This is the third official post in a series titled Putting COVID on Trial, which was recently interrupted by a primer on probability meant to elucidate how it is that the conclusions drawn here — so different from professional publications — are grounded in a philosophy attempting to assign probabilities to things many professional researchers just simply assume.
For example, if a professional researcher records a COVID infection fatality rate that is 2.53% overall, then it is expected that they look carefully at the numbers, to make sure that they performed math operations correctly.
But, besides math, logic can be applied to numbers as well, and it should be asked:
Is it logical that the same disease which had an IFR of 0.2% overall in the UK Technical Briefing #5, ALSO had an IFR over 12 times higher than itself?
Or is it more logical that treatment differences are behind the more-than-12-fold difference in infection fatality?
Professional researchers will argue: But my numbers were CAREFULLY and judiciously recorded!
But the problem is that the numbers don’t make sense. Diseases do not get over 12 times more lethal than themselves “naturally” — though different populations will respond differently to the same disease, creating fatality rates which do differ and sometimes by a lot.
For example, the variation in death from the novel 1957 Asian Flu was 5-fold, with annual crude flu-associated mortality ranging from 23 per 100,000 up to 123 per 100,000.
The more novel the disease, the more it is the “same” worldwide — so that death differences are only those inherent in people. In very novel disease, the disease is the same, but the mortality response varies 5-fold.
With seasonal flu, some seasons are much worse than others, and one of the worst recent flu seasons in the USA was the 2014/15 season. Here is a flow chart showing the total number infected and the total number who died during that season, compared to what would be expected if Delta variant COVID had been the disease:
The 2014/15 flu was so deadly, that it killed one person for every 699 people infected. By contrast, Delta variant COVID only had the lethality to be able to kill one person for every 1,058 people infected.
To properly estimate the lethality of Delta variant, a comparison to pre-Delta COVID is required. This is because a massive vaccine campaign was in place before Delta became the predominant COVID variant in June of 2021.
When massive vaccine campaigns are in place, the “natural” IFR of a disease becomes tainted, leaving only relative changes in lethality as the best means of estimation. In the UK Technical Briefing #25, such a relative lethality was discovered, after comparing almost 700,000 sequenced COVID infections for Alpha vs. Delta.
The verdict?
Delta variant was 42% as fatal as Alpha variant.
Explaining Excess Deaths in the USA
To estimate the proportion of excess death in the USA which can be explained by COVID, I utilized a further relative change in lethality from Delta variant to Omicron variant (Omicron was 31% as fatal as Delta).
The Excel spreadsheet below is “busy” in that an awful lot of information is crammed into one sheet.
The primary analysis uses hypothesized annual attack rates for 3 kinds of COVID: pre-Delta (Alpha variant and wild-type), Delta, and Omicron. The baseline annual attack rate of 25% of us getting infected by COVID every 12 months comes from a seroepidemiologic study by Ioannidis.
Running down the left side of the sheet to the bottom reveals that the unexplained excess deaths during COVID are worth almost seven times the amount of American lives lost during World War I:
From top left, the 28-day fatality rate of Alpha variant from the UK Technical briefing #5 is corrected for only going out 28-days instead of following every single COVID infection for several months to find out the total who died.
While wild-type COVID was not as lethal as Alpha variant, all pre-Delta COVID was assumed to be as lethal as Alpha variant, so as to remain conservative.
The 25% attack rate would mean that 83 million had had COVID by the time that the vaccines rolled out. For the 518 days of pre-Delta COVID, 118 million infections would be expected to cause a quarter-million deaths — yet over 600,000 excess deaths had accrued.
As each new variant became dominant, the IFR dropped, and the ratio of actual death to expected death grew exponentially. At the Omicron IFR, an estimated half-billion US infections are required to explain all of the excess deaths for the 77 days of data.
A half-billion infections in 77 days?
In a nation which only has a third of a billion people (~333 million)?
Accounting for Multiple Assumptions
In order to account for different assumptions in the spread of COVID, I ran a sensitivity analysis using multiples of the cumulative confirmed cases:
3 times as many COVID infections as confirmed cases
4 times as many COVID infections as confirmed cases
5 times as many COVID infections as confirmed cases
Even with the most conservative assumption that only 1 in every 5 infections got confirmed as a COVID case — i.e., a total count of 397 million COVID infections by March of 2022 — it was still impossible for COVID to be the explanation of even one third of the excess deaths in the USA.
