USUAL INFLUENZA DEATHS ARE NOW DUE TO COVID-19
- Deaths attributed to COVID-19 were very significant although not unique early in the pandemic in northern Italy, and demographic factors and comorbid conditions contributed
- Despite problems with how “COVID-19” deaths are counted, there is epidemiologic support for the well-recognised notion that SARS-CoV-2 likely played the role usually played by the influenza virus in prior winter seasons
- WHO clarified in late 2020 that the PCR test is subject to false positives when disease prevalence is low and that positive results alone are not sufficient for diagnosis of COVID-19
- The precipitous decline in COVID-19 attributed deaths immediately following President Trump’s departure in January 2020 must reflect either a change in PCR test criteria or sudden development of herd immunity in an almost entirely unvaccinated population
Claim 13: That many deaths would have happened anyway due to a mild influenza season the year before.
NH Counterclaim: Dr Canaday says just 6 percent of Italy’s recorded deaths early in the pandemic were due to COVID-19, blaming the rest on underlying conditions – claiming many would have died the year before if it weren’t for a mild influenza season, calling them “dry timber”.
DrPC: I never said that 6% of deaths recorded in Italy were due to COVID-19 early in the pandemic. What I said was that CDC statistics in the United States had indicated that 6% of deaths from COVID-19 reported to the CDC had no underlying significant medical conditions, which, if present, would make those who were medically frail more likely to succumb to a viral respiratory disease such as COVID-19. (R1)
On the other hand, an early report of cases from Italy, as reported in NZ popular press, suggested a crude case fatality rate of 3405 deaths among 41,035 “confirmed” COVID-19 patients, or roughly 8% in March 2020. (R2) However, Italy also has the second oldest population in the world after Japan, highest rate of antibiotic resistance deaths in the EU, and high rate of smokers (26%). In addition, ALL patients in hospitals where COVID-19 was present were counted as COVID-19 fatalities, whether they were diagnosed with COVID-19 disease or not. (R3)
This bump in fatality rate in early 2020 was not unique to Italy, but occurred elsewhere in Europe, and represented a significant increase from prior years, especially compared to the year before, 2019: (R4)
Some 88% of patient deaths in Italy were in those, as in the USA, with at least one, and usually 2 or 3 chronic medical conditions which made them susceptible to the respiratory viral illness of early 2020, attributed to SARS-CoV-2. Another report from the Italian National Institute of Health, referenced in the article, suggested that even 99% of deaths involved at least one other health condition. Average age of death was 79.5 years. (R3)
A likely additional factor specific to Italy was the high proportion of Chinese labourers who resided in the northern province of Lombardy, where the pandemic in Italy was most intense, and who may have brought COVID-19 with them on return from celebration of Chinese New Year in January 2020.
Deaths attributed to COVID-19 were very significant although not unique early in the pandemic in northern Italy, and demographic factors and comorbid conditions contributed
NH: [continuing…] Dr Campbell said Italy’s statistics did indeed separate deaths from COVID-19 and other causes, and its overall mortality in 2020 was the worst since World War II. Saying many of the those who succumbed to COVID-19 would have died anyway is “pure hypothesis” with no evidence, she added.
“In a ‘bad’ flu year, around 650,000 die globally. Deaths attributed to COVID-19 are around 4.4 million in 18 months; there really is no comparison.”
Dr Canaday blamed the wave of deaths in late 2020, early 2021 as “dry timber” for similar reasons, which Dr Petousis-Harris said was “horribly callous”.
DrPC: Well, “dry tinder” was not my term. Apparently, Dr Petousis-Harris is not familiar with this term used by epidemiologists to describe the higher than usual risk of death from a winter respiratory viral illness, for example, when the prior year(s)’ winter death rate was lower than average of the preceding years. (R5)
This was, in significant part, also responsible for the increased deaths due to COVID-19 in Sweden and Denmark in 2020-21, although other factors were also responsible. (R6) A New Zealand based opinion piece also described this phenomenon by name— “dry tinder”. (R7)
Since Dr Petousis-Harris is also not and has never been a practicing physician, she likely has not had direct personal experience with managing the onslaught of hospital cases that occurs every winter (especially in the Northern Hemisphere). These are due to viral and bacterial infections which complicate underling chronic cardiorespiratory disease and other conditions and lead to increased mortality in these weakened individuals. Infectious disease specialists, hospitalists and certainly epidemiologists are also well aware of this phenomenon.
