notional 'excess deaths' - in fact about 97% of the latter figure.

There is a meme that doctors have been under pressure to put CV on the certificate to bolster the government's claims as to the threat of the virus; I don't buy that story as a general explanation of these figures. Ordinary flu outbreaks are already included in the 5-year averages; this excess is so large that it stretches credulity to claim that CV deaths are simply flu by another name.

Another way to look at the information is to see what proportion of deaths, week by week, have been certified as CV-related:


We all know that the UK government has had to balance disease prevention against the need to keep our economy going, and despite the measures it has taken there does indeed seem to be a possible early indication of a 'second spike' in CV-related deaths. 

The highest proportion of CV-related fatalities was in the week ending 17 April - just over 39%; this fell steadily to w/e 4 September (1.01%) and has now risen again to 3.23% for week 40 - the first week of the official 'flu season' that runs to week 20 of the following calendar year.

The c. 54,000 extra deaths so far are less than one-thousandth (0.097%) of the total population of England and Wales, so it is tempting (because of the inconvenience of health precautions) to minimise their importance; but that is to think like Stalin, who is alleged to have said:

'The death of one man is a tragedy, the death of millions is a statistic.'

What price are we prepared to pay to hold on to our concept of the value of human life?

7 comments:

Mark Wadsworth said...

The bloke who is fixing my roof has a sister in law who works for the NHS, and she told him that if anybody over 70 pegs it and they can't be bothered to establish cause(s) of death (it's not that important in most cases, to be fair), they just stick down Covid-19.

Sobers said...

"What price are we prepared to pay to hold on to our concept of the value of human life?"

What price the cancer patient who will die far sooner than necessary? What price the stroke victim who will either die or be left disabled for life when timely treatment could have resulted in them living a relatively normal life? What price the suicide, driven by mental health problems exacerbated by the climate of fear being purposely created? What price the child whose education is ruined and results in a life in insecure employment and low wages? What price the unemployed man or woman whose relationship is destroyed by money troubles and who are evicted from their home through failure to afford rent or mortgage payments?

Do none of them have value either? Hundreds of thousands of people die every year, not all of them ancient, for all manner of reasons, very few of which are directly their fault. Yet we do not turn society upside down to prevent their deaths. Each winter tens of thousands of people die from complications caused by flu. Do we shut every pub and restaurant in the country and close every arts and sports venue to try and prevent it? Do we close every school, or make children behave as if the Black Death were in town? If not, why not, if the same number of covid deaths results in those actions?

Just because covid is new does not mean we should be doing anything radically different to what we normally do. By all means protect the very vulnerable, but let everyone else take their chances, because the alternative is worse for society as whole than the consequences of acting as we have done. 1500 people die every year from car accidents, but we don't ban cars. We accept that the benefits to society of being able to travel freely outweigh the personal loss of each individual victim's life. And the same goes for the right to have a job and a growing economy, and to be able to freely socialise and indulge in our favourite activities and pastimes.

Its is Bastiat's 'what is seen and what is unseen' writ large. The covid victims are seen. All the other victims, millions of them, are not being seen, or even looked for.

Sackerson said...

Points understood, both.

But despite the odd anecdote or two I don't think we can write it all off as a hoax. I don't believe the general run of doctors are so fast and loose with their professional judgment and in any case there must be many doctors who disagree with government strategy, aren't there? So for the latter there would be an incentive NOT to record CV on the death certificate.

Now if we see excess deaths rise but not related to CV then we can theorise about non-CV effects of lockdown.

There are other issues, e.g. why have we regarded the annual flu slaughter in care homes as normal, inevitable and ignorable?

And also our perception of risks, e.g. to take up one of your points Sobers, suicide is a far greater threat than manslaughter/murder.

Sobers said...

"why have we regarded the annual flu slaughter in care homes as normal, inevitable and ignorable?"

Because we have considered (if anyone had actually thought about it) that the only methods one could use to combat the flu are precisely the ones used to combat Covid (as we do not have effective flu vaccines, just rather hit and miss annual attempts at guessing which flu viruses are going to be the dominant strain) and they would not be acceptable to society at large, because most people know they are not at risk from flu. They are happy to send their children to school in winter, they are happy to continue their lives as normal, in the knowledge that if they get it it'll be a week on the sofa at worst. Yes occasionally Granny or Great Aunt Betty gets the flu and dies from it, but as both were in their 80s and not exactly that fit and healthy, well they've got to go sometime, and this was their time.

