At this time, we all need to continue to comply with and follow advisories, which have been issued. We also need to think for ourselves and be questioning of what we are required to do. These concepts are not mutually exclusive.Thomas Sowell astutely observed that rather than problems with solutions we face trades offs. This is very apt at present. Covid 19 is presented as a problem and many claim to have solutions. The reality is there are only trade-offs. In Australia some jurisdictions are reporting no new cases. The total number is currently 6617 with 73 fatalities. On average 438 Australians die each day. In the USA there have been over 750,000 cases and 40,000 deaths. In the USA on average 8000 die each day. These figures are not to diminish the impact of the situation on those affected but to provide perspective.
Success has many authors. The current success in stopping spread and minimising fatalities will be hailed as proof that lockdown measures worked. That is possible. It is also possible that the computer modelling which predicted high numbers of fatalities was wrong and that worst-case scenarios may have never come to pass in any circumstance. There remain estimates that total cases could be fifty or a hundred-fold the number reported which reduces case fatality by fifty to one hundred-fold.
The reality is that measures taken have been of benefit but that the doomsday predictions were never going to happen. It is useful; to look at how different countries have managed this. New Zealand and Australia are similar in many ways. NZ went to a complete lockdown, yet their figures are no better (and on some indicators worse) than Australia. Within Australia different states adopted different policies without any evidence that the harshest was best.
Sweden and Taiwan have not shut down their economies. Sweden is flattening the curve in a similar manner to other European countries. Germany has done much better than Italy. Taiwan has done particularly well but the WHO refuses to acknowledge this.
As an aside, the abject failures of the WHO should be the subject of books not blogs.
The most useful statistic will be year on year deaths. If total deaths in February, March and April 2020 are not significantly above the average for the last few years, it means that all-cause mortality is the same. Deaths might be attributed to Covid-19 rather than other causes such as pneumonia, dementia, heart disease or cancer. Coding of cause of death has little science behind it. If a 90-year-old with kidney, lung and heart disease and a virus (of any description) dies – what is the cause?
Lifting restrictions will be difficult for governments. There remain noisy elements, unaffected by loss of income, who will scream that every death is preventable. These same people have zero concern about the massive health implications of unemployment, bankruptcy and loss of a business built through years of effort. They bleat that the economy doesn’t matter. The reality is that a healthy economy supports a healthy population. Sadly, those in ivory towers sneer at the people whose productivity enables society to have ivory towers.
Risk can never be eliminated. The best we can do is manage it in a way that does not do more harm than the problem being managed. That there will not be a daily toll of illness and deaths caused by the response won’t stop them happening – you just won’t read about them. They will be buried in statistics.
There is an adage that says those who do not learn from history are condemned to repeat it. The following is from the book “Scared to death” by Christopher Booker and Richard North published in 2007. It examined a number of health scares in the UK and found a pattern with certain elements in common.
- The source of the supposed danger must be something universal, to which almost anyone in the population might be exposed…
- The nature of the danger it poses must be novel, a threat that has never appeared in this form before.
- Whilst the scientific basis for the scare must seem plausible, the threat must also contain powerful element of uncertainty. It must in some way be ill defined, maximising the opportunity for alarmist speculation as to the danger it might cause.
- Society’s response to the threat must be disproportionate. It is this more than anything else which defines a true ”scare”; that, even where the threat is not wholly imaginary, the response to it is eventually seen to have been out of proportion to its reality.
The further we go, the more we have real data rather than computer projections and modelling. The fundamental fear with Covid-19 has been the case fatality rate and the potential for over whelming health systems. The further we go the more we are finding that the virus is mild in the vast majority of cases.
We need to remain flexible in our approach. The pivot will need to be to, as best we can, to protecting the vulnerable whilst gradually letting everyone else get on with their lives.
The trade off whereby we save lives by destroying other lives is not the long-term solution.
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.