Thursday, 19 November 2020

Hi Michel, 

please see below my reply to your email,

 I am delighted that you have put an emphasis on the excess mortality, something I believe to be an important (and perhaps the only reliable) measure of what's going on. Perhaps we can have a meaningful discussion on this common factual base and its progression, and its significance.

I’ve quoted excess deaths back to you because you don’t trust official statistics regarding infections based on the PCR test. The problem is that excess deaths are a lagging statistic and can’t be used for predicting the future and taking decisions. Covid deaths occur at least two to three weeks after infection and deaths up to 28 days afterwards are also counted. Collating statistics on deaths from all causes takes time as well.

 I have been monitoring this statistic. Its growth, albeit a long time after the dramatic rise in so-called cases, is concerning. My difficulty is in whether the size of it warrants the reaction we have seen. Such events occur regularly - more or less annually with the flu-

The definition of “excess mortality” is the number of deaths that is higher than is normal for the time period in question. “Normal” is established by taking an average of “normal years“.  Unless there’s a new strain of flu virus, annual deaths from this cause would be considered normal and would be included in the average.  If there is an unusual situation like we have now, such as a new virus or a major heat wave, then, as you know, the excess deaths are calculated by taking the totals over a chosen period of time and comparing them with averages from ”normal” previous years. Therefore annual seasonal deaths from flu would not be counted in any calculation of excess deaths.

 - they come and they go, and we do not see fit to bring the economy to its knees, or to cancel normal human contact.

For me it's a question of proportion, and a question of individual responsibility.

I disagree with this. It isn’t just a matter of individual responsibility because there will always be reckless and misguided people who choose not to take simple precautions and therefore present a risk to others. Look at the crazy situation in the USA!  In spite of the best efforts of some politicians, like Nigel Farage, to stoke distrust in government, in Western Europe people expect their leaders to act in the population’s best interests. Can you imagine the outcry there would be if governments did nothing and hospitals were overwhelmed with ambulances queuing outside and people dying on trolleys in corridors.

 If we find that the virus starts killing vast quantities of young fit people, that would alter my perspective.

You are focussed on deaths because they are counted and reported but you’re ignoring the debilitating longer term effects that many people, including younger fitter ones have experienced with Covid 19. These are much worse than being “confined” for a few weeks. Recent estimates put the number of such cases at 10% of those infected. Furthermore there’s no way at present of predicting who will suffer “long Covid” and who will breeze through it with no long term effects.

 But while this concerns largely the old (of which I am one) and sick, I prefer to privilege the lives of the young and the economy which will have to pay for their health in years to come, and I want people who feel themselves to be at risk to take suitable precautions. 

As I’ve stated before and supported with a reference, there cannot be a normal thriving economy if a serious public health crisis is rampaging through the population. People will take action to avoid catching the virus and reduce their risk of exposure. So some sectors of the economy will suffer as a result. The only way of avoiding this without lockdowns is to reduce the circulation of the virus by vaccination. Fortunately early trial results are showing several vaccines to be over 90% effective. But less encouragingly in Le Point of 29/12//2020 there’s an article which states that only 40% of the French population would take up the vaccine! 

Most people are generally hopeless at assessing risk and it seems that the vaccination sceptics are more afraid of a vaccine than a potentially dangerous illness! Perhaps they just don’t want to be “Un des moutons de Panurge”. If more than half of the French refuse to be vaccinated then there will be no herd immunity and it’s time to say a fond farewell to communal life as we used to know it and buy shares in undertaking firms.

 I find in any case that people are responsible, and are busy taking their own decisions - I don't know a single person, old or young, who follows the restrictions to the letter - we each find our own level of compliance, even if we count ourselves more or less in the camp of accepting the government response. 

Actually we do know several people who are following the rules even if we aren’t completely. This lockdown episode is a bit of a joke anyway because there is so much activity it’s hardly a lockdown at all. I would, however, like to have a haircut before Christmas.

Whatever this latest rise in mortality is, it is not the same as the first wave. There has been more than a 2 month delay, rather than the 2-3 week delay we saw at the outset. That might in fact be a very bad sign indeed - if the dramatic rise in cases that started 2 months ago is reflected in the death count now and in the weeks to come, that will be horrific, but it will take its course whether we lock down or not. I suspect that that will not be the case, but as you said before, we'll see.

In my opinion in March there were many many more Covid 19 infections than were ever recorded and reported. We know three people who caught it just before lockdown and never went near a doctor. They were lucky and had mild-ish versions.

It’s not possible to know how many people were actually infected in March, but as an illustration let’s assume it was ten times as many as the official test results showed. The death rate per thousand infections would therefore be a tenth of the rate calculated based on positive test results in March. 

If one now takes the numbers of positive test results in October/November, and applies the same death rate per thousand, you would get a much lower number of deaths than in March/April. This may be an explanation for the apparently lower severity of the virus in the second wave.  There is also, this time round, the availability of therapeutics and better knowledge of how to treat serious cases.

Personally, I’m already waiting for a flu jab and as soon as a vaccine for Covid 19 is available I will have one!