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It is disturbing that our Prime Minister is in intensive care. The leader of a nation has symbolic as well as instrumental value. It is reasonable for the public to assume that any Prime Minister has good security, good health care, good advice and plenty of material comforts.

10 Downing Street is not that comfortable, since most of it is an office, with the flat at 11 better than that over 10, so it is the former that Prime Ministers use. I have never been in the flats, but the rest of the house is reassuringly modest. The famous staircase with pictures of former prime ministers is, er, just a staircase up to the offices. Nothing grand about it. Frankly, if they hadn’t thought of putting some photographs on the wall there would be nothing of interest to notice, other than possibly the monitors when you eventually get to the office upstairs.

So, there is symbolic damage. In the UK we haven’t been able to protect our top guy. Also, there is an instrumental problem. Who is in charge now? When the top man goes down the coming men surge forward. They have the loyalty of ferrets, and if he does not survive, there will be another battle royal, just months after the last one. Not good for a country in trouble.

In retrospect, it is fair to note that the Prime Minister took a relaxed attitude to precautions, still shaking hands mid-March, even with Covid patients; attending meetings and political events, and giving advice about social distancing to journalists crowded into a Downing Street room, which are none of them very large, thus negating the message being given. No face masks anywhere. This was of a piece with his general outlook, that personal freedoms are to be cherished, not curtailed unless there are very good reasons. The Imperial model is credited with changing his mind, and making him move to lockdown, though later than was prudent. Whatever the criticisms of the model, if accepted sooner it could have saved him from a major threat to his health.

Intensive care is not a lovely place to be. Only half survive, despite the best efforts of highly trained and dedicated staff. Have a look at the detailed study which came out a few days ago. It is not reassuring. Even those previously in reasonable health, able to cope with everyday living without assistance, are almost just as much at risk.

https://www.icnarc.org/DataServices/Attachments/Download/76a7364b-4b76-ea11-9124-00505601089b

There are still those who see this pandemic as simply the flu with a new name, and suggest we have made too much fuss about it. I don’t think so.

What we need to look at are the weekly death rates now compared to the weekly death rates in previous years. These data exist for Europe, and show that many countries are experiencing excess deaths, though for the most part not yet at the rates previously experienced for flu.

However, the flu deaths are for all types, and the current upturn is due to the newest variant, if we are to call it just another flu. Corvid-19 has only had a few months to spread, but it already showing excess deaths in many countries. By simple inspection there are excess deaths in Belgium +4, France +4, Italy +8, Spain +8, Switzerland + 4 and England +4. Those are Z scores, so the figures show death rates between 4 and 8 times normal weekly variation. That is alarming.

https://www.euromomo.eu/outputs/zscore_country_total.html

Call it flu if you like. Very contagious flu. Flu that you can get from people who appear to have no symptoms. Cryptic flu.

https://www.medrxiv.org/content/10.1101/2020.04.02.20051417v1

It might be too early to work out the infection to death ratio, but what if it is 1.0 to 1.2%? That would be 10 to 12 times worse than flu, and it may be with us for many years to come.

 
• Category: Science • Tags: Britain, Coronavirus, Disease 
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  1. dearieme says:

    There are still those who see this pandemic as simply the flu with a new name, and suggest we have made too much fuss about it. I don’t think so

    It’s not an ordinary flu, as was obvious from the moment the CCP closed down their economy.

    My objection to the present fuss isn’t that it’s too much but rather that it’s been too unintelligent. Up your street, I’d have thought, doc.

  2. Agreed. However, the effective approaches once the virus is prevalent tend to be less intelligent, because absent Test, Trace, Treat the remaining valid options are medieval.

  3. Just a note on the UK (nearly all hospital) death figures. This is thrice in three weeks that the Sunday and Monday death totals have been lower than Saturday’s, giving false hope to ignorants like me looking for a downturn – only to be depressed when Tuesday’s figures are a new record.

    I presume there’s something about the Great British Weekend that’s messing up the stats. Maybe the senior hospital and NHS admin are all at their weekend homes.

    Saturday 21st March 56
    Sunday 22nd 48
    Monday 23rd 54
    Tuesday 24th 87

    Saturday 28th March 260
    Sunday 29th 209
    Monday 30th 180
    Tuesday 31st 381

    Saturday 4th April 708
    Sunday 5th 621
    Monday 6th 439
    Tuesday 7th 786

    Won’t get fooled again. I wonder if this is the case for other nations?

