Observations in the miasma

September 17, 2021. On the eve of our thirtieth wedding anniversary (16 November 2020), I took some time to curate a slew of summary impressions about the Covid state of affairs, usually citing direct observations from science, and often followed by details. It had already become clear, eight months after the forced two-week lockdown (that lasted months, not weeks, and continues to surface been today), that Covid was not ever going to be eradicated, that a vaccine -- even a somewhat faulty and experimental one) would be needed as an overall useful step to spread induced immunity (and, just as obviously, that Democrat party leaders would show contempt for the efforts to produce same), that PCR tests were, rather than the oft-claimed 'gold standard,' a problematic measure of active, symptomatic Covid cases, that hospitals were more likely to shut down than be overwhelmed, and that political mandates and restrictions would produce economic, social and mental results that were much worse than any virus, i.e., the 'cure' was worse than the virus.

So, remember that these were posted on 16 November 2020, about ten months ago. Here goes:

The Imperial College of London forecast was for 2.2 million American dead, using a now-discredited assumption as to infection rates; the actual figure has been 10% of that estimate. More so, the Imperial College team did not recommend "a complete lockdown which . . . prevents people going to work." They also later acknowledged that perhaps 2/3 of these projected deaths were likely to happen anyway; in 2019, total USA 2020 mortalities had been tracking to be over 3 million – without the Covid crisis.

Epidemiologists have since found growing evidence that the number of undetected cases with few symptoms or none is much larger than merely doubling the small number of known and tested cases. A review of such research by the Oxford University Centre for Evidence-Based Medicine finds "a presumed estimate for the COVID-19 IFR somewhere between 0.1% and 0.36%." A middling estimate of 0.22% would by itself reduce the infamous 2.2 million death estimate to half a million even if 81% were somehow infected.

Flaws in the Imperial model led to flawed public policy.

• We now know the model was so highly flawed it never should have been relied upon for policy decisions to begin with.

• As we learn more about the new coronavirus, it is imperative to continue to update the assumptions used in these models.

• The Imperial College model didn’t meet any of these criteria. And sadly, its model was one of the inputs relied on as the basis for locking down two countries.

Eran Bendavid and Jay Bhattacharya of the Stanford School of Medicine, with 15 others, conducted serological tests for COVID-19 antibodies from a representative sample of 3,300 people from Santa Clara County, CA. The high percentage showing proof of having been cured of undetected asymptomatic cases indicates that between 48,000 to 81,000 people in Santa Clara county had already been infected and cured by the time they were tested on April 3-4. Those numbers are 50 to 85 times larger than the number of known, confirmed cases. They correspond to "an infection fatality rate of 0.12-0.2%" – similar to the flu (which nonetheless killed a CDC-estimated 61,000 in the 2017/18 season by infecting millions).

A critique of the oft-cited University of Washington study followed. “It’s not a model that most of us in the infectious disease epidemiology field think is well suited” to projecting Covid-19 deaths, epidemiologist Marc Lipsitch of the Harvard T.H. Chan School of Public Health told reporters this week, referring to projections by the Institute for Health Metrics and Evaluation at the University of Washington.

Other experts, including some colleagues of the model-makers, are even harsher. “That the IHME model keeps changing is evidence of its lack of reliability as a predictive tool,” said epidemiologist Ruth Etzioni of the Fred Hutchinson Cancer Center, who has served on a search committee for IHME. “That it is being used for policy decisions and its results interpreted wrongly is a travesty unfolding before our eyes.”

Over ninety percent of Covid-attributed deaths have alternative pre-existing co-morbidities as alternative causes of death.

An April 2020 report reported that 86% of New York state deaths involved one or more comorbidities, in declining presence, as follows: hypertension, diabetes, hyperlipidemia, coronary artery disease, renal disease, dementia, COPD, cancer, atrial fibrillation, and heart failure. Almost all of these were pre-existing conditions.

The average age of those dying WITH Covid has been about 80 years old, higher than average life expectancy and the mortality rates are about equal to the mortality rates sans Covid, i.e., about 17%.

