The OffGuardian site initiated a written debate between Dr Denis Rancourt (Canada), leading pandemic sceptic, and Dr Tim Anderson (Australia), an advocate of stronger public health systems. Here are their opening statements and responses.

Dr Denis Rancourt

Denis Rancourt: opening statement in Denis-Tim debate, 6 October 2020

“Does SARS-CoV-2 merit suppression measures in order to combat the virus rather than the herd/community immunity approach?”

The events of COVID-19 can be analysed by unembedded critical commentators following different stances, or using different filters. Examples of useful analytical stances include:

  1. COVID-19 is caused by a particularly virulent and transmissive viral respiratory disease pathogen. The death rate in a given population will depend on the effectiveness of government-coordinated mitigation interventions and treatment practices. Therefore, the hospitalization and death rates are a measure of intervention effectiveness in a given State jurisdiction.
  • Irrespective of anything else, the questions of virulence (infection fatality rate) and transmissivity (contagiousness) can be answered by unbiased scientific enquiry, assuming virulence and transmissivity to be properties of the pathogen, for a given societal structure.
  • The presence of a massive and coordinated information and recommendation (propaganda?) campaign, integrating government departments and health institutions, can be objectively ascertained, and it is both real and unprecedented in magnitude. In-effect this campaign serves to justify: harsh mitigation measures, censorship and surveillance, severe travel and trade restrictions, a large slowdown of the global economy, and a massive and accelerated effort to develop a vaccine.  Are there geopolitical drivers, and what might they be? Or is the campaign simply a rational and apolitical response to a palpable public-health threat, in the other extreme?
  • Large numbers of excess all-cause deaths have occurred in many State and local jurisdictions (and have not occurred in many other infected jurisdictions). Can it be established by scientific enquiry whether these deaths are primarily due to a new pathogen (SARS-CoV-2) or primarily due to the imposed mitigation measures, in the given societal structures? Can the quality of government be evaluated in terms of the lethality of the mitigation measures themselves?

Now, Professor Anderson and I want to debate whether SARS-CoV-2 merits special suppression measures versus business as usual, as, I will venture, would probably have occurred if no pandemic was declared.

One reason that we can even have this debate is that SARS-CoV-2 is not particularly virulent, nor is it more contagious than influenza, which is highly contagious. Folks are not dropping in the streets from SARS-CoV-2, not even in the USA. I do not know anyone who knows anyone who has died of this thing, and virtually all of my social contacts report the same. If SARS-CoV-2 were evidently deadly, in real observable terms for most people, then the debate would be over. There would be an obvious need to do more than the usual. Likewise, with an exceptionally virulent and contagious pathogen, the effectiveness of various mitigation measures would easily be ascertained. With SARS-CoV-2, the weakness of the pathogen allows for endless debate, spin, and policy uncertainty.

In that sense, the nature of the instant debate itself puts a limit on the presumed dangerousness of SARS-CoV-2. Unlike imperialism, war, global exploitation, and so on, in terms of human misery, this is largely an academic exercise, if it is confined to the virulence of SARS-CoV-2.

In my own on-going research, I have examined COVID-19 through the lens of each of the four stances outlined above. My main research articles have been:

  • Evaluation of the virulence of SARS-CoV-2 in France, from all-cause mortality 1946-2020 (20 August 2020) (with Marine Baudin and Jérémie Mercier)
  • All-cause mortality during COVID-19: No plague and a likely signature of mass homicide by government response (2 June 2020)
  • Masks Don’t Work: a Review of Science Relevant to Covid-19 Social Policy (11 April 2020)
  • Face masks, lies, damn lies, and public health officials: “A growing body of evidence” (3 August 2020)

I also authored a Report for the Ontario Civil Liberties Association (ocla.ca), entitled “Criticism of Government Response to COVID-19 in Canada” (18 April 2020); and co-authored an OCLA letter to the WHO, entitled “WHO advising the use of masks in the general population to prevent COVID-19 transmission” (21 June 2020).

