Analysis of NZ serology study

In the year since New Zealand closed its border and adopted an ‘elimination strategy’ against SARS-Cov-2, only one reliable serology test has been conducted. During this period at least 47 serology studies have been conducted throughout the world. Serology tests were banned from import or sale in NZ.

The result of the authorised study of 9806 blood samples taken in December 2020, was pre-print published (not peer reviewed) on April 19: https://www.medrxiv.org/content/10.1101/2021.04.12.21255282v1

The headline result is that it found antibodies to SARS-CoV-2 in 0.1% of samples.

This is lower than we expected – especially when compared to the prevalence found in other nations of studies conducted earlier in the pandemic (as high as 50% in India). It is also much lower than the NZ prevalence of H1N1 (30% positive antibodies), which triggered health authorities to abandon elimination plans.

The title and commentary of the paper suggests this low level is explained by elimination of the virus. It is directly explained by the estimated 3-month half-life of antibodies (S and RBD, compared to month long half-life of N protein). Our reference paper on seropositivity is https://www.medrxiv.org/content/10.1101/2020.07.16.20155663v2.full.pdf. That means ‘fresh’ infections have been falling. This undoubtedly means that border closure has cut off supply of renewed infection but tells us very little about how much infection existed in NZ at the time of the border closure.

Even if you would like to believe the result shows the elimination strategy has throttled infection rates, you cannot ignore that it simultaneously proves that elimination is impossible. The 0.1% prevalence is double the number of identified positive tests. For every identified case, there is at least one other person with covid-19 who has not been identified. That means there has been at least 5000 cases in NZ (5,000,000*0.001).

Worse still, community infection is higher than thought. The study shows the ratio of previously detected locally acquired cases to known cases is 6:8. The number of locally acquired cases from the Ministry of Health is 2600 – 865 in MIQ = 1,735. This indicates that there were 2313 (1,735*8/6) extra locally acquired cases that were not detected.

If we wanted to ascertain true cumulative exposure to infection, then 0.1% is certainly an underestimate, compared to influenza antibodies. The study makes no mention of the possibility of infection that can be found in T-cell levels e.g. from Karolinska. Those studies suggest that if the true infection rate could be, conservatively, 1.5 times the antibody prevalence.

We note that the eight undetected cases claimed in media coverage were widely geographically distributed, so could not have been from a localised cluster. Covid-19 was evidently widespread across NZ, breaking the fiction of being contained by lockdowns and tracking into ‘clusters’.

A big implication of the study is that we now have a more definitive infection fatality ratio (IFR) for NZ of 0.5% (26/~5000). Only a month or two before this serology survey Rod Jackson and the NZ Herald refused to retract articles that told New Zealanders the IFR was at least double that (over 1%). We trust they will now delete those articles. Most other NZ experts have been more recently citing the CDC’s IFR of 0.65% – which is now clearly too high in NZ.

Our search for an accurate IFR now has a more certain starting point. We know that about one quarter of the NZ deaths were attributed to covid without evidence of a positive test. We also know that given the half-life of antibodies, the real infection level must be higher than 5000.  A conservative level would be about 10,000 infections. So NZ’s IFR could be as low as 0.2% (20/10,000). This figure is concordant with median estimates from summaries of serology studies.

In summary, the study reveals a lower antibody level than we expected. It’s a surprise that indicates a likely waning of fresh transmission. But it reveals that we have had at least one undetected case for each detected case. This means:(a) the virus is not as deadly as first thought as these cases were not diagnosed since they didn’t come to clinical attention and(b) it is a fiction that New Zealand has detected each and every case of covid-19 and so can declare the virus ‘eliminated’.

Fact-checking Covid vaccine experts

Simon Thornley

18/04/2021

1014 words

In a recent interview with Radio New Zealand, a vaccine expert claimed that the risk of blood clot was 165,000 times higher after having covid-19, compared to the risk after having the AstraZeneca jab. This claim illuminates several misunderstandings of the nature of the SARS-CoV-2 virus, the true nature of the side effects that are worrying health officials overseas and the influence of misleading claims on social media.

