General (2s) Dominique Delawarde, a former intelligence officer specializing in international issues and particularly in the United States, delivers every fortnight a precise analysis of the evolution of the Covid-19 epidemic at the national and international level.
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 wave. The situation is improving or stabilizing on some continents or sub-continents (Asia, Africa, Oceania, Latin America) and deteriorating on others (Europe and North America, which are heading towards winter). A seasonal factor therefore seems to be appearing in the evolution of this epidemic with which we will have to live for many more months or even years.
As in the first wave, when the country’s organization and hospital resources are in place, when clear-sighted governance leads with serenity and knows how to earn the trust and support of its population, by decentralizing action, delegating and communicating frankly without seeking to instill fear, the management of the epidemic is going well and losses are limited. Things go less well when any of these factors are not present.
The Swedish example
The only country in Europe that has never confined – in order to seek “group immunity” and not to destroy its economy – Sweden seems to be in a position today to succeed in its wager. Unlike other European countries that have implemented very coercive measures, it is virtually unaffected by the rebound in deaths that occurred in early autumn. If this is not the result of group immunity, it looks very much like it. This does not prevent the Swedish government from making “recommendations” to its population, considered as adults.
Its weekly mortality rate, which may have seemed high at first, is now much lower than that of almost all European countries and could show, at the end of the epidemic, a final balance sheet that is doubly to its advantage: in terms of human losses but also and above all in economic and social terms.
Moreover, a study of Swedish weekly mortality statistics for the years in which seasonal influenza was the most deadly shows that the year 2020 (Covid year) was not the worst and that it only came in 5th position behind the years 1988, 1993, 1996 and 2000. It should be noted that at the time, the mainstream media did not make a big deal of it, did not stress the politicians and did not hysterize the population.
A detailed analysis of Swedish deaths shows that of all deaths reported “with” Covid only 16% (872 / 5813 at the date of the study) could be related to Covid alone (Covid deaths) and not to other co-morbidity factors.
Finally, the mortality rate in Sweden – a country that has never confined – all causes, from the first 33 weeks of the year 2020 – thus covering the period of the epidemic peak – is not significantly different from that of the previous 5 years. This should make our political elites and our “scientific council” reflect on the merits of measures that durably burden our economy and cause considerable collateral damage to society as a whole.
Regarding the second wave of the French epidemic that has been announced 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. It also 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 frailty.
So there is indeed “a wave? of mortality” every winter in France that appears on the curves below. Is this the reason why it should be called this year “2nd Covid wave?”. The INSEE will tell us around February-March 2021 when it will have analyzed in detail the 2020 excess mortality, if there is a significant one.
But it is not forbidden to be intelligent! And to look for what is wrong in our “French exception” and in the calamitous management of this epidemic, which generates “panic. Let us hope – without great illusion – that the Court of Justice of the Republic, which is investigating several ministers, will establish responsibilities and sanction those who should be.
We were already familiar with the Franco-French tragi-comedies staged by our governance under the “supervision” of a “scientific council” that bears its name badly: those of the masks, tests and respirators that adorned the very beginning of the epidemic and that we have not forgotten. They are the ones that led to the important losses we have experienced, the 55-day containment (the longest in the world), the curfew, and the economic and social collateral damage, the consequences of which will be important and long-lasting.
Today, I invite the reader to discover the lesser-known tragi-comedy of resuscitation very clearly explained by an excellent teacher: Dr. Louis Fouché, a resuscitation doctor at the IHU in Marseille. This sequence is enlightening:
This tragi-comedy shows us, once again, that the sovietization and centralization of French medicine led by a small team of “medical bureaucrats”, more or less subsidized, who no longer know how to delegate, who enact dogmas and rules, inevitably leads to disastrous results.
Situation report for Saturday 24 October 2020 0h00 GMT
Since the beginning of the epidemic
215 countries or territories were affected by the virus, for 42.5 million reported cases (+2.9 million in one week).
1,148,689 deaths (+ 40,013 in 1 week); 31,414,036 recoveries (+ 1,764,489 in 1 week).
9,898,409 patients undergoing treatment (+1.09 million in one week), including 76,187 in critical condition (+4,752 in one week).