Regarding virulence, the infection fatality rate (IFR) is a scientific question, which cannot be answered merely by using socio-political inferences. The IFR is the number of deaths attributed to the pathogen (SARS-CoV-2), occurring within a relevant time period, per proven infection in the corresponding relevant time period, in a given population.[1]

The IFR must be discerned from the case fatality ratio (CFR), which is the number of deaths, within a relevant time period, per number of diagnosed medical “cases”, which are confirmed and actual illnesses, in a given population. CFR is a measure of clinical severity.  Here, I should stress that a “case” is not a “PCR positive”, as misused in the media, and that the evaluation must be based on a population, without selecting only the most ill individuals presenting themselves to hospitals. At the start of the COVID-19 saga, a large uncorrected CFR, estimated from hospital cases in Wuhan, caused the initial panic.

An authoritative and detailed recent study of the IFR for COVID-19 is provided by Professor John Ioannidis.[2] Professor Joseph Audie reviewed the Ioannidis study, in relation to a demonstrably faulty evaluation of IFR revised and concocted by the CDC (dated 10 July 2020).[3] The CDC published re-revised estimates on 10 September 2020.[4]

Both Ioannidis and Audie conclude that SARS-CoV-2 is not more virulent than a “bad”-season influenza. Ioannidis puts it in these terms, in its socio-political context:

“Based on the IFR estimates obtained here, COVID-19 may have infected as of July 12 approximately 300 million people (or more), far more than the ~13 million PCR-documented cases. The global COVID-19 death toll is still evolving, but it is still not much dissimilar to a typical death toll from seasonal influenza (290,000-650,000), while “bad” influenza years (e.g. 1957-9 and 1968-70) have been associated with 1-4 million deaths. […] COVID-19 seems to affect predominantly the frail, the disadvantaged, and the marginalized – as shown by high rates of infectious burden in nursing homes, homeless shelters, prisons, meat processing plants, and the strong racial/ethnic inequalities against minorities in terms of the cumulative death risk.”

The revised (10 September 2020) CDC best-estimates of the IFR [0.003%, 0-19 years; 0.02%, 20-49 years; 0.5%, 50-69 years; 5.4% 70+ years] are comparable to and smaller than the values for the mild 2009 (H1N1) influenza pandemic [0.00066%, 3-19 years … 0.22% (0.05%—4%), 60+ years].[5]

Therefore, by now, the numbers are in: SARS-CoV-2 is not an extraordinarily deadly respiratory disease pathogen.

This is to say nothing about the unsolved problem of inflationary bias in attributing medical deaths to COVID-19, which is the numerator in the IFR ratio. The latter bias is documented to be particularly severe with deaths of elderly persons having multiple comorbidities. It also says little about the problem of the questionable premise of virology that mortality is primarily due to the genetics of one guilty viral strain, rather than being primarily due to vulnerability of the host population (subjected to an ecology of pathogens), including vulnerability to violent government interventions.


[1] https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v3

[2] Ibid.

[3] https://www.researchgate.net/publication/343889424_Review_of_calculated_SARS-CoV-2_infection_fatality_rates_Good_CDC_science_versus_dubious_CDC_science_the_actual_risk_that_does_not_justify_the_cure_-_By_Prof_Joseph_Audie

[4] https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119689/

Dr Tim Anderson

Opening statement: The pandemic deserved a social response

by Tim Anderson

I ask readers to reflect a little on health systems and the ideas behind them, and not just react to particular measures. To simply react to the crisis as ‘lockdown vs no lockdown’, and complain how it affects individual liberties, misses that.

The 2020 pandemic has shown us massive failures in western neoliberal health systems – privatised, heavily commercialised, lacking in preventive capacity – and this deserve analysis. 

I suggest we learn from the experience of independent countries, those well organised on principles of humanism and social solidarity, e.g. China, Vietnam, Cuba, Venezuela and Syria. Their actions during the pandemic have some important lessons. 

It is important to go beyond the fantasies that the current epidemics were not serious public health threats, which demand a social response. Cynical responses which cry ‘the data is all wrong, scientists should not be believed, public health systems want to poison us all’ both miss the neoliberal failures and prevent us from engaging in social responses. 