  4. Suppose there were a disease that brought death forward by a week or so. I.e. if you’re close to the end of your life, the disease gives you a little push. Then you’d get a few percent of next year’s deaths brought into this year.

    Today’s cumulative corona death count is 6,159, i.e. about 1% of annual deaths from all causes. “Just over half of coronavirus-related deaths announced by hospitals in England so far have been people aged 80 and over, according to NHS England” (ITV news, yesterday). Life expectancy in the UK is about 80. The median age in the UK is about 40. This does not look like a disease that cuts people down in their prime.

    If you think it’s a tragedy for an unwell person to die slightly early, then what we’re doing makes sense. It’s worth severely damaging the economy and punishing people for sunbathing so that the disease’s would-be victims can die of cancer or dementia after a short delay.

    (It’s probably still worth mentioning that “coronavirus-related death” does not imply that the virus was the cause of death.)

  5. YetAnotherAnon, comment 3: you expect the bureaucracy to run as usual *over the weekend*? Come on, this is a massive national crisis, but not *that* massive!

    • LOL: Dieter Kief
  6. @YetAnotherAnon

    Then the ONS are doing stats by date of death. Ooerr missus!

  7. The column of above…

    Using the same provided link as a reference. “There is no year that did not have higher mortality rates in single week(s) then the weeks one to thirteen of 2020.” That is for all of the population groups calculated, including the 65+ group, and the ‘all groups’ group.

    Secondly, since these weeks that show +2-z-scores deviations above the baseline, they all occur in latest to earliest weeks of each year, it is probable that this year also, there are no later peaks to be expected in the countries providing data (EU countries see euromomo.eu).

    Your carefully crafted words are no explicit lies, but are subtle suggestions to the public of what is not, as far as excess death rates. The peaks of deaths per week are minor to the peaks of 2017, 2018, 2019. The conclusion based on the linked data could as well suggest a highly contagious virus maybe, but a very mild killer and that in all age-groups. Since the testing is not following a procedurally correct approach, intentionally?, the data of what is Covid-19 caused deaths, will be buried in history. Opening the door to further jerking around the surplus populations in the future to come.

    In all, the suggestions made in the article could be misleading to the ones that omit to have a look at the graphs at euromomo.eu for themselves.

  8. Whatever the criticisms of the model, if accepted sooner it could have saved him from a major threat to his health.

    This is supported in no way by fact; it is merely conjecture.

    What we need to look at are the weekly death rates now compared to the weekly death rates in previous years. These data exist for Europe ….

    Look at the ONS death stats. It’s still early, but they just started breaking out deaths related to COVID-19 in addition to their stats for deaths attributable to all respiratory diseases, the latter being one they have tracked for quite some time.

    Here’s the main page:

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

    Here’s the latest:

    https://www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fbirthsdeathsandmarriages%2fdeaths%2fdatasets%2fweeklyprovisionalfiguresondeathsregisteredinenglandandwales%2f2020/publishedweek132020.xlsx

    • Replies: @James Thompson
  9. @YetAnotherAnon

    Well, they certainly admit reporting delays. However, the weekend in reality is usually more dangerous: operations are postponed, and outcomes are poorer. Be very careful at weekends.

    • Replies: @BlackFlag
  10. @The Alarmist

    Agree that the first statement was conjecture. More precisely, if he had followed the recommendations himself earlier, he would have reduced his chance of becoming a case.

    On the other ONS stats, thanks very much for these. Will read.

    • Agree: YetAnotherAnon
  11. dearieme says:
    @Bored Lockdownee

    Life expectancy in the UK is about 80

    More exactly, life expectancy at birth in the UK is about 80.

    The average 80 year old can still expect to live for some years. But it’s presumably not the average ones it’s killing.

  12. Sean says:

    In retrospect, it is fair to note that the Prime Minister took a relaxed attitude to precautions, still shaking hands mid-March, even with Covid patients

    What!

    It is reasonable for the public to assume that any Prime Minister has good security, good health care, good advice ….

    And good sense.

    …. plenty of material comforts.

    I can’t help thinking that Johnson (see photo on a park bench) has been emulating Churchill’s excessive reliance 0n bottled comfort. Churchill got pneumonia twice, the second time very seriously. I am reliably informed by someone who works there that the Covid-19 patients in Glasgow intensive care are mainly men in their 40s and 50s. Scotland has the highest rate of cirrhosis in the world.

    • Thanks: AaronInMVD
  13. They complain about various presidents winning with less than a majority. Johnson won with 44 percent and they call it a landslide.

