COVID: The death toll of panic

[T]he lockdowns and panic were unsubstantiated, prevented nothing, and caused indescribable damage to society. Sweden’s statistics tell us, unequivocally, that in much of the world lives have been lost and livelihoods have been destroyed — in vain.” Not a shred of doubt: Sweden was right (Medium article)

Fear is a natural protective mechanism by which we avoid risky, threatening situations. Many years ago, long before anyone knew the cause of cholera, fear has caused people to flee from infected locations until the epidemic subsided. No public health official told them to do so. In fact, there was no such thing as public health. People witnessed excessive deaths, feared for their lives, and ran away. Undoubtedly, many lives were saved back then thanks to natural, intuitive fear.

Regulated fear

In the modern era collective fear is largely regulated, transmitted by third parties — officials and experts — whose messages are transcribed and amplified by the media. We did not observe dozens of pandemic deaths in our neighborhoods, and most of us don’t even personally know a single patient who died from COVID. COVID fear was elicited by daily messages about the pandemic and its death toll.

Since 2020 officials and the media have been counting deaths on a daily basis — something they had never done before. But only one kind of death mattered: death from COVID. That every week about 50,000 Americans die from various causes has never been broadcasted to the public. That’s a scary figure, for the layperson who never looked up the number and did not use to think about death every day. May I remind us that we are all going to die, some sooner unfortunately, and some later luckily? May I also remind us that life expectancy has doubled in the past century?

Fearmongering and bad news sell well, especially for the media. Optimistic messages, encouragement, and hope do not. Moreover, if officials err on the negative — false alarm — they will be forgiven. If they err on the positive, they will not. So it is not that difficult to guess what message they will choose to deliver.

The panic response to the pandemic

The reaction of a handful of officials in March 2020 was unsophisticated, panic reaction. It is as simple as that. Accepting uncritically apocalyptic predictions of 100% excess deaths by the summer, they promoted lockdowns and masks, neither of which had any scientific basis. On the contrary, pre-pandemic research and plans have explicitly excluded such measures and argued against fearmongering and disrupting normal life. Likewise, arbitrary physical distancing (there is nothing “social” about it) proved useless for an infection whose main mode of transmission is aerosols (tiny, virus-carrying droplets that are suspended in the air and can travel long distances.)

The panic reaction (copy China!) of a few influential figures was quickly adopted by officials in Europe and the US. You could hardly find any calming message, or any official voice that questioned baseless, unprecedented counter-pandemic measures.

Once ignited, panic spreads in the public like a wildfire. We don’t have good defensive mechanisms against fearmongering, and it is nearly impossible to reverse panic by data. Back in April 2020, when COVID waves quickly peaked everywhere— uniformly and unrelated to human action — it was clear that whatever the death toll in 2020 might be, it would be far away from 100% excess deaths. The apocalyptic predictions and the panic reaction that followed turned out to be colossal mistakes. But almost everyone was already brainwashed. The genie could not have been put back in the bottle.

Panic-related deaths

There are many costs to fearmongering and disrupting normal life, one of which is death. Some of the mechanisms are shown in the diagram below and are not difficult to grasp: avoiding urgent medical care (let’s ignore the chest pain; I might contract COVID if I leave the house); delayed diagnosis (my skin exam can wait; only COVID matters now); despair (I lost my job; perhaps a double dose could improve my mood).

Another pertinent example? Social isolation in nursing homes shortened lives which were already fragile. I have heard stories of nursing home residents who starved themselves after being disconnected from their families for months. And do you know how many children died in Africa due to disrupted chains of food supply? Look up some estimates.

Those who thought that you could shut down society without deadly consequences were naïve or fools or both. Did any official who shouted “stay home, save lives” try to calculate the cost, the so-called collateral damage? You know the answer.

I show here estimates of panic-related deaths in one Arizona County. These are visible deaths over two years of the pandemic. More will be observed in the decades to come but would be more difficult to quantify.

The horrifying numbers are by no means unique to this county, although I am sure we’ll find a wide range across counties and countries. The extent and effect of panic, just like those of COVID itself, varied widely.

