Archive for the ‘Health’ Category

All the Chinese viruses from the Spanish flu to the Wuhan coronavirus

July 10, 2020

This is the Wuhan virus and it did come from China. 

Trying to be politically correct is more misleading and probably the cause of more disinformation and self-delusion than any other. Political correctness applied to the scientific process is particularly destructive and gives us the burgeoning levels of fake science. Results are determined before the investigations have begun. For the WHO it is servility to Chinese interests which has prevented the Wuhan coronavirus from being named the Wuhan virus.

It now seems highly probable that even the Spanish flu of 1918 originated from China.

National Geographic:

 The deadly “Spanish flu” claimed more lives than World War I, which ended the same year the pandemic struck. Now, new research is placing the flu’s emergence in a forgotten episode of World War I: the shipment of Chinese laborers across Canada in sealed train cars.

Historian Mark Humphries of Canada’s Memorial University of Newfoundland says that newly unearthed records confirm that one of the side stories of the war—the mobilization of 96,000 Chinese laborers to work behind the British and French lines on World War I’s Western Front—may have been the source of the pandemic. …..

…. The 1918 flu pandemic struck in three waves across the globe, starting in the spring of that year, and is tied to a strain of H1N1 influenza ancestral to ones still virulent today.

There is little doubt that the current pandemic originated from Wuhan though, every so often, some journalist or “scientist” who is part of the China lobby will cast doubt on that. 

RealClearScience:

The Asian Flu in 1956 killed between one and four million people worldwide. SARS in 2002 infected 8,098 and killed 774 in seventeen counties. H7N9 emerged ten years later to strike at least 1,223 people and kill four out of every ten of them. Now, the milder, yet more infectious COVID-19 has sickened more than 70,000 across the globe, resulting in 1,771 deaths.
All of these outbreaks originated in China, but why? Why is China such a hotspot for novel diseases?

“It’s not a big mystery why this is happening… lots of concentrated population, with intimate contact with lots of species of animals that are potential reservoirs, and they don’t have great hygiene required. It’s a recipe for spitting out these kinds of viruses,” Dr. Steven Novella recently opined on an episode of the Skeptics’ Guide to the Universe.

South Central China is a noted “mixing vessel” for viruses, Dr. Peter Daszak, President of EcoHealth Alliance, told PBS in 2016. There’s lots of livestock farming, particularly poultry and pigs, with limited sanitation and lax oversight. Farmers often bring their livestock to “wet markets” where they can come into contact with all sorts of exotic animals. The various birds, mammals, and reptiles host viruses that can jump species and rapidly mutate, even potentially infecting humans. Experts are pretty sure this is precisely what happened with the current COVID-19 coronavirus, which is why, on January 30th, China issued a temporary ban on the trade of wild animals. ………

….. China is also notorious for its misinformation, secrecy, and censorship, which raises the chances that new diseases will fester and spread. Back in early January, Chinese government officials told the public that the new infection’s spread had been effectively halted. This was not true. At the same time, the authoritarian regime bullied health experts who attempted to sound alarm. The young doctor Li Wenliang attempted to warn others about the new coronavirus. He was ‘rewarded’ with a threatening reprimand by police. Li subsequently caught COVID-19 and succumbed to the disease the first week of February.

It may be called the Covid-19 virus but it is the Wuhan coronavirus pandemic


 

The great success and the great betrayal of the Swedish coronavirus strategy

July 3, 2020

The Swedish lockdown has been more voluntary than enforced. The over 70’s were told to quarantine themselves to protect the health system. Since the compliance with the voluntary social distancing requirements has been quite high, the spread of infection has not been much worse than in many countries enforcing very strict lockdowns. In total number of deaths due to the Chinese virus, Sweden sticks out among its Scandinavian neighbors who enforced much stricter lockdowns. But Sweden is not an outlier among other European countries. Economically, Sweden will probably be among the countries which recover fastest.

The Swedish strategy has been both a great success and a great failure. The numbers tell the tale.

source: worldometers

There is no right or wrong to the various strategies applied by different countries. Decisions have probably been made in good faith though these have been dominated by the culture of fear and risk aversion that permeates the world today. The fear of alarmist, imaginary crises has meant the world was totally unprepared for a real crisis. The impotence of a politicized WHO and the duplicity of a terrified Chinese bureaucracy has not helped. The stupidity of relying on imperfect and alarmist mathematical models was very evident.

