Do we even know how many have been infected? If not then how do we know...

SOMETHING is wrong with our knowledge of coronavirus. At least in the UK but I think it may be wider. Tonight Michael Gove had the unenviable task of telling us that over 28,500 people in the UK had now died of the covid-19 disease it causes.
And that over 180,000 people had now tested positive for being infected with coronavirus.
That would imply (be sure it is wrong) that the mortality rate for coronavirus is well above 10%. That in fact for every 100 people infected 10 will surely die.
I attach a grim document which tells us the mortality rates for diseases in general.
And sure enough coronavirus is there at line 42. And the current global death rate is calculated at 7%. But it is already, and so far unconfirmed, at the bottom of a horror show of diseases and well above the very next in line - pertussis or whooping cough! Yes really that has a global infant victim mortality rate of 3.7%.
Small pox is lower. Measles is lower. The Spanish flu which killed 20 million or more at the end of the 1914-18 war is lower.
It isn't that simple and the list is complex but I worry. I really do. Because just now it is even higher in the UK at 28k dead out of 180k infected - you do the maths!


The mortality rate for covid-19 is currently much, much higher - but only among those (like me) who are 76 years old with underlying issues: Recovered cancer (leukaemia 2003/4) so two treatments of chemo followed necessarily by one of bone marrow transplant and, now, severe COPD - emphysema and bronchiectasis. My lungs have a life age of 95.
And only because so far we have not the foggiest idea how many people have really been infected. 28k into 18k goes x times; close to 6. Until we do it is vital we keep a sense of proportion. I am no fan of the ridiculous 'herd immunity' idea. That is only possible when an effective treatment is available and/or a vaccine.
So currently for people like me covid-19 is a straightforward, unabashed killer. But it hardly touches children, the young and even the young adults. And vastly more 30-60s survive than die.
What is mortality then? Are we handling this right at all?
Maybe those who get it should be sent to one of two places - hospital and when suitable to the newly minted isolation hospitals - the Nightingale Units.
Maybe with some care lockdown can be eased. Normal life can begin again for most and... well, yes.. it does mean consigning some of us to the grave that is already beckoning. But at least the rest of the world can get a life.


https://en.wikipedia.org/wiki/List_of_human_disease_case_fatality_rates

This is what we need right now to call Government to account

For many decades I have been an avid reader of Private Eye and right now it is doing a far better job of holding Government to account than either the mainstream, the digital or the social media.

Their medical writer(s?) under the pseudonym MD have (has?) this edition done the best job yet of examining the actions - and too many failures - of our national policy. And given I am no expert I am pleased to find that as I have said, following the science does not describe it at all.

From the moment this pandemic reached Britain (whenever that actually was!) errors of policy have followed. For a start of course the emergency supplies of PPE and the 'reserved spare' emergency capacity in the health service had been allowed to wither during ten years of Tory inspired austerity.

On that basis the knee-jerk herd immunity was a disaster. Then came the PPE problem and a devious downgrading of coronavirus to allow lesser protection to, apparently, be allowable.

Then there was the message to care homes – "you have nothing to worry about". In terms of Government intervention they were right. In terms of Covid-19 infection they were woefully wrong.

(MD does not say it but I believe it. That this decision was a cold-blooded means of protecting the weakened and ailing NHS to cope with what was coming. And it now appears to have continued with infected and allegedly recovering care home patients being sent from hospital to care home without testing or tested with a 30% fallible test.)

Testing started. Then stopped. Track and trace started. Then stopped. Yet we all know, from South Korea and others, that this was an essential step in protecting the NHS and saving lives.

Then 'stay home' came two weeks too late and after huge public gatherings. And was not rammed home hard enough to begin.

Now we come to loosen the lockdown. Am I confident we shall get that right? Don't even ask. But they cannot let the likes of me loose yet: too old, too complicated, too vulnerable, too much part of the 0.5%....

AND finally I'd like to share the Eye's leading article this edition. And this I shall quote at length:

LOSE-LOSE SCENARIO

PANDEMIC planning is the ultimate lose-lose scenario. The lives and livelihoods lost from the virus have to be balanced against the lives and livelihoods lost from the "treatment".

