V minulém článku jsem se snažil představit analýzu celkové úmrtnosti v Německu mezi lety 2012 - 2022, tedy včetně pandemických let 2020 a 2021. Velmi mě překvapilo zjištění, že se úmrtnost oproti normálu nezvýšila - nejvyšší nárůst zaznamenalo Německo dokonce v roce 2015.
In follow-up to my lengthy comment on Ians page [1], thought I would quickly weigh in on your post here as well as pick your brain on what you are seeing across the Atlantic.
For background, I live in Cleveland, Ohio, a city of 300K in a metro area of 3 million, in a state of 10 million, which is roughly 25% bigger in area than Czech Republic by my quick math.
I read through your post via Google Translate, and seems we are both wondering about similar things, coming to similar theories, asking similar questions. I have next to zero knowledge of your country, Germany, etc outside of basics so indulge and forgive my American ignorance.
I'll just quickly share my thoughts as an American, and you can tell me if any of this makes sense to what you are seeing.
I am a devout skeptic, so in early 2020 I was doubting Covid hysteria. I saw the same hysteria attempted my whole life (I'm 43), especially in the 00's after we developed tests to find things that were always there but we just couldn't see. They (Media) got spooked with SARS03, H1N1, MERS, Ebola, Zika, etc - yet all of them flamed out.
And that made sense. Viruses have been on this planet 3.8 billion years. They have been mingling with mammals for 360 million years. With our early hominid ancestors for 4 million years. With modern day homo-sapiens of 300,000 years.
The premise that now, after 4 million years, all the sudden a Coronavirus magically appeared this deadly, is arrogant and ridiculous. It reminds of the religious cults who always predict that the apocalypse is going to happen in their lifetime, and soon! Not in 100, 1,000, or 10,000 years, but next year! It's arrogant to think we are special enough to be around for such an event.
That said, I had no idea that in fact we (the US, China) had been spending the last 15 years trying to make Coronaviruses more infectious so we could study how to fight them in case someday in the future they evolved... to become more infectious... like the ones we were making.
It's the most fucking retarded idea in recent history. I didn't even believe we could be so fucking stupid and dismissed this as a "conspiracy theory" early in 2020 (and social media would in fact, prevent me from seeing this was common knowledge and not a conspiracy). After reading Alina Chan's "Viral", or Katherine Eban's journalism, it's hard to ignore that Occam's Razor fact that this virus was created in a lab, with good intentions, and accidentally leaked, just as many other viruses had leaked before. Idiots.
Anyway, so that is my first point, we do have to now consider the chance that we are actually dealing with a slightly more deadly virus than we would normally find in nature. Fortunately it isn't that deadly unless you are very old, sick, and obese. So far.
So in your analysis and comparison of Germany to the CR, how do the population demographics differ? Wouldn't the population of CR be closer to Slovakia than Germany? The former has similar high all cause mortality rates.
Is the population of CR more obese, hypertensive, and elderly than Germany? (I honestly have no idea - this is a genuine question).
Here in the US, all the rumors are true :) We are generally a very obese population, plagued with hypertension, diabetes, lethargy.. etc.
To compensate we have been developing medical ways to extend the lives of these unhealthy people. I'm married to a Vascular Surgeon, which I used to jokingly refer to as a "life extension specialist" as every day she is extending the lives of people who 30 - 50 years ago would have died from the conditions they present. Stenosis of your Carotid artery used to kill you from stroke back in the day, now she can perform a Carotid Enterectomy and buy you more time. An enlargement of your Aortic Artery would lead to an eventual death sentence. Now, if caught, you get more years. If it ruptures, you even might survive (low odds) if you happen to live in a city with a good vascular surgeon who gets you under the knife quickly. Feet and legs turning black from your diabetes? Our amputation techniques are better. Our antibiotics to prevent infection are better. Our prosthetics to help mobility are better.
It doesn't stop there. We have statins to lower blood pressure. Dulaglutide to lower blood sugar. Better cancer drugs. Better antivirals. Less invasive surgical techniques. Better cancer drugs.
In short, we have found ways to prop up people who would in the past typically not made it to their 50's, 60', 70's, 80's.
Now we have created a large population of people who are otherwise unhealthy, but alive and (mostly) enjoying life. It's great news.
But we shouldn't be surprised when a bad influenza-like-illness (ILI, the term we use in the US for flu, coronaviruses, RSV, etc) hits this demographic and more people die "than usual".
Suppose we take the argument that this is a natural virus, not created in a lab, what would have happened if a similar virus hit us in 1950? Given our population was much younger, and the ones who were elderly much healthier (survival bias) than present population, might a theoretical COVID-50 similar in strength to COVID-19 done to 1950s America what it did to 2020's Africa? Nothing at all? If there isn't the demographic available to hit (obese elderly) then we wouldn't even know it was there.
