An earlier version of this article was first published in July 2020. This much revised version was published on December 25, 2020.
|“Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever… It is worthy of comment that three of the greatest benefits conferred on mankind… have been in connection with the fevers: The introduction of cinchona , the discovery of vaccination, and the announcement of the principle of asepsis.” – William Osler, lecture to the American Medical Association, 1896.|
Part 1 Germ Theory and Terrain Theory
Cinchona refers to the plant that provides the anti-malarial drugs quinine, chloroquine, hydroxychloroquine, or just “hydroxy” as Donald Trump referred to it when debate raged about its effectiveness in treating SARS-Cov-2 infections.
Although “fever” may have diminished in the 20th century as the greatest enemy of mankind—with mankind’s industrial civilization itself becoming a new enemy—cinchona is still working miracles and stirring controversy 124 years later. Unfortunately for those who reflexively oppose everything uttered by Donald Trump, there is evidence that a promising prophylactic and cure for the corona virus pandemic is a treatment protocol involving zinc, vitamin D, hydroxychloroquine, and azithromycin, given in the right amounts in the early stages of infection. Another promising protocol involves the drug ivermectin.
In a powerful and angry speech on July 27, 2020, Dr. Stella Immanuel described her use of the treatment with 350 high-risk patients in Texas, none of whom died. (Transcript here). The video was banned by YouTube and Facebook on the day it first appeared, and any mention of it on Facebook was labelled as false information because it allegedly spread lies about effective treatment of Covid-19. That is the state of free speech in the age of privately owned social media giants.
Dr. Immanuel gave an endorsement of everything I’ve been reporting on this blog in recent months about the hydroxychloroquine controversy in France. The views of Dr. Immanuel and the doctors in her group have actually been mainstream and acceptable in France for several months. The eminent virologist Didier Raoult was invited to testify in the French legislature on June 24, 2020 about the effectiveness of the hydroxychloroquine treatment protocol for Covid-19. For very peculiar reasons the message is being censored fiercely in the English-speaking world. Many people in France don’t like his message, either, but at least he got a chance to speak in the Senate and on mainstream media.
Articles critical of Dr. Immanuel appeared immediately after her speech, as if prepared in advance. In addition to her role as a doctor, she is alleged to be active in a church where she has spoken publicly about diseases being caused by evil spirits. It is apparently shocking and unprecedented to see a doctor with superstitious beliefs, but throughout my lifetime I, like you, dear reader, have had to collaborate and socialize with people who believe in things I find irrational, things such as wealth trickling down to the poor, hot winning streaks, and a magic man in the sky answering prayers. Some of these people were highly educated and competent professionals, trustworthy friends, and devoted parents. Thus, regardless of the beliefs that I don’t share with Dr. Immanuel, I’m willing to consider her ideas individually on their merits. If she is right about hydroxychloroquine, her beliefs and opinions on other matters are irrelevant. If she were wrong about hydroxychloroquine, that wouldn’t make her a fool or a malicious person. It would just make her wrong. Most importantly, the ready acceptance of censorship in this incident should be a concern to anyone who cares about free speech rights. Do you believe in free speech for those who say things you oppose, or are you against free speech?
Dr. Immanuel’s critics were also quick to pounce on the fact that she is Nigerian, saying she’s the latest “Nigerian scammer.” None of these critics discussed the substance of her argument, or the fact that it was repeated by other doctors in the group who are Caucasian speakers of American English. The facts ignored by critics are:
1. Doctors in many countries have noted the positive effects of hydroxychloroquine in Covid-19 treatment, in combination with zinc, vitamin D and azithromycin.
2. Research published fifteen years ago described the positive effect of chloroquine in treating SARS-Cov-1.
3. The research that attempted to disprove the effectiveness of the treatment was designed to make sure it would fail—researchers administered chloroquine too late in the progress of infection, without the antibiotic, zinc and vitamin D, at too high a dose or for too long, and to patients with heart conditions that should have excluded them from treatment, and
4. The articles rushed to publication in in late May 2020 by The Lancet and The New England Journal of Medicine that claimed chloroquine was not effective were retracted shortly after publication. Fact checkers patrolling social media continued to reference these articles to say the drug was proven ineffective.
