“Covid 19: We need neither vaccine nor herd immunity”

May 28, 2020

Reblogging this article from https://milindwatve.home.blog/

Both interesting and a refreshing change from the usual.


Covid 19: We need neither vaccine nor herd immunity

Posted on

I had said in an earlier blog article that the SARS Cov-2 virus responsible for the current pandemic is likely to evolve rapidly towards reduced virulence. The reason why I expect this is that on the one hand, almost all countries are implementing strict quarantine measures for all detected positive cases. But on the other hand, we cannot afford to do mass testing, leading to many undetected asymptomatic cases roaming around and spreading the virus. The virus reaches huge populations and also has a high mutation rate, so all possible variants will keep on arising. A virulent strain is most likely to cause severe infection which will invite testing and ultimately quarantine. A mild variant, on the other hand is more likely to lead to asymptomatic or mild symptomatic infections which are more likely to escape screening followed by quarantine and therefore keep on spreading. In several generations of the virus, which is a short time for us, natural selection will favour the mild variants.

While all research on the virus is engaged in developing vaccine, studying pathogenic mechanisms or suggesting treatments, nobody seems to talk about evolution of the virus. This is for two reasons. One is that people in medicine are never trained to think of evolution. The other is that virulence is difficult to quantify. It is easier to sequence the virus, study its proteins, look for antibodies in the host etc. Researchers typically do what is easy to do rather than what is scientifically more relevant. Since one cannot measure a change in virulence easily, nobody will even talk about any hypothesis related to it. This is what I call “evidence bias” in science. If it is difficult to find evidence to either falsify or support a hypothesis, people will avoid talking about the hypothesis because it cannot make a paper. Whether the hypothesis is relevant to public health is not an important issue, whether you can publish a paper is.

But in the epidemiological trend at the global as well as the Indian scene, there are definite signs of reduction in virulence. Although the infection is growing, the death rate is consistently reducing with time. Look at the patterns. From mid-April, although the total number of new cases per day has been increasing, the total reported deaths per day is decreasing.

The same is happening in India too. In fact, the case fatality rate in India was always low and it is decreasing further, although the absolute number of deaths per day has not started decreasing yet.

Data from: https://ourworldindata.org/mortality-risk-covid

I plotted the time trend in the ratio of daily reported positive cases to daily reported deaths starting from the day the new death count exceeded 50. Although there are expected daily chance fluctuations, there is a clear decreasing trend.

Data from https://www.covid19india.org

Now if we make a simplistic assumption that the linear trend continues, then we can come out with a prediction that in India in about 35 days, Covid 19 will remain only as dangerous as any seasonal flu. The assumption of linearity is of course an oversimplification, the slope may not remain the same throughout. The second caveat is that case fatality rate cannot be exactly equated to mortality rate. In a growing epidemic, case fatality rate is an underestimate or mortality. But that need not affect the trend. The estimate of 35 days might be too optimistic. It may take somewhat longer. But the direction is assuring. Anecdotally I heard from some of my clinician friends that the proportion of patients needing critical care is already low.

The vaccine trial and mass production is going to take many months and may not immediately become available or affordable to the masses. For the huge population of India, acquiring herd immunity is a huge task and will not happen for a year or two. But much before either of the two becomes useful for public health, evolution would have taken care of the deadliness of the virus. We need to continue quarantine and good medical care of symptomatic cases, but not be fussy about the asymptomatic ones. Because they are going to be the saviours. Let us wait for a couple of months to see whether the prophecy turns out to be true qualitatively or quantitatively. If it does, it has a long term lesson for medicine. Virulence management strategies should become an integral part of public health planning. This is not the last time that a new virus arises. This will keep on happening. Understanding of evolutionary dynamics is certainly required to manage public health.


 

Guest Posts

April 26, 2020

Going offline for a while.


Update: 

  • I charge no fees for guest posts.
  • I make no payments for guest posts.
  • Third parties seeking to place posts on behalf of others need not reach out.

I check the email for this site (ktwop.info@gmail.com) very irregularly and just found a few mails asking if I would accept guest posts.

In principle, yes.

But

this is my site and I take responsibility for what is “published” here.

Therefore guest posts would be accepted or rejected or edited for publication entirely at my discretion.

The only thing I would not do would be to (intentionally) plagiarize any text that was submitted.

Submissions to the email above. Submission itself will be taken as acceptance of my editing, publication or rejection entirely at my discretion.

No guarantee as to how long I may take to respond.

