World

Covid : situation in France and in the world on November 7, 2020

General (2s) Dominique Delawarde, a former intelligence officer specializing in international issues, particularly the United States, provides a fortnightly analysis of the evolution of the Covid-19 epidemic at the national and international level. Today, he notes a strong seasonal rebound for Europe and North America.

Summary of the situation: At the planetary level, if the contamination progresses mainly in Europe, the general curve of deaths does not yet allow to speak about 2nd “world” wave. Indeed, the situation is stabilizing, or even improving “gradually” on certain continents or sub-continents (Africa, Oceania, Asia, Latin America) and is only deteriorating on those that are walking towards winter (Europe and North America). A seasonal factor therefore seems to be confirmed in the evolution of this epidemic with which we will have to live for many more months or even years. The new epicenter of the epidemic is now clearly European, with the Western EU being by far the most affected by the rebound.

Managing the epidemic

As in the March-April episode, when the country is well organized and the hospital resources are there, when a clear-sighted governance leads in serenity and knows how to deserve the trust and support of its population, by decentralizing action, by delegating and communicating frankly without trying to instill fear, when the media do not add a “ladle” to hysterize politicians and the little people, the management of the epidemic goes well and losses are limited, even very limited (Nordic countries, Germany, Greece, …). Things go less well when one or more of these factors are not present. This is particularly the case in the Western EU, and especially in France, where mortality rates are much higher than elsewhere.

At this stage of the epidemic, it is worth recalling some important data:

1 – If the pandemic is planetary by definition, 93% of deaths are concentrated in 34 countries or territories, which means that the 183 other countries or territories affected by the epidemic have extremely limited human losses to the point that they will go almost unnoticed in their annual balance sheet.

2 – With 7 weeks to go before the end of 2020, at the current pace of the epidemic’s evolution, we can already predict, without risk of error, that the human toll will be between 1.6 and 1.7 million deaths in 2020, i.e. 2.7% of the number of deaths in a normal year on the planet. This number will not be added to the number of usual deaths because a significant part of these deaths labeled Covid (around 75%) are deaths that would have occurred, a few months later, due to another co-morbidity factor. These deaths classified as Covid will therefore often “substitute” for deaths attributed to other pathologies.

Example? a very old person, suffering from cancer and dying “with” Covid, will not die three times. If he is labelled “Covid”, his death will be deducted from the usual deaths from cancer or old age. It is interesting to note that the 3,700 deaths for the year 2020 attributed today to seasonal flu in France will have been a very sharp reduction compared to the average of the previous ten years (9,000) or compared to the 2017 balance sheet.
It will take a long time for INSEE at the beginning of 2021 to restore order to the study on excess deaths by cause in 2020. It will have to distinguish between the part that goes directly to Covid and the part that goes to other causes (increase in suicides linked to business failures or stress for example….).

To put it plainly, and whatever the mainstream media and the members of the executive branch may say in their biased way of presenting things, this epidemic will have been extremely little deadly on the planet in 2020. The human species is not yet at risk of extinction since the number of inhabitants will have increased by more than 80 million in 2020 despite the epidemic: No reason to play the ostrich and hide your head in the sand (confinement of the country and destruction of its economy) at each epidemic episode. These episodes are likely to recur in the years to come, with mutant viruses that are difficult to combat and no country can afford the luxury of repeated confinement.

Foreword: Last week, I mentioned the Swedish case and wondered about the relevance of its non-containment strategy.

Day after day, it is confirmed that this strategy was the right one, because the group immunity sought seems to have been achieved, to a large extent. Today, Sweden is the only country in Europe that can be said not to be affected by a significant increase in deaths. Its mortality rate since the beginning of the epidemic is now lower than that of France, which will have confined its population 55 + 30 days = 85 days in 2020. Let’s look for the error.

The France-Sweden comparison is going to get even worse to the detriment of France in the weeks to come because Sweden has only 92 critical cases, while France has more than 4,500.

It is true that those who have led the losing sides in Western Europe always tend to make excuses (it’s the fault of the referee, the field, the weather, the fans, bad luck ….), or to compare themselves to those who have done worse and who, alas, are becoming increasingly rare.
Regarding the second wave of the French epidemic that we have been hearing about for several weeks, a good sketch is better than a long speech.

