In the US, one source has said that the number of deaths ‘from’ Covid-19, as opposed to the number of deaths of people ‘with’ Covid-19 is vanishingly small, probably less than 10%. Presumably we can apply the same comment to recorded cases (link to embedded video: https://tinyurl.com/y83vtm3w).
Some quick comparisons: globally, nearly a million people die of malaria every year. 1.5 million people die of TB. Nearly 800,000 die of HIV, despite enormous sums of donor funding being poured into this single disease. There are no vaccines for any of these diseases, or for most of the big killers, although many are preventable.
Taylor complains of politicization of statistics and media in Tanzania. He writes: “Controlling the narrative means silencing facts that contradict the official line.” Taylor believes that statistics about Covid-19 are no exception. No doubt, Taylor is right.
Fear-mongering is not exclusive to African leaders or media. Many of the current lockdowns in the UK, US and elsewhere are based on making people feel afraid to go about their normal day to day lives; they are made to feel ashamed if they have the temerity to ‘contravene’ government guidelines in the slightest way.
According to Taylor, Magufuli has “emphasised the importance of working hard, keeping the economy going strong, and maintaining a healthy supply of food and other goods.” He finishes with a couple of facile comparisons with the 1918 ‘Spanish’ flu epidemic, and the Maji Maji Rebellion in 1905.
Perhaps Magufuli’s critical stance towards Covid-19 would be more constructively contrasted with his far less critical stance towards HIV. 1.6m Tanzanians are living with HIV, 24,000 people died from HIV in 2018 and there were 72,000 new infections.
If the president had said what the WHO and UNAIDS have known for several decades, that crumbling and unsafe healthcare infrastructures are probably responsible for more HIV infections than heterosexual sex, they could have started reversing this trend long ago.
Magufuli went along with other high HIV prevalence countries, took the considerable amounts of money offered, and allowed the epidemic to continue, although incidence has been dropping slowly since the 1990s.
Magufuli is no public health expert, and I don’t think he claims otherwise. But the ongoing response of many countries to Covid-19 is not a viable option, and it’s good to hear that a (very) few countries are saying so. I hope the president does ask for help, given Tanzania’s lack of healthcare capacity and poor health infrastructure.
There are plenty of issues Taylor could have looked at before wagging yet another neo-imperialist finger at Magufuli, but here’s just one: with an estimated 800 million people affected by hunger every year, globally, and over 9 million people dying of starvation, closing down any of the fragile African economies is not a viable option.
Firstly, that background color makes this a lot harder to read than it needs to be. I had to highlight it to make it easier to read
This simply isn’t true though: “Despite carrying out tens of thousands of tests a day, the UK is in a very similar position to Tanzania. This is because they (the UK )record many deaths that may not be from Covid-19 as if they resulted from the virus, and there is no way of analyzing the figures to work out what proportion is accurate.”,
and you really shouldn’t be quoting a site like OffGuardian if you expect to be taken seriously.
You didn’t quote a source for this “In the US, one source has said that the number of deaths ‘from’ Covid-19, as opposed to the number of deaths of people ‘with’ Covid-19 is vanishingly small, probably less than 10%. Presumably we can apply the same comment to recorded cases.”
but that’s wrong too.
Thank you for your comments. The UK can’t account for how many people have been infected with Covid-19, nor how many have died *as a result of* the virus because of the way they record cases and deaths. A population based survey would probably show that a huge number of people have been infected, and that even the inflated death rate is a very small proportion. Tanzania can’t account for numbers because they haven’t tested any more than a few hundred people. (Kenya has tested thousands, but only found a handful of cases. But there’s a whole can of worms to be opened when you start to look at each country, individually.)
Sorry you don’t approve of Off-Guardian, but I have found the English Guardian to be very unreliable when it comes to issues in developing countries. The paper seems to have voluntarily censored it’s coverage of Covid-19, so it’s no more useful than the social media that echoes its pronouncements. I would recommend you be more critical of sources such as The Guardian, BBC and others.
The source for the remark about the US is the embedded video, but I have added a link. I agree that excess mortality figures will be very revealing once there are accurate figures on cases and deaths, and that Covid-19 cases are under reported; I doubt if deaths *from* the virus will turn out to have been under reported much, unless deaths *with* the virus, or deaths of people with symptoms similar to or thought to resemble those of the virus in some vague way.
