THE world has been in a continuous state of emergency for more than a year. Many of us are engaged in heated debate about its justification and objectives.
In the following article, I have compiled and analysed the essential medico-epidemiological data.
The facts are undisputed and indisputable. The analyses are open for discussion.
1. Clinical symptoms
The symptoms caused by the SARS-CoV-2 virus are similar to those caused by other pathogens of human respiratory infections, i.e. they are non-specific (see below).
The majority of people infected with the virus either develop no symptoms at all, or only mild ones from which they fully recover.
Severe and potentially fatal forms mainly affect older individuals with pre-existing conditions.
According to the World Health Organisation, www.who.int
the most common symptoms of Covid-19 are :
· Dry cough
Other symptoms that are less common and may affect some patients include:
· loss of taste or smell,
· nasal congestion,
· conjunctivitis (also known as red eyes),
· sore throat,
· muscle or joint pain,
· different types of skin rash,
· nausea or vomiting,
· chills or dizziness.
Symptoms of severe Covid‐19 disease include:
· shortness of breath,
· loss of appetite,
· persistent pain or pressure in the chest,
· high temperature (above 38 °c).
Human beings have had to deal with a large number of continuously mutating respiratory viruses since time immemorial; the best known and most common types include rhino-, adeno-, corona-, influenza and parainfluenza viruses. As toddlers with permanently runny noses, we develop a basic immunity which is often put to the test in adulthood, especially during the common cold season. It undergoes further ‘training’ when it is exposed to newly mutated forms of these viruses.
Severe disease progressions – generally viral pneumonias – have been described for virtually all known types of viruses; they mainly affect older people who have pre-existing health conditions and a weakened immune system. In such patients – especially when they are bedridden – pneumonia is also very common.
What, then, makes SARS-CoV-2 so peculiar?
It may well be that this virus causes severe forms of the disease considerably more frequently than its previously known counterparts. For most types of respiratory viruses, we have never tried specifically to determine this frequency; it is therefore difficult to examine this hypothesis. However, in terms of patient characteristics (especially age and pre-existing conditions), severe Covid-19 is no different from the severe disease progressions caused by other respiratory viruses; this would tend to suggest that it is yet another, unexceptional representative of that same category. For the one type where we do have reasonable numbers, the influenza virus, recent scientific analysis indicates that Covid-19 is certainly not dissimilar.
It may well be that severe Covid-19 is a specific, previously unknown clinical syndrome; this is claimed by some doctors and clinicians. Even they do not establish the diagnosis on clinical grounds (symptoms) only, as confirmation (or refutation) by laboratory testing is always carried out. Similar symptoms and X-ray or CT images had previously been described for other respiratory viruses too; in everyday clinical practice, however, the specific causative agent of a viral pneumonia had hardly ever been determined.
It may well be that some people suffer from the disease caused by this particular virus for extended periods, or are left with specific sequelae (‘Long Covid’). However, late effects have been described for other respiratory viruses as well, the influenza viruses in particular. Furthermore, many a former Covid-19 patient who does not feel fully recovered or who falls victim to some other disease will now conceivably be tempted to blame this on the SARS-CoV-2 virus. It may also be possible that the mere knowledge of having had Covid-19 – or simply having tested positive for SARS-CoV-2 – can make some people feel unwell. Be that as it may, there is as yet no scientifically valid study which would demonstrate any specific long-term consequences of infection with this virus.
It may well be that this virus is particularly ‘contagious’, due to some particular biochemical and/or physiological properties. Here, too, we lack meaningful comparative data; respiratory infection chains are generally difficult to trace. Family members living in close quarters with sick individuals can remain asymptomatic and test-negative, however, and infections in an open-air environment are rare. Thus, we seem rather to be dealing with the typical infection dynamic of a common cold virus, and not with an epidemic which spreads like wildfire.
It may well be that this coronavirus has mutated so far away from the viruses already known to our immune system that we are, so to speak, entirely at its mercy. If this were true, however, the high occurrence of asymptomatic infections could simply not be explained. This proves that many people already have basic immunity (or cross-immunity with other coronaviruses), just as most of us have some basic immunity to most of those constantly mutating respiratory viruses.