In order to decipher the above table correctly, one must keep in mind that the average number of deaths per day in France is seasonal. INSEE tells us that, on average, 1,500 people/day die in summer in France and 1,800 in winter, all causes combined. It informs us that the average winter number of deaths can go up to 2200 per day as in January 2017. Finally, it tells us that the number of deaths in France is increasing year after year because the baby boom generations are reaching old age – that of fragile health.

average number of deathsThere is therefore a “wave of excess mortality” every winter in France, which appears on the curves opposite. We will see if this curve is significantly different in 2020 when INSEE will tell us about it around February-March 2021 by drawing its 2020 death curve, shown in orange on the table opposite.

To put into perspective the importance of the 2020 epidemic episode in France, it should be remembered that in January 2017, the peak of the seasonal flu epidemic that year, the number of deaths in France, all causes combined, was, according to INSEE, 66,990. This number of deaths was higher than in April 2020, the epidemic peak of the Covid-19 crisis: 66,392 deaths. Our media and politicians had not made a big deal of it and France had not resorted to the general containment of the country, a medieval solution, to limit the contagion and lethality of a particularly deadly 2017 influenza virus.
To put the monthly mortality rate in France in context, it should be remembered that between 2017 and 2020, it varied between a summer low of 43,400 and a winter high of 67,000 recorded in January and July 2017. None of the months of 2020 has so far gone beyond these limits. Moreover, it is unlikely that these limits will be crossed in November or December 2020, even though the number of elderly people in France continues to grow. For the month of October, the cumulative and provisional number of deaths recorded by INSEE on the 19th of the month was only 31,000 (last provisional number published). This data is not yet reported below.

 

 

With regard to confinement in France, let us note this new “hiccup” of the Scientific Council which wrote in its report of October 28th addressed to the government (page 9) “we see that the arrival of the cold between September 17th and 24th was accompanied by a decrease in the number of visitors to parks from September 18th , probably reflecting the fact that people stayed more indoors, thus favoring the resumption of the epidemic”.
Reading these lines one realizes that the Scientific Council itself admits that confinement in closed environments favors “the resumption of the epidemic” and one remembers that the use of parks, forests and deserted beaches was forbidden for a very long time during the first confinement. …. This chaotic management of the epidemic by a panic-stricken government, overwhelmed by events, continues with the disastrous decision of the director of the ANSM (National Agency for the Safety of Medicines) who, under the supervision of his minister, takes up again the bad practice of this agency, already noted during the Mediator affair.
This practice consists in wanting to impose at all costs a drug that presents very serious side effects denounced by the WHO and by the most recent scientific studies, Remdesivir, and to eliminate the competition of Hydroxichloroquine by refusing to accede to the request for RTU (Temporary Recommendation of Use), presented by the IHU of Marseille, whereas this drug, not very expensive, is used by many countries representing 4.3 billion inhabitants, without any notable side effect for those who apply, at the right time, the right dosage.

History repeats itself

It is fortunate that the IHU of Marseille is suing this director of the ANSM for “endangering the lives of others”. This director is obviously acting, in this case, with the full support of his minister and the pharmaceutical lobby. Decidedly, the history of the Mediator is repeating itself.
The Franco-French tragi-comedies staged by our governance under the “supervision” of a “scientific council” that bears its name badly, have thus embellished the very beginning of the epidemic: those of “delayed ignition” in the closure of borders, the first round of municipal elections, the soccer match in Lyon, masks, tests, respirators, resuscitations, under-equipped hospital structures. We have not forgotten. They are the ones that led to the major losses that France has experienced, the two longest confinements in the world, curfews, and the collateral economic and social damage, the consequences of which for our country will be very significant and long-lasting.

For those who have a short memory, here are two selected videos describing very clearly the actions of the team that managed this health crisis at the highest level: to be watched in order:
https://twitter.com/PorcherThomas/status/1294931751324835842
https://www.youtube.com/watch?v=RgaZe7ZN2HU&feature=youtu.be
Too many mainstream media have faithfully relayed the government’s word and have lost much of their credibility. (With the notable exceptions of France Soir, Sud Radio and C News).

Situation report for Saturday 7 November 2020 0h00 GMT

Since the beginning of the epidemic

216 countries or territories were affected by the virus, for 49.65 million reported cases (+3.76 million in 1 week).

