March-2021 - Covid-19 A Global Perspective and Tables rev1.pdf
1. CoVID-19 (Sars-CoV2): A GLOBAL PERSPECTIVE
Any mans death diminishes’s me because I am involved in Mankinde; And therefore never send to
know for whom the bell tolls; It tolls for thee (John Donne 1571-1631)
Let me say at the outset that the last year has without doubt been di
ffi
cult for everyone and the
dispassionate tone of what follows is in no way intended to diminish that fact.
In February 2020, I attended the excellent course run at the homeopathic clinic of Drs Subrata and
Saptarshi Banerjea in Calcutta (Kolkata), and since my return home to England have taken an interest
on the impact of the pandemic in India and beyond.
Perhaps, in writing this piece in March 2021, I risk making a premature judgement, but I perceive an
East West divide and the question is why?
It has been said in jest that 2020 was the “Year of the Expert”. Unwisely, I risk self anointment, for
never has so much data available to the amateur via the “Cloud”. Su
ffi
ce to say that what follows are
observations, and speculations, not de
fi
nitive answers. In the years to come much will be penned on
this subject by those better quali
fi
ed than me.
This pandemic has introduced a whole new lexicon: corona viruses; lockdown; furlough; social
distancing; PCR testing; ZOOM and more besides. Although there has been information overload, it is
the restrictions on our taken-for-granted freedoms that have most tested the patience and sanity of
majority of the population; and it is the UK that has the dubious honour of having the longest duration
of lockdowns. Had the mortality statistics been low, this strategy might have been vindicated, alas the
UK is amongst the worst performing globally.
In Table 1 on the next page, fourteen countries are listed, representing all the continents, save
Australasia (neither Australia nor New Zealand have been signi
fi
cantly impacted due to an
“elimination” strategy, aided by geographical remoteness; that said China, which is shown, adopted
much the same strategy). The table is ordered left to right by deaths per million of the population (see
red outlined row).
Dr Oliver Robinson, Associate Professor in Psychology at Greenwich University has undertaken an
interdisciplinary review of lockdown policies, and his paper makes for interesting reading. He gave an
excellent presentation to the Scienti
fi
c and Medical Network, of which I am a member.
As he acknowledges, the
fi
ndings are preliminary and no de
fi
nitive assessment can be written as yet,
but the broad conclusion is that lockdowns have been of questionable e
ff
ectiveness. In the UK, as
already mentioned, lockdowns and mortality correlate poorly. On the other hand, some researchers
referenced by Dr Robinson suggest that lockdowns do in
fl
uence the R (viral reproductive) number in
the short term, only to see a compensating upswing in case rates once the restrictions are removed.
Eire produced a nice example of this, when restrictions were relaxed in early December: the young
went out for a (metaphorical) glass of Guinness, cases soared and lockdown was reimposed by
Christmas eve!
Page of
1 5
2. Table 1: Covid-19 and Population Demographics. Selected Countries (arranged left to right as deaths / million)
Allan Pollock 23/02/2021 Page of
1 5
UK Italy USA Sweden EU Brazil South
Africa
Germany Iran Norway India South
Korea
Cuba Nigeria China
Population (millions) 67 61 331 10 446 212 59 84 84 5.4 1389 51 11 206 1443
GDP per capita
(thousands $US)
42 33 65 52 ~35 9 6 46 6 75 2 32 9 2 10
Health expenditure %GDP 10 8.7 17 11 ~9.9 9.5 8 11.5 8.7 10 3.5 7.5 11 4 5.4
Median age 40 47 38 41 45 33 28 46 32 40 28 44 42 18 38
Over age 65 as % 18 23 16 20 ~20 8.8 5 22 6 17 6 15 16 3 11
Life expectancy 81 83 79 83 81 77 64 81 76 83 69 83 78 54 76
