When the postmortem is done on the media’s coverage of COVID-19 (and it will be), it will be clear that the virus was no Black Plague — it’s not even the flu on a bad year.
SARS-CoV-2, which causes COVID-19, has killed 56,749 Americans as of Tuesday.
That’s not good. But it’s not as bad as the 2017-2018 flu season, when 80,000 -plus perished. And it’s a long cry from what all the experts were warning about just a few weeks ago: First, they predicted 1.7 million Americans dead; then they redid the models (this time apparently entering a few more “facts”) and said 100,000-240,000 dead.
Fatality rate:
A recent Stanford University antibody study estimated the fatality rate from the virus is likely 0.1% to 0.2%
In New York City, the death rate for people 18 to 45 years old is 0.01%, or 10 per 100,000 in the population.
People aged 75 and older: 0.8%
For children under 18, the rate of death is zero per 100,000.
Background: Influenza infection is a common cause of respiratory disease and hospitalization in children. Neurologic manifestations of the infection have been increasingly reported and may have an impact on the severity of the disease. The aim of this study is to describe neurologic events in pediatric patients hospitalized with influenza and identify associated risk factors.
Methods: Retrospective cohort study which included all hospitalized patients with microbiologic confirmation of influenza disease over 4 epidemic seasons, focusing on neurologic complications. Demographic, laboratory and clinical data, as well as past history, were recorded. Descriptive and analytic statistical study was performed using SPSS and R statistical software.
Results: Two hundred forty-five patients were included. Median age was 21 months (interquartile range, 6–57) and 47.8% had a previous underlying condition. Oseltamivir was administered to 86% of patients, median hospitalization was 4 days (interquartile range, 3–6), and pediatric intensive care unit admission rate 8.9%. Twenty-nine patients (11.8%) developed neurologic events, febrile seizures being the most frequent, followed by nonfebrile seizures and encephalopathy. Status epilepticus occurred in 4 children, and 69.6% of seizures recurred. Patients with a previous underlying condition were at greater risk of developing a neurologic complication [odds ratio (OR), 4.55; confidence interval (CI), 95% 1.23–16.81). Male sex (OR, 3.21; CI 95%, 1.22–8.33), influenza B virus (OR, 2.82; CI 95%, 1.14–7.14) and neurologic events (OR, 3.34; CI 95%, 1.10–10.19) were found to be risk factors for pediatric intensive care unit admission.
Conclusions: A significant proportion of influenza-related hospitalized patients develop neurologic complications, especially seizures which may be prolonged or recurrent. Previous underlying conditions pose the greatest risk to neurologic events, which increase disease severity.
The Office for National Statistics (ONS) revealed that in the week ending 28 August 2020 1,040 deaths were linked to influenza or pneumonia. However, just 101 deaths were linked to coronavirus
No statistically significant differences in the rates of hospitalization, admission to the intensive care unit, and mechanical ventilator use between children with COVID-19 and those with seasonal influenza.
Question What are the similarities and differences in clinical features between coronavirus disease 2019 (COVID-19) and seasonal influenza in US children?
Findings In this cohort study of 315 children with COVID-19 and 1402 children with seasonal influenza, there were no statistically significant differences in the rates of hospitalization, admission to the intensive care unit, and mechanical ventilator use between the 2 groups. More patients with COVID-19 than with seasonal influenza reported fever, diarrhea or vomiting, headache, body ache, or chest pain at the time of diagnosis.
Meaning The findings suggest that prevention of both COVID-19 and seasonal influenza in US children is prudent and urgent for the well-being of this population.
But where did this one percent figure come from? You may find this hard to believe, but this figure emerged by mistake. A pretty major thing to make a mistake about, but that’s what happened.
In order to understand what happened, you have to understand the difference between two medical terms that sound the same – but are completely different. [IFR and CFR.]
CFR will always be far higher than the IFR. With influenza, the CFR is around ten times as high as the IFR. Covid seems to have a similar proportion.
Now, clearly, you do not want to get these figures mixed up. By doing so you would either wildly overestimate, or wildly underestimate, the impact of Covid. But mix these figures up, they did.
…we’ve had all the deaths we were ever going to get. And which also means that lockdown achieved, almost precisely nothing with regard to Covid. No deaths were prevented.
Sky News host Alan Jones says people are being swept up into a sense of hysteria and alarmism around COVID-19.
There are only 17 people in hospital with the coronavirus in NSW, eight of them in intensive care, while the World Health Organisation continue to maintain that 99 per cent of all cases will experience mild symptoms.
“I don’t think there’s going to be a vaccine, and we’re going to have to learn to live with this,” Mr Jones told Sky News host Chris Smith.