1.25 million deaths (+54,700 in 1 week); 35.24 million recoveries (+2 million in 1 week).

13.15 million patients undergoing treatment (+1.7 in 1 week), including 90,745 in critical condition (+7,387 in 1 week)

– 34 countries have reported more than 4,500 deaths since the beginning of the epidemic and account for 93% of deaths: in order of loss: (USA, Brazil, India, Mexico, United Kingdom, Italy, France, Spain, Iran, Peru, Argentina, Colombia, Russia, South Africa, Chile, Indonesia, Ecuador, Belgium, Germany, Iraq, Turkey, Canada, Bolivia, Ukraine, Netherlands, Romania, Philippines, Pakistan, Poland, Egypt, Bangladesh, Sweden, Saudi Arabia, China.

On a planetary scale, the pandemic is amplifying its rebound, but we cannot speak of a new epidemic wave. This rebound is important but not brutal. This is, moreover, the observation drawn up by the WHO. The number of deaths has started to increase since 3 weeks, the seasonal aspect of this viral disease seems to want to be part of the duration, as it is for the flu. 54 700 deaths “with” the Covid in 1 week, that is 22% more than last week.

Stabilized in Asia

This rebound mainly affects Europe, and more particularly Western Europe, where elderly and fragile populations abound and are the first victims of the harsh winter weather every year. Critical cases (90,745) are on the rise (+9% in one week). With nearly 3.8 million new cases reported this week, the rate of contamination is also up 10%.
However, the evolution remains slow, the exponential curves raised by those who sow fear still do not point the tip of their nose. The epidemic remains largely within the reach of states that have a quantitatively and qualitatively good health system and whose governments do not panic.
The circulation of the virus continues to increase in Europe but it is much less lethal than last April: (nearly 1.9 million new cases in one week), nearly 7.5 million patients undergoing treatment (if we take into account the countries that no longer report them: UK, Spain, Sweden and the Netherlands); 25,797 critical cases (+10,351 in 2 weeks) for 24,208 deaths in 1 week (+8,616 compared to the previous week).
The epidemic has stabilized in West Asia (India, Bangladesh, Pakistan, Saudi Arabia, Iraq, Iran). It is marking time in Africa (South Africa, Egypt). At the current rate of evolution of the epidemic, the milestone of 80 million cases and 1.6 million deaths is expected to be reached by December 31, 2020, which will represent, roughly, 2.7% of the deaths of the year 2020 on the planet.

The evolution of reported losses over the past weeks can be summarized in a table:
On reading it, one realizes to what extent mortality remains very low and declines in Oceania, stabilizes in Africa, West Asia and Latin America, and rebounds in Europe and the United States. The epicenter of the epidemic has unquestionably shifted back to Europe, and more particularly to the Western EU.

In the past week, the US reported more deaths than India and Mexico. The epicenter of the epidemic has clearly shifted from Latin America to Europe, which now has more than 2.5 times the losses in Latin America or East Asia and more than 3 times the losses in North America. Of the 54,700 deaths in the past week, 24,208 are European, 10,458 are Latin American, 10,829 are West Asian and 7,353 are US or Canadian. The situation appears to have stabilized in West Asia. Countries in the region now account for only 11% of new cases worldwide (67,000 new cases/day).

Current status of the number of cases and deaths by major region of the world

 

The heaviest balance sheets of the day yesterday were those of the USA, France, India and Mexico. These four countries alone reported yesterday: 39.6% of new cases, 35% of new deaths and 37.8% of critical cases in the world.

Oceania, Africa and Asia still have very low mortality rates and a 24% share of global losses, even though they account for 77% of the population. Europe and the American continent (North and South) account for 76% of the losses for less than 23% of the world’s population. The shares of Europe and Northern America will now increase, while those of Africa, Latin America and Asia (West) will therefore decrease.