Even though New Zealand is currently using a different vaccine, the emergence of blood clot reactions to some covid-19 vaccines has worried those who have been saying the vaccines are safe and effective.

In response they have tried to do something they refused to do with SARS-CoV-2; provide people with realistic data about the small risk posed.

To make the vaccine-related blood clots seem comparatively small, Dr Helen Petousis-Harris recently claimed that the risk of covid-19 blood clots was high.

She said the risk of clot from the AstraZeneca vaccine is about 1/1,000,000 against risk of clotting from covid-19 which is 165,000/1,000,000.

The frequencies of 165,000/1,000,000 are hard to understand until we start wiping off a few confusing zeros and end up with 16.5/100 or 16.5%.

Dr Petousis-Harris claims that 1/6 people who have covid-19 infection have a clot; not just any clot, but the rare brain vein clot being experienced by covid-19 vaccine takers.

All Helen’s words are taken verbatim from numbers on an infographic image doing the rounds on social media.

The statistic of 1/6 people suffering rare clots after being infected with the covid-19 virus comes from a summary study of hospitalised patients which evaluated the risk of pulmonary embolus and deep vein thrombosis in patients hospitalised for covid-19. Over half the studies included in the summary were from patients in intensive care. Some studies screened all patients for clots. The average of all studies showed a weighted proportion of 16.5% for both deep vein (leg) and lung clots.

Despite widely held belief, over 95% of people who test positive for covid-19 do not need a hospital, so would not have appeared in the denominator of the 16.5% figure. A study from Iceland, one of the most tested nations on earth, showed that 5% of positive patients for covid-19 were hospitalised, and only 1% went to intensive care. This means that the 16.5% figure is a very skewed proportion of all patients with covid-19. Since only 1-5% of cases make it to intensive care or hospital, that 16.5% chance should be less than 1%.

We know also that many more people have caught the virus than the positive genetic (PCR) tests say, as shown by serological tests and other immune studies. T-cell tests show that even more have been exposed to the virus, compared to antibody studies. The incidence of blood clots following covid-19 infection is simply not known, but it must be at least an order of magnitude lower than presented by our vaccine expert. So now the claimed 16.5% chance of blood clots across the population is not even 1%; it is closer to 0.1%.

Now comes the worst part of this attempt to mislead people about the vaccine risk; we’re not even talking about the same type of blood clot.

The blood clots experienced by some vaccine takers is cerebral venous sinus thrombosis, a deadly and rare condition.

The blood clots that threaten about 0.1% of us who catch covid-19 is deep venous thrombosis, a comparatively common condition found across all manner of hospitalised patients. It is so common that in one autopsy case-series, 10% of deaths in hospital patients who had the post-mortem procedure were caused by venous thromboembolism.

The background rate of cerebral sinus thrombosis is estimated to be 1.32 per 100,000 person years.

In contrast, the background rate of deep venous thrombosis is estimated at 50/100,000 person years, about 38 times higher than for cerebral sinus clots. The risk of leg clots is very strongly age-related, with older people more affected.

A direct comparison of the rate of cerebral sinus thrombosis in covid-19 patients compared to those who have had covid-19 vaccines has been carried out. The rate of cerebral venous thrombosis was higher in the covid-19 group compared to the vaccinated, but by a factor of 6 rather than 165,000-fold higher, as claimed in the Radio NZ interview. The cerebral sinus thrombosis group after covid-19 was more likely to have heart disease than those who had had the virus without the clot. The covid-19 group only counted PCR positive individuals, which as mentioned, underestimates the spread of the virus. The rate of venous thrombosis in the vaccinated groups (both Pfizer and AstraZeneca) was about 4-5 per million people in the two weeks following the vaccine. The risk of the vaccine is clearly higher than baseline which is an annual statistic, even if it is lower than for people who have had covid-19.

The administrative bodies of several nations are rightly concerned about the incidence of a rare type of blood clot from the AstraZeneca vaccine. Concern is justified when one particular risk of taking the vaccine is higher or worse than the risk of not taking it.

