QUESTIONS are being raised as to whether the belated response of the NHS to their failings is any more rational than their previous lack of preparation for such a medical emergency. Controversy is raging over what ‘the science’ really says and what, therefore, the policy implications are. Writing in the Spectator, life support specialist Matt Strauss, a critical care physician and assistant professor of medicine in Canada, rather brutally puts the significance of the ventilator shortage in context. Preliminary data, he reports, now shows that as many as 90 per cent of Covid-19 patients who go on life support will die anyway, and that ventilators save only one in ten of those who are put on them: ‘More ventilators does not seem like the game-changer we seek,’ he says. ‘As a life support specialist, I am greatly chagrined to admit this.’
Debate is also focusing on how many will die, which understandably has become the big question right now. While the high death tolls in Italy and Spain have driven panic about the virus’s advance, evidence has been published that its true mortality rate is much closer to that of flu (around 0.1 per cent) and that many more have already had it than reported figures show. The discrepancy comes about because the number of cases reported depends on how many are tested and who is tested, while the number of deaths reported includes all those who die with the virus but not necessarily of the virus. In Italy, for example, all who die are tested and added to the coronavirus tally if they die with the virus. But many of those will not have died of the virus, and indeed it’s now been shown that only 12 per cent of reported ‘coronavirus deaths’ in the country actually had Covid-19 recorded on their death certificate as a direct cause of death.
So how widespread is it? And most important how is medical planning (and other preventive measures) to be informed? According to a study from Oxford University published last week, the majority of those infected show no symptoms, supporting earlier findings from the Diamond Princess cruise ship outbreak.
The number of medical experts taking up this theme and saying that the emperor has no clothes appears to be growing by the day. They are asking whether the great lockdown and the reorganisation of the NHS into a National Coronavirus Service only – with all other operations and treatments cancelled, as described by Max Pemberton in the Spectator – may be to little point.
Italian virologist Giulio Tarro has said that the mortality rate of Covid-19 is below 1 per cent even in Italy and is therefore comparable to flu. The higher values arise, he says, because no distinction is made between deaths with and from Covid-19 and because the number of symptom-free infected persons is greatly underestimated.
German immunologist and toxicologist Professor Stefan Hockertz explains that Covid-19 is no more dangerous than flu, but that it is simply observed much more closely. He also notes that most so-called ‘corona deaths’ have in fact died of other causes while also testing positive for coronaviruses. Hockertz believes that up to ten times more people than reported have already had Covid-19 but noticed nothing or very little.
Argentinian virologist and biochemist Pablo Goldschmidt explains that Covid-19 is no more dangerous than a bad cold or the flu. It is even possible, he suggests, that it has already circulated in earlier years, but wasn’t discovered because no one was looking for it.
Even the authors of the Imperial College report that spooked the UK government into taking firmer action have now said that the peak of the epidemic may be just two to three weeks away, and have drastically dialled down their predicted death toll from 500,000 to 20,000 (including many who would die this year anyway). They credit the government’s actions for flattening the curve, but international evidence suggests that government action has little impact on the spread or severity of the virus in a country. Countries such as Sweden and Japan – both historically more socially homogeneous – which have taken relatively little action have not seen big outbreaks, while countries such as Italy that have gone into lockdown have suffered badly. South Korea took moderate (though well-targeted) action and saw great success.
Sweden with its much smaller and traditionally obedient population has pursued a more liberal strategy than most, based on two principles: high-risk groups being protected and people with flu symptoms staying at home. Chief epidemiologist Anders Tegnell says: ‘If you follow these two rules, there is no need for further measures, the effect of which is only marginal anyway.’ Social and economic life continue normally, he says, and the big rush to hospitals has so far failed to materialise.
There are many mysteries still with this virus, many of which will be solved in the coming months so we will be better prepared and protected in the future. But for now politicians should admit that their current strategy of locking everything down and sacrificing the economy on the basis of one set of forecast data and scientific modelling was premature and a cure, as Donald Trump now admits, that is worse than the disease.