Perhaps the dissident doctors and scientist are spreading fake news just for the wicked fun of it. They are financially secure, highly educated, politically conservative, but they want to throw all that away just to mess with our heads. The authorities who suppressed these treatments must hope so. Otherwise, they would be liable for hundreds of thousands of cases of negligent death and the financial losses of millions of individuals whose lives were disrupted by the reaction to the pandemic.
In the months after this controversy about hydroxychloroquine, a few doctors in various countries started raising the alarm about the [irony alert] shocking, unwelcome news that they had found another commonplace drug that works effectively as both prophylactic and cure of Covid-19. On December 8, 2020, Dr. Pierre Cory stated this in testimony before the US Senate:
… it is with great pride as well as significant optimism, that I am here to report that our group, led by Professor Paul E. Marik, has developed a highly effective protocol for preventing and early treatment of COVID-19. In the last 3-4 months, emerging publications provide conclusive data on the profound efficacy of the anti-parasite, anti-viral drug, anti-inflammatory agent called ivermectin in all stages of the disease. Our protocol was created only recently, after we identified these data. Nearly all studies are demonstrating the therapeutic potency and safety of ivermectin in preventing transmission and progression of illness in nearly all who take the drug.
This news that would be, one would think, enthusiastically welcomed, was swept aside with the arrival of Pfizer’s mRNA vaccine. Dr. Zubin Dumania, on his popular ZDoggMD Youtube channel, downplayed the testimony, claiming, in direct contradiction of what Dr. Cory stated, that there are no reliable studies to back up the claims being made. Once again it is highly curious that there is this widespread bias toward pessimism unless the solutions are based on newly developed products from the pharmaceutical industry, especially vaccines. The more success there is with existing drug treatments, the less interest there is in vaccines.
For example, there has never been political support for a vaccine for gonorrhea similar to what there was for Sars-Cov-2 this year, in spite of all the harm the former has caused. There are an estimated 300,000-600,000 cases per year in the United States. Ironically, in August of 2020 there was the extremely under-reported news that two pharmaceutical companies had announced success in development of the first vaccine. The impetus to develop it came from the fact that drug resistance has reached a point where the disease will soon be untreatable. Will Dr. Fauci and all the other leaders “keeping us safe” this year be in line to get the jab for gonorrhea?
As for syphilis, Dr. Stewart Sell wrote in his paper “A Vaccine for Syphilis”:
Design and application of a vaccine for syphilis is proposed. Syphilis, once a widespread and crippling disease, has decreased in prevalence and significance due to public health education and the use of penicillin, which is extremely effective in curing the disease. This decline has reduced the urgency for a vaccine for syphilis. However, in recent years the incidence of syphilis has been increasing. A persistent reservoir remains in highly impacted groups… It is proposed that the critical application of a vaccine for syphilis to these groups could eventually eliminate this disease.
One could argue that millions of lives would have been saved, since a long time ago, if vaccines for these sexually transmitted diseases had been developed decades ago. But for vaccine makers there are downsides working against them. There is the risk of lost investments on research that fails to produce a successful vaccine. Then there is the risk of disastrous side-effects, accusations of planned population control, or vaccine refusal because of the social stigma. Then there is the fact that the people most at risk can’t demand the vaccine because they are dis-empowered economically and politically. Even if they had that power, they would have trouble admitting to themselves the possibility of being infected. Those not at risk would just be offended by the suggestion that they need to be vaccinated.