Between “dry tinder” (the large number of aged, sick elderly resulting from unusually low death rates among the US elderly in the 2019 flu season) and “culling the herd” (Covid has been most lethal to the most vulnerable), and given the increase in the number of elderly baby boomers, we can account for most of these “Covid” deaths. People below the age of forty are about a thousand times less likely to die from Covid than for an eighty-year-old.

Transmission of the virus is primarily due to extensive (e.g., ten minutes or more) and intimate (e.g., well below social distancing norms) contact with a symptomatic person, and not by surface contact, by asymptomatic transmission, or by casual contact (momentary violation of social distancing mandates).

· Masks are generally ineffective for use in public. In close quarters, masks below the N95 medical standard are ineffective.

· The direct economic effects and indirect medical/health effects of lockdown are significantly worse than any advantages created by lockdowns.

· Apparently, there have been no studies comparing death certificates and their listed causes of death between “Covid” deaths and deaths from other causes, without Covid. E.g., do most non-Covid deaths have multiple co-morbidities, or only Covid deaths? Can the relative impact of cause of death be objectively determined when there are multiple co-morbidities? Do “Covid” death certificates have a higher rate of co-morbidities caused by Covid, or pre-existing co-morbidities, i.e., respiratory failure versus diabetes or obesity? The leading co-morbidities for Covid are all pre-existing co-morbidities.

· The impact of Covid varies widely state by state; there is no basis for using a national mortality rate, especially for large populations. Deaths per million should be measured by using comparably sized populations. E.g., Sweden versus New Jersey, not Belgium versus the United States. E.g., separate five mid-Atlantic states around NYC from the other USA states’ data and we have an extreme morbidity in those five and relatively low morbidity elsewhere.

Sweden’s non-lockdown economy has continued relatively unabated while their Covid mortality rate is a small fraction of the rate predicted were they NOT to lock down, and even just a fraction of the projected deaths had Sweden locked down. The most negative impacts on Sweden’s mortality was due to their NOT locking down nursing homes, protecting the most vulnerable (and everyone agrees that this should have been done) and by deaths among Sweden’s burgeoning immigrant population. Sweden’s “high” mortality rates are found only in short-term spikes, not in long-term rates.

o In Sweden, only 872 of 5813 deaths could cite Covid as the direct cause, about 15 percent, while the US figure for Covid deaths without co-morbidities has been around six percent.

“Flatten the curve” meant to reduce deaths and not overburden the healthcare system. This would require perhaps two weeks of limited human interaction followed by social distancing, good hygiene, and no large gatherings. The number of ‘cases’ was not of interest and, apparently not always tested, counted or reported.

• Once the Gompertz curve effect had been achieved (a rapid increase in deaths followed by a slightly less rapid decline, i.e., a right skewed curve), the pressure would be off the healthcare system and deaths would trail off, with daily death counts bottoming out around August 1 in the United States.

• At that point, most states became less restrictive on human movement and interaction, and the ‘new’ measure of interest was the PRC RNA test, with initial attention to achieving declining percentages of positive tests.

• The problem quickly became that the PRC test is very sensitive, with a non-trivial amount of positive tests when the virus was well past its virulent stage. In essence, the test neither predicted or prevented anything of real value, be the test positive or negative.

PCR testing is a 'yes' 'no' test that can test positive for redundant, residual dead virus literally months after initial infection. It does not show whether a test subject is infectious or indeed, which corona virus they may be carrying. It is simply not nuanced sufficiently and definitely should not be relied upon to form policy.

The PRC test for Covid was not designed as a Covid test, is admittedly overly sensitive, subject to mishandling by the lab, and one study (see italicized text, below) cited the PRC test results as ‘meaningless.’ A faster, different test emerged by late September, which also ‘correlated better’ with the virus, at the same time

Lockdowns and hygienic measures around the world are based on numbers of cases and mortality rates created by the so-called SARS-CoV-2 RT-PCR tests used to identify “positive” patients, whereby “positive” is usually equated with “infected.”