 


 

Humans are not equal

April 25, 2020

The coronavirus pandemic brings the delusion of human equality into stark relief.

There is a myth that institutions, from the UN to countries and NGO’s, like to propagate. This is the fantasy that humans are born equal and that their lives are of equal value. All across the world we now see that the infection carriers are mainly younger and asymptomatic. The dead are mainly among the old and the weak. Everyone is now seeking “herd immunity”, but a herd is always on the move. Its security lies in leaving behind and sacrificing the old and the infirm to satisfy the predators. The coronavirus is predatory. It is the younger and stronger who can get the economies to start up again. And the old and the infirm are being left behind.

It has happened in Spain and Italy and the UK as well but I take Sweden as an example where the myth that human lives have equal value is particularly strong. It has become exceedingly clear that the lives of those who may place a greater burden on the nationalised health services are worth less than of those who won’t. Almost 90% of all deaths attributed to the coronavirus in Sweden, (actually 87% currently), are of those over 70 years of age. Many of these were because the infection entered the care homes where the elderly were trapped, mainly through asymptomatic care workers. Unions have then blocked care workers from providing care in some infected care homes. Government institutions have even formally promoted the downgrading of the value of the lives of the elderly. The Swedish Board of Health and Welfare (Socialstyrelsen) has explicitly lowered the priority to be given to those with a lower “expected remaining life”. It is not just coincidence that some Stockholm hospitals have rejected some of the elderly from available intensive care places, in case younger patients with a greater chance of survival might have need of them. (Expressen 23rd April)

There is nothing right or wrong with the reality that humans are not equal. Far better to openly accept the reality than hide behind a delusion.


Humans are not born equal, nor do they live equally and they do not die equal.

Humans are born genetically unique. In one estimate by the FBI for identifications in court, the chance of a DNA profile being matched by another person is much less than 1 in 260 billion. All the humans who have ever lived over 200,000 years as “anatomically modern humans” number about 110 billion. No two have ever been genetically alike or have had identical DNA profiles.

Humans are not born “equal” in their genes. The capability envelope – physical, mental and behavioural – for any individual is already set at birth (actually soon after conception). Nurture then determines what an individual can actually achieve within the capability envelope. But, no amount of nurture (nourishment, upbringing, training, learning or experience) can enable an individual to break out of the predetermined envelope of capability. Nurture may have enabled me to run faster than I can, but no amount of nurture would have made it possible for me to run as fast as Usain Bolt.

Humans are not equal either in the nurture they receive. The reality is that all humans are born naked, with no resources, no debts, no liabilities and with only those privileges as may be granted, or liabilities that may be imposed, by the surrounding human society. They are born utterly dependent upon surrounding humans for their survival. Nourishment and upbringing are determined by the far from equal capabilities of parents. Education and learning and experience vary according to the means of the parents and the surrounding society. The vastly varying levels of support they receive from others, at birth and through their upbringing, further emphasizes that they are not equal. They differ in nourishment, upbringing, training, learning and experience. They differ in what they contribute to, or receive from, their surroundings.

Humans do not behave equally. From birth and through their lifetimes, they differ in their actions and behaviour and interactions with others. They differ in the people they interact with. They behave differently from each other, to each other and differently through their lives.

Human lives are not lived equally. The value any creature places on its own life is entirely subjective and not something that can be estimated by others. Presumably this value is at the maximum possible for the individual concerned. The value of any human life within its own society varies with manifested behaviour and over time. The value to its own surrounding society is also a subjective judgement. However, it varies across societies, from one human to the next and over the life of that human. It is neither static nor a constant. The value of an undistinguished human life may be priceless to friends and relatives, but quite low in its immediate society and may approach zero to a distant society. The value of a distinguished life may extend far beyond the boundaries of the local society and long after that life is over. 

And when a human, no matter how distinguished or productive earlier, is committed for life to a care home or a hospice, the reality is that the current value of that human life, to that society, has dwindled to not very much.

Humans are not born equal, nor do they live equally and they do not die equal. 

There is nothing right or wrong with that. It just is. Far better to openly accept the reality than hide behind a delusion.


 

Globalism fail: A global pandemic is having to be handled nation by nation

April 20, 2020

“Globalism” is meaningless sanctimony without nations first taking care of themselves. In this Covid-19 crisis, there is no “globalised” solution and every nation is having to find its own way of handling the problem. There is a great deal of bilateral and even international cooperation, but every nation is then taking its own decisions for its own people. To be truly international, nations must first take care of themselves.

