COVID19 update, May 27, 2020: Norwegian official report now questions necessity of lockdown; Dr. John Campbell on The Lancet hydroxychloroquine study

 

(1)  According to the Spectator (UK), a report (in Norwegian) by the Norwegian public health authority now argues their lockdown was probably unnecessary as voluntary social distancing efforts were already effective enough.

Norway is assembling a picture of what happened before lockdown using observed data – hospital figures, infection numbers and so on – to assess the situation in the country in March. At the time, no one really knew. It was feared that Covid was rampant with each person infecting two or three others – and only lockdown could stop this exponential growth by cutting the R number to 1 or lower. But the country’s public health authority has published a report with a striking conclusion: the virus was never spreading as fast as had been feared and was already on the way out when lockdown was ordered. ‘It looks as if the effective reproduction rate had already dropped to around 1.1 when the most comprehensive measures were implemented on 12 March, and it would not take much to push it down below 1… We have seen in retrospect that the infection was on its way out.’

This raises an awkward question: was lockdown necessary? Could voluntary social distancing alone have achieved the same outcome? Camilla Stoltenberg, director of Norway’s public health agency, has given an interview where she is candid about the implications of this discovery. ‘Our assessment now, and I find that there is a broad consensus in relation to the reopening, was that one could probably achieve the same effect – and avoid part of the unfortunate repercussions – by not closing. But, instead, staying open with precautions to stop the spread.’ This is important to admit, she says, because if infection levels rise again – or a second wave hits in the winter – you need to be brutally honest about whether lockdown proved effective.

Norway’s statistics agency was also the first in the world to calculate the permanent damage inflicted by school closures: every week of classroom education denied to students, it found, stymies life chances and permanently lowers earnings potential. So a country should only enforce this draconian measure if it is sure that the academic foundation for lockdown was sound. And in Stoltenberg’s opinion, ‘the academic foundation was not good enough’ for lockdown this time. The leading article in the new Spectator, out tomorrow, argues that Britons deserve the same candour.

I don’t have enough Norwegian to read the entire report: I will try to get a contact there to help me out. A member of our own ad hoc commission described the situation around the time as “fog of war” (ar`afel krav) — I can understand that, with incomplete information, the Norwegians made the decision they did. (They also had more economic ‘buffer capacity’, as it were, to absorb the economic blow than many others. Their mortality statistics are just 235 dead out of a population of 5.3 million.) 

I would like to venture, however, that “to lockdown” or “to go Swedish”  is a false binary choice. Norway is a very large country with vast differences in population density: I see no intrinsic reason why greater Oslo, for example (and perhaps Bergen and Trondheim) could not have been subjected to a lockdown separately from a more laissez-faire approach for the rest of the country.

Norway started reopening shortly after us — and no, the sky hasn’t fallen there. (We ourselves reopened cafés and sit-down service in restaurants  today, pretty much everything else already being open.)

(2) Dr. John Campbell discusses hydroxychloroquine, the initial encouraging results from clinical trials, and then finally the recent multinational registry analysis published in The Lancet

https://doi.org/10.1016/S0140-6736(20)31180-6

that indicates hospital survival rates are actually lower on HCQ or CQ than without, and that the gap increases when a macrolide antibiotic such as azithromycin is added (presumably owing to heart arrhythmias). Dr. Campbell is clear that neither this study (nor the earlier ones) include zinc supplementation, which would seem to be a fatal flaw.

Collateral results from this very large sample are confirmations of statistical correlation between severity of  COVID19 and factors such as obesity, recent smoking, diabetes, being male, hypertension,… and black or Hispanic ancestry (he again stresses increased propensity for vitamin D deficiency). More surprising was the finding that East Asians (i.e, Chinese, Japanese, and Koreans) appear to be less vulnerable than Caucasians. Taking ACE inhibitors (but not angiotensin receptor blockers) also appears to be correlated with reduced severity, as is taking statins.

(3) For what it’s worth, the CDC website has an aggregator page of the various COVID19 epidemic models. “All models are wrong, but some are useful” (George E. P. Box FRS) — the useful ones now may be those that fit their parameters to the observed time evolution of data.

And while only tangentially COVID19 related, the Jerusalem Post reports on the controversy regarding the tender for building “the largest desalination plaint in the world” Sorek-2 in Israel. The Chinese were poised to win the tender, but following US pressure applied during SecState Mike Pompeo’s visit, an Israeli consortium won out instead. 

 

ADDENDUM: Via commenter “No More Obamas” on Instapundit , here is an article in the Sydney Morning Herald on the Australian lockdown decision 

Australia’s policymakers were in March bracing for up to 150,000 deaths from the coronavirus pandemic as the virus spread globally and health officials warned that hospitals might not be able to cope.

Ten weeks later, with just 103 COVID-19 deaths, some experts say the modelling behind the national cabinet’s decisions was flawed and some commentators say the response went too far.

[…] On Tuesday Chief Medical Officer Brendan Murphy told the Senate inquiry into the Morrison government’s response to the pandemic that Australia had avoided 14,000 deaths by implementing strict social distancing measures, considerably fewer than the initial warning.