Coronavirus & Pharmaceuticals

What is the Most Important Variable in A Country’s Success Versus the Corona Virus?

Executive Summary

  • The public of most countries has been told that their countries need to lockdown, social distancing, and using masks.
  • What is the evidence for the effectiveness of the current status quo Coronavirus response?

Introduction

In the US, the government and media have been adamant in asserting that wearing masks, social distancing, and locking down is an effective strategy for addressing the coronavirus. Lockdowns have been in effect in the US since March, which is now roughly 7 months ago. Since roughly June, masks have increasingly been mandated. Employees at establishments have been directed to approach patrons that have their masks below their nose to tell them to push the mask over the nose. The conventional wisdom is now that people that are socially responsible wear masks.

We now have the passage of a number of months, and we can compare and contrast which countries have been more negatively impacted by the coronavirus, and which countries have followed which approaches to respond to the coronavirus.

See our references for this article and related articles at this link.

Evidence for the Effectiveness of Masks

This video, which was published in February of 2020, so several months before the US Government changed its position on masks, does a good job of explaining that only some masks do much to stop a person from getting the coronavirus. Masks like the N95. The N95 must have a seal, so it must be measured for the face so that there is a seal, and one N95 mask won’t necessarily work for any given person as one model won’t necessarily fit any one person’s face.

However, almost none of the population has an N95 mask, and most of the population is using masks like surgical masks and cloth masks. There is no evidence for these types of masks being effective. Yet, there is no effort by the US Government to get N95 masks out to the public. A person entering an establishment can get by with just about anything, including a bandana.

The MD in this video states that.

I think people see a mask and they see an illusion of protection. Anyone who does not have a respitory illness, a cough or a sneezing, should not be wearing any type of mask. Whether it is a surgical mask or a respirator.

People do not use their masks correctly. They play with it, they use it too long, they rub their nose underneath it.

The following is a comment on this video.

4 months later, there is no new data to support masks yet now, they are the most important thing to wear. Why is that? I still don’t get it. And not only are real masks being recommended, but any old rag across your face is supposed to stop covid in its tracks.

Yet, months after this video was made, the US Government abruptly switched lanes and began recommending masks.

Comparing Countries with Different Strategies Versus the Coronavirus

The US is often listed as the top country for coronavirus — however, this is misleading because the statistic most frequently communicated is total corona cases or total corona deaths. The most important statistic is not the total number of corona cases or total corona deaths, but the incidence of cases and deaths — which takes the total numbers and divides by the population.

Once one sorts the World O Meter statistics by incidence, not total number of cases, the US ranks as the 11th worst-hit country for coronavirus in the world. As we will see further in the article, there is a good reason for the US’s position, and it is most likely not the reason that is often given.

Important Consideration Which Reduces Comparability

There is a built-in bias to the statistics because the developed world maintains far better health statistics than the undeveloped or developing world. Just looking at a table won’t tell you this. It needs to be interpreted by stories from different countries.

  1. For example, India, which for months had a strangely low incidence of coronavirus, now has fast-growing numbers. But this is related to the increase in testing.
  2. China claims a ridiculous 4,600 coronavirus deaths, which is contradicted by multiple sources, so no statistics coming out of China are reliable.

The countries that are ranked close to the US tell an interesting story, which media entities don’t appear to be picking up.

The mortality per 1 M population ranges from 584 for Italy to 470 for France. The US is sandwiched between Sweden and Mexico. Let us look at these two countries. 

Mexico

Mexico is a country that is known as a country that decided not to respond to coronavirus, with the Mexican government going so far as to tell its citizens “not to be afraid of touching.” On the other hand, Mexico has unreliable statistics and have administered very few coronavirus tests.

I found this quote from a comment on a New York Times article.

As someone who knows doctors working in the hospitals in Mexico City I can tell you that they are told they can only put cause of death as COVID on a limited number of death certificates each day in order to keep the numbers down.

Therefore, due to both a lack of testing, coronavirus statistical fraud, and non-measurement of large numbers of Mexicans that die at home, Mexico is not a good comparison country to the US.

