Some Covid Questions

Published: April 5, 2020

Some covid-related reader questions and comments SPR has received in recent weeks that may be of interest to a broader audience.

  1. “Did Sweden have an antibody seroprevalence of 40% by the end of December?” Sweden had a seroprevalence of about 5% by the end of April and about 15% by the end of December (based on comparative mortality data). The values in Stockholm were higher and the national values in young people may also have been higher, but the 40% value was based on non-representative blood donor data.
  2. “Was excess mortality in Sweden in 2020 one of the lowest in Europe?” Reports by the Oxford CEBM and by Reuters/Eurostat appeared to show this, but they were based on the 2015-2019 average mortality, which does not take into account the strongly decreasing mortality trend in Sweden (the CEBM acknowledges this issue). If calculated correctly, Swedish excess mortality in 2020 was close to the European average, as one would expect.
  3. “Professor Ioannidis showed the covid IFR is only 0.15%.” The Ioannidis value is the lower bound of the global average IFR. This value is not applicable to Western countries, not even if nursing homes are excluded (= IFR 0.3% to 0.6% in most Western countries).
  4. “Germany had a very low excess mortality in 2020 (<5%). Proof there is no pandemic?” German seroprevalence was only 5% by December, by far the lowest value among major Western countries. Germany had a very mild first wave and a rather mild second wave, so far.
  5. “The median age of covid deaths is close to life expectancy in most countries. Proof there is no pandemic?” Covid increases natural mortality proportionally per age group; overall, mortality is most closely comparable to medium influenza pandemics of the 20th century (e.g. 1936, 1951, 1957, 1968): lower for children and young adults, but higher for senior citizens.
  6. “Isn’t ‘long covid’ just a vastly exaggerated myth?” According to the latest British ONS survey, close to 14% of PCR-confirmed people (hospitalization rate 8%) reported symptoms lasting longer than three months (compared to 2% in the control group), of which about 60% reported “some limitation” and close to 20% “strong limitation” to their day-to-day activities.
  7. “Hasn’t the flu been relabeled as covid?”┬á The flu has not been relabeled as covid, but has been temporarily displaced by the novel coronavirus. This effect is well known but poorly understood.
  8. “Is early treatment really necessary and effective?” In high-risk patients, early treatment is very important and effective. Even monoclonal antibodies failed in late treatment, but proved very effective in early treatment. Early treatment is intended to inhibit viral replication and avoid disease progression, most notably autoimmune hyperinflammation and thromboembolism.
  9. “Aren’t PCR tests just producing a ‘casedemic’?” PCR tests are highly specific, as data from New Zealand and Australia shows. The problem in high-prevalence countries is lab contamination and high-CT post-infectious positives, which produce a casedemic on top of the pandemic. Overall, there is no correlation between the PCR testing rate and mortality.
  10. “Which are the worst affected regions?” In terms of prevalence and mortality, the worst affected region is Latin America, followed by Russia and South Africa, the USA and Europe, Arab countries, India and some Asian countries, and finally some low-covid islands and Black Africa. Proactive lockdowns in support of early border controls may have worked in a few countries (most of them islands), but reactive lockdowns had no discernible impact on mortality.
  11. Did Asian countries have pre-existing immunity?” Infection rates have been quite high in many Asian countries, including India, Bangladesh, Indonesia, the Philippines, Malaysia, Myanmar, and most recently Papua New Guinea. Only some (quasi) islands, the Mekong countries (Thailand, Vietnam, Cambodia, Laos), and China managed to keep infection rates very low.
  12. “Did China stage its lockdown to fool the West into self-destruction, while the virus is already endemic in China?” Chinese lockdowns are very real and very extreme. Chinese antibody studies have shown that infection prevalence is very low in most regions, but there are still limited new outbreaks in several regions.

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