To put the human toll of the 2020 pandemic into perspective, it should be remembered that since the beginning of 2020, in ten months and one week, there have already been 119.5 million births, 36.2 million abortions and 50 million deaths in the world, of which:
– 13.2 million deaths related to cardiovascular diseases.
– 9.5 million deaths related to malnutrition.
– 7.1 million deaths related to cancer,
– 4.25 million smoking-related deaths,
– 2.56 million lower respiratory infections
– 2.15 million alcohol-related deaths,
– 1.47 million AIDS deaths,
– 1.47 million deaths from diabetes
– 1.37 million deaths from tuberculosis
– 1.25 million deaths from malaria and seasonal influenza.
– 1.25 million deaths “with” Covid-19
– 1.15 million traffic accident deaths,
– 915,000 suicides

These data are estimates taken from WHO annual statistics and related to the period under consideration (10 months and 6 days). To this could be added deaths related to other infectious diseases (excluding Covid), which can be counted in the millions, and deaths related directly and indirectly to military interference or economic sanctions by Western countries in the Near and Middle East or Latin America.

Again to put things into perspective, here is a comparison with the other major global epidemics of the last century

Finally, France records, on average in October and November, 12,200 deaths per week, all causes combined. Last week, 2,835 people, most of them very old, died “with” the Covid-19, which represents about 23% of the weekly deaths).

With regard to Covid deaths, it should be remembered that the numbers reported are very uncertain. The examples of the United Kingdom, which subtracted 5,303 deaths from its total on 12 August, or Spain, which did the same last June, and Colombia, Bolivia, Argentina and Mexico, which have added a few thousand deaths to their figures since the beginning of September, are there to prove it. Some developing countries do not have the means to collect reliable information. Others underestimate the number of deaths by forgetting, for example, voluntarily or not, to count deaths at home, others strongly overestimate this number by attributing to Covid alone, the deaths of very many patients suffering from multiple pathologies (including “old age”). Several of these pathologies, other than Covid, were often the primary cause of death.

Situation by continent, sub-continent, and most affected countries

1 – Latin America
With more than 410,000 reported deaths, Latin America is by far the part of the world most affected by the epidemic in terms of the total number of deaths and the second highest mortality rate per million inhabitants.
In Latin America, human losses are concentrated in eleven states that report nearly 98% of “Latino” deaths and more than 2,300 deaths each. Other countries in the Caribbean and South America are still relatively untouched by the epidemic.

The situation in Brazil is beginning to improve. The number of new cases is decreasing (4 th in the world behind India, USA and France with less than 5% of new cases worldwide) and the number of critical cases (3 rd behind USA and India at 8,318) remains high. The number of daily deaths has fallen far behind that of the USA, India and France. Brazil has passed the epidemic peak since the end of July. Deaths below 600/day should now be the norm in the coming days.
In Mexico, the number of deaths was 2,999 in one week. This is a very slight increase.

2 – Asia

East and Southeast Asia (China, Japan, Vietnam, both Koreas, Taiwan, Philippines, Indonesia, Laos, Cambodia, Malaysia, Burma …) is relatively unaffected by the pandemic. China continues to do well. With 211 new cases declared in 1 week, 419 patients still under treatment including 9 serious cases, and 0 new deaths, China has almost eradicated the epidemic on its soil.
Since the beginning of the epidemic, Indonesia, the most affected country in East Asia, has recorded a derisory mortality rate of 53 deaths per million inhabitants. Taiwan, the least affected country, which has never confined itself, reports a mortality rate of 0.3 per million inhabitants (7 Covid deaths per 24 million inhabitants).
Japan, for its part, declares 1,806 deaths for 126 million hours, or 14 deaths per million inhabitants.
It is therefore West Asia (India, Iran and neighboring countries in the Middle East) that records the bulk of the losses in Asia. It should be noted that Iran is still a country under “maximum” economic sanctions from the USA and has the highest mortality rate in Asia at 443 deaths/million inhabitants. However, this rate remains much lower than the rates in the Americas and Western Europe.

Table showing the situation and losses of the eleven Asian countries with over 1,860 deaths.

3 – North America

The USA still reports 20.8% of new Covid cases worldwide. They also reported 19.4% of the total losses of the epidemic (China 0.37%).
The number of weekly deaths is up 12% to 7,038. The number of patients being treated is approaching 3.425 million and continues to increase (+152,000 in 1 week). The number of critical cases, at 18,246, is on the rise again. The epidemic thus seems to be starting up again in the USA, which will remain in first place worldwide for the number of deaths. The number of deaths is expected to approach 300,000 by the end of 2020. (65 times the losses declared by China!).
In Canada, the epidemic has regained strength with 315 deaths for the entire past week (a slight increase). Its mortality rate since the beginning of the epidemic remains 2.5 times lower than that of the USA. The number of reported critical cases is 234, but these numbers remain very low.