This virus is causing a surge of deaths particularly in the sick and elderly, whereas lockdown is causing a smaller surge in non-Covid deaths and a steady, sustained increase in harm to those who have their whole lives ahead of them.

Brutally put, 100 percent of us are making sacrifices to save 0.5 percent of us (or less).

Children are being harmed to save adults; the poor are being harmed more than the rich; and some people have become so conditioned to "stay at home" that not even a medical

emergency will tempt them to seek help.

Given such staggering complexity, the best one can hope for is an overall "harm minimisation" strategy. To get there, experts from all disciplines need to subject their models and data on the benefits and harms of any strategy to full public scrutiny. And politicians need to admit their errors in real time.

It has taken us more than three months to move from Patient Zero to mass testing and tracing. It would be churlish not to welcome Matt Hancock's 100,000 tests a day (even

though they included requests and promptly fell again), but thousands more lives might have been saved by earlier action. It is time for an apology.

Meanwhile, after the mothballing of the little-used Nightingale hospital in London, questions will be asked about the money and precious resources spent on the hospital — but it's worth noting that the NHS needs extra capacity in case it gets a second spike in infection.

To read it all go to this link in a day or two when it goes live (we subscribers get a bonus) : 
https://www.private-eye.co.uk/current-issue
 Or order your copy now...

The sick man of Europe again with 30,000 plus dead

THERE is still no clarity on the issue of how deadly coronavirus actually is. We know that it is worse for those over 70 with significant underlying health issues. We know it is worse for males. It is worse for members of the black and minority ethnic communities. We know that it barely affects those under 18.
But we have no clear idea why. We can make educated guesses and the educated specialists do, but hesitantly of course.
The disadvantaged old respond badly to the symptomatic progress of the virus.
Smoking, alcohol abuse and diabetes is more common among men of all ages.
The ethnic minorities are often proportionately greater numerically in the nursing and caring professions and live in close-knit communities.
The very young are fit, healthy and have immune systems untouched by the ravage of modern living.
But currently that is about it.

And we also cannot yet get a real handle on what the 'kill rate' is. Horrid phrase I know but it is an essential feature of all known viruses and diseases and it does not deserve dressing up.
The most recent study went from 2.36 per million for China to 124.16 for Italy. Neither will be correct and by how much in error is a long way from being known. And nationas vary wildly in size, density, population.
First you have to know how many have died. 30,000 plus in the UK.
Then how many have been infected – unknown so far but tested and proven about 180,000 plus in the UK.
Those figures would suggest 10% - in the graph I refer to we are 7.10% per million.
But we actually have no idea at all how many have been infected with coronavirus because so many have not been tested. Those who had no symptoms, those with mild symptoms and even those in care homes and the like, who were quite ill but recovered, may not in fact have had the virus. But it is probably a decent bet that, for every one tested and confirmed there will be five more untested, untreated and unconfirmed. Which would mean not 10% but 2%. That is double a serious influenza epidemic, even with a vaccine applied to many millions.
The problem is that influenza has become a less valuable yardstick it seems since we started vaccinating all the most vulnerable. In fact tin the 2018/2019 season that was about 11 million people. Even so about 10,000 deaths were recorded.
That is 10,000 out of a population of 60plus million. Well below 1% thanks to the vaccine. They would still mostly be older people. The same ones who are most at risk from coronavirus.

One curiosity in all this is a government statistic which so far has not been explained. We test a lot of people but only a fraction prove positive. But we claim to test only if symptoms are being displayed.
As of 9am on 3 May 945,299 people had been tested, of whom 190,584 tested positive.
It means that over 700,000 tests were negative. Curious do you not think?
It does tell us that nearly 200,000 people have definitely been infected. But what about the other 700,000. Why were they tested? And why are the tests now being carried out at units across the UK being rolled out so urgently? If so many are negative have we got the wrong parameters to qualify for atest?

I have a theory – that the vast majority of tests are (quite properly) carried out on front line health staff and that happily most remain virus free despite the PPE crisis. It would be nice if the government were to explain this – or maybe try a bit harder to ffind out what really is the total number infected.

If you want to see how close an eye we keep on the influenza disease this impressive report is the latest of an annual series: https://tinyurl.com/y3rd9fsm

A list of diseases and rate of death is here and below:https://en.wikipedia.org/wiki/List_of_human_disease_case_fatality_rates