But if we really are living by the high moral standards that have been claimed for the Covid-19 crisis, it should be all about saving as many lives as possible, regardless of the disease involved. All of the challenges could have been overcome with harsh laws requiring vaccination against STDs, with health passports made essential for travel, employment and access to social support payments—all the things that governments and citizens are proposing as reasonable in 2020 as measures to eradicate a cold virus that would probably fade in strength and become a minor nuisance within two years. Even now it has an extremely high survival rate and short recovery time. Why all this effort in one year to eradicate a new virus and make a vaccine for it, yet no effort over decades to eliminate the scourge of two sexually transmitted diseases? Furthermore, the measures that would really eliminate these diseases would be targeted at the sick societies that create poverty and drive people into prostitution and loveless promiscuity. Whether one aims to eradicate a disease with drugs or vaccines, either approach avoids the root causes of disease. To make the point simply, imagine a re-design of the famous Barbie doll that whined, “Math is haaard.” There should now be a Bill Gates doll that laments, “Vaccines are easy. Poverty eradication is haaard.” He never understood that they aren’t poor because they are sick; they are sick because they are poor.
In the days when there was neither an antibiotic nor a vaccine for tuberculosis, the giant of medical history and the Chinese revolution, Dr. Norman Bethune, cured himself of tuberculosis and campaigned for a total re-imagining of the health care profession during his work in Montreal in the 1930s. In The Medical Life of Henry Norman Bethune, the authors describe his work on tuberculosis and advocacy of universal health care in Canada:
Bethune always felt that if poverty could be eliminated, tuberculosis would disappear. On joining l’Hôpital du Sacré-Coeur, he freely provided his services to the poor and established a free-of-charge clinic, which was held on Saturday mornings in the Montreal suburb of Verdun. He was way ahead of his time in using radio broadcasts for public education on tuberculosis. In a paper published in 1932 in the Canadian Medical Association Journal, Bethune quoted a remark made by Edward Livingston Trudeau, the sanatorium founder: “There is a rich man’s tuberculosis and a poor man’s tuberculosis. The rich man recovers, and the poor man dies.”
Elsewhere in the article the authors quote Bethune’s speeches and writings of the time:
Bring it out into the light of the day… and then stir up enough feeling to get something done. Put it in terms that the people can understand, and may be some of the babies now dying in this benighted land will have a chance to be saved. The facts will be more important than all the pious platitudes in the world… We set ourselves in practice, all smug and satisfied, like tailor shops. We patch an arm, a leg, the way a tailor patches an old coat. We’re not practicing medicine, really, we’re carrying on a cash-and-carry trade. I’ll tell you what’s needed: A new medical concept of universal health protection, a new concept of the function of a doctor.
We, as a people, can get rid of tuberculosis, when once we make up our minds it is worthwhile to spend enough money to do so. Better education of doctors, public education to the point of phthisiophobia [morbid fear of tuberculosis—there is a word for that!], enforced periodic physical and X-ray examinations, early diagnosis, early bed-rest, early compression, isolation and protection of the young are our remedies.
|“Let food be thy medicine and medicine be thy food.” “It is more important to know what sort of person has a disease than to know what sort of disease a person has.”- Hippocrates, 431 BCE|
Thus vaccine promoters ignore that drugs can eliminate the diseases vaccines target, and drug promoters ignore the root causes of the diseases their drugs target. One doesn’t have to be opposed to all vaccines and all drugs all the time to agree with the point made by Dr. Bethune so long ago. The alleviation of misery is the most significant factor in reducing mortality of diseases. Nothing is better than having a healthy immune system. Vaccine critic Professor Michel Georget, author of Vaccinations: Inconvenient Truths, stressed this in a recent interview, citing the limited effect that vaccines have had on positive trends over the decades:
