Returning to COVID19

31st January 2023

With the resignation of Jacinda Ardern, my thoughts were dragged back to Covid once more. Jacinda, as Prime Minster of New Zealand was the ultimate lockdown enforcer. She was feted round the world for her iron will, but I was not a fan, to put it mildly. Whenever I heard her speak, it brought to mind one of my most favourite quotes:

‘Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.’  C.S. Lewis

At one point she actually said the following:

“We will continue to be your single source of truth” “Unless you hear it from us, it is not the truth.’

If I ruled the world, anyone who said, that, or anything remotely like that, would be taken as far as possible from any position of power, never to be allowed anywhere near it again. Ever.

Yet, there are still many who believe her to have been a great and caring leader. She certainly hugged a lot of people with that well rehearsed pained/caring expression on her face.

Enough of that particular woman. But it got me thinking about lockdowns again and the whole worldwide madness of Covid. This was a time of such blundering idiocy that I find increasingly difficult to believe it ever happened. A bad dream.

‘The sky is falling, the sky is falling…’ Cue, everyone running about in panic. People, allegedly, dropping dead on the streets. Mortuaries, allegedly, overflowing. Freezer lorries, allegedly, stacked with dead bodies. Bring out your dead!

I worked with doctors who strode around the wards in positive pressure protective gear. There were GPs who simply refused to visit elderly residents in nursing homes. On my patch this was all GPs and all nursing homes. Meanwhile I happily visited away with a mask stuck to the top of my head.

During the Covid pandemic I travelled far past angry, to reach a point of utter weariness. Instead of becoming outraged by the latest rubbish that was being pronounced, I very nearly washed my hands of it. However, after learning of Jacinda’s resignation I roused myself to have another look at what actually did happen. Or to be more specific, what was the impact of Covid on overall mortality. The only outcome that really matters.

Rid your mind of the numbers claimed to have died of Covid. The, never to be clarified distinction between those who died ‘of’ or ‘with’ Covid. Or those who read an article on Covid and then, overwhelmed with fear, stepped out in front of a bus. Thus, becoming a Covid related…associated, something, anything to do with Covid, death.

Over time the Covid figures became so ridiculous and unreliable as to become meaningless. I should know, I wrote some of the death certificates myself. Let me think… ‘She died of COVID, she died of COVID not. Eeny, meeny, miney mo…’

I am not saying that Covid did not kill a large number of people. But the fact that deaths from influenza disappeared completely for two years tells me all I need to know. ‘Roll up, roll up, Ladies and Gentlemen, to see the amazing lady influenza disappear before your very eyes.’ An astonishing trick, all the way from La La Land. ‘You expect me to believe that?  Ho, ho, ho, very funny….Oh, sorry, you actually do.’

Anyway, to clear my internal database of horribly unreliable figures, I went back to look at my favourite graphs on EuroMOMO. This website looks at overall mortality, and only overall mortality. Their data comes from countries who do know how to record deaths, honestly. Unlike some others, who shall be nameless … China.

However, the main reason to focus on EuroMOMO is that overall mortality is something you cannot fake. About the only thing you can do to manipulate the figures is hold back data for a month or two – which has been done, but not to any great degree. So, without further ado, let us move onto EuroMOMO. Below is a recent graph. I have deliberately removed most of the information you need to know what it is showing. I wanted people to avoid jumping to conclusions … that they might then find it difficult row back from.

I found myself examining this graph idly and thought. Imagine if you had no idea what you were looking at here. What would you think? It’s a squiggly line, yes. Very good, gold star. What else?

To give you a bit more detail. This is a graph of overall mortality, across a large number of European countries. All of those who provide data to the EuroMOMO database anyway. Norway, the ultimate European lockdown champion, has mysteriously disappeared from the database. Maybe they shall return …. I have begun to see everything as a conspiracy nowadays.

The graph itself begins in January 2017 and finishes in January 2023. As you can see (if not terribly clearly) there are two wavy dotted lines. These lines rise up in the winter, and then fall back down in the summer. Something seen every year. This is because, every year, more people die in the winter than in the summer.

