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Drs. C. Van Rijn - Insurance doctor: Is Corona actually worse than the flu?

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How do we actually know how deadly a virus is? This can be known by calculating the IFR. Of course you know the IFR from Corona, this is extensively discussed daily by the media. This comment is obviously meant sarcastically, the IFR never gets in the news, this requires journalistic interest, intelligence and something of a conscience.

Once the IFR was front-page news; In early March, Tedros of the WHO spoke about an IFR of 34 times the flu. No one in the media had commented that they were talking about an IFR of 7 times the flu two weeks earlier and no one asked to substantiate his story. And why wasn't it front-page news when an Oxford study on March 22 mentioned an IFR of only 3 times the flu (Oxord Center for EBM) or mid-April when a study in St. Clara spoke of only 1.5 times the flu. America's RIVM had already reduced lethality to 2.6 x flu since May. Recently, there was a study by Nic Lewis who calculated that there is now immunity in Sweden and the lethality is about 0.6 times the flu. (These examples are a bit cherry picking on my part, but you can do that sometimes)

Good news is apparently not news. Many people have become frightened due to the lack of media perspective. The permanent sickening propaganda for the lockdown is shocking. Even my mother, a usually down-to-earth farmer's daughter who is not afraid of the devil, no longer goes to the restaurant with her grandchildren.
In the lawsuit of virus madness, RIVM did not dare to say how deadly the virus was, because it would turn out that the emperor has no clothes.

The judge in the lawsuit also showed no interest in the IFR. This is similar to a murder case where no interest is shown in the absence of evidence. As if the Public Prosecution Service said "the cause of death and the murder weapon are not known, but we will find them later" and the judge accepts that as a plausible statement.
Death is inevitably part of life. Let's assume we accept the flu as a given that we can live with. Everyone dies someday and the flu in the last phase of his life takes someone across the road in a mild way. Sometimes a younger person is also unlucky and dies from the flu. This is horrifying but fortunately very rare and is also part of life. If you are someone who also crawls under the bed for 3 months during a normal flu wave, you can now stop reading.
The IFR can be calculated by dividing the number of deaths by the number of infected cases. This should not be confused with the CFR, which is the number of deaths divided by the number of people tested positive. The IFR is used as a number for a group. The IFR for people in a nursing home is much higher than the IFR for school children. Usually, the IFR is used to express a country's death rate. Countries with many old people and countries with western conditions such as diabetes and overweight have a much higher IFR.

It is difficult to calculate the IFR correctly because both the denominator and the divisor can cause problems.
The denominator, the number of deaths can be difficult: sometimes it takes 2 months for someone to die from corona, so you have to wait until then to be able to say anything about the IFR. Sometimes it is difficult to know whether someone has died from corona or something else. I myself think the excess mortality is now a fairly reliable number to measure the number of deaths, maybe 10-20% flu deaths should be taken away, but that will not be very much.

Regarding the divisor, the number of infected cases: With corona you can easily overlook the disease, because there are many people without symptoms. The number of infected cases is difficult to measure. Sampling is required for this and we only have two commonly used measurement methods. The PCR or blood test for antibodies.
The latter, measuring antibodies, has the disadvantage that it takes a few weeks for the body to produce antibodies. Furthermore, you are not sure whether everyone who has been in contact with the virus produces antibodies.

It is now clear that a large proportion of people have inhaled viruses but have never become ill.
The disadvantage of the PCR is that it can detect very small numbers of virus particles, but also dead remains of virus particles, for example if someone has not been ill for weeks. It also gives a positive test if someone has been in a room with virus aerosols that they will never get sick that week.

For a really good sample, you would preferably combine PCR and antibody testing and repeat it regularly with a large random group of people and continue to follow this group. This requires foresight that you apparently should not expect from the EU and WHO.
There are many factors that influence IFR or mortality. The most important is age, the older you are the more likely you are to die. Comorbidity, smoking, vitamin D levels, obesity, airborne particulate matter also increase IFR. So if you have a region where many of these factors are present and you also move your patients to nursing homes, your IFR will be significantly higher (think New York, for example).