If someone has tested positive for the virus, and dies with symptoms of it, then it makes sense to assume they died as a a result of the virus. There are lots of people who died with covid-19 symptoms but weren’t tested, and given the excess mortality figures, it’s reasonable to assume that many or most of those died of covid-19 too, particularly when it was so difficult in March and April for people to get tested. There may be some people who died because they didn’t go to hospital because they were afraid of catching the virus there, or because they thought the hospitals were too busy, but they’re at least partially offset by the number of people not dying in traffic accidents or homicides.
The Guardian doesn’t report much on developing countries, but they certainly haven’t been self-censoring over covid-19, and I genuinely struggle to see how anyone could regard Off-Guardian as being even close to as trustworthy as the Guardian or BBC. I’ve been following your blog for years, and you have some very important points to make, but you’re already trying to convince some very skeptical people, and you need to use reliable sources I read/watch lots of media btw, but the BBC is the news source I’d trust over any other.
“A population based survey would probably show that a huge number of people have been infected, and that even the inflated death rate is a very small proportion.”
The death rate is being under-estimated rather than inflated though, and disturbingly, population-based surveys are actually showing that not many people have been infected yet eg:
“Just published @ScienceMagazine France, despite being hard hit by #COVID19, has a population infected rate of only 4.4% (2.8-7.2) from extensive modeling ”
This projection is dated 11th of May, so very recent.
Infection rate: “These different scenarios result in mean IFRs from 0.5 to 0.9%”
Furthermore, based on a larger meta-analysis of a range of studies:
“So, how lethal is COVID? “Based on a systematic review and meta-analysis of published evidence on COVID-19 until the end of April, 2020, the IFR of the disease across populations is 0.75% (0.49-1.01%)” ”
“And maybe to put into context: Average annual flu mortality estimated to be 5.9 / 100,000 population. With ~10% infected each year, this yields an IFR of ~0.06%”
So, how lethal is COVID? "Based on a systematic review and meta-analysis of published evidence on COVID-19 until the end of April, 2020, the IFR of the disease across populations is 0.75% (0.49-1.01%)”
Hi Mark
I’ll change the background soon, I have little time, dated equipment and a poor connection at the moment. But I am aware and appreciative of your contribution to this blog over the years.
Although we agree on some things, we can’t agree on everything. I trusted, to some extent, BBC and Guardian coverage of African and development issues when I started studying HIV and development. But it didn’t take long to find that coverage was often sloppy, unresearched, copy and paste and frequently descends into racism, sexism and deeply anti-African coverage. I read and cited numerous mainstream, specialist and academic sources and I have rarely found sustained and reliable contributions on broad issues such as HIV, sexuality, development, healthcare and others.
Coverage of specific issues, such as mass male circumcision, widespread use of Depo-Provera injectible hormonal contraceptives in high HIV prevalence countries, sexual behavior and others has, if anything, been even more biased. People’s lives are seriously affected by these issues. HIV, in African countries specifically, has been exceptionalized, and treated as if it is transmitted almost entirely through unsafe heterosexual behavior. Yet UN/WHO, CDC, academia and others have long known that unsafe healthcare is likely to be a far bigger contributor to the most serious outbreaks, which are all in developing countries.
I am not able to address each point you make as I have little time at the moment. But you say The Guardian doesn’t report much on developing countries: there is a section called ‘international development’, loudly supported by the Gates Foundation. Little has been said about C19 in developing countries yet because media focus has been on countries in Europe, Asia and the US. If and when they do start covering C19 in African countries, I will be reading it to find out what they are saying, but not to gain information.
Regarding Tanzania, which is my main concern right now, the country has weak healthcare infrastructure and services, huge shortages of trained and experienced professionals, shortages of equipment and supplies; there isn’t even a reliable supply of clean water for much of the time in many hospitals; electricity supply is inconstant and unreliable; there are few ambulances or emergency services even for normal levels of use. A small outbreak, a slight uptick in demand on services, will overwhelm healthcare facilities in most parts of country.