First, I have to go over the history of infectious diseases over a long period of time in order to answer [whether vaccines are effective]. I say that the effectiveness is not at all proven because infectious diseases declined very often long before vaccination campaigns, and the introduction of vaccination did not change the trend. I will give you one or two examples. With respect to measles, at the beginning of the 20th century, around 1910, measles killed five thousand people a year. When measles vaccination was recommended in 1983, it killed 15. That is to say that the mortality due to measles had decreased by 99.6% while the French population had increased by 33% at the same time. The record is similar for whooping cough. The decline was enormous, more than 90%, before the introduction of the pertussis vaccine. Thus, we can’t say in this case that it was vaccinations that reduced mortality. As far as tuberculosis is concerned, it is even more obvious. The BCG did not do anything for the decline of tuberculosis. We poisoned generations of children with BCG, so it should be known that when France vaccinated with BCG, from 1950, tuberculosis had already declined by 85% since the end of the 19th century, even before the vaccination campaign. And vaccination didn’t add anything to further progress. A second thing is even more egregious. If we compare the record of tuberculosis mortality in Holland and France, we find that at the end of the war in 1945, mortality rates were very similar, slightly higher in France, but very similar. Holland has never used the BCG vaccine. France did so from 1950, and twenty-five years after the end of the war, tuberculosis mortality in the Netherlands had fallen to 1.2 per 100,000 inhabitants, and in France, at the same time, it was 8.2. That is, it was almost seven times as much. So we must ask why the French didn’t make the same progress. Well, it is simply because France is a country of alcoholics. I remember the moral lessons of my elementary school where our teacher told us alcoholism “makes the bed” for tuberculosis. And it’s true. There are many studies that have shown that the most alcoholic regions are the regions most affected by tuberculosis. (Author’s translation)
|“The risk of active tuberculosis is substantially elevated in people who drink more than 40 g alcohol per day, and/or have an alcohol use disorder. This may be due to both increased risk of infection related to specific social mixing patterns associated with alcohol use, as well as influence on the immune system of alcohol itself and of alcohol related conditions.”|
The response to Covid-19 came with the same neglect of chronic illnesses, and the social systems that create them, noted by Doctors Bethune and Georget. There was a lack of interest in not only effective drugs and treatment protocols but also in the promotion of immunity and good health. Governments around the world, in unison, went all in for germ theory and deliberately ignored terrain theory. There was no official support of such common sense things as fresh air, sunshine, exercise, vitamin supplements and good food. If harsh measures had to be applied, why not a ban on alcohol and junk food? Governments could have spent their “stimulus money” on health promotion instead of shutting people in their homes and destroying health, immunity, jobs and small businesses. An even better question is why so many people have complied with this and even become the government’s volunteer enforcers and critics of dissidents.
Yes, health promotion might have given some people false confidence because immune-boosting efforts wouldn’t succeed in every case, and they wouldn’t act fast enough to save everyone. It wouldn’t be a guarantee on the individual level, but the effect on populations of hundreds of millions of people would have been significant. In the opposite way, the drastic shutdown measures had a harmful effect on collective immunity. Though there is no way to measure it directly, the increase in fear, stress and despair must have increased the number of people who developed a bad case of Covid-19. It used to be common folk wisdom that you catch a cold when you’re worn down or going through a stressful change in your life, but saying so in the year 2020 was strictly verboten. It was enough to make one wonder if the official effort was designed to impoverish millions, destroy social bonds and transfer wealth upward to the hedge funds and online retail giants. The year 2021 will reveal the damage. Hindsight will be 2020. See Alex Gutentag’s The Great Covid Class War for the full analysis of the great heist of 2020.
Normally, in the world before 1945, a severe crisis of capitalism led to world war, then the end result could be a new order like the one set out by the Bretton Woods Agreement. But world war is not possible when nuclear deterrence exists. Among the three choices of famine, fever and war, perhaps a global crisis generated for “fever” was the only alternative for getting to a great reset of financial systems and global power balances.
What is most suspicious is that usually when a disease or natural or man-made disaster threatens to cause havoc, governments are desperate to deny the problem and be re-assuring. After September 11, 2001 and the Fukushima catastrophe on March 11, 2011, for example, the message was “Don’t worry. Be happy. Go back to work. Keep shopping.” In contrast, in 2020, they pushed nothing but bad news. Good news was censored. At the peak of the hysteria in the spring, every other news story was pushed off of mainstream media platforms, as if nothing else newsworthy was happening in the world.