The image carrying the numbers quoted by Dr Petousis-Harris has been shared over social media by New Zealand doctors. I am sure they were well-intentioned, but it is never justified to allay fears using false information. It is always wrong to misinform people, particularly over the risk to their health of a medical intervention.

I am severely disappointed that our national broadcaster has not questioned these statements. It concerns a vaccine New Zealand is not using. But what happens when it does? What happens if rare reactions and deaths are attributed to treatments used here? We must be able to count on our media, and taxpayer funded experts to look at data impartially.

The conversation they held with Dr Petousis-Harris revealed a hopelessly exaggerated view of the severity of covid-19 in the minds of our “experts”, doctors, and the governing elite.

I call on Dr Petousis-Harris and Radio NZ to check the numbers, issue a retraction and an apology.

 

Govt policies must catch up with latest data on Covid19

Simon Thornley, Ananish Chaudhuri

1258 words.

António Egas Moniz was awarded the Nobel Prize in 1949 for frontal lobotomy, a supposed cure for mental illness. Ultimately, however, Moniz and the Nobel committee were wrong. The operation did irreparable harm to over fifty thousand patients and the results were far from the claimed ‘cure’.

Early in New Zealand’s Covid-19 story we were admonished with predictions of  80,000 covid-19 deaths by Professor Sean Hendy and his colleagues, even with stringent lockdowns in place. Recently, Professor John Gibson questioned the accuracy of these predictions as implausible because they would require our population to be almost 10-times larger, to square with the infection-fatality proportion reported by the WHO for countries like us. Yet Hendy doubled down on the predictions. Considering that New Zealand now has 26 official Covid-19 deaths, it seems at face value that Gibson is right. Hendy overshot the mark. By a lot.

What is remarkable now is the lack of insight into why these predictions were wrong. We have now learned so much more about Covid-19, we must update our ideas. The government’s own advice to its new Minister shows that Hendy’s exaggerated prediction will have enormous costs to New Zealand society. Crown debt is forecast to grow by 2.5 times to a level of NZ$200 billion in 2024, and the real value of output in 2020 is over five percent smaller than what had been forecast in 2019.

With so much at stake, it is essential that we take stock of what we have learned and why Hendy and his colleagues erred. After all, science is little more than the recalibration of our beliefs and predictions to match the stark reality of collected data. From what Hendy indicated in his response with revised predictions of 10,000 deaths he has learned little about the virus since the early forecasts. His response centred on explanations such as: vaccines arriving early, a modest change in the infection fatality rate (0.9% is the new value, compared to 1.0%), and the lack of capacity in intensive care.

What is most remarkable about these explanations is that none of them could possibly explain the discrepancy between Hendy’s original model and the observed deaths. Since the deaths are simply a proportion of the overall cases (infection fatality ratio), a 10% change can in no way explain the difference between models and reality, which differ by three orders of magnitude (3,076 times).

So, what have we learned about Covid-19 and why were Hendy’s models wrong? First, the models assumed the virus was totally new and that the entire New Zealand population was susceptible. Many studies now show that cross-reactivity and T cell responses to other coronaviruses protect us from Covid-19. Many of us will simply shake off the virus since our immune systems have already seen similar ones.

Hendy takes it as a given that Covid-19 is ten times more deadly than influenza, with no evidence cited. Calculating the ‘deadliness’ of a virus is a difficult issue, since it is dependent on accurately estimating cumulative numbers of infection – the denominator, as well as Covid-19 deaths – the numerator. Deaths are sensitive to definitions of what exactly constitutes a Covid-19 death, particularly in the frail elderly, who often have a range of other diseases.

To illustrate, Singapore has a strict definition of Covid-19 deaths, which requires a positive test and respiratory infection leading to death. The city state has registered only 30 deaths out of 60,019 cases (case fatality ratio: 0.05%). In contrast the UK, which has a comparatively loose definition, including all who died within a period of testing positive, has a case fatality ratio of 2.9%, 40 times higher than Singapore, from the same virus. The most comprehensive survey of infection fatality ratios, which account for positive serology, has yielded a corrected median of 0.23%, well under Hendy’s estimate. This figure does not account for T cell responses to the virus, and takes death recording at face value.

