Estimating the true magnitude of the pandemic and lockdown deaths – Part 1

The tiny country of Sweden, with a population less than half of New Delhi, is turning out to be the most important benchmark in 2020 to help us understand the true magnitude of the coronavirus pandemic and the magnitude of deaths caused by lockdowns.

Although many policy makers across the world refuse to admit it, lockdowns kill. Professors Martin Kulldorff, Sunetra Gupta and Jay Bhattacharya summarized this in the Newsweek on 30 October 2020, that “Lockdown strategies have led to many avoidable deaths among those at high risk from COVID-19 infections, while creating enormous collateral non-COVID health damage on everyone else”.

That lockdowns kill more people than COVID was also acknowledged in a 15 July 2020 report by the UK Department of Health and Social Care, Office for National Statistics, Government Actuary’s Department and Home Office which noted that “when morbidity is taken into account, the estimates for the health impacts from a lockdown and lockdown induced recession are greater in terms of QALYs than the direct COVID-19 deaths”. 

There are two types of lockdown deaths. The harms of omission are deaths that were not averted because the risk-based approach was inverted with a focus on low-risk groups instead of on the high-risk groups. For example, in Victoria in Australia the government failed to provide N95 masks in high-risk settings but focused, instead, on trying to stop the spread of the virus among low-risk groups.

The harms of commission of lockdowns are of two types. First, there are the severe mental harms, amounting to torture when people are locked indoor for months at a time. There are many non-fatal consequences of these mental health issues, such as increased self-harm by children. Second, due to the fear, terror and hysteria created by lockdowns, many people in critical health condition did not seek or get timely health check-ups and treatment, leading, for instance, to a spurt in heart-related deaths in 2020. There are also enormous long-term health harms from the compulsion to stay indoors for months on end.

Estimating the size of the pandemic

In my 6 March 2020 article on the pandemic, I noted the extremely high initial mortality estimates from experts, many of whom said that this was going to be in the category of the Spanish flu. I cautioned, however, that: “This doesn’t mean we should lock down entire societies. Instead, we need a risk-based, data-driven approach that will minimise the spread of disease while facilitating economic activity”.

By mid-April 2020 it was clear that this was not the Spanish flu. I critiqued Neil Ferguson’s model on 19 April 2020 – at a time when Sweden’s cases had plateaued. I waited for more information and concluded on 30 May 2020 that “This virus is quite bad but is definitely not like the Spanish flu in its lethality. It is better compared with the Asian flu of 1957-58 or the Hong Kong flu of 1968-1970, both of which were around 20 times less lethal than the Spanish flu”.

The pandemic has fortunately turned out to be even milder. On 20 November 2020 I looked at official data on 2020 deaths in Sweden to deduce that the coronavirus pandemic is more in the nature of a bad flu. Based on updated Swedish data as at 11 December 2020, I believe that there would be around 3000-3500 additional deaths this year compared with what we could have otherwise expected in 2020.

But here’s the key point: that in 2019 there were 3,419 fewer deaths in Sweden than in 2018 because of a mild flu season. We know that most covid deaths in 2020 in Sweden have been among the elderly (with those older than 75 constituting 80 per cent of the deaths). This strongly suggests that many of these 3,419 people (or more) who escaped the flu in 2019 have now died in 2020. If that is confirmed, it will be hard to detect even a mild pandemic in Sweden’s total deaths: just a “bad flu”.

Why has this pandemic turned out to be so mild?

Professor Sunetra Gupta of Oxford University was right to suggest in 2013 that big pandemics are very unlikely in the modern world because of constant international intermingling. 

The most significant risk to a prematurely-born neonate sheltered in a bubble is that it can die from the mildest infection. That is also why the arrival of the Europeans so severely impacted native American and indigenous Australian populations, since they had no resistance to the novel bugs the Europeans were carrying.

But in the modern world, people continuously share with their domestic counterparts the mild bugs that they have picked up from their international travels. This “cross-fertilisation” of bugs across the world builds strong global immunity. 

Likewise, children have a robust immune system that learns quickly. According to a report in Nature on 10 December 2020, children are “the main reservoir for seasonal coronaviruses that cause the common cold” and therefore benefit from cross-reactivity (I discussed this on 24 May 2020). Another factor is that “their noses contain fewer ACE2 receptors, which the virus uses to gain access to cells”. Their innate T-cell immunity is also particularly potent for this virus. Overall, the human species has a high level of immunity to this coronavirus.

The fact that the human species has strong pre-existing immunity to a wide range of viruses was the key lesson learnt from the swine flu “pandemic”. Peter Doshi wrote on 17 September 2020 in the British Medical Journal that: “The data forced a change in views at WHO and CDC, from an assumption before 2009 that most people ‘will have no immunity to the pandemic virus’ to one that acknowledged that ‘the vulnerability of a population to a pandemic virus is related in part to the level of pre-existing immunity to the virus’. But by 2020 it seems that lesson had been forgotten”. 

Using Sweden’s data to estimate global lockdown deaths

Sweden was the only country that did not impose any coercive lockdowns, border closures or mandatory mask requirements. It followed the well-established science and policies that were detailed in all pandemic plans across the world prior to the Wuhan lockdown. As a result, it remains the only benchmark for “normal” deaths from this pandemic. Without Anders Tegnell we would never have come to know the true magnitude of lockdown deaths. 

It will therefore be a mistake to look at the data on excess deaths of 2020 in nations other than Sweden to try to identify the magnitude of this pandemic, for their excess deaths include a vast number of lockdown deaths.