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The Corona Files: Covid is staying … get used to it!

Written by Joerg Steegmueller
The Corona Files: Covid is staying … get used to it!

No Vaccine for Covid-19?

People in Ireland are a friendly bunch, and dealing with others on a first name basis is absolutely normal (apart from in very formal settings). So, since Covid-19 has moved in and isn’t leaving soon, let’s call it by its first name. Hi Covid! Welcome to Ireland!

How does reading that feel in your gut? For many, this might feel VERY uncomfortable. Imagine welcoming British doctor and serial killer of at least 218 people, Harold Shipmann (www.biography.com/crime-figure/harold-shipman), with a “Welcome to Ireland, Harold!”. It just doesn’t feel right!

But during the week, I listened to my daily schedule of virology podcasts and one of the doctors said something really interesting. He said: “Many of us think that the flu is harmless, but this is completely wrong. The flu (also known as “influenza” virus) is a dangerous and often deadly disease.” He then continued to explain that the flu spreads quite fast, it kills people (often through pneumonia) if they are in a high-risk-groups (i.e. have underlying illnesses or are of advanced age) and it can “get us” at any time between October and March.

If some aliens landed on Earth and you told them about the flu, they probably would be VERY VERY afraid. But for us Earthlings, the flu is NORMALITY. We got used to it and it is nothing we think overly about. You probably had it at some stage and you might even know people that died from it. (Although it was probably said that they died of pneumonia or something else that was caused by the flu. It is unlikely that someone said that that person died of the flu.)

But despite that deadly disease (flu!) among us, we do not change our behaviour much during the flu season. MOST of us have never been vaccinated against the flu, at least not if you are young-ish or not in a healthcare profession or risk group. If it hits us we take it on the chin, are out of action for a few days and then go back to work when it is over.

And there are other dangerous and life threatening things that we willingly accept in our lives. Car accidents, plane crashes, smoking, drinking, overeating, “under exercising” and many other things kill people on a daily basis and we all have directly or indirectly been affected or at least know someone who has directly or indirectly been affected. But we still don’t freak out too much over it.

I have no intention to compare the number of deaths and claim that Covid is harmless, it isn’t! But what struck me when I heard the virologist talk about the “normality” of the influenza in our life was the fact that the presence of Covid might just become a new normality! :-O

A yearly or even permanent risk that has to be minimised by certain actions (like using seat belts when in a car), but something we will get used to (because will HAVE to get used to)! And in a few years, it might just be normal to talk about Covid as we talk about the flu today.

Someone born in Ireland today, has an average life expectancy of 81.5 years. This is an average, no promise and certainly no guarantee and many do not reach that age. But in 1960, the average life expectancy in Ireland was just 69.80 years. And in 1946 it was below 60 and in 1900 even below 50. Imagine, on average you only lived until 50 if you were born in 1900! That is a very young death from our point of view today. (Source: www.esr.ie/article/view/730/157)

So from 1900-2020 we removed so many risks and dangers and we improved the health system so much that it resulted in an increase of the life expectancy of more than 30 years. That is a big achievement, but nothing that was guaranteed. If we are honest, we expected that it would continue to go up and up and we NEVER considered that there could be a setback.

Covid might have changed this and will probably put a dent in the graph!

However, it is still completely normal that we will have to die one day and that fact will not change – at least for another long while. What Covid has done is that it has added another risk factor to our lives and my prediction is that we will get used to it

So the real question today is not “How much longer will it take until I can go back to work again?” The real question is “What do we have to do to continue life with this new normality?”.

This might be a worrying thought initially, but think for a moment about all the risks that we are prepared to accept in our lives already and ask yourself WHY we are prepared to accept these risks. And then think about how you might be able to accept this new and added risk.

So, Covid is here to stay! Now we have to find a way to get used to it! …and at the same time again try to reduce the risk of a new danger while still continuing our lives.

——————————————

And just to pre-empt that question: No, we are not doing that at the moment! Currently the politicians and doctors in Ireland are trying to REMOVE the risk and therefore have decided to lock us in for another while. They are talking about lifting the restrictions “when it is safe”. But this is not the solution for the future if you accept that it might never be safe. It is like saying “We will let you use your car again when it is safe.” or “We will let you smoke again when it is safe.”