Everyone thinks they know the reason for this winter summer effect, but I am not so sure they do. But that is an enormously complicated topic for another time.

The lower, dotted lines represent the ‘average’ mortality you would expect to see [with upper and lower ‘normal’ limits] year on year. Above those wavy dotted lines sits a solid spikey line. This represents the actual number of deaths that occurred. Not just from Covid, but from everything.

This does raise an immediate question. If we keep seeing more deaths than we would expect in the winter, year on year, then the ‘average’ number of deaths should rise? Thus, the wavy dotted lines ought to be going up and up, in the winter. But they don’t.

I am not entirely sure why this is not the case. But it is a statistical question of such mind-boggling complexity that I am, frankly, unable to answer it. I have looked into it, but I was scared off by the sheer scale and difficulty of the mathematics involved. Too many equations for my poor wee brain.

Anyway, this graph starts in the winter of 2017 and ends about now. The vertical lines are drawn at midnight on Dec 31^st each year. Which means that we have almost exactly six years of data. Excellent data, not manipulated in any way. I say this because, whilst the diagnosis of ‘Covid death’ may be disputed, the diagnosis of death cannot.

What stands out? Well, there was a very sharp peak of deaths in early 2020. This, as you have probably worked out, was when Covid first hit. I find it fascinating that it was so transient. It came, it went…gone. For a bit anyway.

Was the precipitous fall due to strict lockdowns? Some will doubtless argue this. However, we all locked down again in autumn 2020 and the death rate went up, and stayed up, for about six months. Until, that is, January came along, and it all settled down again. Which follows pretty much the pattern of 2017, 2108 and 2019. And the pattern of all pandemics. They come, and they go. Some a little earlier, some a little later.

What else do you see – now that we are all pretty much fully vaccinated? I think another thing that stands out is the sudden and sharp rise in mortality in November 2022. Which is virtually identical to the spike in 2020. Strange?

However, to my mind, the thing that shouts most loudly about this graph is that the years of Covid pandemic panic really do not look that much different from the previous three years. Half close your eyes, and there is almost nothing to see. The Covid peaks were a little higher, and a little longer – maybe.

If you knew nothing about the Covid pandemic I don’t think you would exclaim. ‘My God, look at these vast waves of death in 2020, 2021. What amazing, never seen before thing, happened here?’ Yes, first spike of early 2020 was certainly sharp, and unusual, but it was short. And very little different to the spike at the end of 2022. As for the rest?

Now, I would like to turn your attention to Germany. The most populous country in Europe. Here it is even more clear that the years of the Covid pandemic are not remotely unusual. If I had removed the calendar years off this graph, you would be hard pressed to spot the Covid pandemic. In truth, you would be more than hard pressed. You couldn’t.

The 2018 influenza spike was equally dramatic to Covid peak of 2021, if not more so. [You may have noticed that there was no peak in 2020] In addition, at the end of 2022, we have the highest peak of all. Future historians might well look at this graph and ask. ‘Tell me, why did the world go mad in 2020, and remain mad through 2021? Why did everyone lockdown in March 2020, and then do nothing whatsoever in December 2022?’

It almost goes without saying that, had we locked down again in November 2022, it would have been claimed that lockdown saved us all. Look at how quickly it came, then went. Well, they could have claimed it. But we didn’t lock down again, did we? In direct contrast to Germany. What of the people living in Luxembourg?

Luxembourg is surrounded by Belgium France and Germany. People move freely from one to the other, always have done, and still do. The ‘deadly’ Covid pandemic raged all around them. Here, absolutely nothing happened. Mind you, they also seem to have been unaffected by influenza.

Whilst the Germans were dying in large numbers in 2018, the Luxembourgians carried on serenely, not an extra death to be seen. Why? Discuss. [It seems that most/all countries unaffected by Covid, were also unaffected by earlier flu epidemics].

I know some of you may be thinking that Germany is much bigger than Luxembourg so … so what? If you are going to see an effect on mortality, you are more likely to see it happen, more dramatically, and rapidly, in a country with fewer people.