The economy is fragile. Recent flooding in neighboring countries has killed hundreds, displaced tens of thousands, destroyed homes and crops. Huge areas have been destroyed by locusts in several countries and this didn’t stop when the international press stopped reporting it, and turned their attention to C19. Millions of people in developing countries, many of them infants and under-5s, die every year from things like acute diarrhea, respiratory conditions, malnutrition, numerous preventable, treatable and curable pathogens.
Even a small crisis in a limited area can cause a massive jump in food and other vital commodity prices, overnight. Jumps in the price of one item causes jumps in the price of others. The majority of people have to work every day to afford what they and their family need every day. A day not working means a day with no food for the family. A few days of crisis could cripple the local economies of tens of millions of people, just in East Africa, alone.
Rich countries, on whom developing countries depend so much for trade, are currently running down their economies in the hope that they will slow down the spread of a pathogen that they have been told may kill a lot of people. But however many it will kill, the numbers will not equal those who will be affected by the economic crisis they are now facing. Subsistance economies will need people to continue working. But big producers, who depend on exporting their produce, may not be able to pay their workers in the coming months.
Sorry, my reply is turning into a post that I haven’t had time to research! But there is little agreement about how rich countries should respond to C19, what has worked and what hasn’t, and how we should go forward. Therefore, neither global media, rich countries, international institutions and others are in a position to lecture leaders of poor countries.
I agree with a lot of what you say, and there’s no doubt that developing countries will be affected very differently from developed countries. A couple of other things though:
This is more evidence, from Spain this time, that only low numbers have been infected so far, and showing a fatality rate of 1.1%:
Seroprevalence study from Spain, seemingly well designed (random sampling of households), 70K subjects, reveals 5% of country w/ antibodies with considerable geographic variation, infection fatality rate of 1.1%, 90% of cases undetected. https://t.co/37mN69Ik3P
and this is very interesting, and suggests, at least for developed countries, that it might be the virus itself rather than the lockdown causing the economic damage:
Compelling statistical evidence that it is the virus not the mandated lockdown that hurts the economy comes from a comparison of Sweden and Denmark. Important work supporting the argument I and many others made:https://t.co/PD3XAVS5Mbhttps://t.co/4WQWOiOj8c
Thanks Mark, I’ll have a look at those issues if I have some time. The amount of published material on this virus is overwhelming. But here’s a relatively short piece on excess deaths that can not be explained by C19:
There are so many individual scientists, doctors, politicians, hacks, administrators, teams, groups, factions, committees and the rest, many with competing and incompatible views. My aim was to emphasize that one foreign hack, albeit based in Tanzania, is not in a position to criticize Magufuli, or to advise him.
He could have criticized the decades of neglect of healthcare, education and social services, and perhaps he has done. But for all anyone knows, Magufuli is genuinely unconvinced by what he is being told by numerous healthcare, academic, political and other advisors. Several other countries have refused to follow the advice of international institutions, and we just don’t know what the outcome will be.
Perhaps we can’t trust figures we get from some countries whose leaders we don’t approve of. But, for example, a model such as the infamous Imperial College one used to predict hundreds of thousands of C19 deaths in the UK can only be judged by the usefulness of the predictions it made. Mathematical models used in previous threatened outbreaks over the past couple of decades in the UK have been similarly inaccurate.
You don’t have to be a scientist, mathematician or any kind of expert to know that if a model’s predictions invariably fail, the model needs to be replaced. The Imperial College model was used to impose a lockdown that was certainly too inclusive to be useful, and may do a lot more damage than C19, if it hasn’t already.
Bloodborne HIV: Don't Get Stuck! 
Firstly, that background color makes this a lot harder to read than it needs to be. I had to highlight it to make it easier to read
This simply isn’t true though: “Despite carrying out tens of thousands of tests a day, the UK is in a very similar position to Tanzania. This is because they (the UK )record many deaths that may not be from Covid-19 as if they resulted from the virus, and there is no way of analyzing the figures to work out what proportion is accurate.”,
and you really shouldn’t be quoting a site like OffGuardian if you expect to be taken seriously.
You didn’t quote a source for this “In the US, one source has said that the number of deaths ‘from’ Covid-19, as opposed to the number of deaths of people ‘with’ Covid-19 is vanishingly small, probably less than 10%. Presumably we can apply the same comment to recorded cases.”
but that’s wrong too.