“But we learned to live with a whole lot of other communicable diseases.
“More people are dying from the flu with a vaccine than are dying from coronavirus without a vaccine.”
The consequences to be inflicted on the personal wellbeing of Australians, business viability, the national economy, and mental health are far beyond what could be described as responsible management of the situation says Sky News host Alan Jones.
“The nation is swimming in debt, kids are out of school, people are locked up while all along the mental anguish of what is taking place is beyond calculation,” Mr Jones said.
On Monday, Premier Daniel Andrews outlined the details of his stage four lockdowns which will affect Metropolitan Melbourne for at least six weeks in a bid to slow the spread of COVID-19.
Mr Andrews ordered all non-essential workers not to leave their homes from Thursday but promised people they will not need to bulk buy food as supermarkets, grocery stores and pharmacies would stay open.
Mr Jones said if lockdowns were the answer, why do deaths continue to escalate around the country.
Mr Jones discussed the issue with Garrick Professor of Law at the University of Queensland.
Australia-wide: 43 critical cases
1% of patients critical
99% of cases are mild
221 COVID-19 deaths so far out of a population of 26 million
440 Australians die every day
1,000-1,500 flu deaths each year
COVID-19 not in top 50 death causes
Professor James Allan: “In a decade this will be looked back on as one of the most colossal public policy fiascos of the century.”
Around 161,000 Australians die every year (440 per day)
Nearly three times as many people are now dying of flu and pneumonia than with coronavirus in England and Wales, new figures have revealed.
Numbers published by the Office For National Statistics show 917 flu and pneumonia deaths were registered for the week ending on July 10.
In comparison, 366 people died that week after testing positive for Covid-19 – the lowest number of deaths involving the virus in the last 16 weeks and a 31.2% decrease compared with the previous week, which saw 532 deaths.
Overall, the number of deaths registered in the same week was 6.1% (560 deaths) below the five-year average – the fourth consecutive week it has been below average.
2:55 – Masks • Tom Jefferson: “Aside from people who are exposed on the frontlines, there is no evidence that masks make any difference, but what’s even more extraordinary is the uncertainty: we don’t know if these things make any difference…. We should have done randomised control trials in February, March and April but not anymore because viral circulation is low and we will need huge number of enrolees to show whether there was any difference”. • Carl Heneghan: “By all means people can wear masks but they can’t say it’s an evidence-based decision… there is a real separation between an evidence-based decision and the opaque term that ‘we are being led by the science’, which isn’t the evidence”.
9:26 – Pandemic life cycle • CH: “One of the keys of the infection is to look at who’s been infected, which shows a crucial difference when comparing the pandemic theory to seasonal theory. In a pandemic you’d expect to see young people disproportionately affected, but in the UK we’ve only had six child deaths, which is far less than we’d normally see in a pandemic. The high number of deaths with over-75s fits with the seasonal theory”.
14:00 – Covid seasonality • CH: “The stability of the virus is far less when the temperature goes up but humidity seems to be particularly important. The lower the humidity, the more stable the virus is in the atmosphere and on surfaces… It’s now winter in the southern hemisphere, which is why places like Australia are suddenly having outbreaks.”
20:37 – Lockdown • CH: “Many people said that we should have locked down earlier, but 50% of care homes developed outbreaks during the lockdown period so there are issues within the transmission of this virus that are not clear… Lockdown is a blunt tool and there needs to be intelligent conversations about what mitigation strategies can keep society functioning while we keep the most vulnerable shielded”.
25:20 – Nightingale hospitals • CH: “They are the wrong structure. What you need is fever hospitals which were here until around the 1980s or 90s. They were on single floors and had isolation within isolation. Theere were no lift shafts and staff were trained, which meant that everyone was protected from each other… It looks like at leats 20% of people got the infection while they were in hospital”
27:30 – Suppression strategy • CH: “The benefits of the current strategy are outweighed by the harms…When it comes to suppression, only the virus will have a determination in that. If you follow the New Zealand policy of suppressing it to zero and locking down the country forever, then you’re going to have a problem… This virus is so out there now, I cannot see a strategy that makes suppression the viable option. The strategy right now should be how we learn to live with this virus”
32:45 – Response to the virus • TJ: “I am a survivor of four pandemics and for the other three, I didn’t even realise they were going on. People died but nothing changed and none of the fabric of society was eroded like this response… Do I see steps being taken at a European level about learning from our mistakes and changing policies? The answer is no…
39:30 – Politics of the virus • CH: “We as individuals are part of the problem because sensationalism drives people to click and read the information. So it’s a big circle because we’ve created the problem — if we put the worst case scenario out there, we will go and have a look. If you want a solution, you’ve got to get people to stop clicking on this sensationalist stuff”.