But diving into the Swedish statistics also shows great successes among some very great betrayals.

Only 10% of the deaths have been of those under 70. Based on the National Board of Health and Welfare (Socialstyrelsen) criterion of “expected remaining life”, the loss of expected remaining life has been kept to a minimum. The 90% of deaths of those above 70 do not contribute much to “expected remaining life”. Among the “productive” population the loss of life has been kept down to about 50/million of population. That is the great success. 

Also among the successes have been:

  • intensive care places were more than doubled in a very short time
  • intensive care places were never overwhelmed
  • restarting the economy is well under way, and
  • herd immunity may not yet have been achieved but the risk of infection to the general population under 70 is greatly reduced. (Effectively, Swedish policy excludes the +70s from the herd).

But the cost has been the betrayal of the elderly. The unvoiced, undercurrent of opinion is that “but they were going to die soon anyway”. Care homes became virtual prisons for their inmates. Following the Socialstyrelsen’s publishing of their criteria for prioritizing lives based on “expected remaining life”, there were cases of those infected in care homes being denied oxygen and respirators. There have been cases where they have been put directly onto palliative care (sometimes a euphemism for a self-fulfilling, end-of-life care). The Swedish government through up its hands and abdicated its responsibilities to the bureaucracy of the Public Health Agency (Folkhälsomyndigheten) and of the National Board of Health and Welfare (Socialstyrelsen). The Public Health Agency were, I think the heroes, at least for honesty and fidelity and for stepping-up, if not always for compassion. The Health Services were also among the heroes. The bureaucrats of the Socialstyrelsen were hypocritical, mealy-mouthed and less than impressive. The reality, which is the opposite of what they often voiced, is that the elderly are second, or even third, class citizens in Sweden. The Swedish herd has protected itself by excluding the elderly from the herd.

I am over 70 and may be a trifle biased. But the villains of this pandemic internationally are the Chinese bureaucracy, the Alarmist Brigade and the WHO. Within Sweden, the villains are the government and the National Board of Health and Welfare (Socialstyrelsen).

And even if herd immunity is achieved, the over 70’s will remain at great risk until such time as a vaccine is developed. Every herd protects itself by sacrificing the weak and the sick. And the old.


 

“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.


 

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.


 

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.


 

Daily death curves

April 12, 2020

The Worldometers website is the most comprehensive and up-to-date site I have found. I believe the global data they display is about as good as can be for any public database. The John Hopkins dashboard is a lot slower and not as user friendly. I find the WHO site is not as useful as the Worldometers site.

Worldometers:

We collect and process data around the clock, 24 hours a day, 7 days a week. Multiple updates per minute are performed on average by our team of analysts and researchers who validate the data from an ever-growing list of over 5,000 sources under the constant solicitation of users who alert us as soon as an official announcement is made anywhere around the world.

Sources and Methods

Our sources include Official Websites of Ministries of Health or other Government Institutions and Government authorities’ social media accounts. Because national aggregates often lag behind the regional and local health departments’ data, an important part of our work consists in monitoring thousands of daily reports released by local authorities. Our multilingual team also monitors press briefings’ live streams throughout the day. Occasionally, we can use a selection of leading and trusted news wires with a proven history of accuracy in communicating the data reported by Governments in live press conferences before it is published on the Official Websites.

I think daily death curves for each country are a better guide to the state of the pandemic than the number of infections (which are contingent on the testing policy being followed).

In the progression of the coronavirus, it would seem that Italy lies about 9 days before Spain, 13 days before the UK and 17 days before the US.


 

India has learnt not to rely on the WHO

April 10, 2020

The WHO leadership is complicit in the suppression of news about the coronavirus. Its guilt will be judged by history. It was warned by Taiwan in December but could not pay attention to anything that might upset China. But it is not always wise even with its advice.

India has learnt over the years to sidestep the WHO when necessary.

So far India has reported just over 7,000 cases with 229 deaths attributed to covid-19 (10th April, 2020). With a population of over 1.3 billion the fatality rate at present is 0.18 per million of population. It is very early days to be sure but, so far, the fatality rate is long from what was, and still is, feared.

