Part 1: Sometimes the problem is the way we look at the problem…

The Coronavirus (COVID-19) has certainly taken centre stage in the lives of everybody living on this planet unlike anything since the Second World War. In fact, this virus, and the subsequent media and political response to it, has directly affected more lives than the War did. In a period of only 3 months the world suddenly finds itself in a self-imposed economic crisis, with billions in isolation at home, and many families without income and uncertain about their futures. Most of us still find it difficult to comprehend how the world we knew could have changed so much, so fast. Almost as if it’s unreal…

Borrowing from a brilliant article Alan Cohen wrote years ago, Whose Pictures Are You Taking Home?, I’d like to share a classic story he tells of a man who went to visit a friend in his country home. “In the middle of the night, the man got up to go to the bathroom and found a huge deadly snake coiled up on the floor, ready to strike him. The next morning the host awoke to find his guest dead on the floor, lying next to a coiled up piece of large rope. The fellow died not of a snakebite, but of fright. He was just as dead as if the snake had been real. His murderer was not a snake; it was his own mind.” In the article, Alan goes on to define the word “FEAR” as an acronym for “False Evidence Appearing Real.”

In no way would I like to deny the existence of a real Coronavirus, or that some people die from it. I am well aware of the fact that at the moment of writing this article 197,355 deaths worldwide have been related to COVID-19 infection. I would however like to share with you a different perspective than what has been painted in mainstream media, based on facts, critical reasoning, and holistic principles of health. I’d like to show you how the coverage on this virus outbreak has been flawed with inaccurate reporting, faulty interpretation of data, and good old fearmongering. And that the reality we are experiencing now, might be a product of what we have chosen to focus on.

Young Woman or Old Lady?

I believe there is a certain spiritual law at work here: the more attention you give to any picture of reality, the more real it becomes to you. In discussing the power of a paradigm shift in his famous book “7 Habits of Highly Effective People”, Steven Covey uses the classic image of the young/old woman. Our individual perceptions of the image will lead to very distinct attitudes and behaviours towards this woman. Covey goes on to say that we all tend to think we see things as they are, that we are ‘objective’. “But this is not the case. We see the world not as it is, but as we are – or, as we are conditioned to see it.”

Never in the history of mankind has there been more powerful tools to condition our perceptions than right now. Through technological advances in visual media, globalization and the world wide web, news from all corners of the world are delivered to billions at the touch of a button. And over the last decade or so, most have slowly been drawn into relying on some or all of the platforms of media for daily ‘entertainment’. Like any other system, there is a machinery of commerce driving the production and delivery of information (the fuel on which this system runs). And like any other system, this one is also corruptible.

In this brilliant cartoon video by Noam Chomsky, he sheds light on the inner working of the modern media machine. To summarize its content: “press-freedom” no longer exists. In order for big media corporations to increase profits, they sell whatever meets that need. The possibility that the media will publish any report or manipulate data in a way that supports the story of a possible looming disaster, especially if that narrative comes from the global elite who owns the big media companies, should not surprise us. I’ll share more about the powerful elite and their agenda in part 2 of this paper. For the moment, hold onto the concept of “manufactured content” as we look at the facts about COVID-19.

Sometimes the problem is the way we look at the problem. Of vital importance to a debate about this virus (or any other viral outbreak) is to clarify the statistical markers that has been used to track and present its threat. On everyone’s lips over the last 2 months has been the “number of cases” in each country. Majority of media reports lead with statistics on the number of “cases”, but omit to say it is the number of confirmed cases they speak about, not the total number of people infected with the virus. The total number of COVID-19 infections are unknown to us, due to a number of reasons:

  • In most countries only those who show severe symptoms are being tested. The “number of cases” is therefore a direct product of the laboratory confirmed testing capacity in that country/area: the more tests, the higher the number of confirmed cases will be. This is an extremely important point, as I’ll explain soon.
  • Many who contract the virus show no symptoms and overcome it due to a healthy immune system.* So even if more tests become available, most who are asymptomatic will not seek out testing. Only once antibody testing has been made available and implemented on a large scale, will we be able to know how many people have been exposed to the virus, and be able to estimate total numbers of infection. Until that time, the “number of cases” as loudly proclaimed by the media on an hourly basis, is of no more value than to add drama.

