How have dire predictions for Sweden panned out?

An article in the NZ Herald on May 27, 2020 predicted Sweden would have 56,000 more COVID-19 deaths and had made “a fatal mistake”. At the time of publishing Sweden had experienced 4408 deaths.

So, how’s that prediction looking five months on?

It was wrong. The deaths have not been 56,000, but as at 23 October, 5,933.

In the past five months a further 1525 people sadly died.

Daily deaths plateaued in July, and over the following three months (23 July to 23 i.e., 92 days) 202 people – an average of just over 2 a day – have died. To put that into perspective, ca. 246 people die every day in Sweden; 77 from cardiovascular disease (Sweden’s biggest killer).

Despite an upsurge in cases (starting ca. 4th September) that now matches the peak of cases recorded in June 2020,  the average daily death since 4 September has been 1.8 deaths per day. Over the last seven days, (16 to 23 October) the daily death rate was 0.57.

Data taken from:

https://ourworldindata.org/coronavirus/country/sweden?country=~SWE

https://www.statista.com/statistics/525353/sweden-number-of-deaths/

NZ data – not many tested, not many positives

A sense of perspective on NZ Covid data

(from Jefferies et al. Lancet paper. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30225-5/fulltext)

Outer circle here is proportional to NZ population, grey is those tested. Blue is those who tested positive. Hospitalised and ICU cases too small to print.

Zeroing on test positive cases (blue circle above, now below), it is not possible from paper to know how many deaths actually went to ICU, so these cells may not be mutually exclusive…

 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)

Six months before the truth caught up with Covid19 doom-mongers

A dismaying aspect of the Western response to Covid19 is that it has been six months before some Governments and public institutions started listening a wider range of advice, and understood they must critically assess advice to decide what is in the fullest public interest.

Even then, the ‘listening’ has been piecemeal and slow. And not at all in New Zealand.

The preference for heeding the warnings of doom-mongers with the worst numbers is somewhat understandable, but it is inexcusable that leaders failed to listen to other advice, and to judge from the data for themselves.

https://www.businessinsider.com.au/boris-johnson-briefed-sw…

Schism regretted but made inevitable by first panicked over-reaction

A rule of thumb in public health, forgotten in the panicked responded to Covid19, was; If you don’t know the likely result of your intervention, don’t do it.

We heavily regret the schism in science and society over Covid19, but it was made inevitable by the first response of politicians and panickers. A determined self-selected group of people in each country promoted erroneous projections and large scale blunt interventions. And they stuck to that plan – refusing to consider alternative interpretations of data and alternative responses.

It was they that decided discussion, moderation and dissent would not be tolerated.

https://www.newshub.co.nz/home/world/2020/10/opinion-is-the-covid-19-cure-worse-than-the-disease-the-most-polarising-question-of-2020.html

What can we learn from Iceland about Covid-19?

Iceland gives us a unique insight into Covid-19 infections since it has one of the highest per capita testing rates in the world, over 10 fold greater than New Zealand.

What’s more they are very open about the severity of cases, and the proportion that need hospital treatment and intensive care.

Iceland has also conducted community surveys of their population. This information is not publicly available in New Zealand. While tables of these figures may be useful, it is sometimes difficult to understand the sense of scale from them.

Euler diagrams scale numbers or percentages to an area of a circle or ellipse. Overlapping relationships may also be depicted. The outer circle represents the 356,000 population of the Nordic country, the grey is the roughly 44% of the population who have been tested, the blue indicates the ~4,000 people (2.5% of all tests) who returned positive. The red indicates those who required hospital treatment (~5% of test positives), with the small yellow circle indicating the 1% of test positives who were treated in intensive care.

Deaths (10 at the time of writing – meaning a case fatality ratio of 0.25%) were too small to render on the diagram.

This study, which outlines antibody testing in a sample of 30,576 people in Iceland suggests that half of all PCR + cases were detected. Therefore, the infection fatality ratio is about half of the case-fatality ratio, so about 0.125%.

This diagram illustrates that in Iceland, only ~1/20 positive Covid infections resulted in the need for hospital treatment. With the high rate of per-capita testing, this information gives us a more accurate assessment of the clinical severity of Covid-19 infection than is otherwise available from countries where testing is more directed at only people with cold or flu symptoms. The plot offers a visual sense of the burden of the virus to hospital and intensive care resources.

Iceland data (16/10/20)

Will NZ follow WHO lead to ‘living with virus’?

12 October 2020

Media Release

The Covid Plan B group is reassured by the shift of international policy and science consensus toward what had been a dissenting position six months ago; learning to live with the virus.

Over the weekend, the WHO’s David Nabarro said that lockdowns caused more harm than good, a position advocated by Covid Plan B back in April 2020.

But early in the Covid-19 crisis, the World Health Organisation supported lockdowns to contain ‘intense transmission’ of the virus, listing six conditions that must be met to lift such measures.

In a remarkable turnaround, Dr David Nabarro has stated that “Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer”.

He also commended the Great Barrington Declaration, an internationally supported statement against lockdowns, which instead calls for a change in government policy toward focused protection of the elderly and those who are vulnerable to the virus from pre-existing medical conditions, while letting the rest of the population return to normal life.

Dr Simon Thornley, spokesman for Covid Plan B, welcomed Nabarro’s statement as “a major change from the World Health Organisation”.

“We have drawn attention to the severe and disproportionate financial costs of lockdown policies in New Zealand.

“The virus is not as deadly as first claimed, so we must adjust our policies accordingly.

“The latest estimates for the infection fatality ratio, a measure of the severity of the virus, are between 0.15 to 0.2 0%, which is concordant with the range of figures for past influenza epidemics.

“Crippling our economies and sacrificing our children’s education can no longer be justified, since the harm from these policies outweighs any benefits.