It may well be, though, that the only truly distinctive characteristic of this virus is the fact that mankind is chasing it with specific tests, declaring everyone who tests positive as an ‘infected person’ or a ‘case’. It may well be that a number of disturbing images and media reports have sent most of us – including nursing staff, doctors and scientists, politicians and leaders – into an entirely irrational panic and hysteria. It may well be that we can theoretically repeat the same procedure every year (every winter – we are dealing with common cold viruses, after all), and with almost any freshly mutated rhinovirus, adenovirus, coronavirus, influenza or parainfluenza virus – if we care to trace one of them with specific testing.
The age distribution of ‘corona deaths’ (people who have died ‘of or with Covid-19’) is similar to that of the general population; in all European countries, the average age of death is 80 and over.
In 2020, some countries saw relative undermortality of up to 5 per cent, as compared to the mean of the previous five years, while others experienced a relative excess mortality of between 1 per cent and slightly over 10 per cent.
The fact that the age distribution of those who died ‘of and with’ corona closely follows that of all-cause mortality in the general population raises the hypothesis that this particular cohort (group of people) is part of that normal, inevitable population mortality.
We all have to die, and on average we die at our average age of death. No government in the world can prevent this from happening.
Most of us would like to avoid factors which can shorten our lives; we therefore need to try to find out what these factors are. That regular tobacco consumption falls into this category is something which we can now be certain of, for example. Wearing red socks seems a highly unlikely factor at first sight, but perhaps it’s something we should check, just to make sure. In order to determine whether wearing red socks is more dangerous than wearing socks of a different colour, we would have to look at the age distribution in the cohort of those who died while wearing red socks. If we find a difference from the general population – if, in particular, the average is lower than that of those who were wearing socks of a different colour – we would establish the hypothesis that it is better to avoid wearing red socks (a hypothesis which would certainly require further investigation). If – as we would expect – the age distribution were the same, and if we could repeat this result in numerous cohorts – in different countries, for example – we would conclude that wearing red socks has no influence on mortality, in other words that it is a so-called random variable.
This retrospective method is generally the first step which epidemiologists use in order to examine certain variables, such as living habits and conditions, pathogens and medical diagnoses, and to determine their potential impact on population mortality.
Now, it is of course true that having reached a certain age, one has a remaining life expectancy which is higher than at birth: in Germany, for example, you may expect to live 16 more years at the age of 70, 9 more at 80, 4 more at 90, and 2 more at 100. Life insurance companies base their premiums on this kind of calculation. In a number of recently published academic articles, this remaining life expectancy of the living has simply been transferred to those who had died ‘of and with corona’, the resulting claim being that these people had lost around 12 years of their lives. In other words, they would have lived, on average, to well over 90 years if they had not been struck down by the virus. This claim is not really plausible in itself. Moreover, following this line of reasoning, we could just as well demonstrate that red socks (or whichever random variable you care to choose) were life-threatening, and demand that the government mobilise all possible means in order to prevent people from wearing them.
On the basis of their age distribution and their multimorbidity (the virtually universal presence of other serious diseases), we can assume that the cohort of people who died with a positive test for SARS-CoV-2 is part of the normal and inevitable mortality of the general population and cannot significantly alter the total amount of that mortality.
The fact that a certain excess mortality is now being reported for some – though not all – countries for the year 2020 deserves closer analysis; it cannot unquestioningly be attributed to the coronavirus. A comparison with the average of previous years may already be misleading in countries with an increasing population and/or progressive ageing, such as the USA, since such factors inevitably lead to a continuous rise in the number of deaths.
For most countries, serious statistical analyses do not demonstrate a significant increase in the number of deaths for the year 2020. In any case, any factually demonstrated local excess mortality might just as well have been the result of general fear and panic among the population (for example by discouraging those with serious conditions from seeking timely medical advice) as well as of failures and disorganisation in the healthcare system and in the treatment of other diseases – at the very least, this hypothesis would have to be examined.
3. Diagnosis – the ‘tests’
The available PCR and antigen tests follow different and variable laboratory protocols. National or international standards do not exist.
The tests detect the presence of virus fragments. A positive test does not prove infection with reproducing viruses.
All laboratory tests have certain inherent error rates (sensitivity, specificity). These error rates, defined under ideal conditions, necessarily increase with improper and/or mass application.
For the first time in medical history, we are tracking a specific respiratory infection pathogen with mass testing in the general population.
Everything hinges on the tests. Given the non-specific clinical and epidemiological characteristics of the SARS-CoV-2 infection, we might not have noticed much of a ‘pandemic’ without these laboratory diagnostics, even if we had continued to live our lives normally.
