Monday, 6 April 2020

Professor Knut Wittkowski: social distancing and lockdown are counter-productive

Professor Knut Wittkowski, for twenty years head of the Rockefeller University's Department of Biostatistics, Epidemiology, and Research Design, says in an interview with Journeyman Pictures that social distancing and lockdown is the absolutely worst way to deal with an airborne respiratory virus. He thinks herd immunity could have been achieved in the USA in four weeks at the cost of 10,000 dead, meaning 2% of patients with symptoms. This compares with the usual 35,000 who die of flu each year in the USA.

The current Coronavirus panic is a creation of the internet, which tells us instantly what is happening on the other side of the world.

In China and South Korea social distancing only began after the illness was close to its peak and herd immunity was in sight. Because social distancing prevented herd immunity in South Korea being fully attained the virus will come back there. Herd immunity lasts typically for a couple of years.

He thinks tracking an airborne contagion is impossible.

A vaccine would be nice to have but is not essential, he says. Flu vaccines 'are not that effective' anyway and, of course, there is no vaccine for the common cold.

Social distancing will result in more old people dying in this wave of infections and in a second wave of infections, either when social distancing stops or when winter comes.He urges that schools be open, so that the virus may spread harmlessly among children and thus shorten the amount of time the elderly and infirm must be sequestered. 

He thinks most people who get the virus won't have any symptoms. A large number of people (In the USA or worldwide?) have the virus and, even without herd immunity being achieved, we see the virus already declining.

If he is right Sweden, which is trying to achieve herd immunity and eschewing social distancing, will show us.

He talk several times about Mother Nature. That there is an order in the universe that transcends man's understanding is something of which hard scientists, unlike social scientists, are constantly aware, but in the wider world it is unfashionable. The fashionable idea resembles Whittaker Chambers' definition of communism.

'It is the vision of man's liberated mind, by the sole force of its rational intelligence, redirecting man's destiny and reorganizing man's life and the world.'

Gentle reader, I am increasingly sceptical about the need for the lockdown but I believe we should observe all the rules on social distancing. We do not know enough about the virus yet. The data we have is almost useless, but we shall know very much more soon, in perhaps a week or so. 

Meanwhile I very certainly do not want Romanian hospitals to be overwhelmed like the very much better ones in Lombardy. 

Professor Wittkowski, on the other hand, told the New York Post a few days ago that he regularly goes to one of two illicit restaurants operating in secret in the smart Upper East Side quarter of Manhatten.

Saturday, 4 April 2020

Has the cavalry arrived?

Sanofi is donating to the Romanian Ministry of Health 1,080,000 doses of hydroxychloroquinine, the anti-malarial drug that 'kills' COVID-19. 

According to the Ministry of Health, the doses will reach over 45,000 patients in Romania. The drugs have already reached the warehouse of Unifarm, the Ministry of Health's distributor, and are being sent to hospitals immediately. 

But is hydroxychloroquinine effective against COVID-19? 

A French study suggests not except in mild cases or cases caught early, either way before the patient develops a temperature.

Cheerful news

This is a time when even contrarians have to become team players. I want everyone in countries that are in lockdown because of the Covid-19 virus (everywhere in Europe except Sweden, Belarus and Iceland) to obey the rules, stay at home as much as they can and keep away from other people, as people in Romania are doing. The economy is closed down, with enormous damage and hardship - if the virus nevertheless continues to spread we are in the worst of all worlds.

On the other hand, a sizable number of virologists and epidemiologists do not agree that the virus is a great threat to humanity. 

Here is another one. Professor John Oxford, virologist, Professor of Queen Mary's College, London, a leading expert on influenza, including bird flu and the 1918 Spanish flu, and HIV/AIDS, who says

"Personally, I would say the best advice is to spend less time watching TV news which is sensational and not very good. Personally, I view this Covid outbreak as akin to a bad winter influenza epidemic. In this case we have had 8000 deaths this last year in the ‘at risk’ groups viz over 65% people with heart disease etc. I do not feel this current Covid will exceed this number. We are suffering from a media epidemic!"
I am not sure when he said it. Britain looks likely to reach 8,000 deaths of people with the virus in a week or so. The professor could ask how many are dying from it, rather than with it, which is by no means a pedantic point, and argue that most are in the former group. His point bout not watching TV news is a good one. It probably applies to most of the news.

But not all of the printed media. It would be a pity to miss out on another reason for hope, from the usually very saturnine Ambrose Evans-Pritchard, in today's Telegraph.

On one level, the immediate global shock is much greater than the onset of world wars. On another, a ‘sudden stop’ for three months is mostly an accounting mirage, so long as governments absorb the hit and productive economies are kept whole.

Ben Bernanke, ex-head of the US Federal Reserve, likens it to a winter shutdown from a polar vortex. There is some permanent loss but pent-up demand and a V-shaped recovery later claws back most of the lost GDP. Catch-up growth gradually pulls down the public debt ratio.

The stoppage does not fundamentally matter in macroeconomic terms unless we repeat the errors of austerity overkill and listen to those telling us that it is all too expensive. Thankfully these voices are being ignored in the US, UK, China, Japan, and Europe (with big caveats).

Friday, 3 April 2020

On the Late Massacre in Lombardy

In February 1957 a new influenza virus emerged in East Asia, which doctors named A (H2N2) and which was known to the world, in the days before political correctness, as Asian Flu.