34 countries have reported more than 3,600 deaths since the beginning of the epidemic and account for 94% of deaths: in order of loss: (USA, Brazil, India, Mexico, United Kingdom, Italy, Spain, France, Peru, Iran, Colombia, Argentina, Russia, South Africa, Chile, Indonesia, Ecuador, Belgium, Iraq, Germany, Canada, Turkey, Bolivia, Netherlands, Philippines, Pakistan, Egypt, Romania, Sweden, Ukraine, Bangladesh, Saudi Arabia, China, Poland.
On a global scale, the pandemic is rebounding, but we cannot speak of a new epidemic wave. This rebound is not brutal, its scope is still limited. This is, moreover, the observation made by the WHO. The number of deaths has begun to increase in the last seven days, the seasonal aspect of this viral disease seems to be a long-term phenomenon, as it is for influenza. 40,013 deaths “with” Covid in 1 week, that is 10% more in 1 week. This rebound mainly affects Europe, and more particularly Western Europe, where elderly and fragile populations abound and are, each year, the first victims of the harsh winter weather. Critical cases (76,000) are on the rise (+8% in 1 week). With nearly 2.9 million new cases reported this week, the rate of contamination is also on the rise. Nevertheless, the evolution remains slow, the exponential curves whipped up by those who sow fear are still not pointing the tip of their nose. The epidemic remains largely within the reach of states that have a quantitatively and qualitatively good health system.
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 is declining in Oceania, stabilizing in Western Asia, Africa and Latin America, and rebounding in Europe and the United States. The epicenter of the epidemic is gradually and indisputably shifting back to Europe, and more particularly to the Western EU.
The circulation of the virus continues to increase in Europe, but it is much less lethal: (nearly 1.26 million new cases in one week), nearly 5 million patients undergoing treatment (if we take into account the countries that no longer report them: UK, Spain, Sweden and the Netherlands); 15,446 critical cases (+3,098 in 1 week) for 10,432 deaths in 1 week (+2,919 compared to the previous week’s results).
The epicenter is shifting
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 milestones of 46 million cases and 1.2 million deaths will be crossed in the first week of November, just after the American election. The 1.5 million death toll is expected to be reached by December 31, 2020, representing roughly 2.5% of all deaths on the planet in 2020.
In the past week, the USA has reported more deaths than India and Brazil. The epicenter of the epidemic is shifting from Latin America to Europe, which is now registering almost twice the losses of Northern America (USA+Canada). Of the 40,013 deaths in the past week, 11,358 are Latin American, 10,819 are West Asian, 10,432 are European and 5,770 are US or Canadian. The situation appears to be improving in West Asia. Countries in the region now account for only 20% of new cases worldwide (97,000 new cases/day).
Current status of the number of cases and deaths by major region of the world
Yesterday’s heaviest balance sheets were those of the USA, India, Brazil and Mexico. These four countries alone reported yesterday: 33.4% of new cases, 39.8% of new deaths and 47.4% of critical cases in the world.
Oceania, Africa and Asia still have very low mortality rates and a share of global losses of 23.5%, even though they account for 77% of the population. Europe and the American continent (North and South) account for 76.5% of the losses for less than 23% of the world’s population. The shares of Europe and North 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 almost ten months, there have already been 114 million births, 34.7 million abortions and 48 million deaths in the world, including:
– 13.2 million deaths related to cardiovascular diseases.
– 9 million deaths related to malnutrition.
– 6.7 million deaths related to cancer,
– 4.1 million smoking-related deaths,
– 2.56 million lower respiratory infections
– 2.1 million alcohol-related deaths,
– 1.4 million AIDS deaths,
– 1.4 million deaths from diabetes
– 1.3 million deaths from tuberculosis
– 1.2 million deaths from malaria and seasonal influenza.
