COVID-19: time to start worrying?

Even the normally calm and sane Matt Ridley seems to be succumbing to the barrage of COVID-19 alarmism. The other day he published a piece entitled Coronavirus is the wolf on the loose.

After describing his own admirable, decades-long track record of staying calm and looking on the bright side – in all of which cases he has been proved to be correct – he now abandons the bright side for the dark side:

So why don’t I think this hobgoblin is imaginary?

He goes on to give us three reasons why the world should be worried about COVID-19. They are all rather overlapping reasons, but let's keep them separate as given.

Vulnerability: easy infection and difficult cure

First, because lethal plagues have a long track record. […] It’s true we have got better at eradicating infectious diseases through vaccinations, pills and public health, but most viruses are still very hard to cure and some are very easy to catch.

Well you can't argue with that. It is true that the bacterial diseases – both in their spread and cure – have been largely brought under control.

But we cannot take the population as an homogeneous mass.

In the advanced nations of the world, higher standards of living, better infrastructures, better hygiene and modern medicine have taken the fear out of bacterial diseases. We moderns have an expectation that somewhere some medicine exists which will cure whatever might afflict us.

Students of the past now have to work hard to recover the mindset of our ancestors, which was one of a permanent fear of things that could hurt you or kill you, without notice and without seeming cause. And do that to every level of society: when the Austrian Emperor Joseph II was dying a lingering death from lung disease, the remedy prescribed by the greatest medical minds of the day was porridge – that is, slime versus phlegm, the basic technique of the old doctrine of signatures, only two hundred or so years ago.

The worst we moderns have to fear are drug-resistant strains of microbes, but usually there is some cocktail of something that will help. We are on the whole a well-nourished, physically fit population, with some vulnerable people among the very young, the old and the already infirm.

In contrast, the populations of the developing nations still have to suffer and die from diseases that are easily and cheaply treatable in advanced countries. The greatest factor in health is wealth.

Similarly, the lethality of a disease is usually given in a single percentage, but this average – as all averages do – distorts the underlying reality. It really depends who you are.

For the already vulnerable, the lethality of a disease such as COVID-19 will be quite high and for the most vulnerable, shockingly high. Even if the new virus itself does not swing the scythe, it prepares the ground for some other microbial opportunist such as pneumonia. Those who do not die will have a rough time of it, perhaps trembling on the brink for some time.

But, for the healthy and fit, its lethality will be much smaller and many of those infected will have no more than a few days of unpleasantness. Some lucky people may not even notice that they have been infected by the latest terror of the human race.

It is also true that medical science is still struggling to conquer viral disease. The vaccination techniques and antibiotics that were so successful against bacterial diseases are useless against virus diseases.

The human race is saved from oblivion by a trade-off that successful viruses make between spreading and killing. This is often expressed in what one can call 'evolutionary intelligence': we are told that in some mysterious way viruses (and most bacteria, too) prefer not to kill their host but keep it mixing with people and spreading the disease as long as possible.

Of course, viruses don't 'prefer' anything. We can state the rule in a sounder form: non-lethal viruses spread faster and wider than dangerous ones. They are more successful, 'fitter' in the Darwinian sense of better adapted. Mild early symptoms means that their hosts have more time to spread them more widely before being incapacitated.

This seems to be an iron law: viruses with high and early onset lethality don't spread well. They may slay people in numbers, but will in their nature stay contained within a locality. Their very lethality draws attention to them, whereas a bit of a temperature and a few sniffles here and there go unremarked. For highly lethal infections, global transport networks are not really relevant: localised quarantine can bring such outbreaks quickly under control.

The converse is true, so that we can state with some confidence that if a virus is highly infectious and able to spread rapidly, it is extremely unlikely that it is lethal for the broad mass of humanity. In such circumstances what is needed is not quarantine or social control measures to limit the spread of the infection, but good medical care of the small percentage of cases where an underlying condition could lead to serious illness and even death.

Until medical science learns how to deal with viruses in the way it has learned to deal with bacteria, the herd just has to get the infection and build up at least a basic immunity.

Vulnerability: lack of immunity

Ridley then gives us his second reason:

The second reason is that new diseases are often more dangerous than existing ones […] But when they first infect our species, viruses can encounter a vulnerable immune system and run riot.