It is estimated that Asian Flu killed 1.1 million people around the world and 116,000 in a United States, which then had a population just over half what it is today. 

Researchers estimate that about 25 percent of Americans were infected. The American liner the President Cleveland arrived in San Francisco from Japan with 96 of its passengers and crew either ill or convalescent(Not 96 percent, as stated in the recent Washington Post article to which I linked.) 

Nevertheless, in 1957 life in the USA and elsewhere went on pretty much as normal. 

There was no lockdown. Is a global lockdown necessary in the face of Covid-19?

If Covid-19 is the pandemic that governments have feared for decades, that can kill a large proportion of the world’s population unless checked, then the answer is yes, but is it?

There are some reasons to make me suspect that we have panicked unnecessarily but, on the other hand, why are the hospitals in Lombardy and Spain in chaos?

It might be partly because the winter was so very mild.

There’s an old saying in England,

‘A green winter makes a full churchyard.’
What that folk wisdom means is that germs that a severe winter kills off supposedly flourish in a mild winter and kill off lots of elderly people. 

This winter in Italy the flu was very mild because of the unusually warm weather and killed many fewer older Italians than average, according to a report by the Italian Ministry of Health. The report argued that old people with chronic diseases who  survived until February and March then became victims of Covid-19.

This partly explains why many people over 65 have suddenly died in Lombardy, but there are other factors.

Italy’s more than 12,000 deaths have happened mostly in Northern cities and towns, but there overall mortality among people age 65 and over was 6% below an average of previous years. In fact, total number of deaths throughout Europe in March 2020 is less than the total numbers in March 2019.

Large numbers of old and frail people, who were going to die anyway, will die of the Coronavirus, as well as a few younger and healthy people. Far more old and frail people will die in hospital with, not of, it and those deaths will also be added to the death toll in the media.

On the other hand, the deaths of many people who die with the virus at home or in nursing homes will go unreported.

In Bergamo and nearby towns deaths in March were several times more than March last year, which would strongly suggest that Covid-19 is responsible, but in fact most are not assigned to Covid-19.

What is going on?

The fear throughout Europe is that the breakdown in hospital care in Lombardy and in Spain will happen throughout Europe, especially in poor countries like Romania. 

What then is causing the disaster reported from Lombardy?

This message from an anonymous observer in Italy, suggests the deaths and health crisis in Lombardy are due to far more than just the virus.

"In recent weeks, most of the Eastern European nurses who worked 24 hours a day, 7 days a week supporting people in need of care in Italy have left the country in a hurry. This is not least because of the panic-mongering and the curfews and border closures threatened by the „emergency governments“. As a result, old people in need of care and disabled people, some without relatives, were left helpless by their carers.

"Many of these abandoned people then ended up after a few days in the hospitals, which had been permanently overloaded for years, because they were dehydrated, among other things. Unfortunately, the hospitals lacked the personnel who had to look after the children locked up in their apartments because schools and kindergartens had been closed. This then led to the complete collapse of the care for the disabled and the elderly, especially in those areas where even harder „measures“ were ordered, and to chaotic conditions.

"The nursing emergency, which was caused by the panic, temporarily led to many deaths among those in need of care and increasingly among younger patients in the hospitals. These fatalities then served to cause even more panic among those in charge and the media, who reported, for example, „another 475 fatalities“, „The dead are being removed from hospitals by the army“, accompanied by pictures of coffins and army trucks lined up.

"However, this was the result of the funeral directors‘ fear of the „killer virus“, who therefore refused their services. Moreover, on the one hand there were too many deaths at once and on the other hand the government passed a law that the corpses carrying the coronavirus had to be cremated. In Catholic Italy, few cremations had been carried out in the past. Therefore there were only a few small crematoria, which very quickly reached their limits. Therefore the deceased had to be laid out in different churches.

"In principle, this development is the same in all countries. However, the quality of the health system has a considerable influence on the effects. Therefore, there are fewer problems in Germany, Austria or Switzerland than in Italy, Spain or the USA. However, as can be seen in the official figures, there is no significant increase in the mortality rate. Just a small mountain that came from this tragedy.“

So much is unclear, but one thing is clear. We need good data and we shall soon have it from reputable countries. 

The data will show whether, as indicated by the research of Dr Gupta of Oxford University, large proportions of populations have the virus without symptoms. 

If so, the stock markets of the word will rise, 'herd immunity' will be the goal of governments, lockdowns will be discontinued and the world will come out of a short V-shaped recession. Those people who said ‘It’s just a flu’ will feel vindicated, even though we know that Covid-19 is not a flu but an ILI (Influenza like illness) with some very nasty attributes.

If not, things look less cheerful, but we can still hope that drugs like hydroxychloroquine, azithromycin and zinc sulphate, all of which are in frequent use and whose side effects are well known, can protect the world while scientists try to find a vaccine.

Finally, here is a link to a story in Time, the American news magazine, headlined 

Hospitals Overwhelmed by Flu Patients Are Treating Them in Tents

It is dated January 18, 2018.

Thursday, 2 April 2020

Greeks, Turks, Romanians, Bulgarians

"I have been informed by a gentleman who has resided forty years in Turkey, that when he first entered the Ottoman dominions every educated Bulgarian called himself a Greek, and would have been ashamed to employ his national designation, which was hardly in general use before the movement of 1860." 

(From the anonymous introduction to the 1890 edition of Kinglake's Eothen.)