1. On the broad debate:

I have read some of the material that my colleague Denis Rancourt has written on this subject. I disagree strongly with his idea that all viruses are part of a regular winter cocktail, with little difference between them. 

Demonstrable, collective medical science is important, and differs in character from political debate, which is mostly constructivist and argumentative.

Differences between diseases are important. Some affect the young and others the old. Many epidemiologists say, “if you’ve seen one pandemic, you’ve seen … one pandemic” (Osterholm; Horton). That is, “COVID-19 doesn’t behave like flu, which doesn’t behave like Ebola” (Spinney). We know now that COVID19 is not only linked to respiratory illness but also vascular and neurological illness. 

It simply entrenches ignorance to say: ‘we can ignore all contemporary public health data’ (because of the chronic uncertainties), and ‘we can ignore medical science consensus’ (in favour of our chosen dissidents). We should engage with the best available evidence.

The consequences of denying the pandemic, as do a western liberal minority, are that people assist the neoliberal privatising project and self-exclude from meaningful engagement in many real issues: how to manage particular quarantine regimes, social security, medical regimes, etc. 

Pandemic deniers run parallel slogans to those of neoliberals like Boris Johnson and Donald Trump: ‘no worse than a flu’, natural herd immunity’, ‘the cure is worse than the disease’. This denialism is not really a ‘left’ position because it begins by rejecting preventive health measures (e.g. quarantine and vaccines, at the centre of all public health systems) and its justifications generally capitulate to individualism (‘my liberties above all’).

2. On the proposition:

‘Does SARS-CoV-2 merit suppression measures in order to combat the virus rather than the herd/community immunity approach?’ I say yes, the 2020 pandemic was a serious health crisis which required prompt protective measures to contain the spread and mitigate the illness and death.

This should be understood in principle, first, before moving to criticise the various quarantine and hygiene measures taken by particular governments. It is always important to not conflate principles with particular political actions. 

Protection of populations could not be achieved by simply allowing the disease to run its course and hope that some sort of natural immunity might result. That would have allowed many millions to die. I will briefly address the science on the danger of the virus and why ‘herd immunity’ is only really viable with the help of a vaccine.

We can debate the science on excess mortality, vaccines, face masks, lockdown casualties, and so on, later. 

Epidemiologists calculated a range of Infection Fatality Rate (IFR) estimates, a few months into the pandemic. They suggested IFRs between 0.2% and 1.3%, but the consensual area is between 0.5% to 1% (Verity et al; Basu; CDC; Bhattacharya; Mallapaty). That is, about 5 to 10 times the seasonal flu, not inconsistent with the more than one million COVID19 deaths reported from 200+ countries and territories in seven to eight months of epidemic, compared to an average of 400,000 annual deaths from flu globally, in recent years (Paget). No responsible health official can afford to just cherry pick the most optimistic estimates. 

On acquired immunity, measurements of antibodies to COVID19 in some of the hardest hit European cities and New York show 10% or less, plus some higher levels T-cell reactivity (Jones and Helmreich; Pitt; Woodley).  That is far too low for any sort of ‘natural’ herd immunity which, given COVID19’s highly contagious nature, has been suggested to require 85%. Observed natural levels of antibodies or T-cell reactivity do not yet come close to that (Pitt; Doshi). This is where the 300+ vaccine candidates try to do better.  Let’s see how good they are.

3. Neoliberal failures and independent responses

This is my characterisation of the approach taken by neoliberal countries (UK, USA, Sweden, Brazil):- they stripped their public health capacity, decades before this crisis;- they developed societies of privilege and exclusion, fuelling distrust and resentment;- they delayed for many weeks state responses to the epidemics, allowing contagion to spread;- they imposed quarantine controls very late, using police and not health officials;- they generated both contagion and prolonged ‘lockdowns’ – the worst of all worlds.

What did the more independent countries (China, Vietnam, Cuba, Venezuela, Syria) do?- they built and extended public health systems; – they extended universal guarantees and made more inclusive systems;- they promptly imposed protective quarantine measures, led by health personnel;- they generated shorter ‘lockdowns’ which, with testing and tracing, could be more focused.

