Thoughts on economics and liberty

Category: Science

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My 1400-word piece in Shillong Times on the true magnitude of covid

I wrote a piece for Shillong Times recently. URL – published today (10 February) : https://theshillongtimes.com/2022/02/10/covid-19-restrictions-never-had-slightest-basis-in-the-sciences/

The image.

Here’s the full text of what I had sent:

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COVID-19 restrictions never had the slightest basis in the science

The COVID pandemic has perhaps been the biggest tragedy of errors in human history. I call it the Great Hysteria in the title of a book that I wrote in 2020 to reflect the unimaginable loss of the most basic elements of civilization.

Grown up men and women in positions of power forgot during this hysteria the elements of arithmetic that they had learnt in school. Proportionately, adjusting for population growth, had COVID-19 been as deadly as the Spanish flu, it would need to have killed 220 million worldwide. Instead, COVID has so far killed about 6 million. That brings it well within the range of the Hong Kong or Asian flu – for which the world never shut down.

As early as February-April 2020, analyses by epidemiologists like John Ioannidis suggested that COVID is not very severe. On 10 March 2020 in its official pandemic plan for COVID, the Victorian government in Australia wrote: “COVID-19 is assessed as being of moderate clinical severity”.

The overall Infection Fatality Rate (IFR) for COVID according to the UK government’s statement in its Parliament on 27 August 2021 is 0.096%[1], which is exactly the same as that for seasonal flu. In an interview I took of Prof. Jay Bhattacharya of Stanford University on 20 January 2022, he said that the IFR for COVID could be slightly higher: maybe 0.2%, but it is nowhere close to that of the Spanish flu. So let’s for a moment even assume that COVID has been twice as deadly as the flu. Would that justify the hysteria we have seen across India – hysteria that continues even today?

The other amazing thing that the hysteria has done is to cause almost all epidemiologists to forget the repeated warnings of the greatest epidemiologist of the 20th century, Donald Henderson, against taking any drastic measures to stop a respiratory virus – for such measures only cause harm and cannot stop the virus. He said in a 2010 conference that “this idea that in this day and age one is going to intercept people coming across the border and you’re going to stop the spread of the disease is a concept that was antiquated a very long time ago”.

Moreover, Dr Sunetra Gupta of Oxford University has demonstrated how international travel and intermingling across nations is hugely beneficial because it strengthens the immunity of people against severe disease. International travel is the panacea for dealing with pandemics, not a cause.

At the beginning of the Wuhan lockdowns, Gauden Galea, the World Health Organisation’s (WHO’s) representative in China made it clear on 24 January 2020: “trying to contain a city of 11 million people is new to science. The lockdown of 11 million people is unprecedented in public health history, so it is certainly not a recommendation the WHO has made”. On 24 June 2020 Sweden’s State Epidemiologist Anders Tegnell exclaimed, “it was as if the world had gone mad, and everything we had discussed was forgotten”. Tegnell also said, consistent with the science: “[c]losing borders, in my opinion, is ridiculous, because COVID-19 is in every European country now”. Stefan Baral, Professor at John Hopkins School of Public Health tweeted on 16 August 2020: “I spent a decade in public health training and do not remember the lockdown lecture”.

On 20 January 2022 Prof. Jay Bhattacharya said to me in an interview: “The kind of lockdowns we have imposed on the world for the past two years is unprecedented in history. I do not know of any pandemic plan that proposed anything like the policy that we followed. It is improvisation as public health policy”. The WHO’s comprehensive and well-researched pandemic guidelines of October 2019 rejected quarantines, let alone recommend society-wide lockdowns.

Not many people are aware that there is sinister underbelly to these policies: the role of China that is hiding in plain sight. In January 2021 I co-signed along with nine others including a senior US General an Open Letter to the world’s major intelligence agencies providing them with unambiguous evidence about China’s orchestration of the Great Hysteria through fake videos and fake computer models, and by getting the WHO to change its October 2019 warnings against lockdowns. China’s propaganda and stealth warfare skills exceed those of Goebbels.

In the midst of the Great Hysteria, only one nation followed the science: Sweden. It did not lockdown. It did not close borders or have any quarantine. It did not close down the lower classes in schools – high schools and universities were encouraged to switch to online classes for part of the duration of the pandemic. It recommended voluntary social distancing but not masks (in fact, parts of Sweden banned masks). A few large events and gatherings were stopped. But no hysteria: the entire focus of Anders Tegnell was to calm down the people and encourage them to carry on their normal life.

