Covid-19 compared to other pandemics this century

According to microbiologist Siouxsie Wiles, compared to other pandemics this century Covid-19 is a bad roll of the dice.

Stuff: We lost this round of pandemic dice

I think it helps to think of these outbreaks and pandemics as a handful of dice.

The dice represent:

  • The microbe and how it spreads.
  • What symptoms it causes.
  • How it can be treated and prevented.
  • How each dice falls influences how the outbreak plays out.

With Covid-19, we’ve rolled almost the worst possible combination, with a collection of ones.

Covid isn’t as lethal as the likes of Ebola, but as symptoms are often not noticed or mild, and take time to present, Covid can spread before it is discovered.

Wiles details the other pandemics in the last 20 years, and compares aspects of them to Covid.

Sars (2002-2004)

Sars appeared in late 2002, also caused by a coronavirus that spreads through the respiratory route. Unlike Covid-19, people with Sars had a high fever early in their infection. That made it easier to identify infected people and stop human-to-human transmission.

By mid-2004, Sars was gone and hasn’t been seen since. By then 8000 people had been infected and over 800 had died. Cases had spread to almost 30 countries and territories.

Covid-19 also emerged in a globally connected part of the world and at a time of year when lots of people were moving about.

H1N1 (early 2009 to August 2010)

H1N1 was a variant of the influenza viruses from humans, birds, and pigs that caused a pandemic from early 2009 to August 2010. Like normal seasonal flu, H1N1 spread through the respiratory route. But unlike normal flu, it was more likely to cause breathing difficulties in young, healthy people. Thankfully, a vaccine was available by late 2009. It’s thought H1N1 caused about 500,000 deaths. 

That was over about 18 months.

Ebola (December 2013-June 2016)

The largest Ebola outbreak began in Guinea, West Africa in December 2013 and spread to Liberia and Sierra Leone. Ebola transmits through bodily fluids from symptomatic people. That means it’s easier to stop than Covid-19, in which people are infectious before they realise they have the virus.

While vaccines were in clinical trials by mid-2015, the Ebola outbreak was mainly brought under control by stopping human-to-human transmission. It also helped that it was in a part of the world that isn’t quite so globally connected. The outbreak was officially declared over in June 2016. By then over 28,000 people had been infected and over 11,000 had died.

Ebola had a very high death rate for those infected, but was much more easily contained.

Zika (2015-2016)

Zika is the virus that causes babies to be born with small heads. It’s spread by mosquito bite and caused an outbreak in the Americas, Pacific, and Southeast Asia in 2015 and 2016. In many mosquito species, the females feed on people one time before laying their eggs. Zika is carried by mosquitoes that feed more than once. As a result, they spread the virus from infected to uninfected people as they ate. The outbreak was largely controlled by getting rid of mosquitoes carrying the virus.

Current Covid totals (Worldometer):

  • Total detected cases – 25 million
  • Total attributed deaths – 848,925

The closest comparison is H1N1, with about half the deaths. A vaccine was available within the year it began but it still nearly a year to eliminate it.

New Zealand has got off lightly so far, with just 1,729 cases and 22 deaths.

Initially Australia had a comparable result but after a big outbreak in Victoria cases have jumped to 25,166 and deaths to 611.

We have been mostly successful at containing Covid but the current outbreak in Auckland is a concern. It shows how quickly things can change.

Health and statistics reasons for staying at level 2 for yonks, but…

“…it would take anywhere between 27 and 91 days of no new cases for there to be a 95% probability that the virus is gone from New Zealand”.

In practice it is getting increasingly difficult for the Government to justify staying at Covid-19 Alert level 2. Based on their current stance it could be another three weeks before they decide whether to change alert levels again, while daily we have been seeing no new cases for more than a week now, and we are down to just one (known) active case.

There are purely health reasons, based on statistics, for staying at level 2 for longer.