*A study in Iceland, a small island nation of 360,000 inhabitants, discovered that around 50% of people testing positive for COVID-19, had no symptoms. In Vò, a town of 3,000 inhabitants near Venice in Italy, all residents were tested. The results showed that of those who were virus-infected, 50-70% were asymptomatic (did not have symptoms). Both these studies are in-line with data from the Diamond Princess cruise ship, which was eventually quarantined on February 3rd and became a floating laboratory. All 3,711 passengers were tested, of which 17% (644) were infected with COVID-19. Of these 644 passengers, 328 had no symptoms. This equates to 50,93%.

The Diamond Princess

Also important to note is that the “death rate” as often used in the media, is not the same as the risk of dying for an infected person. To truly calculate the risk of dying for someone infected with COVID-19, we need to capture the infection fatality rate (IFR). The IFR is the number of deaths from a disease divided by the total number of cases, which at this point has not been establish (as demonstrated above). The only two valid mortality rates we can calculate at this stage are the “case fatality rate” (CFR), and the “crude mortality rate” (CMR). As the number of Corona tests increase, and therefore the number of confirmed cases increase, the CFR will automatically be lower. For example:

If 10 people died out a 100 confirmed cases, the CFR = 0.1 (10%). If a 1000 people are tested as confirmed cases, of which 10 died, the CFR = 0.01 (1%). Since many who are infected with the virus are not tested, the CFR will always overestimate the true risk of death, and is therefore of no scientific value.

In regards to testing it’s also important to mention that no test is 100% accurate in it’s sensitivity (percentage of people that test positive and have the index condition) or it’s specificity (percentage of people who are healthy and tests negative) – not even close. One study found the sensitivity of the PCR test to be 71%. Others found it to be closer to 50%. Some research suggest the specificity rate could exceed 30%, meaning they produce false negatives – indicating people are OK when they’re actually infected. Another reason to believe that the actual number of infected is higher.

Sensitivity and specificity are the starting points as they characterize the performance of a test. To accurately calculate the reliability of a test, one also needs the positive predictive value (PPV) and the negative predictive value (NPV), together with prevalence, health and age risk factors, presentation of symptoms, ext. Truth is, because tests were developed and approved in such a hurry, there is a general sense of uncertainty about its accuracy. Because of this, some people get tested more than once to be sure, which means the number of tests done, exceeds the number of people tested, which further causes an underestimation of the true number of infections.

Red for positive test outcomes, Green for negative test outcomes.
Posterior probability = after the test said something, what is the probability that this result is correct = NPV for negative test result, PPV for positive test result.

While anti-body (serum tests) are not being conducted in most countries yet, the “crude mortality rate” (CMR) is actually the only reliable risk factor we can calculate on a global level, as all required values are known. The CMR measures the probability that any individual in the population will die from the coronavirus. For example, to calculate the CMR of COVID-19 for South Africa based on today’s data, we divide the number of deaths (79) by the total population (59 000 000) = 0.0001338983%. Sadly, most people confuse the CFR for the CMR…

For more on accurate data interpretation and terminology definitions visit: https://ourworldindata.org/coronavirus#what-do-we-know-about-the-risk-of-dying-from-covid-19

Now that we’ve established solid ground regarding the interpretation of available data on the spread of COVID-19, we can make the following reasonable assumptions:

