Week 21: Crossing the t’s, and dotting the i’s

 

An earlier blog first looked at the Scandinavian countries , providing the UK as a sort of  ‘out of Scandinavia’ control. 

 

	Norway	Sweden	Finland	Denmark	(UK)
Blog 9: 16th May
Covid Cases/M	8.1	67.6	19.6	22.3	80
Covid death/M	0.25	10.6	0.8	1.1	8.9

 

Dr. Anders Tagnell, Sweden’s epidemiologist, argued that left to themselves, ‘by end of May 40% of population of Stockholm would have had the virus, and any upswing of morbidity will be quite low’. Sweden is a huge country with a small, thinly distributed population. Dr Tagnell became a hero to teenagers in Sweden, and I hoped he’d have some luck with such an interesting idea.  Schools, restaurants and shops in Sweden stayed open, with the voluntary social distancing the only control measure. At the highest stage off the pandemic teenagers were even having an image of Dr T tattooed onto their bodies. (No other epidemiologist has achieved this distinction). This despite the fact that high schools were eventually closed to children <16 years, and groups of >50 people were ‘discouraged’. We can see that even then we had more cases /M than Sweden.

 

Last night I had the unexpected good fortune to see and hear Dr T on the BBC programme “News Night”, and found him more interesting, but oddly non-apologetic, for his earlier views. He denies that he had hoped to achieve herd immunity for the population of Stockholm, and indeed such an outcome is highly unlikely, as it would require between 50 and 90% of the population to have such immunity. (In fact only 7.3% of the population of the Capital has antibodies to covid-19). By mid May it can be seen (see first 3 lines) that Sweden at the time of my earlier report had the highest numbers of both Cases and deaths/M, higher than any of the other three Scandinavian countries.  Let us see how these figures have developed by today:

 

Today’s blog, No 21, 8^th August

 

	Norway	Sweden	Finland	Denmark	(UK)
Covid Cases/M	1721	8038	1350	2429	4511
Covid death/M	47	568	59	105	679

 

                                                                         

Maybe Dr  Tagnell was  only concerned to compare Sweden with other Scandinavian countries: if he was, he has lost his bet. Even then, the UK had more deaths M/ than Sweden, and so did Italy and Spain. Looking at other countries notable for making a pig’s ear of the pandemic, the US, Brazil and Peru have more cases than Sweden, and Peru, Italy and Spain have more deaths/M than Sweden (all shown in bold type).

 

	Italy	Spain	U.S.A.	Brazil	Peru
Covid Cases/M	4108	6539	14240	12939	13153
Covid death/M	581	608	467	442	594

 

 

It is worth recording that in the UK, Matt Hancock (the Secretary of State for Health in Mr Cumming’s pygmy cabinet) also over looked the number of covid cases in old people’s homes, and sent many virus-positive patients to such homes, without sending nearly enough PPE to protect staff, or test data to discover who actually had the virus.  In fact, Sweden also had severe problems with obtaining PPE, and did not have enough tests for the virus. In Sweden about half of all deaths occurred in old people’s homes.

 

Conclusion:

The fact that Mr Hancock made the same mistakes as a Swedish scientist in no way reflects especially badly on him. We expect politicians to make mistakes.  Interesting that “herd immunity” was originally mentioned both in the UK and in Sweden. In discussion with the BBC journalist, it was clear that Dr. T did not think that he, as an epidemiologist, had any responsibility for old people in homes. Still worse, despite loud claims to our competence in test, trace and quarantine contacts, we don’t really have the necessary skills, and our political masters appear to think that if they achieve a low R-number, the virus will magically disappear. In the UK, USA and probably Sweden as well, the problem is a political one.  In all countries people exist, but they need to be properly trained in order to deal with a problem that needs more than a vaccine.

 

Another, completely different, problem:

 

The other claim made in my previous blogs was that Black and other ethnically diverse populations might be especially sensitive to low levels of the endohormone calciferol, also known as Vitamin D. This is now given to all patients admitted to the South London and Maudsley hospital, irrespective of ethnic group. Knowing them as I do, my guess is that we will not have to wait long for an authoritative paper. NICE does not consider the matter to be established, but it is still an interesting possibility.

 

Refs:

Martineau AR, Jolliffe DA, Hooper RL, et al.  Vitamin D supplementation to

prevent acute respiratory tract infections: systematic review and meta-analysis of

individual participant data. bmj. 2017 Feb 15;356: i6583.

 

Crews M, Lally J, Gardner-Sood, P, et al.  Vitamin D deficiency in first episode psychosis: case–control study,  Schizophr. Res. 2013;150(2-3):533

 

David Goldberg

8^th August 2020

The emergency for old people still stretches on into the future, with no date for remission, even for good behaviours. Some of my more erudite US colleagues confident, that some day, it will end. If one hasn’t died of something else first, of course.