Well you can't argue with that, either. Except that it is another overblown statement of the bleedin' obvious – 'run riot'. Currently, with our present state of medical knowledge, most novel infectious viruses can propagate more or less unhindered through the human herd.

Only personal hygiene measures designed to avoid infection will slow down its spread. But most people in more than passing contact with other humans – particularly families with young children – will get the infection sooner or later. Every parent soon finds out that from the birth of their first little bundle of joy they can look forward to a twenty-year microbial siege from all the invaders the little one will bring home.

Vulnerability: globalisation and international travel

The third reason is yet another statement of the bleedin' obvious.

Then there is the effect of globalisation, and the huge growth in international travel.

International mobility will mean that an infection can jump from country to country rapidly. So? Whether a sufferer infects a couple of other people in the local corner shop or in some distant airline lounge – so what? Those are still only two infections, wherever they occur. The mathematics of the growth of the number of cases remains unchanged. Statistically, an infected person or carrier is going to pass the disease on to about the same number of people whether on a bus in China or in a carriage on the New York subway.

This mathematical misunderstanding is brought on by the feeling that we in the West don't want the diseases from the Orient, particularly from that strange place, China. But the disease is going to follow its mathematical course wherever it is.

We imagine that in the absence of international communications a new infectious disease would stay within the locality in which it first arose. But mankind has ever been on the move – to the ocean's edges and beyond – and this ideal has never been the case.

In the Middle Ages, infectious diseases spread rapidly via the trade routes. Not only that, the pre-industrial traveller had to break long journeys with frequent stops. At each stop, the parasites, bacteria and viruses that were the travelling companions of the wandering host were free to make new friends and influence people. Epidemics spread rapidly through communities, regions and continents.

It could be argued that the modern, globalised world is in fact much safer: we can now cover long distances in one hop with much reduced human interaction compared with the many multiple hops of the pre-industrial traveller.

Viruses jump from host to host, irrespective of whether there is a 5,000 mile journey in the jump. An infectious disease such as COVID-19 cannot be quarantined without bringing normal life to a standstill at a stroke.

It might be helpful for the future of mankind, as Ridley suggested in an earlier, slightly calmer piece on COVID-19, if we could persuade the Chinese to stop eating odd things and stick with fish and chips, steak and kidney pies, burgers and pizzas like the rest of us. But then, as the inventors of mad cow disease, who turned cattle into unwitting carnivores and cannibals, we Westerners are not really in a position to preach at them.

The current governmental pantomimes all pretend that the principle transmission of the virus is essentially contact, hence all the handwashing and avoidance of face touching. If this really were the case then control of its spread would be relatively easy.

But, like all influenza and cold viruses, COVID-19 is happy to hitch a lift on whatever will take it to a new host – coughs and sneezes, of course, but also, in some circumstances, merely breathing. The virus is minute beyond normal comprehension and only one of them in the right place is needed to get the ball rolling. A moment's reflection will make it clear that an effective quarantine and isolation against this type of threat would mean the end of civilisation as we know it.

Conclusion

In conclusion, we have to be clear that all – all – the economic and social disruption in the present COVID-19 epidemic is the consequence of the frantic and quite pointless measures put into place by hyperactive politicians spurred on by the hysterical media. The virus is innocent. If otherwise healthy people who test positive for COVID-19 – a test that anyway delivers an appreciable number of false positives – are going to be rushed with sirens, blue lights and hazmat suits into hospital, societal collapse is preprogrammed.

Why isn't our response to COVID-19 the same as our annual response to 'winter influenza' epidemics. Stay at home, wrap up warm, take an aspirin, 'feed a cold, starve a fever'? If it gets really unpleasant, then you should get the medics involved. What is the point of all this uproar?

Some sort of influenza virus pushes many people into a premature death every year. So far this slaughter has not bothered our rulers: there have been no forced quarantines or facemask panics. Cynics might point to the usefulness of these viruses as the Reaper's Little Helpers in winnowing out the unproductive chaff who are drawing pensions, blocking hospital beds and racking up care-home charges.