As the Indian Express reports:

… when it comes to key aspects of COVID management, the government has politely sidestepped the periodic “advice” from the WHO and, instead, leaned on the Indian Council of Medical Research (ICMR) and the experience of several state governments — from Kerala and Uttar Pradesh to Rajasthan and Maharashtra. …

Most recently, on April 3, the government’s advisory on the use of masks while stepping out of the house was at variance with that of the WHO, which said this should be only for those who are symptomatic, health workers, or caregivers to COVID patients.

That’s not the only point where the government veered off the WHO track.

  • On January 30, WHO Director General Tedros Adhanom Ghebreyesus said that WHO did not recommend travel restrictions to China — in fact, it was opposed to such an idea. This despite the fact that the same day, the WHO’s International Health Regulations Emergency Committee raised a global alert on the need for containment, surveillance, detection, isolation, and even contact tracing. By this time, India’s first advisory on avoiding non-essential travel to China dated January 25, was already in place.
  • Three days after the WHO statement, India advised citizens to refrain from travel to China, a step up from its earlier advisory.
  • On March 16, Ghebreyesus said that the WHO’s key message is “test test test”. On March 22, ICMR head Dr Balram Bhargava said: “There will be no indiscriminate testing. Isolation, Isolation, isolation.”
  • Hours later, India went into lockdown, starting with 75 districts and then, from midnight of March 24, the whole country. The decision was based on a paper by ICMR that quarantine is a more effective way of containing the virus than even airport screening.
  • The day after the lockdown began, WHO executive director Mike Ryan said: “Without implementing the necessary measures, without putting in place those protections, it’s going to be very difficult for the country to exit (the lockdown). And when they do, they have a resurgence and I think that’s the challenge now.”
  • WHO’s clinical care guidelines clearly lay down that there is “no current evidence to recommend any specific anti-COVID-19 treatment for patients”. India, nevertheless, first included two of its undertrial antivirals — lopinavir and ritonavir — in its clinical care guidelines for patients of the novel coronavirus disease, and then revised the management guidelines to replace the antivirals with a combination of hydroxychloroquine and the antibiotic azithromycin.

All the coronavirus solutions are going to be national, not global, solutions and I am quite sure that countries with effective measures will quickly inform other countries directly. They will not rely on a pampered and ineffective WHO leadership to do that.

Mumbai lockdown 9th April 2020

India has removed the ban on exports of hydroxylchloroquine to selected countries on humanitarian grounds and has sent supplies to, at least, USA, Israel, Brazil, Sri Lanka and a few others.


 

Whether for Haiti cholera, Ebola or the coronavirus, the WHO leadership failed

April 9, 2020

The WHO has many skilled, dedicated and hard working staff.

But the WHO leadership and the organisation are not fit for purpose.

After the Haiti earthquake it was poorly screened UN troops who took cholera into Haiti in 2010. But the UN and the WHO leadership were more concerned with appearing politically correct and with CYA than anything else.

NY Times (Dec 2016):

After six years and 10,000 deaths, the United Nations issued a carefully worded public apology on Thursday for its role in the 2010 cholera outbreak in Haiti and the widespread suffering it has caused since then.

The mea culpa, which Secretary General Ban Ki-moon delivered before the General Assembly, avoided any mention of who brought cholera to Haiti, even though the disease was not present in the country until United Nations peacekeepers arrived from Nepal, where an outbreak was underway. ……

One of the reasons the disease spread so widely, public health experts have said, is because it was allowed to; had there been a vigorous response in the first couple of years, it would have been far easier to contain, and fewer people would have died. The death toll stands at an estimated 10,000; some say it could be higher. ………

The WHO knew about the outbreak and the causes but was incapable of taking any actions which might have political implications.

The WHO was even worse with their “egregious failure” after the Ebola outbreak of 2013.

Reuters (Nov 2015):

The World Health Organization’s failure to sound the alarm until months into West Africa’s Ebola outbreak was an “egregious failure” which added to the enormous suffering and death toll, ……

The Ebola epidemic has killed at least 11,300 people in Guinea, Sierra Leone and Liberia since it began in December 2013. The crisis brought already weak health services to their knees and caused social and economic havoc.

“The most egregious failure was by WHO in the delay in sounding the alarm,” said Ashish K. Jha, HGHI’s director and a leading member of the panel. “People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring, and yet it took until August to declare a public health emergency.” …..