But looking closely at the facts, the conclusion is that these PCR tests are meaningless as a diagnostic tool to determine an alleged infection by a supposedly new virus called SARS-CoV-2.

The reason is that the intended use of the PCR was, and still is, to apply it as a manufacturing technique, being able to replicate DNA sequences millions and billions of times, and not as a diagnostic tool to detect viruses.

How declaring virus pandemics based on PCR tests can end in disaster was described by Gina Kolata in her 2007 New York Times article Faith in Quick Test Leads to Epidemic That Wasn’t.

· Politicians responded to positive test results, having embraced the original Trump claim that the virus would ‘disappear,’ i.e., no positive tests, as proof that it was safe to end testing and any lockdowns.

The graphs below are from Johns Hopkins data through July 28, back when the forecast was for the first wave FOR THE NATION to end around August 1. But they forgot to mention that this wave only hit one part of the country -- the Northeast, which peaked at over 60 deaths per day per million. The USA is not homogeneous in any respect; there are major demographic, climate and other important differences by region. So look what happened: the Midwest and West did not reach more than 5 deaths per day per million; they had low ICU use, empty hospitals and few deaths. The South's data are confounded by the large numbers of people that left the Northeast for Florida and other southern states to escape. Either these areas really succeeded at flattening the curve or the virus had not penetrated these regions the way they did the northeast, ie, no first wave. In any case, the Midwest and West were still vulnerable -- no vaccine -- and also not immune to the normal trajectory of an epidemic, one that looks like the one the northeast experienced.

Meanwhile, from late April to August, hospitals were generally empty, nurses were furloughed or idled (some made dance videos to illustrate their free time). Sick people declined or were not allowed to enter hospitals for cancer and other non-Covid testing and treatment. In New York City in April, governor Cuomo declined to use the US Navy Mercy hospital ship, which had been rushed to New York Harbor and furnished to take on hundreds of patients, while the city also declined to use most of the beds set up in the Jacob Javits center.

Overtaxing ICU wards rarely occurred and now, the patients in ICU include patients who were delayed in entering the ICU. Interesting, one report showed that in Ireland, only eighty of 1,649 who died of Covid were given the option of ICU care, only 689 were ever hospitalized. And the median age of the Covid victims was 84.

o In New York, the governor triaged the aged, very ill patients back to nursing homes to die, but not before they infected and killed even more nursing home patients. Estimates of the percent of Covid deaths coming from nursing homes ranged from 42% to 60%.

In South America, Brazil declined to lockdown while Peru chose to lockdown. Daily deaths per million in Peru peaked fifty percent higher that found in Brazil, about 7 versus 4.3 (early June to early August). Italy peaked at over 12 deaths per million in early April.

The number of deaths in the United States has been increasing by around 50,000 additional deaths each year for the past eight years. Estimated/expected deaths in the USA, an estimate made prior to Covid, was about 3.1 million deaths, or about 8500 deaths per day. Studies of ‘extra deaths,’ i.e., deaths above the projected timeline or estimate of expected deaths do not always account for this upward trend nor do they reflect changes in respiratory related deaths each year, e.g. influenza deaths have been as high as 62,000 in a year and a low about 12,000, with typical counts between 34,000 and 43,000.

Meanwhile, after almost forty years, the AIDS pandemic continues, without a vaccine. Dr Fauci was there at the beginning of AIDS, came under intense criticism for his handling of the crisis, and even today acknowledges that the pandemic continues. Globally, in 2019 690,000 people died of AIDS, while over 75 million have become infected since AIDS was diagnosed in the early 1980s. In the United States, there has been 700,000 AIDS deaths. AIDS remains a leading cause of death in America for those aged 25-44. Clearly, AIDS severely impacts the young and the healthy, whereas Covid primarily impacts the elderly and the sick; unlike the right-skewed morbidity curve for Covid-19, the AIDS morbidity curve is left-skewed. A significant majority of AIDS deaths have been among males, although the ratio has become more balanced in the last twenty years, primarily due to a significant decrease in the AIDS death rate for males.