– 1.15 million deaths “with” Covid-19
– 1.1 million traffic accident deaths,
– 872,500 suicides
These data are estimates taken from WHO annual statistics and related to the period under consideration (10 months minus 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, 11,750 deaths per week, all causes combined. Last week, 1,205 people, most of them very old, died “with” the Covid-19, which represents 10% 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 August 12, or Spain, which did the same last June, Colombia, Bolivia, Argentina and Mexico, which have added a few thousand deaths to their toll 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 388,000 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 more than 98% of “Latino” deaths and more than 2,220 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 behind that of the USA and India. 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 2,609 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 101 new cases declared in one week, 248 patients still under treatment including 3 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 48 deaths per million inhabitants. Taiwan, the least affected, reports a mortality rate of 0.3 per million inhabitants (7 Covid deaths per 24 million inhabitants). Japan, for its part, reports 1,694 deaths per 126 million inhabitants, or 13 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 by the USA (to the benefit of Israel) and has the highest mortality rate in Asia at 379 deaths/million inhabitants. However, this rate remains much lower than the rates of the American continents and Western Europe.
Table showing the situation and losses of the eleven Asian countries with more than 1,850 deaths.
3 – North America
The USA now reports only 16.3% of new Covid cases worldwide. They also reported 20% of the total losses of the epidemic (China 0.40%).
The number of weekly deaths is up 10% to 5,770. The number of patients being treated is approaching 2.821 million and continues to increase (+152,000 in 1 week). The number of critical cases increased slightly to 16,205 (+887). The epidemic therefore seems to be starting up again in the United States, which will remain the world leader in terms of the number of deaths. The number of deaths is expected to reach 270,000 by the end of 2020. (58 times the losses declared by China….)
In Canada, the epidemic has regained momentum with 180 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 215 (up significantly), but these numbers remain derisory.
4 – Africa
Mortality related to Covid is derisory. With the exception of South Africa, chloroquine has been massively used to treat patients. Only South Africa is in a worrying situation, with a number of new cases and deaths that alone represent half of those on the continent. Together with Egypt, Morocco, Algeria, Ethiopia and Nigeria, the only other African countries to exceed 900 deaths in 9 months, it accounts for nearly 80% of reported African deaths.
5 – Europe.
A progressive deterioration of the epidemic situation, still on a small scale, can be observed there. 7,842 of the 10,432 European deaths reported this week are in a handful of countries, with, in order: Russia (1,802), France (1,205), United Kingdom (1,142), Spain (977), Poland (832), Ukraine (756), Italy (632), Romania (496),). For the other 40 European countries or territories, the increase in the number of deaths is much less significant. These numbers all remain derisory compared to those at the epidemic peak last April.
The situation in the United Kingdom is deteriorating. Thus, the number of critical cases “would” be up sharply to 707 (but more than 3 times lower than in France). The level of weekly losses has risen sharply to 1,142 reported deaths, which remains derisory compared to the epidemic peak. Total losses are and will remain by far the highest in Europe and are expected to exceed 50,000 deaths at the end of the epidemic (eleven times the figure for China).
The situation in Italy is deteriorating significantly: an increase in critical cases to 1,049 (+411 in 1 week). The number of new cases (+ 93,260 in one week) is high but remains much lower than in France (+ 206,305); the number of patients under treatment is increasing (+ 44,465 in one week). The number of deaths is increasing sharply (+632 in one week).
The situation in France is also deteriorating. Its weekly number of new cases explodes (+ 206,305). But the number of new cases is not a determining factor in characterizing the lethality of an epidemic. Detecting tens of thousands of healthy carriers, or even false positives, is of interest only to define the perimeter of the epidemic and thus avoid, through targeted measures, an excessively large spread. The two most relevant indicators are the number of critical cases, which is on the rise (+641 in one week) and the number of deaths: 1,205 over the week (+485 compared to last week).
The analysis of the 2 following curves shows that we had few cases and many deaths in the first week of April (epidemic peak) and that we now have seven times more cases and 5.6 times fewer deaths. There is therefore a second wave of “cases” much higher than the first (because we are finally testing a lot). But there is still no discernible 2nd wave of deaths.
The Covid mortality rate is, to date, 528 deaths per million inhabitants (excluding deaths at home), for a world average of 147.5 . In terms of the number of deaths, France is in fourth place in Europe (out of 48 countries or territories) behind the United Kingdom, Italy and Spain.
For those who still think that we are now experiencing a second wave of the epidemic, here is the curve of daily deaths (gray bar) and the daily average over 7 days (orange) since the first day of the epidemic. It takes a sharp eye to detect a second wave. Is it really necessary to put the country back under the bell and continue the break-up of its economy?