Evidence from wastewater in Barcelona and retrospective analysis of blood samples from a lung cancer screening study in Italy suggests that SARS-Cov-2 was circulating in Italy before its supposed discovery in Wuhan in December 2019. What do we learn from this? Since there was no excess death at that time, it cannot therefore be assumed that excess death that accompanied lockdowns is a direct consequence of the virus. Many of us have likely seen the virus and not known it, since it was circulating well before Wuhan, and health systems coped at that time.

It is remarkable also that Hendy’s doomsday predictions showed little appreciation of the age of deaths with Covid-19. Other authors predicted the magnitude of deaths in NZ from Covid-19 to those from World War 1, which averaged in the 20s of the soldiers who died. Spanish flu victims, similarly, had a median age of death in the twenties, but not those from Covid-19. The average age of deaths with Covid-19 are about the same as the life expectancy of that country. This means that the virus is certainly not as deadly as Hendy claims, since deaths from the virus will not lower the life expectancy of a population. Put another way, risk of death from the virus is no different to the background risks we face every day.

Hendy also fails to discuss the exaggeration in coding of Covid-19 deaths that has occurred during the pandemic. The fact that many deaths have been due to other illnesses and the usual process of recording death has been overturned. This panic induced exaggeration has also been a feature of many other historical epidemics of respiratory illnesses.

Another feature of the Covid-19 story is that much of the early high fatality was related to foregone opportunities for healthcare for other conditions. In the UK, emergency department visits halved during lockdown. To compound this, early mechanical ventilation in intensive care, which overloaded these units, inflated mortality from the virus. Statistical evidence now supports this policy as a cause of excess deaths in Covid-19 cases.

Hendy’s revised estimate that we must have saved at least 10,000 lives assumes lockdowns are effective. This is counter to the weight of statistical evidence on the subject. A between-country analysis showed no evidence that lockdowns save lives, either measured as a stringency index or from google mobility data.

We urgently need to return to the foundations of science which means a sober assessment of reality over failed forecasts. It seems Hendy is unlikely to champion such a cause, since his predictions have cost New Zealanders dearly. Wrong predictions are a routine part of science, but a stubborn adherence to them indicate a deviation from usual practise.

Our usual way of life, our ability to engage with the world, and much of our economy have been surrendered to erroneous predictions. Even with orders of magnitude differences from the reality of observed data, the author remains wedded to them.

The words of Nobel prize winner, Professor Richard Feynman are relevant:

“It doesn’t matter how beautiful your theory is, it doesn’t matter how smart you are. If it doesn’t agree with experiment, it’s wrong.”

Given what is at stake for New Zealand’s future, the last thing we now need is to cling to failed models. Rather, we must confront the frightening fact that much of what we initially thought we knew about Covid-19 was wrong. Dire predictions simply did not eventuate. The spectre of further lockdowns and strict border closures urgently need to be re-evaluated in this light. Feynman again:

“Reality must take precedence over public relations, for nature cannot be fooled.”

Ivermectin now a proven Covid treatment

A WHO-commissioned meta-analysis of Ivermectin shows that using this generic medicine in hospitals leads to a 83% reduction in covid mortality (95% CI 65%-92%). See: https://www.youtube.com/watch?v=yOAh7GtvcOs
The WHO is understood to be waiting for the results this month from three trials before issuing a recommendation.
The position of NZ’s Ministry of Health cautioning against using Ivermectin has not changed since April 2020, despite a consistent growth in studies showing effectiveness.
On the basis of the studies to date, Covid Plan B urges the Ministry of Health to immediately delete its nine-month old caution against using Ivermectin to treat Covid19. A new formal position can be release following advice from the WHO.
Internationally, front line doctors have been frustrated and even abused by authorities and politicians in their efforts trying to make people aware of the effectiveness of Ivermectin. https://www.hsgac.senate.gov/imo/media/doc/Testimony-Kory-2020-12-08.pdf
Covid Plan B contrasts the MOH warning against studies that emerged in favour of Ivermectin, with its decision to buy respirators at the start of the pandemic without clear evidence of their effectiveness. It now appears that respirators harmed some Covid19 patients.
Panic from politicians and policy makers has driven over-reactions and bad decisions. Acting without evidence has caused more harm than good.

