The Truth About Covid-19 - An Interview With Dr Soler
Amid all the chaos of seeming fact and outright fiction, I was sure that somewhere, there must be truths about Covid-19, the hype surrounding it, the measures put in place by governments and even the repercussions of what has now been well over a year of NOT 'normal'. (Personal opinion here but I won't apologise for not believing that we should ever accept the current situation as a 'new normal' when it isn't.)
Dr Jean Karl Soler MD has kindly agreed to answer some of my questions, in a bid to present a more factual, intelligent and researched account of various ideas being bandied about.
Me: We have now been in what is being called a ‘pandemic’ since March of 2020 without any seeming end in sight. Would you personally class covid is being of pandemic status, or is this a hyperbole created by media and governments and the virus less worrying than it is being made out to be?
Dr: According to the Euromomo database, most of Europe is now not experiencing excess mortality over that expected from historical data. As such, I would not say that Europe is suffering a pandemic situation at this time, even though many countries have cases of COVID-19 infection.
Me: Some countries have gone through full-on lockdowns, others tried to go on as normal. Malta would likely be classed as something in the middle of the two. However we did still see the government shutting down what it termed ‘inessential’ shops more than once. Do you think this was justified or once again an overreaction? Is the financial and even mental damage caused to people with these kind of measures justifiable to keeping everyone ’safe’ or was covid never such a big threat worth the loss of so many jobs and increase in mental health conditions, suicides and alcoholism that the news is also mentioning?
Dr: The harms of lockdowns are not quantified, but are likely to be enormous, including economic harms, psychological harms and social harms. The WHO only recommends lockdowns for short periods, allowing the health care system to recover, but also to increase capacity to help avoid lockdown as far as possible. The effects of lockdown are likely very small, over voluntary social distancing, as shown by the studies by Chaudhry and Bendavid, which have failed to find significant effects on reducing deaths or even case numbers. Sweden, without lockdown, now has a lower number of total COVID-19 deaths than the European average. Lockdowns have high costs, and unquantified benefits, and should be avoided as much as possible.
Me: What exactly is covid in your opinion? Is it really worth worrying over more than the flu, pneumonia and other illnesses that it is normal for everyone to encounter at some point?
Dr: The range of infection fatality rates (deaths from all cases of a disease, including an estimate of those which are asymptomatic) of COVID-19 ranges from 5 times less than to then times more than influenza, in various epidemics. The median is twice that of influenza, but only if you include those over 80 years of age, which account for up to 50% of deaths. The mortality of COVID-19 is 5 per ten thousand in those younger than 70, and the infection fatality rate is lower than that of influenza if you are 45 years old or younger.
Me: Every few years, a supposedly dangerous illness comes along. I can remember off the top of my head that we encountered Swine Flu, Ebola, Bird Flu, all in a decade or so. How does covid compare to these past ’threats’? Is it really more contagious? Are more people really dying OF covid rather than just from other unavoidable deaths but whilst being positive FOR covid?
Dr: This is a difficult question. If someone with a serious illness (e.g. heart failure or cancer) dies whilst positive for COVID-19, is that a COVID-19 associated death, or is that a fatality which should be ascribed to COVID? The best indicator is excess mortality, as charted in the official Euromomo.eu database. The excess mortality of COVID-19 in 2020 was greater than influenza, but there were two waves in 2020. It seems that COVID-19 at this stage produces more excess deaths than influenza, but maybe 30% or so more per epidemic wave. In future, with vaccination and those with natural immunity, it is likely to be quite comparable to seasonal influenza.
Me: Which brings me to, how accurate are the PCR tests really? I quite understand that someone could really test positive for covid and be feeling under the weather or worse. But what about all the people testing positive without any symptoms?
Dr: If the PCR test is performed in someone with symptoms, in the first 3-5 days, and the positive threshold is taken at no more than 24-25 cycles, then it is about 80% predictive of actual live viral infection. However, in those without symptoms, those symptomatic over 5 days, or with a threshold higher than 25 cycles, the predictive value can be quite low, or even zero. As such, the test should not be interpreted without considering this context.
Me: In the event that one feels ill and eventually tests positive for covid, what is your suggestion of how that person should take care of themselves in order to get better more easily and avoid hospitalisation?
Dr: I would suggest staying home, resting, and drinking lots of fluids. I would recommend symptomatic treatment, for example cough syrup for a cough, or paracetamol for fever. Vitamin D and C supplements may help support the immune system. If one gets worse, it is best to speak to one’s doctor, especially with high fever, shortness of breath or feeling very ill.
Thanking once again the good doctor for taking the time to answer my questions, which I am sure are questions that most of us having been asking as the days turned to months into a scenario where we are being told that covid will never go away.
NB - All answers by the Doctor have been unedited in any way, regardless of my personal opinion about the matter.