Urban population % 83 69 83 88 75 88 25 76 76 83 35 82 78 52 61
Density as persons/km2 281 206 36 25 183 25 49 240 52 15 436 527 106 226 153
Total Covid deaths at
22/2/21 (thousands)
121 96 499 13 529 246 49 68 13 0.6 156 1.6 0.3 1.8 5
Deaths per million of
population 1780 1583 1507 1252 1185 1160 827 811 708 607 113 31 26 9 4
Estimated number of cases
at beginning of March 2020 100 1700 32 15 2800 2 1 1300 1000 20 3 3750 3 1 80k
Estimated total cases per
million to date (Feb 2021)
60801 46463 84997 62496 48660 47836 25355 28580 18739 12641 7975 1703 3930 738 70
Tests per million people as
of 18/2/21
1190 615 960
Similar
Norway Variable no data 150 510 160 680 150 130 200 7 no data
Cumulative deaths /
cumulative cases as %
2.9 3.4 1.8 2.0 2.4 2.4 3.3 2.8 3.8 4.8 1.4 1.8 0.7 1.2 5.7
Lockdown(s) duration days
(
fi
rst always March 2020)
103+
27+65
70+13
90+21
California
none varies
47
San
Paulo
35 28+90 37 none 74 none none none
74
Wuhan
International travel / border
restrictions (approx as
complex picture - many had
short term border closures)
selec-
ive
select-
ive
select-
ive +test
select-
ive (EU)
select-
ive (EU)
open
open +
test
open +
test
closed
10 day
q’tine
closed
visa
control
and
q’tine
open
+
test
open
since
11/20
visa
controls
3. The fact of the matter is that you either have the good fortune to possess innate immunity to the virus,
or must obtain it through exposure or vaccination. The mantra in the UK, reasonably enough, has
been “protect the NHS” and this goal has driven lockdown imposition. It is now apparent that this is
less about the number of general or ICU beds, than trained sta
ff
and keeping them healthy. As in war,
pilots are more valuable than aircraft.
Given that constraint, it is obvious that the most important task is to keep all but the most sick out of
hospital (and to isolate Covid patients from non-Covid patients). Furthermore, to minimise the duration
of the pandemic and its impact on the
economy, the virus has to be allowed to
circulate amongst the large majority of the
population who can cope with its transient, if
unpleasant, e
ff
ects. David Livermore, Professor
of Medical Microbiology at the University of
East Anglia, makes the point perfectly:
“immunity .. improves with work, not idleness ..
as vulnerable groups are vaccinated lockdown
should be swiftly released, allowing circulation
of the virus”. However, permitting viral
transmission and minimising hospitalisation
appear incompatible goals, vaccine or none.
Whilst awaiting a vaccine could more have
been done? And what if no vaccine could be
developed? Back in March 2020, Dr Seheult in
California, who fronts MedCram.com (a
website for medical students) made the
pertinent observation in one of a series of video
reports on Covid-19, that patients testing
positive but not in need of hospital care, received no early medical intervention. Given that some
proportion of this group subsequently deteriorated, this inevitably led to increased hospitalisations.
My biggest criticism of the NHS has been the lack of guidance in the simple use of immune
supporting and self care strategies, from vitamin and mineral therapies to diet, sleep and avoiding the
use of antipyretics.
This brings me to India where, possibly uniquely in the World, they have a Government Ministry
(AYUSH) that sets standards for the practice of, and training in, traditional medicine. In a recent
communication with Dr Subrata Banerjea, he tells me that, in the opinion of his many contacts, in
excess of 50% of the population have used homeopathy prophylactically. Ayurvedic medicine is also
widely used both to boost immunity and treat disease, as can be seen in the AYUSH systems poster
from the Government of NCT of Delhi above. (Cuba has also used homeopathy prophylactically and is
included in Table 1 for that reason).