Victorian Englishmen before the Armenian and Bulgarian atrocities assumed all Christian subjects of the Sublime Porte, including Romanians, were Greeks. When Bulgarian nationalists spoke to villagers in what is now called Northern Macedonia about their nationality the only reply they got was that they were Christians (source Mark Mazower's The Balkans). In Romania in the 1860s an Ottoman official said 'all Romanians of distinction' spoke Greek (to him), but not Turkish (ibid).

In Turkey in 1890 any man of distinction would have been ashamed to call himself a Turk. The country was ruled by Ottomans and the word Turk was derogatory, like the derogatory racial epithets that it is dangerous even to quote without bowdlerising, in these straitlaced days. Kemal, when he created modern Turkey insisted on making the word the basis of the Turkish national state, which is why the Kurds will never sign up for it. Kemal of course  named himself Ataturk, Father of Turks.

The anonymous preface of 1890 goes on:

"The “unchanging East” is a popular phrase which is only true in a very limited sense. It has arisen chiefly from the habit of pious publishers of representing Abraham in the costume of a modern Bedouin Sheikh, and it is peculiarly audacious to apply it to regions like Constantinople and Egypt, which have witnessed exceptional vicissitudes and undergone remarkable changes,—political, religious, and linguistic. It is however just to say that the Turk is unchanging,—and it is to the presence of the Turk that are due the peculiar characteristics of the Levant, as the region visited by Kinglake may conveniently be termed; like the Bourbons, he forgets nothing and learns nothing; as he was on the day when he entered Europe, so he was in 1834 and so he is now. The boundaries of Turkey have changed; there are now no Pashas at Belgrade, or even at Sofia; and Ottoman territory is no longer plague-stricken. But whenever one crosses the Turkish frontier, one may find functionaries like the delightful potentate of Karagholookoldour, and be conscious of effecting within the space of a few hundred yards a change greater than can be experienced in any amount of travel in other European countries, including Russia. One passes from regions where people have roughly the same habits and ideas as ourselves—where they believe in political economy, get drunk in public, sit upon chairs, and do not feel there is anything indelicate in mentioning their wives—to a land where people do none of these things, where the naked desolation of the country at the side of the railway offers a startling contrast to the smug prosperity of the Balkan States, where people prefer to sit curled up on hard sofas, and where it is bad taste to condole with a man on his wife’s death."

Ataturk changed Turkey into a modern state and prosperity has changed the East, but Turkey, now purged of the large Christian minorities who lived there in 1890, is still not (and I'd argue never will be) part of Europe, whereas Russia is.

Wednesday, 1 April 2020

The heretical views of Dr Pablo Goldschmidt

With a flu epidemic the number of people who test positive for the flu climbs up exponentially and then drops. In contrast, 5%-15% of people in all countries test positive in Covid19 tests. German researcher Dr. Richard Capek and others have shown that when more tests are done the absolute number testing positive grows but the proportion testing positive stays the same.

Overall mortality throughout Europe remained at or below the normal range up to March 25, and often significantly below the levels of previous years, except in Italy. Though this of course might change. It’s early days yet. But it does prompt questions.

Only in Italy among people aged 65 and above did the overall mortality rate somewhat increase, but it was still below some previous flu seasons. (Now it is beginning to calm down presumably because of the lockdown.)

In Bergamo and surrounding towns the crude number of deaths this month is up to four times as high as this month last year. Theoretically in Italy as in England all hospital patients dying with the virus are classed as having died of it but most of the excess deaths in the Bergamo area are not recorded as being due to the virus.

I am confused. What is happening in Lombardy?

Certainly Lombardy is seeing a breakdown in geriatric health care as a result of neglecting the health service and possibly of a large number of people with chronic pulmonary disease, the legacy of the asbestos factories that operated in the region until 1992. So

Coronavirus scrapbook, April Fool's Day

The Cabinet hold a meeting via Zoom
British cabinet holds Zoom meeting. 
'What do ties matter, Jeeves, at a time like this?'
'There is no time, sir, at which ties do not matter'

"The one thing that is known from China, Italy and Spain (all of which were caught to varying degrees on the back foot) is that 80% are asymptomatic or show very mild symptoms. However it seems that 15% of the remaining 20% need at the very least hospitalisation under observation and varying levels of treatment such as intubation and oxygen. 5% need ICU. That’s a massive stress on a health system. I understand Dr Lee’s argument about the death rate but what follows from that logically is that it is clearly the least of the health services’ problems. It is the huge onslaught from people that can be saved. How to cope with that? Germany seems to have found a way with lots of testing being done and some measures. Sweden has found a way that suits them, too. It’s too early to say for many of the others but they are hoping that ‘the measures’ will help to flatten the curve and decrease the pressure. So, whether you like it or not, the economy-trashing measures still have to be taken." Robert Wilson

"Besides, people are not, so far, dying in unusual numbers. Roughly 50,000 people die in Britain each month. Roughly 1,500 have died with Covid-19 (not necessarily of it) this month. Since many of these deaths are of people who were already very ill for other reasons, the normal monthly statistical total has hardly altered. It is probable that the situation will get much worse, but the prevailing view is that the bad trend will not last very long." Charles Moore yesterday

Image may contain: dog and outdoor
A herd of wild goats with their kids has descended from the Great Orme and taken over the deserted streets of Llandudno in Wales

Tuesday, 31 March 2020

Kinglake's 19 days in Cairo in 1835, at the worst point of the plague

I loved Eothen when I was, I bitterly regret to say, an idle undergraduate reading anything that was not on my syllabus. I am now rereading Alexander Kinglake's account of surviving the plague in Cairo, attended, if my memory serves me, by a man who had been Byron's servant. 