And a final warning: Do not hang all your hope on the discovery of a vaccine! There is still no 100% effective vaccine for Influenza A or Influenza B. Pharmaceutical companies guess every year which strand might break out and combine bits of a number of strands in a vaccine to hopefully cover the one that will hit us that year.
Also, there has never been a vaccine for SARS-1 or for MERS and Covid, which is SARS-2, will most likely mutate so much as well year after year, that there might never be a 100% effective vaccine. Oh, and remember, there is also NO “vaccine” against most cancer types despite them being around for so many years and despite their devastating effect on the life expectancy graph! So it is definitely possible that there will never be a 100% effective vaccine.

And that is another reason why we have to think about this new normality in a way where there is no going back to the old normality.

Corona Virus, Health System, , , , , ,

The Corona Files: Can we trust our leaders in this crisis?

Written by Joerg Steegmueller
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The Corona Files: Can we trust our leaders in this crisis?

[This post got a bit longer than planned and you might not have the time to read the whole post, but I can promise you that it is worth it, because there is some amazing and unheard of news towards the end of it!]

After more than a month in “lockdown”, with a significantly changed infection rate and considering what is happening in other countries, it is now time to think about the trust we can or should have in the politicians in Ireland to do the right thing.

While the picture here is by far not as shocking as in the USA, where Trump suggested to put UV light “inside people” to kill the virus or maybe to inject disinfectant (www.youtube.com/watch?v=33QdTOyXz3w) so that the virus dies, we still need to keep a close eye on what is done with our lives and to us by the people who are in power.

Because I do believe that we are dealing with a virus, a virus that is more dangerous than other viruses (I will write another time about THAT discussion and the Conspiracy Theories that are connected to it.), I do think that the soft-ish lockdown that we were put under, was the right thing to do.

But I am wondering of the people in charge are the right ones to get us out again.

Who is in charge?

First let’s have a look at the power structure in Ireland to see who is really in charge right now.

It seems that the following people and organisations/forums are on this list: Taoiseach Leo Varadkar, Health Minister Simon Harris, National Public Health Emergency Team (NPHET), Chief Medical Officer Tony Holohan and maybe also Professor Philip Nolan, who is leading the modelling team.

This is an interesting list for many reasons:
The majority of people on it are seemingly un-elected and are employees or subcontractors of the Department of Health. It seems to be really difficult to find out who is part of the NPHET (I wasn’t able to!) and the NPHET doesn’t release any minutes of their meetings anymore. But it seems that the two elected politicians (Don’t worry, I will come to that!), Varadkar and Harris, leave ALL or nearly all decisions to the NPHET. Alan Kelly, the Labour leader, has some justified concerns about NPHET: www.thejournal.ie/taoiseach-nphet-alan-kelly-5082184-Apr2020/

In a setup like this, there is a huge risk that experts are experts ONLY in their area, but don’t really see/understand or want to care about any other aspects of their decisions. You probably know the saying, to a man with a hammer, everything looks like a nail!

Because a modeller cares very much about his models and a Chief Medical Officer cares very much about the medical aspects of this pandemic, they definitely have to be PART of the advisory group, but after that should it not be the elected politicians that carry the responsibility and also then make the decisions and announce the decisions?

Yes (I am getting to that now!), I am fully aware that neither Harris nor Varadkar are confirmed in their roles after the recent election. And strictly speaking, they lost the election and would have to get re-elected or re-appointed before they are confirmed in their roles. However, they are – according to the Irish Constitution – rightly and correctly continuing in their roles until a new Taoiseach is elected and a new Minister of Health has been appointed.

On the way into the lockdown, I think they did do the right thing and performed well. But a critic could say that the getting into a lockdown is easy and you can’t do much wrong, the way out of the lockdown is MUCH more complicated and requires completely different leadership.

I am not convinced that the people in power are the right ones to get us out of the lockdown. The Chief Medical Officer will be judged by the only statistic he focuses on on a daily basis: Number of newly infected and number of deaths. The Modelling expert, only looks at the virus reproduction number R (and surprisingly for an expert he seemingly doesn’t understand that R0 and R are not the same!! R0 is the max reproduction number and R or Reff is the REAL reproduction number. Prof Nolan got it wrong here www.gov.ie/en/publication/ea86cc-covid-19-modelling-data-thursday-16-april-2020/). And if you are judged by ONE specific result or number, then naturally you only focus on that one single issue and tend to loose sight of any other issues.