The essence of this article is that the IFR, the lethality was not well known, certainly not at the beginning, but it is becoming increasingly clear. In the first few months, however, only CFR came into view daily, in bold letters, day after day. However, the CFR is a completely useless number. So while the media stared shivering at the CFR for the first few months, they were actually frightened with a ghost number.

I wanted to know where we stood. That is why I emailed RIVM several times to ask if they already knew the IFR.

April 02 I wrote this to RIVM:

Dear Sir / Madam,
I miss estimates on the website and in the media
IFR, is this being researched? Where do the samples go !!
I also miss:
a) Estimate lost years of life without lockdown (a range is sufficient)
b) Estimated lost years of life with lockdown
c) estimate of lost life years due to lockdown (smoking, poverty, obesity, suicide)
-Costs per year of life won = Total costs of recession / a - (b + c)

April 14 I wrote this to the RIVM.

Dear Sir / Madam,

Where the hell is the estimate of the IFR. Worldwide only the CFR is spoken of, why? Lesson 1 in a pandemic: try to estimate the IFR. We are 4 months later and are still in the dark about the IFR, why ????
I only received an automated reply to my emails.
Just a complicated snack (you can skip that). You could already suspect the IFR at the end of March. This is a graph of the CFR compared to the number of tests done. When everyone is tested, the CFR becomes the same as the IFR. You would expect that if the IFR is high, the CFR will remain high if you test more, but that was not the case. (see an example below). That was a first indication for me that it was not all that bad with the IFR. (Italy is different here but they had many cases and only test if the disease was already advanced.)

Until the first samples were taken, we had to make do with an investigation on a cruise ship, the Diamond Princess. There the IFR was estimated at 1.2% but the average age on board was 69. (IFR 0.5% adjusted for age)
A major flu has a mortality, an IFR of about 0.1%. Try to remember this: we always found 0.1% fine and acceptable.

You can determine the IFR by sampling. The first samples in the Netherlands were taken among nurses in early March. This also showed that the number of infections was high, against the 4% of the 10.000 nurses who were already infected, while none of the nurses had died yet. April 9, the newspaper said that 1 in 3 nurses was infected. 2/3 nurses will have been in contact with corona by now. 12 nurses died from corona, out of 200.000. The IFR among nurses will then be around 12 / 140.000. That's an IFR of 0.009%, less than a flu for that category.

Until mid-April, we had to make do with these crumbs of information about the lethality of the virus. How many times have you heard the media ask: could it still be just a big flu? Never. The lockdown was thus done without the mortality being known and, strictly speaking, there was no hard evidence yet that corona is a particularly serious hazard. Hospitals in Brabant were full, but perhaps the infection will go faster and many people will be in the ICU longer because of lung problems. Ultimately, the IFR is the number you want to know.

April 16, a study of antibodies by Sanguin was announced, which resulted in an IFR of 0.8%. However, it was not a representative group, only people who had not been ill for a long time were allowed to participate. Furthermore, this one-off sample was insufficient to calculate the IFR. You should think of it as a speedometer that sways enormously as long as you accelerate. It was also completely unknown whether everyone produces antibodies and how large the real number was in the divisor of the IFR's formula.

In the same period, studies on antibodies were also conducted in other countries, resulting in an IFR of 0.1-1%. So there was still hope for an IFR comparable to the flu, but with the data at that time an average of about 5 times the flu could be assumed.

An overview of the IFR from that time (21-04-2020)

 

Are there any reasons to believe that the IFR was or may be even lower? Yes, and there are several reasons for this:

 

  • ⦁ Due to increased treatment methods and better resistance due to higher vitamin D levels, fewer people die and IFR decreases.
  • ⦁ There is increasing evidence that some of the people do not produce antibodies (this increases the divisor and decreases IFR). They get rid of the virus without using antibodies. The question is whether these people have been ill. They have inhaled the virus, but their defenses have immediately repelled the virus, such as a good doorman who does not even let a wrong guest in. You can demonstrate mathematically that some of the people are already partly immune. With the reproduction number you calculate the speed of transmission in a population, but this number is also a kind of mathematical mirror image of the herd immunity. The interesting thing about this is that you can demonstrate that a large proportion of people cannot get sick from Corona at all. A graph in the course of the development of herd immunity creates a kind of S-curve. If the S-curve is more to the left, more people are immune. In reality, these people are not immune but have such a strong resistance that you have to give them word of mouth by a corona patient to get enough viruses that they can suffer from.