I have also discussed this phenomenon of “displacement” in detail in my response #12, to reiterate as follows:
Since the COVID-19 pandemic began in earnest in March 2020, hospitalisations in the US for lab-proven influenza and respiratory syncytial virus (RSV) fell dramatically, by 99% (R8) with deaths expected to follow a similar decrement. This likely represents a “displacement” process whereby respiratory illnesses usually caused by influenza were displaced by the more infectious and purportedly “novel” coronavirus, as has happened before. (R9) In truth, somewhere from 20,000 to 45,000 of the “usual” annual US influenza deaths may well have been replaced by “COVID-19” deaths since the pandemic began. This “displacement” effect of COVID-19 was, as noted above, more apparent in countries which had previously mild influenza seasons: (R10)
There is also the concern that COVID-19 cases diagnosed by PCR positive tests may have been actual influenza cases, not COVID-19 displacing influenza. The accuracy of the PCR test to differentiate RNA fragments between the influenza or the SARS-CoV-2 virus has been challenged, and indeed the current PCR test will be retired according to the CDC as of 31 December reflecting this concern.
It likely would have been retired earlier than that, except that the replacement “multiplex” PCR test that would be able to differentiate between the two was still being developed, and the CDC specifications to laboratories were just issued on 21 July 2021. (R11)
More to the point, deaths “attributed to COVID-19” have been overstated for a variety of reasons as discussed in responses #9 (false positive PCR tests) and #12 (counting deaths with COVID-19 the same as deaths due to COVID-19, attributed COVID-19 for deaths due to an unrelated cause but positive PCR test, deaths simply “suspected” as due to COVID-19).
I also note that there were credible allegations that widespread sedation of care home residents in the UK also accounted for the high proportion of COVID-19 deaths there, and we can see the very high “spike” in UK deaths in the graph titled “excess death score, 65+” above. (R12)
Any such deaths are significantly higher than they might have been had early and effective outpatient treatment with known safe and effective, repurposed drugs been implemented.
Early and effective treatment has markedly reduced fatality rates, as published by Dr Vladimir Zelenko (R13) with his outpatient regimen, and the publicly reported differences in case fatality rates also show this result within countries where these therapies were allowed (or alternatively not allowed) within their differing, and sometimes even adjacent, administrative regions. (R14)
Despite problems with how “COVID-19” deaths are counted, there is epidemiologic support for the well-recognised notion that SARS-CoV-2 likely played the role usually played by the influenza virus in prior winter seasons
NH: [continuing…] He also suggested a change in the testing method was behind the drop in reported COVID-19 cases, and therefore deaths blamed on it, after US President Donald Trump left office. Dr Petousis-Harris said there was no evidence for this.
DrPC: The basis for the claim is that on 7 Dec 2020 a WHO Information Notice clarified that RT-PCR tests should be evaluated in the context of clinical symptoms as stated in this first notice (R15):
“As the positivity rate for SARS-CoV-2 decreases, the positive predictive value also decreases. This means that the probability that a person who has a positive result (SARS-CoV-2 detected) is truly infected with SARS-CoV-2 decreases as positivity rate decreases, irrespective of the assay specificity.” [= Bayes’ theorem, as in my response #9]
Therefore, healthcare providers are encouraged to take into consideration testing results along with clinical signs and symptoms, confirmed status of any contacts, etc.” [which is always what should have been done in any case]
They go on to state that high viral loads in the patient can be detected with lower cycle threshold values (i.e., the number of repetitions in the testing procedure), and conversely high cycle threshold values (which were in common use, 38-40 at the time) may make…
“the distinction between background noise and actual presence of the target virus … difficult to ascertain… the cut-off should be manually adjusted to ensure that specimens with high CT values are not incorrectly assigned SARS-CoV-2 detected due to background noise.”
In an updated bulletin on 13 January 2021, WHO also reminded medical practitioners (R16):
“Where test results do not correspond with the clinical presentation, a new specimen should be taken and retested using the same or different NAT technology.”
But whether this happens in a busy laboratory with thousands of test runs daily, variable training of the technologists and problematic contact access to the requesting health care practitioners is an open question.