Part 2 How we think about all-causes mortality
The rest of this article focuses on causes of death in first world nations to contrast them with the number of deaths caused by Covid-19. With this discussion I hope to illustrate that this year’s obsession with one infectious disease is suspicious and unwarranted. Also, as discussed above, the number of deaths that has been so frightening might have been much lower if health had been promoted and if the hydroxychloroquine and ivermectin treatment protocols had not been suppressed and patients had got timely access to effective medical care.
|Media reports of crises in other countries—often without critical analysis of their relevance for Canada—can exacerbate fears and may have overly influenced policy decisions. If we tested for influenza every winter as we have done for coronavirus, we would have similar daily reports of cases and deaths, nursing home outbreaks, and stretched capacity of hospitals. Unlike for COVID-19, there would be several reports of influenza deaths in children. Has a precedent now been set for lockdowns every flu season? |
– Joel Kettner, associate professor, Department of Community Health Sciences, University of Manitoba, former chief public health officer, Province of Manitoba, Canada
During the summer of 2020, I was discussing with a colleague whether it would be safe and fair to the students at our university in Japan to return to normal operations in the fall semester. He was very afraid of the new spike in reported cases in the United States and Japan, and he was worried that if the university reopens, the virus might go from students to him, and then to his elderly mother, who, unlike the young students, has a high chance of dying from it. I understand the concern, even though I can’t help but think to myself (I’m tired of arguing about it anymore with people who are determined to be frightened) that this risk has always existed with seasonal viral pandemics, and we always took that risk—even the people most at risk took that risk.
What he said next was something so ridiculous that I decided, for the sake of getting along, not to comment on. He repeated something he had heard in the American media recently about the number of Covid-19 deaths now being greater than all the American deaths in the Vietnam War. It was an utterly irrelevant comparison to make because 20th century American war casualties have always been far lower than the number of deaths that occur annually from other causes. Yet now for some peculiar reason we see people trying to move deaths from a natural disaster (and the pandemic is a natural disaster, despite all attempts to politicize it) into the category of war casualties—to equate it with the political decision to send human beings on a mission to kill other human beings.
I checked to see which media outlets had tried to make something out of the comparison of Covid-19 deaths with Vietnam War fatalities, and it was all the usual suspects: Washington Post, CNBC, Time, National Geographic etc. All compared Covid-19 deaths in the United States to the number of American soldiers who died in Vietnam, which they listed as 58,000. It is notable how, with the usual American narcissism, they overlooked the estimated 2,000,000 deaths of people in Southeast Asia caused by the French and American invasions between 1955 and 1975. I wonder if in socialist Vietnam there have been newspaper editorials remarking on the fact that deaths from Covid-19 there are not even 0.0000005% of deaths during the American invasion—that is, they are zero, not even one versus the two million who died during the war.
The editorialist in The Washington Post was wise enough to note that the comparison was completely inappropriate, but he still described the war as a well-intentioned “blunder” and wrote, “U.S. leaders were accused of remaining in the war far too long.” The “papers of record” in the US never describe the Vietnam War as the war of aggression that it was, “the supreme international crime differing only from other war crimes in that it contains within itself the accumulated evil of the whole,” as the Nuremburg tribunal for Nazi war crimes described it. The Vietnam War was justified under the pretense that US help had been requested by the South Vietnamese government, yet that government was itself a US puppet that never could have held power on its own.
By December, with the Covid-19 death toll in the US said to be around 300,000, comparisons were being made the number of Americans who died in WW II. Americans could have noticed just as easily that that was the estimate of the number of people killed in Hiroshima and Nagasaki in 1945.
In any case, if causes of mortality are going to be compared to war casualties in order to rouse people to action, why has there never been an outcry for months on end in all the media to no longer accept such high rates of death from heart disease or addictions, or several other causes of death which each year cause far more deaths than the Vietnam War? If drastic sacrifices were made and costly actions taken similar to what was done to fight the pandemic of 2020, surely 300,000 lives (the coronavirus death toll estimate for the US in 2020) could be saved. The table below shows that in the US, 782,000 people die each year from heart disease and addictions. A study from 2009 found “uninsured, working-age Americans have 40 percent higher death risk than privately insured counterparts,” adding up to 45,000 excess deaths per year. With health insurance still tied to employment for most people under age 65 in the US, this year’s spike of unemployment going up to 30% means there will be a sharp increase in preventable deaths.
