Late in 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in many European and Asian countries, causing coronavirus disease 2019 (COVID-19). This remained largely unrecognised until a severe outbreak in China made global news.
Emergent information was extremely bleak at first, picturing a serious disease with high infectivity and mortality. Countries around the world prepared for an unprecedented pandemic which threatened to overload healthcare systems with innumerable cases requiring hospitalisation and respirator support.
Fortunately, these dire predictions were far from reality. Most COVID-19 sufferers experienced mild symptoms, or none at all. However, significant numbers tragically developed acute respiratory distress syndrome (ARDS), possibly precipitated by a cytokine storm, followed by multi-organ failure, septic shock and blood clots. Such a poor outcome was far more likely in older people and in those with significant morbidity.
In order to prevent uncontrollable spread of this new virus, simple measures were widely recommended. These included frequent hand washing, social distancing, quarantine of infected individuals, covering coughs and keeping unwashed hands away from the face.
More severe measures, such as travel restrictions, airport and port closures and the prohibition of mass gatherings, should have been a fall-back to be utilised only for short periods in the event of a crisis.
Unfortunately, many countries implemented such ‘lockdown’ measures before any exponential rise in cases and, furthermore, extended such severe restrictions even when the epidemic was clearly receding.
The economic and social impacts of such decisions was unprecedented, incalculable and catastrophically harmful.
Today, much updated information is available about the virus and its transmission and, crucially, the mortality rate among those infected. Deaths in infected individuals might not have resulted directly from the infection but, rather, from associated factors such as old age or significant health problems. Consequently, the best measure of the COVID-19 mortality is the excess mortality (compared to that normally expected) during the epidemic.
Data from the EuroMomo dataset (360 million people) indicate that excess mortality during the first COVID-19 pandemic in Europe was about 13,000 in those aged 15-64 and 167,000 in those over 65 (to total 180,000 excess deaths). In comparison, the figures for seasonal influenza in the winter of 2018 were 20,000 and 120,000 respectively, to total 140,000 excess deaths.
As such, the best data available suggests that excess deaths during the 2020 COVID-19 pandemic were about 30 per cent more than those during a typical seasonal influenza epidemic. Normally, a virus which makes the species jump (from animal to man) tends to subsequently produce mutations which are more infectious, but less lethal, compared to the original virus. As such, in future, we should reasonably expect COVID-19 to cause less deaths.
The WHO is now not recommending lockdown measures as the primary method of infection control- Jean Karl Soler
The rise, and fall, of COVID-19 infection rates all over the world also exhibited other similarities to prior influenza epidemics and pandemics. In the European region and North America, the numbers of cases followed the classic Gompertz curve, with a slow start, followed by a rapid rise, a plateau and then a slow decline to low levels.
In other regions, like South America (and the southern US), the curve was more rounded with a slower rise and longer plateau. In practically all countries, distributions of COVID-19 cases correlated with increased death rates and hospitalisations, at least at first. However, crucially, this only holds true for the period between late March and early June 2020, when, effectively, the real pandemic ended.
In recent weeks, we have seen an increase in cases in many European countries but this has not resulted in excess deaths or hospitalisations. Many cases seen at this time reflect increased surveillance, with frequent testing and low thresholds for polymerase chain reaction tests. Such testing may give false positives or detect virus fragments (dead virus) in healthy individuals.
More importantly, large-scale, robust datasets have not shown any appreciable differences in the Gompertz pattern COVID-19 curves between countries with severe lockdown measures and others, like Sweden, which did not implement lockdowns. As such, it is clear from this evidence that lockdowns did not have major effects. This was not unexpected.
For example, numerous published randomised controlled studies found only small impacts of face masks on influenza virus transmission, specifically in closed environments with individuals in close contact, and even then mostly with N95 masks. Empirical studies on COVID-19 cases quarantined with their families also confirm that it is rare for an asymptomatic person to transmit the virus, anyway. Thus, quarantine does not provide major benefits in asymptomatic cases.
The typical Gompertz pattern curves, evident in so many country data sets, also provide confirmation that COVID-19 infection does indeed confer immunity as, otherwise, the curves would have been very differently shaped. Surprisingly, many people (possibly over 60 per cent, or even 80 per cent, in many European countries) had some degree of immunity to COVID-19 prior to the pandemic, without ever having encountered the virus, due to cross-immunity from prior infection with other common-cold coronaviruses.
Additionally, negative antibody tests do not exclude immunity. Low antibody levels are normally found weeks after a viral infection, despite the presence of ‘memory’ cells which lie dormant in the immune system, ready to fight the infection should it be encountered again. This is also clear from the extreme rarity of COVID-19 recurrence reported in the literature.
In conclusion, it is evident that the actual 2020 COVID-19 pandemic started in March and ended in June in most European countries and that the current ‘cases’ are not associated with large scale excess mortality or hospitalisations.
It is also clear that the more extreme lockdown measures did not have any major additional effects on the unfolding of the epidemic, as against more simple measures, such as reasonable social distancing and basic hygiene. That is why the WHO is now not recommending lockdown measures as the primary method of infection control.
Jean Karl Soler is a medical doctor and researcher.
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