43:30 – IFR • CH: “We will be down about where we were with the swine flu: around 0.1-0.3% which is much lower than what we think because at the moment we are seeing the case fatality”. • TJ: “If you look at the whole narrative, it was distorted from the very beginning by the obsession with influenza which was just one or two agents and nothing else existed. We’re no different now”.
In July Health Secretary Matt Hancock claimed that conspiracy theorists are putting lives at risk
The UK government’s Vaccine Damage Payment scheme is proof that vaccines can be unsafe
Eligibility criteria Vaccine Damage Payment changed in 2015
Update October 2020: AstraZeneca protected from vaccine liability
Update November 2020: MHRA expects high volume of COVID-19 vaccine adverse drug reaction
Update December 2020: Pfizer is given protection from legal action by the UK government
Discussion around vaccinations can be very contentious. There’s great nuance in this area and a short post will not do justice to the complex issues surrounding the usefulness and safety of vaccines. Nevertheless, while vaccines may have their role in protecting target populations from disease, not all have been proven safe to an acceptable level as shown in the resources below.
The UK government’s Vaccine Damage Payment scheme is probably the strongest proof that vaccines can be unsafe. Under the Vaccine Damage Payment scheme, people who have been severely disabled as a result of a vaccination against certain diseases can be eligible for a one-off tax-free payment of £120,000.
Conspiracy theorists are putting lives at risk?
It is an objective fact that a compensation scheme exists for those who have been damaged by vaccines. Nevertheless, Health Secretary Matt Hancock claimed that conspiracy theorists are putting lives at risk:
“Those who promulgate lies about dangers of vaccines that are safe and have been approved–they are threatening lives…”
Clearly, concerns about the safely of vaccines cannot be lies if there is a vaccine damage compensation scheme in place.
Eligibility changed in 2015
Eligibility requirements for vaccines covering certain diseases are listed and change over time. Interestingly, sometime around 2015, damage from vaccines for influenza caused by pandemics are explicitly listed as not eligible.
We do not know how the government compiles is eligibility criteria or why this change was made. However, it would be worthwhile to keep an eye on this list to see if the status of the upcoming COVID-19 vaccines.
AstraZeneca protected from vaccine liability
Update 1 August 2020: On 30 July 2020, Reuters reported that AstraZeneca, the UK government’s partner for developing its COVID-19 vaccine, will be exempt from coronavirus vaccine liability claims in most countries. The countries have not been named but Ruud Dobber, a member of Astra’s senior executive team, commented:
“This is a unique situation where we as a company simply cannot take the risk if in … four years the vaccine is showing side effects.
In the contracts we have in place, we are asking for indemnification. For most countries it is acceptable to take that risk on their shoulders because it is in their national interest.”
MHRA expects high volume of COVID-19 vaccine adverse drug reaction
Update November 2020: It came to light in mid-November that the UK’s Medicines & Healthcare products Regulatory Agency (MHRA) put out a contract award notice for an Artificial Intelligence (AI) software tool. It appears they expect a high volume of COVID-19 vaccine Adverse Drug Reaction (ADRs) from the upcoming vaccines:
…it is not possible to retrofit the MHRA’s legacy systems to handle the volume of ADRs that will be generated by a Covid-19 vaccine. Therefore, if the MHRA does not implement the AI tool, it will be unable to process these ADRs effectively.
Pfizer given legal indemnity
Update 2 December 2020:According to the Independent, Pfizer now has a legal indemnity from being sued by patients who develop any complications from its new mRNA vaccine that will be rolled out in the UK. NHS staff providing the vaccine will also be protected.
A randomized placebo-controlled trial in children showed that flu shots increased fivefold the risk of acute respiratory infections caused by a group of noninfluenza viruses, including coronaviruses. (Cowling et al, Clin Infect Dis 2012;54:1778) From Table 3, vaccine recipients had 20 noninfluenza virus-positive ARIs and 19 virus-negative ARIs; non-recipients had 3 noninfluenza virus-positive ARIs and 14 virus-negative ARIs. These figures yield an odds ratio of 4.91 (CI 1.04 to8.14).
Such an observation may seem counterintuitive, but it is possible that influenza vaccines alter our immune systems non-specifically to increase susceptibility to other infections; this has been observed with DTP and other vaccines. (Benn et al, Trends in Immunology, May 2013) There are other immune mechanisms that might also explain the observation.