And now with the coronavirus outbreak, the WHO leadership has failed again. Instead of preparing for a pandemic it has wasted time on the imaginary threats of climate change, on placating China and playing nice with celebrities.

There are three charges against WHO. First, it failed to prepare the world for a pandemic, spending the years since the Sars and ebola alarms talking more about climate change, obesity and tobacco, while others, including the Wellcome Trust and the Gates foundation, actually set up a coalition for epidemic preparedness innovation, and countries like Singapore and South Korea put in place measures to cope with an outbreak like SARS in the future.

Second, once the epidemic began in China, WHO downplayed its significance, tweeting as late as January 14 that “preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus”, when it had already been warned by the Taiwanese health authorities among others of strong evidence for medical staff in Wuhan becoming ill.

The Chinese government at this stage had known for weeks that the virus was spreading, probably person to person, yet WHO then sycophantically praised the Chinese government. “China is actually setting a new standard for outbreak response,” said WHO’s director-general, Tedros Adhanom Ghebreyesus, a former foreign minister of Ethiopia, a country run by a repressive regime heavily dependent on China. “China is really good at keeping people alive,” echoed the assistant director-general, Bruce Aylward, on 3 March.

On 29 March, a Hong Kong-based journalist asked Aylward to comment on Taiwan’s highly-successful efforts to defeat the virus. At first Aylward ignored the question, claiming not to have heard it. When the journalist offered to repeat it, strangely he said no, he would rather move on to another question. When she pressed, the call was mysteriously cut off. When the journalist called back and asked the question again, he answered a different question, talking about China, rather than Taiwan. The background here is that China is a big funder of WHO and insists that Taiwan be excluded from the organisation since it does not recognise Taiwan’s existence as a separate country. Taiwan banned travel from China very early in the pandemic.

The third charge against WHO is that it has failed before. When the ebola outbreak in West Africa that was to kill 11,000 people began in late 2013, on its own admission WHO hindered the fight against the virus, obsessed with not letting others find out what was happening. In April 2014, the charity Medecins Sans Frontieres announced that the outbreak was out of control. They were promptly slapped down by a WHO spokesman. Others tried again in June to alert WHO. It was not until August that WHO admitted the gravity of the situation.

Later WHO admitted its “initial response was slow and insufficient, we were not aggressive in alerting the world, our surge capacity was limited, we did not work effectively in coordination with other partners, there were shortcomings in risk communication.”

All of which is true again today.

The first case was in November 2019. By December the Chinese authorities knew but were suppressing the news. By end December Taiwan and others had warned the WHO about the outbreak. The pandemic was declared on 12th March 2020. The WHO will not live down this now infamous tweet on January 14th.

The Japanese Deputy Prime Minister recently suggested that the WHO change its name to the China Health Organisation.

The WHO suppresses information, and releases cherry-picked information, to suit what its leadership considers politically correct. Multilateral organisations such as the WHO (and even those of the UN and the EU) do not necessarily level up. They all too often sink to the lowest common level set by what is often compounded among the  worst members.

What is striking is that the global problem of the coronovirus has to find national – not globalised – solutions.


 

Swedish coronavirus policy least successful of the Nordic countries

April 8, 2020

Much as I admire Anders Tegnell (Sweden’s Chief epidemiologist) he appeared, at today’s press conference, to be brushing aside the differences between the Nordic countries a little too lightly. I am sure the health services have done a fantastic job. But, for whatever the reason, Sweden’s policy has so far resulted in many more fatalities (actual and per capita) than in the surrounding Nordic countries. The fatality rate is almost twice that of the next nearest Nordic country (Denmark). There is most likely a lapse of policy, rather than lack of equipment or failure of care, which lies behind this reality.

The reason is probably not unconnected with the overwhelming representation of the over-70’s (88% of all deaths in Sweden) among the fatalities.  (They are not particularly over-represented in the number of cases registered). It seems as if many of these older people were a “captive and doomed” population, stuck helplessly within their care homes – not protected in time from infection by the developing policy.

 


Note for reference:

In the Nordic countries the crude mortality rate (all causes) is between 7,000  and 8,000 per million of population every year. Sweden would normally see about 70,000 -80,000 deaths every year (all causes) compared to the 687 attributed so far to covid-19.

In Italy with a population of 60 million, there would be about 450,000 deaths due to all causes every year. The deaths attributed to covid-19 are currently about 17,500.


 


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