To your point, how much of our reaction to Covid is responsible for the excess mortality the past two years?
Your country is similar to the US in excess mortality, and what you write about sounds similar to our response.
Unfortunately getting to the bottom of this question is nearly impossible because:
1) The reasons are diverse, the variables infinite, the explanations complex. I think the public prefers short and simple which is why simplistic narratives hold sway (one extreme is the virus is the greatest threat to humanity, the other extreme is that it is 100% due to our response and vaccines - these extremes have appeal in their simplicity while the truth is almost certainly in the middle and far more nuanced). This means the simpler answers likely become the dominant ones regardless of truthfulness or veracity - at least in short term, which in our case may mean years to decades.
2) Disinterestedness is one of the most important foundations of scientific thought yet completely missing and dead today. A true scientist should have no preference in the outcome of experiment, should not care whether a mask works or doesn't, whether lockdowns hurt or help. The true scientist should be as removed from the outcome as an alien might be studying our species today a million years from now.
Everyone has bias of course, so reaching a true state of disinterested is impossible, but when politics, your career, and your reputation are intrinsically tied to your scientific output, it's nearly impossible to backtrack from your pet theories, admit error, and be open to being wrong. "The Science" has been shaped the past 100 years to create an inefficient system of output which is why we are in the replication crisis.
Especially for elected and appointed officials, saying you were wrong is a death wish for your career. No matter how obvious the error, you have to continually double down, make excuses, create unfalsifiable explanations. Here in the United States we saw this the War in Vietnam, the War on Drugs, The War on Terror, and now the War on Viruses.
This is what we are up against. The days of a William Farr realizing he was wrong and discarding his pet theory for John Snows seem to be over.
The greater the attention, the less inclined I think public health experts will be to admit error. Perhaps if William Farr had a 2 million following on Twitter back in the 1860's he would have been reluctant to admit Miasma was wrong. I can't see these people admitting they screwed up and are responsible for the 120,000 excess accidental deaths we had in the US the last 2 years. I can't see them acknowledging that lockdowns in New York City immediately caused 4,500 more heart attacks in a 9 week period than expected in spring of 2020.
I lean to where it seems you have arrived - the more disruption which occurred to healthcare and our normal social patterns, the greater the losses - these disruptions had complicated impacts which vary state to state, country to country, culture to culture. I'm fascinated to continue to study it, disinterestedly as possible.
In follow-up to my lengthy comment on Ians page [1], thought I would quickly weigh in on your post here as well as pick your brain on what you are seeing across the Atlantic.
For background, I live in Cleveland, Ohio, a city of 300K in a metro area of 3 million, in a state of 10 million, which is roughly 25% bigger in area than Czech Republic by my quick math.
I read through your post via Google Translate, and seems we are both wondering about similar things, coming to similar theories, asking similar questions. I have next to zero knowledge of your country, Germany, etc outside of basics so indulge and forgive my American ignorance.
I'll just quickly share my thoughts as an American, and you can tell me if any of this makes sense to what you are seeing.
I am a devout skeptic, so in early 2020 I was doubting Covid hysteria. I saw the same hysteria attempted my whole life (I'm 43), especially in the 00's after we developed tests to find things that were always there but we just couldn't see. They (Media) got spooked with SARS03, H1N1, MERS, Ebola, Zika, etc - yet all of them flamed out.
And that made sense. Viruses have been on this planet 3.8 billion years. They have been mingling with mammals for 360 million years. With our early hominid ancestors for 4 million years. With modern day homo-sapiens of 300,000 years.
The premise that now, after 4 million years, all the sudden a Coronavirus magically appeared this deadly, is arrogant and ridiculous. It reminds of the religious cults who always predict that the apocalypse is going to happen in their lifetime, and soon! Not in 100, 1,000, or 10,000 years, but next year! It's arrogant to think we are special enough to be around for such an event.
That said, I had no idea that in fact we (the US, China) had been spending the last 15 years trying to make Coronaviruses more infectious so we could study how to fight them in case someday in the future they evolved... to become more infectious... like the ones we were making.
It's the most fucking retarded idea in recent history. I didn't even believe we could be so fucking stupid and dismissed this as a "conspiracy theory" early in 2020 (and social media would in fact, prevent me from seeing this was common knowledge and not a conspiracy). After reading Alina Chan's "Viral", or Katherine Eban's journalism, it's hard to ignore that Occam's Razor fact that this virus was created in a lab, with good intentions, and accidentally leaked, just as many other viruses had leaked before. Idiots.
