Greater Deaths By Other Causes that we Ignore

People are dying all over the world either with or from the COVID-19 virus.
Every death is significant, but how do these COVID-19 deaths compare to deaths from other causes?
Infectious diseases kill over 17 million people a year: WHO warns of global crisis
Many of these diseases could be prevented or cured for as little as a single dollar per head.
According to the Centers for Disease Control and Prevention (CDC), there were 2,813,503 registered deaths in the United States in 2017 or 7,708 per day.

In South Africa the total deaths in 2013 were 2,015,460, or 5,521 a day of which 1262 per day from the three leading causes of natural deaths, tuberculosis, diabetes mellitus and cerebrovascular diseases.

In Australia there were 165,100 deaths per year or 452 per day.

About 66 million worldwide die from all causes each year, or or 181,000 people today. Half are over 70! On 18 September 2020, about 5,200, down from 5,900 in mid August, died from CO-19. From Worldometer.

Why have we reacted so strongly to deaths from this plaque of mostly the elderly and those with underlying conditions which make them susceptible to virus attack?

Due to some deeply evolved responses to disease, fears of contagion lead us to become more conformist and tribalistic, and our leaders have been driven to a misplaced 'better safe than sorry logic' and reactions.
Apparently any signs of free thinking ... become less valued when there is the risk of contagion.

Trying to understand the value of different containment policies, we might question whether our thoughts are really the result of rational reasoning, or whether they might have been shaped by ancient response that evolved millennia before the discovery of germ theory.  Source https://www.bbc.com/future/article/20200401-covid-19-how-fear-of-coronavirus-is-changing-our-psychology

Is Our Fight Against Coronavirus Worse Than the Disease? This is the article that led me to do some thinking and research on 20/3/2020.
500 Doctors write to President Trump to end the lockdown

The World Health Organisation classifies Z59.5, Extreme Poverty as the biggest of all diseases

An estimated 270 million people are expected to face potentially life-threatening food shortages this year - compared to 150 million before the pandemic - according to analysis from anti-hunger agency of the United Nations. The number of people on the brink of famine, the most severe phase of a hunger crisis, jumped to 41 million people currently from 34 million last year, the analysis showed. NY Times 7 Aug 2021. "When you increase poverty, as occurs when you lockdown the economy in a developing world, you increase death. So, you have to be very careful with your maths.

“The world’s biggest killer and the greatest cause of ill-health and suffering across the globe is listed almost at the end of the International Classification of Diseases. It is given the code Z59.5 — extreme poverty. Poverty is the main reason why babies are not vaccinated, why clean water and sanitation are not provided, why curative drugs and other treatments are unavailable and why mothers die in childbirth.
It is the underlying cause of reduced life expectancy, handicap, disability and starvation.
Poverty is a major contributor to mental illness, stress, suicide, family disintegration and substance abuse.

Every year in the developing world 12.2 million children under 5 years die, most of them from causes which could be prevented for just a few US cents per child.
They die largely because of world indifference, but most of all they die because they are poor." Extract from the WHO.

In a developing country context, it is essential to compare the (projected) “lives saved” due to the lockdown against the (projected) “lives lost” from the general income decline caused by the lockdown.
UN report: Pandemic year marked by spike in world hunger. 12 July 2021. Disturbingly, in 2020 hunger shot up in both absolute and proportional terms, outpacing population growth: some 9.9 percent of all people are estimated to have been undernourished last year, up from 8.4 percent in 2019.

However, it is equally clear, especially in developing countries, that lockdowns cause increased unemployment and poverty, which cause misery, hunger, ill health and death.

"According to a report from the Harvard school of public health, the 2008 financial crisis led to 500,000 excess cancer deaths worldwide. That’s just cancer in a relatively small economic downturn. The IMF is predicting a 3% contraction in economic output for 2020 – a far steeper fall than the 0.1% decline of 2008."