With regard to Covid “lethality” (No. of deaths / No. of confirmed cases), France is gradually improving its “score” with a rate of 3.3%, thanks to test campaigns that detect many healthy carriers. (As a reminder, European Covid lethality: 3.1% and worldwide: 2.7%).
For all the Marseille IHU and HP-HM hospitals out of 16,313 confirmed cases treated since the beginning of the epidemic, the lethality is 252 deaths or 1.5%, all treatments combined. This must be the Good Mother data from 22/10).
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 cure” to be able to hope to save a maximum number of lives.
22% of French people have been tested, the majority of them since the deconfinement. The Italians have tested 23.6% of their population, the Germans 24.3%, the Portuguese 31%, the Russians 38.5%, the Americans 39.4%, the Danes 82.8% by applying the tests at the beginning of the epidemic. Thanks to the belated effort made over the past two months, France has climbed to 42nd place worldwide for the number of tests per million inhabitants.
Most active cases
France is now the European country that reports the most active cases (over 897,000). This number is on the rise (+62,000 in one week). For this indicator, France is second in the world behind the USA and ahead of India. It has largely overtaken Russia, which has only 336,000 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 (10.5% of confirmed cases). It seems that it does not report the cures of mild cases that are treated at home, so it does not follow up … It does less well than Russia which cured 75.6%, Morocco which cured 82.5%, Senegal which cured 90.7% (note that these 3 countries have used, with more than fifty other countries, treatment protocols inspired by that of the IHU in Marseille). The global cure rate for confirmed cases is now 74%, even though a majority of countries entered the epidemic well after France. The European rate is 42.5%: it should be much better at this stage of the epidemic. France is therefore, along with Belgium, the country that pulls this European indicator down the most.
Spain, Germany, Belgium, Russia
The situation in Spain continues to deteriorate. It reports 127,649 new cases, 977 deaths and 263 additional 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 (2,031 ). 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 but slightly: The number of active cases increases by 35,439 in one week and the number of critical cases by 431. The number of weekly deaths is increasing but remains very low (242). Germany has, today, 9 times fewer patients undergoing treatment, 2 times fewer critical cases, 5 times fewer deaths than France.
With a mortality rate of 912 deaths per million inhabitants, Belgium will remain the European leader in this indicator (excluding microstates). It is still in 2nd position worldwide, behind Peru. The number of new cases is very high for a country of 11 million inhabitants (+ 78,173 in one week). The number of patients under treatment continues to increase (237,331 today, i.e. 76,419 more in one week). It is also very high in relation to the population. The number of critical cases is on the rise (+246 in one week). The Belgian cure rate is the lowest in the world (only 8.2% of reported cases to date). Belgium thus remains, behind 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.
In Russia, a significant rebound of the epidemic can be observed: 38.5% of the inhabitants have 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 (111,333 in 1 week). With 335,870 patients under treatment, Russia is in 5th position behind the USA, France, India and Brazil. This number has increased over the last two weeks.
The number of deaths per day is increasing significantly. Russia’s mortality rate per million inhabitants has reached 175, but it is still more than three times lower than in France (528).
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 75.6% of its confirmed cases, or nearly 1.12 million patients. However, Russia entered the epidemic round one month after France, which declared cured only 10.5% of its confirmed cases, i.e. 109,486 patients (almost ten times fewer).
Russia has therefore managed the Covid-19 crisis rather well so far.
5 – Oceania
The epidemic is rapidly receding there. This continent is still largely spared. Out of 42 million inhabitants, it has declared, to date, 35,216 cases, 31,143 of which have already been cured. There are still 3,115 “active” cases, of which only 18 are in a serious or critical state. The Oceanian continent declared 6 deaths this week. Its Covid mortality rate is 21.5 deaths per million inhabitants (France: 528).
The Covid mortality rates per million inhabitants of the 35 countries that have exceeded 3,100 deaths give an idea of the most affected geographical areas and/or countries.
The table below shows the balance sheets of the 34 countries that reported more than 3,600 deaths (94% of the losses).
Reminder: worldwide Covid mortality rate: 147.4 deaths / Millions of inhabitants (and European 331 deaths/M of h)