WHO clarified in late 2020 that the PCR test is subject to false positives when disease prevalence is low and that positive results alone are not sufficient to diagnose COVID-19
Both bulletins from the WHO occurred following the defeat of President Trump in the 3 November 2020 general election in the USA. It’s interesting that these facts had been well known long before these bulletins were brought out. It’s also quite interesting what happened to the CDC’s weekly count of deaths attributed to COVID-19 immediately after President Biden was inaugurated:
There was no change in therapeutic regimens used to treat either outpatients (minimal) or inpatients with COVID-19. It was still winter, which is high season for respiratory viral infectious disease.
The precipitous decline in weekly death counts then could have been due to one of two principal factors, since only 6% of the USA population had been fully vaccinated by 20 February, as above: either the attribution of deaths to COVID-19 changed from a lowering of the RT-PCR cycle threshold or there was a rapid development of “natural” herd immunity in the USA population without significant uptake of vaccination against COVID-19.
So, my question to Dr Petousis-Harris is: which of the two factors do you think accounts for this?
The precipitous decline in COVID-19 attributed deaths immediately following President Trump’s departure in January 2020 must reflect either a change in PCR test criteria or sudden development of herd immunity in an almost entirely unvaccinated population
SUMMARY AND IMPLICATIONS
Early in the pandemic, northern Italy suffered high mortality from what came to be known as COVID-19. An aged population with co-morbid conditions was more susceptible. Returning residents from the hotbed of COVID-19 in Wuhan contributed. Methods of counting COVID-19 deaths likely did also. These factors were not unique to Italy, and occurred in other European countries, some early on and some later.
The phenomenon of “dry tinder” represents individuals with severe underlying and usually chronic diseases who did not succumb to the usual seasonal respiratory viral illnesses because of preceding mild winters or weak influenza or other respiratory viruses. This concept is well-recognised in epidemiology circles, and likely contributed in part to the excess mortality from COVID-19 in 2020 and early 2021.
The CDC changed or at least clarified guidance on the interpretation of the PCR test for SARVS-CoV-2 after the 3 November election was held in the USA. There was new emphasis on how false positives could become a problem when high cycle threshold values are used and when there is low prevalence of disease. There was new emphasis on correlating test results with the clinical condition of the individual, something that every competent treating physician knows implicitly.
Immediately after the incumbent President left office in late January 2021, COVID-attributed deaths declined rapidly. The only plausible explanation for this in an almost entirely unvaccinated population would be either a redefinition of PCR positive (and thus a COVID-19 “death”) or sudden development of “natural” herd immunity. So, which is it?
And, how are COVID-19 deaths actually counted? How many deaths have been over-expressed due to disallowed effective regimens for early treatment, active measures to accelerate deaths in the elderly, or government fiat censoring doctors and other scientists who speak out?
I will leave these matters for the reader to decide.
R1: CDC co-morbidity factors in COVID-19. https://www.cdc.gov/nchs/data/health_policy/covid19-comorbidity-expanded-12092020-508.pdf
R3: Global COVID-19 Case Fatality Rates. https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/
R4: Deaths and excess mortality in Europe. https://euromomo.eu/graphs-and-maps/
R5: The 2020 “dry tinder” effect. https://adapnation.io/the-2020-dry-tinder-effect/
R6: High excess deaths in Sweden during the first wave. https://journals.sagepub.com/doi/full/10.1177/14034948211027818
R7: Sweden’s disaster in disguise.https://www.nzinitiative.org.nz/reports-and-media/opinion/swedens-disaster-in-disguise/
R8: What Effects have COVID had on respiratory virus patterns? https://www.medscape.org/viewarticle/959066?src=WNL_cmemp_211001_mscpedu_imed&impID=3680601&faf=1
R9: Why the flu has “disappeared.’ https://swprs.org/why-the-flu-has-disappeared/
R10: From www.covidplanb.co.nz/category/data-science/page/6/ and
R12: Midazolam in the context of UK COVID-19 deaths. https://theexpose.uk/2021/10/21/midazolam-was-the-real-killer-in-this-pandemic-not-covid-19/
R13: COVID-19 outpatients: early risk-stratified treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587171/
R14: Ivermectin experience in several countries. https://dryburgh.com/wp-content/uploads/2020/12/Ivermectin-Epidemiological-Data-from-Peru-and-other-countries.pdf