Subsequent details

A more recent article looked at flu and pneumonia deaths over several years and compared them to the impact of Covid-19 this year. Excerpts follow:

• 2020’s attributed COVID-19 deaths were equivalent to having another 2017-2018 flu and pneumonia season boosted by 13 percent. The CDC estimated that about 177,000 Americans died during the 2017-2018 flu season, from either the flu itself or by complications of pneumonia.

• And nobody remembers a panic. Just as nobody remembers mask mandates or political leaders shutting down small businesses and locking the healthy in their homes. Because, of course, none of that happened. (This lack of panics during past pandemics is detailed in our book, “The Price of Panic: How the Tyranny of Experts Turned a Pandemic into a Catastrophe.”)

• The CDC itself caused a stir at the end of August by estimating that the virus directly caused only 6 percent, or now just over 11,000 of the 187,000 attributed deaths. Most of these deaths were in the elderly. The remaining 94 percent died with and not exclusively of the coronavirus. These people also were on average elderly and had 2.6 other health problems. This implies a good fraction who succumbed had three or more comorbidities. In other words, most deaths attributed to the coronavirus were in very sick people.

• [NOTE: I’d love to learn the figure for the number of times Covid is listed under causes of death on a death certificate but that death is not counted as a ‘Covid’ death. E.g., George Floyd, a Covid-positive person dying in a car crash, or a Covid patient who committed suicide. It appears to me that almost any time Covid is involved it gets listed as a Covid death.]

• o Unfortunately, PRC tests for the presence of the bug are prone to false positives. This occurs when the test confirms a Covid-19 case when the test mistakes past infections as current, or even tag infections of other coronaviruses. The one causing COVID-19 is only one among many. False positives are not normally a big concern. They are this year because of the huge number of tests given. According to The COVID Tracking Project, in September the USA averaged over 800,000 tests every single day. Over one million tests were conducted on several days.

• o Even a tiny false-positive rate at this level is a problem. Take the 1 percent false-positive rate, cited by some. If 5 percent of the public has the disease at one time, a million tests will produce 9,500 false “new cases.”

• o Testing numbers are going up even as attributed deaths drop, largely due to the fact that we do so much testing. Deaths re-peaked in late July as the virus spread in southern states for the first time. They have been dropping rapidly since. If the current rate of decline holds, attributed deaths will drop to a background level by the end of October.

• · A concurrent article (excerpts quoted below) predicted that these revised numbers will become Dem talking points after the election. Biden calls for a national lockdown because he claims to “follow the science,” yet Dr. Fauci is rejecting the idea of a national lockdown. In any case, does anyone seriously believe Biden would impose a lockdown or that the public would accept one -- if he becomes president three months from now.

• o “Biden doesn’t have any plans to solve the COVID-19 problem. Biden endlessly claims that Trump fumbled his handling of the coronavirus pandemic, without ever saying what he’d do differently. When he has tried to make the case that he would have acted sooner, he comes up against his own contemporaneous statements undercutting his claims of better foresight.”

• o “Don’t be surprised, then, that Democrats and the press suddenly “discover” that the threat from COVID-19 has been exaggerated. They’ll point out that the CDC has been counting deaths with COVID-19, not from COVID-19.”

· A CDC report of US Covid-19 deaths from 1 May to 31 August 2020 showed just over 5% of the deaths were among people under the age of fifty, with thirty percent of decedents eighty-five or older, and 56% 75 or older. Hispanic/Latino population represented 24 percent of deaths and Blacks 18.7 percent, both percentages well in excess of their presence in the US population. More than ninety-five percent of the deaths occurred in nursing homes, hospitals or hospices, including 64.3 percent in a ‘health care setting.’

USA viral update 10 October 2020: https://youtu.be/013L9J7WhuU

· Viruses are, by nature and history, seasonal, with the climate of the region having a significant effect on the seasons where the virus is most virulent.