NZ’s solo effort on elimination

A short piece from us published in NZ Journal of Primary Health Care.

https://www.publish.csiro.au/hc/Fulltext/HC20132

How many more lockdowns, billions of dollars and social and health harm is an acceptable price to pay before this misguided and expensive strategy is abandoned? We implore Prime Minister Jacinda Ardern, Director-General of Health Dr Ashley Bloomfield, and fellow health advisors to reflect on the points raised in this paper and to abandon elimination as a strategy and the use of lockdowns. We believe that future policy should return to the initial approach that was taken. That is to reduce transmission of COVID-19 through reasonable use of infection control, to maintain capacity in our hospitals and intensive care, while focusing public health and infection control efforts to protect the frail and elderly of our community.

Immunologist cautions on lead vaccines

17 November 2020

Byram Bridle, a viral immunologist at the University of Guelph, cautions New Zealanders that the lead vaccines against Covid19 may not be the solution they are expecting to end its isolation under the elimination strategy.

The main points of his caution are:

  1. NZ will have to wait at least two years before the Pfizer vaccine is available, because it is in strict isolation and low on the priority list for the 500m doses available in 2021.
  2. Not enough data has been released to know whether the vaccine prevents or weakens the symptoms of Covid19, or how long the protection will last.
  3. The safety data will be incomplete if it is approved for use next year, so monitoring will need to be carried out on vaccinated people for some years.
  4. The Pfizer data has not been rigorously peer-reviewed.
  5. There is no available data on the qualitative nature of the immune response. Vaccines like this can be misinterpreted by the immune system as an extracellular pathogen, which can cause them to respond poorly to natural infections with future coronaviruses.

“Pfizer’s vaccine is a RNA-vectored vaccine. This technology is relatively new and has not been approved for clinical use before. The company has been able to move surprisingly fast. If the recent data is indicative of what data from the rest of the trial will look like, there is a good chance the vaccine could receive emergency approval by early in 2021.

However, there are many nuances…”

Insufficient public data

“The study is only partially complete. There exists the possibility that the final data set will fail to secure regulatory approval (but it looks like they may be on track).

Data that accompanied the Pfizer press release was extremely superficial and, therefore, difficult to interpret. Data being collected for the Pfizer study cannot accurately be commented on until it undergoes rigorous peer review for publication in a good quality scientific journal.”

Effectiveness of protection

“90% effectiveness sounds surprisingly high. But we have no idea what the demographics look like. Although they opened the trial to high-risk people, we have no idea who contracted COVID-19. As an extreme example, if all the vaccinated volunteers that got COVID-19 were elderly and that number was not significantly different from the elderly among the non-vaccinated volunteers that got COVID-19, that would tell us that the vaccine does not work in those who need it most.

Most of the cases of COVID-19 in the study were presumably mild to moderate since no hospitalizations or deaths were reported, so we don’t know how protective the vaccine will be for those who are susceptible to severe cases.

There is no data regarding immunological memory, which is the entire point of a vaccine. If the memory response is weak or wanes too quickly, people will not be protected over the long term. This would be a fatal flaw because the global roll-out of a vaccine will take a very long time.

Pfizer hasn’t stated what the qualitative nature of the vaccine-induced immune response is. Sub-unit vaccines like theirs have been known to be misinterpreted by the immune system as being an extracellular pathogen. If that is the case, people who receive this vaccine might have a bias imprinted on their immune system that could cause them to respond to natural infections with future coronaviruses in a sub-par fashion.”

Two dose vaccine.