I thought it was one of the books that one 'had to read', though anything but a chore, but like most of those books my life experience has taught me that nobody else has. Dr Johnson said, talking of Greek and Latin authors, that it is remarkable how little literature there is in the world. Nowadays that's true too of English classics.

Kinglake's nineteen days in Cairo must have been at the high point of the plague, when the death rate rose from 400 to 1,200 a day. He ignored the advice he was given that touching someone with the infection meant catching it. All the people he had anything to do with in the city, including his banker, his doctor and even his magician, died of the plague in those nineteen days. When he did develop a fever he was the very epitome of sang-froid, a French expression for an English thing. He hid the food he had no appetite to eat from his servants and, in the end, a cup of tea made him feel better.
"When first I arrived at Cairo the funerals that daily passed under my windows were many, but still there were frequent and long intervals without a single howl. Every day, however (except one, when I fancied that I observed a diminution of funerals), these intervals became less frequent and shorter, and at last, the passing of the howlers from morn till noon was almost incessant. I believe that about one-half of the whole people was carried off by this visitation. The Orientals, however, have more quiet fortitude than Europeans under afflictions of this sort, and they never allow the plague to interfere with their religious usages. I rode one day round the great burial-ground. The tombs are strewed over a great expanse, among the vast mountains of rubbish (the accumulations of many centuries) which surround the city. The ground, unlike the Turkish “cities of the dead,” which are made so beautiful by their dark cypresses, has nothing to sweeten melancholy, nothing to mitigate the odiousness of death. Carnivorous beasts and birds possess the place by night, and now in the fair morning it was all alive with fresh comers—alive with dead. Yet at this very time, when the plague was raging so furiously, and on this very ground, which resounded so mournfully with the howls of arriving funerals, preparations were going on for the religious festival called the Kourban Bairam. Tents were pitched, and swings hung for the amusement of children—a ghastly holiday; but the Mahometans take a pride, and a just pride, in following their ancient customs undisturbed by the shadow of death.

Coronavirus Tuesday 31 March 2020

To use the most popular opening conversational gambit these days, I am no epidemiologist. I  just try to make sense of the news. I do however mightily distrust the media for good reasons.

32,137 out of the 685,623 people in the world who had tested positive for Covid-19 by Sunday had died - meaning 4.7% - but this death rate is meaningless. Half of people in Iceland who are test-positive have no symptoms and most of the rest have mild cold-like symptoms. This does not tell us much either, except that Iceland tests a lot of people and the virus came to Iceland more recently than to, say, Italy.

What is noticeable and hopeful is evidence that the virus is already surprisingly widespread in many countries and that most cases are not detected because the infected people have few or no symptoms.

Measures to prevent deaths sometimes cause deaths. In a German nursing home for people with advanced dementia, 15 test-positive people died, but not necessarily from the virus. Some of these people may have died as a result of the changes to their routine: isolation, no physical contact, staff wearing masks.

I quote from an interesting article today in the Financial Times:

Mike Ryan, executive director of the World Health Organization’s health emergencies programme, has outlined four factors that might contribute to the differing mortality rates: who becomes infected, what stage the epidemic has reached in a country, how much testing a country is doing, and how well different healthcare systems are coping. But there are other sources of doubt too, including how many coronavirus victims would have died of other causes if no pandemic had occurred. In a typical year, about 56m people die around the world — an average of about 153,000 per day. 

Researchers at the University of Hong Kong have estimated that, in Wuhan, where the pandemic began, the likely death rate was 1.4 per cent — much lower than the previous estimate of 4.5 per cent, which was calculated using official statistics on the region’s cases and deaths. In the UK, where the government has been criticised for a slow initial response, only the most serious cases are being tested. In total 1,231 people have died out of 19,758 confirmed cases, giving a death rate of 6.2 per cent. Rosalind Smyth, professor of child health at UCL, said official UK coronavirus data was “so misleading that it should not be used”. Using conservative estimates, the true number of people infected “is likely to be 5-10 times higher”, she said.  

But different countries are also reporting cases and deaths in different ways: in Italy, Covid-19 is listed as the cause of death even if a patient was already ill and died from a combination of illnesses. “Only 12 per cent of death certificates have shown a direct causality from coronavirus,” said the scientific adviser to Italy’s minister of health last week. Spain’s national government simply lists how many people with confirmed cases of coronavirus have died and provides no extra information on any other medical conditions. 

...In the UK, about 150,000 people die every year between January and March. To date, the vast majority of those who have died from Covid-19 in Britain have been aged 70 or older or had serious pre-existing health conditions. What is not clear is how many of those deaths would have occurred anyway if the patients had not contracted Covid-19. Speaking at a parliamentary hearing last week, Professor Neil Ferguson, director of the MRC Centre for Global Infectious Disease Analysis at Imperial College London, said it was not yet clear how many “excess deaths” caused by coronavirus there would be in the UK. However, he said the proportion of Covid-19 victims who would have died anyway could be “as many as half or two-thirds”. 

Italy does not distinguish between people who die with and people who die of the Coronavirus but there is evidence that many deaths of people with or of the virus are not being reported as such at all. This is very worrying.