4 – Africa:
Mortality linked to Covid is derisory. With the exception of South Africa, chloroquine has been massively used to treat patients. It is South Africa that is in a worrying situation with 45% of the number of new cases and deaths on the continent.
Together with Egypt, Morocco, Algeria, Tunisia and Ethiopia, the only other African countries to exceed 1,200 deaths, it accounts for nearly 80% of reported African deaths.

5- Europe

A sharp, but more gradual deterioration in the epidemic situation can be observed than in April. Of the 24,208 European deaths reported this week, 15,604 are in a handful of countries, with, in order: France 2,835, Italy 2,317, United Kingdom 2,271, Russia 2,131, Poland 1,936, Spain 1,818, Belgium 1,212, Ukraine 1,084. For the other 40 European countries or territories, the increase in the number of deaths is much less significant. These numbers remain lower than those of the epidemic peak last April.
The situation in the United Kingdom is deteriorating. Thus, the number of critical cases “would” be up sharply to 1,142 (but nearly 4 times lower than in France). The level of weekly losses has risen sharply to 2,271 deaths reported in one week, which remains low compared to the epidemic peak. Total losses are, and are expected to remain, the highest in Europe. It could exceed 60,000 deaths at the end of the epidemic (thirteen times the death toll in China).

More cases, fewer deaths

The situation in Italy is deteriorating significantly: an increase in critical cases to 2,515 (+ 769 in 1 week). The number of new cases (+ 215,000 in 1 week) is significant; the number of patients under treatment is also increasing (+ 173,334 in 1 week). The number of deaths is increasing sharply (+ 2,317 in one week).
The situation in France is deteriorating sharply. Its number of active cases is exploding, placing France in 2nd position worldwide for this indicator with nearly 1.5 million cases. But the two most relevant indicators are the number of critical cases, which is on the rise (+954 in one week) and the number of deaths: +3300 in one week.
The analysis of the 2 following curves shows that we had very few cases and many deaths in the first week of April (epidemic peak) and that we now have eight times more cases and half as many deaths ….. So there is a second wave of “cases” much higher than the first one (because we are finally testing a lot). But the second wave of deaths is more progressive and less strong.

The Covid mortality rate is, to date, 610 deaths per million inhabitants (excluding deaths at home), for a world average of 160. In terms of the number of deaths, France is in third place in Europe (out of 48 countries or territories) behind the United Kingdom and Italy. At the rate things are going, it should be in second place by mid-November and, why not, be on the top step of the podium at Christmas.

Here is the daily death curve (in grey bar) and the daily 7-day average (in orange) since the first day of the epidemic. You can see the extent of a more gradual rebound than in April. Is it really necessary to put the country back under the bell and to continue the break-up of its economy?

Regarding Covid “lethality” (Number of deaths / Number of confirmed cases), France is clearly improving its “score” with a current rate of 2.4%, thanks to test campaigns that detect many healthy carriers. (For the record: European Covid lethality: 2.47% and worldwide: 2.52%).
For all public hospitals in Marseille (IHU and HP-HM) out of 16,916 confirmed cases treated since the beginning of the epidemic, the lethality is 254 deaths or 1.5%, all treatments combined. It must be the Good Mother (data from 3/11).
At IHU Marseille, out of the 6,806 patients treated with hydroxychloroquine at the beginning of the disease, 30 died (lethality less than 0.5%). Patrick Pelloux, president of the emergency physicians, gave an interesting 27-second message on this subject.
In the acute phase of the epidemic, in April, apart from a few local exceptions (Marseille and Garches in particular), France tested too little for too long, treated too many patients too late, and relied too much on Doliprane and “spontaneous healing” to be able to hope to save as many lives as possible.