Pima County, Arizona: mortality statistics

Bordering Mexico, Pima County is the second most populous county in Arizona (over 1 million residents). About half of its population lives in and around the city of Tucson. It is difficult to estimate precisely the number of residents and how it has changed over time because the county is home to many undocumented immigrants (estimated at over 30,000 in 2015). Nonetheless, the statistical model of linear regression performed well without population denominators.

Arizona ranked close to the top of badly affected states, and Pima County, just like the state, was severely hit by the pandemic. The course and waves in Pima County were similar to the state as a whole.

The bar graph shows the number of all-cause deaths by “flu years” — October through September — since 2010. Flu years, unlike calendar years, do not arbitrarily split excess winter mortality on December 31, so they are better suited for inference on trends. The last two bars (Oct 2019 — Sep 2020, Oct 2020 — Sep 2021) contain the pandemic waves. (The current flu year will end in September 2022 but flu returned last winter and its share in excess mortality will be difficult to estimate.)

Pima County, Arizona: estimating excess mortality

Setting aside the two pandemic flu years, we see that the data points lie fairly close to a rising line. The rise may be due to increased population size, changing demographics, or a combination of both and other causes.

Whatever the reasons might have been, we can continue the regression line to predict the expected number of deaths in each of the two pandemic flu years. The difference between the actual number of deaths and that prediction (located on the line) is the estimated number of excess deaths. To get the estimated excess in percentage, we use the prediction as the denominator. For instance, if the model predicted 10,000 deaths and 11,000 people have died, we would have estimated 1,000 excess mortality (10%).

The results are shown in the table.

First, notice again that the model performed well. Up to flu year 2018–2019, excess mortality (or “deficit”) in each year was small: between +1.6% and -2.9%. The data points lie close to the line, so extending the line should provide a reasonable prediction of what would have happened if there were no pandemic.

As expected, we observe substantial excess mortality in the first pandemic year (11.3%) and twice as high in the second (23.7%). Over the two years combined, the estimated excess mortality in Pima County reached about 3,600 deaths (17.5%).

Were there 3,600 reported COVID deaths in Pima County?

No. The table shows the official county numbers: 2,757 (650 in the first year; 2,107 in the second). The remainder 837 deaths (3,594–2,757) were caused by panic through various mechanisms, as shown earlier in a diagram.

My estimate of 17.5% excess deaths over the two years is split into 13.4% COVID deaths and 4.1% panic deaths. Stated differently, almost one-quarter of the excess mortality in Pima County should be attributed to the consequences of panic, disrupting life, and fearmongering.

In the next section, we’ll discuss two other numbers in the red rectangle: 12.1% COVID deaths (lower) and 5.4% panic deaths (higher).

Under-counting and over-counting COVID deaths

A typical response to such data asserts that many COVID deaths have been missed. For example, reporting estimates of excess deaths in the state versus reported COVID deaths, an Arizona journalist wrote in November 2021:

“Since March of last year, Arizona has had about 32,217 excess deaths, a difference of 10,589 from the state’s reported COVID-19 death numbers… The consensus among health experts is that the majority of excess deaths are unreported COVID-19 cases.”

Nonsensus consensus. That’s the title of a 1990 Lancet article by Petr Skrabanek. To claim that one-third of COVID deaths were missed in the state of Arizona is a prime example of absurdity. No serious, unbiased, scientist should accept it. If anything, COVID deaths were over-counted, not under-counted.

The first major wave hit the state and Pima County in the summer of 2020, not in the spring. While it is possible that some COVID deaths were missed early on, PCR testing was widespread by the summer, and it is inconceivable that people died from COVID in Arizona hospitals or nursing homes without being tested. Death from COVID is not sudden cardiac death on the street. The course from symptomatic infection to death lasts several days to several weeks and I do not need to tell you that all eyes were on COVID. Testing sites were visible everywhere, not only in hospitals.

In contrast, over-counting undoubtedly happened in many countries. It surely happened in places where the number of reported COVID deaths substantially exceeded the estimate of excess deaths. But I am certain it happened everywhere for several reasons:

First, official coding rules explicitly encouraged liberal coding of COVID-related death, including monetary incentives. COVID could have been recorded as a cause of death even in the absence of a PCR test. Second, the mindset of physicians who filled out death certificates was heavily biased towards the disease that dominated our lives and theirs. Lastly, since at least 50% of the infections were asymptomatic, we expect that incidental positive PCR would be found in patients who were admitted to the hospital and died from unrelated conditions.

