Epidemiologists suggest tailored protection for risk groups instead of shutdowns
By Ralph T. Niemeyer
To avoid misunderstandings right from the start: The information in the title refers to the number of people in Germany up to 65 years of age who, according to official information, died of the corona virus by April 4. That was 1.7 per million, or a little less than one per half a million. In Spain’s hotspot, over-80s hit one of 420. This means that the risk of death is set from the minimum to the maximum.
One of the world’s leading epidemiologists, John Ioannidis from Stanford University, took a closer look at the age distribution among corona victims with two colleagues for the study that was submitted for publication but not yet reviewed.
Since this study has not yet been mentioned in the mainstream media in Germany such SciLogs, Telepolis or Tagesschau after my research, I hereby draw your attention to the results. First of all, a remark about the governing politicians.
How politicians gamble away trust
In discussions, I encountered the objection several times that rather authoritarian presidents such as those of the United States or Brazil have played down the dangerousness of the corona virus for far too long. Of course you can criticize that.
It should not be forgotten, however, that governing politicians from almost every country did similar things in February, and then, for example, in Germany it was only in mid-March that a crackdown was taken, before travelers were asked to fill out questionnaires.
A similar U-turn is emerging with the breathing masks: First it was said all the time that these would not work.
Now they are to become legally binding in some places. Incidentally, according to a WHO study, the effectiveness of numerous measures that go beyond basic hygiene rules has not been scientifically proven (COVID-19: WHO study finds little evidence of the effectiveness of containment measures). Evidence-based politics is different.
Federal Health Minister Jens Spahn said in a Bundestag debate that one would have to forgive each other a lot in the next few months (thanks for the reader’s note).
First of all, you have to forgive that appropriate risk analyzes were in the drawer of the ministries, without anything being done about it. That is why many European and American countries were caught cold by the pandemic. That certainly cost human lives.
One should also forgive the austerity measures in the healthcare system, where the staff was overwhelmed with ever new bureaucratic constructs and saved with efficiency-optimizing measures, especially at the “human” cost point.
It took a crisis of the magnitude of the coronavirus to make it clear that not only doctors, but all staff in the nursing and healthcare professions are of crucial importance: important for the lives of many people.
The shortage of resources in the healthcare system and their consequences are therefore homemade. In addition, a remark on gender or gender equality policy: For years – or probably more decades – women have been asked to go more into the technical professions.
In a nutshell, many women still choose to do something with people. Here is a previously overlooked finding from the 2018 PISA survey:
Among the high-performing students in mathematics or science in Germany, about a quarter of boys – but only an eighth of girls – expect to work as an engineer or scientist at the age of 30.
Around a quarter of the high-performing girls assume that they will later pursue a health profession. This is the case for less than a tenth of the high-performing boys. Only 7% of boys and 1% of girls in Germany believe that they will work in the ICT sector.
According to gender or gender equality policy, we would have even bigger health care problems in the future.
In order to compensate for the politically desired migration of women from the human to the technical professions, one would either have to transfer more men to the human occupations or bring more immigrants into the country. The latter would of course lead to an outcry on the right that “foreigners” take our work away from us.
What is this digression about in the corona crisis? It shows that politicians often cause the problems they promise to solve in the media. Women earn too little?
Well, just start paying the people in the nursing profession better! And often enough, these are your own employees at the state level. Or those of corporations that you have spurred privatization on in the first place.
The COVID-19 risk of death
The main reason why we still do not know exactly how many people are seriously ill or dying as a result of a coronavirus infection is the lack of representative studies.
It is inexplicable to me why we are still in the dark at the end of April. If, as Charité virologist Professor Drosten just told the main conservative paper in Germany, Frankfurter Allgemeine Zeitung (FAZ), that more than 300,000 corona tests have been carried out weekly since the third week in March, it would have been easy to reserve 2,000 to 10,000 for representative studies, as I requested on April 8 (Corona crisis numbers and logic).
Mind you, this is not just a matter of pure interest. For the assessment of the constitutionality of the largest encroachments on fundamental rights in the history of the Federal Republic of Germany – that is, since the Nazi regime of terror – the question of proportionality is a decisive factor.
And, for that we just need to know a) how dangerous the virus really is and b) how much the restrictive measures hinder the spread of the virus.
That instead people are scared every day with such dramatic and misleading figures about “new infections”, which in all likelihood give a statistically distorted picture (of the lack of scientific justification for the corona measures), as in the FAZ article quoted, now probably also for Professor Drosten is, in my opinion, difficult to forgive.
I very much hope that the courts will now once again examine the measures for their proportionality. And the calculations by John Ioannidis and colleagues can be informative for this.
As reported at the beginning, these unfortunately only include the data up to April 4.
According to the researchers, most of the countries included in their analysis – specifically: Belgium, Germany, Italy, the Netherlands, Portugal, Spain, Sweden and Switzerland, as well as the US states of Louisiana, Michigan and Washington and finally New York City – were among them, but the time is already over the mountain of coronavirus infections and the COVID-19 outbreaks. Therefore, nothing significant has changed in the basic results so far.
Since, thanks to a lack of representative studies, we do not know the actual dangerousness of the coronavirus, the analyzes by Ioannidis and Co. provide indications on a macroscopic level.
The epidemiologists compared the number of deaths attributed to COVID-19 for different countries, taking into account the age and, where possible, possible previous illnesses of those affected.