I should explain that the figures on the left axis, on the German and Luxembourg graphs (unlike the first one), do not represent total deaths, they are the ‘Z score’. That is, the deviation from the mean.

The upper dotted line represents a Z score of five. That means, five standard deviations above the mean. It has been decreed that if you hit more than five standard deviations above the mean, for any length of time, this is a signal that ‘something bad’ is happening. The alarm starts goes off, and epidemiologists run around bumping into each other. ‘The sky is falling… etc.’

If you use the Z score it makes no difference how large the population is. It has been specifically designed to make it possible to compare changes in overall mortality, in populations of very different sizes. I feel the need here to make it clear that Luxembourg is not that small. It has more than twice the population of Iceland, for example.

Enough of the maths already.

So, deep breath, and trying to bring all these random thoughts together. What does EuroMOMO tell us? It tells us that Covid was a bit worse than a bad flu season, with 2018 being a good reference point. [There have been far worse flu epidemics than 2018, and I am not talking about 1918/19].

What EuroMOMO makes most clear, at least to me, is that Covid was not, repeat not, a pandemic of unique power, and destructiveness. It could have never have remotely justified the drastic actions that were taken to combat it.

Belatedly, this is becoming recognised, as has the damage associated with lockdowns. Here is the abstract of an article from 2022. A bit dry, but worth a read. ‘Are Lockdowns Effective in Managing Pandemics?’

‘The present coronavirus crisis caused a major worldwide disruption which has not been experienced for decades. The lockdown-based crisis management was implemented by nearly all the countries, and studies confirming lockdown effectiveness can be found alongside the studies questioning it.

In this work, we performed a narrative review of the works studying the above effectiveness, as well as the historic experience of previous pandemics and risk-benefit analysis based on the connection of health and wealth. Our aim was to learn lessons and analyze ways to improve the management of similar events in the future.

The comparative analysis of different countries showed that the assumption of lockdowns’ effectiveness cannot be supported by evidence—neither regarding the present COVID-19 pandemic, nor regarding the 1918–1920 Spanish Flu and other less-severe pandemics in the past.

The price tag of lockdowns in terms of public health is high: by using the known connection between health and wealth, we estimate that lockdowns may claim 20 times more life years than they save. It is suggested therefore that a thorough cost-benefit analysis should be performed before imposing any lockdown for either COVID-19 or any future pandemic.’ ¹

In the face of such evidence, the argument for lockdown seems to be transforming into a somewhat pathetic whinge. ‘We didn’t know. It’s all very well people saying we shouldn’t have locked down now. We didn’t hear you saying it at the time. We were just following The Science, don’t blame us. Better safe than sorry. Don’t blame us …I think you’re being very nasty to us.’

This, of course, is nonsense. There were plenty of scientists arguing against lockdown at the time. However, they were all ruthlessly censored, attacked, and silenced. Experts such as Prof. John Ioannidis, Prof. Karol Sikora, Prof. Sunetra Gupta, Prof. Carl Heneghan. These last two UK professors argued very strenuously against lockdowns. They were ignored, then vilified. Here from an article written in January 2021:

‘…Sunetra Gupta. She’s been getting flak from the mob for months but it reached a crescendo yesterday when she was on the Today programme. Why is the BBC giving space to a nutter, people asked? She isn’t a nutter, of course. She’s an infectious disease epidemiologist at Oxford University. But she bristles against the COVID consensus and that makes her a bad person, virtually a witch, in the eyes of the zealous protectors of COVID orthodoxy. Professor Gupta has written about the barrage of abuse she receives via email. ‘Evil’, they call her.’