 

 

It will not be much different in the Netherlands. We still have a few infected people in the Netherlands, perhaps 1000 and possibly with a virus that is no worse than the flu.
I myself suspect that lethality in the Netherlands has been about 2 times the flu. If you look at the graph of excess mortality (red line), this line was slightly higher than in 2018 (blue line). In many European countries, you see the same form of graph that shows that it has been a short fast spreading and rapidly diminishing spicy condition.

 

 

Usually in winter you are surrounded by 200.000 people with the flu, with an IFR of 0.1%. Now in the Netherlands there are 1000 people with corona and an IFR of possibly 0.2%. Just do the second situation.

To put things further into perspective, another calculation example for clarification. I was recently in Efteling and it turned out that one cart is left empty between each cart. Because there are still 1000 people in the Netherlands who have corona, the chance that you will meet someone with Corona is about 1000 in 17 million or 1 in 17.000. In a cart you sit near 4 people at 1.5 meters. So a chance of 4 in 17.000 that someone has corona. Assuming most people are under 65 (IFR approximately 0.015%), the probability of death is max 0.015% x 4 / 17.000, which is 0,00000003. And then you also have to be infected in the open air, assume a chance of 1 in 10.000. The chance that someone dies from a rollercoaster ride is therefore 0,000000000005. Thanks Hugo for the long queues in the Efteling, this gave me some time to kill to calculate the nonsense of your measures.

The IFR should have received more attention from day one, then things might not have gotten so out of hand. On television you saw no discussion about the IFR but about the R-value, the reproduction number. They let Ben Slachter talk a little bit about the R value while this number is of no value if you don't know the IFR. That's similar to a discussion about a car's brake and accelerator when you don't know how hard you are driving.
The IFR is therefore the key question: How likely are you to die? So next time you are going to protest you should make a banner: What is the IFR Mr van Dissel? I would just turn off any TV program that is not about the IFR, do not be poisoned with that propaganda, that is unnecessary scare, far-fetched sensation dredge.

I have not watched TV for months and I like it very much. Netflix and YouTube are great alternatives. I can also recommend Jensen, he is not the most timid presenter but has a healthier approach to the coronavirus than the whole RIVM and OMT combined. That also makes you happier and that is good for your personal IFR. I still have the feeling that we have all been brainwashed. I am also surprised; shall we turn Hugo de Jonge Netherlands into communist Russia with his emergency law? Are we down-to-earth Dutch really scared and do we believe in unproven suppressive measures? May I remind you that life expectancy in Communist Russia was around 55 years old (or am I going through now?).
Rutte said we flew in the dark, so he locked everything just to be sure. You could also have reasoned: because we do not know how deadly the virus is, we do nothing at all. Let's do some sampling first. Certainly because social distancing is an unproven approach, better safe then sorry seems to me to be an excellent argument for doing nothing. Unfortunately, because of all the propaganda, leaders who have locked down are more popular than leaders who have not have done.

The question is whether this will also apply to Rutte if next year the bill falls on the mat for the corona bonds that will be used to save foreign banks. It is hoped that he can stretch it beyond March 21.
Concluding: The emergency law I would introduce is that a lockdown should be treated as a crime against humanity and banned by law as long as the IFR and mode of transmission is unknown. But that's my opinion.

Drs. C. van Rijn, insurance physician

 

Previous articles and video by Drs. C. van Rijn:

Proven again: A Lockdown is useless.

VIDEO: NO EVIDENCE FOR EFFECT LOCKDOWN


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