The excess mortality figures in many countries show the covid-19 deaths are *under*-reported eg
https://www.ft.com/content/67e6a4ee-3d05-43bc-ba03-e239799fa6ab
https://www.ft.com/content/a26fbf7e-48f8-11ea-aeb3-955839e06441
https://www.bbc.co.uk/news/uk-51768274
Thank you for your comments. The UK can’t account for how many people have been infected with Covid-19, nor how many have died *as a result of* the virus because of the way they record cases and deaths. A population based survey would probably show that a huge number of people have been infected, and that even the inflated death rate is a very small proportion. Tanzania can’t account for numbers because they haven’t tested any more than a few hundred people. (Kenya has tested thousands, but only found a handful of cases. But there’s a whole can of worms to be opened when you start to look at each country, individually.)
Sorry you don’t approve of Off-Guardian, but I have found the English Guardian to be very unreliable when it comes to issues in developing countries. The paper seems to have voluntarily censored it’s coverage of Covid-19, so it’s no more useful than the social media that echoes its pronouncements. I would recommend you be more critical of sources such as The Guardian, BBC and others.
The source for the remark about the US is the embedded video, but I have added a link. I agree that excess mortality figures will be very revealing once there are accurate figures on cases and deaths, and that Covid-19 cases are under reported; I doubt if deaths *from* the virus will turn out to have been under reported much, unless deaths *with* the virus, or deaths of people with symptoms similar to or thought to resemble those of the virus in some vague way.
If someone has tested positive for the virus, and dies with symptoms of it, then it makes sense to assume they died as a a result of the virus. There are lots of people who died with covid-19 symptoms but weren’t tested, and given the excess mortality figures, it’s reasonable to assume that many or most of those died of covid-19 too, particularly when it was so difficult in March and April for people to get tested. There may be some people who died because they didn’t go to hospital because they were afraid of catching the virus there, or because they thought the hospitals were too busy, but they’re at least partially offset by the number of people not dying in traffic accidents or homicides.
Here’s an article on different ways of counting the numbers.
https://www.bbc.co.uk/news/health-52623141
The Guardian doesn’t report much on developing countries, but they certainly haven’t been self-censoring over covid-19, and I genuinely struggle to see how anyone could regard Off-Guardian as being even close to as trustworthy as the Guardian or BBC. I’ve been following your blog for years, and you have some very important points to make, but you’re already trying to convince some very skeptical people, and you need to use reliable sources I read/watch lots of media btw, but the BBC is the news source I’d trust over any other.
“A population based survey would probably show that a huge number of people have been infected, and that even the inflated death rate is a very small proportion.”
The death rate is being under-estimated rather than inflated though, and disturbingly, population-based surveys are actually showing that not many people have been infected yet eg:
“Just published @ScienceMagazine France, despite being hard hit by #COVID19, has a population infected rate of only 4.4% (2.8-7.2) from extensive modeling ”
This projection is dated 11th of May, so very recent.
Infection rate: “These different scenarios result in mean IFRs from 0.5 to 0.9%”
Furthermore, based on a larger meta-analysis of a range of studies:
“So, how lethal is COVID? “Based on a systematic review and meta-analysis of published evidence on COVID-19 until the end of April, 2020, the IFR of the disease across populations is 0.75% (0.49-1.01%)” ”
“And maybe to put into context: Average annual flu mortality estimated to be 5.9 / 100,000 population. With ~10% infected each year, this yields an IFR of ~0.06%”
(please start using a different background color btw – I spend 70-80 hours a week looking ac screen, and this one makes my eyes hurt)
Hi Mark
I’ll change the background soon, I have little time, dated equipment and a poor connection at the moment. But I am aware and appreciative of your contribution to this blog over the years.
Although we agree on some things, we can’t agree on everything. I trusted, to some extent, BBC and Guardian coverage of African and development issues when I started studying HIV and development. But it didn’t take long to find that coverage was often sloppy, unresearched, copy and paste and frequently descends into racism, sexism and deeply anti-African coverage. I read and cited numerous mainstream, specialist and academic sources and I have rarely found sustained and reliable contributions on broad issues such as HIV, sexuality, development, healthcare and others.