The upshot:
Something besides COVID killed over twice as many people as COVID did.
Reference
[Past seasons CDC reports of symptomatic flu infections and flu deaths by age] — CDC. https://www.cdc.gov/flu/about/burden/index.html
[16% of all flu infections remain asymptomatic; 84% of them progress to symptoms] — Leung NH, Xu C, Ip DK, Cowling BJ. Review Article: The Fraction of Influenza Virus Infections That Are Asymptomatic: A Systematic Review and Meta-analysis. Epidemiology. 2015 Nov;26(6):862-72. doi: 10.1097/EDE.0000000000000340. PMID: 26133025; PMCID: PMC4586318. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586318/
[Confirmed COVID cases] — OurWorldInData. https://ourworldindata.org/covid-cases
[25% annual attack rate for COVID] — Ioannidis JPA. Reconciling estimates of global spread and infection fatality rates of COVID-19: An overview of systematic evaluations. Eur J Clin Invest. 2021 May;51(5):e13554. doi: 10.1111/eci.13554. Epub 2021 Apr 9. PMID: 33768536; PMCID: PMC8250317. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250317/
[Cumulative Excess Mortality during COVID-19] — OurWorldInData [Human Mortality Database data]. https://ourworldindata.org/excess-mortality-covid
[Delta dominant after 26 Jun 2021; Omicron dominant since 19 Dec 2021] — Shi DS, Whitaker M, Marks KJ, et al. Hospitalizations of Children Aged 5–11 Years with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 2020–February 2022. MMWR Morb Mortal Wkly Rep 2022;71:574-581. DOI: http://dx.doi.org/10.15585/mmwr.mm7116e1
[As of 19 Jan 2021, from 52,000 COVID infections with Alpha (SGTF) variant, there were 104 deaths by Day 28, 1 death per 500 Alpha infections (corrected to 117 total deaths, by using Linton et. al., leads to IFR=0.225%] — Page 3. Epidemiological findings. UK Technical Briefing #5. https://www.gov.uk/government/publications/investigation-of-novel-sars-cov-2-variant-variant-of-concern-20201201
[“Time-to-death” model for COVID; using the 95% UB of both the mean and SD of the lognormal model that fit the actual deaths best] — Linton NM, Kobayashi T, Yang Y, et al. Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data. Journal of Clinical Medicine. 2020 Feb;9(2). DOI: 10.3390/jcm9020538. PMID: 32079150; PMCID: PMC7074197. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074197/
[From ~700,000 cases confirmed by sequencing, Delta was 42% as fatal as Alpha] — Table 3. Number of confirmed and probable cases by variant as of 11 October 2021. UK Technical Briefing #25. https://www.gov.uk/government/publications/investigation-of-sars-cov-2-variants-technical-briefings
[From 1.5 million confirmed cases, Omicron is 31% as lethal as Delta (IFR ~ 0.03%), making Omicron much safer than the seasonal flu] — Nyberg T, Ferguson NM, Nash SG, Webster HH, Flaxman S, Andrews N, Hinsley W, Bernal JL, Kall M, Bhatt S, Blomquist P, Zaidi A, Volz E, Aziz NA, Harman K, Funk S, Abbott S; COVID-19 Genomics UK (COG-UK) consortium, Hope R, Charlett A, Chand M, Ghani AC, Seaman SR, Dabrera G, De Angelis D, Presanis AM, Thelwall S. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022 Mar 16:S0140-6736(22)00462-7. doi: 10.1016/S0140-6736(22)00462-7. Epub ahead of print. PMID: 35305296; PMCID: PMC8926413. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926413/
[Five-fold death difference due to novel 1957 Asian Flu, where both antigens were H2N2, instead of the H1N1 to which people had been exposed in 1918] — Li L, Wong JY, Wu P, Bond HS, Lau EHY, Sullivan SG, Cowling BJ. Heterogeneity in Estimates of the Impact of Influenza on Population Mortality: A Systematic Review. Am J Epidemiol. 2018 Feb 1;187(2):378-388. doi: 10.1093/aje/kwx270. PMID: 28679157; PMCID: PMC5860627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860627/
[USA lost 117,465 lives in 19 months of fighting in WWI] — From: https://www.census.gov/history/pdf/reperes112018.pdf