Why should we not reflect on why Cuba and Syria (e.g.) imposed quarantine measures before they had a single infection, while the UK and the USA waited 7-8 weeks? The first two contained their epidemics, the latter two did not. 


References 
Basu, Anirban (2020) ‘Estimating The Infection Fatality Rate Among
Symptomatic COVID19 Cases In The United States’, Health Affairs, 7
May, online:
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00455

Bhattacharya, Jay (2020) ‘We Must Question The COVID-19 Status Quo
(w/Dr. Jay Bhattacharya)’, ZDoggMD, YouTube, 14 September, online:
https://www.youtube.com/watch?v=T_COvdCujaA&feature=emb_title

CDC (2020) ‘COVID-19 Pandemic Planning Scenarios’, US Centre for
Disease Control and Prevention, 20 May, online:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

Doshi, Peter (2020) ‘Covid-19: Do many people have pre-existing
immunity?’, BMJ, 17 September, online:
https://www.bmj.com/content/370/bmj.m3563

Horton, Richard (2020) The COVID-19 Catastrophe, Polity, Cambridge MA
Jones, David and Stefan Helmreich (2020) ‘A history of herd
immunity’, The Lancet, 19 September, online:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31924-3/fulltext

Mallapaty, Smriti (2020) ‘How deadly is the coronavirus? Scientists
are close to an answer, Nature, 16 June, online:
https://www.nature.com/articles/d41586-020-01738-2

Paget, James et al (2019) ‘Global mortality associated with seasonal
influenza epidemics: New burden estimates and predictors from the
GLaMOR Project’, J Glob Health. 2019 Dec; 9(2): 020421., online:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815659/

Osterholm, MT (2012) ‘Final column: pandemic preparedness after
H1N1: remember if you’ve seen one pandemic, you’ve seen one
pandemic’, in Gigi Kwik Gronvall (2012) Preparing for Bioterrorism,
Center for Biosecurity of UPMC, Maryland, online:
https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2012/sloan_book/Preparing%20for%20Bioterrorism_Gigi%20Kwik%20Gronvall_December%202012.pdf

Pitt, Sarah (2020) ‘What will happen if we can’t produce a
coronavirus vaccine? And is herd immunity the answer?’, The
Conversation, 15 August, online:
https://www.abc.net.au/news/2020-08-15/coronavirus-herd-immunity-unlikely-without-vaccine/12559298

Spinney, Laura (2020) ‘The Rules of Contagion by Adam Kucharski
review – outbreaks of all kinds’, The Guardian, 25 March, online:
https://www.theguardian.com/books/2020/mar/25/the-rules-of-contagion-by-adam-kucharski-review-outbreaks-of-all-kinds

Verity, Robert et al (2020) ‘Estimates of the severity of
coronavirus disease 2019: a model-based analysis’, Lancet, 30 March,
online:
https://www.thelancet.com/action/showPdf?pii=S1473-3099(20)30243-7&fbclid=IwAR3Ly0mFOWWh3E74id0uHphEcKK0R0gp0-uXOP-D5Euj0jvKzqbdGIeKCF0

Woodley, Matt (2020) ‘More evidence suggests no long-term COVID-19
immunity’, News GP, 13 July, online:
https://www1.racgp.org.au/newsgp/clinical/more-evidence-suggests-no-long-term-covid-19-immun

Denis Rancourt: FIRST RESPONSE in Denis-Tim debate, 10 October 2020

“Does SARS-CoV-2 merit suppression measures in order to combat the virus rather than the herd/community immunity approach?”

Our opening statements were made separately, blindly. We now proceed one after the other.  I am going first.

“On the broad debate” Tim tars me as being a “pandemic denier”. I do not deny that there has been a large wave of deaths in an epidemiological context of viral respiratory diseases.

My focus has been to research why the all-cause-mortality-quantified excess deaths have been so different from one jurisdiction to the next (state to state in the USA, province to province in Canada, region to region in France, country to country in Europe, and so on); and the ways in which “science” and “medicine” are misused in the palpable global propaganda campaign, including the propaganda by government public-health directives, law and enforcement.