I wrote many articles for my Times of India blog to warn India against lockdowns. It was known from February 2020 onwards that the risk of death from COVID is disproportionately high for the elderly, so I wrote a piece on 6 March 2020: “Age-based risk management of coronavirus”. That idea also underpins the 4 October 2020 Great Barrington Declaration by some of the most eminent epidemiologists. The idea is for the elderly to take extra precautions but for the young to carry on their normal life. Coincidentally, on the morning of the day that Mr Modi declared India’s lockdowns (24 March 2020) I wrote the piece: “Lockdowns won’t defeat the virus but will definitely destroy us all”. I sent all my pieces and much other information to Rajiv Gauba, India’s Cabinet Secretary and my batchmate in the IAS. To no avail. Everyone had shut their minds – and their minds remain shut till today.

Like with everything else in life, there are never any “solutions”, only trade-offs. With lockdowns the trade-offs were clear: that children and the young would suffer hugely even as we would inevitably fail to prevent most of the elderly from catching the virus.

Over the past few months I have been supporting Professor Gigi Foster of Australia on a cost-benefit analysis (CBA) of Australia’s COVID policies. The draft CBA confirms that Australia’s policies have caused havoc. A recent study from John Hopkins University has found that globally, lockdowns have prevented only 0.2% of COVID deaths, but their harms are so great it will take decades just to account for them.

No one has prepared a CBA for India as far as I’m aware, but estimates of harm for India are so huge, probably no country was harmed more than India. I don’t think a single COVID death was prevented in India by lockdowns, not even 0.2%. Instead, more COVID deaths must have occurred in India since people were forced indoors, thereby reducing their Vitamin D levels, making them more vulnerable.

In economics we value the life of a child around 80 times (roughly speaking) that of an elderly person who is in their last year of life. If such a calculation is applied to India, the harms caused by lockdowns will exceed any benefits by an order of tens of thousands, if not more. The damage to children continues: schools remain closed in most parts of India. Mask mandates continue.

To calculate the damage from lockdowns we need to count many other things, as well: e.g. the loss of happiness and mental illness due to loneliness from social isolation, the crowding-out of healthcare for problems other than COVID, the long-term costs to the earning capacity of our children and university students from disrupted education, the economic losses of millions of small businesses, the starvation of the families of daily wage labourers who only eat if they earn on a given day; the early deaths from causes other than COVID since people did not get their cancer or heart issues diagnosed in time; increased inequality in society; the damage to the government’s revenues which means there will be less money to spend on everything from roads to hospitals for years to come.

Sweden managed its pandemic with aplomb. As Reuters reports, Sweden “emerged from 2020 with a smaller increase in its overall mortality rate than most European countries”. No harms to children, no harms to the youth. On 9 February 2022, Sweden will return to complete and total normalcy. The people of Sweden are blessed.

[1] https://questions-statements.parliament.uk/written-questions/detail/2021-07-12/31381/

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The reason why Henderson wrote this 2006 article – to fight quarantines and such stupid ideas of computer programmers

I missed this May 2020 piece – I do know about Henderson’s 2006 paper but didn’t realise why he wrote it – to fight stupid computer modelling started by Bush in 2006.
 
IGNORANT FOOLS HAVE FLOODED public health – we have forgotten basic science.
 

In his 2006 paper he was contesting the ridiculous computer modelling of quarantines and closures kickstarted by George Bush, he said clearly:

“A number of mitigation measures that are now being considered could have a serious impact on the ability of the health system to deliver adequate care and could have potentially adverse consequences for the provision of essential services. Many could result in significant disruption of the social functioning of communities and result in possibly serious economic problems. Such negative consequences might be worth chancing if there were compelling evidence or reason to believe they would seriously diminish the consequences or spread of a pandemic. However, few analyses have been produced that weigh the hoped-for efficacy of such measures against the potential impacts of large-scale or long-term implementation of these measures”.
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Donald Henderson’s 2002 notes on smallpox eradication – and why other viruses are not suitable for eradication

I’m trying to identify a document in which Donald Henderson has explained what he did at this 2010 conference.

In the meantime, I’ll publish what I consider are important writings of Donald Henderson

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Considerations for Viral Disease Eradication: Lessons Learned and Future Strategies: Workshop

(2002)

SMALLPOX

D.A. Henderson, M.D., M.P.H.

