A century of Epidemiology Tells us Something Different



“It would be time to use the knowledge of a hundred years of epidemiology in the management of this epidemic, instead of taking extreme measures that will certainly have a major negative impact on our lives.

Original (Portuguese) April 10 2020 By Andre Dias.   

English Translation by Marc Gauvin Spanish version Pdf


The initial data on infectious outbreaks is essentially noise, with very little to take away from the signal. First, because for a few weeks there is no agent identified, then there is no specific test for the agent, then there are only virological tests (where we are now) and, only much later, serological / antibody tests appear.

Virological tests can only be carried out in a very short time window or are negative, hence inducing a gigantic noise. Serological’s indicate if there has ever been contact with the virus, so they can be done in population sampling and allow statistically significant data.

At the moment (written on March 23), there is no reliable data to estimate the lethality of covid-19, it could be 0.001% or 5%. This is all noise. The number of infected people can be what we assume or ten thousand times greater (yes, ten thousand times).

Only with the arrival of serological tests do we begin to have a real picture of the disease in society. The Netherlands has announced that it has achieved a marker antibody test, but no results are known so far.

For example, Swine flu started with estimates of 30% - literally human extinction in a few months - and ended below 1%, below seasonal flu and did no harm.

This is the type of noise we are dealing with.

The only minimally reliable data we have from virological tests is from the Diamond Princess cruise, because everyone has been tested in a relatively short interval. They indicate 1% lethality in a very high age population, in a confined environment and sharing a canteen. We can be sure that the world outside the cruise will have much lower rates. In addition, less than 20% of people have been infected and there is still no explanation for this.

Since lethality cannot even be estimated at the beginning, all fear and panic are irrational.

Extreme, extreme care is needed with the release of initial data on outbreaks in particular with lethality. The World Health Organization (WHO) should answer criminally for not properly managing the data and indicating the order of magnitude of the noise data. It was only on the basis of this (incomplete data picture” that world has reacted to this “crisis”.

Looking at http://www.euromomo.eu something is immediately visible: The 2018/19 flu season was incredibly light and the 2010/20 season was even lighter so far.

Also worth noting in the detailed country charts is that all of the previous peaks, caused mainly by seasonal flu, are closed in week 19 of the year (first week of May) and peak before week 12. The baseline of mortality crosses the average at that time and represents the initial impact of lung disease mortality in winter.

There is almost a certainty that covid19 will behave the same and will cease to be relevant soon, at least until next autumn / winter.

The most vulnerable people, who died at home, homes, palliative care, are now sent to central hospitals for fear of caregivers becoming infected and because, as it is mandatory in reporting disease, they have to go to referral hospitals.

The National Health Service collapses every winter with the flu, covid 19 is clinically more complicated and occupies the intensive care beds longer, but fear and the bureaucratic processes associated with the disease explain a relevant part of the overload of services.

It was the same fear that made funeral services collapse in Bergamo and Madrid and now New York. The bodies have to be cremated as it is a formally contagious notification disease, and employees are required to take total protection measures that decrease productivity.

Allied to this decrease in the capacity of crematoriums, patients are concentrated in cities and families cannot take care of them, again because it is a contagious disease, causing the collapse.

Bergamo is one of the oldest cities in Italy, two years above average. In the central hospital's area of influence there are 300,000 people. In flu peaks, an average of fifty people per week per 100,000 inhabitants die. It is normal to expect 100 deaths a day on some peak days. The news reported that the crematorium could only handle 24. It was not an exceptional current mortality that created the problem it was the requiring everyone cremated given and the slowness inherent in the imposed rules for this disease. The flu also has epicenters.

The comparison with previous years in tight windows as it now circulates “four times more mortality in March, in Madrid and Bergamo” is disingenuous as flu outbreaks slide a lot within the flu season, mostly between December and February. Thus comparing mortality with in March this year, with covid19, has no statistical relation with the same periods of previous years.

A 140% increase in mortality in Bergamo is banal compared to last year, given the mild flu season. Mortality is likely to fall several times below 2014 when an excess of 54,000 died from all causes in Italy, an increase of three times even in relation to flu peaks. At that peak of 54,000 dead, not a single school was closed, nor was there any relevant research to determine the causes.

Current (April 1) estimates of lethality put covid19 at the level of the flu. The number of deaths by infected, IFR (infected fatility rate), of 0.26% is perfectly commonplace for flu peaks. The numbers that have been circulating are averages of the flu lethality of many decades that blur the peaks, where peaks with lethalities of 1% being considered as banal.

There is no lack of epidemiologists to come out in public, from the first day, to say that this is crazy. Some speak on behalf of Helmholtz Gesellschaft, a giant of medical science, where about 20,000 people are doing epidemiology. Most were insulted.

The Imperial College team that made catastrophic predictions has a macabre history of referring to the slaughter of hundreds of thousands of animals because of ‘foot and mouth disease’. It was found at the time that the model was wrong, essentially being the same used now. At a parliamentary hearing, Neil Ferguson reviewed Imperial College's estimates, without any plausible justification other than "measures" he did not specify, going from 500,000 to 20,000 dead!

Containment measures do not demonstrate the most remote effectiveness. All countries, with the exception of South Korea now, have perfect theoretical curves with 12 to 15 days until the peak of new cases, after entering exponential, which is the representative pattern of uncontrolled lung infections.

In Portugal, fifteen days have passed since a state of emergency, regarding a disease with 14 days from infection until diagnosis and has only slowed down with the same pattern as in all other countries.

There are indicators that the rate of infected people is much higher than what is believed. If so, not only did confinement not help the health system, it accelerated infection - unimportant, but ironic.

Schools should never have been closed. Children are virtually at no risk with this infection, and are immune quickly, with no symptoms in most. They become virus brooms to collect viruses from surfaces that do nothing to them and that are no longer available to infect vulnerable people.

It would be reasonable to ask the children-grandparents to stay away for a week to avoid the most active phase of contagion. Eventually it could be reasonable to send staff and teachers in risk groups home and reduce the teaching load with more physical contact activities.

It was probably the air quality in Wuhan that triggered the WHO outbreak alerts and the Chinese government went in. The images created panic in the world… then, there is a new alert in the Po valley, also with miserable air quality.

All epidemic monitoring is done computationally, with data collection. Until there was this alert, WHO did not seek anything.

Politicians were just after the creating fear in the population. The big exception is Marke Rutte, from the Netherlands, who makes an exemplary statesman speech, half the time talking about fear being real and recognizing that this fear cannot be denied, but that life will continue as if it were nothing.

Even if it was very bad, pulmonary viruses are always slow, never infecting more than 30% of people per year, no matter how “and” where “. Rapid viruses are viruses that are available on the skin or secretions, which are protected from the environment until the moment of infecting a new host.

Pulmonary viruses must be exposed to the hostile environment for a minimum to long time, which dramatically reduces their capacity to infection - for example they are destroyed by ultraviolet rays - which makes them much slower and greatly influenced by small increases in group immunity.

There was plenty of time to make decisions, observe how the epidemic evolved and decide accordingly, rationally and taking weight and measure into account.

The flu always has strains with zero immunisation. WHO predicts strains and often fails, leaving one or two strains out of the vaccine for which immunity is zero.

It would be time to use the knowledge of a hundred years of epidemiology to manage this epidemic, instead of taking extreme measures, which have never been tested anywhere, and which will certainly have a major negative impact on our lives.

Note: By his own choice, the author does not write according to the new spelling agreement.

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