Indeed. and thank you. There is something to say about the current comparisons to flu numbers, especially the absurd notion that the flu 'kills more'. It doesn't. It's already endemic and affects hundreds of millions yearly, absolutely not the same.
You again state that like it's a fact. It's not. It's a theory the media has run with.
Why could this 'flu-like illness, with attendant complications in some'
also not be "already endemic and affect[ing] hundreds of millions"?
Look at this
latest info about the 'original cluster' in northern Italy:
Mattia [Italy's 'Patient 1'] first went to the hospital in Codogno on Feb. 18 complaining of flu-like symptoms. He was sent home but came back the next day after his condition worsened dramatically. He was only tested for coronavirus after doctors learned that in early February he had met with a man who had been to China.
By then, however, he had infected his wife and several doctors, nurses and patients at the Codogno hospital, creating what was thought initially to have been Italy’s main cluster. Since his China contact turned out to be negative, though, experts now believe that the virus had been circulating widely and quietly in northern Italy since at least the second half of January.
Extrapolate that out to 'circulating widely and quietly'
everywhere since at least the second half of January - such that it's likely been spread around the whole world in the last two months - which would mean it's "already endemic and affecting hundreds of millions," thus the mortality rate could turn out to be within average for flu season.
But then you say 'but they've run out of ICU beds in Italian hospitals!'
Indeed, as they have been
for many years now because of a decade of post-2008 'financial crash' austerity cuts. Here's an item on how the UK's hospitals were struggling to cope with the combination of austerity + 'regular flu' + cold weather
just 3 months ago, right
before COVID-19 entered the mix:
NHS winter crisis: extra beds created by 52% of UK hospitals
BTS says 48% are still using overflow beds introduced for the same period last year
The Guardian, 2 Dec 2019
More than half of hospitals have opened extra beds to help them cope with the NHS winter crisis amid
an influx of patients with potentially fatal breathing problems.
Many of the so-called escalation beds are
already occupied by people suffering from flu, pneumonia or chronic obstructive pulmonary disease exacerbated by the arrival of very cold weather in many parts of the UK.
The British Thoracic Society (BTS), which represents specialist lung doctors and nurses, has found that
52% of UK hospitals have already created extra bed capacity to help them prepare for the imminent surge in winter demand.
In addition,
almost half (48%) have kept open and are still using the overflow beds they created last winter, in a sign that the sustained pressure the NHS is under is not confined to December, January and February.
“As the winter season starts, life is already really tough at the coal-face of the NHS,” said Prof Jon Bennett, the chair of the BTS.
“
It’s a sign of the intense year-round pressure that the NHS is under that more than half of hospitals have already opened extra ‘winter beds’ to help them cope with the cold season – and that many haven’t closed them from last year.
“We are already hearing of
rising numbers of people being admitted to hospital with potentially fatal lung and breathing problems who require specialist support.
“[While] an under-resourced NHS lung workforce is working tirelessly to provide the best possible care in the circumstances …
we just can’t carry on like this long term.” [...]
“In recent years the NHS has defied the odds and somehow managed to cope despite warnings about the impact of winter pressures.
This time it is heading into what is likely to be the worst winter since modern records began in the eye of a perfect storm,” said
Siva Anandaciva, chief analyst at the King’s Fund thinktank,
in a new blog.
“The NHS is heading into winter in unusually bad shape”
because it has not had any respite from an unusually busy summer and also because ministers have provided no extra money for winter pressures, he added. [...]
The
Guardian disclosed last week that
hospitals in England have the smallest number of beds available on record.
NHS England admitted recently that
bed occupancy figures in July, August and September were the worst for the time of year since records began.
So yes, a MAJOR global health crisis is underway; a long-term,
ongoing health crisis, and one caused partly by environmental factors and partly by feckless government/resource management. In this context - the truly horrifying background context, which the vast majority are only tangentially becoming aware of because of their recently redirected attention onto this particular outbreak - COVID-19 is just one more feather on scales that were already beyond overloaded with problems: tens of millions of kids with autism and other developmental disorders; hundreds of millions of cancer patients; tens or maybe hundreds of millions of people with mutated or potentially mutating vaccine-delivered viruses in their systems; exploding rates of heart attacks, diabetes and autoimmune diseases, etc etc.
Now read carefully what the WHO is
actually saying about COVID-19:
Statnews.com, 25 Feb 2020
One of the hopes of people watching China’s coronavirus outbreak was that the alarming picture of its lethality is
probably exaggerated because a lot of mild cases are likely being missed.
But on Tuesday, a World Health Organization expert suggested that does not appear to be the case. Bruce Aylward, who led an international mission to China to learn about the virus and China’s response, said the specialists did not see evidence that a large number of mild cases of the novel disease called Covid-19 are evading detection. [...]