"The World Food Program projects that a further 130 million people will face acute hunger by the end of 2020 due to global lockdowns, almost doubling the 135 million people in the world who are already starving."
"President Ramaphosa recently said:
"Covid-19 has brought about a total destruction of our economy."
But it’s not Covid-19 that has done this — it's the lockdown. The lockdown is intended to save lives. Yet the fact that lower income leads to more misery and higher mortality is the bedrock of almost all our policy decisions."

The onus is on the Government to justify the lockdown, not for its citizens to prove it's unwarranted.

Constitutional Court Chief Justice Mogoeng expressed grave concerns over the lockdowns, encouraging citizens to challenge the regulations if their rights have been unduly infringed. We have the right to gather, to trade and to travel within the borders of our country. We have the right to work and sustain ourselves with the labour of our hands. If a Government seeks to suppress these rights, it cannot do so simply by pointing out that some benefits will accrue if those rights are suppressed. It is essential that they show with reasons why those benefits outweigh the deadly costs the act of administrative fiat will impose. This has not been done in South Africa. In our view, then, the lockdown regulations remain improperly imposed.
Source Prof Robert Lipshitz

Deaths that we do little about - TB

Tuberculosis is a serious public health issue in South Africa. In 2014 about 450,000 people developed the disease every year, and 270,000 of those are also living with HIV.
TB is South Africa's leading cause of death. Between 63,000 and 89,000 people die from it every year; that's over TEN people every hour. WHO figures as per Maverick publication. Source https://www.copenhagenconsensus.com/publication/south-africa-perspective-tuberculosis

A total of 1.5 million people died from TB in 2018 (including 251 000 people with HIV). Worldwide, TB is one of the top 10 causes of death and the leading cause from a single infectious agent (above HIV/AIDS).
In 2018, an estimated 10 million people fell ill with tuberculosis(TB) worldwide. 5.7 million men, 3.2 million women and 1.1 million children. There were cases in all countries and age groups. But TB is curable and preventable.
In 2018, 1.1 million children fell ill with TB globally, and there were 205 000 child deaths due to TB (including among children with HIV). Child and adolescent TB is often overlooked by health providers and can be difficult to diagnose and treat.
Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO estimates that there were 484 000 new cases with resistance to rifampicin - the most effective first-line drug, of which 78% had MDR-TB.
Ending the TB epidemic by 2030 is among the health targets of the Sustainable Development Goals. Tuberculosis is curable and preventable.

TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB bacteria into the air. A person needs to inhale only a few of these bacteria to become infected.
About one-quarter of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease. Persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill.
People with active TB can infect 5 to 15 other people through close contact over a year.
Without proper treatment, 45% of HIV-negative people with TB on average and nearly all HIV-positive people with TB will die.

Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.

Could South Africa by some miracle dodge worst of Covid-19 curse?

A new study has found Countries with mandatory policies to vaccinate with bacillus Calmette-Guerin (BCG) against tuberculosis register fewer coronavirus deaths than countries that don't have those policies.

The presence of national policies for universal BCG vaccination is associated with flattened growth curves for confirmed cases of COVID-19 infection and resulting deaths in the first 30-day period of country-wise outbreaks.Report It may just turn out that most South Africans are safer because it's mandatory to have a Bacillus Calmette-Guèrin (BCG) vaccination when they are born to prevent life-threatening TB later on.
Source - Alan Knott-Craig.

Road Casualties

Approximately 1.35 million people die in road crashes each year, on average, 3,700 people lose their lives every day on the roads worldwide.
An additional 20-50 million worldwide suffer non-fatal injuries, often resulting in long-term disabilities.

More than 38,000 people die every year or 104 per day in crashes on U.S. roadways. An additional 4.4 million or 12,054 per day are injured seriously enough to require medical attention. The U.S. traffic fatality rate is 12.4 deaths per 100,000 inhabitants.
Road crashes are the leading cause of death in the U.S. for people aged 1-54.

Approximately 18,000 South Africans die in road crashes each year, on average 50 lose their lives every day on the South African roads.
These are mostly deaths of people in the prime of their lives, not mostly the elderly and sick as caused by COVID-19.