In fact, governments spend a great deal of money trying to reduce chronic illnesses and their root causes in the misery that comes from the socio-economic order. Some doctors have even blamed the poor response to the coronavirus on the fact that government health agencies are full of people specialized in chronic diseases but not in infectious diseases.
The trouble is that in spite of the resources thrown at the problem of chronic disease, systemic reform in capitalist countries is off the political agenda. The causes are thoroughly researched and understood, but nothing is done about them. The oligarchy that controls the political parties has no interest in improving the lives of the oppressed in any meaningful way.
According to the US Centers for Disease Control and Prevention (CDC), there were 2,813,503 registered deaths in the United States in 2017. The age-adjusted death rate, which accounts for the aging population, is 731.9 annual deaths per 100,000 people in the U.S., meaning 0.73% of the population dies every year.
Medical News Today states the following about causes of death in the United States:
Around 74% of all deaths in the United States occur as a result of 10 causes (heart disease, cancer, unintentional injuries, chronic lower respiratory disease, stroke and cerebrovascular diseases, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide). Over the past 5 years [before 2017], the main causes of death in the U.S. have remained fairly consistent.
From Medical News Today and the American National Institutes of Health, I compiled the following list of fourteen causes of mortality in the United States, with statistics from 2017 (Medical News Today, rows 1-10) and 2018 (ANIH, rows 11-14) rounded to the nearest thousand. The total of all deaths was higher because not all causes are covered in this list. There is also some possible overlap between the two sources, but the statistics are informative nonetheless. I have chosen statistics from the United States because they are in English and they cover a very large population, but this sort of analysis and commentary could be done for any industrialized nation where governments have applied neoliberalism and austerity budgets in recent decades.
Fourteen causes of death in the United States, recent annual figures
|4||chronic lower respiratory disease||160,000|
|8||influenza and pneumonia||55,000|
|11||murder and manslaughter||16,214|
|TOTAL of 1-14||2,263,214|
An obvious problem with the list is that each death has to be attributed to only one cause. Most deaths have multiple causes, and the attributed causes conceal ultimate causes such as childhood malnutrition, childhood trauma, environmental toxins, and poverty. Statisticians can tell us how many died of heart disease, but not how many died of broken heart.
The interesting question about statistics for 2020 is how deaths attributed to SARS-Cov-2 will fit into the list above. Will the total number of deaths be higher or lower? Will rows 10 to 13 (deaths by crime and deaths of despair) increase due to the effects of the confinement and economic contraction? Will rows 3 and 14 (unintentional injuries and automobile collisions) decrease because people stayed home? Will rows 1, 2 (heart disease and cancer) and 4-9 (chronic lower respiratory disease, stroke/cerebrovascular, Alzheimer’s, diabetes, influenza and pneumonia, kidney disease) decrease because some of the deaths usually attributed to those causes will be attributed to SARS-Cov-2? Will SARS-Cov-2 be added to row 8 (influenza and pneumonia) or will it get its own category? Hospitals have been incentivized and pressured to write Covid-19 on death certificates. Consider the relatively small number of deaths in row 8 (influenza and pneumonia) which actually could be much higher every year because it is “the final blow” in many deaths caused by heart disease and cancer. Until 2020, doctors always sensibly indicated the chronic disease as the cause of death.
In the figures in rows 1 and 2 and rows 4 to 9 there may be an increase in 2020 as a result of the pandemic because people delayed seeking medical treatment while they were afraid of being infected by the coronavirus. Perhaps these likely increases and decreases will cancel each other out to some extent.
With the number of deaths attributed to SARS-Cov-2 estimated to be 300,000 it is important to mention here too that many of these deaths were preventable. Government was slow to respond in the early weeks. The hydroxychloroquine and ivermectin treatments mentioned above were suppressed. Patients got emergency care too late because they were not told that shortness of breath is an unreliable indicator of trouble. Unlike other types of pneumonia, patients with Covid symptoms can have a “happy hypoxia” even after their blood oxygen levels have fallen below 95. Thus they didn’t get anti-coagulants and oxygen in a timely manner. In the early weeks of the pandemic, they were intubated too quickly, and the virus was carelessly (criminally) allowed to spread in seniors’ residences.