    Nobody seems to notice or care.

    • Replies: @YetAnotherAnon
  14. dearieme, comment 11:

    > But it’s presumably not the average [80 year old] ones it’s killing.

    Why do you think that?

    • Replies: @dearieme
  15. dearieme says:
    @Bored Lockdownee

    Why do you think that?

    I’m assuming the truth of the claims that it’s people who are already unusually ill who are most at risk.

    I don’t see any reason why that wouldn’t apply to 80 year olds just as much as it applies to 70 years olds. Time will tell, presumably.

    Consider it the other way round. Some poor 80 year old has his immune system suppressed because of his cancer treatment, his heart is dodgy, his liver is in poor nick, he’s got Type I diabetes, and he has a record of lung problems. I suspect he’s unlikely to be a statistically better bet to survive than his fit and well 80 year old neighbour (unless COVID-19 has heretofore unsuspected curative properties).

  16. @Bored Lockdownee

    “Just over half of coronavirus-related deaths announced by hospitals in England so far have been people aged 80 and over, according to NHS England”

    People who didn’t get the BCG vaccine!

    https://www.dailymail.co.uk/sciencetech/article-8197247/Coronavirus-death-rate-SIX-TIMES-lower-countries-use-BCG-vaccine.html

    “In the UK, all schoolchildren between ten and 14 were injected with the vaccine between 1953 and 2005.”

    I presume none of the various Arab/Sudanese(?) doctors who have died had the jab either. Nor Dr Anton Sebastianpillai, nor Nurse Alice Kit Tak Ong, who came to the UK at 23.

    This might explain why London bus drivers are taking a hit, too.

    • Replies: @Philip Owen
  17. Realist says:

    This stupid idea that we can’t go on without our leader is appalling. There are damn few national leaders worth a crap…most are corrupt and or stupid.

  18. Realist says:

    It might be too early to work out the infection to death ratio, but what if it is 1.0 to 1.2%? That would be 10 to 12 times worse than flu, and it may be with us for many years to come.

    Why all the hysteria? Calm down…the worst part will be the economy.

  19. @YetAnotherAnon

    I have looked at the TB relationship myself after I read a paper from Wuhan noting a high correlation between dormant TB and death from CV19 pneumonia. There was an interesting correlation between an early outbreak and traditional steel making areas, of course places of great poverty (TB is a disease of poverty) in the 1930’s. Examples include:

    Wuhan
    Lombardy
    Qom
    Toledo/Madrid
    Lorraine
    Gwent

    These were all #1 or #2 in their countries to be infected and similarily had very high rates of infection.

    There are alternative explanations. I now favour steel executives from Wuhan travelling to all these places. A new rod mill was being completed in Qom. Chinese buyers were looking at Orb Steel in Newport. The reason for the travelling salesmen preference is that there are no steel industry clusters in the US. The US is fighting a trade war with China. Wuhan steel personnel would not have been in Pittsburg or Gary.

    • Thanks: Johann Ricke
  20. @obwandiyag

    ” Johnson won with 44 percent and they call it a landslide.”

    Different system. First past the post in (iirc) 635 constituencies contested by multiple parties, then the elected MPs choose a government. It would be theoretically possible to form a government with maybe 25% of the popular vote.

    Thatcher’s vote for a 43 seat majority in 1979 was 43.9%, Blair’s vote for a 66-seat majority in 2005 was 35.2%, which he considered enough of a mandate to open the borders and change Britain forever for the worse.

    • Replies: @obwandiyag
  21. BlackFlag says:
    @James Thompson

    Off Topic

    Dr. Thompson, have you ever researched on whether twins suffer an IQ penalty? Very important for couples considering IVF.

    I couldn’t find in your archives.
    Here are a few links I came across:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661696/
    https://eric.ed.gov/?id=EJ814952
    https://www.bmj.com/content/337/bmj.a438

    https://isteve.blogspot.com/2010/04/twins.html
    People have remarked on how few famous thinkers were twins.
    This comment by anonymous is the best in the thread:
    “As far as twins having an average 5 point lower IQ, remember that this is an average. Twins are much more likely to be born VERY premature than single babies, leading in many cases to mental retardation. In most cases, there is either going to be a serious deficit (20 points or more) or no effect at all. In a vaginal birth, the second twin is much more likely to be born dead or to be retarded. If the birth of the first twin is prolonged, the oxygen supply of the second can be compromised by the delay.”

