Covid-19 : the strange pandemic

Interesting article today from Swiss Policy research, covering many of the issues that I have posted over the last five months or so, which I have slightly curated to exclude the swine flu “pandemic” of 2009.

Why does covid-19 appear to be a somewhat strange pandemic? It is because of the covid-19 mortality profile, which is almost identical to natural mortality.

To better understand this crucial point, we must compare it with the notorious 1918 “Spanish flu” pandemic. The 1918 “Spanish flu” virus was a very dangerous virus that had a very different mortality profile. In addition to old people, it also killed babies and young children plus young adults between 20 and 45 years at very high rates (see chart at the bottom).

In contrast, the mortality profile of the covid-19 coronavirus is essentially zero for children and young adults and near zero below 50, before it begins to rise slowly and then very steeply above 70 and especially above 80, reaching extreme levels in nursing homes. Thus the covid-19 mortality profile is almost identical to natural mortality. This doesn’t mean that covid-19 doesn’t increase someone’s risk of death – it absolutely does – but this increase is proportional to the pre-existing risk of death of the respective age and risk group.

The following chart by Cambridge statistics professor David Spiegelhalter compares covid mortality to natural mortality. As mentioned above, covid does increase the risk of death, but this increase is proportional to natural mortality. The curve appears linear because the scale is logarithmic.

The characteristics of covid-19 may have to do with the cardiovascular and immunological properties of the virus and they explain the high death rate in nursing homes (up to 70% of deaths), in people above 70 years (about 90%), and in Western countries in general. In contrast, covid death rates in Africa, predicted by many (including Bill Gates) to be high, have been very low.

Many people expect a “real pandemic” to kill also younger people, or at least babies, at a significant rate, as the 1918 flu and other flu pandemics indeed did. Some skeptics therefore concluded that covid-19 must then be another “fake pandemic”. But it is not – it simply has a very different and much more “natural” mortality profile.

If covid-19 had hit us in the 1950s – with a much younger population, few nursing homes, and a much lower prevalence of cardiovascular disease – it would have caused very few deaths.

Because of the covid-19 mortality profile, mass PCR testing and contact tracing in the general population make little sense and create an additional “casedemic” on top of the pandemic. Mass vaccinations will also make rather little sense, especially because at the  time experimental vaccines might become available, many people will already have been exposed to the wild virus.

However, the mortality profile of covid-19 is only “the tip of the iceberg”. Covid-19 is also causing many standard and intensive care hospitalizations – even in people below 65 years – and it is causing post-acute “long covid” in about 10% of symptomatic people, including many young and healthy people. These are potentially very serious issues that should not be downplayed in any way.

The best currently available answer to these issues is early and prophylactic treatment based on simple and effective means, as emphasized by many leading experts from around the world. Simply isolating sick people at home until they cannot breathe anymore is the worst possible approach. Unfortunately, in most Western countries, it is still the most common approach.

It is important to keep in mind that in many parts of Europe and some parts of the US, coronavirus antibody values are still very low (e.g. 2% in Germany). Hence it is not reasonable at all to assume that the pandemic is already over. Even in global hotspots with a 20% antibody rate, it is not at all certain if this is going to provide collective immunity during winter months.

The following chart compares the very different mortality profiles of covid-19 and the 1918 flu. Note that even in the 85+ age group, covid-19 lethality doesn’t reach the value of the 1918 flu, as the chart uses two different scales (left and right), and the covid scale is four times smaller.

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