  • “It can be hard to get people back for a second dose. It is probably achievable in urban centres but could be hard to get the same people back 21 days later in remote and/or difficult-to-access places, especially in developing countries.
  • A vaccine that needs two doses is arguably a ‘weak’ vaccine. For this vaccine, it will take 28 days to build up sufficient protection. So there will be a one-month window during which people will remain susceptible. A better quality, single-dose vaccine could probably reduce this to 10-14 days.
  • Fewer than 500 million people could be vaccinated within a year of the vaccine being approved. The company is going to try to stockpile 50 million vaccines this year in anticipation of the vaccine being approved, and they optimistically predict that they can make 1.3 billion doses by the end of 2021. This sounds like a lot, but a two-dose regimen cuts the number of people that can be immunized in half. The person to get the 500 millionth dose will have to wait a year compared to the person who gets the first one. Some will wonder why some people get two doses while they get none. The vaccine won’t be protective unless two doses are given.”

Roll out internationally

“What about the rest of the population? As many of us have been predicting, it could take years to roll out these vaccines. Approval of a vaccine doesn’t help anyone; what matters is when it has been administered and sufficient time has passed for the immune system to respond. Of course, where in this very long timeline for the roll-out will countries that have used strict isolation to control their cases be (arguably, low on the priority list). Pfizer’s press release is essentially saying that everyone beyond the first half-million people will have to wait over 1 year. Presumably, it also means that people beyond the first billion or so may have to wait over 2 years.”

Long term safety

“Long-term safety in people is inferred based on animal models (such as rodents) that have shorter lifespans. Usually, clinical trials are done sequentially and span quite a few years. So acute and some long-term (i.e. 4 or more years) safety data would be in-hand. With the different trial stages overlapping and being run faster than normal, we will likely have less than a year’s-worth of safety data. Ultimately, the only way to be completely sure about long-term (i.e. beyond the duration of the clinical trial phase) safety in people is to monitor vaccinated people for a long period of time after the roll-out. Things like long-term kidney damage, etc. can often (but not always) be predicted/ruled out by things like blood chemistry within the acute stages.”

/ends

Covid19 elimination strategy almost abandoned

13 November 2020

Media Release

Covid Plan B has welcomed the Government’s decision not to over-react to cases of people testing positive to Covid-19 by starting another lockdown.

Simon Thornley, spokesperson for the group, says the Government appears to finally be adapting its strategy to new information about ineffectiveness of lockdowns and the low death and ill health effects of the virus.

“We support the Government’s inclination not to go back to lockdowns. Positive tests in Auckland, Christchurch and Wellington show the elimination strategy is fragile, futile and unnecessary.

“We urge the Government to be clear about why it is less fearful of Covid and more concerned by lockdowns. The public will understand and accept an admission that elimination attempts are over,” Thornley says.

Covid Plan B experts were this week published in the British Medical Journal showing the threat of Covid-19 is not what it was initially thought to be, in large part because of inaccurate recording of deaths.

Countries such as Singapore that use a strict definition of covid-19 death have very low fatality rates from the virus. Studies show that in past pandemics, coding of death certificates exaggerate fatality rates.

Estimates of covid-19 fatality are now extremely low; at 0.05% for people under seventy years old.

Statistical evidence now shows lockdowns do not reduce mortality from the virus, while causing much health and economic harm.

“Envoys from the World Health Organisation caution against the use of lockdowns since they “… have one consequence that you must never belittle and that is making poor people an awful lot poorer.

“This has happened in Auckland, where thousands turned to food banks to make ends meet. Over 50,000 people have started on the jobseeker benefit since March this year. The disproportionate economic costs of lockdown, relative to any benefits are also now apparent.

Heavily restricted borders will continue to devastate New Zealand’s tourist economy, and are leading to labour shortages, further reducing productivity. In contrast, many academics, doctors and the public are now urging their governments to focus on protection of the vulnerable, while allowing those at low risk from the virus to return to normal life.

/ends

Contact: Simon Thornley, 021 299 1752

 NZ Doctors sign statement against ‘Covid fear’

26 October 2020

A group of New Zealand health practitioners have joined a growing international movement that says Covid19 is not a sufficient threat to warrant the elimination strategy and lockdowns. 

The founding signatories felt obliged by their professional ethics to express support by signing a statement of principles that assert the low risk posed by Covid19, the availability of treatment, the dangers of Government over-reaction, and primacy of the doctor-patient relationship.

Covid Plan B spokesperson Simon Thornley praised the medical practitioners for expressing their views.