Page of
2 5
4. Table 2: India, Top 15 Covid-19 Impacted States (29 States + 7 Union territories NCT Dehli being one of the latter)
Allan Pollock 23/02/2021 Page of
2 5
State Deaths (‘000) Cases to mid Feb
2021(‘000)
Population
(million)
Area
km2
% Urban Density
persons/km2
Case Fatality
Rate%
Major cities and
populations (millions)
INDIA 156 11022 1390 3,287,000 35 436 1.4 -
Maharashtra 51.8 (33%) 2106 123.1 307,713
(equivalent to Italy)
45.2 365 2.5 Mumbai 12.7; Pune 3.1
Nagpur 2.4; Thane 1.8
Pimpri-Ch’d 1.7; Nashik 1.5;
Kalyan-D’li 1.2; Vasai-Virar 1.2
Aurangabad 1.2; Navi M’bai 1.1
Tamil Nadu 12.4 (8%) 849 77.8 130,058 48.4 555 1.5 Chennai 4.7; Coimbatore 1.1
Madurai 1.0; Tiruchirappalli 1.0
Karnataka 12.3 (8%) 948 67.6 191,791 38.7 319 1.3 Bangalore 8.5
Hubli-Dharwad 1.0
Mysore 1.0
NCT Dehli 10.9 (7%) 638 18.7 1,483 97.5 11297 1.7 Dehli 11.0
West Bengal 10.3 (7%) 574 99.6 88,752 31.9 1029 1.8 Kolkata 4.6
Howrah 1.0
Uttar Pradesh 8.7 (6%) 602 237.9 240,928 22.3 828 1.4 Lucknow 2.8
Kanpur 2.7
Andhra
Pradesh
7.1 (5%) 889 49.6 160,205 29.5 303 0.8 Visakhapatnam 1.7
Vijayawada 1.0
Punjab 5.8 (4%) 178 27.7 50,362 37.5 551 3.2 Ludhiana 1.6
Amritsar 1.1
Gujarat 4.4 (3%) 267 63.8 196,024 42.6 308 1.6 Ahmedabad 5.6; Surat 4.5
Vadodara1.7; Rajkot 1.3
Kerala 4.1 (3%) 1036 35.7 38,863 47.7 859 0.4 Thiruvanvana’pan 0.7
Madhya
Pradesh
3.9 (3%) 259 85.4 308,252 27.6 236 1.5 Indore 2.0; Bhopal 1.8
Gwalior 1.1; Jabalpur 1.1
Chhattisgarh 3.8 (2.5%) 311 29.4 135,191 23.2 189 1.2 Chandigahr 1.0; Raipur 1.0
Haryana 3 (2%) 270 28.2 44,212 34.9 573 1.1 Faridabad 1.1
Rajastan 2.8 (2%) 320 81 342,239 24.9 201 0.9 Jaipur 3.0; Jodhpur 1.0
Kota 1.0
5. Has it worked? The death toll in India as at the beginning of March 2021 is just under 160 thousand,
each life lost a tragedy of course, but the toll is modest for a country that is home to 18% of the World
population.
Mischievous reporting from the BBC and elsewhere in the UK media stating, for example, that India
has “the second highest number of corona cases globally” (link here) creates an impression that belies
the reality. Mortality or case rates need a common comparator and Chart 1 showing rolling 7 day
average deaths per million tells another story.
But what lies behind the story? Is it too simplistic to say that India’s better performance in this
pandemic correlates to better immunity? On the the one hand, survival is favoured by the lower
median age; a simpler diet; less obesity, and less reliance on pharmaceutical products such as
paracetamol / Tylenol (acetaminophen). On the other, infection and mortality are surely favoured by the
very high urban densities and high pollution levels.
More 12 million died in India in the 1918 H1N1 ‘Spanish in
fl
uenza’ pandemic (250 thousand in the UK);
poverty, overcrowding and lack of medical care being likely key factors. Unsurprisingly it is the urban
populations that have again su
ff
ered in this pandemic as Table 2 shows.
India imposed a strict lockdown and had its
fi
rst fatality coincident with that in the UK, but the
lockdown was not repeated, not least because of the hazard of starvation in cities with many day
wage earners. Unlike the UK, India’s lockdown included border closures, although the virus was
already in circulation. Alas, viruses don’t respond to deportation orders. Currently, I understand that
Page of
3 5
Chart 1: Deaths per Million - for clarity only USA; European Union; Asia (& India) shown
6. India requires ‘
fi
t to
fl
y’ certi
fi
cates and tracks visitors to ascertain health status etc., which may
provide a measure of protection against “new variants”.
By December Dr Banerjea noted large wedding festivities going ahead, shops and malls open,
“Calcutta felt almost 80% normal”, he wrote. In February, cricket fans might have noticed the
unmasked crowds of spectators rejoicing during the recent test match against England. I hesitate to
tempt fate, but the pandemic in India seems to have done its worst.
But it is not just India, the impact of the pandemic in Asia is generally remarkable. South Korea, with
not dissimilar statistics to the UK makes for a particularly interesting comparison (see highlighted
columns in Table 1). As a result of MERS (2015; with 38 deaths) the Korean’s were better prepared,
and by report they are more obliging of Government mandates. Be that as it may, their restrictions
have been modest, the economic disruption minimised, and morale kept high.