A multitude of viruses constantly scurry across the mucous membranes of our respiratory tract; most of the time our immune system deals with them invisibly, not allowing them to multiply any further. A temporary weakening of our immune defences (e.g. when we catch a ‘cold’) or a particularly high exposure (intake of a high viral load) may lead to an inflammatory body reaction which translates into a running nose, a cough, hoarseness, fever and/or a general feeling of being unwell. Which specific virus (or viruses – so-called co-infections, e.g. with SARS-CoV-2 and influenza viruses at the same time, are not uncommon) is responsible for these symptoms had so far never been investigated in clinical practice, as any such knowledge would not have had any practical therapeutic consequences.
For more than a year now, we have been tracking the presence of fragments of one specific respiratory virus with mass laboratory testing, not only in sick people but also (and now primarily) in healthy individuals, declaring them to be ‘infected’ as soon as any one of these tests, following any one of many different lab protocols, detects or purports to detect any viral debris on their mucous membranes. Given the known seasonality of respiratory viruses, it is not surprising that we are seeing more ‘infected’ cases, hospitalisations and deaths in the cold season than in the summer; this would be no different for any other representative of these pathogens if we cared to test for them.
Perfectly healthy people are being quarantined because of their test results, under the assumption that they could infect and endanger others. Leaving aside the question of whether such an ‘asymptomatic infection’ with the virus really exists at all (though it should be noted here that all coercive government measures are based on this unproven assumption) the virus is now endemic anyway, that is to say it is constantly circulating – and mutating – in the population. This at least the mass testing has demonstrated for certain. Neither the isolation of clinically healthy people, nor any other government orders, can alter this fact.
Every hospitalisation, for whatever reason, is accompanied by one or (usually) several SARS-CoV-2 tests, and the patient is declared a ‘corona case’ as soon as the result is positive – sometimes even without such a positive test. After all, there are, in many countries, financial and other incentives for the admission and treatment of ‘corona patients’. Ultimately, all this quite naturally leads to a considerable number of ‘corona’ death certificates.
In severe cases of respiratory tract infections, the identification of a specific pathogen – using validated methods! – may sometimes be therapeutically relevant. Otherwise, the mass testing as it is currently being practised is medically pointless. It only creates fear and anxiety in the population, while necessarily leading to the neglect of other, more important concerns in the healthcare system.
The medical therapy of a symptomatic Covid-19 infection is in principle identical to that of any other viral respiratory disease; the specific efficacy of pharmaceuticals recommended by some experts (hydroxychloroquine, ivermectin, immunoglobulins) is controversial.
Severe forms of infection leading to respiratory failure may necessitate oxygen therapy, as with all pneumonias.
The decision of governments to counter this newly mutated coronavirus not only medically, but socially and politically, was originally based on the desire to grant hospitals and intensive care units a few weeks to prepare for the expected epidemic rush of patients – to ‘flatten the curve’.
As a point of reference for their preventive measures, policy-makers and their scientific advisers have over the past year used various and shifting parameters (R-number, positivity rate, mortality, hospital and intensive care bed occupancy, case incidence, etc.) as well as various and shifting levels of these parameters.
Medical therapy of a symptomatic SARS-CoV-2 infection is precisely that – symptomatic. The pathogen cannot be eliminated pharmaceutically; antiviral therapies have – at least as yet – not been able to clearly prove efficacy. Ultimately, the human body has to come to grips with the virus by itself, and in the vast majority of cases it does. All we can do is to alleviate the signs of inflammation caused by this fight; this is as true of SARS-CoV-2 as it is of any other respiratory virus.
In the panic caused by the images and reports from Wuhan, we probably overshot the mark in treating severely ill and fragile people with intensive medical interventions such as artificial ventilation – regrettably violating one of the fundamental precepts of medicine, namely primum non nocere (first, do no harm).
Under the impact of the images and news from Wuhan (and subsequently from Bergamo), fuelled by a number of frightening epidemiological models, the political leaders of our societies opted for preventive measures to contain the spread of this particular respiratory virus to mitigate an expected onslaught on our hospitals.
For a whole year, our healthcare systems have largely been switched into transmission prevention mode. Everywhere, one encounters protective suits, Covid corridors, disinfectants, testing stations, quarantine rooms, etc. Yet in spite of the substantial additional administrative and organisational burden caused by all this, the overall charge on doctors, emergency rooms, hospitals and intensive care units has not significantly increased – in fact, the very opposite has been shown to be the case in a number of countries and regions.