Director, Center for Civilian Biodefense Studies

The Johns Hopkins University, Baltimore, MD

The eradication of smallpox removed, hopefully forever, one of the greatest of all the world’s plagues. With a 30% fatality rate, smallpox was in a class by itself as a global health problem. Eradication was an extraordinary, cooperative effort involving, under World Health Organization (WHO) leadership, countries throughout the world and perhaps as many as 150,000 field staff at various points during the campaign (Fenner et al., 1988). It dramatically demonstrated the extraordinary cost-benefit ratios that might be achieved with eradication. The total investment in international assistance was just under $100 million; national investments were estimated to be perhaps $200 million. Yet, because vaccination and quarantine measures are no longer necessary, savings of at least $1 billion annually are being realized.

Lessons for Eradication of Other Diseases

Poliomyelitis is generally considered to be the next candidate for eradication, and a heroic effort is now being made to eradicate it. However, given the task yet to be done and the many current uncertainties, it would be presumptuous to forecast a reasonably certain date for polio eradication, its status now being roughly where we were with smallpox some five years before transmission was finally stopped. Thus, as the first lesson from the smallpox campaign, and before indulging in extended discussions about what might or might not be done post-eradication, it would be productive to ascertain whether, in the cold hard light of accumulating experience and available technology, there are reasonable prospects for the eradication of any other disease within the next ten to twenty years.

So far, there have been seven campaigns intended to eradicate an infectious disease globally. The first four failed; only one—smallpox—succeeded; and two are still in progress. Despite the fact that there has been only one success in eradicating a disease, many experts speculate that a wide variety of diseases and conditions should be susceptible to eradication given sufficient resources, effort, and cooperation. However, this is precisely the wrong lesson to be learned from the smallpox campaign.

There were many factors that uniquely favored smallpox eradication:

  • No other disease has features that made diagnosis and surveillance for infection so easy. Because every infected person had a characteristic rash, the presence or absence of the virus could be determined quickly in every geographic area.
  • Most transmission was through droplets spread by face-to-face contact, making outbreak containment comparatively easy.
  • It was one of the few diseases that both confers permanent immunity and has no carrier state or animal reservoir (two important preconditions for the eradication of disease—see Chapter 1).
  • The smallpox vaccine had many advantageous properties: it was heat-stable and inexpensive; it provided protection with only a single inoculation, it could be administered anytime from birth onward; and, using the new bifurcated needle, vaccination was simply accomplished.

Given the fact that all countries were deeply concerned about smallpox and were regularly vaccinating large numbers of their citizens, it was an eradication program that should have commanded the highest possible political commitment. However, expected voluntary contributions to the program were sparse at best, and inadequate funds seriously hampered the program throughout its first nine years of existence. A number of endemic countries had to be cajoled into undertaking any program at all. On several occasions, the program hung in the balance because of political and social problems and, despite the best efforts of technical staff, could well have suffered serious setbacks that delayed eradication, perhaps indefinitely. Not until seven years into the program were the staff confident that eradication could be achieved, and events as late as 12 months prior to the last case threatened a successful conclusion.

Vaccine played an especially critical role in the success of the smallpox program. The smallpox vaccine had been known since 1798, but not until the end of the 19th century did large quantities become available as a result of growth of the virus on the flank of cows. Transporting it, however, was a problem. Thus, smallpox continued to spread largely unabated in most of the world, except in industrialized countries where sufficiently rapid transport and refrigeration were possible. Finally, in Indonesia in the 1930s, a vaccine that retained potency for periods of six months or more at 37ºC was perfected by air-drying over sulfuric acid. Although often heavily contaminated, take rates of 80%+ were usual. By the end of the 1930s, Indonesia was smallpox-free. A similar product was introduced into a number of French colonies with similarly dramatic results.

In 1967, when the global smallpox campaign began, there were a number of Latin American, east Asian, and African countries where smallpox transmission had been stopped. This was due in large part to the use of the air-dried vaccine or a new freeze-dried product developed in the early 1950s.

Thus, vaccine technology had advanced to the point where eradication was a feasible proposition. Had we been dependent on a vaccine no more heat-stable nor immunogenic than, for example, polio vaccine, the prospects for eradication would have been significantly diminished.