Siouxsie Wiles: Many want to go to alert level one right now. I get that. But we’d be fools to rush

There are several reasons why holding at alert level two for a little longer is the right thing to do. The main one is that a run of several days with no new cases doesn’t mean that there are no undetected active cases of Covid-19 out there. Recent modelling by Professor Nick Wilson and his colleagues at the University of Otago estimated it would take anywhere between 27 and 91 days of no new cases for there to be a 95% probability that the virus is gone from New Zealand.

The lower estimate was based on the assumption that most people showing symptoms would go and get tested. The higher estimate was based on fewer people getting tested. In other words, those estimates are the difference between shrugging of that runny nose as an allergy or going to get tested for Covid-19 just in case.

I get why so many people want to move to level one, I really do. These last few months have turned our lives and our economy upside down. Just as they have right around the globe. We’ve made big sacrifices and we feel we’ve earned it. But surely none of us wants to risk going back to alert level three. Alert level one will come. Let’s not squander what we’ve achieved.

That’s from an academic who presumably doesn’t have their job at risk.

But there is increasing pressure (with justification) for lowering the level for social reasons, for non-Covid health reasons, and particularly for economic and employment reasons.

More and more jobs are being lost (37.500 were lost in April), and when the 3 month wage subsidy runs out next month there are likely to be many more people who lose their jobs, and businesses who have to shut up shop.

As well as being devastating financially, that will impact on mental health and general health.

Health officials and academics with secure jobs and incomes may prefer to play ultra safe with Covid, but the rest of us have a lot of other things to consider and to be worried about.

The Government may be worried about what effect a second wave of Covid cases may have on their election chances.

They should also be worried about what effect a second wave of job losses and business failures might have, not just on their election chances, but also on the health of the country.

NZ academics argue over Covid-19

There are a number of contentious aspects of the Covid-19 pandemic, in particular how stringent restrictions should be on travel and on home isolation, and the economic management and effects. There is a lot to debate.

Some New Zealand academics have been doing their debating in public, which is generally a good thing, these are important issues that need to be openly discussed.

Newsroom: Navigating a public spat between scientists

A scientific spat over Covid-19 reached peak contrarian yesterday thanks to the country’s contrarian-in-chief, Mike Hosking.

Following a Stuff opinion piece that said “We don’t want to squash a flea with a sledgehammer and bring the house down”, University of Auckland senior lecturer and epidemiologist Simon Thornley explained his views on Newstalk ZB.

He told broadcaster Hosking overall mortality figures in heavily affected countries haven’t gone up, concluding: “These deaths are occurring in people who are running out of time.”

“Exactly,” one-man-reckon-machine Hosking responded. “They were going to die anyway and something was going to get them. It just happens, now, to have been this. Or maybe it wasn’t. Or maybe this exacerbated it. Or maybe this complicated it.”

(Or maybe the fact these people were going to die “anyway”, of something, sometime, is a statistical irrelevance in a society that cares about preserving life and protecting the public from preventable causes of death.)

Thornley’s column angered arguably our country’s most prominent scientist, Siouxsie Wiles, who tweeted on Tuesday: “For anyone who comes across the opinion piece of an epidemiologist suggesting lockdown is like using a sledgehammer to hit a flea: he studies diet not infectious diseases. Don’t listen to his reckons.”

She later apologised for making it personal, albeit without naming Thornley. Not before Auckland University of Technology Professor of Public Health Grant Schofield jumped in to back Thornley. Schofield, too, made it personal.

Accusing someone of being out of their scientific “lane” without discussing data wasn’t acceptable, he said on Twitter, adding: “Some would criticise you a microbiologist in public health.”

Wiles tells Newsroom it’s fair to question her credentials. “But I am doing my best to stay on top of the literature, which it would appear others are not. And have also changed my position as the evidence has changed and explained why.”

She says her frustration was sparked by “a piece that used old data disingenuously to strongly push a message that has the potential to lead to people’s deaths by undermining the lockdown”.

Thornley, meanwhile, says science, at its heart, is about open and honest debate. “That is what I intended to bring to this discussion, which, I believe, has been very one-sided.”

Schofield maintains he’s all for the lockdown but he’s also for robust, and civil, scientific debate. He was disappointed that Wiles used her authority not for scientific argument but to dismiss science she didn’t agree with.

