“In ~ 98% of the comparisons using 87 different regions of the world we found no evidence that the number of deaths/million is reduced by staying at home. Regional differences in treatment methods and the natural course of the virus may also be major factors in this pandemic…”
The small sample size and the non-stationary nature of COVID-19 data are challenges for statistical models, but our analysis, with 25 epidemiological weeks, is relatively larger than previous publications which used only 7 weeks62. A short interval of observation between the introduction of an NPI and the observed effect on death rates yields no sound conclusion, and is a case where the follow-up period is not long enough to capture the outcome, as seen in previous publications44,45
given the importance of social isolation promoted by world authorities63, we expected a higher incidence of significant comparisons, even though it could be an ecological fallacy. The low number of significant associations between regions for mortality rate and the percentage of staying at home may be a case of exception fallacy, which is a generalization of individual characteristics applied at the group-level characteristics64.
For information on studies about Ivermectin and Covid19: https://ivmmeta.com/
New virus strain not “more deadly”
In December Boris Johnson announced to UK citizens that a new strain of the Sars-Cov2 virus – B1.1.7 or the “kent” strain – was 70% more infectious and probably more deadly. His Government, including health bureaucrats, used this to justify more lockdowns.
Around the world nations responded fearfully, in an echo of the first wave of border closures, lockdowns and infection-control responses that followed China’s dramatic actions in Wuhan.
In New Zealand the Government took special measures to isolate returning citizens coming from the UK. The media keep referring to the strain as more dangerous.
Johnson had noted “considerable uncertainty” about the December prediction, but to most people, including him, the 70% estimate outweighed the uncertainty. Notes of uncertainty were swamped by fear generated when the UK’s Health minister said the new strain was “out of control”. Johnson said of the 70% transmissibility number: “it’s the best that we have at the moment and we have to act on information as we have it, because this is now spreading very fast.”
By 22 Jan, the UK Government doubled-down on its prediction, claiming that it was 30% more deadly. To be fair, some media reporting at the time noted a lack of certainty in the data, but went ahead and reported the claims anyway. In the UK a row quickly broke out when it was admitted that the scientists were not sure about the 30% more deadly number. One advisor to the Government admitted it was still not a serious disease for most people. Despite this, most reports reaching the public, especially outside of the UK – such as this in NZ – made no mention of the debate over the 30% claim.
The alarmist reporting was made possible because credible people repeated it. The almost iconic Dr Anthony Fauci, the US chief health officer, said the strain was 30% more deadly. The CDC warned it’s increased contagiousness meant it would become the dominant strain in the US.
Here in NZ Nick Wilson claims the strain meant we are in “the most dangerous period” and urged limits to number of people returning from the UK or close to the UK completely. There is no mention of the lack of certainty.
This is important because it was all wrong.
A UK study in January found ‘some evidence’ for increased transmission but “we found no evidence for changes in reported symptoms, disease severity and disease duration associated with B.1.1.7. We found a likely reinfection rate of around 0.7% (95% CI 0.6-0.8), but no evidence that this was higher compared to older strains”.
In fairness we should note that the study found that the increase in the R rate subsequently fell in lockdown. (That’s interesting and deserves follow-up because there’s no other causal evidence that lockdowns do this).
But the results of that study were not surprising. There were indications early on that this strain was not significantly more transmissable or deadly.
Johnson’s subsequent ‘30% more deadly’ claim in January was far more widely challenged and revealed to have less than a 50% probability.
Studies and data analysis in mid and late December were already clear that although it might be slightly more infectious, it was not more dangerous – the mode of transmission was no different and symptoms were similar – and mutations were hardly surprising nor generally much cause for special alarm.
A central problem was terminology. The most problematic phrase was “more deadly”. It was a technically accurate way of phrasing the idea that if the strain was more infectious, it would reach more people and thus kill more. Remember that it now appears to be only marginally more transmissable than earlier strains, not the 70% Johnson and his health officials claimed (and that’s from studies looking at its spread, not its mode of action).