So who will look at the other effects and impacts? There are social, mental, economic, educational and political impacts as well.

This is the sphere were politicians need to make decisions, but to do that, they might have to tell the medics and modellers that they appreciate their advise but might choose not to follow it for now and do we think Varadkar and Harris would do that? I don’t think Harris would and I am not too sure about Varadkar.

NO politician anywhere in Europe or even worldwide KNOWS what to do in the current situation, so we can’t be tooo harsh with our judgement. No medic or modeller really has reliable and 100% correct data! Apart from the number of deaths, everything else is pure guess work. We have NO idea how many people have been infected. We don’t even know exactly how the infections happen and why some people have a weak reaction and others have a strong reaction to an infection. So all the people in power are totally winging it! Not only in Ireland, but worldwide.

So what can be done? In my opinion, we should watch closely what is happening in other countries. Austria, Germany, Denmark and Czech (and a few more) are starting to ease the restrictions and our politicians should look at that to 50% and listen to the experts with the other 50%.

But this expert forum has to change now! Medics and modellers are still needed, but in addition we need to add people that know about mental health, that are experts in education and in economy. The expert group that will ADVISE our politicians (not lead instead of the politicians) has to spread wider and cover more bases.

How come I dare to say that? Do I think that all the deaths are not real? Do I think that we are over the hospital emergency?
No, I do not think that at all! What our health care workers experience is definitely real and we definitely need to continue the work on easing the pressure they are under.

But we also need to be aware that Covid-19 is not the only health issue in this country. There are people avoiding hospitals that urgently should be seen and possibly operated. And we need to take into account that there is NO good justification for some of the restrictions and the renewed clamping down that gardai have announced for this coming weekend. There is a good justification for the physical distance, but NOT for the 2km radius for exercise and also not for the travel limitations (as long as you continue to keep the physical distance wherever you go to).

And if business life doesn’t continue in some shape of form, we will NOT be able to pay for the out of work aid that is being paid at the moment and we will NOT even be able to keep financing the hospitals. Heck, we were not able to finance hospitals sufficiently to avoid overcrowding when the economy was going well, so how can it be possible when the economy has stopped?

I am NOT talking about a “getting back to normality”, but I am talking about moving out of emergency shutdown mode into a emergency handling mode in the same way as these other European countries do it.

And YES, it could happen that we will get back into lockdown mode again for another 2 weeks or so. Maybe even a few times. And that is absolutely ok, but we now need to work on a plan for getting out and I am not sure we can trust the people who are currently in charge to have the ability to do that in a reasonable way.

I should mention something else as well and I have to admit that it influenced my opinion a good bit. It is a very important aspect and maybe I should put up a separate post about this, because it is VERY surprising:

The deaths that we are currently experiencing is the only reliable number. We don’t know in a lot of cases if a death was caused by Covid-19 or not and for the dead person or his/her family it is not even relevant. But we know that these deaths are real! The ridiculous and brutal restriction to just 10 family member at a funeral, no matter how big the church or funeral venue is is also real and there is not the slightest justification for it. Thanks NPHET for one of exceptionally nonsensical rules!
But I discovered something else this week and I have not found ANYBODY writing or talking about it!!

There is a European Project that has the cute name “EuroMOMO”, but is not cute at all. EuroMOMO is a European mortality monitoring activity, so they cound the number of deaths that happen in Europe. And the goal of EuroMOMO is to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats.

So, the 24 participating countries report their number of deaths to EuroMOMO and EuroMOMO creates graphics and reports to show if and to what degree the deaths in a certain period of time are above or below the “normal” death rate. In normal years the deaths that are above the normal death rate are considered as influenza deaths if they happen between October and May. EuroMOMO has a lot of graphs and stats on their website, but the most relevant is the Z-scores by country and you should have a look at that here www.euromomo.eu/graphs-and-maps/#z-scores-by-country

The results are shown on a time graph and the Z-score shows by how much the current number of deaths varies from the normal number of deaths. In Belgium, France, Italy, Netherlands, Spain and UK you see a significant peak. That shows that they are having significant more deaths than in normal years.

But now check Ireland! And you will be surprised to see that Ireland has LESS deaths in this Covid-19 period than it would be normal this time of the year. LESS!!!