“Around the world medical specialists are speaking out. They have seen the data and seen that the initial fear is now clearly unfounded. They are seeing the damage to people’s heath caused by institutional fear and compliance, and by elimination strategies and lockdowns. Unlike too many others, they are prepared to say so.

“Their statement will signal to like-minded New Zealanders in the healthcare sector that they can and should resist, and they should reassure patients and the public.”

The group says its statement was intended to break the silence. It says New Zealand registered health practitioners who want to join the movement should sign the international Great Barrington Declaration and email Covid Plan B (info@covidplanb.co.nz).

The Great Barrington Declaration is now supported by over 11,000 medical specialists and over 30,000 medical practitioners.

Contact: Simon Thornley, 021 299 1752

GPs support Covid Plan B

26 October 2020

Registered Health Practitioners for Covid Plan B

 Statement of principles

Health is based on freedom and trust. Free human beings can decide themselves about their health.

Free societies decide in democratic discussions how to deal with their health. The NZ Bill of Rights guarantees free choice of treatment.

Fear of the pandemic makes us unfree. It makes us see vaccination and lockdowns as the only way to get back to normality.

International health data and our own experience shows that the fear engendered in the public and our patients is not proportional to the threat to their health posed by covid-19.

Therefore New Zealand’s public health and economic response to covid-19 needs reviewing. It is very likely to be more harmful than the threat posed by the virus in the medium to long term.

Doctors can help. We can develop trust through mutual respect, transparency and democratic debate. We can take action with our patients, so they are healthier and better able to fight infection, and by providing treatments if they fall ill to Covid-19.

There is nothing we have yet seen in the features of this virus that warrants it being regarded as especially dangerous above the many other viruses that are with us every day. The most practical response is the standard precautions of improving personal hygiene, physical health and improving lifestyles.

We want the public to know that the infection fatality rate of Covid-19 is currently about 0.3% once antibody levels are accounted for. The infection fatality rate of influenza, which is strongest each winter, is about 0.1%. It is also clear that the ages of people who die with Covid-19 is about the same as that from natural mortality. This information is enough to inspire us to take better care of our health, but not to drastically change our society and economy.

It is impossible to obtain information about the severity of Covid-19 infections in New Zealand, so we have had to rely on overseas research. About a third of Covid-19 positive patients have no symptoms, with about 90% of infections treated in the community, and only about 1.5% needing intensive care. In the US, almost all hospital treated cases have had other serious medical conditions and are almost all people who die with the virus are over 50 years old. Unusual or long lasting symptoms currently appear similar to a range of responses seen in other respiratory illnesses.

Doctors now have many promising treatments against Covid-19, including easily available supplements like vitamin D. Internationally, the death rate is falling, in part, because we are getting better at treating the disease.

Immune function can benefit from minimising sugar and refined starch intake, eating several servings of fruit and vegetables daily, being physically active, socially connected and having sensible sun exposure to ensure adequate levels of vitamin D, avoiding tobacco and excess alcohol.

We have identified comorbidities that make people susceptible to Covid-19, such as diabetes, hypertension and raised cholesterol. We need to treat a condition in these patients called Metabolic Syndrome, which creates immune system dysfunction.

Decision makers, when assessing health strategies, compare the economic costs of a policy to its benefits. Recent assessments by economists indicate that the costs of lockdowns in New Zealand outweigh benefits by a ratio of between 90 and 200 to one. This indicates that Covid-19 has been disproportionately treated compared to critical health issues that our patients face day-to-day.