The failure of the transmission data to back up the predicted spread could explain why the officials switched to a different way of saying the same thing: not that it was more transmissable but that that is was more deadly (because the same disease reached more people).
This implies that if you got the strain, you were more likely to die. But you aren’t – your chances are just the same as with other strains: 0.7%.
The choice of the word deadly is deliberate; technically correct across a population even if the difference is not much, while absolutely not correct for an individual. The phrase creates personal fear, and that destabilises the public’s ability to debate and respond cohesively to extreme measures.
The choice of politicians and many of the world’s senior health personalities to use the ‘more deadly’ phrase signals they are interested in the outcome, not accuracy. The misuse of the word and duplicity of intent was suggested by some scientists.
The development of awareness and response to the UK strain is symptomatic of democratic Government management of the virus from the start in early 2020. Their inability to present a fair and dispassionate assessment makes them unreliable sources and decision-makers. As Prof Carl Heneghan said in December, democratic nations should not be in a situation where Government data is unquantifiable”. That is bad for science, public policy, and democracy.
We go head to head in the BMJ on the goal of eliminating Covid19.
We would all like to eradicate covid-19 from the globe. However, closer scrutiny shows that the odds are heavily stacked against this as a sustainable, cost effective, long term strategy. New Zealand’s apparent three month success has recently been broken by a cluster with no known link to overseas travel. Ongoing lockdowns have now occurred in Auckland, and the country is still focusing on elimination.
While New Zealand commentators remain enamoured with lockdown, the rest of the world is thinking again…
A member of the UK’s Sage group advising the government says lockdowns were a mistake.
14 August 2020
Epidemiologist Simon Thornley has reassured people that there has been no new information that concludes masks are warranted against COVID19.
“The trials are clear; there is no statistically useful safety gain in wearing a mask, although low quality observational studies show an advantage to wearing one in confined spaces.”
Thornley says he was moved to clarify the science because people advocating masks were claiming ‘things had changed’, leading to an increase in public mask-wearing since Wednesday.
“Nothing in medical science has changed since Ashley Bloomfield first told us months ago that there was no advantage to masks. What has changed is social and political advantage in advocating masks, and that’s not science.
“I will not be wearing a mask without symptoms, but anyone with compromised health could choose to carry a mask to wear in places like public transport.”
Thornley urged all public communicators, including media, to reference the latest science on masks so people could decide for themselves (see below).
On Monday, the Covid Plan B group is live streaming a COVID-19 Science and Policy Symposium, featuring international experts analysing the New Zealand situation. Find out more here.
The Science on masks
A trial in Australia showed that in households exposed to children with respiratory symptoms and fever, there was no difference in outcome between households that wore either surgical or P2 masks with controls who did not wear masks. The incidence of laboratory confirmed infections were twice as high in the mask wearing groups compared to controls, but the difference was not statistically significant.1 About 50% of patients reported problems with the masks, and by day five, only 30% of participants were compliant with the mask use.
A larger trial in Thailand that compared control, to handwashing, and handwashing and surgical masks in households with influenza-like illness showed no difference between the three groups, in terms of reducing the incidence of secondary transmission from primary cases.2
Meta-analyses of observational studies have reported benefits of reductions in risk of using masks.3 A case-control study of H1N1 transmission following a prolonged flight between China and the US showed a very strong association between mask use and protection from infection. None of the 9 cases wore masks, compared to 47% (15/32) of control passengers.4
The World Health Organisation5 only recommends masks when individuals have symptoms compatible with Covid-19. In populations such as those with a high prevalence of Covid, immunocompromised patients or times where high population density cannot be avoided, such as mass gatherings, public transportation (including aeroplanes), masks are considered useful for ‘source control’, rather than ‘protection’.
- MacIntyre CR, Cauchemez S, Dwyer DE, et al. Face mask use and control of respiratory virus transmission in households. Emerging infectious diseases 2009;15(2):233.
- Simmerman JM, Suntarattiwong P, Levy J, et al. Findings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailand. Influenza and other respiratory viruses 2011;5(4):256-67.
- Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet 2020;395(10242):1973-87. doi: https://doi.org/10.1016/S0140-6736(20)31142-9
- Zhang L, Peng Z, Ou J, et al. Protection by face masks against influenza A(H1N1)pdm09 virus on trans-Pacific passenger aircraft, 2009. Emerging infectious diseases 2013;19(9):1403-10. doi: 10.3201/eid1909.121765
- Organization WH. Advice on the use of masks in the context of COVID-19: interim guidance, 5 June 2020: World Health Organization, 2020.
22 April 2020: Gerhard Sundborn, Senior Lecturer at the University of Auckland, says the Plan B group is receiving information from across New Zealand indicating the real human tragedy of lockdown is greater than the lives which may have been saved.
In a post to the Covid Plan B website, Sundborn says one piece of information from inside a district Health Board has heightened fears that suicides may have increased.
“A person in a top level DHB position has told us that the number of suicides in that region has risen, although the information is unobtainable under current rules empowering CEOs.
“Whether or not the report is accurate, the stress of lockdown-induced events will be taking a terrible toll on people and families.
“The elderly are alone, the sick are not seeking help, the newly unemployed are afraid, and people with mental health issues are without a network or health facilities to help.
“Strict conditions during the lockdown has meant families have not been able to farewell the more than 2600 other people who died this past month – that has exacerbated their grief.”
“As these tragic experiences grow, devastating families and communities, this will become a silent ‘counter-epidemic’ to Covid-19.”
Last week, think tank Koi Tū: Centre for Informed Futures, founded by former Chief Science Advisor to the Prime Minister Sir Peter Gluckman, released a report predicting that rates of depression, anxiety and suicide will increase because of the pandemic.
Similarly, one of New Zealand’s leading suicide prevention centres, The Taranaki Retreat, has said there is a link between the lockdown and an increased suicide risk.
The police have admitted there is an increased risk of self-harm incidents but say there is no evidence yet.
“The 13 coronavirus related deaths in New Zealand are undeniably sad. However, throughout the lockdown period, an additional 2,688 people have died from less publicised yet equally terrible illnesses.
“Staying home may be saving some lives, but it is also taking others.”
Contact: Gerhard Sundborn 021 100 3989
Media Statement: April 15 2020
University of Auckland Economist Dr Ananish Chaudhuri says the immediate emotional power of people dying with the disease could lead New Zealand into an extension of the Covid-19 lockdown with dire consequences, including more deaths.
Chaudhuri, who is currently Visiting Professor of Public Policy, at Harvard Kennedy School, says people over-estimate the costs of immediate and visible dangers, which clouds judgement and calculations of the unseen costs arising from their reaction.
“Extension of the lockdown would aim to save a more certain number of lives now, for an unknown number of lives we will lose over time due to health and economic impacts.
“People have tried to claim that extending the current lockdown is a choice between saving lives and losing money, but it’s not. It’s a choice between losing lives now but losing lives later – and possibly a greater number and a greater variety of otherwise healthy people later.”
“Unemployment is not just a number; there are human health and fatality costs. When unemployment goes up the life expectancy of those people goes down. Furthermore, there are devastating consequences for communities from high unemployment – depression, poverty, violence, falling education.”
Chaudhuri points to research showing that the immediate aftermath of the 911 attacks was an estimated 1500 additional deaths on the road, from people driving rather than flying. It arose because in an environment surrounded by concerns over terrorism, people judged they were more likely to die of terrorism than a traffic accident, or even of the more likely event of respiratory illness or heart attack.
“The problem is that we pay more attention to, and value higher, things happening right in front of us – but we don’t pay attention to, or value, even larger things that happen less visibly or more slowly.”
Chaudhuri says an error is being made by those who differentiate between objectives of suppression, eradication, or mitigation.
“It’s a continuum between doing nothing and doing everything – and there’s different costs along that continuum. The challenge is to correctly perceive and calculate those costs.” Chaudhuri says.
Contact: Ananish Chaudhuri / 021-258-1525