I have no idea why that is, maybe it is because there are less other hospital operations. Maybe because there are less accidents because people stay at home. Maybe the fact that people avoid going to hospital if they have some other issues, keeps them alive longer? I have no clue! It also doesn’t mean – and I repeat that on purpose again – that Covid-19 is not happening or that it is harmless or that it is just like a normal flu. NO! That is all nonsense! And the numbers in other countries clearly show that. But if our excess mortality at the moment is lower than normal, then maybe the 1014 deaths (as of yesterday) are at least in Ireland, just normality. And if that is the case then we have to continue keeping the virus under control by keeping a physical distance, but we have to wonder if the current lockdown is justified in its current form!

Soooo, can we trust the people in charge? What do you think?

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The Corona Files: We did go too far!

Written by Joerg Steegmueller
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The Corona Files: We did go too far!

Johann Wolfgang von Goethe wrote a poem that is called “The Sorcerer’s Apprentice” and when I went to school, we had to learn it. I did exceptionally badly that day and got the worst mark on reciting the poem that I ever got in my whole school “career”. So it is a poem that I will never completely forget. One of the lines is “Die Geister die ich rief, werd ich nicht mehr los.” and that translates to “The spirits that I called, I can’t get rid of anymore.”

We are clearly still in the middle of the Covid-19 crisis (some think we are only at the beginning of it!), but a lot has happened and I am genuinely and deeply concerned about the long term effects that policy decisions had already and will have on our behaviour to each other.

The “We are all in it together!” is long forgotten and fear and panic has replaced the we-will-fight-through-this attitude from before.

I came across a whole range of scenarios that worry me! Here are just a few examples:

1) The Police State

Over the Easter weekend when the much stricter restrictions where in place a friend of mine and his partner went on a food shopping trip for his and her parents who are elderly and are cocooning. Because they live a little bit apart at the outskirts of Dublin, they had to travel a bit to shops and then to deliver the food. On their way, they were stopped at SIX garda checkpoints and they were never able to deliver the food. On one of the checkpoints an ill informed garda gave them nearly the full “E-E-E-E” treatment that was used as garda strategy that weekend. The four Es is Engagement / Explain / Encourage / Enforcement. (www.rte.ie/news/coronavirus/2020/0409/1129677-what-to-expect-from-gardai-during-covid-19-restrictions/)

They were told that they are NOT allowed to drive to their parents to bring them food despite the fact that “caring for the elderly” was clearly classed as ESSENTIAL during the Covid-19 crisis. They were also threatened with legal action if they don’t turn around. Nonsensically, the garda told them that instead they should bring all their shopping to the next garda station so that the food would be delivered by gardai to their parents. (There was no answer on how to deal with frozen food.)
Maybe this was just ONE garda on a power trip or an extremely badly briefed garda? But at another one of the six checkpoints, they were berated by a garda because two people (who live together!!!) were in the same car. :-O There is no rule or law in Ireland that disallows that.
By the way: They had to give up and turn around to avoid being prosecuted or arrested…and the parents didn’t get the food for Easter!

2) Inexcusable Misinformation

A situation that was not related to Covid-19 forced me to be in A&E in a Dublin hospital 2 weeks ago. I was there with my partner and as it is normal and natural during the waiting period and between examinations we sat next to each other and talked about what happened. The shift of the office based A&E staff had changed and the new admin at the reception had taken over. 10 minutes later he spotted us and came running out from behind his glass screen, shouting at me for not keeping a social distance. I explained to him that this was my partner who I live with. But that didn’t stop him! Instead he got even more excited and told me that this does not matter in the slightest. We are in a hospital and therefore have to keep a distance of 2m from each other.
He either didn’t understand the rules OR he was taught nonsensical rules and didn’t question them.

3) Blinding Fear

Someone I am “friends” with on Facebook wrote in a Facebook conversation
during the week:

“If people meet and don’t keep the distance at the moment, they could infect others. The infected people could die. So meeting others is akin to murder!”

I am lost for words in this case. How can any sane and sensible person draw that conclusion?? The person who wrote that clearly lost all reason and I can only conclude that this is caused by a blinding fear.

4) Attacking the people who help!

Luckily we have not reached the lowest of lows in Ireland: In the UK, Health Care workers are being attacked and abused for being “virus spreaders”. Tires of ambulances are slashed and cars of hospital employees are damaged. The ITV news on 15 April had this report:

How can it come to this? My guess is: Irrational fear, stirred by sensational media reports. This is shocking stuff!

5) No Way Out

At some point in the not toooo distant future, we will have to go back to offices again and kids will have to go to schools. But the virus will not be gone! So how will we deal with that?
In Denmark, where they are a little faster with lifting restrictions and thought about letting young children return to school first, rapidly 18,000 parents declared that they will refuse letting their kids go back to school.

How will we deal with a loosening of the restrictions? Will we also refuse to go to work? Let kids go to school? If a vaccine is another 12-18 months away, will some of us lock themselves in at home and refuse to go to work until then? How will YOU react when you have to go back to work? Enter a room again with other people inside?

In my opinion, we have definitely overdone it! We have over-egged the pudding!! And it is all based on fear that has been whipped up by our authorities, lead by the government and advised by medical officers and epidemiologists.

Don’t get me wrong, I think the lockdown was the right thing to do, BUT what did the Taoiseach do to “incentivise” the country? He said on 09 March that in Ireland 85,000 people could die from the Coronavirus. (www.independent.ie/world-news/coronavirus/up-to-85000-irish-people-could-die-from-coronavirus-in-worst-case-scenario-taoiseach-indicates-as-three-more-diagnosed-39029363.html) This was not wrong information, but it was information that was used to get us worried so that we would adhere to the restrictions.

Later on, language was used that suggested to us that our lives were in serious and immediate danger. All measures were “to save lives”. “Stay home stay safe!!” This is also not wrong, but we can’t be surprised that then many look at the other people on the same footpath as a threat to their life. Or when leaving your home to go back to work is seen as risking ones life.

And now you see where “The spirits that I called, I can’t get rid of anymore.” becomes relevant! We over did it! We became so fearful that the care that people showed for each other in the beginning turned into people being prepared to report their neighbours for the smallest Covid-19 rule infringement.

It is a little early to think about things going back to “normality”, but what type of society do we want when we are going back to a sort of normality? If you have certain preferences, don’t let others pound fears and believes in you that are counterproductive!

Assess for yourself and judge what makes sense and what doesn’t. Then check with people that you trust if your assessment is reasonably and logical. Be prepared to learn and to speak up if necessary!

Oh and never ever forget that MOST others don’t do the (questionable) things they do to hurt or harm you, but because they don’t know better. Always be compassionate!

Corona Virus, Health System, Irish, Media, Overexaggerations, Politics, Taoiseach, , , , , , ,

The Corona Files: Get me out of here!

Written by Joerg Steegmueller
1 Comment
The Corona Files: Get me out of here!

In Ireland, restrictions of public life started on 13 March, so we are one month into it and last Friday it was announced that the lockdown will continue for at least another 3.5 weeks until 05 May.

So it is much too early to pain for a “back to normality”, we need a lot of patience, but at the same time, it is the right time to think (or learn) about how we will be able to get out of this lockdown situation again.

There are a lot of people that think that as long as we are patient and stay away from other people, the virus will disappear again and we can go back to normality. However, this is a highly unlikely scenario!! The Coronavirus will be with us for a long long time and can (and probably will) flare up again and again.

If you think this through, then there is no straight forward and simple way to lift the lockdown. Not on 05 May and not on 05 June or 05 July unless something else happens.

The job description of a of an efficient virus includes the requirement “must spread…ideally like wildfire”. And in that respect the Coronavirus is a very efficient virus. Not as efficient as measles, but doing a good job nevertheless.

Virus Reproduction numbers are essential

The efficiency is expressed through the “max speed of spread” or reproduction number, which is called R0 (R Zero). For measles this is around 15 and for the Coronavirus it is up to 3, for the influenza virus (flu) it is around 1.3. That means that one infected person will infect 15 others for measles and 3 others for the Coronavirus. 15 is crazy, but even 3 (or on some areas around 2.2) is exponential spread. So to reign it in the effective reproduction or Reff (R effective) has to be brought down to 1 or better below one. That would mean then that one infected person will infect just one other person or maybe even less than one person. At that point the spread is linear or is decreasing (when smaller than 1).

In Ireland we have the advantage that the country is quite small and this combined with relatively fast action that was taken, we are allegedly at the point where Reff is at around 1. I say “allegedly” because I think that the numbers of infected people are MUCH underestimated in Ireland due to the low number of tests that have been carried out. But lets hope that we are actually close to 1.

At that point, the virus is far from being gone. It is just more under control and therefore it is expected that the hospitals will be able to deal with virus patients better.

So what Reff doe the authorities aim for? The simple and complicated answer is “as low as possible”. But be aware that it is unlikely to be Zero, because the Coronavirus is devious and smart. It is hiding its presence for 5-14 days and only after that you will get symptoms. During these 5-14 days a carrier can infect a LOT of people.

With R0 being around 3, ONE single carrier could easily infect all his/her social contacts in a week and for a busy person that could amount to 3-4 per day. So in, let’s say 10 days ONE single highly socially active person could infect 20-30 people and BOOM there is a new cluster that can lead to another wildfire-like spread.

How to lift the lockdown?

If we lifted the lockdown completely, we could be back in a uncontrollable situation within 1-2 weeks. So we can’t do it that way. In Austria they are talking about lifting the limitations for smaller shops and trades people on 14 April and then for hairdressers (WHY them!?) on 01 May and then for the first few pubs and restaurants in mid May. Schools will still stay closed at that time. This is just an idea, a concept that might get changed faster than you can read this blog post, but it shows what we also might have to do.

What do we want to achieve?

That is an important question! The virus can be stopped by only one thing according to virologists and that is a high enough immunity in the population so that it can’t spread anymore. In virology terms, this is called “herd immunity”. This term got a bad meaning because the UK tried to wait for natural “herd immunity” at the outbreak of Covid-19 and now many think that “herd immunity” doesn’t work. This is totally incorrect. Herd immunity is not the same as letting the virus go rampant. Herd immunity just describes that 60-70% of the herd (or population) reached immunity. This can be achieved in two ways: Either they get immunity because they were infected, got through the infection and are now immune OR because they were vaccinated.

The natural immunity is still not certain for the Coronavirus. A trial was done with 5 monkeys that showed that after an infection and going through Covid-19 the monkeys got immune and didn’t show any symptoms when they were re-infected afterwards. But monkeys are only similar not identical to human beings, so more tests are needed to be absolutely certain. The indications are good though. The second problem is that we have no clue yet how long the immunity will last. Some viruses (chicken pox) will be kept away because our body will develop immunity forever, but with other viruses, the immunity is time limited. And with a bad ass Coronavirus, it is POSSIBLE that the immunity will only last a few weeks or months or maybe one or two years. We have no clue yet about that!

What do we need to reach herd immunity?

If we need 60% of the population to have survived Covid-19, we need a LOT more infected people than we have at the moment. Right now, there are around 9000 people tested and found infected in Ireland. IT is assumed that in countries with a high test rate around 80% had the virus and didn’t show any or no severe symptoms, so in a best case scenario the 9000 are our 20% and then we would have had a total of around 45,000 people that were infected and survived and now might have immunity. Because the test rate in Ireland is super low, let’s be generous and let’s assume that we actually have only 10% of detected cases. Then the total immunity level in Ireland after Covid-19 would be around 90,000. This is a immunity level of measly 1.8%!!

So to achieve herd immunity (60%) we need to get another 2.79 million people infected. :-O Imagine! And this has to happen soo slow that the Intensive Care Units will not get overwhelmed again. So maybe at a rate of 90,000 every 1.5 months (at the moment we might have 90,000 in one month with catastrophic consequences for ICUs). With this infection rate, it could take 31 *1.5= 46.5 months (!) to reach herd immunity!

Luckily there is an expectation that in a best case scenario we will have a vaccine in about 12-18 months. So we wouldn’t have to go through the whole infection process of 46.5 months, but would only have to do it for around 18 months. Still in these 18 months we would have to continue protect (=shelter) the high-risk groups and we would have to control the planned infection process constantly and be prepared to shut down life again as soon as it threatens to get out of control.

You can see that this is not an easy situation and that we will be dealing with that WELL after 05 May. This is a bit of a grim prospect, right!?

It will be interesting to see IF Austria will go through with their plan and it will also be interesting to keep a close eye on Denmark and other countries.

I expect that the lifting of the lockdown will have to be a very careful gradual lifting ALL the time being prepared to go into full shut down mode again if needed.

Smart Distancing + Tracing App

An alternative possibility would be to move from Social Distancing to Smart Distancing, in this case we would stay away from people that could be infected and we would continue to quarantine them for 2 weeks as soon as they get some symptoms. We would still need to cocoon the high risk group and couldn’t go back to normal international travel and large events (concerts, football matches, olympic games etc.). And we also would have to combine that with a HOPEFULLY anonymous contact tracing app that would tell you when you had contact with someone who is infected and once you had contact, you would have to self-quarantine immediately (and the app information would have to be proof to your employer that you will have to stay at home for 2 weeks). We also would need LOTS of antibody tests so that people with Coronavirus antibodies would be allowed to freely move around again without having to quarantine.

I am not a modeller or epidemiologist, so all the “models” I described above are very much simplified, but it shows that the Social Distancing and “Stay at home” measures are 100% required to protect the health care system at the moment, but they are not an ideal approach to reach a form of “normality” again.

What do you think about Smart Distancing and a Corona tracing app? If antibody tests are available, you might have to check yourself every two weeks or so. Would you be ok with that? And what if the app was NOT anonymised? Like in China now, the authorities would be able to trace EVERY move you make. Would you consider using the app still?

Corona Virus, Health System, Politics, , , , , , , ,

The Corona Files: Don’t trust the statistics!

Written by Joerg Steegmueller
1 Comment
The Corona Files: Don’t trust the statistics!

After 79 days of Corona cases, China announced on 19 March that they had NO more new cases. (www.theguardian.com/world/2020/mar/19/china-reports-no-domestic-cases-of-coronavirus-for-first-time-since-outbreak-began)

Not just a a lot less than before! No, NONE! Not a SINGLE one! Fishy? Dodgy? Untrustworthy? You bet! But it seems that many did believe (or wanted to believe) that a totalitarian government, that is dead set on totally controlling its citizens and that didn’t have much regard for the truth in the past, would suddenly be totally trustworthy. It seems even some governments were mislead (or just not so smart!?) and might have based some of their strategies on the most likely fake numbers from China. (www.businessinsider.com/coronavirus-boris-johnsons-government-reportedly-furious-with-china-2020-3)

Now it even emerged that the CIA is doing whatever possible to find out accurate numbers. (www.nytimes.com/2020/04/02/us/politics/cia-coronavirus-china.html) There are reports that the number of deaths in connection with the Coronavirus in China is not 3,326 but possibly well over 40,000. :-O

With all that attention on the Chinese numbers and with daily announcements from all other affected countries about how many new infected cases were detected and also how many people died, some have become a bit obsessed with the Covide-19 stats. If you check the numbers every day or if you frequently check the updates from the Johns Hopkins University on the site www.domo.com/coronavirus-tracking or even worse on the 24×7 Coronavirus Pandemic Livestream (www.youtube.com/watch?v=qgylp3Td1Bw), you could really despair.

But how much can we trust all these numbers? Actually, we can’t trust their accuracy at all and there are lots of reasons for it, which I will try to explain as much as possible.

Wait! Are you saying all numbers are wrong?

Yes, it does look like that! The number of infected cases, the number of deaths and the number of recovered patients all do not reflect the correct situation.

Are not even the number of deaths correct?

Many countries have different methods of counting the people that have died in connection with Covid-19. Some countries surpress some numbers and others might overexaggerate them.
In China it seems that the numbers are seriously below the real situation. In Italy, only the people that die in hospital are considered in the Covid-19 statistic, not the people that die at home. This could also apply to other countries and would result in a much too low number.
But there is a flip side! In most countries a detected infection means that the patient is added to the Covid-19 statistic even if the cause of death was a different one. Somebody put it like this: Imagine someone falls of the 10th storey of a building and after he crashes on the street a tank drives over him. If he miraculously survives this and is brought to a hospital where a Coronavirus infection is detected, his subsequent death will be added to the Covid-19 statistic. But then some countries don’t do that, but have separate stats for patients that die of pneumonia, independent from an infection.
You can already see that it is a mess that nobody can really fully understand. But the bottom line is that the figures are NOT consistent and therefore not correct.

And what about the figures of infected people?

You can only detect infections if you test. In some countries a LOT of tests are carried out. But it is still FAR away from mass tests and since 80% of the people show only very mild symptoms, there are probably a LOT more people infected even in the countries were many tests are carried out.

Germany has a quite low number of deaths and the – to me – odd explanation for this is “because Germany tests a LOT”. The fact that they test a lot, might mean that the number of infections is closer to the truth than in other countries, but how does knowing if someone is infected influence the number of people that die? Strange!