The amazing thing is that we accept these casualties without thinking, while they could be greatly reduced at a small cost compared to lockdown by reducing car speeds drastically and making relatively costly technology such automatic collision detection technology compulsory in all new cars.

Influenza Deaths

Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 290 000 (794 per day) to 650 000 (1780- per day) from respiratory deaths.
Hospitalization and death occur mainly among high-risk groups, with between 27,000 and 62,000 a year.

Source https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)



DEATHS DUE TO INFLUENZA, 2017 in Australia. Source Australian Bureau of Statistics

"In 2017 there were 1,255 deaths due to influenza, recording a standardised death rate of 3.9 per 100,000 persons. This is a significant increase from 2016 where 464 influenza deaths were recorded. An individual dying from influenza in 2017 was most likely to be female, aged over 75 years, have multiple co-morbidities and living in the eastern states of Australia."
"Influenza and pneumonia are often reported together, however they are two different diseases. While influenza is a viral respiratory tract infection, pneumonia is an infection or inflammation of the lungs which can be caused by bacteria, fungi or a virus. Influenza is a common cause of pneumonia and in 2017 there were 563 influenza deaths where pneumonia was also certified on the death certificate as having developed and contributed to death.
When grouped together, influenza and pneumonia accounted for 4,269 deaths, and were the 9th leading cause of death, moving from the 11th leading cause of death in 2016 (3,334 deaths). The majority of the increase was driven by the influenza virus (84.6%)." There appears to be a correlation between deaths from Covid-19 infection and deaths in the past year from flu. The higher the deaths from flu in the past year, the lower the deaths from Covid-19 in the next year. This could be due to several reasons, one being the lower the deaths from flu in one year, the greater the number of vulnerable people in the next year, or to compare it to fire, the greater the amount of dry tinder on the ground, the worse the fire. Another reason could be the resistance to the Covid-19, a coronovirus is greater with those who have encountered the flu virus during the past year.

Gun deaths in the USA

In 2013, there were 73,505 nonfatal firearm injuries (23.2 injuries per 100,000 people), and 33,636 deaths due to "injury by firearms". Wikipedia.

Australian Facts

"Suicide Statistics from Lifeline. Eight Australians die every day by suicide. In 2018, 3,046 Australians took their own life. That’s more than double the road toll.
The leading cause of death between 15 and 44 years of age, with 75% of those who take their own life are male. Over 65,000 Australians make a suicide attempt each year.
For each life lost to suicide, the impacts are felt by up to 135 people, including family members, work colleagues, friends, first responders at the time of death."


HIV Deaths

South Africa estimates the number of deaths attributable to AIDS in 2017 as 126,755 or 25.03% of all South African deaths.
About 330,000 South Africans died around 2006/7 because of Mbeki's government HIV policies. Cape Town - Over 11 870 new HIV infections among young women and girls were recorded by the Western Cape government between January 2018 and March 2019 alone.
According to the provincial Department of Health, this equates to an average of 791 new infections per month, while nationally 1200 new infections were recorded weekly.
Equally shocking is the number of girls aged between 10 and 14 - at 312 - who were recorded as having given birth between April 1, 2018, and March 31, 2019. And 10675 deliveries by girls aged between 15 and 19 were recorded over the same 12-month period nationally.

Source https://www.iol.co.za/weekend-argus/news/saaids2019-shocking-hiv-stats-recorded-in-sa-27381499

HIV and COVID-19

"First data on HIV and Covid-19 offers tentative hope By Rebecca Davis 1 May 2020". Source South African Daily Maverick

The study found that underlying conditions which were much more common than HIV in the New York patients admitted for Covid-19 were high blood pressure (present in 57% of patients), obesity (42%) and diabetes (34%).
As far as Daily Maverick is able to establish, based on department of health reporting, however, there has to date been just one Covid-19 death in South Africa of a person living with HIV, of the 103 total fatalities – 0.97%.
A greater problem may be posed by growing reports of HIV-positive people in South Africa skipping treatment because of anxieties around visiting hospitals and clinics during the Covid-19 pandemic.