‘…her chief crime, judging from the hysterical commentary about her, is that she is critical of harsh lockdowns. She is a founder of the Great Barrington Declaration, which proposes that instead of locking down the whole of society we should shield the elderly and the vulnerable while allowing other people to carry on pretty much as normal. It is this perfectly legitimate discussion of a social and political question — the question of lockdown — that has earned Gupta the most ire.’ ²

I would like to point out that I was arguing against lockdown, right from the very beginning. Yes, I do enjoy saying, ‘I told you so’ from time to time. It is one of the few satisfactions I get in life nowadays. Here is a section from a blog I wrote in March 2020. Once again, right from the start:

‘…However, there is also a health downside associated with our current approach. Many people are also going to suffer and die, because of the actions we are currently taking. On the BBC, a man with cancer was being interviewed. Due to the shutdown, his operation is being put back by several months – at least. Others with cancer will not be getting treatment. The level of worry and anxiety will be massive.

Hip replacements are also being postponed and other, hugely beneficial interventions are not being done. Those with heart disease and diabetes will not be treated. Elderly people, with no support, may simply die of starvation in their own homes. Jobs will be lost, companies are going bust, suicides will go up. Psychosocial stress will be immense.

In my role, working in Out of Hours, we are being asked to watch out for abuse in the home. Because we know that children will now be more at risk, trapped in their houses. Also, partners will suffer greater physical abuse, stuck in the home, unable to get out. Not much fun.

Which means that we are certainly not looking at a zero-sum game here, where every case of COVID prevented, or treated, is one less death. There is a health cost.

There is also the impact of economic damage, which can be immense. I studied what happened in Russia, following the breakup of the Soviet Union, and the economic and social chaos that ensued. There was a massive spike in premature deaths.

In men, life expectancy fell by almost seven years, over a two to three-year period. A seven-year loss of life expectancy in seventy million men, is forty-nine million QALYs worth. It is certainly a far greater health disaster than COVID can possibly create…’ ³

And lo, the damage is coming to pass. Maybe not so many people dying of starvation as I predicted, at least not in the West. In poorer countries, however …

Another terrible thing that happened during lockdown was the vilification of anyone who dared question the official narrative. Yet almost everything they predicted has come true. Have the likes of Professor Gupta been forgiven and welcomed back into the fold? Have a wild guess on that one.

What of those who deliberately whipped up the panic and led the dreadful behavioural psychology teams. They quite deliberately frothed the population into a state of terror. What of those, whose ridiculous models kicked the whole damned thing off? The Professor Neil Fergusons of this land? Yes, you.

These people are all still comfortably ensconced, advising away. Their positions fully secure. In the UK they were mostly given knighthoods, damehoods, and other shiny gongs to impress their friends with. This, I find hard to swallow.

More worrying is that there will never be an honest review on the pandemic. Why, because so many people in positions of power would be seriously threatened by it. Which means that any such review will end up as a completely bland whitewash.  ‘In general the actions taken were reasonable, and in a situation where so much was unknown, it was better to try and protect the public … blah, blah.’ Case closed.

The reality is that these lockdowns were a complete disaster. A complete disaster. The fact that we will never have a proper debate about them, means that we will learn nothing from what happened. This, in turn, means that another disaster is on the way. Those who should be listened to will be attacked, silenced and censored, again.

Those who got it all horribly wrong last time will be handed even greater powers … next time. The reason why lockdowns did not work, they will argue, is because they were not strict enough, or long enough. We need proper lockdowns next time. You have been warned. Cast your eyes over China.

I will leave you with the conclusion of the paper ‘Are lockdowns effective in managing pandemics?’

• Neither previous pandemics nor COVID19 provide clear evidence that lockdowns help to prevent death in pandemic
• Lockdowns are associated with a considerable human cost. Even if somewhat effective in preventing COVID19 death, they probably cause far more extensive (an order of magnitude or more) loss of life
• A thorough risk-benefit analysis must be performed before imposing any lockdown in future.

Which can probably be summed in in the words: Primum non nocere. First, do no harm.

The central guiding principle of medicine that was hurled out of the window in March 2020 by people who seem not to exhibit a scrap of humility, or humanity. Nor apology.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9368251/

2: https://www.spectator.co.uk/article/the-censorious-war-on-lockdown-sceptics/

3: https://drmalcolmkendrick.org/2020/03/29/a-health-economic-perspective-on-covid-19/