RAMESH THAKUR. Coronavirus postscript

Two brief comments as a follow up to my article on coronavirus on Monday.

First, I noted the puzzling variance in the fatality rates, from 0.75% in Germany to 10.84% in Italy. Here is a plausible explanation. In Italy, every person who dies with a coronavirus infection is recorded as dying from it, but only 12% of these deaths have actually been caused by coronavirus. The latter would imply a mortality rate of a more credible 1.3%. A similar point is made about the UK by John Lee, a recently-retired Professor of Pathology who spent most of his adult life in healthcare and science, regarding the relative mortality rates of flu and coronavirus with only the latter listed as a notifiable disease. Incidentally, having scaled down its estimate of the maximum death toll from 500,000 to 20,000, Imperial College now puts the figure of 5,700 as the likely number of coronavirus deaths, of whom up to two-thirds would have died from other causes within one year anyway. So 5,700 will die with coronavirus in the UK but under 2,000 will die due to coronavirus.

In Germany, by contrast, the underlying health conditions are recorded as the cause of death, not coronavirus. And Germany has tested a broader spectrum of the population, including children and those with very mild symptoms, rather than the Italian practice of testing the very sick who have been hospitalised.

Second, more and more medical-scientific-epidemiological experts are speaking out questioning the mass hysteria and the panicky responses. The diversion of resources to fight coronavirus on a war footing, the  damage inflicted on the economy as a result, the rise in serious mental health problems and the  degrading of health services with sharp economic losses means that the true moral debate is not ‘lives vs money’, but ‘lives vs lives’.

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Ramesh Thakur is a professor emeritus at the Crawford School of Public Policy, the Australian National University.

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3 Responses to RAMESH THAKUR. Coronavirus postscript

  1. David Maxwell Gray says:

    Thank you for the thoughtful article which your further comment above augments.

    My perspective is that an expert advisory group extremely well-funded should have been set up from the start by the Federal Government, not just the group of chief medical officers of the Federal and State Governments, few of whom are virologists as I understand it. In the advisory group would be virologists, medical scientists with expertise in epidemiology and mathematical modelling, statistical analysis, production of vaccines and extraction of hyperimmune serum, and so on.

    On of the key important issues to confirm through actual studies is the rate at which those who are infected, but are without clear symptoms, can infect others. The public information I have seen lumps all infected, whether symptomatic or not, and estimates that each infected person infects on average about 2.5 others, in the absence of measures of strict physical separation. If there is a strong difference, as might but hypothesized, between the infectivity rates of symptomatic and asymptomatic persons who are infected, such that asymptomatic persons still infect others but a lot less than symptomatic ones, then modelling this might show that herd immunity may be relied upon without killing too many vulnerable people (the elderly and otherwise sick) before herd immunity renders the total death rates across society to be more acceptable. If however, asymptomatic persons infect others at a high rate, the carnage before herd immunity is reached would be at unacceptable levels for the Australian society. I posit these relationships without doing actual modelling, but it is to highlight how facts (and there are many others relevant to proper modelling) should guide public responses, given how extraordinary those responses now are.

    The expert group I propose should also address and guide an appropriate response by governments to supporting the effort to find an appropriate vaccine, however temporary given the ability of viruses like Covid 19 to rapidly mutate, or an appropriate hyperimmune serum processed from an extract from affected persons. The ratio of benefit to costs on this effort would dwarf that of the collective macroeconomic measures now being taken, I suggest.

  2. Chris Borthwick says:

    I presume you’re suggesting, then, that the chaos in Italian hospitals is due to a 12% increase in caseload? A 12% increase in ICU beds? This is utterly implausible.

  3. Kien Choong says:

    Thank you, very interesting.

    We urgently need to do a random test of the population to estimate: (i) the true fatality rate, and (ii) the asymptomatic rate. If (i) is low, and (ii) is high, a “herd immunity” strategy may be feasible. If (i) is high, and (ii) is low, then a suppression strategy seems appropriate.

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