If large numbers of mild or virtually symptom-free cases are evading detection, that would suggest that estimates of the proportion of people who might end up in ICUs or might die during a Covid-19 epidemic would be lower than what has been seen to date in China.
“What [the data] support is that sure, there may be a few asymptomatic cases … but there’s probably not huge transmission beyond what you can actually see clinically,” Aylward said.
Ok, but on what data is he basing that claim? We'll see it below...
The claim was quickly challenged by an infectious diseases expert who serves on a committee that advises the WHO’s health emergencies program.
Gary Kobinger, director of the Infectious Disease Research Center at Laval University in Quebec, said it would be highly unusual for there not to be mild or symptom-free cases that are being missed. He pointed to the fact that outbreaks have popped up in countries far from China — including Iran and Italy — because people with mild infections were not detected and traveled to other places.
“There are mild cases that are undetected. This is why it’s spreading. Otherwise it would not be spreading because we would know where those cases are and they would be contained and that would be the end of it,” said Kobinger, who insisted that mild, undetected infections cannot be ruled out until people who haven’t been diagnosed with the illness can be tested for antibodies to the virus.
Those kinds of tests, called serology tests, are just becoming available in China, Aylward said.
“As long as we do not have good serology data, I think that it is completely speculative to say that there are no undetected cases,” Kobinger said.
Now here comes Aylward's reason for assuming that there are very few undetected cases out there...
Aylward pointed to an analysis from Guangdong province suggesting that, at least there, most of the infections were coming to the attention of health authorities.
When the virus started to spread in Guangdong — the province where the 2002-2003 SARS outbreak began — worried people flooded fever clinics to be tested. Of 320,000 tests performed, just under 0.5% were positive for the virus at the peak of transmission there, he said — which suggests that only 1 case out of 200 was being missed.
Transmission of the virus has subsided in Guangdong, and the number of positive tests at the fever clinics has declined; now only about 1 in 5,000 people tested at the fever clinics is positive for the virus, he said.
Ok, sounds convincing. But which of these two is correct; the WHO's Aylward, or the WHO's Kobinger?
Aylward thinks the vast majority of cases are being recorded, therefore the case-to-fatality rates (CFR) being calculated based on these 'numbers of confirmed cases' are largely accurate. The evidence he cites is the above rate of positive tests for COVID-19 found in people in Guangdong province.
But his colleague Kobinger disagrees with ruling out large numbers of people who test negative because those test results are based on
tests for genetic evidence of the virus. Here's the catch with that:
only serology tests for antibodies conducted on random samples of the population not displaying symptoms can provide the realistic baseline number for how endemic this virus is in the community.
Why is this distinction important?
This article explains the difference between these two types of testing:
Current tests for SARS-CoV-2, the virus that causes COVID-19, look for genetic material of the virus, for instance in saliva or nasal, oral, or anal swabs, using the polymerase chain reaction (PCR). They have one huge drawback: They only give a positive result when the virus is still present. The tests can’t identify people who went through an infection, recovered, and cleared the virus from their bodies.
It's this cohort that they need to account for before attempting to calculate the true CFRs. Serology tests on the general population have apparently just recently begun in China and Singapore. But Chinese hospitals 'on the front-line' were conducting in-house serological tests on everyone coming to them to be checked out. Guess what
they found:
most people were 'negative' for presence of the virus, but "almost all" were positive for the antibodies!
And there's more. Recall the high numbers of medical workers coming down with 'illness from COVID-19' in China? Well, case-tracking revealed them to have mostly contracted the illness
from the wider community, NOT at the hospitals they were working at!!!
statnews.com, 6 Mar 2020
With this new disease, more than 2,000 health workers have become ill. But Maria Van Kerkhove,
who heads the World Health Organization’s emerging diseases and zoonoses unit, said in a recent interview it seems like
most of them were infected at home — something she acknowledged came as a surprise.
“Given our experience with SARS and MERS, I was expecting that there would be large hospital outbreaks,” she said. “But even among the health care worker infections that have been reported to date, when they went back and did interviews with them and then looked at exposures,
it’s likely that most of those exposures were in the community rather than in health care facilities.” [...]
If they find antibodies to the virus in the blood of people who never made the case list, that will change the math. [...]
Researchers have been working feverishly to develop the tests needed to do this kind of research. China has recently licensed a couple of serology tests and Singaporean researchers have developed one as well. More will come on board soon.
“These types of studies should be conducted now,” she said. “This is one of the major things that needs to be done now. And everywhere. Not just in China. In the U.S., in Italy, in Iran — that would give us a better understanding of where this virus is and if we’re truly missing a large number of cases,” she said.
“Until we have population based sero-surveys, we really don’t truly know.”
They don't know, and yet the WHO just today formally declared this a 'pandemic'.
