IT WILL be some time before we fully understand the true nature of this coronavirus crisis. However even at this stage a picture is beginning to emerge based on some initial hard data. It is a picture that is quite different to the one routinely presented in the mainstream media, where a fixation on the reported case and death statistics (which understate cases and overstate deaths) gives a misleading impression of the real situation.
Here are the important data points for gaining a true appreciation of the nature of the beast.
First and perhaps most important are the overall European mortality statistics. These show that up to 25 March all parts of Europe have seen below average overall numbers of deaths for this time of year, with the exception of the over-65s in northern Italy. This means that so far Covid-19 is not resulting in more deaths generally in Europe than would normally happen at this time of year, except in some parts of Italy among the older age brackets. There may be specific local reasons for this, such as poor air quality and overstretched health services (resulting from, among other things, the demand and staff shortages induced by a health panic).
The likely reasons for these below-average figures are, first, because pneumonia and complications of flu and colds are common killers around the world, with an estimated 650,000 such deaths globally each year and more than 28,000 in the UK in the 2014-15 flu season alone. Secondly, because almost all those who die with Covid-19 have serious underlying health conditions, meaning many have not so much died of the virus as died of something else while having the virus. It has been shown, for example, that only 12 per cent of deaths reported as coronavirus related in Italy actually have coronavirus recorded as a direct cause of death on the death certificate.
A second key data point for the emerging coronavirus picture is that of how widespread the virus is, and whether it is currently spreading exponentially through the population, as many of the doom-laden models assume. While we must await the results of serosurveys to learn for sure how far the virus has spread, there are already several studies that give us a strong idea of what to expect.
A study by immunology professor Sergio Romagnani from the University of Florence looks at 3,000 people in the fully Covid-19 tested Italian community of Vo and comes to the conclusion that 50 to 75 per cent of the test-positive people of all ages remain completely symptom-free.
An extensive survey in Iceland finds that 50 per cent of all test-positive people show ‘no symptoms’ at all.
A Japanese study shows that 48 per cent of the test-positive passengers on the Diamond Princess cruise ship remain symptom-free.
The consistency of these findings from a variety of contexts is remarkable and suggests Covid-19 may turn out to be symptom-free in around half of infections.
In terms of how many people already have it, Dr Richard Capek and others have looked at the Covid-19 test results from around the world and found that in all the countries they have studied so far the number of people who test positive for Covid-19 remains constant as a proportion of the number of tests performed, at between 5 and 15 per cent depending on the country. Importantly, this contradicts the notion of a current exponential spread of the virus in these populations, and indicates instead an exponential increase only in the number of tests.
These figures are notably similar to those from the Diamond Princess, where 17 per cent of the 3,700 passengers were infected despite all of them (we assume, given the confined context) being exposed to the virus before it was discovered.
What, then, is the picture emerging of Covid-19? It is of a virus that may infect between 5 and 20 per cent of a population, with around half of those not showing any symptoms. A virus that may already have infected most of the people it is going to infect, having been active in populations for some time longer than we have been aware of. A virus that is not in most places resulting (yet) in more deaths than average for the time of year.
This picture fits well with the death rate of around 0.1 per cent (or the same as flu) ascribed to it by a significant number of virologists, immunologists and epidemiologists around the world, including John Ioannidis, Sucharit Bhakdi, Stefan Hockertz, Pablo Goldschmidt, Giulio Tarro, Carsten Scheller, Yanis Roussel, and Eran Bendavid and Jay Bhattacharya.
We might also note that the UK government appears, oddly, to agree with this mortality rate since, despite the extraordinarily costly, illiberal and harmful lengths it has gone to in its efforts to suppress Covid-19, it has just removed it from the official list of High Consequence Infectious Diseases (HCID), stating that mortality rates are ‘low overall’.
If this emerging picture turns out to be in any way close to the mark (and we will know by comparing the outcomes in different countries that have taken different approaches, such as Sweden) the most important lesson to take away from this debacle will be never again to do something as monumentally disproportionate as lock down the country and crash the economy over something comparable to a bad epidemic of the seasonal flu.