One might, one should ask which parameters – and under what circumstances – are to be used to decide on the unconditional withdrawal of all these preventive, temporary emergency measures? The SARS CoV-2 virus and its mutated and constantly mutating descendants have been endemic for a while now. There will always be mutated respiratory viruses, new ones every year, posing variable levels of risks – risks however which in all likelihood will fundamentally remain controllable by medical means alone. Shall we accept this as a sufficient reason to declare a permanent state of societal emergency?
5. Governmental, non-pharmaceutical measures
The measures adopted by Western democracies to combat SARS-CoV-2 follow the initial example of the Chinese dictatorship – not their own pandemic plans or the original recommendations of the World Health Organisation.
To date, no government has presented a documented cost/benefit analysis of its measures, let alone been guided by such an analysis in its decision-making.
A clear, scientifically accepted proof of the effectiveness of any of the governmental measures does not exist.
It is indisputable that these measures cause human and economic harm.
Let us consider the panoply of coercive measures imposed on the population in the course of last year’s pandemic, such as house arrests, bans on work, contact, sports and movement, masking requirements, etc. If these were medicines that required marketing authorisation, they would have to prove therapeutic efficacy and safety, or at least acceptable side-effect profiles, in relation to proven benefits.
Since practically all these measures were applied, for the first time in world history, to the healthy general population, they have been and continue to be enforced politically, without prior proof of efficacy, based on the dogma that interpersonal contact and therefore the potential exchange of viruses should be avoided or reduced to a minimum.
It should by now be obvious to everybody that neither the evolution over time in individual countries, nor any comparison between countries where different measures had been applied, show any effect whatsoever of government intervention on the course of the epidemic, especially on the most important parameter, mortality. If, as claimed, hundreds of thousands more people were to fall victim to the virus in the absence of tough restrictions, we would have had to see this happen in Europe last summer, and we would have had to see this happen over the course of the whole year in Sweden, in Belarus, in South Korea, in Japan and in Florida, as well as in a number of other US states.
In fact, the very opposite seems to be true: Countries (and periods) with hard lockdowns have shown and continue to show the highest mortality rates. The virus spreads according to its own laws, according to a clear seasonal rhythm in the temperate European climate zones – it is a common cold virus which doesn’t care about government guidelines. Nor will Australia or New Zealand be able to cut themselves off from it – and from the rest of the world – in the long run. What would be the point anyway?
On the other hand, the enormous damage caused by the governments’ coercive measures is becoming increasingly clear, even if the majority of the Western population has yet to start feeling it personally.
World economic growth is being slowed down on a gigantic scale and put into reverse gear. Initially, it is mainly the poorer countries which suffer: here, misery and hunger are now on the rise again, after being in steady decline over recent years and decades. Part of the additional trillions of euros or dollars that the world could have generated last year without government restrictions could and would have been spent on saving millions of lives. The polarising debate about the dichotomy between saving lives or saving the economy is completely out of touch with reality: prosperity and economic activity are fundamental prerequisites for effective healthcare. The rich West could have used last year’s lost tax revenues to build numerous hospitals and hire additional nursing staff. In developing countries, our lockdowns and the ensuing diminished economic activity and trade lead to mass misery and starvation, especially among children.
Slowly but surely, investigations are getting under way to examine the direct and indirect consequences of government fear propaganda and media scaremongering, of forced house arrests, of social isolation and bans on work and sports, of curfews, school absences, anxiety-driven education, compulsory face coverings and other hygiene constraints. It seems highly unlikely that the side-effect profile of all these coercive measures will historically be deemed acceptable.
The SARS-CoV-2 vaccines were developed in record time, with many of the steps normally required by the regulatory authorities being omitted.
The pivotal clinical trials demonstrate a preventive efficacy against common cold symptoms with a positive SARS CoV-2 test and show a trend – albeit not a statistically significant one – towards a reduction in severe cases with a positive test for SARS CoV-2.
No preventive effect against mortality (death) has been demonstrated, nor are there apparently any plans to do so.