All indicators are that Mexico if its statistics were maintained correctly, would have one of the highest incidences of coronavirus deaths in the world.

However, as will be covered further in the article, this is unlikely to be because Mexico has been so lax in response to coronavirus (not mandating masks, not locking down the economy, etc..) but because of Mexico’s high rate of obesity and lower than average health of its citizens versus other countries.

Sweden

Sweden is one of the best-known countries in the world for its divergent strategy regarding coronavirus. Sweden has minimally locked down, and the Swedish Government does not recommend wearing masks. It is accepted that the general population is expected to be exposed to coronavirus, and the vulnerable groups (those with pre-existing conditions and old) are told to self-isolate.

Sweden’s strategy is based upon the reality of the coronavirus that it spreads very easily but is only dangerous to a small and known percentage of the population.

Anders Tegnell, Sweden’s State Epidemiologist, has stated there is no evidence for the effectiveness of masks in stopping the spread of coronavirus. Notice the street images of Sweden in this video are almost devoid of mask usage. Sweden has been pilloried in international media for this policy.

As stated in the video, countries that also mandated masks were France, Spain, Greece, and Italy. However, Spain and Italy have a higher incidence of coronavirus cases and deaths than the US. Greece, on the other hand, is very low, as the 110th worst-hit country.

These countries, and other countries, appears to indicate that there is little relationship between the use of masks and the incidence of coronavirus in countries. Yet, this easily observed relationship is almost nowhere in the coverage of coronavirus.

Observe the following video from CNN.

Why did CNN only compare Sweden’s mortality to its neighbors? Should the US’s coronavirus incidence only be compared to its neighbors — so Canada and Mexico? This appears to be designed not to look across a larger data, but to a restricted data set. This is called cherry-picking or excluding data to tell the story you are intent on telling. Why Sweden’s coronavirus incidence should not be compared against all developed countries (that have reasonably reliable statistics) is not explained by CNN. 

The CNN interviewer is intent on pushing the discussion to only focus on Sweden’s immediate neighbors. However, Dr. Tegnell points out to Christiane Amanpour that the neighbors of Sweden have a lower population density than Sweden. Sweden’s city of Stockholm is significantly larger than Olso, Helsinki, etc. (I checked this, and it was true). Dr. Tegnell also proposes that how mortality is recorded is more stringent in Sweden than in most other countries, so again this gets to the comparability of coronavirus statistics.

And where did most of the deaths occur in Sweden? In the long term, care (i.e., old people homes). How would a general lockdown have impacted these deaths?

There is no attempt to review each of the country’s approaches and to see which have been effective. Is it truly lost on CNN that there is no relationship between masks mandated in countries and their incidence of coronavirus? Is that a relationship CNN is not interested in exploring?

If so, why not?

This is the “analysis” provided by CNN. Cherry-picked data and preconceived notions. CNN’s health coverage seems to match their political coverage, where they are known to be in the tank for one US political party and the US intelligence community, and they rig the data points to support these agendas.

Also, what is the point of saying that the incidence will double by the end of the year? That relates to all countries and is related to the coming colder weather.

Christiane Amanpour then argues that is was bad that 50% of the deaths came from elderly care facilities. This appears to be an argument for more social distancing or other measures in these facilities — not as an argument for a general lockdown.

Close Schools to Protect the Young? (Do the Young and Healthy Need Protecting?)

At the end of the video, Dr. Tegnell states that schools were kept open. This is a huge difference from the US. It is not only a massive inconvenience to parents to have schools closed, but is pushing back the education of children. The US can point to no incremental benefit in terms of mortality from shutting down schools. Children and young adults have an infinitesimal risk of adverse effects from coronavirus. These schools have been closed, with virtually no health benefits to students from these closures. The answer to coronavirus is not to try to protect those that are least likely to suffer health consequences from being exposed to the virus.

Observe the following incidence of deaths from coronavirus by age.

