Sunday 2 August 2020

Panic over rising Covid-19 case numbers is as irrational as it is dangerous says Ross Clark

The Telegraph's Ross Clark explains why testing for coronavirus is a waste of time (citing Donald Trump, that well-known expert) and why it's hospital deaths that matter (he seems to recognise no other, which might surprise relatives of 25,000 care home dead).

Ross's piece might have worked better if he'd just surrendered to his inner demons and said, "They are weak, let them perish."

Why is anyone interested in the number of recorded cases of Covid 19? It might sound a daft question, given that we are in the middle of a pandemic, but it ought to be clear to anyone who spends a few minutes digging around the figures that it is a meaningless statistic. Count deaths, by all means, hospital admissions, ICU admissions - but as for the official figures of how many people have tested positive for the disease, it is pointless worrying about them.

Why? First, because we are only - and only ever have been - detecting a small fraction of total cases of infection with SARS-CoV-2, the virus which causes Covid 19. Take the UK. Officially, as of Monday evening, there have been 300,111 recorded cases of Covid 19. Yet serological tests by Public Health England suggest that 6.5 per cent of the population of England have antibodies suggesting they have at some point been infected with the virus - which works out at 4.2 million. In other words, the official count has only managed to capture one in 14 cases of the disease. Why so few? Because in the vast majority of cases - between 70 and 80 per cent according to some estimates - Covid 19 causes no symptoms whatsoever. Those infected have no reason to assume they are infected, no need to seek medical attention and no reason to seek being tested.

Globally, there is also a growing discrepancy between the graph of infections and the graph of deaths. The World Health Organisation (WHO) keeps on telling us that the pandemic is accelerating. On Friday, it counted 218,307 new cases - a fresh high. In April, when the pandemic peaked in Europe, the daily count of cases globally never exceeded 100,000. Yet look at the figures for recorded deaths, and while there has been a small rise in recent weeks, daily deaths have flattened off at around 5,000. This is markedly less than was being reported back at April's peak, when more than 8,000 deaths were being reported on some days. There is a slight lag between reported cases and deaths, but not enough to account for the discrepancy.

Why the divergent paths of recorded cases and deaths? Either the world is recording more cases of Covid 19 because it is testing more, we are recording fewer deaths because we have become better at treating the disease, or fewer cases are going on to develop into medical emergencies because a greater proportion of new infections now are among less vulnerable groups - they are in younger, healthier people - than was the case in April. Perhaps it is a mixture of all three.

Look at the US, where recorded cases are currently running at more than twice what they were in April but where deaths have more than halved since then. How come? Tests for Covid 19 are now running at around 800,000 a day. In the middle of April, by comparison, the US was carrying out 150,000 tests a day. Testing is, as Donald Trump said recently, a "double-edged sword" in that increased testing has allowed authorities to establish where the disease is spreading, but at the same time it makes the epidemic look worse on paper than it actually is. He was, of course, vilified for saying this as he is vilified for whatever he says, foolish or sensible. But perhaps his critics would like to explain the divergent paths of recorded cases and deaths. Again, a lag between infections and deaths cannot explain it alone.

In Spain, the subject of this week's panic, the number of new cases started jolting upwards three weeks ago. Yet there is not the faintest sign yet of an increase in Covid deaths, which have fallen away to virtually nothing: three died last Thursday, the most recent day for which figures are available, compared with nearly a thousand on the worst days in April. The "second spike" has been blamed on young people partying in Barcelona and elsewhere. But does it really matter if they get infected so long as the disease is kept away from elderly people, especially those in care homes, where it accounted for so many deaths earlier in the year? Logically, rather than confine everyone indoors, as is happening again with some local lockdowns, everyone in Spain under 40 ought to be invited to a fortnight-long beach party - the equivalent of a measles party - where they can all get infected and perhaps build up herd immunity.

But whatever policy a country chooses to follow, can we please stop fretting over meaningless graphs of the number of new infections and look instead at what really matters: hospital admissions and deaths? So long as they are falling, any rise in recorded infections matters little.


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