{"id":169796,"date":"2020-10-05T12:00:42","date_gmt":"2020-10-05T11:00:42","guid":{"rendered":"https:\/\/www.transcend.org\/tms\/?p=169796"},"modified":"2020-12-02T09:53:23","modified_gmt":"2020-12-02T09:53:23","slug":"covid-the-big-picture-in-7-charts","status":"publish","type":"post","link":"https:\/\/www.transcend.org\/tms\/2020\/10\/covid-the-big-picture-in-7-charts\/","title":{"rendered":"Covid: The Big Picture in 7 Charts"},"content":{"rendered":"

1 Oct 2020 – Covid globally, compared to the flu, in nursing homes, in the USA, in Sweden, compared to epidemiological models, and the economic impact of political reactions.<\/em><\/p><\/blockquote>\n

1) Gobal covid \u201ccases\u201d and deaths vs. all-cause deaths<\/h4>\n

Chart number one shows global covid deaths by September in blue (about 1 million) versus global all-cause deaths in purple (about 40 million). The chart also shows the cumulative number of global covid \u201ccases\u201d (i.e. positive PCR tests) \u2013 the so-called \u201ccasedemic\u201d on top of the pandemic.<\/p>\n

In contrast, the UN expects that the political reaction to the pandemic may put the livelihood of up to 1.6 billion people<\/a> at immediate risk and may, by the end of 2020, push an additional 130 million people<\/a> \u201cto the brink of starvation\u201d and an additional 150 million children<\/a> into poverty.<\/p>\n

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Global covid deaths and \u201ccases\u201d vs. global all-cause deaths. (Data: OWD)<\/p><\/div>

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2) Covid mortality vs. flu mortality<\/h4>\n

Chart number two compares mortality by age of covid and seasonal influenza (based on US CDC data). Below 50 years, influenza is somewhat deadlier than covid; above 50 years, covid is quickly getting deadlier than seasonal influenza (for which vaccines are available).<\/p>\n

This \u201cclose to natural\u201d mortality profile explains the very high median age of covid deaths<\/a> in most Western countries (80 to 85 years in Europe, about 78 years in the US).<\/p>\n

Overall, in Western countries a severe seasonal to medium pandemic influenza remains the best comparison to covid in terms of overall lethality and mortality. In non-Western countries, including Japan and most of Africa, covid mortality appears to be comparable to seasonal influenza.<\/p>\n

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Flu vs. Covid mortality by age (CC\/CDC<\/a>)<\/strong><\/figcaption><\/figure>\n

3) The role of nursing homes<\/h4>\n

Chart number three compares covid lethality (IFR) between the entire population (including nursing homes) and the non-nursing home population in Belgium (the hardest hit country in Europe; nevertheless, Belgian peak mortality is comparable<\/a> to flu waves in the 1950s\/60s.)<\/p>\n

In most Western countries, nursing homes account for<\/a> about 40% (Germany) to 80% (Canada and some US states) of all covid deaths, but encompass only about 0.6% of the population; their IFR (about 30%) is about 100 times higher than for the general population (about 0.3%<\/a>).<\/p>\n

When calculating and communicating IFRs, it is therefore crucial to distinguish between the nursing home and the non-nursing home population in order to provide meaningful values. Nursing homes require not a general lockdown, but a targeted, and humane, protection.<\/p>\n

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Belgium: IFRs in entire population vs. non-nursing home population (Molenberghs)<\/p><\/div>\n<\/figcaption><\/figure>\n

4) Covid mortality in the USA<\/h4>\n

Chart number four shows monthly mortality in the USA since 1960. Regarding covid, the US is one of the hardest hit Western countries; nevertheless, its peak monthly mortality (driven by the Northeast region) is comparable to the strong influenza waves of the 1960s.<\/p>\n

If covid had hit the US in the 1960s, its impact would have been much lower, due to a younger population, fewer nursing homes (which account for about 50% of US covid deaths), and much lower metabolic disease prevalence (i.e. diabetes, obesity and cardiovascular disease).<\/p>\n

However, in much of the US (and Europe), coronavirus antibody prevalence is still below 10% (compared to values between 20 and 50% in global hotspots). It is therefore possible that the new coronavirus will cause additional deaths if high-risk population groups get infected. On the other hand, both intensive and early treatment options<\/a> have improved in the meantime.<\/p>\n

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\nUS: Monthly all-cause deaths since 1960 (Whelan\/CDC<\/a>)<\/strong><\/figcaption><\/figure>\n

5) Covid mortality in Sweden<\/h4>\n

Chart number five shows monthly mortality in Sweden since 1851. Sweden did not impose a covid lockdown, did not introduce a face mask mandate, and has one of the lowest intensive care bed capacities<\/a> in Europe (two times lower than Italy). Nevertheless, its peak mortality is comparable to the strong seasonal flu waves of the 1990s. By September, Sweden was the only European country with decreasing<\/a> daily coronavirus infection numbers.<\/p>\n

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Sweden: Mortality since 1851 (JH\/FOHM)<\/p><\/div>\n

\u00a0<\/strong><\/figcaption><\/figure>\n

6) Epidemiological models vs. reality<\/h4>\n

Chart number six shows covid mortality in Sweden predicted by Imperial College London (professor Neil Fergusson) without measures (orange) and with moderate measures (gray), compared to the actual mortality curve (blue). 70% of Swedish deaths occurred in<\/a> nursing facilities; mortality in people below 65 remained below<\/a> the five-year average.<\/p>\n

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Sweden: Predicted deaths vs. reality (HTY\/FOHM)<\/p><\/div>\n

7) Economic and social impact of political measures<\/h4>\n

Chart number seven shows US job losses in post-1945 recessions. The political reaction to the new coronavirus, notably the lockdowns, has caused the worst employment recession since 1945, putting millions of people out of job and bankrupting tens or hundreds of thousands<\/a> of businesses.<\/p>\n

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US recessions in comparison (BLS \/ CRB)<\/p><\/div>\n

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Conclusions<\/h4>\n

Covid is a very serious public health issue, but:<\/p>\n

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  1. Talking about \u201ccases\u201d as if these were sick people is misguided.<\/li>\n
  2. Talking about IFRs (lethality) without distinguishing between the general population and nursing homes, as well as early and late pandemic phase, is misguided.<\/li>\n
  3. Saying covid is \u201cworse than the flu\u201d without saying for whom, is misguided.<\/li>\n
  4. Saying the recession is \u201cdue to covid\u201d, not the political reaction, is misguided.<\/li>\n
  5. Saying epidemiological models have been accurate and helpful, is also misguided.<\/li>\n<\/ol>\n

    See also<\/h4>\n