I quote Ambrose Evans-Pritchard in The Daily Telegraph. He is pessimistic and alarmist about everything but has strong arguments to alarm us.

We have a ‘real time’ laboratory before our eyes. What is happening at the Italian coal face is not remotely consistent with claims being made by some that the death rate from Covid-19 is akin to seasonal winter flu at around 0.1pc.

....The mayors of Bergamo and Brescia - two Covid-19 hotspots - say the reported deaths in their cities are a small fraction of the true numbers. An epidemiological portrait is easy to construct. You compare deaths since January with seasonal averages over recent years. Corriere Della Sera has done exactly that.

The small town of Nembro has 11,600 inhabitants. Typically it would have 35 deaths over the first quarter. This year it had already had 158 deaths by March 24. Yet the official data counts just 31 Covid-19 mortalities. The implication is that the real pandemic death rate has been four times higher.

The same method showed that deaths were 6.1 times normal in Cernusco and Pesaro, and 10.4 times higher in the city of Bergamo. This is partly because Covid-19 care is crowding out treatment for other diseases. But that changes nothing in practical terms. It is all part of the same drama.
Ambrose Evans-Pritchard suspects that the Government’s original strategy of herd immunity wasted weeks when was happening in Wuhan and Lombardy was ignored and that Boris Johnson 'overruled bad counsel in the nick of time'. I am told by insiders that the reverse is true, that the Scientific Advisory Group for Emergencies (SAGE) wanted a lockdown earlier and were overruled by Boris.

It is too soon to guess at what the social and political consequences of the epidemic will be. Will it mean more globalism and more movement of people or more emphasis on the local?  More respect for experts and the state or less? Fortress Europe or Europe as an immigrant society like the USA?

The virus could symbolise the dangers of globalisation and interconnectedness or it could make young people see the value of both.

David Aaronovtch, archglobalist and neocon, advocate of the invasion of Iraq and ardent critic of Brexit, thinks the latter is certain.

After COVID-19 there will not be some snapping back to ancient virtues of faith, flag and family. Those who imagine that the young, freed from a psychological and social austerity imposed upon them for the sake mostly of their elders, are going to decide to live for ever in such a condition are fooling themselves.

Inevitably NGOs are arguing that conditions in migrant camps make them dangerous breeding grounds for the epidemic but in fact COVID-19 is not a deadly plague slaughtering wholescale like the bubonic plague. It kills overwhelmingly the old and infirm. The migrants in camps or being expelled by Turkey, are mostly in their 20s. To allow them to settle in Europe because of the virus is to give up on a European external border. That in turn means giving up on keeping Europe European.

In the case of Syrian migrants, they can be sent back to Syria in return for some pay off for the Syrian government but very few refugees now are Syrian and those mostly Syrians who have been in Turkey long before the war. Almost all are economic migrants seeking a better life. European states - unfortunately - really must resile from the 1967 Protocol to the Geneva Convention on Refugees obliging them to take in refugees from outside Europe. Turkey has never signed this protocol, by the way.

Monday, 30 March 2020

"Coronavirus Threatens European Unity"

The problem with the EU is that it cannot be democratic because there is no European demos. Marx has bedevilled intellectuals from his day to ours with the idea that class is real and nationality is not, but as history has shown time and again (not least when the USSR broke up into 15 countries) nationality and ethnicity are real and drive history, whereas class is (to use a phrase coined by Marxist John Berger) a social construct.

The EU is an artificial construction too. 

Marxists and extreme leftists disagree of course. Here is the view of an Englishman who says he is no longer exactly a Marxist but who does not want to be English or believe there is any English national identity or demos. 

Now we see that the lack of a European demos does not just make democracy impossible at a European level but solidarity (in French revolutionary terms, fraternity) too. How much better the Hapsburgs managed things. Their empire had a monarch, a central government, armed forces and Catholicism and conservatism to give the country purpose, rather than modern liberalism.

I thought EXACTLY the same as the estimable Lilico. 

This essentially is what worries me about what the media reports. They seem to ignore the fact that very large numbers of people over 65 or 70 die everyday anyway, and at times of a nasty new virus the number shoots up a long way.

This may be why Italy and Spain are in grave trouble. In Sweden there are (I was shocked to learn) almost no families in which three generations live together and virtually no mothers who stay at home with their children. Sweden has no lockdown and so far 110 deaths.

Coronavirus in Romania: Monday 30 March

Raed Arafat said last night that in Romania there were 1,815 known Coronavirus cases, 52 patients were in intensive care and 43 people have died.

1,213 people are in quarantine and 162,374 are in self-isolation.

When the number of cases reaches 2000, as it will today, Romania goes up to level 4 of the lockdown.

Since movement restrictions were enforced, on March 25, almost 33,500 people have been fined, with fines totaling RON 46 million (EUR 9.5 million).

I adore long walks and had hoped to enjoy lots of them in deserted streets, but then they brought in the restrictions on movement. 
I left the house only to walk short distances at the weekend, intimidated because the old town in Bucharest, where I live, is full of policemen and women, enjoying the sunshine, chatting and not minding me. I'd love a long walk along the Dimbovita or Calea Victoriei. 

A sporty friend told me she went for a 8 km (5 mile) walk yesterday without any trouble.
Adevarul has a couple of stories of people with declarations written out and in order getting fined. One wanted to go into the centre of Timisoara from somewhere on the edge of town to a bakery that baked bread she liked. Although I too am a gourmand, I think they probably got her bang to rights.