In my opinion (and not only mine), 10–20% of reported COVID deaths were “death with COVID”, not “from COVID” — namely, a positive PCR test was incidental finding or the disease itself was clinically insignificant. Taking the lower bound (just 10%), the excess mortality in Pima County is divided between 12.1% excess deaths due to COVID and 5.4% panic death (table, red rectangle). In absolute numbers: 2,481 COVID deaths and 1,113 panic deaths.

Whichever estimate you prefer, the following holds: For every 2–3 COVID deaths, there was one additional panic-related death. Read the last sentence again and recall that we had no evidence that lockdown, masks, 6-foot physical distance, and fearmongering would save anyone. Those interventions, in the name of public health, were analogous to treating patients with a set of useless drugs that would eventually kill some of them.

But what about controlling the spread?

“Control the spread” is a fiction — wishful thinking. There was never evidence that a wave of an airborne virus can be controlled, and no such evidence emerged during the pandemic. Anyone who observed the regularity of COVID waves should have concluded that nature, not humans, dictated their course: the rise, the peak, and the decline. That no spread was ever controlled will become common knowledge someday.

All pandemic deaths were anthropogenic

Panic accounted for 4–5% of excess deaths in Pima County during the two pandemic flu years. Unfortunately, the responsibility is spread so widely that no one will be held accountable in any county or country.

Next. How many of the 12–13% excess COVID deaths were anthropogenic — that is, caused by human beings?

All of them.

First, the evidence point to a human-made virus. SARS-Cov-2 was created in a Chinese laboratory as part of dangerous and foolish gain-of-function research. Whether the virus escaped the lab accidentally or released intentionally remains unknown for the time being and might remain unknown forever. Don’t expect any official word. Perhaps a whistleblower will show up some day.

Second, many lives were lost due to aggressive suppression of promising early treatments, in particular Ivermectin, a widely used drug in many countries (for other purposes) with a safety profile similar to that of Tylenol. What harm could have been done if it were permitted months before any vaccine was available? None. So why was Ivermectin ridiculed and forcefully suppressed, rather than tested by government-initiated, randomized trials, as soon as promising data emerged? Check the rules for emergency use authorization (EUA) of experimental vaccines. If there is a treatment, there is no EUA. Billions of dollars were at stake, and the forces operated accordingly.

All pandemic deaths, much like World War deaths, were caused by human beings: the human beings who created the virus, the human beings who suppressed early treatment, and the human beings who caused panic on an unprecedented scale.

The search for truth will resume

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it.” — M. Planck

Over the past two years we have observed aggressive attacks on critics of official COVID narratives — be it the merit of lockdown and masks, the magnitude of the pandemic, the benefit of early treatment protocols, or the efficiency, fatality, and side effects of COVID vaccines. Dissenting voices were subject to personal attacks, intimidation, name-calling, ridiculing, and silencing.

Anyone who is familiar with the scientific method should be astonished because questioning and criticizing are the pillars of modern science, whereas suppression of dissenting voices belongs to dark times in history. The science around COVID has been corrupted to an unbelievable extent. The search for truth was halted.

But not forever.

Look at today’s kids, the next generation of scientists. They will not forget the two years of fearmongering, masked faces, and stolen childhood. They are the generation that will try to understand what has happened and why. They will have no obligation to conform to any historical narrative. They will not pledge allegiance to the officials who took control of our lives in the past two years. They will ask penetrating questions, demand and analyze hidden data, review official records and email exchanges, and relentlessly seek answers.

Future scientists, free of brainwashing and conflicts of interest, will mercilessly search for the truth in every domain of the pandemic, and no one will silence them.

Sources:

Arizona Department of Health Services: monthly vital statistics

Pima County COVID-19 Data Reports (May 26, 2022)

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Professor Emeritus of Public Health (University of Arizona); MD (Tel-Aviv University, Israel); MPH, Epidemiology (University of Minnesota)

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Eyal Shahar

Professor Emeritus of Public Health (University of Arizona); MD (Tel-Aviv University, Israel); MPH, Epidemiology (University of Minnesota)