And of the .2% or .002 incidence (which means 1 out of 500 of those that contract the virus) for the 10 to 19-year-olds. The 70 to 79-year cohort has 4000 times this mortality rate. 

How many of these children had some pre-existing conditions, are obese, and could be isolated from school based on this? Many more than 1 out of 500 children have a pre-existing condition or are obese. Once these individuals are isolated, the actual risk to normal healthy children would have to be close to zero.

What are we protecting children without pre-existing conditions from again by shutting down schools? What is going on here with the decision making?

Little Reduction in Coronavirus Incidence Since Masks Have Become Widely Worn in the US

Furthermore, if masks work to reduce coronavirus mortalities, why has the US death rate only slightly declined since masks began being mandated, the current rate of deaths is around 1,100 per day, while the pre-mask mandate was around 1,400 per day. However, other changes have also been applied, such as a long term shut down and significant adjustments to people’s lives — including large scale working from home.

Therefore the decline in mortality of roughly 300 to 350 cases per day cannot only be allocated to mask usage.

The CDC Mortality Report

The CDC publishes a report on mortality from coronavirus.

This report shows that only 6% of all of those that die from coronavirus only die from the virus, and that the rest die from other complications, some of which are pre-existing conditions, and some of which are not. The “not” category can be interpreted as the patient had a weakness in one of the areas, or that coronavirus caused or triggered a failure of that system.

This CDC report was exaggerated by some on social media who dislike the government’s current approach to the virus. However, these presentations of the CDC report were then shut down by those that support the status quo policy in the US.

The claim in this video about the CDC seemingly not wanting the public to read this report is true. We checked the CDC website. 

The CDC publishes a report that does not conform with the status quo policy and then does not make the report that most people interested in reading it easy to find on their website. 

Notice this quotation.

He noted that the 6% figure includes cases where COVID-19 was listed as the only cause of death. “That does not mean that someone who has hypertension or diabetes who dies of Covid didn’t die of Covid-19. They did,” Fauci said on ABC’s “Good Morning America.”

“So the numbers you’ve been hearing — the 180,000-plus deaths — are real deaths from Covid-19. Let [there] not be any confusion about that,” Fauci said.

Meyerowitz-Katz notes that influenza and pneumonia are listed as the most common concurrent diseases, which isn’t surprising. “Similarly,” he writes, “respiratory failure, something that the coronavirus directly causes, is listed here as a ‘comorbidity’ that 55,000 people had.” – FactCheck.org

There was an immediate reaction from many sources like the one above that “people should not read into this study.”

However, what the report shows is that healthy people or those with reasonably good/uncompromised immune systems rarely die from coronavirus. And yes, while coronavirus “directly causes” influenza or pneumonia — it won’t do that in healthy individuals. If it did, the mortality by age cohort would not look like it does. For example, why can’t coronavirus seem to cause any of these comorbidities in the young unless they are obese?

And this is not just restricted to coronavirus.

Communicable diseases typically impact those with lowered health. The comorbidities, or pre-existing conditions, weaken the person, making them more susceptible. This is true of surgery as well. Those with circulation issues have a higher risk of dying after surgeries.

It is not a reasonable conclusion that only 6% of the deaths attributed to coronavirus were due to coronavirus. But it is reasonable to say that coronavirus deaths are a trigger that pushes the aged or the relatively unhealthy over the edge. Another related topic is that of obesity. Obesity is never listed as the cause of mortality on a death certificate. However, obesity leads to a specific medical condition such as diabetes.

The following quote explains how obesity makes one more susceptible to either dying or having complications from the coronavirus.

Obesity causes restricted breathing, making it more difficult to clear pneumonia and other respiratory infections. Fat is biologically active and a source of pro-inflammatory chemicals, promoting a state of chronic inflammation in the body even before Covid-19 sets in. Obesity causes metabolic changes and abnormalities, even in the absence of diabetes.

Some coronavirus patients with obesity may already have compromised respiratory function that preceded the infection. Abdominal obesity, more prominent in men, can cause compression of the diaphragm, lungs and chest capacity. Obesity is known to cause chronic, low-grade inflammation and an increase in circulating, pro-inflammatory cytokines, which may play a role in the worst Covid-19 outcomes.