But for some reason the current epidemic narrative with its colourful Chinese menu options has caught the attention of the media and we are going to have no peace from it until that gentle warming of the northern hemisphere called spring takes place and the virus takes a plane to a southern hemisphere destination and settles down for a few months among those hospitable people Down Under.

Update 26.03.2020

The immunologist Professor Dr rer. nat. Stefan W. Hockertz has given several interviews recently in which he expressed strong opinions on the political reaction to the COVID-19 epidemic.

Below is the audio in German and our English transcription of an interview he gave to the rs2 station in Berlin on 24 March. Prof Hockertz's remarks are reasonable and measured, but even reasonable and measured remarks made by a highly qualified professional in his own field are in danger of being removed when they depart from the party line, as other dissidents are currently finding out.

Berliner Rundfunk rs2.

[Interviewer] What do you think: how dangerous is this virus?

[Hockertz] This virus follows the same course as respiratory tract infections and thus it is comparable to influenza. Its progress is comparable with influenza and also – something that is very important for us – it is comparable in its death rates.

For influenza this is somewhere between 0.5% and 1.0% and this is the roughly the same range we find with this virus. My basic position is therefore that we are dealing here with a coronavirus which represents around the same level of danger as influenza.

It is just that we are observing it more closely, we are looking at it in more detail and for that reason it has gained our attention.

[Interviewer] That's surprising, because we hear that in Madrid every six minutes a dead victim of coronavirus is transported from the hospital, in which case we think that I will get it soon and then my end will follow quickly.

[Hockertz] That is correct, but in my opinion we have reporting by the media that is of course totally fixated on the idea that every person who has corona and who dies, has died from corona. That is wrong.

Most people whom we now designate as death cases would have either died anyway. That is, they died with corona and not of corona. If we look at Italy, which, with its high death rate – over ten percent of those infected – demands our particular attention, we have to consider the total number of those infected. In this respect I agree with the IKRK that the quantity of people who have been infected by corona or with COVID-19 is a multiple higher than what we are measuring, I might even say a factor of ten. That is shown in the tests. And if we take such a number as a basis then the death rates become much lower.

[Interviewer] But then why are the hospitals so overwhelmed and so full? If, as mentioned, we compare this with influenza the situation is much the same.

I recall that two or three years ago we had a very big influenza wave with 25,000 dead. Firstly no one even mentioned this, it wasn't worth a headline, and secondly no report ever came that the health system was overloaded.

And now, in Germany, we have 94 dead and everything has been locked down.

[Hockertz] That is disproportionate and it is something that I have been saying in public for many days. The political reaction is disproportionate, it is authoritarian, dogmatic and it is excessive. There is no question about that. And we as citizens expect to be informed and treated in a science-based, rational and measured way.

Why is the hospital system overloaded? I should like to begin with Germany: the German system is not at the moment overloaded – on the contrary I find it outstanding that it is possible to take seriously-ill patients from Alsace and seriously-ill patients from Italy into our hospital system and treat them. That is excellent and shows that our system is not yet overloaded. In contrast, the hospital system in southern Europe is chronically overloaded, but only now are we starting to see it.

With every influenza wave, every pandemic, the hospital systems are overloaded, because firstly they were economised almost to destruction, as was the case in Germany.

But even worse and most important of all, a very important reason in connection with the death rates, is that the level of hospital hygiene is miserable in Italy and also in Spain.

People die, I repeat, not of corona but with corona, and because they pick up nosocomial infections: hospital microbes. There are interesting figures to which, as you have pointed out, no one pays any attention. In 2015 the European Center of Disease Control, ECDC, published figures for nosocomial infections and death rates.

In Germany we had 2,363 deaths. That is, people who came into hospital with a broken bone, for example, and who died from a lung infection because they had picked up an infection there – multiresistent staphylococcal infections etc.

So, once again: Germany 2,363, France 5,543. And now a good number: Holland 206. We know that in Holland hospital hygiene is taken very seriously. And then Italy, almost 11,000. Any questions?

[Interviewer] That means that the cleaner the hospitals are, the better the health care will be and the fewer dead there will be. But if you say that the illness is like influenza, how must I imagine that, how dangerous is the disease for us?