This also explains the list of countries and states, because the required data was only available for these areas.
At the beginning, these researchers also criticize the dramatization in the media:
The media has highlighted cases of young, healthy individuals with severe, fatalities.
However, the majority of patients who die with SARS-CoV-2 are older and the vast majority of those who have died may have serious medical conditions. Exaggeration should be avoided in response to the pandemic.
Based on their findings, John Ioannidis and colleagues can now calculate precisely that people in the European countries mentioned up to 65 years of age were 34 to 73 times less likely to die from COVID-19 than the elderly. The difference was smaller in the US regions and was only 13 to 15 times less risk.
The researchers explain this through socio-demographic factors, that is, primarily poverty and lack of access to the health system.
So far we have dealt with relative numbers. For better understanding, here are the absolute numbers (again up to and including April 4):
The officially determined deaths due to COVID-19, based on the age of those affected and relative to the population. For details on the data collection, I refer to the original work of the three researchers.
These numbers give us a better idea of how dangerous the corona virus is now. This contains the 1.7 deaths in Germany per million among the younger people that I mentioned at the beginning.
In Spain, which was hard hit, the elderly had around 2300 per million – with around 3 million over-80s living in the country. By April 4, every 420th of the over-80s in Spain “got it”, in Germany every 6,000th in this age group.
The researchers discuss in more detail how previous diseases – namely cardiovascular diseases, high blood pressure, diabetes, chronic respiratory diseases, kidney failure, severe liver diseases, immune deficiency and malignant tumors – and age differences in the group of up to 65-year-olds influence the risks.
The three epidemiologists finally come up with the idea of comparing the risks of the coronavirus with the risks in road traffic.
For this purpose, they collected the data for the traffic fatalities per kilometer covered by a motor vehicle for each of the regions mentioned. This gives the following picture:
The risks of the corona virus since the outbreak of the pandemic in the respective region for the under-65-year-olds, expressed in daily kilometers traveled with a motor vehicle.
For details on the data collection, I refer to the original work of the three researchers.
In other words, the corona crisis has been as life-threatening for the under-65-year-olds as (since the outbreak of the pandemic) a distance of 14.5 km per day by car, motorcycle, truck and so on.
The higher this value, the more dangerous the virus was compared in this country. Because logically, the risk of a traffic accident is greater if you travel 50 or 100km than if you only drive 15km. In the words of the scientists:
Based on data up to April 4, COVID-19 mortality (as of the first day a region was diagnosed with a death) corresponds to 14.5 to 667 years for a 65-year-old, 7km in a motor vehicle.
Most of the foci of infection analyzed were at the lower end of this spectrum, where the risk is about the same level as that of a traffic accident in daily commuting.
Given the lack of representative data on the dangerousness of the corona virus, which is the responsibility of leading politicians and relevant researchers, the calculations by John Ioannidis and his colleagues represent an interesting alternative approach.
Of course, the results of the protective measures in the various regions and the capacities are in their results of the respective health systems included.
In any case, this shows that SARS-CoV-2 is not a dangerous killer virus and that it is largely harmless for people up to 65 years of age and without previous illnesses if they have adequate healthcare.
This does not mean that the virus should be allowed to spread freely, but it does question the need for a hard lockdown. Here are the three scientists again:
The absolute risk of death does not exceed 0.24% even in the highest age category and even in the largest foci of infection and is less than one in a thousand in most places.
However, these risks could be high enough to warrant high vigilance and suggest that regardless of the strategy chosen, in response to COVID-19, now or in future epidemic waves, special emphasis should be placed on protecting the oldest individuals. […]
Aggressive measures such as lockdowns have been introduced in many countries. This is a fully justified ‘sure-is-sure’ approach in the absence of good data.
However, long-term lockdowns could have major health side effects (such as suicides, deteriorated mental health, cardiovascular disease, unemployment loss due to unemployment, and so on) in society as a whole.
The epidemiologists finally come to the data from Iceland to estimate the death rate of the corona infected.
In this small country, a particularly large number of people were tested and the data situation is therefore particularly good.
According to this, the death rate could be 0.1% or one in a thousand of all infected and would be in the order of the seasonal flu. We now need tailor-made measures that also take social life and economic functioning into account.
I would also like to add that Corona can also be dangerous in the sense of a “second flu”, especially if it straddles the capacities of the health system. That would have brought us back to the political level where we started.
I doubt that the mask requirement that has now been prescribed and was only a few weeks ago described as senseless is the right way out.
In the Netherlands, on the other hand, they try an “intelligent lockdown”.
Suspending major events until further notice seems a sensible measure to me. In the rest of social life, one should observe certain hygiene measures, the effectiveness of which has also been scientifically proven by WHO studies.
Life will go on and, despite certain, quantifiable risks, most of us move around in traffic every day as a matter of course.
In my opinion, the next economic crash would have occurred in 2020/2021 anyway – due to the slowing global economy, the debt problem that is still unsolved in the EU and other trouble spots around the world.
Let us see the corona pandemic as an opportunity to blame the virus for it and to avoid major distortions.
So far, far-reaching aid measures around the world have been justified. However, it would be a fallacy to assume that this will solve all problems.
Regarding epidemic protection, but also the monetary and economic system, ruling politicians must finally do their homework and draw the necessary conclusions for peaceful and sustainable living together.