It is absurd to consider the United States is a single entity when it comes to the impact of the virus. Separate from differing demographics and local political and public healthcare actions, the climate of the different regions of the USA has a significant impact on the timing of the impact of the virus.

Note also the additional factor of the reversal of seasons when one moves from the northern to the southern hemisphere, e.g., Sweden versus Brazil. Note tat Brazil and Sweden are prominent for their absences of a significant lockdown and for – in some cases – better health data than in comparable countries that did impose lockdowns, yet without the devastating economic impacts stemming from restrictions on economic activity. Note also that evidence of the Covid-19 virus had been found in human waste in Brazil in November 2019, well ahead of the oft-cited outbreak in China.

· Ireland (20 October 2020). Adjusting for co-morbidities – causes of death that precluded Covid-19 cases from receiving ICU treatment – we see conclusions like this:

Economic recovery: Experts: US GDP to Show Massive Growth Not Seen in Decades Just in Time for Election. Quoted excerpts follow:

America’s economy has come roaring back, according to predictions for next week’s unveiling of the third-quarter figure for the nation’s gross domestic product.

The federal government will officially unveil its figures next Thursday, but Bloomberg, in its survey of economists, is predicting a 30 percent growth, which it labeled “remarkable” as well as a postwar record.

In September, the Bank of America predicted the third-quarter GDP growth will be 27 percent, according to Yahoo.

The GDP Now calculator of the Federal Reserve is even more positive, with a prediction of 35.3 percent growth when it was last updated on Tuesday, according to the Federal Reserve of Atlanta.

In its reporting on the expected 30 percent GDP growth, CNBC noted that the economy has added 11.5 million jobs since May and that confidence is rising.

The Conference Board’s CEO Confidence Index, which measures the percent of positive responses on economic conditions, hit 64 in September after a reading of 45 in August.

“Under my continued leadership, we will continue our V-shaped recovery and launch a record-smashing economic boom,” he said. “We will end the pandemic with a safe and effective vaccine, create 10 million jobs in the first 10 months of 2021, and quickly return to full employment,” Trump said.

General observations 25 October 2020

A large percentage of USA Covid-19 deaths shared the following characteristics:[1]

• They were elderly. USA life expectancy was 78.54 in 2017; the number of Americans aged 78 or older is increasing as the baby boom populations moves deeper into retirement and with longer life expectancies than that of their parents; 56.4% of those dying of the virus were 75 or older, including 30.4% 85 or older.

• They were obese, morbidly obese and/or suffered from diabetes.

• They had two or more pre-existing (i.e., had the condition prior to contracting the virus) co-morbidities.[2]

• Death occurred in an assisted living nursing home or long-term healthcare facility.

• What does the science say about this? Is it reasonable, rational logical or fair to assert with confidence that their deaths were FROM Covid, and not just WITH Covid?

• Consider an elderly man speeding down the highway. He loses concentration for a second or reacts slowly to a distraction at the side of the road. He drives into a bridge abutment and dies instantly. He had that morning taken a dose of oxycontin to reduce chronic pain. A post-mortem PRC test for Covid-19 showed positive. What was the cause of his death?

October 26, 2020: When is a positive Covid-19 test result not a Covid case? Excerpts follow:

What exactly is this current surge? Is it a surge in positive tests, cases, hospitalizations, or deaths? A positive test alone is not a case, according to the CDC. The “case definition” of COVID is a positive test and symptoms.People who might have had a mild case a month ago may still have dead viral particles in their noses, triggering positive tests.

Over a million tests per day are performed in the US with acceptable positive rates of under 5 percent. That means 50,000 positive tests per day but most not infectious or symptomatic. More tests mean more positive results, what the media calls “cases.” If the US didn’t offer tests on demand as we do now, this so-called surge would go away. According to the New York Times:

• The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

• Most of these people are not likely to be contagious and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time.