Anyway, so that is my first point, we do have to now consider the chance that we are actually dealing with a slightly more deadly virus than we would normally find in nature. Fortunately it isn't that deadly unless you are very old, sick, and obese. So far.
So in your analysis and comparison of Germany to the CR, how do the population demographics differ? Wouldn't the population of CR be closer to Slovakia than Germany? The former has similar high all cause mortality rates.
Is the population of CR more obese, hypertensive, and elderly than Germany? (I honestly have no idea - this is a genuine question).
Here in the US, all the rumors are true :) We are generally a very obese population, plagued with hypertension, diabetes, lethargy.. etc.
To compensate we have been developing medical ways to extend the lives of these unhealthy people. I'm married to a Vascular Surgeon, which I used to jokingly refer to as a "life extension specialist" as every day she is extending the lives of people who 30 - 50 years ago would have died from the conditions they present. Stenosis of your Carotid artery used to kill you from stroke back in the day, now she can perform a Carotid Enterectomy and buy you more time. An enlargement of your Aortic Artery would lead to an eventual death sentence. Now, if caught, you get more years. If it ruptures, you even might survive (low odds) if you happen to live in a city with a good vascular surgeon who gets you under the knife quickly. Feet and legs turning black from your diabetes? Our amputation techniques are better. Our antibiotics to prevent infection are better. Our prosthetics to help mobility are better.
It doesn't stop there. We have statins to lower blood pressure. Dulaglutide to lower blood sugar. Better cancer drugs. Better antivirals. Less invasive surgical techniques. Better cancer drugs.
In short, we have found ways to prop up people who would in the past typically not made it to their 50's, 60', 70's, 80's.
Now we have created a large population of people who are otherwise unhealthy, but alive and (mostly) enjoying life. It's great news.
But we shouldn't be surprised when a bad influenza-like-illness (ILI, the term we use in the US for flu, coronaviruses, RSV, etc) hits this demographic and more people die "than usual".
Suppose we take the argument that this is a natural virus, not created in a lab, what would have happened if a similar virus hit us in 1950? Given our population was much younger, and the ones who were elderly much healthier (survival bias) than present population, might a theoretical COVID-50 similar in strength to COVID-19 done to 1950s America what it did to 2020's Africa? Nothing at all? If there isn't the demographic available to hit (obese elderly) then we wouldn't even know it was there.
To your point, how much of our reaction to Covid is responsible for the excess mortality the past two years?
Your country is similar to the US in excess mortality, and what you write about sounds similar to our response.
Unfortunately getting to the bottom of this question is nearly impossible because:
1) The reasons are diverse, the variables infinite, the explanations complex. I think the public prefers short and simple which is why simplistic narratives hold sway (one extreme is the virus is the greatest threat to humanity, the other extreme is that it is 100% due to our response and vaccines - these extremes have appeal in their simplicity while the truth is almost certainly in the middle and far more nuanced). This means the simpler answers likely become the dominant ones regardless of truthfulness or veracity - at least in short term, which in our case may mean years to decades.
2) Disinterestedness is one of the most important foundations of scientific thought yet completely missing and dead today. A true scientist should have no preference in the outcome of experiment, should not care whether a mask works or doesn't, whether lockdowns hurt or help. The true scientist should be as removed from the outcome as an alien might be studying our species today a million years from now.
Everyone has bias of course, so reaching a true state of disinterested is impossible, but when politics, your career, and your reputation are intrinsically tied to your scientific output, it's nearly impossible to backtrack from your pet theories, admit error, and be open to being wrong. "The Science" has been shaped the past 100 years to create an inefficient system of output which is why we are in the replication crisis.
Especially for elected and appointed officials, saying you were wrong is a death wish for your career. No matter how obvious the error, you have to continually double down, make excuses, create unfalsifiable explanations. Here in the United States we saw this the War in Vietnam, the War on Drugs, The War on Terror, and now the War on Viruses.
This is what we are up against. The days of a William Farr realizing he was wrong and discarding his pet theory for John Snows seem to be over.
The greater the attention, the less inclined I think public health experts will be to admit error. Perhaps if William Farr had a 2 million following on Twitter back in the 1860's he would have been reluctant to admit Miasma was wrong. I can't see these people admitting they screwed up and are responsible for the 120,000 excess accidental deaths we had in the US the last 2 years. I can't see them acknowledging that lockdowns in New York City immediately caused 4,500 more heart attacks in a 9 week period than expected in spring of 2020.
I lean to where it seems you have arrived - the more disruption which occurred to healthcare and our normal social patterns, the greater the losses - these disruptions had complicated impacts which vary state to state, country to country, culture to culture. I'm fascinated to continue to study it, disinterestedly as possible.
[1] https://ianmsc.substack.com/p/a-new-world-health-organization-report/comment/6761196?s=r