“On the proposition” Tim advances that SARS-CoV-2 is undeniably more virulent than influenza, and that there is a “scientific consensus” on this point. Both are demonstrably false.

Regarding virulence of the pathogen, Tim quotes incorrect early estimates of the infection fatality rate (IFR), and does not quote the latest CDC summary of IFR values, nor does Tim quote the most complete critical review made by Professor Ioannidis (see my opening statement). Tim follows this by stating: “No responsible health official can afford to just cherry pick the most optimistic estimates.”

Regarding comparison to influenza, Tim fails to appreciate the complexity of the epidemiology of influenza, and the difficulty in calculating meaningful (unbiased) mortality burdens, using statistical models.

Average mortality from epidemic influenza varies 20-fold from locality to locality, and mortality from seasonal influenza varies 100-fold and more with age. The highly-cited longitudinal field study of Loeb et al. (2000) found an influenza-outbreak case fatality ratio (CFR) of 8% in 5 care homes in Toronto over 3 years, a hard number large enough easily to have been the nucleus of a pandemic propaganda campaign. For other cities, Loeb et al. noted: [1]

“Rates of pneumonia as high as 42% and case-fatality rates exceeding 70% have been reported in outbreaks due to influenza virus. [their references 8 through 10]”

There is also an extensive scientific literature showing that elderly people are not significantly protected from influenza by vaccination, despite the pressures of the massive vaccine industry on the scientific establishment.

Regarding “Neoliberal failures and independent responses”, I reject Tim’s simplistic proposition that a difference in “COVID deaths” between “neoliberal countries (UK, USA, Sweden, Brazil)” and “more independent countries (China, Vietnam, Cuba, Venezuela, Syria)” is caused by decimated medical systems in the West versus responsible medical care management in his list of non-neoliberal (communistic?) countries.

I expect that three factors are more important than Tim’s “they promptly imposed protective quarantine measures”, etc., to explain differences in excess all-cause mortality in the March-April catastrophe period. I use all-cause mortality because the attributed-death statistics are notoriously unreliable.

First, an important factor in comparing Western and non-Western nations is the degree to which the elderly population is housed in care homes versus family homes. There is little doubt that care homes are killing fields for viral respiratory diseases, and that WHO air-ventilation standards “for Infection Control in Health-Care Settings” are not being followed.[2] Ventilation is crucial where there are groups of vulnerable people.[3], [4]  Natural ventilation will be abundant in homes in hot climates.

Second, viral respiratory disease transmission operates via aerosol particles, which are stable in air only in low absolute humidity conditions. I have reviewed the relevant established science in my articles. This explains: why viral respiratory disease transmission is highly seasonal and predominantly occurs in winter in mid-latitude countries, with reversal in our summer for mid-latitude Southern Hemisphere countries (their winter). Viral respiratory diseases virtually do not transmit in hot and humid (equatorial) countries, or in hot and humid seasons or environments.

For example, if you wanted high transmission in Texas in the summer, you would have to confine the interacting population to air-conditioned closed spaces. Likewise, if you want summer transmission in hospitals, you have to air-condition the air in common areas, and reduce humidity “to control mold and bacterial cultures”, while not paying attention to ventilation as a means to remove aerosols.

Third, confinement, psychological stress, and social isolation of elderly people in care homes or elsewhere are deadly, as is introducing infected patients from hospitals into the care homes. I have reviewed the established relevant science in my articles. In my papers and interviews, I have explained why we should interpret the March-April excess all-cause mortality events (e.g., 30,200 accelerated deaths in France) as having been caused by the government response measures, not any virus acting in an undisturbed society.

So, the simple idea that the funding model of the national health-care system explains the pandemic deaths is not a useful generalization. I agree that the Western countries are vicious and irresponsible towards their own populations. I believe the highest-level driver is geopolitical. 


[1] https://www.cmaj.ca/content/cmaj/162/8/1133.full.pdf

[2] https://www.who.int/water_sanitation_health/publications/natural_ventilation/en/ (WHO seems to have filed this under “Water sanitation hygiene”, rather than highlight its relevance to COVID.)