Saturday, 28 March 2020

Coronavirus Saturday 28 March

People should isolate themselves and if possible stay at home and work from home. In three weeks we shall have much more information about the Coronavirus. It is much better to be safe than sorry. 

However, there are a lot of interesting scraps of information already that I am trying to make sense of. One of my main reasons for blogging is to clarify my mind.

The most concerning news at the moment is from Italy but what is happening there and why?

In Italy 969 died yesterday with (not necessarily of) the Coronavirus.  Normally, on average, 1750 people die in Italy per day. 

The latest figures from Bergamo show that total mortality there almost quadrupled in March 2020, from 200 to 300 people per month to around 900 people. It is unclear what proportion of this was due to Covid19.

In total, 9,134 people in Italy have now died with Covid-19. Around one in seven are under the age of 70.

A number of people have said that the high number of deaths in Lombardy is a crisis caused by lack of facilities for geriatric care. The ageing population does not help. 

Northern Italy also has the worst air quality in Europe, which has led to an increased number of respiratory diseases and deaths in the past.

Two professors of medicine at Stanford, Dr. Eran Bendavid and Dr. Jay Bhattacharya, say that the lethality of Covid19 is overestimated by several orders of magnitude and probably even in Italy is only at 0.01% to 0.06% and thus below that of influenza. The reason for this overestimate is the greatly underestimated number of people already infected (without symptoms).

Friday, 27 March 2020

How infectious is the Coronavirus?

Thousands of foreigners were evacuated from Wuhan city in late January and February and quarantined for 14 days. Back home in their various countries, 0.6% tested positive, so the virus is not very infectious and yet it is, because it gallops fast across the globe. How is this paradox possible?

The British Chief Officer told us a while back that mass gatherings are not dangerous - the disease is spread between people who live or work together. Now we mustn't leave the house unless really necessary - this change of policy in the UK is based on a report from Imperial College, London which is contradicted by another one from Oxford. Neither report is very convincing


For those who remember William Boot's telegrams in Scoop:


Biden is clearly becoming senile

This clip from the Jimmy Dore Show shows that Joe Biden is clearly in the early stages of senility. By the way, CNN describes the Jimmy Dore Show as "a far-left YouTube channel", so Jimmy Dore's mockery comes from the left not the right.

Does every country have the Coronavirus outbreak it deserves?

Every country has the government it deserves, according to Joseph de Maistre. No-one deserves to contract a virus and yet every rich country has the Coronavirus outbreak it deserves. 

The Japanese prefer to make the nation and the economy the first priority rather than the individual, life in Tokyo carries on much as normal but they are very efficient at treating pneumonia. Remarkably few Japanese, 47, are reported to have died of the virus.

The British are laid back and then panic. 

The French, according to an article in Asia Times by Pepe Escobar, corruptly prevented the sale of the antimalarial drug which is said to cure the covid-19 virus and then the stocks were stolen. 

The Americans are fighting a culture war over the virus, as they do over everything.

Italians might say that they did not deserve to have Chinese tourists bring the virus to their shores in a cruise ship, but cruises are a fact of life. On the other hand, the left-wing Italian government did waste time warning against anti-Chinese racism, rather than getting down to the job of looking after its people. 

I was astonished to read last night that

“British Deputy Chief Medical Officer Jenny Harries has told the BBC that ‘overall we are looking at a scenario of over a six month period but not necessarily with a lock down of this level going on throughout that time’.”

On Facebook a friend posted a BBC story that ‘a Scottish diplomat’ has died after getting coronavirus. The BBC should of course have said a British diplomat, but let that pass. What I found very strange is that in Italy recently only two people had died under the age of 60 and both were 59 with ‘serious health conditions’. The average age of people in Italy dying of the coronavirus was 79.5. But several much younger British people have died from the virus including a previously healthy woman of 21 and a boy of 18. Why?

Back on the 29th of February, which seems another age (though it was two months after Brexit) Ross Clark in The Spectator said,

"If you have just cancelled your trip to Venice and ordered your £19.99 surgical face mask from Amazon, how about this for a terrifying vision: by the time we get to April, 50,000 Britons will have succumbed to a combination of infectious disease and adverse weather. Frightened? If you are, don’t worry: you survived. It was two years ago. In 2017-18 the Office for National Statistics recorded 50,100 ‘excess winter deaths’. The explanation, according to the ONS, was probably ‘the predominant strain of flu, the effectiveness of the influenza vaccine, and below average winter temperatures’."

The British government's new lockdown is being compared, favourably or unfavourably, with the previous policy of herd immunity, which is still being pursued in Sweden, the Netherlands, Mexico and Brazil, where people go blithely to restaurants and bars. We shall see how those countries fare.

You will scarcely be surprised that right-wing populist President Bolsonaro of Brazil is bitterly attacked in the English language media for this policy, while progressive Sweden is not criticised at all.

South Korea which seems to have overcome the virus, did not have a lockdown but did have a lot of testing and a lot of spontaneous self—isolation.

Dr. Dan Yamin, an Israeli who has developed models for predicting the spread of infectious diseases and helped curb the Ebola epidemic, has said,

“But there is one country we can learn from: South Korea. South Korea has been coping with corona for a long time, more than most Western countries, and they lead in the number of tests per capita. Therefore, the official mortality rate there is 0.9 percent. But even in South Korea, not all the infected were tested – most have very mild symptoms. 