  22. @Bored Lockdownee

    If you think it’s a tragedy for an unwell person to die slightly early, then what we’re doing makes sense.

    It makes sense iff the cost (however measured) is lower than the benefits. It’s not even close.

    As I’ve said elsewhere: significant economic slowdowns cause increases in suicides.

    Cause cause. Granger-cause.

    .

    As to costs vs benefits

    Let’s put a finger on the scale, and err on the side of slightly-delaying-inevitable-octagenarian-deaths because reasons. Old people are nice, or fought in just wars, or something.

    Well…

     • the median suicide is a person in their mid-40s, with a HALE (health-adjusted life-expectancy) of about 30 years (it’s more like 35).

     • the median COVID19 (dies-with) victim is about 80 years old.

    The HALE65 in the West is currently 10 years (EU average); so a sickly 80 year old has a HALE of zero – let’s bung it up to 0.5 years just to be nice (which assumes that sickly 80-year-olds die at roughly twice the rate as non-sickly ones).

    So each suicide imposes a cost of 60× that of a sickly 80-year old, in DALY/QALY terms (disability|quality adjusted life-years).

    Round it down to 50× – thumb on the scale (again).

    That’s before you start counting “dollars”, but also ignores the disparate emotional impacts on next-of-kin.

    A sickly 80 year old’s death doesn’t take anyone by surprise: people are sad, but”they had a good innings” etc.

    Compare that to the shock of the unanticipated suicide of a father of 3, or a son in his late 20s. (In a circle 1 degree of Kevin Bacon from me, an unanticipated suicide caused 2 other suicides within a year: ZOMFG R[0] = 2!!! EXPERNENSHULLLL!!!)

    .

    In gauche dollar-terms, the median pre-suicide[1] is a net drain on the tax system (the bottom 3 income quintiles all get more in tax-funded services than they pay in tax).

    However they’re less so than the average 80 year old, who have far higher levels of welfare-dependency (and pensions are higher than unemployment benefits). Plus, end-of-life medical care is expensive as balls. 80 year olds more costly, but not for long.

    The average pre-suicide has some small chance of income-decile migration, and of eventually being a net tax payer: the 80 year, old not so much.

    However when you start talking about the marginal excess suicide, things change: excess suicides that result from economic despair are people who were previously OK – they’re more productive, less welfare-dependent etc.

    And again… this is ignoring the adverse impacts that periods of high adversity have on fertility, as Hail pointed out a while back (seems like a year ago – it was probably a week).

    [1] it makes no sense to talk about potential future economic contributions for ‘actual’ suicides. Those are zero (except for the ‘stimulus’ to gravediggers and morticians, if you’re Krugman)

  23. wwebd said ……

    “could be with us for years”
    The Chinese people may insist that their cultural right to wet markets will not be infringed , and if they get what they want, it or something like it
    “could be with us for generations.”

    There is zero chance that the world community will crack down on those wet markets by successfully making them illegal, the way, for example, in the mid-1940s, the possession of nuclear devices by private individuals was made universally illegal – almost immediately, by the way, after the realization that such thingamabobs existed.

    In 1939, it was not illegal to own a nuclear bomb if you were a resident of North America . You can look it up. Just like in 2019 in the CCP’s China, it was not illegal to eat undercooked bat soup at a trendy Wuhan dinery, even after the first SARS go-round. (I think it was illegal for a few years after the first SARS go round, but I could be wrong). You can look it up.
    In 1946 you would have gone to jail for a very long time for being a private citizen who owned a nuclear bomb, even if you lived in North America!
    In 2020 – trust me – hundreds of people are enjoying bat soup tonight. Not just in China, either.

    • Replies: @Anon
  24. Anon[171] • Disclaimer says:
    @Stephen Dodge

    Man the bat soup thing (they eat the head…..sinus cavity and bat phlegm too) is one of the most truth-is-stranger-than-fiction-revelations of my lifetime.

    I know cultures are different, but looking at pangolin, a bat, a snake, or a civet and thinking of them as anything other than starvation-desperate food measures…………makes you feel like an alien on your own planet.

  25. Anonymous[320] • Disclaimer says:

    Epidemiologist: Coronavirus could be ‘exterminated’ if lockdowns were lifted

    https://www.thecollegefix.com/epidemiologist-coronavirus-could-be-exterminated-if-lockdowns-were-lifted/

    #coronahoax < Captain Trips

    • Replies: @Sean
  26. Sean says:
    @Anonymous

    The epidemic would end naturally once two thirds of the population has immunity, but that immunity would could only be gained by letting it burn through the population. The lockdown is supposed to be stopping the deaths among a proportion of the aged and vulnerable, yet they are not really being saved because the epidemic ending naturally is also being stopped. It is not sustainable and when they take it off it would only take one infection to start a new second wave epidemic.