I have been waiting for the UN Security Council to pass a resolution banning the coronavirus. However such a resolution might well attract a veto from China.

The WHO preferred not to listen to warnings from Taiwan because they follow the Chinese line that Taiwan does not exist.

FT: The criticism by the World Medical Association … accusing it of “severely mismanaging and covering up the spread of the coronavirus”. The WMA said the WHO’s failure to heed Taiwan’s early warnings resulted in “errors that led to the world paying a high price” in the 2003 Sars outbreak and the coronavirus pandemic. …. Taiwan has accused the WHO of dismissing its early efforts to raise the red flag that the virus might spread among humans because of the organisation’s pro-China bias. It has been excluded from having “observer status” at the UN body’s annual meeting of decision makers since 2018. 

Shinzo Abe, the Japanese prime minister, was among those to call for an investigation into the WHO once the pandemic was under control. ….. Health officials in Taiwan said they alerted the WHO in late December about the risk of human-to-human transmission of the new virus but said its concerns were not passed on to other countries.

The EU is another organisation which promotes the “globalist” religion (provided the EU is first among equals). The reality is that the EU cannot take care of any member state which cannot take care of itself. The EU has proved itself impotent in time of crisis.

Forbes: Mauro Ferrari, head of the European Union’s top scientific research body, … resigned on Tuesday, effective immediately, citing a “political thunderstorm” in the European Commission in response to his plans to address the pandemic. ….. “I moved that the European Research Council should establish a special program directed at combating COVID-19,” he wrote, but that the plan was outright rejected by the European Commission, ……..
Ferrari said, in a two-page statement, printed in the Financial Times: “I have been extremely disappointed by the European response to COVID-19, for what pertains to the complete absence of coordination of health care policies among member states, the recurrent opposition to cohesive financial support initiatives, the pervasive one-sided border closures, and the marginal scale of synergistic scientific initiatives.”

However, the EU did express solidarity with Italy and Spain but had to apologise for being incapable of providing any help.

Guardian: ….. when Italy pleaded for fellow countries to send it medical equipment such as masks, France and Germany not only failed to respond, they placed export bans (since lifted) on the export of the kit Italian hospitals were crying out for. 

 ….. Another problem for Italy is that ….. it has to pay a higher rate of interest on the money the government borrows than is the case for Germany and, when the hospitals in the cities of Lombardy started to fill up with Covid-19 cases, this gap – or spread – started to widen. It was therefore deeply unhelpful for Christine Lagarde, the president of the ECB, to say that it was not the job of her institution to “close bond spreads”. …….. Last week’s virtual meeting of EU leaders was supposed to come up with a joint approach to the crisis but was instead a complete car crash.

Italy’s prime minister, Giuseppe Conte, said at the weekend: “If Europe does not rise to this unprecedented challenge, the whole European structure loses its raison d’être to the people. We are at a critical point in European history.”

The “Marshall plan” for the EU has been under discussion for over a month but the Commission cannot take their hands out of their pockets for fear of the virus.

Freedom of travel has been suspended in the EU. The EU regulations for reimbursements from airlines for cancelled flights are largely being ignored by EU member countries and their hard-hit airlines.

Of course, following Brexit, the EU has little sympathy to share with the UK.

India and other SE Asian countries have learnt to be very selective in listening to the WHO.


 

Can gorillas find a role in the world?

April 19, 2020

Some 40 million years ago there was a primate which was the common ancestor of all the current great apes. The primates were established first in Africa and Asia and then some found their way, somehow, across the ocean to South and Central America. They were restricted to forest areas and were not to be found in northern climes (Europe, N America, Asia). Great deserts and mountain ranges were a major barrier to their spread. They did not reach Australia even though the body of water to be traversed was shorter than that to S America.

 

Non-human primate range

The appearance of new species of apes was not something that happened across the entire range of the primates. In South and Central America, apes did not evolve. Gibbons and orangutans only appeared in South-East Asia. Gorillas, chimpanzees and the precursors of humans appeared only in Africa.