  • Based on at least 3 studies (Iceland, Vò and the Diamond Princess), roughly 50% of the population in any given part of the western world who are infected with COVID-19, will not show any symptoms. Given that only those who show symptoms for the virus are being tested, it would be reasonable to estimate that the true ‘number of cases’ is at least 50% higher than what is currently implied. Which means the Infection Fatality Rate (IFR) is much lower than proposed. The suggested Corona “death rate” in Italy for example, as reported by journalists during March “to work out to a mortality rate of roughly 10%” (example from CBS News), was void of any scientific/statistical grounds!
  • A recent anti-body study was done by Professor Hendrick Streeck, German professor and director of the Institute of Virology and HIV Research at the University of Bonn, in Gangelt (dubbed “Germany’s Wuhan”). The study showed 15 percent of the population had antibodies as a result of contracting coronavirus, and the death rate was 0.37% (44 deaths). Unlike all the other COVID-19 stats based on guesswork, this is a reliable scientific risk factor, as it’s based on a real IFR. This is in-line with best practice studies in countries like South Korea, Iceland and Denmark, which shows an overall lethality of Covid-19 to be between 0.1% and 0.4%.
  • When comparing the CFR between different countries, the differences do not only reflect rates of mortality, but also differences in the scale of testing efforts. For example, the fact that the USA has the highest number of 925,758 confirmed cases, speaks louder of their ability and infrastructures to implement more tests than any other country (5,037,473). Although there has been outcries from within the USA about a lack of available testing, this really is a matter of perspective. In the first week of April, the State of New York have tested 321,000 people. Around the same time, South Africa has conducted a total of 50,000 COVID-19 tests among their population of more than 3 times the size of New York State.
  • Comparing the CMR gives one a much clearer picture when comparing the impact of coronavirus from county to country. Using the USA as an example again: the number of 52,217 deaths divided by the total population of the USA gives us a CMR rate of 0.0159%. Compare this to the CMR of Spain (0.048%) and Italy (0.043%), and it paints a very different picture. Repeated claims by the media that the USA has the highest Corona ‘death rate’ in the world is therefore nothing else than fearmongering. With a population of 328,2 million (more than 1.6 times that of Western Europe) it makes perfect sense for the number of deaths in the USA to be higher than any country in Europe.
  • With 79 recorded COVID-19 related deaths in South Africa up to date, the virus hardly qualifies as a pandemic when compared to the established mortality rate of the Flu of 11,000 per year. “We should be more concerned about the flu because every year, in South Africa alone, it kills more than 11 000 people”, said Professor Wolfgang Prieser, Head of the Division of Medical Virology at the University of Stellenbosch.
  • According to new estimates by the United States Centers for Disease Control and Prevention (US-CDC), the World Health Organisation and global health partners, up to 650,000 deaths annually are associated with respiratory diseases from seasonal influenza. Yet, in recent weeks the director of the WHO, Tedros Adhanom Ghebreyesus, stated: “The mortality rate of COVID-19 is estimated to be 10 times higher than influenza”. Based on all the legitimate statistics that are available on COVID-19 (as discussed above), this is a completely irrational and untruthful statement! When the director of the international authority on health, with access to a team of educated scientist, makes unfounded public statements like this, it begs the question of planned deceit…

The second questionable theme in our discussion has to do with possibly the biggest reason for the drastic steps of implementing national lock-downs worldwide during March, in response to the potential threat of the coronavirus: that which happened in Italy. The images of the tragedy and chaos of overrun hospitals and overwhelmed medical staff that were shown all over the world, caused shock and paranoia. Without taking the time to investigate the possible contributing factors that led to Italy showing a ‘mortality rate’ 10 x higher than any other country, its example was immediately postulated as the reference point in all conversations about the threat of the coronavirus. This does of course break all the rules of scientific statistical analysis, again.

Before we look at concrete factors which contributed to the unfolding events in Italy, just the following: The extreme COVID-19 numbers from Italy qualifies it as what’s referred to in statistics as an ‘outlier’ – an observation point so far from other observations, that it is regarded as the result of variability in measurement or error in the collection of data. Outliers are for this reason often excluded from a data set, capped, or at least assigned a new value. To use an outlier as the mean, would mean the end of your career as statistician or mathematician.

