Measures against the pandemic must be weighed against the negative consequences – which is not done enough. For example, with regard to acute diseases, minors and addictive behavior. (Part 2)
From 16. December, governments ied a "hard lockdown" which will initially apply until 10 January. January shall apply. In a series of three articles, the scientific rationale is explored in more detail. The first article addresses the lack of scientific evidence for the effectiveness of lockdowns. The second article describes the collateral damage of lockdowns, which has been ignored in professional society and government statements and which is now supported by numerous studies. In the third article, a critical discussion of the corona case figures published by the Robert Koch Institute sheds light on the extent to which fear in the rough order conveyed by governments, the media and some scientists is really justified.
Part 1: on the lack of scientific evidence for efficacy It follows: Part 3: Why we don’t actually need to have extreme fears
At the 16. December, public life in Germany was once again drastically downgraded. The retail trade, with the exception of shops for daily needs, had to close, schools and kindergartens were closed, strict contact restrictions are still in force. Had recommended such a "Hard lockdown" among others, the National Academy of Sciences Leopoldina in its 7. Ad hoc statement.
If one reads the statement of the Leopoldina as a scientist or if one listens to the reasons based on it in the governmental declarations, one is astonished: When prescribing drugs for millions of people, one should not only ame that the effectiveness of a drug is scientifically proven (for problems in this regard, see the first article in this series on the scientific justifications of the Leopoldina), but also that it is scientifically proven "hard lockdowns"The lack of scientific evidence of efficacy). Rather, it was expected that the potential collateral damage of a lockdown would also be assessed and the benefits of a lockdown weighed against the side effects. A medicine can only be recommended if its benefits outweigh its side effects.
Problematically, both the Leopoldina statement and the government statements on the lockdown regulation completely ignore the extensive collateral damage of a hard lockdown at the level of physical, mental and social health, which has now been proven in numerous studies. The statement of the Leopoldina as well as the actions of the governments thus violate the principles of evidence-based medicine.
Ignoring the collateral damage of lockdowns
The Leopoldina statement only addresses the collateral damage of a lockdown in the following terms:
Although a stricter lockdown increases [economic] value losses in the short term, it also shortens the period of time until new infections have decreased to the point where lockdowns become possible.
Otherwise no side effects are considered. This is highly questionable, as it is now empirically proven that a lockdown is associated with dramatic side effects on people’s physical, mental and social health.
A published article by renowned medical scientist and statistician John Ioannidis provides an initial overview of the collateral damage associated with the corona measures taken. The following table is shown there:
|Possible non-COVID-19 causes of excess deaths compounded by aggressive measures taken for COVID-19|
|Cause of excess death||Reason/comments||Possible time horizon for excess deaths|
|People with AMI (acute myocardial infarction) and other acute disease not given proper hospital care||Patients afraid to go to hospital and hospitals reducing admissions afraid of overload||Acute, during pandemic|
|People with cancer having delayed treatment||Postponement of cancer treatment in anticipation of COVID‐19 overload||Next 5 y|
|Disrupted cancer prevention||Inability to offer cancer prevention services under aggressive measures||Next 20 y|
|Other healthcare disruption||Postponement or cancellation of elective procedures and regular care||Variable for different medical conditions|
|Suicides||Mental health disruption||Both acute and long‐term|
|Violence (domestic, homicide)||Mental health disruption||Acute, possibly long‐term|
|Starvation||Disruption in food production and transport||Acute, and possibly worse over next several years|
|Tuberculosis||Disruption of tuberculosis management programmes||Next 5 y|
|Childhood diseases||Disruption of vaccination programs||Next 5 y|
|Alcoholism and other diseases of despair||mental health disruption, unemployment||Next 10 y|
|Multiple chronic diseases||Unemployment, lack of health insurance and poverty||Next 20 y|
|Lack of proper medical care||Disruption of healthcare, as hospitals and health programs get financially disrupted, furlough personnel or even shut down services||Next 20 y|
To clarify the rough order of the side effects, one can first look at the observed mortality in Germany for the year 2020 compared to the years 2016-2019 and the number of people who died with or from the Sars-CoV-2 virus. In the following figure, the height of the blue bars shows the number of people who died with and from the Sars-CoV-2 virus. Undermortality per calendar week (number of more or less. fewer people died compared to the 2016-2019 average). The height of the red bars shows the number of people who died with and from the Sars-CoV-2 virus:
Data: Federal Statistical Office / Graphic: Christof Kuhbandner
As the graph shows, there has been excess mortality in many weeks since the start of the Corona crisis in early March compared to the average number of death traps in 2016-2019. However, only 51.1 percent of the deaths were due to persons who died with and from the Sars-CoV-2 virus. About half of the observed excess mortality is due to other causes of death.
The argument is sometimes made here that Sars-CoV-2-related death traps are undercounted. However, the opposite is probably the case, as severe traps and death traps were tested for Sars-CoV-2 on a very flat scale . In addition, a coarser percentage of those who died as "Sars-CoV-2 death trap" The majority of the deaths actually occurred from other causes and only had a positive Sars-CoV-2 test result.
According to the official figures from Bavaria, for example, only 81.8 percent of the people considered to be "Sars-CoV-2 death trap" statistically calculated number of deaths caused by the virus.