“There is considerable uncertainty,” Schofield says. “[Thornley] is the single smartest guy I know, and he does have some challenging and possibly inconvenient truths about the uncertainty.”

The article then goes on to ‘weigh the evidence’ in some detail.

One aspect of Thornley’s article was quite questionable due to being too soon to call about the far more relaxed approach that Sweden had taken – see Sweden’s different Covid strategy looks shaky.

After making his “squash a flea with a sledgehammer” comment, he wrote in his Stuff story that he believed other countries, such as Sweden, are steering a more “sensible course”. He linked to a Guardian article, which mentions schools, kindergartens, bars, restaurants, ski resorts, sports clubs, and hairdressers remain open, unlike in neighbouring Denmark and Norway.

The Swedish Prime Minister, Stefan Löfven, has said coping with Covid-19 is about commonsense behaviour. “We all, as individuals, have to take responsibility. We can’t legislate and ban everything,” That country’s Public Health Agency’s position has been criticised in a joint letter from 2000 Swedish university researchers.

On Monday, in another Guardian article, Professor Cecilia Söderberg-Nauclér, a virus immunology researcher at Sweden’s Karolinska Institute, said: “We’re not testing enough, we’re not tracking, we’re not isolating enough – we have let the virus loose.” She concluded: “They are leading us to catastrophe.”

Comparing Sweden, Denmark, and Norway on coronavirus counter shows a concerning trend. Norway (4651) has more confirmed cases than Sweden (4435), but fewer deaths – 39 versus 180. Seventy of those Swedish deaths were reported on March 30 and 31. Denmark, meanwhile, has 90 deaths but far fewer cases than Sweden, at 2860.

Current numbers on those countries:

  • Sweden 282 deaths, 28 per million (population)
  • Denmark 123 deaths, 21 per million
  • Norway 50 deaths, 9 per million

Note that these are just snapshots and can be misleading as different countries are at different stages on Covid spread and effect.

Sweden was recently looking relatively good but over the last few days has surged as the curves (cases and deaths) swing upwards – see

It will actually be months before we can really compare countries and try to see what approaches were most successful at minimising health issues and deaths as well as minimising the economic effects.

More from Newsroom: Lockdowns spark bad faith backlash

No one was more surprised to see that Neil Ferguson, the author of a groundbreaking paper on how to stop Covid-19, had walked back his dire projections on the anticipated death toll of the virus than Ferguson himself.

The Imperial College London academic, whose paper changed government policy towards Covid-19 in nations worldwide – including New Zealand – told a British parliamentary committee that, with the advent of the United Kingdom’s lockdown, he expected the death toll to be in the range of 20,000.

Critics then leapt on this statement, arguing that because Ferguson had previously predicted a death toll of 250,000 for the UK, he had now substantially walked back his estimates. Former New York Times journalist Alex Berenson, recently famous for publishing a book on cannabis and violence that was widely-panned as inaccurate, took to Twitter to make this argument.

It then went viral on right-wing websites like the Daily Wire and the Washington Times, the first of which has substantially edited its article in the face of fact-checking from more authoritative sources.

As the Financial Times explains, Ferguson didn’t revise his prediction at all – in fact, the 20,000 deaths figure was directly taken from his original report. This was the estimated toll if the United Kingdom engaged in the strict suppression measures – closing schools and most workplaces – that it ultimately has, whereas 250,000 deaths were anticipated if the UK took no action whatsoever.

Misinformation circulated online is a major problem generally, especially when it influences presidents.

In the United States, an article by highly-cited libertarian legal scholar and climate change denier Richard Epstein has buoyed an anti-lockdown faction within the White House. The March 16 article, titled “Coronavirus Perspective”, sought to contextualise what Epstein saw as a massive overreaction to Covid-19, which he thought would only kill 500 Americans.

Epstein now says he made a minor error while calculating this figure and has offered 5,000 as the final death toll. As of Thursday morning in New Zealand, more than 4,700 Americans have been killed by the virus and there are no signs of this slowing. Even Donald Trump now admits a far higher toll is likely – his goal is to limit deaths to 100,000, although they could rise as high as 240,000.