[Hockertz] The disease is dangerous for about 5% of the population – elderly, ill, weak people, damaged people, smokers – that is, all those people whose lungs have been damaged. One discusses why there are so many dead in Italy, because the level of air pollution in Italy is so high that we have many more damaged patients.

That is, five percent of the population is really in danger of developing this disease. I am not speaking of dying, only of developing the disease from respiratory disease to pneumonia.

Ninety-five percent of all people get through this disease lightly or have no symptoms at all. Politicians in their ignorance stupidly complain about that. I find that very good.

It is good because firstly, this infection is as non-dangerous as influenza (or as dangerous as influenza, if you prefer).

Secondly, this infection is very, very mild for many people. These people develop an immunity that lasts at least a year, a kind of protective shield around the person at risk, because these people have had the infection and have developed antibodies.

This process happens very quickly. I have been very surprised by the rapid progress of the disease in China, especially since it is alleged that this virus had its origins in a wild animal – that is, it was untypical for humans. Despite that, the people in China have developed their immunity very, very quickly. I am an immunologist and I can permit myself this conclusion. Our immune system was clearly able to identify this virus very quickly and very precisely, then counter it so effectively that it never comes to the development of the disease itself.

[Interviewer] That is tremendously reassuring for the moment, but then we have to ask: why these drastic measures? We have to do what the politicians tell us, we should to stay home, we should not even go to work and sometime perhaps there may even be a confinement order. And you don't think much of that.

[Hockertz] That is correct. I consider this reaction as completely over the top. I won't speculated why politicians have reacted in this way, clearly they have not been correctly advised.

They clearly have a great fear of not doing anything and having to watch this event, which we see every year for influenza. As we mentioned earlier, we had 25,100 dead last year and never spoke of an 'infection wave' or 'deadly plague' or 'war' and such terms which drive people to panic and which cause great collateral damage.

We speak of 'infection waves' or 'seasons' for influenza and have 25,100 dead, all of which no one bothered to talk about. That is for me hysteria: no one is well advised with fear and hysteria, but rather only with science-based, rational behaviour. In that sense politicians have run off the rails.

[Interviewer] I assume you would say that we should wash our hands. What measures would you take if it were up to you?

[Hockertz] Yes, of course. In our society we have neglected public hygiene completely. This is not only the politics of hospital hygiene – the politicians who today tell us that the hospital system is overloaded are the same ones who have economised the hospitals to the brink of ruin. One must always remember that. But what would I recommend?

Hand washing, and of course correct hand washing, twenty seconds with soap. That is the good thing about this infections wave, that we are beginning to think about hygiene again. Of course it is correct: keep a distance from others, especially when they show symptoms of infection. In order to reduce a little the exponential progress of the infection. That is necessary with every influenza, not just COVID-19: hygiene, hygiene, hygiene.

I would not wear a mask, that doesn't do much, but we should take extra steps towards hygiene. When did you last see the handles of supermarket trolleys being cleaned? I have never seen that. Those are transmission routes.

We should also change our own behaviour. If we hold a COVID-19 patient, touch them, come in contact with them, with their droplets, come into contact with the pathogen, that is not dangerous – so long as we do not put our hands in our mouth or nose.

This virus does not penetrate the skin, as deadly viruses such as Ebola do. No, we have actively to get it on our own mucous membranes.

[Interviewer] You are no prophet but an immunologist, how bad will it get and when will it be over, on the basis of what you know?

[Hockertz] Looking at the virus aspects, we shall get through this pandemic just as we have got through every other influenza pandemic. After about two to three months we shall have achieved an infection level of around 60% of the population. The virus, simply because of the general immunity of the populace, cannot spread any further. This is natural process that we also see with influenza.

However, viruses are continually changing their surface. They have 'learned' during their evolution that only a mutation will allow them to continue to infect hosts. Without mutations these viruses would just die out.

That's the virus aspect of the matter. But what happens to our social peace, what collateral damage will have been caused, for which politicians will have to be held responsible because of their disproportionate and immoderate reaction, that will require many, many years and cause discontent and unhappiness in the populace.

I said very early, and that is an important statement: it is not the virus that makes us ill, it is the fear that makes us ill.

English translation ©Figures of Speech [Reproduction only with a link to this page]. Corrected 27.03.2020: A few minor typos removed.