Coverage of specific issues, such as mass male circumcision, widespread use of Depo-Provera injectible hormonal contraceptives in high HIV prevalence countries, sexual behavior and others has, if anything, been even more biased. People’s lives are seriously affected by these issues. HIV, in African countries specifically, has been exceptionalized, and treated as if it is transmitted almost entirely through unsafe heterosexual behavior. Yet UN/WHO, CDC, academia and others have long known that unsafe healthcare is likely to be a far bigger contributor to the most serious outbreaks, which are all in developing countries.
I am not able to address each point you make as I have little time at the moment. But you say The Guardian doesn’t report much on developing countries: there is a section called ‘international development’, loudly supported by the Gates Foundation. Little has been said about C19 in developing countries yet because media focus has been on countries in Europe, Asia and the US. If and when they do start covering C19 in African countries, I will be reading it to find out what they are saying, but not to gain information.
Regarding Tanzania, which is my main concern right now, the country has weak healthcare infrastructure and services, huge shortages of trained and experienced professionals, shortages of equipment and supplies; there isn’t even a reliable supply of clean water for much of the time in many hospitals; electricity supply is inconstant and unreliable; there are few ambulances or emergency services even for normal levels of use. A small outbreak, a slight uptick in demand on services, will overwhelm healthcare facilities in most parts of country.
The economy is fragile. Recent flooding in neighboring countries has killed hundreds, displaced tens of thousands, destroyed homes and crops. Huge areas have been destroyed by locusts in several countries and this didn’t stop when the international press stopped reporting it, and turned their attention to C19. Millions of people in developing countries, many of them infants and under-5s, die every year from things like acute diarrhea, respiratory conditions, malnutrition, numerous preventable, treatable and curable pathogens.
Even a small crisis in a limited area can cause a massive jump in food and other vital commodity prices, overnight. Jumps in the price of one item causes jumps in the price of others. The majority of people have to work every day to afford what they and their family need every day. A day not working means a day with no food for the family. A few days of crisis could cripple the local economies of tens of millions of people, just in East Africa, alone.
Rich countries, on whom developing countries depend so much for trade, are currently running down their economies in the hope that they will slow down the spread of a pathogen that they have been told may kill a lot of people. But however many it will kill, the numbers will not equal those who will be affected by the economic crisis they are now facing. Subsistance economies will need people to continue working. But big producers, who depend on exporting their produce, may not be able to pay their workers in the coming months.
Sorry, my reply is turning into a post that I haven’t had time to research! But there is little agreement about how rich countries should respond to C19, what has worked and what hasn’t, and how we should go forward. Therefore, neither global media, rich countries, international institutions and others are in a position to lecture leaders of poor countries.
I agree with a lot of what you say, and there’s no doubt that developing countries will be affected very differently from developed countries. A couple of other things though:
This is more evidence, from Spain this time, that only low numbers have been infected so far, and showing a fatality rate of 1.1%:
and this is very interesting, and suggests, at least for developed countries, that it might be the virus itself rather than the lockdown causing the economic damage:
Thanks Mark, I’ll have a look at those issues if I have some time. The amount of published material on this virus is overwhelming. But here’s a relatively short piece on excess deaths that can not be explained by C19:
https://www.bmj.com/content/369/bmj.m1931
There are so many individual scientists, doctors, politicians, hacks, administrators, teams, groups, factions, committees and the rest, many with competing and incompatible views. My aim was to emphasize that one foreign hack, albeit based in Tanzania, is not in a position to criticize Magufuli, or to advise him.
He could have criticized the decades of neglect of healthcare, education and social services, and perhaps he has done. But for all anyone knows, Magufuli is genuinely unconvinced by what he is being told by numerous healthcare, academic, political and other advisors. Several other countries have refused to follow the advice of international institutions, and we just don’t know what the outcome will be.
Perhaps we can’t trust figures we get from some countries whose leaders we don’t approve of. But, for example, a model such as the infamous Imperial College one used to predict hundreds of thousands of C19 deaths in the UK can only be judged by the usefulness of the predictions it made. Mathematical models used in previous threatened outbreaks over the past couple of decades in the UK have been similarly inaccurate.
You don’t have to be a scientist, mathematician or any kind of expert to know that if a model’s predictions invariably fail, the model needs to be replaced. The Imperial College model was used to impose a lockdown that was certainly too inclusive to be useful, and may do a lot more damage than C19, if it hasn’t already.
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