“Coronavirus Perspective” emboldened the anti-lockdown faction in Trump’s inner circle and lead to musings from Trump of lifting mitigation and lockdown measures by Easter. “We’re opening up this incredible country, because we have to do that. I would love to have it open by Easter,” Trump said on March 24, as the US death toll hit 706.

Evidently, more rational heads within the administration have managed to steer Trump back towards a strategy that avoided opening up the President to accusations of leading a death cult, but Epstein still took the time to defend his work in a March 30 interview with The New Yorker‘s Isaac Chotiner.

In defending his sloppy math, Epstein turned to bunk science, saying there are multiple strains of the virus – a stronger one that kills more people and a weaker one that is less lethal. Epstein believes, astoundingly, that the virus will also evolve to become weaker over time and falsely claimed the same occurred with AIDS, SARS and Ebola. Chotiner ended up having to turn to experts to fact-check Epstein in the text of the interview, lest he accidentally distribute fake news to all his readers.

Trump seems to have swung in behind the conventional concerns and actions over Covid.

I’m still very dubious about even best case projections because they still mention some very big numbers – Trump has accepted ‘successful’ death limitation in the US to a 100,000-220,000 range.

Even the worst hit countries (based on published data , China numbers in particular have to be questioned) are well below projections, Italy currently 13,155 deaths (yesterday +727 but already 760 today) and Spain 9,312 (yesterday +923, 709 so far today).

The UK curve is starting to look bad. The currently have ‘just’ 2,921 deaths, but were up 563 yesterday and have already reached that today (GMT so six hours to go).

Currently there are ‘just’ 5,600 deaths in the US. But deaths have recently surged, currently to about 1,000 a day.

But, if there is a widespread staggered hit from Covid around the US, that death rate over 100 days comes to 100,000 so that number doesn’t look out of reasonable expectations. And the daily death rate could easily climb quite a bit higher before it peaks and comes back down.

And it should be remember if lockdowns are relaxed there’s a high chance (it’s expected) that there will be ongoing surges in infections and deaths for many months, until vaccines become available – if effective vaccines are developed.

There’s a lot for academics and the rest of us to discuss and debate for some time on this.

Symptoms of Covid-19 and what to do if you might have it

Symptoms of the Covid-19 coronavirus have some things in common with a cold or flu, but this shows differences (it has been posted in comments but it’s worth repeating):

The article it is from is interesting too – Siouxsie Wiles: How testing for Covid-19 works

How the process runs, why we’re not testing everyone who feels ill, and something you can do online immediately and easily to help the fight against the virus.

What you can do to help

While the Ministry of Health look at other strategies for early detection of Covid-19, there is one we can all help with right now. We need every household in New Zealand to sign up to the FluTracking project. Each week you’ll be sent an email asking if anyone in your house has had a fever or cough. This information is being used as an early warning system for Covid-19.

So, in summary. If all you know about testing for infectious diseases is stuff you’ve been reading on the internet, then stop tweeting your reckons and firing off your hot takes. Sign up to FluTracking. Wash your hands. Stay at home if you start to develop any symptoms. If you’re unsure what those symptoms are, we’ve got you covered.

Check Spinoff cartoonist Toby Morris’s handy guide above or  click here for a printable, high-res PDF version.

Ministry of Health latest report:

New Zealand has twenty confirmed cases of COVID-19. For a summary of the current status see our latest media release (18 March).

More information is now available on our current cases page.

With continued vigilance the chance of widespread community outbreak is expected to remain low.

New border measures are in place as of Monday 16 March. Most travellers arriving in New Zealand are now required to self isolate for 14 days – check our information for travellers arriving to New Zealand to find out more.

If you have been overseas within the last 14 days and develop a fever, cough or shortness of breath, phone Healthline’s dedicated COVID-19 number 0800 358 5453 or contact your GP, including phoning ahead of your visit.

For COVID-19 health advice and information, contact the Healthline team (for free) on 0800 358 5453 or +64 9 358 5453 for international SIMS.

Other information and advice: