Author Archives: Dr. Malcolm Kendrick

About Dr. Malcolm Kendrick

Malcolm Kendrick is a Scottish doctor and author of The Great Cholesterol Con (2008). He has been a general practitioner for over 25 years and has worked with the European Society of Cardiology.

How deadly is COVID19?

17th February 2021

I have spent large chunks of my life trying to untangle medial data and research. COVID19 has long since defeated me. I have been unable to make any sense of the information we are bombarded with daily. So, I decided to go back to basics.

At the start of the COVID19 saga, I was interested to know what the infection fatality rate (IFR) was likely to be. I felt I could then have a go at comparing it to other diseases, primarily influenza.

The infection fatality is the number of people infected with the virus who then die. This is very different to the case fatality rate (CFR), which is the number of people infected with the disease who become unwell enough (sometimes, but not always) to be admitted to hospital – the ‘cases’. Who then die.

Before COVID19 appeared, there used to be a reasonably clear distinction between the infection fatality rate (IFR), and the case fatality fate (CFR) and it is important that they should not get mixed up. Because the case fatality rate is almost always far higher than the infection fatality rate – as you would expect. People who are ill enough to go into hospital are far more likely to die than people who do not suffer any symptoms. Bear this in mind.

Another thing to bear in mind is that, at the start of any epidemic it is simpler to establish the case fatality rate, because most people who are seriously ill end up in hospital and/or will have tests to see if they have the disease in question. Those with no symptoms may never cross the path of a medical professional and are very unlikely to be tested.

What is the ratio between the two? It depends on the virus. With Ebola the infection fatality rate and case fatality rate are closely matched – more than fifty per cent of people who are infected, die. With the common ‘coronavirus’ cold, the spread is far wider, maybe a hundred to one, or a thousand to one – perhaps more.

The fact that most infections are never noted, is one of the reasons why the infection fatality rate for previous flu epidemics can vary so wildly from paper to paper. However, with influenza the CFR/IFR ratio has generally been estimated to be about ten to one. By which I mean that, for each ten infections, one will be severe, and it is amongst the severe infections that you get the deaths.

Armed with such knowledge, and assuming COVID19 had a similar case: infection ratio to influenza you could have a go at working out the infection fatality rate. Always bearing in mind that people with no symptoms, who are not tested, are very unlikely to appear in any figures.

You are always guessing – to some degree or another.  

However, you always know three things:

1: The infection fatality rate must always be lower than the case fatality rate.

2: The case fatality rate will appear to fall as less severely infected people are tested.

3: The infection fatality rate will also appear to fall as more people with no symptoms are found to have had the infection.

For example, in China, at the start of the COVID19 pandemic, the infection fatality rate was reported to be three to four per-cent. This rapidly fell. Then it went up a bit, then it fell, then it went up. Then, everyone started giving different figures. The highly influential Imperial College group, led by Professor Neil Ferguson, decided to use an infection fatality rate of 0.9% for their modelling.

Somewhat later on, John Ioannidis, an influential figure in the world of medical research, estimated the infection fatality rate to be 0.27%. This was a couple of months after the Imperial College figure was published 1.

Peter Gotzsche, who established the highly regarded Nordic Cochrane collaboration, put the figure even lower than this. He looked at a study in Denmark, where blood donors were tested for antibodies. Using these data, the researchers established an infection fatality rate of 0.16% 2. Other figures came in higher, some lower.

The most tested population in the World – per head of population – is Iceland. Last time I looked, Iceland had 6,033 ‘cases,’ and twenty-nine deaths. This represents a case fatality rate of 0.5%, which suggests an infection fatality rate of 0.05% 3.

However, these figures I am quoting from Iceland come from a time after everything changed. At some point, difficult to put an exact date on this, it was decreed that if you had a positive PCR COVID19 test, with or without symptoms, you were to be defined as a case. No matter if you had symptoms, or not. This had the result of making the infection fatality rate, and case fatality rate, the same thing. Suddenly, all cases are infections, and all infections are cases.

Which means that any comparisons of the infection fatality rate with COVID19, and other diseases became virtually meaningless. The infection fatality rate suddenly shot up to match the case fatality rate, which point I gave up trying to work out the infection fatality rate. I doubly gave up when I tried to find out the accuracy of the PCR tests. Were these tests over-diagnosing, or under-diagnosing?

So, I thought I would turn my attention to the population fatality rate instead. That is, how many people has COVID19 killed in a population, or country. This figure is the bald, unvarnished, death rate. It does not, necessarily, tell you how many people have been infected. It does not tell you the percentage of cases, that die. It simply tells you how many people have died… with COVID19 written somewhere on their death certificate. [Or even not written on their death certificate]

At present, in the UK, the total number who have died is one hundred and seventeen thousand. This represents a population death rate of 0.17%. if you knew how many people had been infected, in total, you could work out the infection fatality rate from this. But we don’t know how many people were infected, and now we never will. Because so many people are now being vaccinated. They will show antibodies, and it will not be known if that is because of an infection, or due to vaccination.

So, where to turn to next. If you look at the entire world, the current figure of COVID19 deaths, on the fourteenth of February, stood at 2,406,689 3. Which is a little over one in three thousand, or 0.033%. How many people in the world have been infected? Nobody knows that answer to this question. There are some countries that have done very little testing, others far more.

On the basis that there are so many questions, with very few clear-cut answers, I thought I would try to compare the two point four million figure with previous influenza epidemics.

A study was done in 2016, looking at the influenza epidemic of 1957 – one of the worst in recent history. They extrapolated the mortality figures from 1957 to 2005, because the World’s population doubled during that time period (I am not entirely sure why they chose 2005). Their conclusion was that a flu epidemic of similar magnitude to that of 1957 could kill two point seven million people.

‘In conclusion, our study fills a gap in the availability of global mortality estimates for historical influenza pandemics, which can help guide pandemic planning. Our model extrapolates 2.7 million influenza-related deaths (95% CI, 1.6 million–3.4 million deaths) should a virus of similar severity to the 1957 pandemic influenza A(H2N2) virus return in the 2005 population, which is intermediate between global estimates for the 2009 pandemic (0.3 million–0.4 million deaths and a devastating 1918-like pandemic (62 million deaths; range, 51 million–81 million deaths)’ 4.

Extrapolating onwards to 2020, where the population is significantly greater than in 2005, then the figure from the 1957 epidemic would now be just over three million deaths. Which means that, up to this point COVID19 has been thirty per-cent less deadly than the influenza epidemic of 1957 – per head of population.

If the Imperial College infection fatality rate of 0.9% is accurate, once around eighty per cent of the world’s population has been infected [at which point population wide immunity would be reached] we should see fifty-four million deaths. We are currently nowhere near that figure, and at the current rate of deaths, per year, it will take twenty-two and a half years to reach the fifty-four million figure.

Of course, people will argue that this outbreak is far from over, and millions more will certainly die. Yes, more people will die, but the current number of new cases and deaths is falling pretty rapidly worldwide, rather than rising. We may reach three million, we may not. It is exceedingly hard to believe we would ever have reached fifty-four million even without any vaccines.

So, how deadly is COVID19? It seems, so far, to be equivalent to a bad flu pandemic. Worse than most in recent times. However, it seems to have had an extremely variable impact.

In Singapore, there have been nearly sixty thousand ‘cases’ and twenty-nine deaths. A case fatality rate of around one in two thousand, or 0.02%. The UK has had four million cases and one hundred and seven thousand deaths. A case fatality rate of 3%. Therefore, if you get COVID19 you are one hundred and fifty times more likely to die of it in the UK, than in Singapore 3.

Yes, I went back to basics and the figures still didn’t make any sense.

 

1: https://www.who.int/bulletin/online_first/BLT.20.265892.pdf

2: https://www.bmj.com/content/371/bmj.m4509/rr

3: https://www.worldometers.info/coronavirus/

4: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747626/

Does Lockdown work, or not?

27th January 2021

This blog was published on RT-com, after much discussion and a few changes. It can be seen here  It took a few days. The editors were concerned about the fact-checkers having a go at it and demanding retraction.

We went back and forward. I assured them that all my quoted facts were correct, so the fact-checkers could only attack the ‘opinion’ stated. Which they may well do. If so, fact checkers are no longer checking facts, they are decreeing which scientific opinions are correct, and which are wrong.

Which puts them in a very dangerous place indeed. We do not know who the fact checkers are, we do not know how much they are paid, we do not know what editorial control is exerted over them. We know nothing about them, yet their pronouncements are decreed final on all matters.

This is the recreation of Soviet show trials of another era. “We know you are guilty, you will be found guilty, all that is required of you is that you admit your guilt. We, the judges in this case, however, are subject to no control, no-one can find us in the wrong, or punish us in any way.”

Anyway, the main concerns of Russia Today were that I did not look at enough variable factors. What about population density? What about secondary lockdowns etc. I replied it was impossible to assess all variables fully. I sat and thought about the confounding variables inherent in lockdown, that you would probably need to include in any study on them:

Number of tests carried out
False positives
False negatives
How deaths are recorded/validated
Population density
Percentage of population living in cities [not the same as population density]
Population density within cities
Number of single person households
Average age of population
Age distribution
Percentage of ethnic minorities
Primary ethnicity of population
Number of people with multimorbidity’s
ICU beds per head of population
Time of first lockdown
Time of relaxation of first lockdown
How well lockdown measures were followed.
Time of second lockdown
Restrictions within lockdowns curfews etc.
Test and trace set-up
Vitamin D levels
Northern or Southern hemisphere
Strain 1 COVID
Strain 2 COVID
Strain 3 COVID
Air pollution
Main method of commuting, underground, buses etc.

That’s just for starters.

The total number of interactions between these twenty-seven factors is twenty-seven factorial 27 x 26 x 25….x 3 x 2 x 1

Which is …

10,888,869,450,418,352,160,768,000,000 possible interactions.

So, if anyone says you have not taken the interactions of all variables into account, you can say that this is – effectively – impossible. Perhaps they would like to demonstrate they have done so.

I also pointed out I was not the only person to believe that lockdowns had little, or no effect on transmission rates and death from COVID. Here is part of an article from South Africa, based on the paper ‘COVID-19 in South Africa’

The article was published on Prevention Web:

Lockdown didn’t work in South Africa: why it shouldn’t happen again

By Benjamin T H Smart, Alex Broadbent and Herkulaas MvE Combrink

At the start of October, the World Health Organisation (WHO) and the Chinese government lauded South Africa’s response to the global COVID-19 pandemic. Yet data concerning both the spread of the virus and the indirect consequences of the lockdown suggest that the severe restrictions imposed in South Africa – some of the strictest in the world – were far from effective.

We recently reviewed the evidence for the effectiveness of the lockdown at slowing the spread of the pandemic. The mitigation strategies initially implemented may well have gone some way to “flattening-the-curve” – that is, reducing the rate at which the virus spreads through the population. But we found no decline in either daily new cases or deaths between around 27 March, which was the first day of level 5; and the latter part of July, when cases began to tail off during level 3.

Lockdown level 5 in South Africa was one of the world’s strictest. Citizens weren’t allowed to leave their residence except for essential purposes such as grocery shopping and medical care. All non-essential businesses were shut down, and cigarette and alcohol sales were banned.

If this “hard lockdown” had been effective, the rate of infection would have dropped significantly 7-14 days after lockdown was implemented. Note that one must look for a delay due to the disease’s 5-6 day average incubation period, and time for test results to be released. This simply did not happen.

Of course, the number of cases did increase over time, but what counts is whether the rate of increase changed when lockdowns changed. We found no such changes. As lockdown restrictions were relaxed and South Africa entered levels 4 and 3, when much of the economy re-opened and restrictions on movement were substantially reduced, there was no increase in the rate of infection.

In fact, during level 3, the pandemic peaked. And as the country entered level 2, the pandemic started to recede. If lockdown regulations were having the intended effect, one would expect the rate of infection to spike as restrictions were relaxed. This did not happen…..

Here is the article that first appeared in RT-com:

The scientific evidence so far on COVID lockdowns suggests that they don’t work – and may actually increase the death rate

We are being told that lockdowns halt the spread of the infection, but where’s the proof? The places with the worst death rates all followed that path – and the ones who didn’t have generally fared better. 

‘Paradoxically, human beings, when compelled to act, learn to justify a chosen course with an assurance unwarranted by the evidence for the course chosen.’ Bernard Lown.

I have studied the history of medicine, and medical interventions, for many years. The most extreme disasters have always followed a fairly distinct pattern. A series of steps, if you like.

Step one = we have a serious disease that is killing lots of people.

Step two = it creates great fear, and the medical profession has nothing much in place to deal with it.

Step three = a charismatic leader emerges to decree that he (almost always a ‘he’ up to now) knows how to treat it/control it, etc. This is ‘the idea’.

Step four = The ‘idea’ is enthusiastically taken up around the world and becomes mainstream thinking.

Step five = the ‘idea’ becomes standard practice.

Step six – the ‘idea’ is taught to medics and becomes accepted truth, a fact.

Step six = anyone who goes against the ‘idea’ is ruthlessly attacked.

There is always, of course, the possibility that the ‘idea’ is the best thing to do. This happens from time to time. However, there seems to be little or no correlation between the enthusiasm, and speed, with which ideas are taken up, and the likelihood they are correct.

The problem, as I came to recognise, lies between step two and step four. By which I mean that a charismatic figure convinces everyone that they have the answer, before there is any evidence to support it. The person may not be charismatic, simply someone who has the ability to grab attention and push the ‘idea’ forward. Such as the Chinese Premier.

Another thing that leads to disaster, which is perhaps of even greater importance, is that the ‘idea’ must sound like the most obvious common sense. It should trigger a response along the lines of ‘Yes, of course, that sounds perfectly reasonable’. Once that’s been achieved, the ‘idea’ drops neatly into people’s minds, settles down, and grows roots, creating not a ripple of cognitive dissonance.

At which point it cements itself in, and becomes difficult, even painful, to remove.

To quote the film Inception: ‘What is the most resilient parasite? Bacteria? A virus? An intestinal worm? An idea. Resilient… highly contagious. Once an idea has taken hold of the brain it’s almost impossible to eradicate. An idea that is fully formed – fully understood – that sticks; right in there somewhere.’

We love ideas, they make us who we are. We defend them, sometimes with our very lives.

“Why do people insist on defending their ideas and opinions with such ferocity, as if defending honour itself? What could be easier to change than an idea?” J.G. Farrell.

So, yes, I have no illusions about the strength of ideas. They are so powerful, and so dangerous that you must be very careful where you aim them. Because ideas also have a God-like power, which is that they are immortal.

The damage inflicted by medical ideas

You can kill a person who holds an idea. You can kill thousands of people who hold the same idea – but you cannot kill that idea. Unless you kill every single person who believes in it, then wipe it from the historical record, so that no-one can ever think it again. See 1984.

I will give you a couple of examples of horribly damaging medical ideas. The first is the radical mastectomy. An idea first driven by William Halsted, a US surgeon from the end of the nineteenth century. He believed, as did almost everyone else at the time, that breast cancer spread locally – as did all cancers. Therefore, anything located anywhere near the cancer had to be cut away in case it had already been polluted.

With a radical mastectomy the entire breast, the other breast, muscles on the chest wall, lymph nodes, more muscles were cut out. Almost anything that could be removed without actually killing the women in the process.

The mutilated women were immensely grateful, and the surgeons proud of their expertise. They were doing a good thing, because the idea was considered to be inarguably correct. Questioning it was to be met with the response like, ‘Do you want these women to die – you heartless swine?

Except that it wasn’t correct. Breast cancer does not spread locally. At least, when it does, it does so very slowly. The spread that causes problems, and kills women, is not local. Cancer cells get into the lymphatic system, and the bloodstream, and spread widely around the body, very early on. Often, long before the primary cancer can be detected.

Those who questioned the radical mastectomy, were attacked. Geoffrey Keynes, brother of John Maynard, tried less radical surgery in the 1920s. It did not go down well:

‘Halsted’s followers in America ridiculed this approach, and came up with the name “lumpectomy” to call the local surgery. In their minds, the surgeon was simply removing “just” a lump, and this did not make much sense. They were aligning themselves with the paradigm of Radical Mastectomy. In fact, some of the surgeons even went further to come up with “superradical” and “ultraradical” procedures that were morbidly disfiguring procedures where the breast, underlying muscles, axillary nodes, the chest wall, and occasionally the ribs, part of the sternum, the clavicle and the lymph nodes inside the chest were removed. The idea of “more was better” became prevalent.’

More is better… this is another of the deadly repeating themes of ‘the idea.’ The idea can never be wrong, it is just that people are not doing with sufficient vigour. If women are still dying from metastatic breast cancer, even after radical mastectomies (and they were), the answer could not possibly be that the procedure doesn’t work. The answer is that we are not being radical enough: ‘Hack away more, and then more.’

 ‘I was greeted with hands stretched out in a Nazi salute’

Another big medical idea is that of bed rest following a heart attack. It was thought, at one time, that all heart attacks were fatal. James Herrick, another US doctor, described the first non-fatal heart attack in 1912, then suggested that following such an attack, strict bed rest was important. This would take pressure off the heart and allow it a chance to heal. Again, this sounds perfectly reasonable. As described by Dr Bernard Lown, a professor of cardiology and the developer of the  defibrillator:

“To a medical novice like me, the justification for enforced bed rest was persuasive. It was based on a sacrosanct therapeutic principle, the need to rest a diseased body part, be it a fractured limb or a tuberculosis-affected lung. Unlike a broken bone, which could be immobilized in a cast, or a lung lobe, which could be collapsed by inflating the chest cavity with air, the heart could not be cradled into quietude. The only approximation for a diseased heart was to diminish its workload. It was long known that during recumbency the heart rate slows and blood pressure drops, both indices of less oxygen usage and therefore of decreased cardiac work. Heart rest was therefore equated with bed rest.”

And so it became standard practice. It was simply what you did:

“Patients were confined to strict bed rest for four to six weeks. Sitting in a chair was prohibited. They were not allowed to turn from side to side without assistance. During the first week, they were fed. Moving their bowels and urinating required a bedpan. For the constipated, which included nearly every patient, precariously balancing on a bedpan was agonizing as well as embarrassing.

“Because world events might provoke unease, some physicians prohibited their patients from listening to the radio or reading a newspaper. Visits by family members were limited. Since recumbency provoked much restiveness and anxiety, patients required heavy sedation, which contributed to a pervasive sense of hopelessness and depression. Around one in three patients died.”

Bed rest started as a relatively mild thing. However, as it is with almost all things, it became increasingly ‘radical’. Lown, along with his mentor Dr Samuel Levine, tried to change this. He became involved in trying to get patients up out of bed to sit in a chair:

“Little did I realize that violating firmly held traditions can raise a tsunami of opposition. The idea of moving critically ill patients into a chair was regarded as off‑the‑wall. Initially the house staff refused to cooperate and strenuously resisted getting patients out of bed. They accused me of planning to commit crimes not unlike those of the heinous Nazi experimentations in concentration camps. Arriving on the medical ward one morning I was greeted by interns and residents lined up with hands stretched out in a Nazi salute and a “Heil Hitler!” shouted in unison.”

Step six = anyone who goes against the ‘idea’ is ruthlessly attacked

No evidence, no problem

Then, among all the other problems with ‘the idea’, between steps two and three, is one that I have not yet mentioned. It is that no study is ever done to find out if the idea works, or not. It is just conceived to be so obviously beneficial, such common sense, that there would be no point in wasting time and resources trying to prove it works.

No-one ever did a study to find out if the radical mastectomy improved survival. No-one ever did a study to prove that bed rest saved lives. They were both introduced on the back of absolutely nothing. In time, eventually, the folly of both was finally recognised. It took seventy years for radical mastectomy, fifty for bed rest.

Which takes us to lockdowns. The most expensive, invasive, and potentially destructive medical intervention ever attempted by humanity.  Was there any evidence from anywhere, in history, that lockdowns would work? No, there was none. But we have the six steps on full display here.

Step one = we have a serious disease that is killing lots of people – check.

Step two = it creates great fear, and the medical profession has nothing in place to deal with it – check.

Step three = a charismatic leader emerges to decree that he (almost always a ‘he’ up to now) knows how to treat it/control it etc. This is the ‘idea’ – check.

Step four = The ‘idea’ is enthusiastically taken up around the world and becomes ‘mainstream thinking’ – check.

Step five = the ‘idea’ becomes standard practice – check.

Step six – the ‘idea’ is taught to medics and becomes accepted truth, a fact – check.

Step six = anyone who goes against the ‘idea’ is ruthlessly attacked – check.

Does it work – have lockdowns worked? You can pick and choose countries to support the case that it does and dismiss any evidence you don’t much like. Unfortunately, once you introduce a medical intervention that affects everyone, everywhere, you have lost the possibility of carrying out a controlled experiment of any sort.

Despite the lack of any randomised evidence, most people are absolutely convinced that lockdowns work to control the spread of COVID-19. They point to various countries, e.g. New Zealand, Norway, Australia and Taiwan, to prove their case. They always have a ready explanation as to why countries that underwent lockdown still have high death rates and vice-versa.

The ‘idea’ has become the truth. Its proponents now demand that those who doubt the efficacy of lockdowns prove that they don’t work. However, I don’t believe it’s up to those who don’t believe that lockdowns work, to prove that case.

The starting point, for any scientific hypothesis, is for the proponents to disprove the null hypothesis. Demanding that those who believe something may not work, to prove that it doesn’t, is to turn the scientific method upside down. You can never prove a negative.

The null hypothesis, by the way, is that there is no difference between two things. Randomised Controlled Trials (RCTs) in medicine are designed to prove, statistically, that there is an actual difference between doing A or B. This is how science is done, how research is done.

We must look carefully at the death rates

Unfortunately, it is not possible to do a controlled trial with COVID-19. The possibility of doing any randomised study was lost very early on. Which means that we are forced to rely, instead, on observational studies. We can look at country X, that did Y, and see how it compares with country Z that did not do Y.

Or we can look at two countries that did Y, to see how they compare. Or two countries that did not do Y. With COVID, of course, no two countries did exactly the same thing. Not even the four ‘countries’ within the UK. So any observations become more difficult to rely on due to this ‘confounding variable’.

In some UK countries, six people could meet up, in others it was eight, or two households, or only one household etc. In some, restaurants were open, in others they were shut – at varying times. From a scientific perspective, it’s a mess.

Anyway, to simplify things, let’s look at the 10 countries around the world with the highest death rate from COVID. That is, deaths per million population (I have left out countries with population of less than one million, such as Monaco, or Liechtenstein, or Andorra because a few deaths here or there can distort the death rate considerably)

What did they do differently, what did they do the same? Looking only at first lockdown dates:

Belgium first locked down on March 18th, 2020.

Slovenia first locked down on March 20th, 2020.

Czechia first locked down on March 16th, 2020.

The UK first locked down March 23rd, 2020.

Bosnia-Herzegovina first locked down March 16th, 2020.

Italy first locked down March 9th, 2020.

North Macedonia first locked down March 18th, 2020.

The USA is highly federal and different states took different approaches – seven states did not issue lockdown orders: Arkansas, Iowa, Nebraska, North and South Dakota, Utah, and Wyoming. In those seven states the death rate from COVID averaged at 1,280 per million vs. 1,254 as the US average.

In comparison, New Jersey first locked down March 21st, 2020, and its current death rate is 2,310 per million. New York locked down on March 12th – its current death rate is 2,130 per million. These states have the highest COVID related deaths in the US.

Bulgaria first locked down on March 13th, 2020.

Hungary first locked down on March 28th, 2020.

All countries locked down, Italy first, Hungary last.  As you can see, the date of first lockdown is unrelated to the death rate. The other stand out facts are that these are all ‘European’ countries. All with majority Caucasian populations. They are all in the Northern hemisphere.

If I were thinking of running a clinical trial where the hypothesis was that a lockdown was the best way to prevent deaths from COVID, then I would start by looking at observational data such as this.

I would find that the ten countries in the world with the highest death rates all locked down at similar times, with similar restrictions.

I would look at the US where the death rate in states that locked down, and those that did not, were almost the same rate (or vastly higher in the cases of New Jersey and New York), and I would conclude that the observational studies had – thus far – failed to disprove the null hypothesis. In fact, the evidence up to this point could suggest that lockdowns may actually increase the death rate.

In short, I would look for another idea.

What is left to say?

30th December 2020

I have not written much about COVID19 recently. What can be said? In my opinion the world has simply gone bonkers. The best description can be found in Dante’s Inferno, written many hundreds of years ago.

In it, Dante describes the outcasts, who took no side in the rebellion of angels. They live in the vestibule. Not in heaven, not in hell, forever unclassified. They reside on the shores of the Acheron. Naked and futile, they race around through a hellish mist in eternal pursuit of an elusive, wavering banner, symbolic of their pursuit of ever-shifting self-interest.

I find this description of the desperate pursuit of an elusive wavering banner rings rather true. This, it seems, is pretty much the place we have arrived at. Which banner have you decided to follow?

The ‘COVID19 s the most terrible infection ever, and we must do everything in our power to stop it, whatever the cost’ banner.

Or the ‘What on earth are we doing? This is no worse than a bad flu, and we are destroying the world economy, stripping away basic human rights and killing more people than we are saving’ banner.

There may be others.

Between these two, main, completely incompatible positions, lies the truth. It is in pretty poor shape. It has been crushed, and bent out of shape, smashed, and left as a broken heap in the corner. I search where I can, to find the fragments, in an attempt to bring together a picture that makes some kind of sense.

But what to believe? Who to believe?

I feel somewhat like Rene Descartes. In order to find the ineluctable truth he scraped everything away until he was left with ‘Cogito, ergo sum’. ‘I think, therefore I am.’

I have stripped away at the accuracy of PCR COVID19 testing. I found myself left with nothing I could make any sense of. I hacked down to establish the way that COVID19 deaths are recorded. All I found were assumptions and difficulties.

Did someone die with COVID19, of COVID19 – or did it have absolutely nothing whatsoever to do with COVID19? Who knows? I certainly don’t, and I wrote some of the death certificates myself.

Have we overestimated deaths, or underestimated deaths? I do not know … and so it goes on.

So, what do I know? I know that COVID19 exists – or I am as certain of this as I can be. Was it a natural mutation from a bat, or was it created in a laboratory? Well, I suppose it doesn’t really matter. It’s here, and there is no chance that any Government, anywhere, would ever admit responsibility for creating the damned thing. So, we will never know. If you asked me to bet, I would say it was created in a lab, then escaped by accident.

Is it deadlier than influenza? Well, it is certainly deadlier than some strains of influenza. Indeed, most strains. However, Spanish flu was estimated to have killed fifty million, when the world’s population was about a fifth of what it is now. So, COVID19 is definitely less deadly than that one. About as deadly as the influenzas of 1957 and 1967. Probably.

Will it mutate into something worse? Who knows.

Will the current vaccines work on mutated strains? Who knows.

Can it be transmitted by asymptomatic carriers? Who knows.

How effective are the current vaccines going to be? Who knows.

What are we left with?

At the beginning, I kept relatively quiet on how deadly COVID19 would prove to be. Because I didn’t know. The figures raged up and down. The infection fatality rate become a battle scene, with warriors lined up on either side to defend their positions.

I even got attacked by factcheckers, the self-appointed know-it-alls who are, it seems, capable of judging on all matters of scientific dispute. Truly, the Gods have descended to live amongst us. Those who can determine what is true, and what is not. No need for any further clinical trials, or any more scientific studies of any sort, ever. We just need to ask the Fact Checkers for the answer, to any given question.

Anyway, it appeared that tens of thousands died in some countries, almost none in others. What I was waiting to see, was the impact on the one outcome that you cannot alter, or fudge. The outcome that is overall mortality i.e. the chances of dying, of anything.

I did this because, when it comes to recording deaths from a specific illness, things can go in and out of fashion. A couple of years ago I looked at deaths from sepsis. At one time this was a condition of far lower priority. Doctors didn’t routinely search for it, or routinely record it, on death certificates.

Sepsis is an infection that gets into the blood, toxins are released, and people die. Everyone knew it happened. Or at least I hope they did.

Then, all of a sudden, there was a gigantic push to look for it more diligently, diagnose it more, treat it better. I think this was generally a good thing. Sepsis is eminently treatable, if you think to look for it, and lives can be saved. We now have initiatives like ‘Sepsis six’ and warnings that pop up on computers. ‘Have you considered sepsis,’ and suchlike. I love it … not. Because I do not love being told how to think, and do my job, by a computer algorithm programmed with ‘zero risk’ as their touchstone. But, hey ho.

In 2013, in the UK, a report was published by the health ombudsman ‘Time to Act – severe sepsis, rapid diagnosis and treatment saves lives.’ As the report stated.

‘Sepsis is a more common reason for hospital admission than heart attack – and has a higher mortality.’ The UK Sepsis Trust 1

That last statement is somewhat disingenuous, as many people with sepsis are very elderly, often with multiple morbidities, and suchlike. They were probably going to die, shortly, from something else.

Anyway. With all this activity, with all this increased sepsis recognition and treatment, you would expect the rate of deaths from sepsis to fall. It did not. The rate has gone up, by around 30% since 2013. Does this mean there is far more sepsis going about? Or, that it is just more often written on death certificates? I suggest the latter. I use this example, simply to make it clear that even the cause of death written on a death certificate is far from rock solid evidence.

With COVID19, this is a massive problem. In the UK, and several other countries if you have had a COVID19 positive test (which may, or may not, be accurate) and you die within twenty-eight days of that positive test, you will be recorded as a COVID19 death. I do not know much for sure about COVID19, but I do know that is just complete nonsense.

There are so many cases where – even if the COVID19 test was accurate – COVID19 would have had nothing whatsoever to do with the death. Another thing known, or at least we probably know, is that the vast majority of people who die had many other things wrong with them.

In the US, the Centre of Disease Control (CDC) found that ninety-four per cent of people who died of COVID19 ‘related deaths’ had other significant diseases (co-morbidities) 2.  This ninety-four per-cent figures would only be the co-morbidities that were known about – who knows what lurked beneath? Especially as people stopped doing post-mortems (i.e., autopsies in the US).

So yes, they had COVID19 (or at least they had a positive test – which may not be the same thing), but they were often very old, and already severely ill. Using an extreme example, someone with terminal cancer who is a week from death, catches COVID19 in hospital, and dies. What killed them? The statistics say COVID19. I say, bollocks.

When I started in medicine, ‘bronchopneumonia’ (a bad chest infection) used to be known as the ‘old man’s friend.’ For those who were very old, and frail, often demented, lying in care homes, often incontinent, a chest infection represented a reasonably painless way to die.

Very often we would not actively treat it, instead we allowed for a peaceful death. Indeed, this still happens. Less so now, as someone, somewhere, often a relative from a country far, far, away – who has not visited for years – is far more likely to sue you.

Did they really die of bronchopneumonia? You could argue yes, you could argue no. Yes, it was the thing that finally pushed them over the edge. No, they were already slowly dying as their body gave out. In the end, what does anyone actually die of? My Scottish grannie, who lived to one hundred and two, used to say ‘they die frae want of breath.’ Entirely accurate, but, alas, also completely useless.

So, what you need to do, is look beyond what is written on death certificates. You need to look at what is happening to the overall mortality. Whilst you can argue endlessly, pointlessly, about specific causes of death. What you cannot argue about is whether or not someone is alive, or dead. Even I usually get this one right. No pulse, no breathing, no reaction of the pupils to light, no response to pain… and suchlike. Yup, dead. Now… what they die of? Um… let me think.

Thus, I have tended to look to EuroMOMO. The European Mortality Monitoring project. As they say, of themselves:

‘The overall objective of the original European Mortality Monitoring Project was to design a routine public health mortality monitoring system aimed at detecting and measuring, on a real-time basis, excess number of deaths related to influenza and other possible public health threats across participating European Countries.

Mortality is a basic indicator of health. Therefore, understanding its epidemiology is fundamental for effective public health planning and action.

Mortality monitoring becomes pivotal during influenza or other pandemics for several reasons. In a severe pandemic, mortality monitoring can be a robust way to monitor the pandemics progression and its public health impact when other systems are failing, due to an overburdened health care sector. Decision makers will require data on the pandemics impact and on deaths by age and geographical area in various stages of the pandemic. Mortality monitoring can provide such estimates, which will be important to guide and prioritize health service response and decision-making, i.e. use of antivirals and vaccines.’ 3  

Here are the data that you can therefore, pretty much, fully rely on. It is where I go to see what is really happening across Europe. Not all of Europe, as some countries do not participate. However, there are more than enough, to get a good picture. It encompasses key countries such as Spain, Italy, the UK (split into four separate countries), Sweden and suchlike.

Here is the graph of overall mortality for all ages, in all countries. The graph starts at the beginning of 2017 and carries on to almost the end of 2020.

As you can see, in each winter there is an increase in deaths. In 2020, nothing much happened at the start of the year, then we had – what must have been – the COVID19 spike. The tall pointy bit around week 15.

It started in late March and was pretty much finished by mid-May. Now, we are in winter, and the usual winter spike appears. It seems to be around the same size as winter 2017/18. It also seems to have passed the peak and is now falling. But it could jump up again. [The figures in the most recent weeks can always be a bit inaccurate, as it can take some time for all the data to arrive]

Two things stand out. First, there was an obvious ‘COVID19 spike’. Second, what we are seeing at present does not differ greatly from previous years. The normal winter spike in deaths.

If we split this down into individual countries, this reasonably clear pattern falls apart.

Here are the figures from England

Unlike the first graph, the scale on the left is not absolute numbers. It is a thing called the Z-score. Which means standard deviation from the mean. Sorry, maths. If the Z-score goes above five, this means something significant is happening. The red, upper, dotted line is Z > 5. As you can see, despite the howls of anguish from England about COVID19 overwhelming the country, we are really not seeing much at all.

What of Sweden, that pariah country? They did not fully lock-down, the irresponsible fools (all they did was follow WHO guidance – by the way), and we are now told they are suffering terribly, they should have enforced far more rigid lockdown, their ‘experiment’ failed etc. etc. COVID19 shall have its vengeance. Or to quote Arnie – I’ll be back.

As you can see, nothing much happening in Sweden either.

Then, if you look further, there are anomalies all over the place. Northern Ireland, which is part of the UK, and did exactly the same things as the rest of the UK with regard to lockdown, masks etc. At least it did in the earlier part of the year. However, it shows a completely different pattern to England. Or, to be fully accurate, it shows no pattern at all. No waves, and nobody drowning.

What of Slovenia?

As you can see absolutely nothing happened earlier in the year in Slovenia. Now, it has the biggest spike of all – apart from, maybe, Switzerland. Earlier in the year it was held up as a great example of how brilliantly effective masks were. Now… you don’t hear so much about masks. Maybe masks only work in months beginning with M. [Maybe, whisper it, they don’t work at all].

So, what have I learned from euroMOMO? First that it appears to have made absolutely no difference if a country locked down hard, and early, or did not. Everyone points at Norway and Finland as examples of great and early government action, and how wonderful everything would have been if we had done the same.

Well, look up at Northern Ireland. Then look at Finland

Spot the difference. There is none.

Of course, much of the most heated debate surrounded what happened during the so-called first wave. Who dealt with it well, or badly. Now, everyone in Europe is doing much the same things. Lockdown, restrictions on travel, restrictions on meeting other people, everyone wearing masks, etc. etc. Yet some countries are having a new wave, and others are not.

There is a special prize for anyone who can match up the severity of restrictions in various countries, to the Z-score. I say this, because no correlation exists.

So, again, what have I learned about COVID19? I learned that all Governments are floundering about, all claiming to have exerted some sort of control over this disease and ignoring all evidence to the contrary. In truth, they have achieved nothing. As restrictions and lockdowns have become more severe, in many cases the number of infections has simply risen and risen, completely unaffected by anything that has been done.

The official solution is, of course, more restrictions. ‘We just haven’t restricted people enough!’ Sigh. When something doesn’t work, the answer is not to keep doing it with even greater fervour. The real answer is to stop doing it and try something else instead.

I have also learned that, in most countries, COVID19 appears to be seasonal. It went away – everywhere – in the summer. It came back in the autumn/winter, as various viruses do.

On its return is has been, generally, far less deadly. Much you would expect. The most vulnerable died on first exposure, and far fewer people had any resistance to it, at all. Now, a number of people do have some immunity, and may of the vulnerable are already dead.

Which means that, in this so-called second wave COVID19 is of no greater an issue than a moderately bad flu season.

If I were to recommend actions. I would recommend that we stop testing – unless someone is admitted to hospital and is seriously ill. Mass testing is simply causing mass panic and achieves absolutely nothing. At great cost. We should also just get on with our lives as before. We should just vaccinate those at greatest risk of dying, the elderly and vulnerable, and put this rather embarrassing episode of mad banner waving behind us.

Hopefully, in time, we will learn something. Which is that we should not, ever, run about panicking, following the madly waved banners… ever again. However, I suspect that we will. This pandemic is going to be a model for all mass panicking stupidity in the future. Because to do otherwise, would be to admit that we made a pig’s ear of it this time. Far too many powerful reputations at stake to allow that.

1: https://www.ombudsman.org.uk/sites/default/files/Time_to_act_report.pdf

2: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm?fbclid=IwAR3-wrg3tTKK5-9tOHPGAHWFVO3DfslkJ0KsDEPQpWmPbKtp6EsoVV2Qs1Q&_ga=2.83596054.1497558416.1598967201-386365132.1598967194#Comorbidities

3: https://www.euromomo.eu/about-us/history/

The case for Keto – a review

9th December 2020

Gary Taubes has a new book out called ‘The Case for Keto,’ which he sent to me in the form of a real book with real pages, that he wanted me to read. Which I have.

I then suggested I should do a review and stick it up on my blog. I shall say, right up front, that I strongly recommend this book.

This may not be a surprise to those who know my thoughts on diet, heart disease and suchlike. In my case Gary is preaching to the converted. This is a book which covers the fact that fats, saturated fats, indeed any fats (other than trans-fats, and the industrially produced fats from grains) are perfectly healthy. Humans have eaten them for millennia.

You don’t see cave paintings of early humans out scything autumn wheat fields. No, you see pictures of men, because men always get the easy jobs, chasing woolly mammoths with spears. They are not just taking the mammoths out on early morning exercise, and throwing the spears to play catch. They are throwing those spears at the mammoths, and chasing them into spike filled pits, then eating them – saturated fats and all.

Anyway, as Gary makes very clear, despite the endless claims that animal fats are bad for us, when you get down to it, the evidence simply does not exist. The idea that fats make us fat and diabetic and kill us with heart disease is simply a ‘meme.’

An idea so widely held that everyone just believes it must be true. So much so that there is no need to even think about it. Fat gets into your body, floats about and gets stuck to your artery walls. Fat, cholesterol, same thing innit? ‘My mind is made up, don’t confuse me with facts.’

I think I should mention that Gary first gained considerable fame in this area with his book ‘Good Calories, Bad Calories.’ In the UK and Australia, it was called. ‘The Diet Delusion.’ This is where he first looked at the idea that fats were bad for us and found it to be based almost entirely on hot air.

So, if it is not fat in the diet that is capable of causing weight gain, diabetes, heart disease, and other such nasty things, what is it? As Gary points out clearly, and inarguably, the answer is sugar. By sugar, he means carbohydrates (all sugars are just simple carbohydrates).

Slightly more complex carbohydrates are bread, and pasta, and rice and potatoes. These are just made up of lots of glucose molecules stuck together. Many people are unaware that our body takes in pasta, bread, rice etc. and simply breaks them down into sugar. So, pasta = sugar. Bread = sugar. Potatoes = sugar. Just as much as sugar = sugar. They all have the same effect.

Gary goes through the history of the brave individuals who have been those pointing out the damage that can be caused by excess carbohydrate intake for decades. Those who have been squashed flat by the mainstream. An English professor of nutrition, John Yudkin, tried to make this all clear in his book on sugar(s): ‘Pure, white and Deadly’ first published in the early 1970s. He was attacked and shouted down by Ancel Keys – the main promoter of the diet/heart hypothesis.

Gary maintains a calm and reasonable tone when discussing some of these events. Which is admirable. If I were him, I would be breaking the furniture, and chewing the curtains. He also calmly points out where the evidence is strong, and where it is weak, or where it does not exist at all. He does not overclaim, nor suggest that cutting down on carbs is a panacea that will benefit everyone. It is the calm reasonable tone that is actually most impressive. He knows his stuff, and he lays it out carefully and clearly.

What of the title of the book itself? ‘The case for Keto.’ For those who know this area ‘Keto’ is the metabolic state achieved when the body stops using sugar for energy and starts to break down the stored fats instead. These stored ‘fatty acids’ are converted to molecules known as ketone bodies in the liver. The body is perfectly happy to use them for energy. This is ‘ketosis’. Explaining the title of the book.

Many people think ketones are the preferred energy source for most organs in the body. Virtually the only exception being some processes in the brain, that require glucose, and only glucose, to function.

The downstream benefit to entering ketosis is that, when you burn up fats and ketones, you are also using up your “energy stores” aka fat. So, once you stop burning glucose, and start using ketones, you can finally lose weight. Also, your blood glucose levels fall, your insulin levels fall, and the body has a chance to reset itself.

Gary has spoken to many, many doctors and researchers who are now absolutely convinced that the best way to prevent, even reverse, the wave of obesity and diabetes sweeping the modern world is to change from eating carbohydrates and eat more fats. I agree with him. If you read this book, I believe you will agree with him too. He makes a compelling case. It is the Case for Keto.

A YouTube interview you may want to listen to

28th November 2020

This YouTube interview is me, speaking to Ivor Cummins, and discussing many things COVID. Lockdown, the weird statistics, the absolute lack of any real science, the crushing of dissent, and suchlike.

I have known Ivor for years, as he has been a long-term critic of the dietary guidelines, and a fervent supporter of the low carbohydrate high fat (LCHF) diet as a way of treating type II diabetes.

I find it interesting that many of the people I know who are critical of the mainstream thinking on diet and heart disease also find themselves critical of the mainstream response to COVID. I like to think this means we are all highly intelligent, with a clear understanding of the scientific method. Maybe we are all just stroppy buggers, who like a bit of controversy. I think that is for others to decide.

Anyway, the interview is on YouTube, and can be found here

Stamping on the ‘anti-vaxxers’ – a very stupid idea

17th November 2020

The COVID19 pandemic has thrown into sharp relief the concerns that a number of people have about vaccination. However, such is the eagerness to develop a vaccine, and get everyone to take it, that authorities are now looking to ban anyone who raises doubts. For example, the Labour Party in the UK is now calling for emergency ‘anti-vaccine’ laws:

‘Emergency laws to “stamp out dangerous” anti-vaccine content online should be introduced, Labour has said. The party is calling for financial and criminal penalties for social media firms that do not remove false scare stories about vaccines.

It follows news of progress on the first effective coronavirus vaccine. The government said it took the issue “extremely seriously” with “a major commitment” from Facebook, Twitter and Google to tackle anti-vaccine content.’ 1

There are so many things that could be said about this, that it is difficult to know where to start. Or to finish. I think in this blog I am just going to stick to focussing on a single issue. Which is that, if the intention of such laws is to ensure more people are keen to be vaccinated then I have news for the Labour party.

It will almost certainly backfire.

This is because state censorship does not change minds, never has. Whilst debate, at least superficially, has been silenced, the concerns do not disappear. Instead, the doubts are often redoubled. Once you start banning and censoring and fining and arresting, people start to wonder if you are just afraid to make your case. As Wendell Phillips said, and many people think:

‘He who stifles free discussion, secretly doubts whether what he professes to believe is really true.’

Once censorship starts, people are also reminded of the worst, most dreadful periods in history the world has even seen. It has always been one of the primary tools of totalitarian regimes:- Nazi Germany, Russia under Stalin, North Korea, China and Iran today.

One of the greatest books of the twentieth century is George Orwell’s 1984. It is a book mainly concerned with how facts, and truth, are tightly controlled by the party.

‘And if all others accepted the lie which the Party imposed — if all records told the same tale — then the lie passed into history and became truth.’

Of course, Orwell was not the first to notice the critical importance of freedom of speech

‘Liberty is meaningless where the right to utter one’s thoughts and opinions has ceased to exist. That, of all rights, is the dread of tyrants. It is the right which they first of all strike down. They know its power. Thrones, dominions, principalities, and powers, founded in injustice and wrong, are sure to tremble, if men are allowed to reason of righteousness, temperance, and of a judgment to come in their presence.’ Frederick Douglass

‘Freedom of speech is a principal pillar of a free government; when this support is taken away, the constitution of a free society is dissolved, and tyranny is erected on its ruins. Republics and limited monarchies derive their strength and vigor from a popular examination into the action of the magistrates.’ Benjamin Franklin.

Deep down we all know this. We know that this essential freedom – to say what you really believe to be true – is the essential pillar of any free society. It carries a cost, of course it carries a cost. People say stupid things, people say wrong and misguided things. They can be damaging things, but the alternative will always be much worse in the end.

I say this because people also say things that, whilst angrily dismissed at the time as dangerous foolishness, are later found to have been correct all along. I have spent many years looking at the history of medical science (if that is not, at times, an oxymoron). I have seen many activities considered to be of inarguable benefit, turn out to be indefensible malpractice.

Bernard Lown is, I think, my number one medical hero. His motto ‘Do as much as possible for the patient, and as little as possible to the patient.’

As he also said:

‘From my earliest days in medicine, I have struggled against the prevailing model of health care. My opposition in part was provoked by the growing prevalence of overtreatment. Resorting to excessive interventions seemed to be the illegitimate child of technology in the age of market medicine.’ 2

He tells a tale from the 1950s where the orthodoxy of the time was to ensure strict bed rest following a heart attack. In the face of considerable hostility, he and his mentor, Dr Samuel Levine allowed patients to sit up in a comfortable chair at the end of the bed. Shock horror. In his own words:

‘The idea of moving critically ill patients into a chair was regarded as off‑the‑wall. Initially the house staff refused to cooperate and strenuously resisted getting patients out of bed. They accused me of planning to commit crimes not unlike those of the heinous Nazi experimentations in concentration camps. Arriving on the medical ward one morning I was greeted by interns and residents lined up with hands stretched out in a Nazi salute and a “Heil Hitler!” shouted in unison.’  3

Heil Hitler indeed. An almost perfect irony, I suppose.

It turns out that strict bed rest was absolutely and completely and totally the worst possible single thing you could do. I estimated, some years ago, that this action resulted in the premature death of around one hundred million people, worldwide. It could well have been more.

I imagine the ‘Heil Hitler’ shouting interns and residents would have happily endorsed censorship of any criticism of strict bed rest … for the good of society, no doubt.

Of course, had this happened, we would probably still be enforcing strict bed rest to this very day. Once a treatment becomes ‘standard practice’, there is no longer anything else against which to compare it, so you have no idea if it is beneficial, or harmful. That is what happens when you ban freedom of thought, and speech.

Leaving aside the principle that freedom of speech is our single most important freedom and must be handled with exquisite care. If we crush dissent, we also crush progress. Stupid ideas will, in the end, be shown to be stupid. Nonsense will be exposed as nonsense. However, if no criticism allowed, stupid ideas that are widely believed to be true, cannot be challenged and we will be stuck – forever.

I think most people recognise this truth. I also think most people, when they see things being banned and censored … wonder why. You immediately raise doubts. Why are they doing this, are they attempting to hide something? You will not convince anyone, ever, by censoring them, or shutting them up. You will, instead, make them more certain that you are hiding something, and that they are right.

Censorship always hardens attitudes; it does not change minds. Anti-vaxxers (whatever that stupid deliberately demeaning term means) will become more anti-vaxx. Discussion will be driven underground. Heroes and martyrs will be created. You will have done the exact oppositive of what you hoped to achieve.

You don’t win arguments by clubbing people into submission. All you do is silence them and redouble their determination.

1: https://www.bbc.co.uk/news/uk-politics-54947661

2: https://myheartsisters.org/2019/11/17/bed-rest-overtreatment-dr-bernard-lown/ 3: https://bernardlown.wordpress.com/2011/02/03/a-chair-to-the-rescue/

3: https://bernardlown.wordpress.com/2011/02/03/a-chair-to-the-rescue/

Ninety per cent

10th November 2020

‘Ladies and gentlemen, roll-up, roll-up, roll-up. My new product, just brought to the market this very day, prevents ninety per-cent, yes ninety per-cent of all known things happening to you. Yes, a remarkable ninety per cent. Not sixty per cent, not seventy per cent, no…not even eighty per cent. But ninety of your finest American per cent – of things’.

‘What is a thing, madam? What a very good question, and by the way your child is a most beautiful young girl, is she not. And your hair, someone did a most fantastic job on that. You must have paid a fortune for such magnificent styling… you sir.’

‘You are asking how much it costs. Cost sir, now cost doesn’t come into it. I can promise that I will never make a penny from selling this product, this year…. Not a penny, as I promise on my mother’s grave sir, my mother’s grave.’

‘Lady at the back there what was that …you say that my mother is still alive, you met her for coffee last week. Gracious, she does get about doesn’t she.’

‘Back to you sir. Cost, this product .. it does have to be kept at a very low temperature, so valuable is it sir. The cost of the refrigeration unit. Now, that is pricey sir very pricey.  Pricey indeed.

‘How pricey sir. I can tell you are a very clever man, there is no way I could fool you, is there. But pricey sir…made by top scientists, and they do not come cheap, no they do not. I wish with all my heart it were otherwise, but you cannot buy the product without the refrigeration. It would not make sense otherwise, would it sir. But you know, my good fellow, how can anyone quibble about the costs of keeping this remarkable product cold, when it will prevent ninety per cent….of things.’

‘But do not simply take my word for it. No. Here is a young lady who was injected with this product just the other day. Yes, just the other day. And do you know what… Well, don’t listen to me. Here she is…. big round of applause for this very brave young lady. Now Miss Fauci, for that is your name is it not… yes it is. You were injected with this very product seven days ago and what has happened to you?’

Miss Fauci: ‘Nothing.’

‘Yes, absolutely nothing happened to young Miss Fauci. Nothing at all. When you think of all the things that could have happened, and yet none of them did, did they. Well, this is remarkable, truly remarkable. No fevers, no loss of smell, no cough….?’

Miss Fauci: ‘Yes, nothing at all.’

‘Ladies and gentlemen, can you believe it. Nothing happened to this young lady at all after seven whole days.’

‘What was that madam, nothing happened to you either. Goodness me, you have been lucky haven’t you. You must be one of the lucky ten per cent. Here, have a free PCR swab to celebrate. Yes, keep it madam, its yours. Your day just got even better. Yes, have two, one could be positive, the other negative, we never really know do we. Ha, ha… my little joke.’

‘You sir, you still want to know what a thing is. Goodness me, you’re not one of those anti-product protestors are you. Our products undergo the most rigorous testing for safety, the most rigorous. How many, why, at least thirty people sir. We are not one of those fly-by-night organisations.’

‘You still want more information on things? Have I not just told you everything you could possibly need to know sir? Our product can prevent ninety per cent of things. If that is not enough to convince you sir, then I have not idea what else I can say.

‘Roll up, roll up. Only twenty billion for you, Mr Johnson – you know a bargain when you see one, don’t you. You’re certainly no mug, are you.’

Dr David Unwin can stop people dying of COVID19

3rd November 2020

[By helping them to lose weight]

If you want to avoid dying of COVID19, one of the most important things you can do, if you are overweight, is to shed the pounds

‘….in the first meta-analysis of its kind, published on 26 August in Obesity Reviews, an international team of researchers pooled data from scores of peer-reviewed papers capturing 399,000 patients. They found that people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.’ 1

Why? Well, the ‘why’ centres around the damaging effect of raised blood glucose on endothelial cells and… it gets complicated.

For now, though, the most important thing is not to understand the complex metabolic and physiological pathways involved, it is simply to help people to lose weight, and this is where Dr David Unwin comes in.

For years now he has believed, as I do, that the main driver of weight gain, leading on to type 2 (T2) diabetes, is a high carbohydrate diet.

This, of course, is the exact opposite of what we have been told for decades by the ‘experts’ who demonise fat and promote carbohydrates. We have the ‘eat-well’ plate, and the ‘food pyramid’, and hundreds of thousands of dieticians around the world, all promoting carbohydrates as the ‘healthy’ option.

Dutifully following this advice, the entire population of the western world has become fatter, and fatter… and fatter. By the way, this is not a coincidence; it is cause and effect.

Getting back to Dr Unwin, years ago he despaired of ever getting any of his patients to lose weight. It was so disheartening that he furtively studied his pension plan, and dreamed of retirement, so fed up was he becoming. Then one day a patient came in who had lost a lot of weight and kept it off.

At first this woman was reluctant to say how she had done it, as she feared the inevitable criticism. In the end, she told Dr Unwin that she had lost weight, and kept it off, by eating a low carbohydrate diet. In Dr Unwin’s own words:

‘A few years ago, I was interested to find out how a patient had improved her diabetic control.  She confessed she had ignored my advice and learnt a much better way to look after herself, from the internet. I suppressed my wounded pride and looked at the Low Carb Forum on Diabetes.co.uk There were thousands of type two diabetics on there ignoring their doctors – and getting great results (now that is just not allowed).’ 2

Yes, Dr Unwin did not criticize, instead he was intrigued. Could this possibly be true? It went against everything he had been told about healthy eating, and weight loss, and T2 diabetes. Fat has twice the calories, per gram, as carbohydrates and suchlike. Eating fat, he believed, makes you fat, and then you develop diabetes, and heart disease.

Dr Unwin did more research, then he made the decision to work with patients, mainly those with diabetes, to see if a low carbohydrate diet could be beneficial. Lo and behold, it was … very beneficial. It was like a miracle cure.

In 2014 he published a paper on his results on a small number of patients. ‘Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice.’

‘It was observed that a low carbohydrate diet achieved substantial weight loss in all patients and brought about normalisation of blood glucose control in 16 out of 18 patients. At the same time, plasma lipid profiles improved, and BP fell allowing discontinuation of antihypertensive therapy in some individuals…

Conclusions Based on our work so far, we can understand the reasons for the internet enthusiasm for a low carbohydrate diet; the majority of patients lose weight rapidly and fairly easily; predictably the HbA1c levels are not far behind. Cholesterol levels, liver enzymes and BP levels all improved. This approach is simple to implement and much appreciated by people with diabetes.’ 3

Now, he has published results of a much larger study, on nearly two hundred patients over a six-year period. It is called. ‘Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes’ Published in BMJ nutrition 4.

Here are the main findings, which I nicked directly from the press release:

  • 46% drug-free T2 diabetes remission
  • Significant improvements in weight, blood pressure and lipid profiles
  • 93% remission of prediabetes
  • £50,885 annual saving on the Norwood GP practice NHS diabetes drug budget
  • If every GP practice in England spent the same on drugs for diabetes per patient as Norwood the NHS could save £277 million!
  • Older patients can do as well as younger ones with a low carb approach.
  • The participants who started with the worst blood sugars saw the greatest improvements in diabetic control
  • Four individuals came off insulin altogether
  • Total weight loss for the 199 participants was 1.6 metric tons!

This paper will be attacked, of course. There are massive financial interests involved here. As stated, if every GP practice in the UK used the low carb approach, the NHS could save £277 million (~$350m) in drug costs. Scaled up to the US, with much higher drugs costs, one could be looking at around $2Bn/year. Around the world, who knows, but vast sums of money.

So, you can imagine the joy that this paper will be met with in pharmaceutical company boardrooms around the world. The words ‘lead’ and ‘balloon’, spring to mind. Equally the massive low-fat, high carb food manufacturers will be throwing their hands up in horror – ‘my bonus, my bonus…nooooo.’ You can take your low carb yoghurts and….

As for the rest of us. I can assure you that Dr David Unwin has only ever been interested in one thing. Working out how to help people lose weight and control their diabetes. He has achieved this.

Will his research now be taken up by the authorities around the world? Will we move away from promoting a high carbohydrate diet? You have to be joking. There is far too much money to be lost by companies who exert tight control over the world of medical research, and whose lobbyists swarm around the politicians in rich countries.

Which is a damn shame, because more than ever in this endless COVID19 pandemic, obesity represents a health crisis. This paper, and the tireless work by Dr David Unwin, clearly tells us what we need to do, now, urgently. His approach won’t work instantly, and it won’t work for everyone – nothing ever does. However, it represents hope. It could save hundreds and thousands of lives. Better than any vaccine?

Thank you, once again, Dr Unwin. A man who I think of as a friend. Your research should be shouted from the rooftops. I can only do my bit.

1: https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young

2: https://www.rcgp.org.uk/clinical-and-research/resources/bright-ideas/working-on-weight-loss-with-type-ii-diabetic-patients-dr-david-unwin.aspx

3: https://www.practicaldiabetes.com/wp-content/uploads/sites/29/2016/03/Low-carbohydrate-diet-to-achieve-weight-loss-and-improve-HbA1c-in-type-2-diabetes-and-pre-diabetes-experience-from-one-general-practice.pdf

4: https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-2020-000072

How dangerous is COVID19?

26th October 2020

[What is the true Infection Fatality Rate]

This article appeared in Russia Today https://www.rt.com/op-ed/504167-facebook-fact-checkers-censorship/ I have made a couple of small changes to it

Facebook fact checkers censured me, and informed me I was wrong, when I said COVID infection fatality rate was around 0.1%. But what do the latest studies say?

The world’s top scientists can’t yet be certain how deadly COVID-19 is, so why are Facebook’s censorial police consistently flagging stories saying this is ‘misinformation’ & claiming the rate is NINE times worse than my estimate?

COVID-19 has impacted the world with massive force, a pandemic beyond anything seen in living memory. There has been an unprecedented reaction – some would say an unprecedented over-reaction. But what are the real figures, what is the true risk from the virus?

It is very difficult to know. At the start of any pandemic, no-one can be sure how many people have been infected. As the World Health Organization states:

“Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities).”

As a general rule, the fatality rate starts by being significantly overestimated, and then falls, as more and more people are tested, and those with mild or asymptomatic infections are identified. With swine flu, the lowest estimated infection fatality rate – the total number of people who die after being infected, whether or not they suffered any symptoms – was one in a thousand, ten weeks into the pandemic. It ended up at 2 in 10,000. Five times lower.

A few weeks ago, I suggested the final infection rate from COVID-19 could be as low as 0.1%. By which I mean that out of every thousand people infected, one would die.

This created something of a storm and various self-appointed fact-checking ‘authorities’ decreed that this figure was completely wrong. Under the heading ‘What is the real death rate’ it was stated that:

“By looking at English data, it is clear that the death rate in this country must be much higher than 0.1%. The researchers who conducted the REACT-2 survey produced a more detailed analysis, which estimated an overall death rate that is nine times higher, at about 0.9%.

Of course, this is important to get right. If the infection fatality rate is 0.1%, then the total number of deaths in the UK will top out at around 67,000. If it is 0.9%, the final death toll could be over 500,000, which means we have (potentially) another 450,000 deaths to go. Indeed, it is the fear of the ‘450,000’ figure that is driving the renewed lockdowns.

So, where do we stand now? The figures are still all over the place, with some perhaps more reliable than others. Interestingly, the WHO (perhaps inadvertently) estimated the infection at far lower than 0.9%

Around two weeks ago, Dr Mike Ryan, the executive director of the WHO’s health emergencies programme, stated the WHO estimated that 750 million people have been infected worldwide:

‘An estimated 750 million, or 10 per cent of the world’s population, have been infected by COVID-19, World Health Organisation (WHO) official Dr Mike Ryan has said.’

At the time of his statement, there had been just over one million deaths recorded worldwide (1,034,068 to be fully accurate). Using these two figures, the IFR can be easily calculated. It is 1,034,068/750,000,000 = 0.138%. How accurate is this figure? Well, who knows for certain? It is probably as accurate as most other current estimates.

Yet even using these WHO-endorsed figures is apparently verboten in the eyes of the Facebook ‘fact checkers’. Another site that reported these numbers also found its story flagged as “misinformation” by Facebook, and has subsequently accused the social media giant of “selling falsehoods and re-writing history”.

One wide-ranging piece of work, a review of 61 studies of COVID deaths covering 51 countries, was done recently by John Ioannidis, a professor of epidemiology at Stanford University, and a man described as “a lion of medical science”. The article, peer-reviewed and published by the WHO, concluded that the infection fatality rate currently stands at 0.23%, and suggested it would fall further, warning: “The inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic.”

Who would one rather believe on this matter? A Harvard-trained infectious disease specialist, author of some of the most cited articles in medical history, and a man who “The Atlantic” has called “one of the most influential scientists alive”? Or some ‘fact checkers’ who, I’m confidently guessing, don’t have quite such a track record or expertise?

It is true the fatality rates currently differ widely from country to country, influenced by other factors such as age and health. In Singapore, there have been nearly 60,000 ‘cases’ recorded, with twenty-eight deaths. This represents a case fatality rate of 0.02%.

As for Iceland, which was (proportionately) the most tested population in the world and used as a benchmark in the early days of the pandemic, things have moved on. As of late October, they have had just over 4,000 ‘cases’ of COVID19 and eleven deaths.

This represents a case fatality rate of 0.26%. You may have noticed my switch to case fatality rate. Case fatality rate means (or used to mean) those with symptoms of the disease, not just those infected. So, the case fatality rate will always be higher than the infection fatality rate, as the infection fatality rate includes those with no symptoms. Many of whom will be untested and undetected.

Another, more recent paper, by Prof. Ioannidis looking at the global Infection Fatality Rate came to the conclusion that it stood, as of October 7th, at 0.15‐0.20%.

Of course, this figure is for the entire population, including the elderly, and those at higher risk because they have other serious medical conditions. His latest estimate of the IFR in the population aged under 70 is 0.04%. Which is 4 in 10,000, and this figure includes people with serious underlying medical conditions.

What would it be for healthy people under 70? Almost certainly a lot less, but I have seen no good figures on this.

As is very clear, the figures have not yet settled down, and different countries have very different estimates. One constant thing though, as with previous pandemics, is the high fatality figures found at the start are steadily falling. The Centre for Evidence Based Medicine in Oxford have been looking at the declining case fatality rates over time, and says:

“Crude estimates of the CFR over time show that for people aged 80 and over the average CFR was 29% up to week 18, fell to 17% in weeks 19 to 27, and for mid-July onwards the CFR was 11% – a decrease of 61%.

“A larger decrease is seen in the ages 60-79 with average CFR ~ 9% in March/April falling to 2% in July August.”

Of course, it is up the individual to decide which figures they believe to be the most accurate. This is an area where the science is clearly not yet settled. Different authorities are claiming very different fatality rates. But – despite what Facebook’s ‘fact checkers’ maintain – very few researchers currently appear to believe the infection fatality rate of COVID-19 is anywhere near 0.9%.

What about those who believe that they can determine what the infection fatality rate for COVID19 really is, and will be, and also believe that they can act as judge and jury in determining who is right, and who is wrong, on this issue? Well, at the risk of being damned again, I politely suggest a bit of humility would be appropriate. Attempting to shut down debate in science used to be the role of the Spanish Inquisition. I thought we had moved on. Debate is the lifeblood of science.

Promoting the Fifth International Public Conference on Vaccination

13th October 2020

‘I would rather have questions that cannot be answered, than answers that cannot be questioned’ Richard Feynman.

As the impact of COVID19 rampages around the world, there is going to be a massive push to get vaccines launched, and immense pressure applied to people to be vaccinated. Therefore, this seems like a perfect time to have a conference on informed consent in Vaccination.

So, I am helping to publicise the Fifth International Public Conference on Vaccination on-line conference*. Information on this can be found here:

https://app.glueup.com/event/protecting-health-and-autonomy-in-the-21st-century-20563/home.htmlhttps://www.nvic.org/about/conference.aspx

I am acutely aware of the fact that even the mildest caution about vaccines leads to you being instantly labelled as an anti-vaxxer, and thus dismissed as some kind of anti-science lunatic.

However, I think we have an immensely important issue rising to the surface today, with many countries lining up to make any vaccine for COVID19 as close to mandatory as can be achieved, without using force.

This is distinctly worrying. As I pointed out in a previous blog, the Phase III trials for any Sars-Cov2 are not due to report for years. Which means that vaccines are about to be rushed onto the market with very sparse data on safety and efficacy. I think that people have a right to be concerned, and a right to refuse to be vaccinated without massive pressure brought to bear.

I strongly believe that this, and other issues on informed consent, desperately need to be debated – out in the open – and the National Vaccine Information Center is trying to do this. The people involved seem to be as far from being zealots as can be imagined. They just want an open and reasoned discussion.

Here is their statement on the issues of informed consent.

Informed Consent: An Ethical Principle

The National Vaccine Information Center (NVIC) has not advocated for the abolishment of vaccination laws as other groups have proposed. However, we have always endorsed the right to informed consent as an overarching ethical principle in the practice of medicine for which vaccination should be no exception. We maintain this is a responsible and ethically justifiable position to take in light of the fact that vaccination is a medical intervention performed on a healthy person that has the inherent ability to result in the injury or death of that healthy person.

In consideration of:

  • the fact that there can be no guarantee that the deliberate introduction of killed or live microorganisms into the body of a healthy person will not compromise the health or cause the death of that person either immediately or in the future; and
  • with very few predictors having been identified by medical science to give advance warning that injury or death may occur; and
  • with no guarantee that the vaccine will indeed protect the person from contracting a disease; and
  • in the absence of adequate scientific knowledge of the way vaccines singly or in combination act in the human body at the cellular and molecular level
  • vaccination is a medical procedure that could reasonably be termed as experimental each time it is performed on a healthy individual

Further, the FDA, CDC and vaccine makers openly state that often the number of human subjects used in pre-licensing studies are too small to detect rarer adverse events, making post-marketing surveillance of new vaccines a de facto scientific experiment. In this regard, the ethical principle of informed consent to vaccination attains even greater importance

I would urge people to have a look at this conference, sign in, and make up their own minds about what is going on.

*Disclosure of interest: I was asked to give a lecture at this conference for which I will be paid. The title of my talk is ‘Manipulating Science to Endorse Policy, and Market Products.

A Sars-Cov2 vaccine – don’t hold your breath

10th October 2020

[But concern may be in order]

I suppose most people believe the trials on vaccines for COVID19 will be looking to demonstrate that they reduce the risk of infection, death, or serious illness – or suchlike.

Also, you may have heard that several vaccines could be ready for use early next year 2021. Maybe even later this year.

As Dilbert may retort: Hahahahahahahahahahahaha! Oh, let me pause and wipe away my tears of mirth.

Really. Think about it. Then think a bit more…

AstraZeneca (AZ) is thought to be leading the pack with their vaccine AZD1222. Their major clinical trial will recruit 30,000 participants – which is good. You can find the trial description on Clinicaltrials.gov. It goes by the snappy title ‘Phase III Double-blind, Placebo-controlled Study of AZD1222 for the Prevention of COVID-19 in Adults.’ 1

You may be interested in the start  and end date of this AZ trial:

Estimated Study Start Date:                                    August 17, 2020

Estimated Primary Completion Date*:                  December 2, 2020

Estimated Study Completion Date:                       October 5, 2022

*date when all volunteers have been recruited onto the trial.

As you can see, even if all goes to plan, their study will not be completed until two years from now. Then they will have to analyse the data and suchlike, which will take a couple of months, even as a rush job. Which means they are unlikely to have everything sorted before early 2023.

For those who were claiming, a few months ago, that a vaccine would be ready by September this year i.e. a month ago, this would be stretching the word ‘ready’ far beyond its natural boundaries.

As for studying deaths from COVID19, this trial will not be looking at anything as tricky as that. Preventing deaths from COVID19 is not an end-point they are aiming for.  

Below I have listed the primary end-points for study NCT04516746. By primary end-points, I mean those outcomes that will be used to determine if the trial has been a success or failure.

Sorry, jargon alert, and boring but also necessary, I feel, just so you know I am not making this stuff up. My comments in brackets [ ].

PRIMARY END-POINTS OF AZ STUDY

1: To estimate the efficacy of 2 IM doses of AZD1222 compared to placebo for the prevention of COVID-19 in adults ≥ 18 years of age [Time Frame: 1 year]

A binary response, whereby a participant is defined as a COVID-19 case if their first case of SARS-CoV-2 RT-PCR-positive symptomatic illness occurs ≥ 15 days post second dose of study intervention. Otherwise, a participant is not defined as a COVID-19 case.

[You may note that a positive SARS-Cov-2 RT-PCR test is not sufficient to define someone as having been infected with the virus – they must also have symptoms.]

2: To assess the safety and tolerability of 2 IM doses of AZD1222 compared to placebo in adults ≥ 18 years of age [ Time Frame: a: 28 days post each dose of study Intervention. / b: from Day 1 post-treatment through Day 730.]

a: Incidence of adverse events.

b: Incidence of serious adverse events, medically attended adverse events, and adverse events of special interest.

3: To assess the reactogenicity* of 2 IM doses of AZD1222 compared to placebo in adults ≥ 18 years of age (Substudy only) [ Time Frame: 7 days post each dose of study intervention.]

Incidence of local and systemic solicited adverse events.

*In vaccine clinical trials, the term reactogenicity refers to the property of a vaccine of being able to produce common, “expected” adverse reactions, especially excessive immunological responses and associated signs and symptoms, including fever and sore arm at injection site.

At this point I feel the need to point out that preventing deaths from COVID19 is not even a secondary end-point for this trial either. So, whatever else we will find out, we are not going to know if AZD1222 saves any lives. Or, to be technical, the trial is not sufficiently ‘powered’ to reach statistical significance for overall mortality.

Anyway, getting back to the timelines, you may now be thinking, how on earth are they planning to launch a vaccine next year, if they are not going to complete their key clinical trial until October 2022? Do they have a time machine?

Well, it goes like this.

Clinical trials – before a drug is approved – normally go through three clinical phases.

  • Phase I: Evaluate safety, determine safe dosage, identify side effects (in a small group of human volunteers, maybe twenty or thirty)
  • Phase II: Test effectiveness, further evaluate safety (maybe a couple of hundred volunteers).
  • Phase III: Confirm effectiveness, monitor side-effects, compare to other treatments (up to tens of thousands of volunteers).

Following completion of the Phase III trial, the data are sent to the regulatory authorities, who will then determine if the ‘drug’ is both safe and effective. Or at least safe and effective enough to recommend approval.

The AZ trial I have been talking about up to now, is a phase III trial, with 30,000 participants.

However, clearly, with SARS-Cov-2 vaccines, they are not going to (and cannot)  wait for Phase III trials to complete. Instead, they are planning to launch directly after (what would normally be called phase II trials) to finish.

Regarding this, I was sent an e-mail by a friend regarding these phase II trials, and what they are trying to achieve. The e-mail is summary of an article by William A Haseltine who writes this, of himself.

‘For nearly two decades, [William A. Haseltine] was a professor at Harvard Medical School and Harvard School of Public Health where I founded two academic research departments, the Division of Biochemical Pharmacology and the Division of Human Retrovirology. I am perhaps most well-known for my work on cancer, HIV/AIDS, and genomics.’

You can look him up on Wikipedia if you like.2 Basically, it sounds like he knows what he is talking about, with regard to science, viruses and suchlike. Although when it comes to research on vaccines for COVID19 he seems to have spotted commercial reality for the first time in his life.

Here was the e-mail, sent to me:

Here is an interesting article about the COVID-19 vaccine trials written by William A. Haseltine, who was a professor at Harvard Medical School and Harvard School of Public Health, and who founded two academic research departments, the Division of Biochemical Pharmacology and the Division of Human Retrovirology.

Here are the two most important points he makes, which summarizes what he says in his article, are:

“These [vaccine] protocols do not emphasize the most important ramifications of COVID-19 that people are most interested in preventing: overall infection, hospitalization, and death.”

[The COVID-19 vaccine trials are only looking to see if these vaccines reduce symptoms that may be as mild as cough and headache. They are NOT requiring that the vaccines reduce the risk of infection, hospitalization or death.]

“It boggles the mind and defies common sense that the National Institute of Health, the Center for Disease Control, the National Institute of Allergy and Infectious Disease, and the rest would consider the approval of a vaccine that would be distributed to hundreds of millions on such slender threads of success.”

He also notes how few people there are in each of these studies for their interim analysis, which he says the companies will probably use to try and get Emergency Use Authorization from the FDA:

  • “For Moderna, the interim analysis includes giving the vaccine to only 53 people.”
  • “For Johnson & Johnson, their interim analysis includes [only] 77 vaccine recipients “
  • “For AstraZeneca, their interim analysis includes [only] 50 vaccine recipients”
  • “For Pfizer, their interim analysis includes only 32 people getting the vaccine.”

“These companies likely intend to apply for an emergency use authorization (EUA)

The full article was published in Forbes magazine, and can be seen there 3 .

In super-short form, the current plan is these vaccines will be launched after giving them to around fifty people – each. At which point we will have no idea if they prevent infection, hospitalisation, or death. In addition, we will not really know if they are safe, as the numbers involved are simply too small – and the timelines too short.

I hope you can now see my scepticism earlier this year, when people were claiming a vaccine could be made available six months after the start of the outbreak. I was aware – as is everyone else who knows how clinical trials are done – that this simply cannot be done. Or to be more accurate, the only way to do it is by cutting some essentially corners. The corners called ‘safety’, and ‘efficacy’.

Yes, I fully accept these are not normal times, and there is certainly a need for speed. Yes, I also accept that we probably should be willing to accept an increased level of risk to tackle the enormous problems caused by COVID19.

However, for the average person, between the ages of twenty and fifty, the upper range estimate of the risk of dying of COVID19, if you get infected, is 0.0003 = 0.03%, which is 3 in 10,000.4 This figure comes from the CDC in the US, which continues to stick to a higher estimated Infection Fatality Rate (IFR), than almost anyone else.

Their lower level estimated IFR for this age group is around one in 15,000. Either way, these are very low risk levels indeed.  Under the age of twenty, the risk is almost incalculably small. So, for the majority of the population, under the age of fifty (realistically under sixty), we really should not be in a mad rush to vaccinate. We need the type evidence for both safety and efficacy that can only be provided by a Phase III trial.

However, I fear that such is the clamour for a vaccine, so desperate the need, we are going to be launching vaccine after vaccine, based on extremely thin evidence indeed. Not only that, it seems that in some countries, whilst reluctantly backing away from suggesting that COVID19 vaccination would be compulsory, are going to make it almost impossible to refuse.

Here is one headline, discussing the ideas being talked about in Australia ‘No overseas travel, and no welfare payments: The way the government will force people to get a COVID-19 jab – even as the PM insists the vaccine will NOT be compulsory.’

  • Australians could face being banned from travelling overseas for refusing jab
  • Federal Health Minister Greg Hunt said he would ‘not rule out’ strict measures
  • Echoed prime minister saying he’d make vaccine ‘as mandatory as possible’
  • Scott Morrison said later on Wednesday he had no power to enforce a vaccine
  • Mr Hunt said government was not considering making inoculation compulsory
  • But said authorities would have option of enforcing policies like ‘no jab, no pay’5

As mandatory as possible? Sorry, but mandatory is binary. It is, or it isn’t. As for the concept of compulsory vaccination. According to the Australian Prime Minister compulsory vaccination would mean pinning people to the floor and vaccinating them. However, telling people that they cannot travel, or work, or receive welfare payments, is tantamount to compulsion.

In my opinion, if we had fully tested vaccines, that were known to be both safe and effective, contemplating such actions would still be several steps too far. However, compelling people to get vaccinated, when all we have is Phase II studies to go on, ventures into extremely worrying territory.

We will effectively be compelling people to become participants in a massive medical research trial. It is my understanding that actions such as this would lie directly within the Nuremberg Code.

Point one: The voluntary consent of the human subject is absolutely essential.

This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person which may possibly come from his participation in the experiment. 6

The Nuremburg Code was written after the Second World War to ensure that nothing like the unethical human experimentation carried out then on prisoners would ever happen again.

If people want to take these vaccines, of their own free will, that is up to them, and they may be right to make that decision.

However, I am deeply concerned that many others will be coerced, one way or another, to be vaccinated against their will.

1: https://clinicaltrials.gov/ct2/show/NCT04516746?term=NCT04516746&draw=2&rank=1

2; https://en.wikipedia.org/wiki/William_A._Haseltine

3: https://www.forbes.com/sites/williamhaseltine/2020/09/23/COVID-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed/

4: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

5: https://www.dailymail.co.uk/news/article-8642881/Health-Minister-Greg-Hunt-reveals-tough-rules-people-refuse-COVID-19-jab.html

6: https://www.nejm.org/doi/full/10.1056/nejm199711133372006

 

A podcast on Covid

A couple of days ago I had a chat with Dr Zac Cox about all things Covid. Which wandered about a bit, and does last for an hour and a half, we were enjoying ourselves. Sorry for my hungover look. I was a bit hungover.

However, even though it is a bit long, I thought that regular readers of this blog may be interested in having a look. It is on Brandnewtube, because if it were on YouTube it would not last long. The new world censors would have a fit.

It can be seen here https://brandnewtube.com/watch/dr-zac-uncensored-with-dr-malcolm-kendrick-live_W2EGf2HuoMorJVI.html

False positive tests

28th September 2020

(This post contains an erratum regarding a technical issue, at the end)

There has been a lot of noise about false positive COVID19 tests in the news. So, I thought I would try to explain what it all means. Or do my best anyway.

There are two measures in most medical screening tests which are usually defined as the ‘sensitivity’ and the ‘specificity’ of a test. In my opinion, these two words are far too close together in sound, so they are very easy to mix up in your brain.

I find it easier to think of the accuracy of test results in this way.

  • False negatives
  • False positives

A false negative is a result which informs someone that they do not have a disease, when in fact they do.

A false positive is a result which informs someone they do have a disease, when they don’t.

Ideally a test should never give a false negative (100% sensitivity) nor give a false positive (100% specificity). There is no known test that does this. In general, there is a trade-off going on between these two measures.

By which I mean, if you aim for 100% sensitivity, the specificity often falls away – and vice-versa

For example, in cancer screening the primary objective is you must never miss a case. So, the sensitivity rate is set very high. By definition the rate of false negatives is very low.

A shadow on the breast, a few strange cells here, a few strange cells there – ‘that might be cancer, better to be safe than sorry. Don’t take the risk’. Positive cancer test.

To put this another way. The fear of missing any cases of cancer results in the number of false positives being high. This raises the question with COVID19. Is it better to underdiagnose – many false negatives. Or over diagnose – many false positives?

Note I am talking here primarily about the naso-pharyngeal swab tests (i.e., antigen tests) which are used to see if you have the virus NOW and not the blood (antibody) test done which may be done later to see if you have ever had the virus.

This issue does not seem to have been discussed. If you want to prevent spread of COVID19, you would presumably want very few false negatives in these swab tests. Otherwise people will be told they don’t have the disease – when they do – and happily go off spreading it around. Equally, you would be relaxed about false positives. People would isolate when they don’t need to, but not a great health issue.

Weirdly, however, this does not seem to be the case.

COVID19 false negatives

With COVID19, there are a lot of false negatives, with some studies quoting figures as high as 50%. That is, half of those told they are not infected with COVID19, are probably infected1. A systematic review got figures between 2% and 29%. So, we could call that an average of 16%?

As you can see, these figures are clearly all over the place. This is in major part because there is no ‘gold-standard’ COVID19 test. By which I mean that we do not have a ‘test of tests.’ Namely, the expensive and time-consuming test by which we absolutely can know if someone truly is infected. The test against which your ‘field tests’ can be calibrated/verified.

Indeed, currently, there is no current agreement as to what ‘infected’ means with COVID19. Does it mean finding viral particles in the nose, sputum, or throat – or all three? Does it mean finding viral particles in these places, and also isolating it in the bloodstream, or lungs? Does it mean finding evidence of antibodies specific to COVID19 two to three weeks following ‘infection?’ Or what? It would be nice to know.

COVID19 false positives

More troubling, right now, than the very poor sensitivity of COVID19 testing (high number of false negatives) is the knotty question of how many false positive tests there are? This is important, because we are told that cases are rising and rising as we suffer a ‘second wave’ of COVID19.

However, if we have a high rate of false positives, then the rise in ‘cases’ could be driven by a rise in testing – and nothing else. And you don’t need a high percentage of false positive tests to do this. If the false positive rate is as little as just one per cent (1%) this means the majority of people told they are positive for COVID19, do not have COVID19!

I know that most people find this a difficult one. It goes like this.

First, you have to know the estimated prevalence of the disease in the community. That is, the total number currently infected. Last time I looked it was one in nine hundred. For the sake of this calculation I shall call it one in a thousand. [Or, to put it another way, sixty-seven thousand people in the UK (population 67 million) are currently infected with COVID19].

Using this one in a thousand figure. This means, if you randomly tested ten thousand people, you would expect to find ten COVID19 cases [forgetting the false negatives for now].

On the other side of the coin. If the false positive rate is one per cent, you would have an additional one hundred false positives cases.

10,000 x.01(1%) = 100

Putting this another way. With a prevalence of one in a thousand, and a false positive rate of one per-cent you would have ten true COVID19 positive cases, and ninety false positives. Ergo, the vast majority of people told that they have COVID19, do not. Is this actually happening?

There is heated debate. As in much heat and little light.

In order to shed a little light, I have been communicating with a senior scientist in a COVID19 facility who feels things have gone very wrong. Below is his take on the false positive situation, from a couple of weeks ago. It is highly technical, but for those who can follow it, I think the author makes some critical points. I have not named him for, were I to do so, he would almost certainly land in very hot water. However, the references are verifiable.

1: https://www.bmj.com/content/bmj/369/bmj.m1808.full.pdf
What do positive SARS-CoV-2 RT-PCR tests mean? (Absolutely Nothing!)
The Cepheid Xpert Xpress SARS-CoV-2 RT-PCR test is the “Gold Standard” COVID-19 antigen test used in our laboratory. The specificity of this test from the manufacturer’s package insert1. [Here referred to as negative percentage agreement or NPA) is 95.6% or 0.956 when expressed as a fraction].

I don’t know about other RT-PCR tests, but I imagine the specificity will be similar for all widely used commercially available kits.

The specificity of a test is defined by the equation:

SP = TN / (TN + FP)

Where SP = specificity, TN = number of true negatives, FP = number of false positives.  TN + FP = the total number of tests carried out.

Now the latest Government figures from Monday 7th September state that 350,100 tests were carried out and 2,948 people tested positive 2. So, if we apply the above equation to our PCR test and the Government’s figures, we get:

0.956 = TN / 350,100

Therefore, the number of true negatives is:

TN = 350,100 * 0.956 = 334696

Therefore, the number of false positives, FP we would expect from 350,100 tests is:

FP = 350,100 – 334,696 = 15,404

This is more than five times the number of positive tests reported, which means we cannot have any confidence that any one of those positive tests represents a genuine case.

What these figures show is that it is totally inappropriate to use RT-PCR as a screening test for a virus in an asymptomatic population when the prevalence of the infection is very low.

Even if there were a test with 99% specificity, you would still expect to get 3500 false positives from performing 350,000 tests – which is still greater than the number of “cases” reported. When the number of “cases” is lower than your rate of false positives, then a positive result on its own is virtually meaningless.

The PCR test is best utilized as a diagnostic test to confirm the diagnosis of an infection based on clinical signs and symptoms. It certainly should not be used as a screening test when there is low prevalence of disease and should NEVER be used as the sole determinant in the diagnosis of a case.

One source of false positives is the persistence of fragments of viral RNA long after a patient may have recovered and is no longer infective. These fragments will be amplified by PCR and will give a positive result that is indistinguishable from a genuine case.  We’ve had a patient whose swabs have been testing positive in our lab every week for over 3 months!

Non-specific amplification is another possible source of false positives. The nasopharyngeal swab samples are “dirty” samples: they are full of bacterial, fungal, other viral, and host DNA and RNA. Some of these will have high percentage sequence homology [NB homology basically means a similar sequence of base pairs- my words] to the gene sequences targeted by the PCR assay and these can also be amplified. The risk that this may have occurred is higher if the positive test has a very high Cycle Threshold (Ct) value – say 35 or above.

Recently, it has come to my attention that one of the primers – an 18-base primer for a region of the RdRP gene – has exact sequence homology with a region on human chromosome 8 3,4.

So, if any laboratory uses a PCR assay with that particular primer, they’re likely to get a lot of false positives!

Politicians and Health Officials are basing their numbers of cases entirely on the results of these tests, which are not fit for this purpose.

They are then using these figures to terrorise the population, and to justify decisions to impose local lockdowns, and increase nonsensical general restrictions which are having a massive impact on people’s lives and their health, and also on the economy, particularly hitting small businesses hard.

  1. https://www.cepheid.com/Package%20Insert%20Files/Xpress-SARS-CoV-2/Xpert%20Xpress%20SARS-CoV-2%20EUA%20PI%20GX%20System%20rev%20D.pdf
  2. https://coronavirus.data.gov.uk/
  3. https://pieceofmindful.com/2020/04/06/bombshell-who-coronavirus-pcr-test-primer-sequence-is-found-in-all-human-dna/
  4. https://www.ncbi.nlm.nih.gov/nucleotide/NC_000008.11?report=genbank&log%24=nuclalign&from=63648346&to=63648363

ERRATUM

In this blog I included a piece on false positives from a senior laboratory scientist. A number of people wrote in suggesting that the calculation was wrong. I contacted the scientist on this matter, and he has written:

In performing my calculation, I was unable to calculate the number of true positives (TP) because I did not have a figure for the prevalence of COVID-19. Since the prevalence seemed to be close to zero from the results obtained in the laboratory where I work, I assumed that TP would be negligible compared to the total number of tests carried out, and therefore did not include this in the equation I used. I acknowledge that the number of false positives (FP) calculated was thus an approximation.

I have since learned that the prevalence is approximately 0.1% according to the ONS, which means that my value for FP is actually a very good approximation, and this validates my argument that the number of false positives far outnumbers the number of true positives.

I hope that clarifies matters

More COVID19 news from Sweden

A few weeks ago, an emergency physician working in Sweden, Dr. Sebastian Rushworth, asked me if I would be willing to replicate an article from his blog on mine. I was more than happy; it was a great article. The only problem being that his writing puts mine to shame – in a second language. Although he did later tell me he had been to boarding school in England for several years. So, I feel a bit better. If not much.

He has now done an update, outlining how things are getting along in Sweden. I thought it would be of great interest for people to get news from the front line, so to speak.

As many of us know Sweden, alone in Western Europe, decided not to impose a tough lockdown. In fact, the only forcible restriction that was imposed was to ban people meeting in groups of more than fifty. Slightly later, a further restriction was placed on nursing home visits.

Apart from this, all other Government recommendations were purely voluntary [Imagine that, a Government treating its citizens as responsible human beings].

When Sebastian wrote to me recently, I sent him back this e-mail.

“Great article. Could you send it in Word format? I will obviously link back to your blog.

Also, would it be possible to put in an additional section – to go at the front of the piece – as to what measures were taken in Sweden, and what the average person in Sweden actually did. The narrative we now have (from the pro-Lockdown lobby) is that the people of Sweden, being so law-abiding and community aware, essentially locked themselves down.

Which meant that the Swedish partial lockdown was more effective than, for example, the UK ‘harsh’ lockdown. Because the Swedes self-policed themselves, and the Brits did not. This is usually stated with great confidence from people who provide no evidence to back this assertion up. People who have probably never been to Sweden, nor ever talked to anyone from Sweden, and probably couldn’t point to Sweden on a map.

I understand schools stayed open, bars and restaurants stayed open. Gatherings of more than five hundred people were prohibited etc. What did Swedes do with masks, and going to work, for example? I think that information directly from the front line in Sweden, on these things, would be useful for people to know.”

So, Sebastian added a bit onto the front as follows:

“At the beginning of August I wrote an article about my experiences working as an emergency physician in Stockholm, Sweden during the COVID pandemic. For those who are unaware, Sweden never went into full lockdown. Instead, the country imposed a partial lockdown that was almost entirely voluntary. People with office jobs were recommended to work from home, and people in general were recommended to avoid public transport unless necessary. Those who were over seventy years old, or who had serious underlying conditions, were recommended to limit social contacts.

The only forcible restriction imposed by the government from the start was a requirement that people not gather in groups of more than fifty at a time. After it became clear that COVID was above all dangerous to people in nursing homes, an additional restriction was placed on nursing home visits.

At no time has there been any requirement on people to wear face masks in public. Restaurants, cafés, hairdressers, and shops have stayed open throughout the pandemic. Pre-schools and schools for children up to the age of sixteen have stayed open, while schools for children ages sixteen to nineteen switched to distance learning.

My personal experience is that people followed the voluntary restrictions pretty well at the beginning, but that they have become increasingly lax as time has gone on. As a personal example, my mother and my parents-in-law stayed locked up in their homes for the first six weeks or so of the pandemic. After that they couldn’t bear to be away from their grandchildren any longer.

In my earlier article in August, I mentioned that after an initial peak that lasted for a month or so, from March to April, visits to the Emergency Room due to COVID had been declining continuously, and deaths in Sweden had dropped from over one hundred a day at the peak in April, to around five per day in August.

At the point in August when I wrote that article, I hadn’t seen a single COVID patient in over a month. I speculated that Sweden had developed herd immunity, since the huge and continuous drop was happening in spite of the fact that Sweden wasn’t really taking any serious measures to prevent spread of the infection.

So, how have things developed in the six weeks since that first article?

Well, as things stand now, I haven’t seen a single COVID patient in the Emergency Room in over two and a half months. People have continued to become ever more relaxed in their behaviour, which is noticeable in increasing volumes in the Emergency Room. At the peak of the pandemic in April, I was seeing about half as many patients per shift as usual, probably because lots of people were afraid to go the ER for fear of catching COVID. Now volumes are back to normal.

When I sit in the tube on the way to and from work, it is packed with people. Maybe one in a hundred people is choosing to wear a face mask in public. In Stockholm, life is largely back to normal. If you look at the front pages of the tabloids, on many days there isn’t a single mention of COVID anywhere. As I write this (19th September 2020) the front pages of the two main tabloids have big spreads about arthritis and pensions. Apparently, arthritis and pensions are currently more exciting than COVID-19 in Sweden.

In spite of this relaxed attitude, the death rate has continued to drop. When I wrote the first article, I wrote that COVID had killed under 6,000 people. How many people have died now, six weeks later? Actually, we’re still at under 6,000 deaths. On average, one to two people per day are dying of COVID in Sweden at present, and that number continues to drop.

In the hospital where I work, there isn’t a single person currently being treated for COVID. In fact, in the whole of Stockholm, a county with very nearly two and half million inhabitants, there are currently only twenty-eight people being treated for COVID in all the hospitals combined. At the peak, in April, that number was over a thousand. If twenty-eight people are currently in hospital, out of two and a half million who live in Stockholm. Which means the odds of having a case of COVID so severe that it requires in-hospital treatment are, at the moment, about one in eighty-six thousand.

Since March, the Emergency Room where I work has been divided in to a “COVID” section and a “non-COVID” section. Anyone with a fever, cough, or sore throat has ended up in the COVID section, and we’ve been required to wear full personal protective equipment when interacting with patients in that section. Last Wednesday the hospital shut down the COVID section. So, few true cases of COVID are coming through the Emergency Room that it no longer makes sense to have a separate section for COVID.

What about the few formal restrictions that were imposed early in the pandemic?

The restriction on visits to nursing homes is going to be lifted from October 1st. The older children, ages sixteen to nineteen, who were engaging in distance learning during part of the spring, are now back in school, seeing each other and their teachers face to face. The Swedish public health authority has recommended that the government lift the restriction on gatherings from fifty people to five hundred people.

When I wrote my first article, I engaged in speculation that the reason Sweden seemed to be developing herd immunity, in spite of the fact that only a minority had antibodies, was due to T-cells. Since I wrote that article, studies have appeared which support that argument.

This is good, because T-cells tend to last longer than antibodies. In fact, studies of people who were infected with SARS-CoV-1 back in 2003 have found that they still have T-cells seventeen years after being infected. This suggests that immunity is long lasting, and probably explains why there have only been a handful of reported cases of re-infection with COVID, even though the virus has spent the last nine months bouncing around the planet infecting many millions of people.

As to the handful of people who have been reported to have been re-infected. Almost all those cases have been completely asymptomatic. That is not a sign of waning immunity, as some claim. In fact, it is the opposite. It shows that people develop a functioning immunity after the first infection, which allows them to fight off the second infection without ever developing any symptoms.

So, if Sweden already has herd immunity, what about other countries? How close are they to herd immunity? The places that have experienced a lot of COVID infections, like England and Italy, have mortality curves that are very similar to Sweden’s, in spite of the fact that they went into lockdown. My interpretation is that they went into lockdown too late for it to have any noticeable impact on the spread of the disease. If that is the case, then they have likely also developed herd immunity by now. Which would make the ongoing lockdowns in those countries bizarre.

What about the vaccine? Will it arrive in time to make a difference? As I mentioned in my first article, lockdown only makes sense if you are willing to stay in lockdown until there is an effective vaccine. Otherwise you are merely postponing the inevitable. At the earliest, a vaccine will be widely available at some point in the middle of next year.

How many governments are willing to keep their populations in lockdown until then? And what if the vaccine is only thirty per-cent effective? Or fifty per-cent? Will governments decide that is good enough for them to end lockdown? Or will they want to stay in lockdown until there is a vaccine that is at least ninety per-cent effective? How many years will that take?

So, to conclude: COVID is over in Sweden. We have herd immunity. Most likely, many other parts of the world do too, including England, Italy, and parts of the US, like New York. And the countries that have successfully contained the spread of the disease, like Germany, Denmark, New Zealand, and Australia, are going to have to stay in lockdown for at least another year, and possibly several years, if they don’t want to develop herd immunity the natural way.

Growing concern about Lockdown from doctors in Belgium

19th September 2020

In order to make you aware that there are a growing number of doctors in Europe who feel that Lockdown has been an unmitigated disaster, I have downloaded an open Letter from doctors in Belgium. It can be seen here. https://docs4opendebate.be/en/open-letter/

Doctors in other countries e.g. Germany have done much the same thing. I am putting this on my blog so that as many people as possible read it.

 

Open letter from medical doctors and health professionals to all Belgian authorities and all Belgian media.

We, Belgian doctors and health professionals, wish to express our serious concern about the evolution of the situation in the recent months surrounding the outbreak of the SARS-CoV-2 virus. We call on politicians to be independently and critically informed in the decision-making process and in the compulsory implementation of corona-measures. We ask for an open debate, where all experts are represented without any form of censorship. After the initial panic surrounding covid-19, the objective facts now show a completely different picture – there is no medical justification for any emergency policy anymore.

The current crisis management has become totally disproportionate and causes more damage than it does any good.

We call for an end to all measures and ask for an immediate restoration of our normal democratic governance and legal structures and of all our civil liberties.

‘A cure must not be worse than the problem’ is a thesis that is more relevant than ever in the current situation. We note, however, that the collateral damage now being caused to the population will have a greater impact in the short and long term on all sections of the population than the number of people now being safeguarded from corona.

In our opinion, the current corona measures and the strict penalties for non-compliance with them are contrary to the values formulated by the Belgian Supreme Health Council, which, until recently, as the health authority, has always ensured quality medicine in our country: “Science – Expertise – Quality – Impartiality – Independence – Transparency”. 1

We believe that the policy has introduced mandatory measures that are not sufficiently scientifically based, unilaterally directed, and that there is not enough space in the media for an open debate in which different views and opinions are heard. In addition, each municipality and province now has the authorisation to add its own measures, whether well-founded or not.

Moreover, the strict repressive policy on corona strongly contrasts with the government’s minimal policy when it comes to disease prevention, strengthening our own immune system through a healthy lifestyle, optimal care with attention for the individual and investment in care personnel.2

The concept of health

In 1948, the WHO defined health as follows: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or other physical impairment’.3

Health, therefore, is a broad concept that goes beyond the physical and also relates to the emotional and social well-being of the individual. Belgium also has a duty, from the point of view of subscribing to fundamental human rights, to include these human rights in its decision-making when it comes to measures taken in the context of public health. 4

The current global measures taken to combat SARS-CoV-2 violate to a large extent this view of health and human rights. Measures include compulsory wearing of a mask (also in open air and during sporting activities, and in some municipalities even when there are no other people in the vicinity), physical distancing, social isolation, compulsory quarantine for some groups and hygiene measures.

The predicted pandemic with millions of deaths

At the beginning of the pandemic, the measures were understandable and widely supported, even if there were differences in implementation in the countries around us. The WHO originally predicted a pandemic that would claim 3.4% victims, in other words millions of deaths, and a highly contagious virus for which no treatment or vaccine was available.  This would put unprecedented pressure on the intensive care units (ICUs) of our hospitals.

This led to a global alarm situation, never seen in the history of mankind: “flatten the curve” was represented by a lockdown that shut down the entire society and economy and quarantined healthy people. Social distancing became the new normal in anticipation of a rescue vaccine.

The facts about covid-19

Gradually, the alarm bell was sounded from many sources: the objective facts showed a completely different reality. 5 6

The course of covid-19 followed the course of a normal wave of infection similar to a flu season. As every year, we see a mix of flu viruses following the curve: first the rhinoviruses, then the influenza A and B viruses, followed by the coronaviruses. There is nothing different from what we normally see.

The use of the non-specific PCR test, which produces many false positives, showed an exponential picture.  This test was rushed through with an emergency procedure and was never seriously self-tested. The creator expressly warned that this test was intended for research and not for diagnostics.7

The PCR test works with cycles of amplification of genetic material – a piece of genome is amplified each time. Any contamination (e.g. other viruses, debris from old virus genomes) can possibly result in false positives.8

The test does not measure how many viruses are present in the sample. A real viral infection means a massive presence of viruses, the so-called virus load. If someone tests positive, this does not mean that that person is actually clinically infected, is ill or is going to become ill. Koch’s postulate was not fulfilled (“The pure agent found in a patient with complaints can provoke the same complaints in a healthy person”).

Since a positive PCR test does not automatically indicate active infection or infectivity, this does not justify the social measures taken, which are based solely on these tests. 9 10

Lockdown.

If we compare the waves of infection in countries with strict lockdown policies to countries that did not impose lockdowns (Sweden, Iceland …), we see similar curves.  So there is no link between the imposed lockdown and the course of the infection. Lockdown has not led to a lower mortality rate.

If we look at the date of application of the imposed lockdowns we see that the lockdowns were set after the peak was already over and the number of cases decreasing. The drop was therefore not the result of the taken measures. 11

As every year, it seems that climatic conditions (weather, temperature and humidity) and growing immunity are more likely to reduce the wave of infection.

Our immune system

For thousands of years, the human body has been exposed daily to moisture and droplets containing infectious microorganisms (viruses, bacteria and fungi).

The penetration of these microorganisms is prevented by an advanced defence mechanism – the immune system. A strong immune system relies on normal daily exposure to these microbial influences. Overly hygienic measures have a detrimental effect on our immunity. 12 13 Only people with a weak or faulty immune system should be protected by extensive hygiene or social distancing.

Influenza will re-emerge in the autumn (in combination with covid-19) and a possible decrease in natural resilience may lead to further casualties.

Our immune system consists of two parts: a congenital, non-specific immune system and an adaptive immune system.

The non-specific immune system forms a first barrier: skin, saliva, gastric juice, intestinal mucus, vibratory hair cells, commensal flora, … and prevents the attachment of micro-organisms to tissue.

If they do attach, macrophages can cause the microorganisms to be encapsulated and destroyed.

The adaptive immune system consists of mucosal immunity (IgA antibodies, mainly produced by cells in the intestines and lung epithelium), cellular immunity (T-cell activation), which can be generated in contact with foreign substances or microorganisms, and humoral immunity (IgM and IgG antibodies produced by the B cells).

Recent research shows that both systems are highly entangled.

It appears that most people already have a congenital or general immunity to e.g. influenza and other viruses. This is confirmed by the findings on the cruise ship Diamond Princess, which was quarantined because of a few passengers who died of Covid-19. Most of the passengers were elderly and were in an ideal situation of transmission on the ship. However, 75% did not appear to be infected. So even in this high-risk group, the majority are resistant to the virus.

A study in the journal Cell shows that most people neutralise the coronavirus by mucosal (IgA) and cellular immunity (T-cells), while experiencing few or no symptoms 14.

Researchers found up to 60% SARS-Cov-2 reactivity with CD4+T cells in a non-infected population, suggesting cross-reactivity with other cold (corona) viruses.15 Most people therefore already have a congenital or cross-immunity because they were already in contact with variants of the same virus.

The antibody formation (IgM and IgG) by B-cells only occupies a relatively small part of our immune system. This may explain why, with an antibody percentage of 5-10%, there may be a group immunity anyway. The efficacy of vaccines is assessed precisely on the basis of whether or not we have these antibodies. This is a misrepresentation.

Most people who test positive (PCR) have no complaints. Their immune system is strong enough. Strengthening natural immunity is a much more logical approach. Prevention is an important, insufficiently highlighted pillar: healthy, full-fledged nutrition, exercise in fresh air, without a mask, stress reduction and nourishing emotional and social contacts.

Consequences of social isolation on physical and mental health

Social isolation and economic damage led to an increase in depression, anxiety, suicides, intra-family violence and child abuse.16

Studies have shown that the more social and emotional commitments people have, the more resistant they are to viruses. It is much more likely that isolation and quarantine have fatal consequences. 17

The isolation measures have also led to physical inactivity in many older people due to their being forced to stay indoors. However, sufficient exercise has a positive effect on cognitive functioning, reducing depressive complaints and anxiety and improving physical health, energy levels, well-being and, in general, quality of life.18

Fear, persistent stress and loneliness induced by social distancing have a proven negative influence on psychological and general health. 19

A highly contagious virus with millions of deaths without any treatment?

Mortality turned out to be many times lower than expected and close to that of a normal seasonal flu (0.2%). 20

The number of registered corona deaths therefore still seems to be overestimated.

There is a difference between death by corona and death with corona. Humans are often carriers of multiple viruses and potentially pathogenic bacteria at the same time. Taking into account the fact that most people who developed serious symptoms suffered from additional pathology, one cannot simply conclude that the corona-infection was the cause of death. This was mostly not taken into account in the statistics.

The most vulnerable groups can be clearly identified. The vast majority of deceased patients were 80 years of age or older. The majority (70%) of the deceased, younger than 70 years, had an underlying disorder, such as cardiovascular suffering, diabetes mellitus, chronic lung disease or obesity. The vast majority of infected persons (>98%) did not or hardly became ill or recovered spontaneously.

Meanwhile, there is an affordable, safe and efficient therapy available for those who do show severe symptoms of disease in the form of HCQ (hydroxychloroquine), zinc and AZT (azithromycin). Rapidly applied this therapy leads to recovery and often prevents hospitalisation. Hardly anyone has to die now.

This effective therapy has been confirmed by the clinical experience of colleagues in the field with impressive results. This contrasts sharply with the theoretical criticism (insufficient substantiation by double-blind studies) which in some countries (e.g. the Netherlands) has even led to a ban on this therapy. A meta-analysis in The Lancet, which could not demonstrate an effect of HCQ, was withdrawn. The primary data sources used proved to be unreliable and 2 out of 3 authors were in conflict of interest. However, most of the guidelines based on this study remained unchanged … 48 49

We have serious questions about this state of affairs.

In the US, a group of doctors in the field, who see patients on a daily basis, united in “America’s Frontline Doctors” and gave a press conference which has been watched millions of times.21 51

French Prof Didier Raoult of the Institut d’Infectiologie de Marseille (IHU) also presented this promising combination therapy as early as April. Dutch GP Rob Elens, who cured many patients in his practice with HCQ and zinc, called on colleagues in a petition for freedom of therapy.22

The definitive evidence comes from the epidemiological follow-up in Switzerland: mortality rates compared with and without this therapy.23

From the distressing media images of ARDS (acute respiratory distress syndrome) where people were suffocating and given artificial respiration in agony, we now know that this was caused by an exaggerated immune response with intravascular coagulation in the pulmonary blood vessels. The administration of blood thinners and dexamethasone and the avoidance of artificial ventilation, which was found to cause additional damage to lung tissue, means that this dreaded complication, too, is virtually not fatal anymore. 47

It is therefore not a killer virus, but a well-treatable condition.

Propagation

Spreading occurs by drip infection (only for patients who cough or sneeze) and aerosols in closed, unventilated rooms. Contamination is therefore not possible in the open air. Contact tracing and epidemiological studies show that healthy people (or positively tested asymptomatic carriers) are virtually unable to transmit the virus. Healthy people therefore do not put each other at risk. 24 25

Transfer via objects (e.g. money, shopping or shopping trolleys) has not been scientifically proven.26 27 28

All this seriously calls into question the whole policy of social distancing and compulsory mouth masks for healthy people – there is no scientific basis for this.

Masks

Oral masks belong in contexts where contacts with proven at-risk groups or people with upper respiratory complaints take place, and in a medical context/hospital-retirement home setting. They reduce the risk of droplet infection by sneezing or coughing. Oral masks in healthy individuals are ineffective against the spread of viral infections. 29 30 31

Wearing a mask is not without side effects. 32 33 Oxygen deficiency (headache, nausea, fatigue, loss of concentration) occurs fairly quickly, an effect similar to altitude sickness. Every day we now see patients complaining of headaches, sinus problems, respiratory problems and hyperventilation due to wearing masks. In addition, the accumulated CO2 leads to a toxic acidification of the organism which affects our immunity. Some experts even warn of an increased transmission of the virus in case of inappropriate use of the mask.34

Our Labour Code (Codex 6) refers to a CO2 content (ventilation in workplaces) of 900 ppm, maximum 1200 ppm in special circumstances. After wearing a mask for one minute, this toxic limit is considerably exceeded to values that are three to four times higher than these maximum values. Anyone who wears a mask is therefore in an extreme poorly ventilated room. 35

Inappropriate use of masks without a comprehensive medical cardio-pulmonary test file is therefore not recommended by recognised safety specialists for workers.

Hospitals have a sterile environment in their operating rooms where staff wear masks and there is precise regulation of humidity / temperature with appropriately monitored oxygen flow to compensate for this, thus meeting strict safety standards. 36

A second corona wave?

A second wave is now being discussed in Belgium, with a further tightening of the measures as a result. However, closer examination of Sciensano’s figures (latest report of 3 September 2020)37 shows that, although there has been an increase in the number of infections since mid-July, there was no increase in hospital admissions or deaths at that time. It is therefore not a second wave of corona, but a so-called “case chemistry” due to an increased number of tests. 50

The number of hospital admissions or deaths showed a shortlasting minimal increase in recent weeks, but in interpreting it, we must take into account the recent heatwave. In addition, the vast majority of the victims are still in the population group >75 years.

This indicates that the proportion of the measures taken in relation to the working population and young people is disproportionate to the intended objectives.

The vast majority of the positively tested “infected” persons are in the age group of the active population, which does not develop any or merely limited symptoms, due to a well-functioning immune system.

So nothing has changed – the peak is over.

Strengthening a prevention policy

The corona measures form a striking contrast to the minimal policy pursued by the government until now, when it comes to well-founded measures with proven health benefits such as the sugar tax, the ban on (e-)cigarettes and making healthy food, exercise and social support networks financially attractive and widely accessible. It is a missed opportunity for a better prevention policy that could have brought about a change in mentality in all sections of the population with clear results in terms of public health. At present, only 3% of the health care budget goes to prevention. 2

The Hippocratic Oath

As a doctor, we took the Hippocratic Oath:

“I will above all care for my patients, promote their health and alleviate their suffering”.

“I will inform my patients correctly.”

“Even under pressure, I will not use my medical knowledge for practices that are against humanity.”

The current measures force us to act against this oath.

Other health professionals have a similar code.

The ‘primum non nocere’, which every doctor and health professional assumes, is also undermined by the current measures and by the prospect of the possible introduction of a generalised vaccine, which is not subject to extensive prior testing.

Vaccine

Survey studies on influenza vaccinations show that in 10 years we have only succeeded three times in developing a vaccine with an efficiency rate of more than 50%. Vaccinating our elderly appears to be inefficient. Over 75 years of age, the efficacy is almost non-existent.38

Due to the continuous natural mutation of viruses, as we also see every year in the case of the influenza virus, a vaccine is at most a temporary solution, which requires new vaccines each time afterwards. An untested vaccine, which is implemented by emergency procedure and for which the manufacturers have already obtained legal immunity from possible harm, raises serious questions. 39 40 We do not wish to use our patients as guinea pigs.

On a global scale, 700 000 cases of damage or death are expected as a result of the vaccine.41 If 95% of people experience Covid-19 virtually symptom-free, the risk of exposure to an untested vaccine is irresponsible.

The role of the media and the official communication plan

Over the past few months, newspaper, radio and TV makers seemed to stand almost uncritically behind the panel of experts and the government, there, where it is precisely the press that should be critical and prevent one-sided governmental communication. This has led to a public communication in our news media, that was more like propaganda than objective reporting.

In our opinion, it is the task of journalism to bring news as objectively and neutrally as possible, aimed at finding the truth and critically controlling power, with dissenting experts also being given a forum in which to express themselves.

This view is supported by the journalistic codes of ethics.42

The official story that a lockdown was necessary, that this was the only possible solution, and that everyone stood behind this lockdown, made it difficult for people with a different view, as well as experts, to express a different opinion.

Alternative opinions were ignored or ridiculed. We have not seen open debates in the media, where different views could be expressed.

We were also surprised by the many videos and articles by many scientific experts and authorities, which were and are still being removed from social media. We feel that this does not fit in with a free, democratic constitutional state, all the more so as it leads to tunnel vision. This policy also has a paralysing effect and feeds fear and concern in society. In this context, we reject the intention of censorship of dissidents in the European Union! 43

The way in which Covid-19 has been portrayed by politicians and the media has not done the situation any good either. War terms were popular and warlike language was not lacking. There has often been mention of a ‘war’ with an ‘invisible enemy’ who has to be ‘defeated’. The use in the media of phrases such as ‘care heroes in the front line’ and ‘corona victims’ has further fuelled fear, as has the idea that we are globally dealing with a ‘killer virus’.

The relentless bombardment with figures, that were unleashed on the population day after day, hour after hour, without interpreting those figures, without comparing them to flu deaths in other years, without comparing them to deaths from other causes, has induced a real psychosis of fear in the population. This is not information, this is manipulation.

We deplore the role of the WHO in this, which has called for the infodemic (i.e. all divergent opinions from the official discourse, including by experts with different views) to be silenced by an unprecedented media censorship.43 44

We urgently call on the media to take their responsibilities here!

We demand an open debate in which all experts are heard.

Emergency law versus Human Rights

The general principle of good governance calls for the proportionality of government decisions to be weighed up in the light of the Higher Legal Standards: any interference by government must comply with the fundamental rights as protected in the European Convention on Human Rights (ECHR). Interference by public authorities is only permitted in crisis situations. In other words, discretionary decisions must be proportionate to an absolute necessity.

The measures currently taken concern interference in the exercise of, among other things, the right to respect of private and family life, freedom of thought, conscience and religion, freedom of expression and freedom of assembly and association, the right to education, etc., and must therefore comply with fundamental rights as protected by the European Convention on Human Rights (ECHR).

For example, in accordance with Article 8(2) of the ECHR, interference with the right to private and family life is permissible only if the measures are necessary in the interests of national security, public safety, the economic well-being of the country, the protection of public order and the prevention of criminal offences, the protection of health or the protection of the rights and freedoms of others, the regulatory text on which the interference is based must be sufficiently clear, foreseeable and proportionate to the objectives pursued.45

The predicted pandemic of millions of deaths seemed to respond to these crisis conditions, leading to the establishment of an emergency government. Now that the objective facts show something completely different, the condition of inability to act otherwise (no time to evaluate thoroughly if there is an emergency) is no longer in place. Covid-19 is not a cold virus, but a well treatable condition with a mortality rate comparable to the seasonal flu. In other words, there is no longer an insurmountable obstacle to public health.

There is no state of emergency.

Immense damage caused by the current policies

An open discussion on corona measures means that, in addition to the years of life gained by corona patients, we must also take into account other factors affecting the health of the entire population. These include damage in the psychosocial domain (increase in depression, anxiety, suicides, intra-family violence and child abuse)16 and economic damage.

If we take this collateral damage into account, the current policy is out of all proportion, the proverbial use of a sledgehammer to crack a nut.We find it shocking that the government is invoking health as a reason for the emergency law.

As doctors and health professionals, in the face of a virus which, in terms of its harmfulness, mortality and transmissibility, approaches the seasonal influenza, we can only reject these extremely disproportionate measures.

We therefore demand an immediate end to all measures.

We are questioning the legitimacy of the current advisory experts, who meet behind closed doors.

Following on from ACU 2020 46 https://acu2020.org/nederlandse-versie/ we call for an in-depth examination of the role of the WHO and the possible influence of conflicts of interest in this organisation. It was also at the heart of the fight against the “infodemic”, i.e. the systematic censorship of all dissenting opinions in the media. This is unacceptable for a democratic state governed by the rule of law.43

Distribution of this letter

We would like to make a public appeal to our professional associations and fellow carers to give their opinion on the current measures.We draw attention to and call for an open discussion in which carers can and dare to speak out.

With this open letter, we send out the signal that progress on the same footing does more harm than good, and call on politicians to inform themselves independently and critically about the available evidence – including that from experts with different views, as long as it is based on sound science – when rolling out a policy, with the aim of promoting optimum health.

With concern, hope and in a personal capacity.

 

1: https://www.health.belgium.be/nl/wie-zijn-we#Missie standaard.be/preventie

2: https://www.who.int/about/who-we-are/constitution

3: https://www.who.int/news-room/fact-sheets/detail/human-rights-and-health

4: https://swprs.org/feiten-over-covid19/

5: https://the-iceberg.net/

6: https://www.creative-diagnostics.com/sars-cov-2-coronavirus-multiplex-rt-qpcr-kit-277854-457.htm

7: President John Magufuli of Tanzania: “Even Papaya and Goats are Corona positive” https://www.youtube.com/watch?v=207HuOxltvI

8: Open letter by biochemist Drs Mario Ortiz Martinez to the Dutch chamber https://www.gentechvrij.nl/2020/08/15/foute-interpretatie/

9: Interview with Drs Mario Ortiz Martinez https://troo.tube/videos/watch/6ed900eb-7459-4a1b-93fd-b393069f4fcd?fbclid=IwAR1XrullC2qopJjgFxEgbSTBvh-4ZCuJa1VxkHTXEtYMEyGG3DsNwUdaatY

10: https://infekt.ch/2020/04/sind-wir-tatsaechlich-im-blindflug/

11: Lambrecht, B., Hammad, H. The immunology of the allergy epidemic and the hygiene hypothesis. Nat Immunol 18, 1076–1083 (2017). https://www.nature.com/articles/ni.3829

12: Sharvan Sehrawat, Barry T. Rouse, Does the hygiene hypothesis apply to COVID-19 susceptibility?, Microbes and Infection, 2020, ISSN 1286-4579, https://doi.org/10.1016/j.micinf.2020.07.002

13: https://www.cell.com/cell/fulltext/S0092-8674(20)30610-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867420306103%3Fshowall%3Dtrue

14: https://www.hpdetijd.nl/2020-08-11/9-manieren-om-corona-te-voorkomen/

15: Feys, F., Brokken, S., & De Peuter, S. (2020, May 22). Risk-benefit and cost-utility analysis for COVID-19 lockdown in Belgium: the impact on mental health and wellbeing. https://psyarxiv.com/xczb3/

16: Kompanje, 2020

17: Conn, Hafdahl en Brown, 2009; Martinsen 2008; Yau, 2008

18: https://brandbriefggz.nl/

19: https://swprs.org/studies-on-covid-19-lethality/#overall-mortality

20: https://www.xandernieuws.net/algemeen/groep-artsen-vs-komt-in-verzet-facebook-bant-hun-17-miljoen-keer-bekeken-video/

21: https://www.petities.com/einde_corona_crises_overheid_sta_behandeling_van_covid-19_met_hcq_en_zink_toe

22: https://zelfzorgcovid19.nl/statistieken-zwitserland-met-hcq-zonder-hcq-met-hcq-leveren-het-bewijs/

23: https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html

24: http://www.emro.who.int/health-topics/corona-virus/transmission-of-covid-19-by-asymptomatic-cases.html

25: WHO https://www.marketwatch.com/story/who-we-did-not-say-that-cash-was-transmitting-coronavirus-2020-03-06

26: https://www.nordkurier.de/ratgeber/es-gibt-keine-gefahr-jemandem-beim-einkaufen-zu-infizieren-0238940804.html

27: https://www.reuters.com/article/us-health-coronavirus-germany-banknotes/banknotes-carry-no-particular-coronavirus-risk-german-disease-expert-idUSKBN20Y2ZT

  1. Contradictory statements by our virologists https://www.youtube.com/watch?v=6K9xfmkMsvM

30: https://www.hpdetijd.nl/2020-07-05/stop-met-anderhalve-meter-afstand-en-het-verplicht-dragen-van-mondkapjes/

31: Security expert Tammy K. Herrema Clark https://youtu.be/TgDm_maAglM

32: https://theplantstrongclub.org/2020/07/04/healthy-people-should-not-wear-face-masks-by-jim-meehan-md/

33: https://www.technocracy.news/blaylock-face-masks-pose-serious-risks-to-the-healthy/

34: https://www.news-medical.net/news/20200315/Reusing-masks-may-increase-your-risk-of-coronavirus-infection-expert-says.aspx

35: https://werk.belgie.be/nl/nieuws/nieuwe-regels-voor-de-kwaliteit-van-de-binnenlucht-werklokalen

36: https://kavlaanderen.blogspot.com/2020/07/als-maskers-niet-werken-waarom-dragen.html

37: https://covid-19.sciensano.be/sites/default/files/Covid19/Meest%20recente%20update.pdf

38: Haralambieva, I.H. et al., 2015. The impact of immunosenescence on humoral immune response variation after influenza A/H1N1 vaccination in older subjects. https://pubmed.ncbi.nlm.nih.gov/26044074/

39: Global vaccine safety summit WHO 2019 https://www.youtube.com/watch?v=oJXXDLGKmPg

40: No liability manufacturers vaccines https://m.nieuwsblad.be/cnt/dmf20200804_95956456?fbclid=IwAR0IgiA-6sNVQvE8rMC6O5Gq5xhOulbcN1BhdI7Rw-7eq_pRtJDCxde6SQI

41: https://www.newsbreak.com/news/1572921830018/bill-gates-admits-700000-people-will-be-harmed-or-killed-by-his-covid-19-solution

42: Journalistic code https://www.rvdj.be/node/63

43: Disinformation related to COVID-19 approaches European Commission EurLex, juni 2020 (this file will not damage your computer)

44: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30461-X/fulltext

45: http://www.raadvst-consetat.be/dbx/adviezen/67142.pdf#search=67.142

46: https://acu2020.org/

47: https://reader.elsevier.com/reader/sd/pii/S0049384820303297?token=9718E5413AACDE0D14A3A0A56A89A3EF744B5A201097F4459AE565EA5EDB222803FF46D7C6CD3419652A215FDD2C874F

48: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

49 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31324-6/fulltext

There is no revival of the pandemic, but a so-called casedemic due to more testing.

50: https://www.greenmedinfo.com/blog/crucial-viewing-understanding-covid-19-casedemic1

51: https://docs4opendebate.be/wp-content/uploads/2020/09/white-paper-on-hcq-from-AFD.pdf

COVID-19 and Foxy-Loxy

17th September 2020

In the last few weeks in various podcasts and interviews people have been trying their best to get me to say that the entire COVID-19 panic is a conspiracy. I understand what they are trying to do, but I was not born yesterday! The moment you say, or even imply, something is a conspiracy you step on a landmine that blows you, and your reputation, to smithereens.

Because you immediately become a conspiracy theorist. ‘You are David Icke and I claim my million pounds’. For those who have never heard of him, look him up. According to Wikipedia:

“Icke believes that the universe is made up of “vibrational” energy and consists of an infinite number of dimensions that share the same space. He claims that an inter-dimensional race of reptilian beings called the Archons (or Anunnaki) have hijacked the earth, and that a genetically modified human–Archon hybrid race of shape-shifting reptilians known as the Babylonian Brotherhood, the Illuminati, or the “elite”, manipulate global events to help keep humans in constant fear. The Archons feed off the “negative energy” this creates 1. “

Now, he may not believe that anymore, maybe he never did. Maybe it was a joke, and his words got twisted. But he has managed to gather the kind of reputation that tends to make people suspect he may not be entirely tightly sane. ‘Beware the Archons.’

In truth, I have thought long and hard about what a COVID19 conspiracy might actually be or look like. A shadowy Dr. No sitting in an underground layer, stroking a spoiled, fluffy white cat, and cackling. ‘Yes, Mr Bond, soon the entire world will be under my control as my vaccine is released, turning everyone into mindless zombies. Mwahahahahahaha!

I would just say to Dr. No. Sorry, it’s too late, the Kardashians already did the ‘turning the entire world into mindless zombies’ thing. Now their work here is done. They will soon be heading back to their home-world of Kardashia to plot the destruction of entire inter-galactic civilisations using their inanitron device, powered entirely by trivium crystals.

However, I do not believe in worldwide conspiracies… humans are too incompetent to get a proper worldwide conspiracy organised for one thing. However I do  believe in Foxy-Loxy.

If you remember the children’s tale of ‘the sky is falling’, Chicken Little manages to scare all the other animals, Ducky Lucky et al. into believing the sky is falling, and they rush in blind panic to tell the king. They then run into Foxy-Loxy:

“Well, well, and good day,” said Foxy Loxy. “Where are you rushing on such a fine day, my delicious little friends?”

“Help us! Help us!” cried Chicken Little, Henny Penny, Ducky Lucky, Goosey Loosey, and Turkey Lurkey. “It’s not a fine day at all. The sky is falling, and we’re rushing to tell the king!”

 “And how do you know the sky is falling?” asked Foxy Loxy.

“I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head,” Chicken Little said. “I see,” said Foxy Loxy. “Well then, follow me, and I’ll show you the way to the king.”

So Foxy Loxy led Chicken Little, Henny Penny, Ducky Lucky, Goosey Loosey, and Turkey Lurkey across a field and through the woods. He led them straight to his den, and they never saw the king, or anyone else, ever again

In other versions of the story, Foxy-Loxy deliberately throws the acorn that hits Chicken Little on the head, in order to start the panic in the first place. He then waits to take advantage of the ensuing events. ‘Now please, you must all to follow me, for I will keep you safe.’

In other words, there is no worldwide cabal, no great shadowy conspiracy. Instead what we have is – what I call – a conspiracy of the willing. When fear strikes, the vast bulk of the public really, really, want to be protected, and will do almost anything to feel safe. The medical profession wishes to protect people and will do almost anything they are told, to help their patients.

Politicians very much wish to be seen as great statesmen, protecting the public and bringing in laws to do so. Standing at podiums looking terribly serious and important and pretending to be Winston Churchill.

So, if Sciensey-Wyensey can convince Experty-Wexperty that the sky is falling, then it is easy to get Publicky-Wublickey, Doctory-Woctory and Nursey Wursey, and Politiciany-Opportunity-Wunity to join in. There is no conspiracy here, but there is a massive drive for them all to rush to the king for protection.

At which point, Foxy Loxy has them all perfectly under control. A little nudge here, a little nudge there, and the entire mob will head off in whatever direction you wish. A shepherd with two perfectly controlled sheepdogs. The dread sheepdogs of fear and empty promises.

1: https://en.wikipedia.org/wiki/David_Icke

 

A way to control COVID-19 (for now)

13th September 2020

[Winter is coming]

In the flu pandemic at the end of World War One, the average age of death was twenty-eight 1. In the UK, the average age of death from COVID19 is eighty-one for men, and eighty-four for women. Which is older than the average life expectancy in parts of the UK. These data are from the Office of National Statistics (ONS), as analysed and reported in the Daily Mail 2.

[I do not usually reference newspapers for scientific data, but this article is very clear and understandable for the lay reader].

The risk of dying if you get infected and have serious symptoms, requiring some medical actions – the case fatality rate (CFR*) – also rises exponentially as you get older. In Italy, in the early stages of the pandemic, the CFR for those under twenty-nine was zero per cent. Rising to twenty per cent in those over eighty 3.

[*this figure changes over time. It always falls as more and more people are tested. See previous blogs also about mixing up CFR with Infection Fatality Rate (IFR)]

I am not getting into an unwinnable argument as to the value of human life at different ages. I am simply making the point that COVID19 is, for reasons not well established, vastly more serious in the elderly population. This is very different from previous epidemics.

COVID19 also targets those with significant underlying medical conditions. A recent report from the Centers for Disease Control and Prevention (CDC) in the US, found that ninety-four per cent of patients who died from COVID19 had other ‘health conditions and contributing causes.’ 4

In essence, we know that COVID19 is a disease that is both significant and deadly in the elderly population. Particularly the elderly population with underlying medical conditions. For those of working age – who are otherwise healthy – COVID19 is far less serious. The risk appears to be lower than for influenza. In children, and those under forty, the risk is almost non-existent.

Therefore, it is relatively straightforward to identify pretty accurately those who we need to help protect from COVID19, and those who we do not.

On this basis I am going to recommend that the best way to protect the vulnerable elderly is to build up immunity in the younger population, in order to stop the spread throughout the whole community. If eighty per cent of the population under seventy were to get infected, this would stop transmission in its tracks, and COVID19 would be gone.

However, what we are doing currently is to lockdown ever more tightly to stop the spread. Whether or not this is working is unclear. However, let us assume that it is doing so. Then, I would argue that we are doing precisely the wrong thing at precisely the wrong time.

It is true that in recent weeks, positive infection tests have risen rapidly. However, deaths have not nor have hospital admissions. In the month of August (which is as far as the Office for National Statistics figures go), in the under thirty age group, there was one death 5.

Of course, if more and more people get infected, and more elderly vulnerable people get infected, there will eventually be an increase in deaths. Therefore, what we need to do right now – before winter comes – is to encourage everyone who is fit and well and under the age of seventy (slightly arbitrary figure) to take the masks off, get together and spread this virus far and wide.

At the same time, all of those who are older and/or vulnerable should self-isolate, and this should be rigorously encouraged, and supported. How long would it take to infect the rest of the population?

Using widely accepted figures. If the R number is three (average number of people an infected person will go on to infect), and the serial interval is four days (time from becoming infected to infecting others) 6, then we can do a little thought experiment.

We start with the number of people currently infected. Today, Sept 11th there were 3,539 positive tests in the UK. Assuming people are infectious for a week, then the minimum number of people who have COVID19, currently, who could spread it is 3,539 x 7 = 24,773.

This assumes we have detected every single infected person in the UK, which is not possible, so my 24,773 figure is a major underestimate of the true starting point.

If the R number is three, and the serial interval is four, we would treble the number of cases every four days. We start on day one with 24,773 infective people.

Day one                                 = 24,773

Day five                                 = 74,319

Day nine                                = 222,957

Day thirteen                          = 668,871

Day seventeen                     = 2,006,613

Day twenty                            = 6,019,839

Day twenty-four                    = 18,059,517

Day twenty-eight                  = 54,178,551

That’s it. Done in a month. Of course, it doesn’t quite work like that. As more and more people get infected, there are less people left to infect so the R number drops. We also know that a number of people have already been infected. How many? Who knows.

However, the general principle stands. We could protect the vulnerable elderly by creating sufficient immunity in the rest of the population, ensuring that the elderly are shielded at the same time, and it could be done rapidly.

Matt Hancock (UK health secretary, for those reading this blog in other countries), made the utterly insensitive comment urging people not to kill their granny:

‘Young people have been urged by the health secretary not to “kill your gran” by spreading coronavirus after an increase in cases led to calls for mass testing of students.’7

Has this man been on a course on how to really and truly insult and upset your electorate? If not, then he is clearly just a natural.

Leaving that to one side, Matt Hancock should be urging young people to get infected and ‘protect your granny’ – and also your grandpa. Because grandpas are people too.

Yes, I know, some people, many people… most people? Will be upset by what I have written. How can you possibly encourage people to go out and get infected? Do you want people to die?

No, I want the least possible number of people to die of this awful disease, and its terrible consequences. I also want to stop lockdown as soon as possible because I know that lockdown kills people. Currently it is killing far more than COVID19. Forgetting the economy, forgetting the social destruction and loss of jobs and livelihoods, there are terrible things happening to lives.

Here is what the UK Parliament was told, early on in the lockdown:

‘A global surge in domestic abuse has been reported during the coronavirus pandemic, as those living with domestic violence face greater risks at home during lockdowns, and support services are harder to reach and to provide.

The UK has followed the global pattern of rising domestic abuse risks during the crisis: calls and contacts to helplines have increased markedly and evidence suggests incidents are becoming more complex and serious, with higher levels of physical violence and coercive control.

Counting Dead Women has calculated that there were at least sixteen domestic abuse killings of women and children between 23 March and 12 April.’ 8

Young children are far more likely to die at the hands of their parents than they are to die of COVID19, and young women are far more likely to die at the hands of their abusive partners. Vulnerable children are far safer at school than at home. Yet, we are locking them in their houses.

So, I would turn the whole argument around. Why are we killing children with Lockdown? Get rid of the virus, now, get rid of lockdown now, and allow them to live. Allow the rest of us to have a job, and a future.

As for our elderly people, trapped in houses and Care Homes, unable to see their families. Get rid of this virus now, get rid of lockdown now, and allow them to live. To those who believe they occupy the moral high ground by demanding more lockdowns, more protection etc. I believe that you are failing to protect anyone.

The fact is that we know who to protect, and the best way to do it is to create population-wide immunity as fast as possible. In doing so, we will not overwhelm the hospitals. We will not destroy the NHS – or any other health service around the world. So long as this disease does not rampage through the elderly population again.

For those who say, we must wait for a vaccine. I would say that you could be right to do so, one may appear. However, if you are not right, if problems emerge in development or rollout, what do we do. Lockdown forever? Keep the elderly apart from the rest of society, forever?

I would also say that we cannot plan on the basis that this ‘vaccine’ saviour of humanity may appear. We can only plan on the basis of what we know, what we have got right now. What we have got is a virus that is, for the vast majority of the population is, relatively benign. The majority of people who test positive are not even aware they have been infected.

Yes, of course, if we let COVID19 fly free in those under seventy, there will be deaths. How many? That is very difficult to say. John Ioannidis, a professor and researcher that I rate very highly, attempted to calculate the Infection Fatality Rate in the under seventy population. In July he put it at 0.04%. So, I will go with his figure 9.

0.04% is four in ten thousand. Which may not sound a lot to some. However, in the UK, we have sixty-seven million people, of whom fifty-six million are under age seventy. So, four in ten thousand fatalities would result in twenty-two thousand four hundred deaths. I agree that is a lot, but this figure comes in far too high, for a number of reasons.

First, it is estimated that we would need 80% of population to be infected, to create population wide immunity. So, we can immediately reduce twenty-two thousand four hundred to eighteen thousand. Still too many? Well we would, of course, shield people with underlying diseases such as type II diabetes and cancer and heart disease.

If the Centers for Disease Control and Prevention (CDC) figures are correct, ninety-four per cent of those who die of COVID19 have other serious underlying conditions.  So, if we also protect those under seventy, who have serious underlying condition, the eighteen thousand figure reduces to one thousand and eighty.

Which means that it may be possible to achieve population wide immunity at a (maximum) cost of just over one thousand deaths, from COVID19, Probably not even that, as we do now know far better how to treat it than we did at the start. We could also do this by the end of the year – by the latest. You still think one thousand deaths is too many. Well, consider the alternative.

Let us look at just one condition, cancer. Due to the actions taken to reduce deaths from COVID19, there has been a serious delay in cancer diagnosis. Here from the Lancet:

‘Substantial increases in the number of avoidable cancer deaths in England are to be expected as a result of diagnostic delays due to the COVID-19 pandemic in the UK. Urgent policy interventions are necessary, particularly the need to manage the backlog within routine diagnostic services to mitigate the expected impact of the COVID-19 pandemic on patients with cancer.’10

The authors estimated the years of life lost from delayed cancer diagnosis and treatment will be in the region of 59,204 – 63,229. A year of life lost is not the same outcome as a life lost dying from COVID. However, sixty thousand years of life lost is significantly greater than one thousand COVID19 deaths, and the longer we go on, the greater this number becomes.

This, remember, is just one condition. The ONS estimated that lockdown has, so far, caused sixteen thousand excess deaths due to such things as people not attending hospital with heart attacks and strokes, and suchlike. I want to emphasize this is not my figure, it comes from SAGE 11.

I don’t think I can make the point forcefully enough that we are not playing a zero-sum game here, whereby every COVID life saved is a life saved, that would otherwise be lost. Lockdown itself, kills people, in their thousands and thousands. Their tens of thousands. More than COVID19 itself, in total? Some people think so, including me.

I say this because ONS further estimated that, in England alone, the economic recession itself will lead to around 17,000  excess deaths per year, for several years. Add that to the sixteen thousand this year, add that to the cancer lives lost…

‘This (estimated recession) produces an increase in deaths of between 1.2% and 6.8% in England as a result of the negative economic impact from COVID-19 and associated NPIs (actions that are taken to prevent the disease i.e. lockdown), with a central estimate of 3.1%. This is between 6,800 and 38,300 additional deaths per year, with a central estimate of 17,400 per year 11.’

The other point to bear in mind is that, if we shield the elderly and vulnerable, and create population immunity, we are also protecting millions of people who would have a far greater risk of dying if they became infected.

Using an infection fatality rate of one per cent in the over seventies [it is probably higher than that] we have twelve million people over seventy in the UK. If eighty per cent got infected, this could result in nine hundred and sixty thousand deaths. That would certainly overwhelm the health service.

So, I would ask people to turn their thinking around on COVID19. We have it within our power, right now, to get rid of COVID19 by the end of the year. Will this get rid of it forever – who knows – it may return in the winter. If not this winter, next winter?

If we open up society there will be a cost, there will be deaths, that is inarguable. However, I believe that we will save far more lives by letting this disease spread in the younger, healthy population. We will save both children and adults, and we can return to normal life.

Therefore, the proposal is simple. Work out who is most at risk, work out how to keep them shielded, then encourage everyone else to get out there and live their lives as before. [General Practitioners have already been asked to create lists of their patients who are most vulnerable, so most of this work has been done]. Once we have the infection rates sufficiently high to block viral spread, the entire population, including the elderly and vulnerable, can be released to live their lives as before.

The alternative is to wait, in hope, for a vaccine. One that is almost certainly not going to get here before winter arrives in the Northern Hemisphere. By which time further irreparable harm will have been done, and thousands more lives will have been lost, unnecessarily.

 

1; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/

2: https://www.dailymail.co.uk/news/article-8470843/The-average-COVID-19-victim-OLDER-age-people-usually-die-Scotland.html

3: https://ourworldindata.org/mortality-risk-COVID#the-case-fatality-rate

4: https://www.jems.com/2020/08/31/cdc-report-underlying-conditions-94-percent-COVID-19-deaths/

5: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

6: https://www.sciencedaily.com/releases/2020/03/200316143313.htm

7: https://www.thetimes.co.uk/article/affluent-youth-are-catching-coronavirus-most-says-matt-hancock-qvbpxw2nk

8: https://publications.parliament.uk/pa/cm5801/cmselect/cmhaff/321/321.pdf

9: https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v3

10: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30388-0/fulltext

11: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907616/s0650-direct-indirect-impacts-COVID-19-excess-deaths-morbidity-sage-48.pdf

COVID – why terminology really, really matters

4th September 2020

COVID – why terminology really, really matters

[And the consequences of getting it horribly wrong]

When is a case not a case?

Since the start of the COVID pandemic I have watched almost everyone get mission critical things wrong. In some ways this is not surprising. Medical terminology is horribly imprecise, and often poorly understood. In calmer times such things are only of interest to research geeks like me. Were they talking about CVD, or CHD?

However, right now, it really, really, matters. Specifically, with regards to the term COVID ‘cases.’

Every day we are informed of a worrying rise in COVID cases in country after country, region after region, city after city. Portugal, France, Leicester, Bolton. Panic, lockdown, quarantine. In France the number of reported cases is now as high as it was at the peak of the epidemic. Over 5,000, on the first of September.

But what does this actually mean? Just to keep the focus on France for a moment. On March 26th, just before their deaths peaked, there were 3,900  ‘cases’. Fourteen days later, there were 1,400 deaths. So, using a widely accepted figure, which is a delay of around two weeks between diagnoses and death, 36% of cases died.

In stark contrast, on August 16th, there were 3,000 cases. Fourteen days later there were 26 deaths.  Which means that, in March, 36% of ‘cases’ died. In August 0.8% of ‘cases’ died. This, in turn, means that COVID was 45 times as deadly in March, as it was in August?

This seems extremely unlikely. In fact, it is so unlikely that it is, in fact, complete rubbish. What we have is a combination of nonsense figures which, added together, create nonsense squared. Or nonsense to the power ten.

To start with, we have the mangling of the concept of a ‘case’.

Previously, in the world of infectious diseases, it has been accepted that a ‘case’ represents someone with symptoms, usually severe symptoms, usually severe enough to be admitted to hospital. Here, from Wikipedia…. yes, I know, but on this sort of stuff they are a good resource.

‘In epidemiology, a case fatality rate (CFR) — sometimes called case fatality risk or disease lethality — is the proportion of deaths from a certain disease compared to the total number of symptomatic people diagnosed with the disease.’ 1

Note the word symptomatic i.e. someone with symptoms.

However, now we stick a swab up someone’s nose, who feels completely well, or very mildly ill. We find that they have some COVID particles lodged up there, and we call them a case of COVID. Sigh, thud!

A symptomless, or even mildly symptomatic positive swab is not a case. Never, in recorded history, has this been true. However, now we have an almost unquestioned acceptance that a positive swab represents a case of COVID. This is then parroted on all the news channels as if it were gospel.

I note that, at last, some people are beginning to question how it can be that, whilst cases are going up and up, deaths are going down, and down.

This is even the case in Sweden, which seems to be the final bastion of people with functioning brains. However, even they seem surprised by this dichotomy. In the first two weeks of August they had 4,152 positive swabs. Yet, in the last two weeks of August, they had a mere 14 deaths (one a day, on average).

That represents 1 death for every 300 positive swabs or, as the mainstream media insists on calling them, positive ‘cases’. Which, currently, represent a case fatality rate of 0.33%. Just to compare that with something similar, the case fatality rate of swine flu (HIN1),  was 0.5%. 2

Thus, lo and behold, COVID is a less severe infection than swine flu – the pandemic that never was. That’s what these figures appear to tell us. They tell us almost exactly the same in France where they ‘appear’ to have a current case fatality rate of 0.4%.

On the other hand, if you look at the figures from around the world, they are very different. As I write this there have been, according to the WHO, 25 million cases and 850,000 deaths. That is a case fatality rate of more than 3%. Ten times as high.

Why are these figures so all over the place? It is because we are using horribly inaccurate terminology. We are comparing apples with pomegranates to tell us how many bananas we have. Our experts are, essentially, talking gibberish, and the mainstream media is lapping it up. They are defining asymptomatic swabs as cases, and no-one is calling them out on it. Why?

Because… because they are frightened of looking stupid? Primarily, I believe, because they also have no idea what a case might actually be So, it all sounds quite reasonable to them.

The good news

However, moving on from that nonsense, there is some extremely good news buried in here. Which I am going to try and explain. It goes as follows.

At the start of the epidemic, the only people being tested were those who were being admitted to hospital, who were seriously ill. Many of them died. Which is why, in France, there was this very sharp, initial case fatality rate of 35%. In the UK the initial case fatality rate was I think 14%. Last time I looked at the UK figures, the case fatality was 5%, and falling fast.

This fall has occurred, and will occur everywhere in the World, because as you increase your testing, you pick up more and more people with less severe symptoms. People who are far less likely to die. The more you test, the more the case fatality rate falls.

It falls even more dramatically when you start to test people who have no symptoms at all. In fact, as you broaden your testing net, something else very important happens. You gradually move from looking at the case fatality rate to the infection fatality rate.

The infection fatality rate is the measure of how many people who are infected [even those without symptoms, or very mild symptoms] who then die. This is the critical figure to know because it gives you an accurate assessment of the total number of deaths you are likely to see.

IFR x population of a country x % of population infected = total number of deaths (total mortality)

So, where have we got to. Well, although the case fatality rate in the UK still currently stands at 5%, because it is dragged up by the 14% rate we had at the start. If we look at the more recent figures things have changed very dramatically.

In the first two weeks of August there were 13,996 positive swabs in the UK. In the second two weeks of August there were 129 deaths. If you consider every positive swab to be a case, this represents a case fatality rate of 0.9%. Around one fifteenth of that seen at the start.

I think you can clearly see a direction of travel here.

  • At the start on the pandemic we had a, brief, 35% fatality rate in France
  • It was 14% in the UK at the start
  • It now sits at 5% in the UK – over the whole pandemic
  • In August, in the UK, it was down to 0.9%
  • It is currently 0.47% in Germany
  • It is currently 0.4% in France
  • It is currently 0.33% in Sweden

It is falling, falling, everywhere. Where does it end up, this hybrid case/infection fatality rate? Remember, we are still only testing a fraction of the population, so we are missing the majority of people who have been infected, mainly those who do not have symptoms. Which means that these rates must fall further, as they always do in any pandemic.

To quote the Centre for Evidence Base Medicine on the matter:

‘In Swine flu, the IFR (infection fatality rate) ended up as 0.02%, fivefold less than the lowest estimate during the outbreak (the lowest estimate was 0.1% in the 1st ten weeks of the outbreak).3

The best place to estimate where we may finally end up with COVID, is with the country that has tested the most people, per head of population. This is Iceland. To quote the Centre for Evidence Based Medicine once more:

‘In Iceland, where the most testing per capita has occurred, the IFR lies somewhere between 0.03% and 0.28%.’ 3

Sitting in the middle of 0.03% and 0.28% is 0.16%. As you can see, Iceland, having tested more people than anywhere else, has the lowest IFR of all. This is not a coincidence. This is an inevitable result of testing more people.

I am going to make a prediction that, in the end, we will end up with an IFR of somewhere around 0.1%. Which is about the same as severe flu pandemics we have had in the past. Remember that figure. It is one in a thousand.

It may surprise you to know that I am not the only person to have made this exact same prediction. On the 28th February, yes that far back, the New England Journal of Medicine published a report by the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (A.S.F., H.C.L.); and the Centers for Disease Control and Prevention, Atlanta. 4

In this paper ‘Covid-19 — Navigating the Uncharted’ they stated the following:

‘On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%. In another article in the Journal, Guan et al. report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate (my underline) may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza.’ 

A case fatality rate considerably less than 1%. Their words, not mine. As they also added, ‘the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza.’ 

At this point, you may well be asking. Why the hell did we lockdown if COVID was believed to be no more serious than influenza? Right from the start by the most influential infectious disease organisations in the World.

It is because of the mad mathematical modellers. The academic epidemiologists. Neil Ferguson, and others of his ilk. When they were guessing (sorry estimating, sorry modelling) the impact of COVID they used a figure of approximately one per cent as the infection fatality rate. Not the case fatality rate. In so doing, they overestimated the likely impact of COVID by, at the very least, ten-fold.

How could this possibly have happened?

When they put their carefully constructed model together on the 16th of March, if they had been reading the research, they must have been aware that they were looking at a maximum case fatality rate of just over 1% in China, right at the start, where the figures are always at their highest.

Which means that, unless COVID was going to turn out nearly 100% fatal, we could never get anywhere near 1%, for the infection fatality rate. Even Ebola only kills 50%.

But they went with it, they went with 1%. Actually, Imperial College reduced it slightly to 0.9%, for reasons that are opaque.

From this, all else flowed.

If the INFECTION fatality rate truly were 0.9%, and 80% of the population of the UK became infected, there would have been/could have been, around 500,000 deaths.

0.9% x 80% x 67million = 482,000

LOCKDOWN

However, if the case fatality rate is around 1%, then the infection fatality rate will be about one tenth of this, maybe less. So, we would see around 50,000 deaths, about the same as was seen in previous bad flu pandemics.

DO NOT LOCKDOWN

What Imperial College London did was to use a model that overestimated the infection fatality rate by a factor of ten.

We now know, as the IFR rates of various countries falls and falls, that the Imperial College estimated IFR was completely wrong. The UK, for example, has seen 42,000 deaths so far, which is 0.074% of population. The US has seen about 200,000 deaths 0.053%. Sweden, which did not lockdown down, has seen about 6,000 deaths, which is an infection fatality rate of 0.06%. All three countries are opening up and opening up. Whilst the ‘cases’ are rising and rising, the deaths continue to fall. They are, to all intents and purposes, flatlining.

In Iceland it is around 0.16% and falling. In other words…

Stop panicking – it’s over

Whilst everyone is panicking about the ever-increasing number of cases, we should be celebrating them. They are demonstrating, very clearly, that COVID is far, far, less deadly then was feared. The Infection Fatality Rate is most likely going to end up around 0.1%, not 1%.

So yes, it does seem that ‘the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza.’

Wise words, wise words indeed. Words that were written by one Anthony S Fauci on the 28th of February 2020. If you haven’t heard of him, look him up.

Critically though, eleven days after this, he rather blotted his copybook, because he went on to say this “The flu has a mortality rate of 0.1 percent. This (COVID) has a mortality rate of 10 times that. That’s the reason I want to emphasize we have to stay ahead of the game in preventing this.” 5

The mortality rate Dr Fauci? Could it possibly be that he failed to understand that there is no such thing as a mortality rate? Did he mean the case fatality rate, or the infection fatality rate? If he meant the Infection mortality rate of influenza, he was pretty much bang on. If he meant the case fatality rate, he was wrong by a factor of ten.

The reality is that, no matter what Fauci went on to say, severe influenza has a case fatality rate of 1%, and so does COVID. They also have approximately the same infection fatality fate of 0.1%.

It seems that Dr Fauci just got mixed up with the terminology. Because in his Journal article eleven days earlier, he did state… ‘This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza… [and here is the kicker at the end] (which has a case fatality rate of approximately 0.1%).

You see, he did say the case fatality rate of influenza was approximately 0.1%. Wrong, wrong, wrong, wrong… wrong.

Oh dear, oh dear, oh dear. With influenza, Dr Fauci, the CDC, his co-authors, the National Institute of Allergy and Infectious Diseases and the National Institutes of Health and the New England Journal of Medicine got case fatality rate and infection fatality rate mixed up with influenza. Easy mistake to make. Could have done it myself. But didn’t.

You want to know where Imperial College London really got their 1% infection fatality rate figure from? It seems clear that they got it from Anthony S Fauci and the New England Journal of Medicine. The highest impact journal in the world – which should have the highest impact proof-readers in the world. But clearly does not.

Imperial College then used this wrong NEJM influenza case fatality rate 0.1%. It seems that they then compared this 0.1% figure to the reported COVID case fatality rate, estimated to be 1% and multiplied the impact of COVID by ten – as you would. As you probably should.

So, we got Lockdown. The US used the Fauci figure and got locked down. The world used that figure and got locked down.

That figure just happens to be ten times too high.

I know it is going to be virtually impossible to walk the world back from having made such a ridiculous, stupid, mistake. There are so many reputations at stake. The entire egg production of the world will be required to supply enough yolk to cover appropriate faces.

Of course, it will be denied, absolutely, vehemently, angrily, that anyone got anything wrong. It will be denied that a simple error, a mix up between case fatality and infection fatality led to this. It will even more forcefully stated that COVID remains a deadly killer disease and that all Governments around the world have done exactly the right thing. The actions were right, the models were correct. We all did the RIGHT thing. Only those who are stupid, or incompetent cannot see it.

When wrong, shout louder, get angry, double-down, attack your critics in any way possible. Accuse them of being anti-vaxx, or something of the sort. Dig for the dirt. ‘How to succeed in politics 101, page one, paragraph one.’

However, just have a look, at the figures. Tell me where they are wrong – if you can. The truth is that this particular Emperor has no clothes on and is, currently, standing bollock naked, right in front of you. Hard to believe, but true.

I would like to thank Ronald B Brown for pointing out this catastrophic error, in his article ‘Public health lessons learned from biases in coronavirus mortality overestimation. 6

I had not spotted it. He did. All credit is his. I am simply drawing your attention to what has simply been – probably the biggest single mistake that has ever been made in the history of the world.

1: https://en.wikipedia.org/wiki/Case_fatality_rate

2: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70120-1/fulltext#:~:text=Methods%20for%20estimating%20the%20case,a%20novel%2C%20emerging%20infectious%20disease.&text=To%20avoid%20similar%20underestimations%2C%20accounting,be%20about%200%C2%B75%25.

3: https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

4: https://www.nejm.org/doi/full/10.1056/nejme2002387

5: https://reason.com/2020/03/11/covid-19-mortality-rate-ten-times-worse-than-seasonal-flu-says-dr-anthony-fauci/

6: https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/public-health-lessons-learned-from-biases-in-coronavirus-mortality-overestimation/7ACD87D8FD2237285EB667BB28DCC6E9

COVID – What have we learned?

25th August 2020

We have learned that people who are asymptomatic can, cannot, can, cannot, can, cannot, can… spread the virus.

That the accuracy of PCR antigen testing is brilliant, useless, brilliant, useless, brilliant, useless.

That false positive tests are impossible, common, impossible, common, impossible, common.

That facemasks are useless, necessary, useless, necessary, useless… absolutely necessary.

We also know that some people are, are not, are, are not are, naturally immune. In addition, we know that having had COVID means that you can, cannot, can, cannot, can cannot – maybe you can, frankly who knows, get it again. I think Kurt Vonnegut Junior put it best:

“We do, doodley do, doodley do, doodely do,
What we must, muddily must, muddily must, muddily must;
Muddily do, muddily do, muddily do, muddily do,
Until we bust, bodily bust, bodily bust, bodily bust.”

I like to think I have some expertise in reading medical research papers, then trying to work out what they really mean, rather than what they say they mean. I even gritted my teeth and wrote the book “Doctoring Data” in order to help people understand the endless games and manipulations that are played with research studies.

I analysed the power of money to distort research findings, in ways such that black can be magically turned into white.

Of course, distortion is not just driven by money. This is only one of the factors that lays its heavy hand upon research. There are many others. The immense power of an idea to set thoughts in concrete, previous public statements made and fearing loss of authority if you change your mind. Status, power, political games, etc.

Just to look at an example of actions not (obviously) driven by money. On the back of COVID, Bill Gates seems determined to be remembered as the man who vaccinated the world. It will be his enduring legacy. He probably knows that his Microsoft empire will simply be a sub-paragraph in an MBA hypothesis in a hundred years. On the other hand, worldwide vaccination will secure him a place in history.

Although I understand many of the forces at work to distort research, and how the manipulates are carried out, when it comes to COVID I have almost given up. Almost everyone seems to have an agenda, twisting and turning meaning this way and that.

In many cases, the end result seems to be a determined effort to inflate the mortality figures, or paint COVID as the evillest virus ever. I suspect the vaccine manufacturers have a major role to play in this.

Just to give one reasonably well-known example of this. In England, if you ever had a positive test for COVID, and then died, you were added to the COVID death statistics. Whatever killed you, however long after you had a positive test you died of COVID.

This has recently been changed. Primarily because it was so patently ridiculous that even Matt Hancock (UK health secretary) was no longer able to confirm that this was absolutely the correct thing to do. Although it seems he had no idea it was happening in the first place.

Despite this change, we still have the situation in the UK, where you can never, officially recover from COVID – which is equally mad. Once you’ve got it, you’ve got it. I suspect this will be quietly changed at some point – maybe it has been, and I didn’t notice.

On the other hand, other very strange things took place, in the opposite direction. Right at the start of the pandemic, the UK Govt changed COVID to an infection no longer considered of high consequence

As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious disease (HCID) in the UK.1

Yes, the 19th of March. The UK went into lockdown on the 16th of March [Error, this should be the 23rd march], and three days later COVID was no longer a high consequence disease. The only disease in history which has required lockdown, including the obliteration of many basic human rights, and the trashing of the entire economy. Yet it is not a disease of high consequence?

This happened virtually unremarked. Very quietly, you could almost say sneakily. What on earth went on here? My guess is this was done to stop healthcare workers suing the NHS if they contracted COVID at work – as almost no medical staff had adequate PPE. There may be other reasons, but I struggle to think what they may be.

Wherever you looked there was confusion, and statistical manipulation, and then we moved onto the hydroxychloroquine saga. At the very start of the pandemic I wrote a blog suggesting hydroxychloroquine could be helpful. This was based on earlier research demonstrating this drug could hamper viral entry into cells and, once within the cell, could impede viral entry into the nucleus. I even tried to get my trust to stockpile some of the drug – no chance there. Hydroxy-what?

Little did I know the massive storm that would erupt around this drug. A drug that has been around for decades. It is available over the counter in many countries and is, I think, the most widely used drug in India. It is primarily an anti-malarial drug – as it helps to prevent entry of the malaria parasite into cells and can hamper it breaking down haemoglobin, thus destroying red blood cells.

It is also used as an anti-inflammatory in diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE), where it is extraordinarily safe (in the correct doses). It has been looked at as a possible anti-viral for many years. Earlier this year, I was reading various papers about it. Such as this one ‘Effects of chloroquine on viral infections: an old drug against today’s diseases.’

Chloroquine is a 9-aminoquinoline known since 1934. Apart from its well-known antimalarial effects, the drug has interesting biochemical properties that might be applied against some viral infections. Chloroquine exerts direct antiviral effects, inhibiting pH-dependent steps of the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses. Its best-studied effects are those against HIV replication, which are being tested in clinical trials. Moreover, chloroquine has immunomodulatory effects, suppressing the production/release of tumour necrosis factor α and interleukin 6, which mediate the inflammatory complications of several viral diseases’.2

[Chloroquine and hydroxychloroquine are essentially the same drug, when it comes to efficacy/activity, but hydroxychloroquine has less side-effects. ‘Hydroxy’ means an OH group has been added to the basic compound]

I have to say I didn’t bother to read anything from 2020. It was clear that commercial interests were already heavily contaminating this area.

Which meant that, in order to get a handle on untainted data, I went back to calmer research papers from another era. Anyway, having read around the area, it seemed that hydroxychloroquine might do some good. It was certainly pretty safe, and we had nothing else at the time. Thus, I recommended that it might be used.

Then, the distorting engine was switched to full power. Driven by two main fuel types. Type one was money. Companies with anti-viral agents, such as remdesivir, did not want a ‘cheap as chips’ drug being used. No sirree, they wanted massively expensive (and almost entirely useless) anti-virals to be used instead.

This resulted in a study published in the Lancet, no less, slamming hydroxychloroquine through the floor. It turns out the study was almost entirely fabricated, by researchers strongly associated with various companies who, surprise, surprise, make anti-virals.

The other fuel type was the hybrid money/vaccine. If hydroxychloroquine (plus zinc and azithromycin) works, then there was great concern this would lower uptake of any vaccine that was developed. In addition, it would not be possible to impose emergency vaccine laws, which would make the manufacture of any vaccine far quicker and easier.

Such laws, in the US, are known as Emergency Use Authorisation (EUA). If enacted, these laws mean that a vaccine does not have to be tested for safety and efficacy before use. Just whack it out there, untested. Also, there is no possibility of suing a vaccine manufacturer if it turns out the vaccine caused serious problems.

In the US, UK, and several other countries, complete legal protection against vaccine damage is already enshrined in the law, so nothing changes here.

However, there is still a requirement to carry out at least some research on efficacy and safety. The EUA would remove this barrier. Just get it out there, no questions asked, none possible.

Depending on your view of the ethical standards of those companies manufacturing such vaccines, you would either welcome this move, or feel deeply disturbed. I would be in the latter camp. No way I am taking an active medication that has not been tested for either safety or efficacy.

Whatever camp you are in, there are vast fortunes to be made from developing the first vaccine for COVID-19. If all barriers to immediate uptake are removed, we have a goldrush on our hands. No need to prove your vaccine works, no need to demonstrate it is safe, no chance of being sued. Billions of dollars to be made. What could possibly go wrong?

Which takes us back to that pesky drug, hydroxychloroquine. Does it work, does it not? It seems we will never be allowed to know. Recently the Food and Drug Administration in the US, removed authorisation for its use. Even in a hospital, such as he Henry Ford in Detroit, that appeared to be getting impressive results:

‘”The U.S. Food and Drug Administration informed us that it would not grant our request for an emergency use authorization for hydroxychloroquine for a segment of COVID-19 patients meeting very specific criteria,” said Dr. Adnan Munkarah, Henry Ford’s executive vice president and chief clinical officer, in a statement’ 3

All other trials around the world have also being stopped by the National Institutes of Health, the World Health Orhanisation and the UK health authorities.

This, remember, is a drug that has been taken by, literally, billions of people. It is considered safe enough to buy over the counter, yet now it is so dangerous that it cannot even be used for research purposes. Of course, you can still take it if you have rheumatoid arthritis, SLE, malaria – or suchlike – where it remains perfectly safe and is also known to reduce inflammation (a major problem with COVID).

At a stroke discussion, or research, has become virtually impossible, as noted by the Henry Ford hospital in Detroit.

‘Last week, Henry Ford issued an open letter about its study, saying, “the political climate that has persisted has made any objective discussion about this drug impossible.”

The health system said in the letter that it will no longer comment outside the medical community on the use of hydroxychloroquine to treat novel coronavirus.’

So, what have we learned? We have learned that medical science is not a pure thing – not in the slightest. We have also learned that the world of research has not come together to conquer COVID, it has split apart.

Those wanting to make money, have distorted and damaged research for their own ends. Those who want to vaccinate the world, forever, have seen a door open to the promised land. Those who wanted lockdown, are inflating the numbers of those killed. Democrats in the US are using COVID as a stick to beat Donald Trump. It is all a bloody horrible mess.

It is said that the first casualty of war is the truth. Never has this been more certain that with COVID. In this case, first we killed the truth, then we killed science, then we beat inconvenient facts to death with a club. It is all extraordinarily depressing.

1: https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid#status-of-covid-19

2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128816/

3: https://eu.freep.com/story/news/health/2020/08/13/henry-ford-health-hydroxychloroquine-covid-fda/3360940001/

How bad is COVID really? (A Swedish doctor’s perspective)

7th August 2020

A doctor working in Sweden as an emergency care physician contacted me to discuss all things COVID-19. He has also written a blog, which can be seen here.

I asked if I could reproduce it on my blog as I felt it was a fascinating persepctive on what was happening in Sweden. It is also incredibly well written, in English, for someone who is Swedish. Most humbled. I hope you enjoy it.

Ok, I want to preface this article by stating that it is entirely anecdotal and based on my experience working as a doctor in the emergency room of one of the big hospitals in Stockholm, Sweden, and of living as a citizen in Sweden.

As many people know, Sweden is perhaps the country that has taken the most relaxed attitude of any towards the COVID pandemic. Unlike other countries, Sweden never went in to complete lockdown. Non-essential businesses have remained open, people have continues to go to cafés and restaurants, children have remained in school, and very few people have bothered with face masks in public.

COVID hit Stockholm like a storm in mid-March. One day I was seeing people with appendicitis and kidney stones, the usual things you see in the emergency room. The next day all those patients were gone and the only thing coming in to the hospital was COVID. Practically everyone who was tested had COVID, regardless of what the presenting symptom was. People came in with a nose bleed and they had COVID. They came in with stomach pain and they had COVID.

Then, after a few months, all the COVID patients disappeared. It is now four months since the start of the pandemic, and I haven’t seen a single COVID patient in over a month. When I do test someone because they have a cough or a fever, the test invariably comes back negative.

At the peak three months back, a hundred people were dying a day of COVID in Sweden, a country with a population of ten million. We are now down to around five people dying per day in the whole country, and that number continues to drop. Since people generally die around three weeks after infection, that means virtually no-one is getting infected any more.

If we assume around 0.5 percent of those infected die (which I think is very generous, more on that later), then that means that three weeks back 1,000 people were getting infected per day in the whole country, which works out to a daily risk per person of getting infected of 1 in 10,000, which is miniscule. And remember, the risk of dying is at the very most 1 in 200 if you actually do get infected. And that was three weeks ago. Basically,COVID is in all practical senses over and done with in Sweden.

After four months. In total COVID has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people. Considering that 70% of those who have died of COVID are over 80 years old, quite a few of those 6,000 would have died this year anyway. That makes covid a mere blip in terms of its effect on mortality.

That is why it is nonsensical to compare covid to other major pandemics, like the 1918 pandemic that killed tens of millions of people. COVID will never even come close to those numbers. And yet many countries have shut down their entire economies, stopped children going to school, and made large portions of their population unemployed in order to deal with this disease.

The media have been proclaiming that only a small percentage of the population have antibodies, and therefore it is impossible that herd immunity has developed. Well, if herd immunity hasn’t developed, where are all the sick people? Why has the rate of infection dropped so precipitously? Considering that most people in Sweden are leading their lives normally now, not socially distancing, not wearing masks, there should still be high rates of infection.

The reason we test for antibodies is because it is easy and cheap. Antibodies are in fact not the body’s main defence against virus infections. T-cells are. But T-cells are harder to measure than antibodies, so we don’t really do it clinically. It is quite possible to have T-cells that are specific for covid and thereby make you immune to the disease, without having any antibodies.

Personally, I think this is what has happened. Everybody who works in the emergency room where I work has had the antibody test. Very few actually have antibodies. This is in spite of being exposed to huge numbers of infected people, including at the beginning of the pandemic, before we realized how widespread COVID was, when no-one was wearing protective equipment.

I am not denying that COVID is awful for the people who do get really sick or for the families of the people who die, just as it is awful for the families of people who die of cancer, or influenza, or an opioid overdose. But the size of the response in most of the world (not including Sweden) has been totally disproportionate to the size of the threat.

Sweden ripped the metaphorical band-aid off quickly and got the epidemic over and done with in a short amount of time, while the rest of the world has chosen to try to peel the band-aid off slowly. At present that means Sweden has one of the highest total death rates in the world. But COVID is over in Sweden. People have gone back to their normal lives and barely anyone is getting infected any more.

I am willing to bet that the countries that have shut down completely will see rates spike when they open up. If that is the case, then there won’t have been any point in shutting down in the first place, because all those countries are going to end up with the same number of dead at the end of the day anyway. Shutting down completely in order to decrease the total number of deaths only makes sense if you are willing to stay shut down until a vaccine is available. That could take years. No country is willing to wait that long.

COVID has at present killed less than 6000 in Sweden. It is very unlikely that the number of dead will go above 7,000. An average influenza year in Sweden, 700 people die of influenza. Does that mean COVID is ten times worse than influenza? No, because influenza has been around for centuries while COVID is completely new.

In an average influenza year most people already have some level of immunity because they’ve been infected with a similar strain previously, or because they’re vaccinated. So it is quite possible, in fact likely, that the case fatality rate for COVID is the same as for influenza, or only slightly higher, and the entire difference we have seen is due to the complete lack of any immunity in the population at the start of this pandemic.

This conclusion makes sense of the Swedish fatality numbers – if we’ve reached a point where there is hardly any active infection going on any more in Sweden, in spite of the fact that there is barely any social distancing happening, then that means at least 50% of the population has been infected already and have developed immunity, which is five million people.

This number is perfectly reasonable if we assume a reproductive number for the virus of two: If each person infects two new, with a five day period between being infected and infecting others, and you start out with just one infected person in the country, then you will reach a point where several million are infected in just four months. If only 6000 are dead out of five million infected, that works out to a case fatality rate of 0.12 percent, roughly the same as regular old influenza, which no-one is the least bit frightened of, and which we don’t shut down our societies for.