Knowledge about evolution has exploded in the last century especially now as genetic analysis is getting into its stride. But the common feature with the growth of knowledge is that the questions, too, grow. Why did the ancestors of all apes break away from the parent primate line? What survival advantage led to the gibbons separating from the ancestral ape line to become a separate species? The survival advantages then that caused the speciation of the gorilla ancestors are probably no longer valid now. When a species evolves and a new species appears, the parent species may become extinct, or may well continue down other, separate evolutionary paths. But not all these many paths can be successful. At any given time many of the ongoing evolutionary paths being followed will – and must – be dead-ends leading eventually to the extinction of the dead-end branches. The appearance of every new species must have been because some non-standard individuals, in that place, at that time, exhibited some survival or reproductive advantage over their more “standard” relatives. Clearly the pressures and conditions that caused orangutans and gibbons to appear in SE Asia were not of significance in South and Central America. Neither were the conditions and pressures which caused gorillas and chimpanzees and the species homo to appear in Africa of significance in other parts of the world. Equally the conditions in Africa did not give rise to gibbons or orangutans.

What then were the advantages of being a gorilla – when gorillas evolved – that are now of very little benefit?

The reasons for the splits at A, B, C, D and E are still more a matter of speculation rather than of knowledge.

The current status of a species can only be measured by its numbers. Dinosaurs may once have been of high status and were clearly successful for a long time but – as with every other extinct species – they are all, now, failed species. (Since birds do originate from the dinosaurs then they, at least, represent some very successful current species). If we consider just the surviving ape species (gibbons, orangutans, gorillas, chimpanzees and humans), there is a striking difference in their current status as species.

We have to go back about 40 million years to find a common ancestor. The most striking difference is that which separates humans from all other species – the control of fire. It makes the “fire and cooked meat” theory of human brain development seem very plausible.

Smithsonian Magazine:

Thus, the unprecedented increase in brain size that hominids embarked on around 1.8 million years ago had to be paid for with added calories either taken in or diverted from some other function in the body. Many anthropologists think the key breakthrough was adding meat to the diet. But Wrangham and his Harvard colleague Rachel Carmody think that’s only a part of what was going on in evolution at the time. What matters, they say, is not just how many calories you can put into your mouth, but what happens to the food once it gets there. How much useful energy does it provide, after subtracting the calories spent in chewing, swallowing and digesting? The real breakthrough, they argue, was cooking.

I find watching gorillas (on film) compulsive. When I have seen them in zoos, they are magnificent but deeply tragic figures. They radiate a benign strength which is more than impressive. They are quite intelligent. It is claimed they have an IQ around 40 -50, though applying human IQ tests on them is largely meaningless. Their motor skills develop faster than with human infants and even if some have learned the meaning of some human words, gorillas do not have language. Gorillas are a dying species and, as such, are a failing species. “Conservation” is concerned with the survival and protection of individuals and groups. Though laudable, these efforts only freeze the species within the shrinking habitat they are comfortable with and in the unsuccessful form they have reached.

The gorilla as a species has reached an evolutionary dead-end. I don’t want gorillas to disappear, but to keep them in their frozen, unsuccessful, evolutionary state in zoos or reserves or protected habitats does not seem right either. The conservation practiced today, which makes no provision for the further development of a species, is both unethical and immoral. Other species which adapt and find a role to play in the world of today are not threatened. It is not necessary for a species to find that role within human society as livestock and household pets do. But the survival of livestock and pets is as slaves to humans. Birds and insects remain free of human control but have adapted to varying degrees and continue together with humans. Fish and sea-creatures don’t compete for habitat with humans but do constitute prey. Foxes and rodents and even urban leopards are adapting to continue in freedom and in parallel with humans. It is more difficult for primates. The challenge is to find a way for a species to develop and move forward in the reality of a world dominated by humans. When conservation denies reality and merely tries to go back to some scenario from the past it does no service to any species.

How then can we find a free and meaningful, role for gorillas (or tigers) in a world dominated by humans but which is not an evolutionary cul-de-sac?


 

Has the world overreacted?

April 17, 2020

As countries now begin to, or plan to, relax their lockdowns and struggle to restart their economies, I have a niggling suspicion at the back of my brain that the world reaction may have involved more of panic and less of rationality. That the world may have overreacted in a fearful chain reaction may be understandable but was the chosen solution actually worse than the problem?

” ….. the spread of COVID-19 peaks after about 40 days and declines to almost zero after 70 days — no matter where it strikes, and no matter what measures governments impose to try to thwart it”.

This is from Prof Isaac Ben-Israel, head of the Security Studies program in Tel Aviv University, Chairman of the National Council for Research and Development and Head of Israel’s Space Agency.

A case perhaps of a kind of Mass hysteria?