There are a number of substantial reasons why the coronavirus in Italy appeared much more like a true pandemic within the first 6 weeks of it’s spread:

  • Firstly, 55.8% (12,946 as on 23 April) of the COVID-19 related deaths in Italy, was recorded in the northern province of Lombardy, covering an area of 23,844 km². This is smaller than the tiny country of Lesotho (30,355 km²), which is nestled in the middle of the Republic of South Africa.
  • More interesting facts about Lombardy is that it is the leading industrial region of Italy, and notorious for its pollution. A study published in October 1997 looking at the correlation found between high lung cancer mortality rates and Radon poisoning in Lombardy, states the following: “The death rates in the male population (age range: 35-64 years) in northern Italy average 100 events/100,000 inhabitants, but several local health centres in Lombardy at the foot of the Alpine range, north of the Po River, have mortality rates more than 50% higher than estimated rates.”
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  • The above, coupled with the demographical fact that Italy has the second oldest population in the world, gives you a very high concentration of high risk patients. A study in the Journal of the American Medical Association found that 87% of corona related deaths in this country have been in patients older than age 70. A study by The Istituto Superiore di Sanità, Italy’s national health authority, says the median age of those who’ve died was 81.
  • Then possibly the most important piece of information I can share with you regarding Italy’s COVID-19 data, is that their death rate may further appear higher because of the way doctors record fatalities. “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus”, says Professor Walter Ricciardi, the scientific adviser to Roberto Speranza, Italy’s minister of health. “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he says.
  • Lastly, let us not forget the southern European double-cheek kiss which is very common in Italian culture. This practice would certainly have helped along the spreading of the virus, and might be related to the higher rates of Corona deaths seen in Spain as well.

So to summarize, you have small provincial towns with a high number of the elderly, majority of whom lived in this air-polluted region most of their lives, and therefore already have seriously compromised total lung capacity. Add to that a winter season with a virus that primarily attacks the pulmonary system, and easily transmits among communities for whom showing physical affection is central to their culture, and you get what you got: small town hospitals overrun with immune-compromised patients of whom 88% already have at least one pre-morbidity. Hardly an average scenario for the rest of the world to base their reaction plan on.

I believe it’s important to also expand on the issue of inconsistency on how coronavirus deaths are recorded in different countries around the world. By far the vast majority of deaths has been among those with one or more pre-existing diseases (99% according to the Italian National Institute of Health). When co-morbidities are present, ascribing an exact cause of death (COD) is often difficult, even more so in areas/countries where medical staff are highly burdened. Some countries are recording only the deaths they can ascribe with certainty to coronavirus, which in the presence of co-morbidities requires a post-mortem. Others are recording COVID-19 as the COD of anyone who has tested positive for the virus and had symptoms, regardless of the presence of other diseases (listed as contributory) and the specific mechanism of death.

The USA Centres for Disease Control and Prevention said in a statement that regardless of which is stated as the immediate COD on a death certificate, it will add the death to the COVID-19 tally. Furthermore, in some places like New York (accounting for more than 40% of the USA Corona deaths) they no longer use death certificates to report COVID-19 fatalities, but use a quick reporting form designed to helps public health officials track the unfolding of the pandemic. Unlike a full death certificate, it only provides one place to record “the disease”.

In the UK, Coronavirus Act 2020 also made changes to the requirements for death certificates to no longer need the signature from the doctor who saw the patient during their last illness. The new act enables “a doctor who may not have seen the deceased to certify the cause of death without the death being referred to the coroner”. Basic psychology tells me it’s highly likely, given the current circumstances with overwhelmed hospital staff and COVID-19 on everyone’s lips, putting all the responsibility on the doctor-on-call’s shoulders for stating a single cause of death, there will be bias towards COVID-19.

Figure-Ground
Figure-Ground

Now that we’ve looked at the data around the coronavirus and debunked some statistical and interpretation errors, lets take a step back and remind ourselves of the bigger picture. The concept of Figure-Ground is used in Gestalt psychology to depict the tendency to define the figure (object of focus) in contrast to the ground (undifferentiated background) of our perceptual field. First I’d like to shed more light on the “undifferentiated” background (context), in order to then better position the object of our focus (coronavirus).