While early reports from China and Italy did not focus on obesity as an independent risk factor, physicians in other parts of the world, where obesity is more prevalent, were quick to notice that younger individuals who became very ill were often obese.

Though most of the early reports from China pointed to risk factors like Type 2 diabetes and hypertension, which are common in people with obesity, scientists in Shenzhen, China, posted a preliminary report online this month finding that Covid-19 patients with a high body mass index were at more than double the risk of severe pneumonia than those with a lower B.M.I.

Another study from China, which looked at outcomes among a group of 112 Covid-19 patients, reported that of the 17 patients who died, 15 were either overweight or obese. – New York Times

This graphic is from the website of Rethinking Obesity.

Something else interesting is that the media entities that covered this story by in large did not include a link to the CDC report. If they read the report, they are obligated to provide a link. If they did not give the link on purpose, then they appear to want readers not to read the report.

We found the report from The Scientist article, and have both that article and the CDC link included below.

The title of the report is..

Weekly Updates by Select Demographic and Geographic Characteristics

Once again, notice the differences in the causes of death by age cohort. While coronavirus is traced to 1.5% of deaths in the 15 to 24 age cohort, it is traced to 10.1% of deaths in the 75 to 84 age cohort. 

Here is the quote that started all of the commotions.

For 6% of the deaths, COVID-19 was the only cause mentioned. For deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death. The number of deaths with each condition or cause is shown for all deaths and by age groups. For data on comorbidities,

Some people indeed shared on their social media accounts that the actual number of coronavirus deaths is only 6% of the total reported. That is inaccurate. But it is nearly as inaccurate to propose that this report does not tell us important things about what category of person is dying from coronavirus. Although, it is most likely just a further corroboration of the mortality from coronavirus by age cohort. One wonders if major media entities also think that one should not read the mortality by age cohort table. The media is interested in telling the story of how some groups are “disproportionately” impacted by coronavirus, apparently because it is good for drumming up sympathy and appealing to emotions, but not interested in having the disproportion analyzed for what they mean in terms of a policy response to the virus. That is, it is very curious how the establishment media has been interested in using information about coronavirus mortality. If we look at CNN, their programming appears to be centered around getting people to feel rather than getting them to think. And any thought is determined not by the audience but is prepackaged by CNN. CNN will tell its audience what to think. The audience’s role is to “feel” exactly has instructed in reaction to the conclusion that has been determined by CNN, which itself seems to do little thinking or analysis. So observing disproportionate impacts of coronavirus on different groups is acceptable for emotion, but it is not acceptable for analysis. CNN’s catchphrase could be “Think this, not that, and feel this not that.”

The evidence for the unsupportability of the US’s current policy of lockdown and mask usage already comes to us from comparisons across various developed countries. This demonstrates there is either no or a very weak relationship between the degree of lockdown or mask usage and coronavirus cases or mortality.

Research That Should be Happening and Should be Seriously Funded

Optimally a binary coded categorical regression with a column for each factor — one for masks (masks, no masks) coded as 1 or 0, (high lockdown, low lockdown) coded as 1 or 0 would be performed for all developed countries (that is those with reliable stats). Then the result checked for the correlation across multiple factors.

I did find some research like this.

One article was published in The Lancet titled A country-level analysis measuring the impact of government actions, country preparedness, and socioeconomic factors on COVID-19 mortality and related health outcomes.

Its conclusions were as follows.

Increasing COVID-19 caseloads were associated with countries with higher obesity (adjusted rate ratio [RR]=1.06; 95%CI: 1.01–1.11), median population age (RR=1.10; 95%CI: 1.05–1.15) and longer time to border closures from the first reported case (RR=1.04; 95%CI: 1.01–1.08).

