BMJ letter - The covid-19 elimination debate needs correct data - 2020

[Emily]

https://www.bmj.com/content/371/bmj.m3883
The covid-19 elimination debate needs correct data

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3883 (Published 06 October 2020) Cite this as: BMJ 2020;371:m3883


https://www.bmj.com/content/371/bmj.m3883/rr
Rapid Response:

How fatal is covid-19 compared with seasonal influenza? The devil is in the detail.

Dear Editor
Accurate assessment of the chance of death following exposure to covid-19 is important, since this statistic has been used by governments to direct lockdowns in an effort to mitigate these deaths. In correspondence to the BMJ, professors Baker and Wilson, both proponents of New Zealand?s lockdown, have criticised our assertion that the infection fatality proportion (IFP) of covid-19 is similar to seasonal influenza.[1] They claim that the IFP for influenza is 0.039%, about six times lower than the IFP for covid-19 we cited, a corrected median value of 0.23%.[2]...

....

....So, what is a reasonable IFP for covid-19? The overall corrected median IFP from 61 studies in a meta-analysis is 0.23%.[2] This agrees with a population serosurvey in Indiana.[20] These studies consider only seropositivity as an indicator of cumulative exposure to the virus. They have also assumed cause of death figures are accurate. So, once these factors have been considered, we believe that our comparison with seasonal influenza is not misleading. Since models that have incorporated higher IFPs have led to economically crippling lockdowns,[21] we believe scrutiny of these comparisons are vital and a reappraisal of the covid-19 IFP is overdue.

Simon Thornley, Section of Epidemiology and Biostatistics, The University of Auckland

Arthur J. Morris, LabPLUS, Auckland City Hospital

Gerhard Sundborn, Section of Pacific Health, The University of Auckland

Samantha Bailey, Clinical & Pharmaceutical Research Trust, 40 Stewart Street, Christchurch.

 

[tetano]

An old paper

Early in the course of covid-19, the all-age IFP was high, estimated at 0.66% (credible interval: 0.39 to 1.33%).[3] This led to alarming projections of covid-19 deaths, if the infection was left to spread. These IFPs were obtained by adjusting case-fatality proportions by the proportions of returnees testing positive from repatriation flights from Wuhan. This led to 250,000 deaths overall being predicted for the UK,[4] justifying lockdowns. Yet observed fatalities in the UK now show that these models overestimated deaths by seven times

In UK actually confirmed deaths are 127000 with lockdown

 

[tetano]

The document reported in the bibliography regarding mortality in Italy, is not a scientific article, but only mentions the statements made by a single exponent of the National Health Service at the beginning of the pandemic regarding deaths in the elderly population,
The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.
"On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity ? many had two or three," he says.

This thesis were later proved wrong. Elderly with or without comorbidies died in large majority "for" and not "with" coronavirus

 

[tetano]

This is not a scientific article, but only a response letter to the journal

 

[Emily]

So the lockdown made it worse?

 

[Emily]

Is it necessary to point that out when the post is labeled as such?

 

[sharon sanders]

Here is the original paper that the letter is a response to.

Should countries aim for elimination in the covid-19 pandemic?
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3410 (Published 09 September 2020)Cite this as: BMJ 2020;370:m3410


I am not sure what the debate here is. It is impossible to eliminate COVID-19 from the planet. This is proven science and common sense. Think of the common cold. Has that been eliminated? No.

 

[tetano]

sorry, I missed

 

[tetano]

Boris Johnson initially opposed to the lockdown and the belated measures that have been taken in the UK resulted in many more fatalities than other countries.

 

[sharon sanders]

I have moved this thread out of the news forums to the discussion forum since there seems to be some discussion about this topic.

 

[Emily]

I see, thanks. I think we have a paper titled something like "Lock down early or don't lock down at all."

 

[Emily]

It does look like one side of the debate was promoting total elimination. But as Tetano point out, the article and response are old within the pandemic timeframe. (Published 09 September 2020). Isn't the Covid coronavirus already endemic? Maybe that part of the debate is settled.