[3] https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa939/5867798

[4] https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa939/5867798#supplementary-data

First response to Denis Rancourt’s 6 October statement and his 10 October response

by Tim Anderson, 11 October 2020

In response to the opening statement and first response by Denis, let me first list the matters on which I agree. I agree that the danger and contagion of COVID19 can and should be determined by “unbiased scientific enquiry”; that there are “large numbers of [unexplained] excess all cause deaths” in many jurisdictions; that the infection fatality ratio (IFR) is “a scientific question, which cannot be answered merely by using socio-political inferences”; and that IFRs (the fatality rate of all infected, not just those presenting as ill) must be distinguished from the initially inflated case fatality ratios (CFRs).

Given the nature of western opinion on many big debates – strong, often tending to abusive – few are likely to change their minds based on our arguments. Yet our agreement on the need for independent scientific arbitration is important because readers will have reference to our sources and perspectives.

Nevertheless I say Denis is in error in several matters of method and substance. 

On method, his first error is to introduce personal anecdotes in an attempt to prove a general proposition: “I do not know anyone who knows anyone who has died of this thing”, he says, suggesting it cannot be very dangerous. This proves nothing, any more than the fact that I do personally know of such deaths and illnesses. Trying to prove the general from the particular is a basic logical fallacy.

His second error is to mix insinuations of a global conspiracy (without evidence) with an argument over ‘virulence’ which founds itself on scientific evidence. The vague back-text undermines his scientific logic and provides an alternative ‘escape route’ in case his recourse to science fails (i.e. ‘where there are excess deaths there is another ‘obvious’ cause’).

The third problem is his cherry picking of scientific estimates. All the scientific reports (including Ioannidis, on whom Denis relies) admit a large degree of uncertainty over many aspects of COVID-19. That means we should have regard to the range of scientific estimates on COVID IFRs. I did that in my opening, citing a range of 0.2% to 1.3%, with a consensus of between 0.5% and 1%. The seasonal flu IFR is commonly said to be about 0.1%.

In substance, Denis relies for his ‘no worse than a flu’ argument on Ioannidis, corroborated by some correspondence he had with an academic friend, Joseph Audie. He also claims the Washington based CDC revised its estimates in September to fit in with Ioannidis. Yet Denis does not report these cherry picked sources accurately.

John Ioannidis is a scientist who (with colleagues including Jay Bhattacharya) has engaged in political lobbying of the Trump administration since mid-March, to prevent a ‘lockdown’, based on his ‘relatively harmless’ view vs likely economic damage. Several of his arguments are now touted by Trump (see Stephanie Lee).

But his COVID19 predictions are poor. On 17 March Ioannidis predicted “about 10,000 deaths” in the USA from COVID-19. By that time the US government had reported just 121 deaths, one month later it was 38,000 deaths, six months later more than 200,000. In mid-July Ioannidis revised upwards his IFR estimate to a median 0.27% – but as much as “0.90% in locations exceeding 500 COVID-19 deaths per million”. That is, a median rate almost 3 times the seasonal flu. Audie’s letter mentions this but Denis does not.

He also wrongly claims that the US CDC in September revised its IFR estimates to figures “comparable to and smaller than” that of the 2009 Swine Flu. Not so. The 10 September CDC report cited by Denis says it relies on the European IFR calculations by Hauser et al, which range from 0.5% to 1.4%. The Audie letter bemoans the fact that the CDC in July presented “a second and higher estimate of 0.65%”, a figure confirmed in late September by congressional testimony from CDC Director Robert Redfield:

“The preliminary results on the first round show that a majority of our nation—more than 90 percent of the population—remains susceptible … [and] that the overall COVID-19 infection fatality rate (IFR)—the share of Americans infected by the virus who will die as a result—is about 0.65 percent” (in Sullum, 29 September).

So is the “massive and coordinated information and recommendation (propaganda?) campaign” mentioned by Denis (i) that of Ioannidis and Trump, who play down the epidemic, or (ii) that of the CDC, which cites international studies to maintain that COVID19 is 6.5 times more deadly than the seasonal flu? The US state is clearly divided on the matter.

