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Saturday, November 23, 2024

Covid-19: Using science and evidence to put it in perspective

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A wonderful friend of mine posted that the number of UK deaths from flu/pneumonia last week was 1,260 and suggested therefore that our response to Covid-19 may be unnecessarily cautious. This led me to do a little research and I’m presenting this below in the hope that people find it informative/useful (with links to sources). Please note that most of these statistics are for England & Wales and are taken from the Office for National Statistics.

I’m not sure where the 1,260 figure came from but it’s surprisingly high (for normal, average weekly influenza/pneumonia deaths even during the Winter Flu season).

1. Influenza kills a relatively tiny number of people – it is however the cause of associated pneumonia which kills way more and thus the two are generally combined in the ’cause of death’ data.

2. In the last 5 years, 2015-19, the average number of influenza/pneumonia deaths per year was 28,188. The figures for the last two years were 29,516 in 2018 and 26,398 in 2019. The average number of influenza deaths in the 5-year period was just 799 whereas the average number of pneumonia deaths was 27,389. Obviously, these deaths greatly increase during the winter ‘flu season’.Source: https://www.ons.gov.uk/…/12267numberofdeathswhereinflue…

3. In the 4 months from March to June 2020, the total number of Influenza/Pneumonia deaths was 6,613 (average = 389 per week). In the same period, the total number of official Covid-19 deaths was 46,736 (average = 2,749 per week)!

Please note that the total excess deaths (compared to the 5-year average) for the period (7th March to 26th June) was 58,759 (this is 37% above the 5-year average) and 84% of this number had Covid on the death certificate (so not all of the excess deaths are attributed to Covid).

It is interesting to note that, during this time, the total number of deaths from Alzheimer’s/Dementia (which is the No 1 cause of death in the UK) was 26,555, so Covid was far and away the UK’s number one cause of death during these 4 months. It is also worth noting that some 4,476 people died from Covid-19 who had NO underlying health condition. This corresponds fairly well with the general scientific view that the number who die of Covid-19 with no underlying health condition is a little below 10% of the total Covid-19 deaths. However, some 22% of the UK population are estimated to have an underlying health condition (15 million out of a 66.65 million population).

Source for the March-June data: https://www.ons.gov.uk/…/deathsinvolvingcovid19englanda…

4. What is obviously critical in terms of how we respond to (and view) Covid-19 is the fatality rate. People should understand that there are two different measures: the Case Fatality Rate and the Infection Fatality Rate. The Case Fatality Rate (CFR) is the % of confirmed cases who die whereas the Infection Fatality Rate (IFR) is the % of those calculated as having contracted the virus (test/symptoms or not) who die.

The CFR is much less relevant as this obviously depends entirely on the comprehensiveness of the testing system in any country. The IFR is a much better and more important measure of a virus’ threat.

The IFR for Flu is approximately 0.1% (so, 1 in 1,000 die).

The IFR for Covid-19 in the UK is currently estimated to be approx 1.3% (actually between 1.1% and 1.5%), so current estimates for the UK are that Covid-19 is 11-15 times more deadly than flu (and any resultant pneumonia). 1.3% means 13 in 1,000 die.

The Case Fatality Rate for Covid-19 in the UK is currently 9.65% (435,000 confirmed cases and 42,000 official deaths). Worldwide, the CFR for Covid-19 is 3.02% (32.9M confirmed cases and 996,000 deaths). As I said, the CFR depends very much on the testing system employed (and as such, can be argued to present a measure of each country’s effectiveness in both testing and providing treatment). It is the IFR that represents the ‘threat’ of any virus and is therefore the far more important statistic. The estimates do change as more is known about the virus and its prevalence.

Source: https://www.bmj.com/content/370/bmj.m3259

5. The danger that Covid represents should, of course, not only be measured in deaths. In fact, scientists and medical professionals are increasingly sounding the alarm about ‘long-covid’ or ‘long-haul covid’ – the long term effects that many people suffer. The evidence regarding this is obviously emerging over time and as we learn about the virus and its effects. However, there is now significant evidence that large numbers of people who had the virus (INCLUDING those with mild or no symptoms) are now suffering a variety of long-term and often debilitating symptoms.

Shockingly, a recent study by King’s College, London, using data collected from 3.6M users of their study app, estimated that almost 600,000 people in the UK are suffering ‘post-covid syndrome’ (long term symptoms)!! The current estimate is that approx 1 in 10 people who are infected have long-term symptoms. I believe that, 10 years from now, we will of course talk about the number of deaths caused by Covid-19, but we will talk far more (and society will be greatly affected by) the number of people with long-term illnesses and disabilities due to Covid-19.

This, of course, would make sense, given that I watched a US Coroner (who performs autopsies on Covid-19 patients who have died) describe large blood clots in all the major organs as well as inflammation (or immune system response) issues. It makes sense that some people who have ‘survived’ will also have these blood clots and inflammation issues and that this will cause the kinds of problems associated with long-covid – scarring of lung tissues, heart problems, neurological problems (including loss of brain function), liver problems etc.

Likewise, doctors in the US are describing large numbers of people now attending hospital with the type of long-covid problems I outlined.

Source (there are loads if you do an internet search but here are a couple of Inews articles: https://inews.co.uk/…/long-haul-covid-19-post-viral…and:https://inews.co.uk/…/coronavirus-post-viral-effects…

6. On the issue of ‘ignoring it/letting everyone get it/herd immunity’ etc.

The BMJ article cited in 4 above outlined what might happen if the virus was left to ‘run amok’ – if we just carried on with our normal lives and ignored it and took no preventative measures (or just allowed everyone to get it to acquire ‘herd immunity’)….

A scientific study published by Ferguson et al estimated that if the virus went completely unchallenged, around 80% of people would be infected (the amount needed to attain so-called ‘herd immunity’) and there would be around 510,000 UK deaths (0.76% of the UK population or 1 in 131 people, albeit that the majority will be elderly and/or have underlying health conditions).

Interestingly, if everyone (100% of the population) got infected there would be an estimated 637,500 UK deaths. This is fairly close to the 2018 annual total of 616,000 deaths from all causes in the UK (so an additional entire year of deaths).

I hope this information is useful.

Tom Lane

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