Studies suggest that the excess mortality observed independently of Sars-CoV-2 – apart from random seasonal variations such as z.B. due to heat waves – due to side effects of the Mabnahmen. For example, a recent preprint study of the Waldshut region of Germany found that 45 percent of the mortality observed there in April was not due to people dying with or from the Sars-CoV-2 virus, but to other causes of death. The authors write about this in the summary (translation by the author):
We hypothesize that fear of infection in overburdened hospitals, biased public communication and reporting, and the prevalence of contact traps have contributed significantly to the decline in treated cases and excess mortality (collateral damage). For similar situations in the future, it is strongly recommended that crisis communication and media coverage be more balanced so as not to discourage people with acute health problems from seeking medical help. Contact restraints should be critically reviewed and limited to the objectively necessary minimum.
Numerous psychological studies have shown that lockdown-induced contact restrictions can increase the risk of death. For example, a 2015 meta-analysis found that social isolation increases the likelihood of death by 29 percent and loneliness increases the likelihood of death by 26 percent, regardless of whether social isolation is perceived as such by a person – an effect that is on the rough order of magnitude of the increase in risk of death from moderate-level smoking.
A study published as a preprint from Great Britain continues to show that people with dementia and mental illness are particularly affected by the negative consequences of a lockdown. Compared to the period between January and early March 2020, the likelihood of death for dementia patients increased by 53 percent and for patients with more severe mental disorders by 123 percent during the lockdown in the U.K.
As numerous studies show, the excess mortality observed independently of Sars-CoV-2 is also due to the fact that many people with acute health problems have been discouraged from leaving their homes and seeking medical help by fear-mongering media coverage and social isolation during lockdowns.
The rough order of these collateral damages are immense. According to a study from Great Britain, the number of deaths due to heart disease increased by about 50-70 per day at the time of the lockdown compared to previous years. Comparatively many of these persons died at home instead of in a hospital. It is possible that many of these people could have been saved if they had visited a clinic in time.
Comparable findings exist with regard to other diseases such as stroke cases. For example, a study shows that hospital admissions in the U.S. dropped 31 percent during the lockdown compared to before. The authors write about it (translation by the author):
Stroke therapies are time-critical, so reduced health care utilization may lead to more stroke-related disability, more fatal strokes, and more severe non-neurological complications associated with strokes.
Moreover, studies show that even among patients with heart disease admitted to clinics, the mortality rate increased substantially at the time of the lockdown. For example, a study by the Medical University of Graz showed that in Styria at the time of the lockdown, compared with the previous four years, the mortality rate among hospitalized patients with heart disease increased by 65 percent, and among heart attack patients by as much as 80 percent.
These increases cannot be explained by Sars-CoV-2-related effects because only 6.2 percent of patients with heart disease tested positive for Sars-CoV-2, and the relatively small number of Sars-CoV-2 patients who died cannot explain the increase in mortality rates. According to the study authors, the higher hospital mortality rate is instead due to patients attending clinics too late at the time of lockdown, which delays life-saving treatment and increases mortality rates.
In the case of cancer, too, evidence now shows that not visiting hospitals due to fear-mongering reports and social isolation during lockdowns can significantly increase mortality rates in the long term. For example, a recently published meta-analysis showed that even a four-week postponement of cancer therapy increases the risk of death by six to 13 percent, depending on the cancer type.
For longer postponements, the effects are even more dramatic. For example, an eight-week postponement for breast cancer increases the risk of death by 17 percent, and a postponement of twelve weeks by 26 percent. Based on this, the authors of the study calculate that postponing all breast cancer surgeries by twelve weeks, for example, would result in 1.400 additional deaths per year in the UK.
Furthermore, studies show that violence against women and children is increased by lockdowns because conflicts are heightened by being forced to remain in the home, it is more difficult for the victim to escape, opportunities to seek help are reduced, and the protective and predictive functions of entities outside the home (e.g., the home, the homeowner, the homeowner, the homeowner, and the homeowner) are diminished.B. school) are no longer available. In a published overview of the situation, it is stated (translation by the author):
Many victims of familiar violence (domestic violence, child abuse and abuse of pets) may currently be facing a "Worst Case"-Scenario exposed – they are trapped in an apartment with a violent person with extremely limited contact with the outside world. (…) In addition, schools, libraries and churches are important components of family life around the world. Families who are victims of violence or abuse at home indicate that these institutions often provide helpful emotional support and a way to recover from their dire home environment "recover" – a relief that they currently no longer receive. (…) Risk factors for family violence are further increased by the threat of unemployment, reduced income, limited resources, and limited social support.
Initial studies suggest that the effects are dramatic. For example, according to a study in a London children’s hospital, the number of children admitted for head injuries due to maltreatment, compared to the average frequency per month over the past three years, increased by 1.493 percent, although the authors even suspect that this figure is underestimated.
Similar results are available for the frequency of sexual abuse. According to data from Ireland, the number of people who turned to rape crisis centers for counseling increased by 98 percent between March and the end of June compared to the same period last year. Again, social isolation at home makes it difficult for victims to seek help, and this number is also likely an underestimate.
In general, children in particular suffer from the effects of lockdowns. The so-called COPSY study by the University Medical Center Hamburg-Eppendorf, for example, found that 71 percent of children and adolescents felt burdened by the contact restrictions, 27 percent reported that they argued more often, and 37 percent of parents said that arguments with their children escalated more often. For 39% of children and young people, the relationship with friends deteriorated due to limited personal contacts, which burdened almost all respondents.
The percentage of children and adolescents with reduced health-related quality of life increased from 15 to 40 percent, and the risk of mental health problems increased from about 18 to 30 percent. Children and young people were particularly affected, in whose homes there is a poor family climate and where at the same time either their parents have a low level of education or a migrant background. This group experienced a significantly higher incidence of psychosomatic complaints, a significantly reduced quality of life, and more pronounced symptoms of anxiety and depression.