Post-Eradication Strategies

During the course of the eradication campaign, there was very little planning for post-eradication strategies and activities. Procedures were developed for certifying large contiguous geographic areas as smallpox-free, but this was the extent of the effort. In major part, this reflected the belief that the margin for error in the program was small and that all available resources had to be directed toward the goal of interrupting smallpox transmission. Otherwise, there would be no post-eradication era. In fact, transmission continued for one year beyond the date anticipated, when smallpox invaded Somalia, spread throughout the country, and threatened the whole of the Middle East. Not until late 1975, when smallpox was confined to Ethiopia, and the interruption of transmission appeared to be only a matter of months away, were significant efforts made to define post-eradication needs.

In December 1979, the Global Commission for the Certification of Smallpox Eradication, as part of its final report, made 19 recommendations for post-eradication actions (WHO, 1980). The recommendations were subsequently approved by the 1980 World Health Assembly (WHA), after which a special committee, the Orthopoxvirus Committee, regularly met every four years up until recently. Some of the post-eradication actions taken in response to the recommendations are described below.

Vaccine and Vaccination (Recommendations 1–6)

Most countries discontinued routine vaccination by 1982, and all countries by 1984. By that time, countries had also stopped requiring travelers to show certificates of proof of recent smallpox vaccination. A few countries continued to vaccinate their military, but that practice ceased by about 1990.

Seed lot vials of smallpox vaccine were produced at the Rijks Institute (The Netherlands) and distributed to several vaccine production centers for storage to assure that vaccinia virus would be available at several sites, should it ever be needed. Vaccine was also stored in rented cold storage lockers at two locations in Switzerland and regularly retitered to assure that it retained potency, which it did. But the costs of vaccine storage and periodic retitering were considerable, and WHO budgets were under great stress due in large part to the U.S. failure to pay its assessments to the organization. Thus, in 1990, nearly 13 years after the last known case, the committee recommended, perhaps prematurely, that the WHO stockpile be reduced from 200 million doses to 500,000 doses, and that the balance of the vaccine be sent back to its respective donor countries. As of 1999, individual countries reported retaining as much as 80 million doses of vaccine, not all of which has been properly stored or retitered.

Suspect Cases of Smallpox (Recommendations 7, 8)

As anticipated, rumors of possible smallpox cases continued to be reported to WHO. It was considered important that all rumors be thoroughly investigated so as to provide assurance to the international community that there were no further naturally occurring cases. The number of rumors decreased from 30 or so annually in the first two years to 10 per year by 1985, with a scattering of cases thereafter. About half were found to be chickenpox or measles, one-third were erroneous news reports, and the rest, a miscellaneous collection of skin diseases.

Laboratory Retention of Specimens (Recommendations 9–15)

A major concern following eradication was the possible reintroduction of smallpox virus from a laboratory. Limiting the number of laboratories that retained smallpox virus was considered an important step in mitigating the risk of this occurring. In 1975, a survey was undertaken to determine which laboratories might have retained smallpox isolates. All countries and 823 laboratories included in the WHO list of virus laboratories were contacted. Special contacts were made with those laboratories that had published papers over the preceding 25 years indicating that they had grown smallpox virus. A total of 75 laboratories, nearly two-thirds of which were in Europe and the Americas, reported having smallpox virus isolates in 1975.

The comparatively small number of labs is explained by the fact that most virus labs did not process smallpox virus specimens:

  • Clinical characteristics were sufficient for diagnosis, and laboratory confirmation was seldom required.
  • Growth on chick chorioallantoic membrane (CAM) was necessary for diagnosis and, in many areas, suitable uncontaminated eggs were extremely difficult to obtain.
  • Laboratory researchers preferred to work with other orthopox-viruses for which there were suitable animal models for infection.
  • The need for many countries to develop their own laboratories was diminished because official WHO Collaborating Laboratories provided laboratory services.

Following a request by the WHA that the laboratories destroy their isolates or transfer them to one of the two WHO Collaborating Laboratories, 57 of the 75 reported that they had done so by July 1977. No effort was made by WHO to confirm these reports. It was recognized that laboratories customarily retain microbial isolates for later reference, and that such specimens were not always well-referenced. A search of all deep freezers in the relevant laboratories throughout the world was far beyond the resources of WHO. The objective of mitigation of risk of release of smallpox virus was as much as could be reasonably expected.

In 1978, a laboratory-associated outbreak in Birmingham, England, prompted a number of countries to destroy or transfer isolates to WHO laboratories. By 1980, only six laboratories reported holding the virus but they strenuously resisted parting with specimens. However, by 1983, WHO had reduced this number to two. Both labs were regularly inspected by WHO consultants.