In Ireland, on the other hand, the tests were stopped a number of times due to a shortage of test kits and now the shortage of some substances in the labs. In addition the one-symptom indicator that would get you a test place was changed to a two-symptom requirement to keep people away from the test centres. So there MIGHT be a situation where a LOT more people have or had a mild infection than we will ever know.

Bottom line: Only people that have been tested can be negative or positive. And if you don’t test many, you will not find many infected people.

Does that mean someone is intentionally lying to us?

In China, many think that this is really the case. In other countries, it is probably not an intentional lie, but it is a misguided trust in statistics that is unjustifiable. But you can be certain that you are not hearing the truth and nothing but the trust!

When, for example, Taoiseach Leo Varadkar said that “in two weeks, we could have 15,000 infected patients”. He was describing what one scenario (possibly a worst case scenario) said to frighten people, so that we would be more willing to follow the social distancing and lockdown measures. This is much more effective than if he had said, “well experts are not too sure, but it could be between 2,000 and 15,000 infected”.

So propaganda is always part of it!

And then there is sensationalism! We know that in the times of 24×7 news channels, the TV and radio stations that constantly report about the news in this world (CNN, Sky News, etc) will jump on the smallest bit of information and will make the biggest story out of it if they can.

What do all these wrong numbers mean?

It really means that we have not the slightest clue internationally where we are. Nationally, the growth rates are an indicator how things are developing in every country, but comparisons are a dangerous thing!

And if we don’t know where we stand, it is possible that the Coronavirus is not at all deadlier than the “normal” influenza virus!! :-O We currently assume that the death rate is around 2-4% for Corona and only around 0.1-0.5% for the influenza, but if only SOME of the infected people are counted, then that obviously will make the virus look a LOT more dangerous. If 100,000 infections are found then 1,000 deaths sound completely different than if 1,000,000 infections are found of which 900,000 were just not detected.

Will we ever find out what the correct numbers are?

No! Actually, we will find out what the number of deaths were and we can compare this number with the number of ALL deaths in a country in previous years. But we will never find out what the total number of infected people was. It is VERY unlikely that mass antibody tests will be carried out.

And the number of recovered people is also wrong?

Sure! If you don’t know how many have been infected, you can’t know either how many have recovered. In addition, not every country does carry out another test AFTER the symptoms are gone (why would you!), so then there is never the formal test-based confirmation that the patient now has no more Coronavirus in him or her.

But the number of deaths are horrendously high, how can you say the virus is possibly not a killer virus?

Yes, the numbers look huge if you don’t compare them. At the time of writing this 14,681 people died in Italy, that is as much as around 73 plane crashes of Ryanair-sized planes. That is a HUGE number. Imagine how shocked we would be if there was only ONE plane crash! 73 is crazy!

But then we need to look at other years and we will find that, for example, in the flu season 2016/2017 more than 24,000 people died of the flu in Italy. So only in a few months we will know if the Covid-19 death rate will really be significantly above the 2016/2017 numbers.

Oh and in 2016/2017 there was no lockdown, no panic, no new laws and countries didn’t build mass morgues in city centres. I don’t want to minimise or banalise the death of people and I also want to stress that the social distancing and lockdown regulations were probably the correct measures to contain the problem.

The virus IS different than the influenza virus and because we have not even a partial immunity from previous infections, it is running rampant, Also the health systems in most countries can’t keep up because the infection for a small number of cases is a LOT more severe than any influenza infection in recent years has been.

Also the numbers will grow further, so we could have well over 30,000 deaths from the Coronavirus in Italy alone and that would be well over the 2016/2017 numbers. Every single death means a family will lose a mother, a father, a grandfather or a grandmother or an uncle or aunt. That is sad and very painful and for everyone affected, the statistics are totally irrelevant. But we need to try to lock at the human pain and sorrow separately from the situational assessment that is based on statistics to be able to consider what are the right steps forward.

So after reading all this, what is the advise?

Don’t trust the numbers and don’t let the numbers make you anxious! also be prepared to question the information that is put in front of you by media and politicians!

Accuracy, truthfulness and reliability are minimum requirements to consider what the right next steps are!

Corona Virus, Health System, Media, Overexaggerations, Taoiseach, , , , ,
 
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