“The actual number of people who are sick with the virus in South Korea is at least double what’s being reported, so the chance of dying is at least twice as low, standing at about 0.45 percent – very far from the World Health Organization’s [global mortality] figure of 3.4 percent. And that’s already a reason for cautious optimism.”
In Japan the approach that has been tried involves ignoring the virus in order not to damage the economy. Trains and buses are full of people. CT scans are provided for early detection of pneumonia. Expert treatment of pneumonia is provided, the elderly are vaccinated against it and Covid-19 numbers are suppressed by losing them in unpublished pneumonia statistics. Japan has recorded a mere 49 deaths from the virus although how many have died who knows?

The Japanese Medical Association has said that there were 290 cases of doctors deciding patients need to be tested for the virus but healthcare centres refuse to administer the tests. Because few tests are carried out in Japan it is really impossible to know what the fatality rate there is but in South Korea very extensive testing was done, nearly 4000 tests per million people were carried out and the mortality among those infected was only 0.6%. I imagine in developed countries the mortality rate will be something like this or maybe half as much – higher figures reflect paucity of tests.

Japan has the advantage that social distancing is a cultural norm. People rarely kiss or shake hands. Wearing masks for health reasons is also part of their culture – as it will be from now on in Europe - and they are an extremely clean people.

And what of Romania? Romania has a severe lockdown, more severe than the one in England. 1,029 confirmed coronavirus (Covid-19) cases had been reported yesterday, exactly a month after the first one, and the number of new cases in the last 24 hours was 123, down for the second day in a row.

17 people have died. Most were over 65 and already had chronic diseases, according to the authorities. 

Romanians always live in an atmosphere of fear. Now if it is not fear of the virus then it's fear of the police. The streets and shops have been empty for a couple of weeks. The police yesterday were everywhere and more than 5,600 people were fined yesterday for leaving the house without having a good reason. The total value of the fines is over one and a half million euros. We're talking serious money.

Different political tailors cut the cloth of the coronavirus to suit their political purposes. The American left complains loudly about racism. The Old Trumpites see in Chinese viruses examples of the perils of globalisation and ain’t that the sorry truth? Other right wingers see the lockdown as an example of over-mighty state interfering with civil liberties because of misinformation. That might well be true too.  Endless numbers of people somehow try to link Brexit with the coronavirus or attempt in a way that is very transparent to make this Donald Trump's Hurricane Katrina.

Donald Trump I said the virus was only flu. His hunch was right that the mortality rate from the virus be less 1%. Donald Trump II instituted travel bans and a lockdown. Donald Trump III might decide to the economy had to be prioritised above the virus. If so, this could be lethal for his chances of re-election - or it could be the right call. Nobody knows. We are flying blind, people.

Thursday, 26 March 2020

Don’t Make Trump Worse

I have no time for people who use the Coronavirus crisis to score partisan points about Boris or the Donald or anybody else. Criticisms of the Chinese Communist Party are something else. 

The American media obsess about fact checking but are intolerably unreliable and politically biassed, consumed with an obsessive hatred for the President. The story of the poor people who died after swallowing fish tank cleaning fluid was a low point. Very low as the media have been, this was yet lower.

I link to a good article in the National Review on this subject by Kyle Smith, headed

Don’t Make Trump Worse

"...The president is not us, but for now he is tied up with us. We want him to succeed, do we not? Is it not obvious that, even if you despise everything the man has ever said and done and want his presidency to end so spectacularly it’ll make the Hindenburg look like a Duraflame log, it would be good for us if he got us through these next few months with the least conceivable damage to life, health, and wealth?

We know that the president is unusually thin-skinned and capricious, that he is keenly and perhaps unhealthily focused on what the media are saying about him at any given nanosecond, that he has a short temper and a quick fuse. He goes through cabinet secretaries like a newborn goes through diapers. And pointing out his errors is the legitimate business of CNN, NBC, ABC, MSNBC, the Washington Post, etc. But the way the media are trying to gin up a feud between Trump and Dr. Anthony Fauci is disgraceful and disgusting.

Folks, and by “folks” I mean you absolute freaking Muppets, are you trying to get Fauci fired? Do we really want to start over with a new specialist in infectious diseases in the White House? Would you be happy if Omarosa were Trump’s chief adviser on epidemiology? Would you be more secure if Jared were the last man standing during the medical briefings?

The incandescently moronic jibber-jabber (I won’t call it “reporting”) about the bizarre case of the Arizona woman whose husband died after taking fish-tank cleaner he and she incorrectly supposed to be the drug Trump touted in the White House is the kind of barnyard waste product that shouldn’t even make it to national news reports, and ordinarily wouldn’t, except that the media seem to be getting a near-erotic thrill out of any scrap of information they think might set off Trump. The dead Arizona man didn’t take chloroquine. He took chloroquine phosphate, in a massive dose. Please run the tape for me where Trump said, “Everybody take a spoonful of fish-tank cleaner to save your lives.” “The difference between the fish tank cleaning additive that the couple took and the drug used to treat malaria is the way they are formulated,” dryly noted CBS News. Oh, you don’t say? Because I was going to put rubbing alcohol in my martini tonight. Or is rubbing alcohol differently formulated than gin?..."