“Our health system has largely avoided severe outbreaks in hospitals and nursing homes, and this is where the focus of our response to the virus should be.”

Contact: Simon Thornley, 021 299 1752

Covid Plan B signs the Great Barrington Declaration

Covid Plan B members have signed a global petition against Covid lockdowns, other over-reactions and urging a return to normal.

The petition was formulated by our international colleagues; Dr. Martin Kulldorff, professor of medicine at Harvard University; Dr. Sunetra Gupta, professor at Oxford University; and Dr. Jay Bhattacharya, professor at Stanford University Medical School.

Check out the growing list of international academics and compare and contrast with the New Zealand experts advising the NZ Government.

Co-signers

Medical and Public Health Scientists and Medical Practitioners

Dr. Rodney Sturdivant, PhD. associate professor of biostatistics at Baylor University

Dr. Eitan Friedman, MD, PhD. Founder and Director, The Susanne Levy Gertner Oncogenetics Unit,

Dr. Rajiv Bhatia, MD, MPH a physician with the VA health system

Dr. Michael Levitt, PhD is a biophysicist and a professor of structural biology at Stanford University.

Dr. Eyal Shahar, MD professor (emeritus) of public health at the University of Arizona

Dr. David Katz, MD, MPH, President, True Health Initiative and the Founder and Former Director of the Yale University Prevention Research Center

Dr. Laura Lazzeroni, PhD., professor of psychiatry and behavioral sciences and of biomedical data science at Stanford University Medical School

Dr. Simon Thornley, PhD is an epidemiologist at the University of Auckland, New Zealand.

Dr. Michael Jackson, PhD is an ecologist and research fellow at the University of Canterbury, New Zealand.

Dr. Jonas Ludvigsson, pediatrician, epidemiologist and professor at Karolinska Institute and senior physician at Örebro University Hospital, Sweden.

Dr. Sylvia Fogel, autism expert and psychiatrist at Massachusetts General Hospital and instructor at Harvard Medical School, USA.

Dr. Andrius Kavaliunas, epidemiologist and assistant professor at Karolinska Institute, Sweden

Prof. Udi Qimron, Chair, Department of Clinical Microbiology and Immunology, Tel Aviv University

Prof. Ariel Munitz, Department of Clinical Microbiology and Immunology, Tel Aviv University

Prof. Motti Gerlic, Department of Clinical Microbiology and Immunology, Tel Aviv University

Dr. Uri Gavish, an expert in algorithm analysis and a biomedical consultant

Dr. Paul McKeigue, professor of epidemiology in the University of Edinburgh and public health physician, with expertise in statistical modelling of disease.

Prof. Ellen Townsend, Self-Harm Research Group, University of Nottingham, UK.

Prof. Matthew Ratcliffe, Professor of Philosophy specializing in philosophy of mental health, University of York, UK

Prof. Mike Hulme, professor of human geography, University of Cambridge

Dr. Cody Meissner, professor of pediatrics at Tufts University School of Medicine, an expert on vaccine development, efficacy and safety.

Dr. Mario Recker, Associate Professor in Applied Mathematics at the Centre for Mathematics and the Environment, University of Exeter.

Prof. Lisa White, Professor of Modelling and Epidemiology Nuffield Department of Medicine, Oxford University, UK

Prof. Angus Dalgleish, MD, FRCP, FRACP, FRCPath, FMedSci, Department of Oncology, St. George’s, University of London

Prof. David Livermore, Professor at University of East Anglia, a microbiologist with expertise in disease epidemiology, antibiotic resistance and rapid diagnostics

Dr. Helen Colhoun, professor of medical informatics and epidemiology in the University of Edinburgh and public health physician, with expertise in risk prediction.

Prof. Partha P. Majumder, PhD, FNA, FASc, FNASc, FTWAS National Science Chair, Distinguished Professor and Founder National Institute of Biomedical Genomics, KalyaniEmeritus Professor Indian Statistical Institute, Kolkata

Dr. Gabriela Gomes, professor at the University of Strathclyde, Glasgow, a mathematician focussing on population dynamics, evolutionary theory and infectious disease epidemiology.

Prof. Simon Wood, professor at Edinburgh University, a statistician with expertise in statistical methodology, applied statistics and mathematical modelling in biology

Prof. Anthony J Brookes, Department of Genetics & Genome Biology, University of Leicester, UK

Prof. Sucharit Bhakdi, em. Professor of Medical Microbiology, University of Mainz, Germany

Prof. Stephen Bremner,
Professor of Medical Statistics, Brighton and Sussex Medical School, University of Sussex

Prof. Yaz Gulnur Muradoglu, Professor of Finance, Director at Behavioural Finance Working Group, School of Business and Management, Queen Mary University of London

Prof. Karol Sikora MA, PhD, MBBChir, FRCP, FRCR, FFPM, Medical Director of Rutherford Health, Oncologist, & Dean of Medicine

Ananish Chaudhuri: no forethought about effect of lockdown policies

… this government launched into a set of policy choices without adequate fore-thought or consultation about the consequences. Now that those consequences are becoming clear, it is scrambling to find an appropriate response. After having staked its reputation on elimination, ego and hubris is making it difficult to change course.

But recovering from the coming recession requires that the government does some soul-searching and adapt its future approach by calling upon a wide range of experts and expertise.

Covid-19 would have been challenging enough but we made things more difficult for ourselves by not investing the time and effort to think through alternative scenarios.

Recently, an interlocutor asked me: Where would you rather be, if not in New Zealand? I find this to be a non sequitur.

For one thing, the outlook for a middle-aged tenured professor is vastly different from a that of a young family struggling with debt and mortgage payments while worrying about their jobs.

And secondly, just because many others around us are losing their minds does not make irrationality rational.

https://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=12366928