Most active cases in France

26.6% of the French have been tested, the majority of them since the first deconfinement. The Italians and Germans have tested 28% of their population, the Portuguese 35%, the Russians 43.5%, the Americans 46.5%, the Danes 97.7% by applying the tests from the beginning of the epidemic. Thanks to the belated effort made over the past two months, France has climbed back to 39th place in the world for the number of tests per million inhabitants.
France is now the European country that reports the most active cases (nearly 1.5 million). This number is on the rise (+ 316,773 in one week). For this indicator, France is now second in the world behind the USA and ahead of India. It has largely overtaken Russia, which has only 407,000 active cases). However, the vast majority of cases are benign and do not all require hospitalization.
France still lags behind in terms of reported cures (7.6% of confirmed cases). It seems that it does not declare the cures of benign cases that are treated at home, and therefore does not follow up on them. It does less well than Russia which cured 75%, Morocco which cured 81.7%, Senegal which cured 97.6% (note that these 3 countries have used, with more than fifty other countries, treatment protocols inspired by that of the IHU of Marseille).
The global cure rate for confirmed cases is now 71%, even though a majority of countries entered the epidemic well after France. The European rate is 36.7%: it should be much better at this stage of the epidemic. France is therefore, along with Belgium, the country that is pulling this European indicator down the most.

Elsewhere in Europe

The situation in Spain continues to deteriorate. It reports 123,814 new cases, 1,818 deaths and an additional 304 critical cases in one week. These last two indicators are worrying. After France and Russia, Spain is the country with the most critical cases in Europe (2,786). These critical cases carry the seeds of an inevitable increase in the number of deaths in the coming weeks.

The situation in Germany is deteriorating significantly: The number of active cases has increased by 60,322 in one week and the number of critical cases by 814. The number of weekly deaths triples but remains low (776). Today, Germany has 7 times fewer patients undergoing treatment, almost half as many critical cases and almost 4 times fewer deaths than France.

With a mortality rate of 1,079 deaths per million inhabitants, Belgium is once again the world leader in this indicator (excluding microstates). It has moved back ahead of Peru. The number of new cases is very high for a country of 11 million inhabitants (+ 87,083 in one week). The number of patients under treatment continues to increase (438,834 today, i.e. 82,327 more in one week). It is also very high in terms of population, as it is higher than in Russia, a country of 146 million inhabitants. The number of critical cases is on the rise (+371 in one week). The Belgian cure rate is the lowest in the world (only 5.8% of cases reported to date, which probably means that it does not follow non-hospitalized cases who cure alone at home). Belgium thus remains, along with Spain and France, the most active focus of the epidemic in Western Europe. It should be noted that Belgians report Covid deaths at home, which some of its neighbors do not do.

Rebound in Russia

In Russia, a significant rebound of the epidemic can be observed: 43.5% of the population has been tested, which represents the 3rd highest rate of screening for countries with more than 10 million inhabitants, hence a still high number of new cases reported (133,464 in 1 week). With 407,400 patients under treatment, Russia is in 6th position behind the USA, France, India, Brazil and Belgium. This number has increased over the last two weeks.
The number of daily deaths is increasing significantly. Russia’s mortality rate per million inhabitants has reached 205, but it is still nearly 3 times lower than in France (610).
Because it detects quickly, isolates and treats without delay, and because it applies a strategy and protocol inspired by those of the Marseille IHU, Russia has already cured nearly 75% of its confirmed cases, i.e. nearly 1.3 million patients. However, Russia entered the epidemic round one month after France, which declared cured only 7.6% of its confirmed cases, i.e. 126,329 patients (almost ten times fewer).
Russia has therefore managed the Covid-19 crisis rather well so far.

6- Oceania

The epidemic is rapidly receding there. This continent is still largely spared. Out of 42 million inhabitants, it has declared, to date, 40,048 cases, of which 32,819 have already been cured. There are still 6,249 “active” cases, of which only 24 are in serious or critical condition. The continent of Oceania declared 10 deaths this week. Its Covid mortality rate is 23.3 deaths per million inhabitants (France: 610).

The Covid mortality rates per million inhabitants of the 34 countries that have exceeded 4,500 deaths give an idea of the most affected geographical areas and/or countries.

Un tableau présente ci après  les bilans du 7 novembre 0h00 GMT des 34 pays ayant déclaré plus de 4 000  décès
(93% des pertes)

Table of data concerning Europe (and the EU) in the face of the epidemic

Reminder: worldwide Covid mortality rate: 160.1 deaths / Million inhabitants (and European 385 deaths / Million inhabitants).

Europe,France,World,