Wednesday, 25 March 2020

Heretical views on the Coronavirus panic

A site called Off-Guardian has published a collection of opinions from distinguished professors of medicine who think the Coronavirus scare misjudged. Well worth clicking on.

As I keep repeating because it is so important, 58,000 people died in the UK from flu in 2017/8 meaning 40,000 more than usual. There were stories about the NHS under great pressure that winter, but the flu itself did not attract much attention at all.

I have wondered from the start if the virus panic might be a terrible mistake, a product of Facebook and Twitter. 

Still we must behave in the next three weeks as if it is not a mistake. What is true is that the health systems in Italy and Spain are under pressure with which they cannot cope, meaning many lives are being lost.

Even if, as all hope, the total number of deaths this year from Corona virus and other ILI (influenza like illnesses) is not hugely higher than the deaths from ILI in previous years, we are faced with the danger that the extremely infectious Coronavirus could crowd its victims into a short period in which hospitals and doctors would be unable to cope. 

If that happened and you had a heart attack, for example, you might find it impossible to get an ambulance to take you to the hospital in time, because of the number of people gravely ill from the Coronavirus. You might find no spare beds in the hospital. You might die as an indirect result of the epidemic even though you did not contract the virus.

Here are some quotations from the article, in case you did not click on it when I advised you above to do so.

'Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.

'That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.'

'If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average.'

Dr John Ioannidis, Professor of Medicine, of Health Research and Policy and of Biomedical Data Science, at Stanford University School of Medicine and a Professor of Statistics at Stanford University School of Humanities and Science, in an essay called “A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data”, Stat News, 17th March 2020

'We are afraid that 1 million infections with the new virus will lead to 30 deaths per day over the next 100 days. But we do not realise that 20, 30, 40 or 100 patients positive for normal coronaviruses are already dying every day.

'[The government’s anti-COVID19 measures] are grotesque, absurd and very dangerous […] The life expectancy of millions is being shortened. The horrifying impact on the world economy threatens the existence of countless people. The consequences on medical care are profound. Already services to patients in need are reduced, operations cancelled, practices empty, hospital personnel dwindling. All this will impact profoundly on our whole society.

'All these measures are leading to self-destruction and collective suicide based on nothing but a spook.'

Professor Sucharit Bhakdi, head of the Institute for Medical Microbiology and Hygiene in Dresden

'In Hubei, in the province of Hubei, where there has been the most cases and deaths by far, the actual number of cases reported is 1 per 1000 people and the actual rate of deaths reported is 1 per 20,000. So maybe that would help to put things into perspective.'

Dr Joel Kettner, professor of Community Health Sciences and Surgery at Manitoba University

'The problem of SARS-CoV-2 is probably overestimated, as 2.6 million people die of respiratory infections each year compared with less than 4000 deaths for SARS-CoV-2 at the time of writing.'

A team of researchers from the Institut Hospitalo-universitaire Méditerranée Infection, Marseille and the Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, conducting a peer-reviewed study on Coronavirus mortality.

A Swiss Doctor on Covid-19, on quotes a learned article in the Journal of Antimicrobial Agents, titled SARS-CoV-2: fear versus data, that concludes that

'the problem of SARS-CoV-2 is probably overestimated', since 'the mortality rate for SARS-CoV-2 is not significantly different from that for common coronaviruses identified at the study hospital in France'.

A Swiss Doctor on Covid-19 goes on

An Italian study of August 2019 found that flu deaths in Italy were between 7,000 and 25,000 in recent years. This value is higher than in most other European countries due to the large elderly population in Italy, and much higher than anything attributed to Covid-19 so far.

In a new fact sheet, the World Health Organization WHO reports that Covid-19 is in fact spreading slower, not faster, than influenza by a factor of about 50%. Moreover, pre-symptomatic transmission appears to be much lower with Covid-19 than with influenza.

A leading Italian doctor reports that "strange cases of pneumonia" were seen in the Lombardy region already in November 2019, raising again the question if they were caused by the new virus (which officially only appeared in Italy in February 2020), or by other factors, such as the dangerously high smog levels in Northern Italy.

Tuesday, 24 March 2020

Where we are now

Italian coronavirus cases are likely to be ‘10 times higher than reported’, the head of the Italian Civil Protection Agency Angelo Borrelli told La Repubblica. This would bring the estimated number of coronavirus cases in Italy is closer to 640,000 rather than the confirmed number of 63,927 of which 6,077 have died. A mortality rate of less than 1% is very much more credible than almost 10%. Fortunately the death and infection rate has recently slowed, no doubt because people do not go outdoors.

Romania is in a state of emergency and the President decreed today that as of tomorrow we have something like the 'lockdown' Boris imposed last night on the UK. 

A canny and experienced British nurse I know told me a week ago that she thought we would be over the worst of this in two weeks. I never thought that likely. In London the Chancellor of the Duchy of Lancaster (minister without portfolio) Michael Gove told Sky News this morning that ‘in three weeks’ time we’ll be able to say whether or not the path we’ve followed needs intensification’.

In an interesting article in Haarretz by Professor Ran Balicer, Founding Director of the Clalit Research Institute, which researches non-communicable diseases, said this about the prospects for

"If we can halt the rate of multiplying deaths within three weeks, we can start a gradual exit from the closure, until we reach the new status quo. We won’t return to the routine of two months ago, but life will return slowly but surely under a new routine. And who knows – maybe the summer will bring a significant easing of the disease, and we will join the countries that succeeded in avoiding disaster."