A prominent Israeli mathematician, analyst and former general claims simple statistical analysis demonstrates that the spread of COVID-19 peaks after about 40 days and declines to almost zero after 70 days — no matter where it strikes, and no matter what measures governments impose to try to thwart it.

Prof Isaac Ben-Israel, head of the Security Studies program in Tel Aviv University and the chairman of the National Council for Research and Development, told Israel’s Channel 12 (Hebrew) Monday night that research he conducted with a fellow professor, analyzing the growth and decline of new cases in countries around the world, showed repeatedly that “there’s a set pattern” and “the numbers speak for themselves.”

……..

Asked to explain the phenomenon, Ben-Israel, who also heads Israel’s Space Agency, later said: “I have no explanation. There are all kinds of speculations. Maybe it’s related to climate, or the virus has a life-span of its own.” He said the policy of lockdowns and closures was a case of “mass hysteria.” Simple social distancing would be sufficient, he said. If the lockdowns instituted in Israel and elsewhere were not causing such immense economic havoc, there wouldn’t be a problem with them, he said. “But you shouldn’t be closing down the entire country when most of the population is not at high risk.”

Asked to explain why the virus had caused such a high death toll in countries such as Italy, he said the Italian health service was already overwhelmed. “It collapsed in 2017 because of the flu,” he said.


 

4042

April 16, 2020

404.2 posts / year which means I am still ahead of my one post per day target.

 


 

Have you noticed?

April 15, 2020

Fear and alarm affects the brain and stops people from thinking.

I don’t find sanctimonious platitudes very attractive.

 


 

Fatality League: Without the 70+ deaths, Sweden would be doing very well

April 14, 2020

The pandemic is far from over, but as some countries contemplate or begin to relax their lockdowns, it is not too early to begin to look at some of the emerging data.

With its 10.1 million population Sweden has suffered over 1,000 deaths due to Covid-19. In the fatality league (deaths/million of population), Sweden has by far the worst numbers in Scandinavia and lies among the worst 10 globally (and in Europe) as of 14th April 2020. (Countries with fewer than 100 deaths are not included). Almost 90% of the fatalities in Sweden are of those over 70. Without these included, Sweden would have a fatality rate just one tenth of that observed.

I merely observe that in a mathematical model which gives little value to the lives of those over 70, Sweden would be doing very well indeed.

The questions are accumulating but any attempt at answers will have to wait at least a year.

Death League (as of 14th April 2020)

Some of the questions that will have to be addressed in Sweden at some time are:

  • Most countries have used “worst case” models (which are always ridiculously alarmist) but Sweden has used, it seems, “best case” models. Why?
  • Do the mathematical models give a lower “value” to the lives of the 70+?
  • Policy has been to restrict the movement of those over 70 to reduce load on the health service in case they are infected. However the infection carriers are the young and the mobile. Has the policy led to more of the 70+ being infected or less?
  • How much of the spread of infection was initiated/due to returning, asymptomatic tourists from the Alps who were neither tested nor quarantined?
  • Almost 90% of the dead in Sweden are 70+. Was this modeled at all?
  • How many of the 70+ were “prisoners” to infection in their care homes?
  • Was the main source of infection in the care homes through infected but asymptomatic staff?
  • Sweden has more than doubled Intensive Care Places in the last month. By establishing “priorities” for intensive care, Sweden has succeeded in ensuring that they have not been full to the limit. How many of the 70+ were denied Intensive Care due to the “priorities” established by the Social Welfare Board? (Priority is based on “expected life remaining”).
  • Was it optimal that unlike in other countries, leadership was abdicated by politicians in favour of the officials of the National Health Board.
  • …….
  • ….

 

 

In Sweden, coronavirus deaths are almost invisible among average daily deaths

April 12, 2020

In response to great demand Sweden’s Statistics Central Bureau (SCB) has published daily deaths (all causes) data for 2015 – 2020.

For the month of March 2020, the daily total deaths do not appear much different than the average for 2015-2019. The average daily death toll is about 250 (+/- 30). The coronavirus has been responsible (so far) for about 30 fatalities per day but there is some probable offset due to reduction of deaths from some other causes. During March there is no visible spike in total daily deaths that can be attributed to the coronavirus.

Daily Deaths March 2020 compared to average 2015-2019

We can never know what it would have been without a lockdown. What is visible during March is that with the voluntary lockdown in place, fatalities by all causes have not increased significantly.

In a few months, when the outbreak has been brought under control, I will not be surprised if we will be asking if the level of economic disruption was worth it.


 


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