    No one knows what proportion of any population has immunity so no one knows if the lockdown is necessary in any particular country, The probability the lockdown is not necessary is 50/50 according to the leading epidemiologists. This is a limited thing because they are not going to go into open ended lockdown until a vaccine is found next year. And they are not going to end the lockdown then restart it. So this is a period to get hospitals ready for the burn through to herd immunity. It may turn out that we already had more of less had the burn though so the lockdown was far less necessary to stop hospitals being overwhelmed than the Imperial projections assumed. Imperial did not start from known facts of the epidemic to judge how far along it was.

    China misled the world and themselves about Wuhan. Few people think China is suddenly sharing all it knows with the world now. Contrary to what is being said, we simply do not know whether the Chinese epidemic ended because of timely measures they took, or by a largely natural process that was quietly making people immune before the aforementioned measure were enacted. A third of the population can be enough for herd immunity, two thirds is only the proportion guaranteed to be enough to end an epidemic.

    • Replies: @James Thompson
  27. @Sean

    We are beginning to get small scale epidemiological studies of hard-hit towns, cruise ships and the like which will give us better estimates of herd immunity, as well as the infection-to-death ratios. Our understanding of events, and refinement of strategies, should get much better over the next few weeks.

    • Replies: @Sean
  28. Sean says:
    @James Thompson

    https://edition.cnn.com/2020/04/10/europe/sweden-lockdown-turmp-intl/index.html

    An Austrian better left unmentioned called Sweden a ‘nation on furlough’. Changed days. They will have put it behind them and be in excellent immunological and economic shape a few weeks hence. Britain will be desperate and calling a halt to the lockdown in a few months having gained nothing but an enormous breach in national wealth and vulnerability to an inevitable second epidemic in October.

  29. @YetAnotherAnon

    Correct. And that’s why their system sucks. Not that the American one doesn’t. But theirs isn’t an iota better. Constant minority rule.

  30. I have started tracking death rates from all causes in Wales. The Aneurin Bevan University Health Board in Wales has, measured in deaths per 100,000, the most intense outbreak of Covid-19 in the UK. This is particularly concentrated in the city of Newport. (There was a Rugby match against an North Italian team). Next door Cardiff, a haven for foreign students is also at a very high level.

    And yet, there has not been a flicker on the overall death rate from all causes. The 60% fall in Emergency Admissions to hospital seems to have compensated for the SARS-CoV-2 infections.

    Here is the graph. I imagine the rest of the UK is the same. I will check next time but the garden calls.

    • Replies: @James Thompson
  31. @Philip Owen

    Sometimes when health services are not available, death rates go down! However, across Europe several countries are definitely up, and beginning to get in to the range of the flu outbreaks in 2017/18

    • Replies: @Philip Owen
    , @Sean
  32. dearieme says:

    I’ve seen it claimed that the third most common cause of death in the US is Doctors.

    https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

    Come to think of it, if medical staff/hospitals are a major vector for the Wuhan virus maybe part of the the Wuhan toll should be added to the iatrogenic score.

    (Mind you I don’t understand US cause-of-death numbers: I once had to look some up for professional purposes and I couldn’t believe the high number attributed to electricity.)

  33. @James Thompson

    Yes. To be fair it may not be iatrogenesis! The graph above shows a strong drop in the last week of the year during the normal Christmas lockdown. (It isn’t just a reporting issue, the January rebound is not big enough to compensate).

  34. Sean says:
    @James Thompson

    If COVID-19 had appeared immediately after the flu outbreaks in 2017/18, then COVID-19 would have seemed much less virulent judged by the number it killed, because the ‘low hanging fruit’ vulnerable individuals would be few in number, many having died of flu. On the other hand, a mild weather flu season (and highly effective flu inoculation) would lead to more vulnerable people being left alive to be killed by COVID-19 and late season flu. Influenza B is notorious as a late flu.

  35. Fo rthe sake of following through, here is my latest graphing of deaths from all causes in Wales,. Covid-19 deaths are now shown seperately. Take off has occurred but so far no more than a bad flu season by magnitude and last bad flu season lasted 16 weeks.

    93% of UK (no seperate figure for Wales) Covid-19 deaths are attributed to hospitals.

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