In theory the declaration of a pandemic is “not necessarily connected […] to an increased overall risk to the population”, but rather “allows for the expansion of administrative capacity of national and global public health agencies” in it’s response to the disease, says Jennifer A. Horney (PhD), founding director of the epidemiology program at the College of Health Sciences, University of Delaware. This however, is not how the public sees a pandemic, and certainly not how the media has pictured it. It’s all about risk! And in particular, the risk of dying. Even though there are only two absolute certainties in this life, namely death and taxes, for most people there is nothing more fearful than death. It is this fear that the media machine, and the powers which orchestrate it, take advantage of…

Back to risk for the moment though. The cold truth is that we’re all at some risk of dying in the coming year. In fact, over the past 4 ½ months of 2020 alone, 4,115,180 (and counting) people have already died of Communicable (infectious) Diseases worldwide. That’s right, more than 4 million! I’d say this gives a slightly different look to the 144,515 who passed on from COVID-19 over the last 4 months. Especially since the loss of the lives to the latter has been deemed worthy of calling the whole world economy to a halt.

Non-communicable diseases (NCDs) dominate mortality figures at a global level though, especially in high-income countries. The Global Burden of Disease (a global study on disease published in The Lancet) estimated Cardiovascular disease and Cancer to be the biggest causes of death in 2017, at 17.79 million and 9.56 million respectively. Deaths from Infectious disease (more common in low- and middle-income nations) include Respiratory disease (3.91 million), Lower respiratory infections (2.56 million), Tuberculosis (1.18 million), HIV/AIDS (954,492) and Malaria (619,827).

In the above mentioned study on all human deaths in 2017, nearly 50% of these were aged 70 years or older; 27% aged 50-69; 14% aged 15-49; only 1% aged 5-14; and around 10% were children under the age of 5. Although only God knows the exact time a specific life will end, based on the above research data, combined with an individual’s history of underlying conditions and lifestyle habits, we can estimate whether a person is at a higher risks of dying in the near future. Does corona increase that risk, or does it form part of the normal curve?

The epidemiologists of the Global Burden of Disease study also attributed risk factors to mortality, specific to each age group. For both the age groups 50-69 years, and 70+ years, (within which the vast majority of corona casualties fall), the four biggest risk factors are high blood pressure, high blood sugar, smoking and obesity. The study by Italy’s National Institute of Health found that 99% of fatalities from COVID-19 in that country occurred among people who had the following underlying medical conditions: high blood pressure (76.1%), diabetes (35.5%) and heart disease (33%). A study by the Intensive Care National Audit and Research Centre found that more than 71% of patients critically ill with the coronavirus were overweight, obese or severely obese. Do you spot the connections?

Therefore, given that the median age of COVID-19 casualties in most countries is over 80, and 99% have at least one underlying condition ranked under the top 4 risk factors for their age, it would appear that Corona does not alter the normal curve of mortality risk. This is the conclusion Martin Posch from the Center for Medical Statistics at Medical University of Vienna came to: “…the risk of dying with Covid-19 is essentially proportional to the normal risk for each age group”. It would be save to say these immune-compromised individuals were already at a very high risk of succumbing to a number of viral infections this winter. Possibly even the flu…

“What?! Coronavirus is nothing like the flu”, they say. “The seasonal flu doesn’t overwhelm health services like this”. The media claimed that COVID-19 is having an unprecedented effect on hospitals, and so it’s argued that lock-downs implemented by governments around the world is the only way “to prevent the healthcare system from being overwhelmed”. A brilliant ‘fact check’ article on Off-Guardian investigated this claim. This is what they found:

In part 2 of this paper I will examine the opinion of various respected and experienced experts around the globe who regard COVID-19 as no more than a new flu. I’ll also look at the potent effect stress and beliefs have on the immune system, and why these are bigger threats to our health than catching COVID-19. We’ll compare the cost of the lock-down strategy of most governments, to that of the virus itself. And finally, unveil the powerful elite and their hidden agendas behind this coronavirus deception, by making connections with unprecedented global developments which preceded/coincided with the outbreak of COVID-19.

Sources not directly Referenced with a link in article:

4 thoughts on “Coronavirus: Pandemic or Paranoia?

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