Conveniently, this current surge is in positive tests. Despite a rare moment of honesty and clarity from the New York Times, their current headline is, “US sets coronavirus case record amid new surge.” CNN is singing in harmony, “The US just reported its highest number of Covid-19 infections in one day since the pandemic's start.”

October 24, 2020: Herd insanity

A British MP speaks out on the real impact of the pandemic and the subsequent lockdown.

October 2020: Excess deaths

Has Covid had a significant impact on mortality rate in the USA?

From the Washington Post: “The coronavirus pandemic has left about 299,000 more people dead in the United States than would be expected in a typical year, two-thirds of them from covid-19 and the rest from other causes, the Centers for Disease Control and Prevention reported Tuesday.”

• USA mortality rate continues to grow at a rate of about 1% a year. The United Nations previously (prior to 2020) projected about 2.9 million deaths in the USA in 2020, up from about 2.4 million ten years earlier. As with any statistical projection, there is a standard error present, i.e., the ‘expected’ prediction should be a range, not a discrete number. ‘Expected deaths’ are probably better described as between 2.75m and 3.05m.

• The birth rate in the USA is declining. Meanwhile life expectancy remains high and infant mortality remains low, and unmeasured immigration all have fueled a doubling of the US population in the last fifty years.

• There are about fifty million Americans over the age of 65. The number of Americans over the age of 75 continues to increase, a demographic most vulnerable to the virus. The numbers of the very elderly (age>75) population reflect population bulge from the ‘baby boom’ births from 1945 to 1955.

• Comparisons of ‘excess deaths’ over selected periods of time, e.g., April 2020 through August 2020, ignores the periods of below ‘excess deaths’ both preceding and following the periods of ‘excess’ deaths.

• Unlike the traditional ‘seasonal’ flu, which has a fall-winter season, the Covid-19 virus has been a spring-summer virus. Recent ‘suhes’ in positive tests reflect the erosion of social distancing and masking practices, the inability of the test to distinguish between an active, symptomatic virus case from a non-symptomatic person showing a positive test.

• There is good reason to believe that the Covid virus both ‘harvested dry tinder’ from fewer deaths in the year prior to Covid (e.g., a relatively light flu season 2019-20) and that the current Covid deaths are accelerating deaths, or ‘culling the herd’.

• In addition, the conflation of multiple causes of death with deaths caused by Covid alone continues to make clear analyses problematic.

October 19, 2020 Dr. Jay Bhattacharya, The Barrington Declaration

Accurate mortality rates need to use infections, not ‘cases’ in the denominator. ‘Cases’ are most often determined by non-random sampling of people with symptoms who requests test, using the unreliable PRC test that often shows positive when the person has a residue of the infection from perhaps weeks ago, but that person is no longer infected and probably never had significant symptoms.

The result has been to exaggerate the mortality by a rate ten to twenty times higher than the actual mortality rate, the rate based on infections. The WHO had asserted a ‘case’ rate of 3.4% at a time when the population was not being widely or randomly tested. The above tables show the infection rate (IFR) for more representative samples.

The result of these data and this analysis has been the Barrington Declaration, which prescribes an approach to infection mitigation that rejects massive lockdowns and prohibitions of mass gatherings, while demanding protection for the most vulnerable, e.g., those over age of 70, those living in nursing homes.

[1] African Americans and Hispanics/Latinos (per US Census data) represent 13.4% and 18.5% of the USA population, respectively, they represent 18.7% and 24.2% of Covid-19 deaths, respectively. Thirty-two percent of the population accounted for 42% of “Covid” deaths. In Ireland, most Covid-19 victims died without ICU ever having been made available to them. Ivor Cummins claims: “95% were to aged or moribund…to even be afforded ICU care.” This may be indicative of the triaging used in socialized healthcare systems.

[2] An April 2020 report reported that 86% of New York state deaths involved one or more comorbidities, in declining presence, as follows: hypertension, diabetes, hyperlipidemia, coronary artery disease, renal disease, dementia, COPD, cancer, atrial fibrillation, and heart failure. Almost all of these were pre-existing conditions.