Increased mortality per million was significantly associated with higher obesity prevalence (RR=1.12; 95%CI: 1.06–1.19) and per capita gross domestic product (GDP) (RR=1.03; 95%CI: 1.00–1.06). Reduced income dispersion reduced mortality (RR=0.88; 95%CI: 0.83–0.93) and the number of critical cases (RR=0.92; 95% CI: 0.87–0.97). Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.

Roughly speaking, this means that obesity (relative health) and age play a strong role in the incidence of coronavirus deaths in a country. This is an important factor to control for, as two countries with identical policies will have different coronavirus deaths based upon the relative health and age of their populations.

And this quote is of course critical.

Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.

This means the things that have been proposed to be effective in fighting the coronavirus, are not correlated with doing so.

The Issue of Obesity and Coronavirus

Previously, obesity was little observed as it related to susceptibility to the coronavirus, as again, obesity is not listed as a cause of mortality. However, as the time dealing with coronavirus has passed, obesity is looking more like a primary risk factor, as if the following quotation explains.

“Many cardiac conditions are associated with obesity, so in a given patient you may not be able to disentangle them, but certainly a lot of research has pointed to prior MI and other things as being really important risk factors,” Tartof told TCTMD. “But in a lot of those early papers, BMI wasn’t even included as a covariate.(emphasis added) So a lot of the risk attributed to cardiovascular diseases I think we need to put in context and also consider BMI as actually a really primary driver of COVID-19 severe outcomes.” – TCT MD

For example, a number of Asian countries have been credited with having effective responses to the coronavirus. However, the Asian country with the highest number of coronavirus deaths is the Philippines, which is currently the 96th most impacted country. (i.e. very little impacted) A number of Asian countries are not developed, so they do not have good health statistics. However, the Asian countries that are, like South Korea, Japan, and Taiwan have very low coronavirus deaths. And the anecdotal stories coming out of the undeveloped or developing countries in Asia are not indicative that Asian countries (outside of China) have been very impacted by the virus (although they have certainly been impacted economically).

Asian countries not only have lower impacts from coronavirus, but Asians in the US also have some of the lowest incidences of death from coronavirus — as their levels of obesity are the lowest of all ethnic groups.

In general, obesity rates vary by race and ethnicity, according to the C.D.C. The age-adjusted obesity rate among Blacks is 49.6 percent, compared with 45 percent among Hispanics, 42 percent among whites and 17 percent among Asian-American. – New York Times

One has to wonder how much this low mortality is related to low obesity, generally in Asia. 

Also note that the methods that are generally thought to be effective, including rapid border closures, lockdowns, and extensive testing, were not related to the mortality rate.

There appears to be a curious desire by media entities in not explaining the relationship between coronavirus deaths and obesity, pre-existing conditions, or age. This video seems to think it unusual that a single-family containing a large number of obese members succumbed to the coronavirus. The New York Times covered the story and that several of the members that died had “no known pre-existing conditions.” However, the images tell you they do have pre-existing conditions. Obesity is itself a pre-existing condition. It is exceedingly unlikely, or should I say, impossible that the Fusco family members that died did not have high blood pressure, diabetes, and other conditions. 

How the US Nutrition Policy is Controlled by Food Companies

US nutrition policy has been essentially run by food companies with little concern for public health. Over time information that was provided by the FDA has been eroded to be more industry-friendly.

The meat and dairy industry never liked the original food pyramid. So by applying lobbying pressure, they had it changed to the pyramid on the right. This pyramid is both much more difficult to make sense of. And they were able to get exercise added to the pyramid — which of course is not nutrition. The concept was to emphasize that the problem is less high calorically dense foods, but instead insufficient exercise. This has been an assertion/PR talking point by the food industry. Therefore isn’t it interesting that it curiously appeared in the government’s food pyramid? The current “food plate” is now so watered down that it is close to meaningless — exactly what the most powerful food industry companies want. 

One might think that perhaps the fruit and vegetable portion of the food lobby would be able to lobby for its interests the way the meat, dairy, and packaged food companies do. However, the profits on less healthy foods, like packaged foods, are much higher than the profits on fruits and vegetables. There is no fruit or vegetable company that has the profits of a Coke, McDonald’s, or General Mills.