However, assuming that we have to work with a figure of 300,000 deaths in 2020 as the unavoidable outcome of the pandemic, it is still only about 10% of annual deaths from all causes. This number might just melt into the overall figures and become statistically meaningless, if other attributed causes of death fluctuate to offset deaths from SARS-Cov-2 and if the total deaths for 2020 are close to the figures for the previous years.
It seems reasonable to conclude that the deciding upon the role of SARS-Cov-2 in deaths from all causes will involve a lot of guesswork and arbitrary categorization. The only truly useful number may be the total number of deaths, and if that number is not significantly more than the figures for recent years, people will really wonder what all the social disruption was for. And if it is significantly higher, people will want to know if coronavirus infections were the cause or the social disruption was the cause. And the answer to these questions may stay locked in the proverbial black box. The disruption of 2020 will also continue to cause many non-lethal and lethal harms over several years. The harmful effects of bankruptcies, unemployment and disrupted education, won’t necessarily show up in next year’s mortality figures. They will ripple out slowly over several years.
Yes, every individual who died a horrible death from this new viral infection represents a tragedy for the people involved, but people who plan public policy have to detach themselves from those tragedies and look at the overall picture and adopt policies that will do the least harm over the long term. The reaction to the pandemic is likely to increase deaths from causes 10-13 (deaths of despair), and increase or decrease deaths from causes 1, 2, and 4-9 (injuries and common chronic illnesses). Some will say that the reaction to the pandemic saved half a million lives (or any number they choose), but that is an unfalsifiable claim. What is more certain is, firstly, that the total number of deaths for 2020 is unlikely to be much different than the totals for recent years, and secondly, that fatal and non-fatal adverse consequences of the confinement and economic contraction will continue to rise and be more clearly understood as time goes by.
What will we do when the next frightening new virus appears in the world, or just the next influenza virus, which, through a careful public relations campaign, could also be used to paralyze millions of people with fear? Fully aware of the social disruption caused by the previous political decisions, the public may get wise and say, “No way, not all that again!” When that happens, we had better hope that we get lucky as we did this time with a virus that has an infection fatality rate (IFR) of about 0.3%, and an extremely lower rate for people under age sixty. If we ever really do have to deal with a virus that has a 5% infection fatality rate, as SARS-Cov-2 was first described, then we will be living through a serious “boy who cried wolf” story.
 M.J. Vincent, E. Bergeron, S. Benjannet, et al. “Chloroquine is a potent inhibitor of SARS coronavirus infection and spread,” Virology Journal 2, 69, 2005.
 Andrew Joseph, “Lancet, New England Journal retract Covid-19 studies, including one that raised safety concerns about malaria drugs,” Stat News, June 6, 2020.
 K. Lönnroth, B.G. Williams, B.G., S. Stadlin et al. “Alcohol Use as a Risk Factor for Tuberculosis – A Systematic Review,” BMC Public Health, 8, 289 (2008).
 Joel Kettner, “A New Normal, or New Abnormal? Change in Direction Needed on COVID-19 Response,” CBC News, July 28, 2020. The author is associate professor, Department of Community Health Sciences, University of Manitoba, former chief public health officer, Province of Manitoba, Canada.
 Aaron Blake, “The Coronavirus Death Toll Just Surpassed Vietnam. Here’s Why That Comparison is Fraught.” Washington Post, April 30, 2020.
 “New Study Finds 45,000 Deaths Annually Linked to Lack of Health Coverage,” Harvard Gazette (blog), September 17, 2009.
 Streeck, H., Schulte, B., Kümmerer, B.M. et al. Infection Fatality Rate of SARS-Cov2 in a Super-Spreading Event in Germany. Nature Communication 11,5829 (2020).