Vaccination of the whole of humanity is being described by many of our experts and politicians as the only possible way for a return to normal life. The (conditional) approval of vaccines developed in less than a year was carried out under high political pressure. Given the lack of the normally required safety studies (for example, animal toxicology) and given the extremely brief period of clinical observation, we can only hope that these products will not cause too many serious side-effects. Even though it is never possible to rule those out entirely for any new drug, the development steps normally required by regulatory authorities are based on medico-historical experience and have a well-reasoned purpose.
The ‘emergency approval’ of a new medical intervention may perhaps sometimes be justified by its clearly proven efficacy and the severity of the disease to be treated. Neither one of these factors applies to the SARS-CoV-2 vaccines, however.
The highly publicised efficacy of the products approved to date is a statistically significant reduction in common cold symptoms with a positive test compared with placebo (or, in the case of the AstraZeneca vaccine, oddly enough, also compared with a meningitis vaccination).
The fact that these vaccines succeed in clearly reducing the detectability of SARS-CoV-2 in individuals suffering from fever, cough or hoarseness is certainly an interesting biological result. From the patient’s point of view, this is irrelevant: he or she simply wants to have less fever, cough and hoarseness, no matter what is causing them. That is precisely what has not been shown in the clinical trials. The articles published in the world’s leading and, under normal circumstances, best medical journals (New England Journal of Medicine, the Lancet) do not specify the absolute numbers of symptoms that occurred in the comparative groups. However, since most of these common cold symptoms are also listed as side-effects after vaccination, and occurred much more frequently in the respective vaccination groups than under placebo, as well as occurring much more frequently than the symptomatic SARS-CoV-2 infections chosen as the clinical endpoint, the conclusion surely has to be that people in the vaccination group became ill significantly more frequently than those in the placebo group.
None of the clinical trials was able to demonstrate a statistically significant effect on the occurrence of severe forms of respiratory disease, as they happened too rarely. In any case, the reasoning with respect to the clinical endpoint ‘with a positive test for SARS-CoV-2’ would apply again: patients do not care whether their shortness of breath, their hospitalisation or their death is associated with a positive SARS-CoV-2 test or not; they just do not want any of this.
In fact, a truly relevant proof of efficacy of all these vaccines could be provided only through rigorously conducted mortality studies (i.e. the comparison of the absolute death rate between the vaccination and the placebo groups), or, at the very least, through a so-called combined endpoint trial (for example, hospitalisation and/or death). If this is a deadly virus, if the situation is truly urgent, this is what we would have (had) to ask the pharmaceutical companies to carry out, and this is what we would have (had) to ask the regulatory authorities to demand from them.
This is not even planned, however – in all likelihood for very good reasons. In the clinical vaccine studies published to date, a total of well over 100,000 subjects were included, but to date not a single Covid-19 death has apparently been recorded; in the not yet published trial of the J&J vaccine, a few ‘Covid-related’ deaths (single digit number) seem to have occurred.
The disease is quite clearly not serious enough for well-designed clinical trials conclusively to demonstrate any effect on severe forms or death.
The vaccines have now largely been rolled out, and claims of efficacy abound, based on observational data. They seem in fact to be doing what they demonstrated in the randomised clinical trials – reducing the number of positively tested individuals (corona ‘cases’).
Their side-effect profiles are being established as we go along. Whether these vaccines will have any significant positive effect on population morbidity and above all mortality remains to be seen. It might be asking a little too much of them to prevent normal population mortality, but perhaps there will yield a welcome psychological result, allowing our societies to re-open (assuming that this is what governments and the governed people want).
7. Freedom and human rights
As of now (April 2021), elementary freedoms and human rights are restricted or suspended for an unlimited period in almost all countries of the world.
Elected and non-elected representatives of the people are currently conducting a – in some cases openly declared – ‘war’ against a common cold virus, forcing their infantilised populations into a permanent state of emergency. How and with what kind of outcome this war is to be won remains fundamentally open, even if some protagonists are planning and propagating a new, totalitarian normality after a ‘great reset’.
The measures taken by governments to protect a certain ‘at-risk group’ (ostensibly, at least) are impacting enormously on other groups, indeed on the entire population. The modern constitutional state is, in principle, barred from taking such action; it must not actively harm innocent people in an attempt to protect others. Even if we were dealing with a truly severe epidemic, with the plague itself: fundamental human rights are not to be bent, even if democratic majorities were to agree to their suspension or abolition.
We are indeed engaged in a struggle – a struggle for freedom and for human dignity. Let us hope that the battle can still be won with facts and rational argument.
This is a translation of the original German article which is republished by kind permission.