Michelle Obama’s “Lets Move” initiative emphasized the food industry’s PR position. However, the foods offered by the most profitable food companies are too calorically dense to be “hula hooped” away, or even run off. If a country allows food companies to control their food policy, the result is obesity and poor health outcomes. A major part of the exaggerated health care costs in the US is due to poor nutritional choices.

Michelle Obama wanted to push for better nutrition and obesity and make nutrition her pet issue. However, as soon as the food companies began to push back — she modified her messaging to be as much about increased activity. This messaging helps divert attention from the unhealthy, but profitable food that is in the US food system.

Unfortunately, all indications suggest that Michelle Obama is leaning towards complicity with the beverage industry. Michelle’s public health initiative has partnered with the American Beverage Association, but has denied partnering with Big Soda and does not mention the ABA, Coca-Cola or PepsiCo in its list of partners.

The ABA also can exploit Drink Up as part of its lobbying agenda. For example, the ABA fights public health campaigns against added sugar, as well as proposed soda warning labels and taxes, with its own “Energy Balance” propaganda. The message is clear: don’t worry about removing sugar and soda from your diet. Just move around a bit more and keep enjoying our products. – Crossfit

The end result of decades of having the food industry influence (control?) US food policy has resulted in obesity and a less healthy population than similarly developed countries.

This is a big part of the problem with dealing with the coronavirus, but the food industry cannot be questioned, is a major political donor — so it important that they are held blameless.

Under the Trump Administration, the nutritional focus has gotten even worse, with school lunch standards being reduced, and with Trump considering fast food as a normal way of eating.

The difference between what American children are served and what the children from the other countries in this video are served is stark. These other countries take an interest in the health of their children, and in building too nutritional habits. While the US does not. 

Conclusion

The US Government, media, and private entities are not following an evidence-based approach to dealing with the coronavirus. And this means they don’t have much of a reason to have instituted the current policy the US is following. Much of the response appears to be designed around “doing something” and maintaining the appearance of being responsible, rather than doing what is effective. This policy is extremely expensive to implement, is not sustainable over the long term, and is not leading to lower mortality.

There have been few multivariate studies into what factors make for an effective policy response to coronavirus. One of the studies that looked the most conclusive, published in The Lancet, stated that it had no funding. Our current policy is costing trillions.

A few questions naturally arise.

  1. Why are we not funding studies to determine if our policy is worthwhile?
  2. What is the expected reduction in mortality from the current policy? We have no idea.

Secondly, there has been close to no interest by the policymaking entities in the US to address the issue that the health of the person primarily determines the severity of the impact of the coronavirus. Article after article that obtained quotes from doctors showed the doctors stating that the nation must do something about obesity and overall health. The UK government has come to the same conclusion and is passing legislation to try to reduce obesity.

Why is this not more of a topic of coverage and conversation?

This information coming straight from doctors treating coronavirus patients could be useful and would promote many to become more healthy and to self-isolate. It could also lead to a far more intelligent response than trying to restrict the overall population. We layout one coronavirus policy response in the article The Answer to Corona Virus is Isolating the Plus 65 Age Group. After completing this article, it is clear that the obese should be added to the list of individuals who are isolated.

Furthermore, a primary reason for the high number of coronavirus deaths in the US is the fact that Egypt is the only country with a substantial population that has a higher percentage of their population that are obese than the US. The US has a large population, one of the highest incidences of obesity, and one might say naturally, the highest incidence of coronavirus mortality. The multivariable analysis shows that it is not the response to the coronavirus that is strongly correlated to the mortality from the coronavirus, but the health of that country’s population. 

The major media outlets are not communicating the evidence for the lack of effectiveness of lockdowns or mask usage, social distancing, and lockdowns. And now that this policy is the status quo, few media entities will question the policy as it would mean..

  • a.) having a tiny smidgen of independent thinking
  • b.) it would mean admitting to their audiences that they did not do their own research before getting behind the status quo.