—–

On the new matters raised by Denis in his 10 October response, first there was no need for me to “tar”, him as a ‘pandemic denier’. He does that himself in his Facebook group ‘Denis Rancourt denying everything’, where he says “I deny climate, vaccine, face masks, COVID-19, medicine, pedagogy, … everything!”

Denis spends some time on why he thinks so many people have died in aged care homes in the COVID era. I welcome his suggestions for the reform of aged care. But we know the Swedish voluntarist and ‘herd immunity’ approach did not work. Swedish health official Anders Tegnall admitted in August that older people in Sweden were worst hit than those in neighbouring countries (Holroyd 2020).

My emphasis on public health systems is not simply about a “funding model”, but about values and systems. I have explained this in several articles and it has relevance for the important debate about the costs of ‘lockdowns’, which are mainly in delayed or denied health care, plus child nutrition and schooling.

So health systems remain at the root of the important debate about ‘costs of the virus vs costs of the lockdown’. A British tabloid story in July, citing an unpublished government report, headlined ‘200,000 deaths’ in Britain from the ‘lockdown’. Most of these were said to be in delayed health care. Those who read through to paragraph 20 might have noticed the same report was said to have predicted 500,000 COVID19 deaths “if the virus had been allowed to run through the population unchecked” (Knapton 2020). Public health matters.

———–

References

Anderson, Tim (2020) ‘Public Health, COVID-19 and Recovery’, AHT, 10 April, online: https://ahtribune.com/world/covid-19/4062-public-health-covid-19-recovery.html

Anderson, Tim (2020) ‘Myths of the Pandemic Deniers’, AHT, 6 August, online: https://ahtribune.com/world/covid-19/4331-pandemic-deniers.html

Anderson, Tim (2020) ‘How the Pandemic Defrocked Hegemonic Neoliberalism’, AHT, 22 may, online: https://ahtribune.com/world/covid-19/4181-pandemic-defrocked-hegemonic-neoliberalism.html  

Anderson, Tim (2020) ‘COVID-19: the Swedish Model’, AHT, 4 October, online: https://ahtribune.com/world/covid-19/4414-swedish-model.html

CDC (2020: 11 Sept) ‘Early Insights from Statistical and Mathematical Modeling of Key Epidemiologic Parameters of COVID-19’, Volume 26, Number 11—November 2020, online: https://wwwnc.cdc.gov/eid/article/26/11/20-1074_article

CDC (2020: 10 Sept) ‘COVID-19 Pandemic Planning Scenarios’, 10 September, online: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

Hauser, A., Counotte, M.J., Margossian, C.C., Konstantinoudis, G., Low, N., Althaus, C.L. and Riou, J. (2020) Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: a modeling study in Hubei, China, and six regions in Europe. PLoS medicine, 17(7), p.e1003189. 28 July, online: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003189

Holroyd, Matthew (2020) ‘Coronavirus: Sweden stands firm over its controversial COVID-19 approach’, 4 August, online: https://www.euronews.com/2020/04/06/coronavirus-sweden-stands-firm-over-its-controversial-covid-19-approach

Ioannidis, John (2020: 17 March) ‘A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data’, 17 March, Stat, online: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

Ioannidis, John P.A. (2020: 14 July) ‘The infection fatality rate of COVID-19 inferred from seroprevalence data’, Medrixiv, online: https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v3.full.pdf

Lee, Stephanie M. (2020) ‘An Elite Group Of Scientists Tried To Warn Trump Against Lockdowns In March’, BuzzFeed, 24 July, online: https://www.buzzfeednews.com/article/stephaniemlee/ioannidis-trump-white-house-coronavirus-lockdowns

Sullum, Jacob (2020: 23 July) ‘There Is More Than One COVID-19 Infection Fatality Rate’, Reason, online: https://reason.com/2020/07/23/there-is-more-than-one-covid-19-infection-fatality-rate/

Sullum, Jacob (2020: 29 September) ‘The Latest CDC Estimates of COVID-19’s Infection Fatality Rate Vary Dramatically With Age’, Reason, 29 September, online: https://reason.com/2020/09/29/the-latest-cdc-estimates-of-covid-19s-infection-fatality-rate-vary-dramatically-with-age/

to be continued …