On January 20, 2020, the World Health Organisation (WHO) declared an international public health emergency over the global outbreak of COVID-19 (coronavirus disease 2019). The WHO declared an end to the pandemic over three years later, on May 5, 2023.

Many would argue that such was at least two years too late, since from early 2021 the European excess death curves (Euromomo) were not much higher than an average year with seasonal influenza. Was the global response to the pandemic excessive?

The outbreak started in China, which immediately deviated from the existing 2019 WHO pandemic influenza guidelines, locking down entire cities and districts. The guidelines strongly recommended against contact tracing, quarantine of contacts or exposed individuals and border closures, entry or exit screening.

Sweden famously avoided lockdowns along with their devastating effects on the economy, people’s lives, employment, well-being and mental health and the disruption of the education of a generation of children.

In 2020, the infection fatality rate of COVID-19 was probably about twice to 2.5 times that of seasonal flu but was actually less than flu in those under 45.

The original plan by the UK government was also to follow the evidence-based approach, namely advising social distancing during periods of high transmission and advising sick individuals to stay home. Such would have allowed natural herd immunity in healthy, young individuals to curb the epidemic in a few weeks.

That plan was abandoned due to a landmark paper by professor Neil Ferguson of London’s Imperial College, which predicted 400,000 UK COVID-19 deaths without lockdown. He created purely fictional models, based on absurdly extreme numbers which overestimated COVID-19 infectivity and fixed mortality at 1.5 per cent.

Instead, John Ioannidis from Stanford, the third top-rated university worldwide, calculated that the actual observed infection fatality rate in early 2020 was around 0.23 per cent and only five per 10,000 (0.05 per cent) in those under 70.

Unsurprisingly, the actual death rate in Sweden in 2020 was 10 times lower than predicted by Ferguson and, by 2022, Swedish excess deaths were far lower than the European average. The BBC reported that Sweden did far better than the UK, in terms of excess deaths between 2020 and 2023  and had among the best global COVID-19 pandemic outcomes.

I attach a graphic of the excess mortality in Sweden and Malta from 2020 to 2023 (source: Our World in Data, University of Oxford). This metric is the most accurate as it is not skewed by false positive PCR tests or incorrectly attributing a death to COVID-19.

One can see a slight excess of deaths in Sweden, as compared to Malta, in mid-2020 but similar to lower Swedish excess mortality during the remaining three years. The difference is minimal, tending to favour

Sweden in the long term.

Could we have known that early on? Yes. Already by July 2020, a paper by Chaudhry in The Lancet demonstrated that lockdowns did not reduce COVID-19 mortality and this was corroborated by a meta-analysis by Bendavid in November 2020.

A systematic review of the evidence on lockdowns by the London Institute of Economic Affairs, published recently by Herby, Jonung and Hanke, found that “the average lockdown in Europe and the United States in the spring of 2020 only reduced COVID-19 mortality by 3.2 per cent”. That translates to 6,000 deaths avoided in the whole of Europe and 4,000 in the entire US. Compare that with the 400,000 UK deaths predicted by Ferguson.

That colossal policy failure in 2020 was compounded by the imposition of vaccination from early 2021.

I shall not repeat the evidence-informed arguments I have already published in the Times of Malta between 2020 and 2022, which demonstrated that natural immunity was as protective as vaccination and for longer, that people at low risk enjoyed little benefit from vaccination, that vaccination protection was short-lived, did not prevent transmission and was associated with rare but dangerous adverse effects.

Excess mortality: deaths from all causes compared to projectionExcess mortality: deaths from all causes compared to projection

I now move on to the imposition of masks. In both 2020 and 2023, we had gold-standard systematic reviews from the Cochrane Collaboration, proving that N95, surgical, cloth masks and face shields had no supporting evidence: “wearing masks in the community probably makes little or no difference to the outcome

of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks.”

Furthermore, we were told that newer variants of COVID-19 were to be feared. On the contrary, such proved milder and more infectious, finally bringing the pandemic to an effective end during 2021 with globally high levels of natural herd immunity.

Finally, we were forcefully educated to believe that all COVID-19 vaccines were not only extremely effective but fully tested, safe and suitable for use in all ages with multiple doses.

Although the vaccine was indeed effective in protecting those at high risk, a large body of literature demonstrates clear associations with severe adverse events and even death. The risk is low but the cumulative incidence is not, being around one per 3,000 to 5,000 persons vaccinated.

For example, in a Thai prospective study, two per cent of children showed signs of heart damage, sub-clinical myocarditis and pericarditis, immediately after vaccination. Such was mild and most fully recovered. However, that is a very high incidence of a serious side effect.

A recent UK study found that around one per 350,000 young people (12 to 29) died in the weeks after vaccination. That is practically identical to the 2020 COVID-19 infection fatality rate in those under 20 as reported by Ioannidis. The mortality risk in healthy children and young adults would be even less, effectively zero. In healthy children and young adults, the risk from vaccination clearly exceeded benefit.

Indeed, the Astra Zeneca and Johnson and Johnson vaccines have since been withdrawn, many countries stopped using the Moderna vaccine in males under 40 by 2022 and  most countries have suspended routine vaccination programmes.

During the pandemic, those who supported a risk/benefit approach to vaccination, and/or defended basic human rights such as freedom of speech, association, religious worship, movement, education or employment, were associated with fringe groups and extremist views. Till this day, one quickly finds a link to an article in the Times of Malta titled “15 medical associations refute Dr Jean Karl Soler’s vaccine claims”. Indeed, it is the claims made therein which are refuted by the evidence quoted above.

For example, they claim that “side effects from the vaccine, while occurring in one per 100,000, are typically minor events”. If so, of the 1.3 million COVID-19 vaccines doses administered in Malta to date (source: WHO), only 13 people would have had “minor” side effects. They also claim that 2.7 per cent of those aged between 18 and 34 could die of a COVID-19 infection and that social distancing and lockdowns “have the potential to reduce the number of new infection cases by up to 98.9 per cent”. It is clear that such claims are demonstrably false.

According to the Hippocratic Oath, which I took on graduation in mid-1990, I am bound to first do no harm, tell the truth, and respect patients’ autonomy, including the choice to refuse treatment. I was, therefore, bound to speak out.

Jean Karl Soler is a medical doctor and researcher.

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