Why Covid-19 Is a “Strange Pandemic”

Covid mortality (solid) and natural mortality (dashed) in men (red) and women (blue) (Spiegelhalter)

Published: September 2020 (updated)
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Why does covid-19 appear to be a somewhat strange pandemic? It is because of the covid-19 mortality profile, which is almost identical to natural mortality.

To better understand this crucial point, we first look at two other well-known pandemics: the 2009 swine flu “fake pandemic” and the notorious 1918 “Spanish flu” pandemic.

The 2009 swine flu was a “fake pandemic” because in reality it was a rather mild flu that caused few deaths globally. It was labeled a “pandemic” in June 2009 only because the WHO had removed the requirement of “enormous numbers of death and illness” one month before. The pandemic warning then triggered a multi-billion dollar sale of rather useless and partially dangerous vaccines.

The 2009 swine flu strain was mild because it was somewhat similar to a flu virus strain that had circulated prior to the 1957 Asian flu pandemic. This meant that most people over 60 years – the main risk group – had already developed immunity against the new virus. And the virus simply wasn’t dangerous enough to seriously threaten many people younger than 60 years.

The 1918 “Spanish flu” virus, on the other hand, was a very dangerous virus that had a very different mortality profile. In addition to old people, it also killed babies and young children plus young adults between 20 and 45 years at very high rates (see chart at the bottom).

In contrast, the mortality profile of the covid-19 coronavirus is essentially zero for children and young adults and near zero below 50, before it begins to rise slowly and then very steeply above 70 and especially above 80, reaching extreme levels in nursing homes.

Thus the covid-19 mortality profile is almost identical to natural mortality. This doesn’t mean that covid-19 doesn’t increase someone’s risk of death – it absolutely does – but this increase is proportional to the pre-existing risk of death of the respective age and risk group.

The characteristics of covid-19 may have to do with the cardiovascular and immunological effects of the virus and they explain the high death rate in nursing homes (up to 70% of deaths), in people above 70 years (about 90%), and in Western countries in general. In contrast, covid death rates in Africa, predicted by many (including Bill Gates) to be high, have been very low.

Many people expect a “real pandemic” to kill also younger people, or at least babies, at a significant rate, as the 1918 flu and other flu pandemics indeed did. Some skeptics therefore concluded that covid-19 must then be another “fake pandemic”. But it is not – it simply has a very different and much more “natural” mortality profile.

If covid-19 had hit us in the 1950s – with a much younger population, few nursing homes, and a much lower prevalence of cardiovascular disease – it would have caused rather few deaths.

Because of the covid-19 mortality profile, mass PCR testing and contact tracing in the general population make little sense and create an additional “casedemic” on top of the pandemic. Mass vaccinations will also make rather little sense, especially because at the time experimental vaccines might become available, many people may already have been exposed to the wild virus.

However, the mortality profile of covid-19 is only “the tip of the iceberg”. Covid-19 is also causing many standard and intensive care hospitalizations – even in people below 65 years – and it is causing post-acute “long covid” in about 10% of symptomatic people, including many young and healthy people. These are potentially serious issues that should not be downplayed in any way.

The best currently available answer to these issues is evidence-based early and prophylactic treatment, as emphasized by many leading experts from around the world. Simply isolating sick people at home until they cannot breathe anymore is the worst possible approach. Unfortunately, in many Western countries, it continues to be the most common approach.

It is important to keep in mind that in many parts of Europe and some parts of the US, coronavirus antibody values are still very low (e.g. 2% in Germany). Hence it is not reasonable at all to assume that the pandemic is already over. Even in global hotspots with a 20% antibody rate, it is not at all certain if this is going to provide collective immunity during winter months.

The following chart by Cambridge statistics professor David Spiegelhalter compares covid mortality (solid line) to natural mortality (dashed line) in men (red) and women (blue). As mentioned above, covid does increase the risk of death – covid mortality comes on top of natural mortality – but this increase is proportional to natural mortality.

Covid mortality (solid) and natural mortality (dashed) in men (red) and women (blue) (Spiegelhalter)

The following chart shows US mortality by age in previous pandemic years compared to 2020 US excess mortality, which consisted primarily (>75%) of confirmed and suspected covid-19 deaths, according to the CDC. To learn more about this comparison, please read this article.

Pneumonia and influenza mortality by age in previous pandemic years (Glezen, 1996) vs. 2020 excess mortality by age, primarily driven by covid-19, overall and excluding nursing homes (SPR based on CDC data)

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