In 1994, the WHO Orthopoxvirus Committee, in a report to the Director General, recommended that the 1995 WHA pass a resolution calling for the destruction of all remaining stocks of smallpox virus in June 1995. By that time, representative strains of variola virus had been prepared as a cloned fragment library and sequenced. A five-year study of monkeypox demonstrated it to be a zoonotic virus which only occasionally infected humans and which was unable to sustain human-to-human transmission (Jezek and Fenner, 1988). No research was known to have been conducted using smallpox virus for at least the past 12 years. In fact, the virus was known to have been grown only at the Centers for Disease Control and Prevention (CDC) to produce material for sequencing and to validate diagnostic tests. The WHO laboratory in Moscow ceased research in 1982 and, in a later written report, Dr. Sandakhchiev, Director of the Novosibirsk Laboratory to which the Moscow strains had been sent, asserted that they had undertaken no laboratory studies using variola virus until July 1996. At that time, the only stated reason for retaining the virus was a hypothetical one—perhaps some day, someone would wish to undertake some type of research that would require the intact variola virus. Weighing the risks associated with retaining it against a hypothetical scientific need, the committee, supported by five major scientific societies that had been explicitly consulted, recommended its destruction.

As concerns grew about the use of smallpox as a biological weapon, scientists from a number of nations argued that the virus should be retained for research purposes to develop an anti-viral drug or improved vaccine. It was generally recognized that to do so would be costly and, even if a product were produced, its effectiveness in humans could not be determined. In 1999, WHA delegates voted to defer a final decision on the destruction of the virus until 2002. Additionally, the United States contracted for 40 million vaccine doses to be produced for use in an emergency.

What Lessons Does the Smallpox Eradication Experience Provide?

  • Disease eradication is extremely difficult even when, as in the case of smallpox, the disease is severe, a heat-stable, highly effective single-dose vaccine is available, and the epidemiological characteristics are as close to ideal as one might wish.
  • The direct implications of a failed eradication program can be significant. For most diseases, the cost of eradication is far greater than that of control (see Chapter 1 for definitions of eradication and control). Unless eradication is achieved within a finite time, and control measures can be stopped or significantly decreased, the added costs of eradication will not be recouped. Moreover, experience has shown that failed eradication programs in most areas, although resulting in better control while special measures are in place, gradually revert to a pre-eradication status as special funds and interest fade.
  • For sometime after the declaration of eradication, the only likely sources for the reintroduction of smallpox virus were from victims exhumed from the tundra or escape from the laboratory. In either case, it was felt that the outbreaks would be small and readily containable. Use of smallpox as a biological weapon was considered to be unlikely, but potentially catastrophic if outbreaks were to occur. The fact that the Soviet Union, during the 1980s, had engaged in a massive research and development program to produce smallpox virus as a biological weapon heightened this concern.
  • Persuading most laboratories to destroy or transfer smallpox virus to WHO Collaborating Laboratories posed few problems. A few objected strongly, and cooperation was achieved only with difficulty. In 1999, the WHA, passed unanimously a resolution which reads as follows: “1) Strongly reaffirms the decision of previous Assemblies that the remaining stocks of variola virus should be destroyed; 2) Decides to authorize temporary retention up to not later than 2002 and subject to annual review by the World Health Assembly of the existing stocks of variola virus…”
  • It was evident during the smallpox program that a failed eradication effort could have serious repercussions for other global initiatives. Financial support for smallpox eradication was problematic throughout its course, largely because of a failed WHO-sponsored global malaria eradication program after the investment of more than $2 billion. Thus, the credibility of expert public health advice was at a low ebb, and most countries did not want any involvement with another eradication fiasco.
  • Sustaining interest and support among countries was extremely difficult, especially after a nil incidence was achieved. Each country was understandably anxious to transfer money and manpower to deal with other critical health problems as soon as possible. They were not enthusiastic about sustaining two or more years of intensive surveillance to confirm that eradication had been achieved. This needs to be borne in mind for eradication campaigns that would need to be phased-in over a long period.

In brief, eradication is not a program to be undertaken lightly. To do so before the necessary technology is clearly in hand and before the practicability of eradication has been demonstrated in the field is an invitation for costly failure and, more importantly, a loss of professional public health and medical credibility.

 

 

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