In reality many of the people who died from Covid-19 were likely to die this year anyway, so in one respect this estimate is likely to be too high. In another respect it’s likely to be too low, as it will not include ‘lockdown deaths’, that is, the deaths from delayed cancer and heart treatments, and so on, but as I was interested in the effect of Covid-19 I didn’t want those in my graph anyway. (Another complication is that not everyone who is classed as a Covid-19 death actually died from it, but I decided to ignore this.)
The five year average for 2015-19 is 531,355 deaths per year. As of writing this there were 42,462 Covid-19 deaths in the UK. There are likely to be a few more deaths in the next few weeks, but not many more, as the disease is (barring an unlikely second wave in winter), on its way out. Besides, the number we are adding on here is for the whole of the UK, not just England and Wales, so if anything this number is inflated. That gives us 573,817 deaths for 2020. Then I got hold of the historical population figures for England and Wales, and calculated the death rates per 1000 from it, so that population increases are taken account of. Here is the result:
Persons who are diagnosed with influenza…should remain at home until the fever is resolved for 24 hours…and the cough is resolving to avoid exposing other members of the public. If such symptomatic persons cannot stay home during the acute phase of their illness, consideration should be given to having them wear a mask in public places when they may have close contact with other persons.
No recommendation can be made at this time for mask use in the community by asymptomatic persons, including those at high risk for complications, to prevent exposure to influenza viruses.
The study, published in JAMA, found that surgical masks were as effective as N95 respirators at preventing the flu, which is to say, not all that effective because, of the 446 nurses who took part in this study, nearly one in four (24%) in the surgical mask group still got the flu as did 23% of those who wore the N95 respirator. And, because both groups wore masks, it’s impossible to say how they would have fared compared with not wearing a mask at all.
Basically, there is no strong evidence to support well people wearing surgical masks in public. Or as the US Centers for Disease Control and Prevention put it: “No recommendation can be made at this time for mask use in the community by asymptomatic persons, including those at high risk for complications, to prevent exposure to influenza viruses.”
The best thing you can do to stop getting the flu is to regularly wash your hands, and try to avoid touching your face.
Britain could have been hit harder by Covid-19 than other European nations because the past two winter flu outbreaks have only been mild, according to a study.
Researchers say influenza kills the same groups of people as the coronavirus, with both illnesses posing the greatest danger to the elderly and those with underlying conditions.
Public Health England statistics show around 20,000 excess deaths – those of any cause that happen above average – occur from influenza each year.
But only 1,700 extra fatalities were recorded during the 2018/19 outbreak, said lead author Dr Chris Hope who claimed data showed the 2019/20 season was also ‘very mild’.
It means more than 30,000 people in England alone were alive at the start of the Covid-19 pandemic who would have been expected to die in the previous two flu seasons.
We have already developed herd immunity to COVID-19 and will continue to manage it through herd immunity.
Flu is much more dangerous than COVID-19.
COVID-19 will settle into an endemic state just like flu.
Hopefully vaccines will be important in protecting the vulnerable.
Another way to protect the vulnerable sector is to allow the population to develop natural immunity.
There’s no reason to think the virus will mutate into a lower level of virulence.
During the 1918 flu because of a large number of ‘immunologically naive’ individuals but this is not the case with COVID-19.
Most of us have some degree of coronavirus immunity and therefore some protection to COVID-19.
The current H1 influenza strain is antigenically identical to the 1918 flu. H1 flu doesn’t kill as many people as the 1918 flu because most people already have cross immunity.
The death rate from COVID-19 (coronavirus) in Europe appears to be linked to low-intensity flu seasons in the past two years as the same people are vulnerable, says a working paper by Dr Chris Hope, Emeritus Reader in Policy Modelling at Cambridge Judge Business School.
“90 percent or more of SARS-CoV-2 virus will be inactivated after being exposed [to summer sun] for 11 to 34 minutes.”
Using a model developed for estimating solar inactivation of viruses of biodefense concerns, we calculated the expected inactivation of SARS-CoV-2 virus, cause of COVID-19 pandemic, by artificial UVC and by solar ultraviolet radiation in several cities of the world during different times of the year. The UV sensitivity estimated here for SARS-CoV-2 is compared with those reported for other ssRNA viruses, including influenza A virus. The results indicate that SARS-CoV-2 aerosolized from infected patients and deposited on surfaces could remain infectious outdoors for considerable time during the winter in many temperate-zone cities, with continued risk for re-aerosolization and human infection. Conversely, the presented data indicate that SARS-CoV-2 should be inactivated relatively fast (faster than influenza A) during summer in many populous cities of the world, indicating that sunlight should have a role in the occurrence, spread rate, and duration of coronavirus pandemics.
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