The difference with covid is that rightly or wrongly everyone got the idea that they were at risk from it, when they are not. And thus were petrified into accepting the controls that were suddenly placed on society. Covid is not a 'new' disease, it attacks precisely the same people that flu attacks, the elderly and the infirm. And as such should be treated like the flu.

Sackerson said...

Actually it has been recognised that there are historically 'issues around' the care of the elderly in care homes. More to do with negligence and incompetence than conscious policy:

https://phw.nhs.wales/services-and-teams/harp/infection-prevention-and-control/guidance/accordians/docs/influenza-guide-for-care-home-managers-and-staff/

Sackerson said...

JD comments:

It seems to me that the Governments response to Novel Coronavirus is one dimensional; 'run away and hide' is the only option and wait for the miracle cure of a vaccine. Fear is our daily message from Johnson and Hancock and the media, as usual, are the modern day Cassandras (although the original Cassandra told the truth but was not believed - the opposite of our journalists who tell lies and are believed)

The cure for covid is readily available and is being used successfully. Would I be cynical in assuming that these cures are being ignored because there is no money to be made from them?

Here is Dr Brian Tyson in Southern California who has successfully treated over 1,700 patients with the drug hydroxychloroquine.
https://youtu.be/PE3QfTnIazU

And here is Matt Hancock who lied to the HoC about the efficacy of Vitamin D
https://youtu.be/nwWLoruXthQ


HCQ is also being used by Dr Didier Raoult in France and, of course, he is condemned as a quack.

https://www.connexionfrance.com/French-news/Controversial-French-chloroquine-Professor-Didier-Raoult-I-could-have-halved-Covid-death

Also being ignored by all concerned is the old 'folklore' that pessimists catch more colds than optimists and you have already touched on that subject here-

https://theylaughedatnoah.blogspot.com/2020/07/the-power-of-belief.html

Any individual has two choices. You can either lie back and say 'woe is me' or you can sit up and pay attention to what your body is telling you. The second response is part of positive thinking which the majority of people mistakenly assume to be the same as wishful thinking. It is not.

Illness begins and ends in the imagination - https://mh.bmj.com/content/26/1/9

Sackerson said...

Expert, slantendicular commentary on Covid from Legiron here:
https://underdogsbiteupwards.wordpress.com/2020/10/14/the-lockdown-zone/

To which I reply:

Largely, I agree. I take zinc, D and 4*one-a-day Vit C (Linus Pauling was a great fan). I do think CV is real, is nasty, and may well have been a contributory factor in over 50,000 excess deaths in 2020 so far. Yes, the victims tend to be the very elderly; and that does raise two issues:

1. The old N*z* joke about mind over matter – ‘I don’t mind and you don’t matter’. How ruthless are we prepared to be? Roll the dice on those QUALYs? ‘Bring out your not-dead and we’ll finish the job?’ https://www.youtube.com/watch?v=QcbR1J_4ICg

2. The care of the elderly has long been a quietly ignored scandal. Flu has been roaring through care homes annually for years – a Welsh survey found 75% of residents got the flu jab but only 10% of the workers (who tend to do stints at several homes, so acting as a vector).
https://phw.nhs.wales/services-and-teams/harp/infection-prevention-and-control/guidance/accordians/docs/influenza-guide-for-care-home-managers-and-staff/
Instead of comparing this year with previous ones, we should look at the previous ones. Or maybe go full-on Logan’s Run, with Carousel at ooh, age 60? https://www.youtube.com/watch?v=_wjXpTDuHiE
That should stop the WASPIs whingeing and boost the care-burdened economy no end.

Btw I had ‘three weeks bedridden and wishing for a visit from the Reaper’ a few years ago. Bloody hell, the boredom! If it was in my foot I’d have gladly had it amputated, instead it was in my head. Until then I thought flu was a cold that lasted more than a couple of days.

The Belarus President recommends drinking vodka*; my preference is Glenmorangie, though Waitrose are selling Johnny Walker for a hard-to-resist £15. G&T is nice but more than one session and one tends to get the gin blues, I don’t know if that’s because of the botanicals? But sorry, not taking up smoking again, it took me 5 years to stop (and you would be hard put to name a brand I didn’t smoke from 15 to 25).
*https://www.dailymail.co.uk/news/article-8569375/Belarus-president-said-vodka-Covid-19-remedy-tests-positive-coronavirus.html