Morale should not be underestimated. Dr Robinson, referenced the work of fellow psychologist Dr
Sheldon Cohen, of Carnegie Mellon
University, Pennsylvania, who over three
decades has tested the susceptibility to
infectious disease. He has established
that stresses (psychological, social,
chemical e.g. alcohol) all negatively
i m p a c t i m m u n i t y a n d i n c re a s e
vulnerability. (Recall Dr Samuel
Hahnemann’s “Organon” aphorism 71
onwards!).
China, Taiwan, Korea and Japan use
traditional medicines; all allied to the
Traditional Chinese Medicine (TCM)
model. India has its systems as
described. Robinson asks if now is the
time for a paradigm shift to an alternative
health model, as concisely described in
the graphic by Maria Schlafke of the
University of Florida (image taken from
Dr Robinson’s presentation).
It is hard to deny that the UK’s Covid-19
strategy appears to have been wanting.
As Scottish television presenter and
author, Neil Oliver, pithily said on BBC
Radio 4’s Any Questions (26/2/21) “B
plus” on vaccine roll-out, and “F minus”
for everything else.
Page of
4 5
7. Calamities seldom have a single cause; instead their aetiology stems from multiple failings. Future
analysts and the self-interested parties will surely focus on
fl
aws in preparedness, the spending on
resources, and the need for novel hi-tech drug treatments and vaccination programmes. But will what
naturopath, the late Jan de Vries called his “Five Pillars”: Nutrition; Digestion; Elimination; Circulation;
Relaxation be recognised or remembered as the true foundation of health? With homeopathic help, as
required, of course.
Finally, for readers with a detailed interest in the workings of the immune system I commend this
interview with microbiologist Gabor Erdosi which arrived just as I put my pen down. Quite pertinent!
link here.
Allan Pollock BSc, MIChemE, C.Eng, RSHom (aapollo6242@gmail.com)
Key sources
Dr Oliver Robinson (Associate Professor of Psychology at University of Greenwich)
https://www.oliverrobinson.info/ (you can
fi
nd both his paper and slide presentation)
Dr David Livermore (Prof. of Medical Microbiology at University of East Anglia)
Prof. Dr David Livermore quoted from The Daily Telegraph 20/2/21
Dr Jan de Vries, Naturopath (1937-2015)
https://www.scotsman.com/news/obituaries/obituary-dr-jan-de-vries-naturopath-1500200
Dr Sheldon Cohen, Professor of Psychology Carnegie Mellon University
https://www.cmu.edu/dietrich/psychology/stress-immunity-disease-lab/cohen/index.html
MedCram.com Episode 47 Dr Seheult
https://www.youtube.com/watch?v=H1LHgyfPPQ8
South Korea and Eire
https://www.bbc.co.uk/news/world-asia-56156234
https://www.bma.org.uk/news-and-opinion/prepared-for-the-worst-how-south-korea-fought-o
ff
-covid-19
The Conversation - Eire spike (10/2/21)
BBC Mischief (see caption to third image)
https://www.bbc.co.uk/news/56172784
Neil Oliver
http://www.neiloliver.com/
Ivor Cummins and microbiologist Gabor Erdosi
https://youtu.be/jPNu8sOU5RM
Scienti
fi
c and Medical Network
https://explore.scimednet.org/
Hahnemann S, (1842 / 1921) Organon of Medicine 6th Edition, A New Translation, Kunzli J et al 1989, London UK, Victor
Gollanz Ltd
.
Data Sources for Tables / Chart
https://statisticstimes.com/demographics/india/indian-states-population.php
https://www.covid19india.org/
https://ourworldindata.org/coronavirus
https://data.worldbank.org/indicator/SP.POP.65UP.T
O
https://www.worldometers.info/world-population/population-by-country
/
https://en.wikipedia.org/wiki/Travel_restrictions_related_to_the_COVID-19_pandemi
c
https://en.wikipedia.org/wiki/National_responses_to_the_COVID-19_pandemi
c
https://covid-statistics.jrc.ec.europa.eu/RMeasure
s
https://theconversation.com/1918-
fl
u-pandemic-killed-12-million-indians-and-british-overlords-indifference-strengthened-the-anti-
colonial-movement-133605
Page of
5 5