Policies that the Government should prioritise or review are:

  • Adequate resourcing of high-quality infection control and quality care in rest homes and hospitals to prevent the spread of covid-19 to vulnerable people.
  • Abandon the use of lockdowns to contain the virus. Strong evidence now indicates that these measures are disastrous economically and do little to contain viral spread.
  • Review the requirement for managed quarantine and compulsory detention for both community and hospital cases in the light of the updated lower fatality risk of the virus. This measure leads to social isolation and undue mental distress.
  • Further limits on border travel should be urgently reviewed in the light of a cost-benefit analysis.
  • Avoid any measures that lead to social isolation in the response to contain the virus.
  • Review the requirement for compulsory diagnostic tests in the light of the lower fatality rate of the virus. We believe that patients should continue to have the right to refuse medical tests, as they do for other procedures, and that the public health risk from this virus does not warrant these rights being superseded.
  • Abandon the requirement to wear masks on public transport. We believe that the best epidemiological evidence available does not support mask wearing to reduce the risk of respiratory virus transmission.
  • We believe that the doctor-patient relationship should be safe-guarded, along with the ability for doctors to see patients in-person rather than online. Online patient consultations detract from the quality of the doctor-patient relationship and raise the risk of mis-diagnosis.

As facts about the virus become self-evident, the public is wondering whether the current measures cause more harm than good. They will wonder why authorities have been unwilling to listen to, or even allow, discussion of the facts and alternative policies. We are deeply concerned that the consequence will be a loss of faith in health services, science and bureaucracy.

Foundation Signatories:

Dr Cindy de Villiers – General Practitioner, M.B.,Ch.B

Dr Matthias Seidel – Obstetrician and Gynaecologist

Dr Anne O’Reilly – General Practitioner. MB BCh FRNZCGP

Dr Rob Maunsell – General Practitioner

Dr René de Monchy – Consultant Psychiatrist

Dr Robin Kelly – General Practitioner MRCS, LRCP, FRNZCGP

Dr Tessa Jones – Integrative medical practitioner MBChB, Dip Obs, FRNZCGP, FACNEM, FABAARM

Dr Alison Goodwin – General Practitioner, MBChB, FRNZCGP

Dr Ronald Goedeke – Director of Appearance Medicine, BSc Hons MBChB

Dr Deon Claassens – General Practitioner, MBChB, Dip. SportsMed, FRNZCGP

Shane Chafin – Pharmacist,AGPP,BCACP

Dr Ulrich Doering – General Practitioner, MBChB, Dipl O&G, FRNZCGP

Dr Samantha Bailey – Research Physician MBChB (Otago)

Call for data on Covid-19 health impacts

22 October 2020

New Zealand has not released any analysis about the negative health impacts of the Covid-19 elimination and lockdown policy.

This is highlighted by studies released in the UK this week which indicates that their lockdowns are responsible for thousands of deaths and new illnesses, principally as a result of delayed cancer diagnoses (see note below).

The only known study of lockdown health impacts in New Zealand was of a Dunedin primary health clinic, where referrals and tests had dropped 100% and 99% respectively. Anecdotal evidence provided to the Covid Plan B group is that referrals and tests may be down across the country by two thirds. Auckland District Health Board is also investigating after four women died during and after pregnancy this year, with three dying since alert level 3 was instituted in late March. Expected numbers of deaths are between 0 and one from previous years.

Evidence provided from affected individuals indicate illnesses and health prognosis have worsened due to delayed tests and treatment. Whether these cases represent a wider problem is not known.

Dr Simon Thornley, spokesman for Covid Plan B, said the Government’s elimination and lockdown policy was based on hope, because little analysis of the downsides of the policy has been carried out.

“If you base your rationale on discredited models and you don’t count impacts, this is not a policy based on evidence.

“This is a policy based on an assumption that the low Covid-19 impact is the result of the lockdown policy. There is no proof of that, and international studies indicate it is unlikely.

“This is also a policy continued on the assumption that there are no negative effects. But firsthand testimony in New Zealand and overseas statistics suggest this is not true. Economic analysis from the government and independent sources indicate that lockdowns are a disproportionate response to Covid-19. The effect on unemployment is now clear, with a 38% rise in adults on the jobseeker benefit since late March. Now, the impact of delayed diagnosis and under treatment of other conditions must be considered.

“We are not even trying to count what the other effects have been on health. We do not know how many people have died, had conditions or prognosis worsen because of the ways lockdown and fear have affected healthcare.

“We call on the Ministry of Health to undertake the same studies we’ve seen in the UK, and to weigh those costs against what they imagine, or count, are the benefits of the elimination strategy,” Simon Thornley says.

– ends