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Monday, 7 September 2020

COVID – why terminology really, really matters

[Dr Malcolm Kendrick]: To start with, we have the mangling of the concept of a ‘case’.

Previously, in the world of infectious diseases, it has been accepted that a ‘case’ represents someone with symptoms, usually severe symptoms, usually severe enough to be admitted to hospital. Here, from Wikipedia…. yes, I know, but on this sort of stuff they are a good resource.

In epidemiology, a case fatality rate (CFR) — sometimes called case fatality risk or disease lethality — is the proportion of deaths from a certain disease compared to the total number of symptomatic people diagnosed with the disease.’

Note the word symptomatic i.e. someone with symptoms.

However, now we stick a swab up someone’s nose, who feels completely well, or very mildly ill. We find that they have some COVID particles lodged up there, and we call them a case of COVID. Sigh, thud!

A symptomless, or even mildly symptomatic positive swab is not a case. Never, in recorded history, has this been true. However, now we have an almost unquestioned acceptance that a positive swab represents a case of COVID. This is then parroted on all the news channels as if it were gospel.

 
I note that, at last, some people are beginning to question how it can be that, whilst cases are going up and up, deaths are going down, and down.

This is even the case in Sweden, which seems to be the final bastion of people with functioning brains. However, even they seem surprised by this dichotomy. In the first two weeks of August they had 4,152 positive swabs. Yet, in the last two weeks of August, they had a mere 14 deaths (one a day, on average).

That represents 1 death for every 300 positive swabs or, as the mainstream media insists on calling them, positive ‘cases’. Which, currently, represent a case fatality rate of 0.33%. Just to compare that with something similar, the case fatality rate of swine flu (HIN1), was 0.5%. 2

Thus, lo and behold, COVID is a less severe infection than swine flu – the pandemic that never was. That’s what these figures appear to tell us. They tell us almost exactly the same in France where they ‘appear’ to have a current case fatality rate of 0.4%.

On the other hand, if you look at the figures from around the world, they are very different. As I write this there have been, according to the WHO, 25 million cases and 850,000 deaths. That is a case fatality rate of more than 3%. Ten times as high.

Why are these figures so all over the place? It is because we are using horribly inaccurate terminology. We are comparing apples with pomegranates to tell us how many bananas we have. Our experts are, essentially, talking gibberish, and the mainstream media is lapping it up. They are defining asymptomatic swabs as cases, and no-one is calling them out on it. Why?

Because… because they are frightened of looking stupid? Primarily, I believe, because they also have no idea what a case might actually be So, it all sounds quite reasonable to them.


The good news

However, moving on from that nonsense, there is some extremely good news buried in here. Which I am going to try and explain. It goes as follows.

At the start of the epidemic, the only people being tested were those who were being admitted to hospital, who were seriously ill. Many of them died. Which is why, in France, there was this very sharp, initial case fatality rate of 35%. In the UK the initial case fatality rate was I think 14%. Last time I looked at the UK figures, the case fatality was 5%, and falling fast.

This fall has occurred, and will occur everywhere in the World, because as you increase your testing, you pick up more and more people with less severe symptoms. People who are far less likely to die. The more you test, the more the case fatality rate falls.

It falls even more dramatically when you start to test people who have no symptoms at all. In fact, as you broaden your testing net, something else very important happens. You gradually move from looking at the case fatality rate to the infection fatality rate....<<<Read The Full Article Here>>>...