On Thursday, the European Aids Clinical Society (EACS) published a statement noting:
"So far there is no evidence for a higher Covid-19 infection rate or different disease course in people living with HIV than in HIV-negative people. Current evidence indicates that the risk of severe illness increases with age, male sex and with certain chronic medical problems such as cardiovascular disease, chronic lung disease and diabetes." However, the EACS also cautioned:
"It has to be assumed that immune suppression, indicated by a low CD4 T-cell count, or not receiving antiretroviral treatment, will also be associated with an increased risk for a more severe disease presentation." DM

Malaria

Malaria kills one child every 30 seconds, about 3000 children every day. Over one million people die from malaria each year, mostly children under five years of age, with 90 per cent of malaria cases occurring in Sub-Saharan Africa. Source https://www.unicef.org/media/files/MALARIAFACTSHEETAFRICA.pdf "Furthermore, COVID-19 will compromise control efforts on epidemics like malaria; even more worrying is its potential to compromise access to life-saving antimalarial medicines and emergency care."

 Source https://www.mmv.org/newsroom/news/support-covid-19-response

Suicide

"After two months of devastating lockdown, doctors at one California clinic say they’ve seen more suicides than Covid-19 deaths – and they’re not alone.
But warning signs were there since day one. Why have they been ignored?
“We’ve seen a year’s worth of suicide attempts in the last four weeks,” Dr Mike deBoisblanc, lead trauma surgeon at the John Muir Medical Center in Walnut Creek, California, told local media on Thursday, confirming the center had seen more deaths from suicide over the two-month lockdown period than deaths from coronavirus.

Not only are the numbers of attempts “unprecedented” but so is their seriousness, according to a trauma nurse at the clinic. “I have never seen so much intentional injury,” nurse Kacey Hansen attested, adding the deaths are mostly young adults who are clearly not making “cry for help” suicidal gestures. “They intend to die." Source with more discussion on the causes

Overdose deaths hit record high in pandemic - More stress, less treatment cited
The Washington Times - Thursday, February 18, 2021
Drug overdoses killed an estimated 83,544 people in the USA during a 12-month period ending in July 2020, a record that coincides with the COVID-19 pandemic, which experts say has created a huge amount of stress and hampered treatment services. That is almost a 25% increase from the year that ended in July 2019, when the Centers for Disease Control and Prevention reported 68,023 overdose deaths.
"What we started to see as the COVID-19 pandemic hit was a lot of social isolation, and in the recovery community, a lot of people depend on the support they get from in-person connections they get from other people in meetings," William Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance said. "In the recovery community, we have seen more people experiencing mental health struggles as they are experiencing elements of despair."

146 000 cancelled surgeries in SA, including 12 000 cancer procedures, as many as 28 million procedures could be missed.

Prof Bruce Biccard of UCT Anaesthesia and Perioperative Medicine Dept says it will take about 45 weeks to catch up surgeries.
It is extremely important that the health system is able to manage the surge of Covid-19 infections, but an unfortunate consequence is that it has led to the reorganisation of many other medical systems of which one is surgery.
We think we will lose one in two elective surgeries, and about 3 out of four benign surgeries - that's 12, 000 surgeries a week or 150, 000 in a 12-week surge period.
This is terrible for patients. Surgeries are obviously an important part of public health. You can't have a healthy society without adequate surgery. And it's going to take a long time to catch up.
It's not great for the patient, because what was once a need for elective surgery, could become urgent, their quality of life diminishes, it has economic implications.
The research shows some 12,000 cancer-related procedures would be delayed and the danger is cancer can progress, he explains.

Murders

There were 20,805 murders per year in South Africa or 57 per day. In the USA there were 15,498 homicides or 42 per day. Worldwide there were 412,450 murders or 1,130 per day.

Yet we do not know the real death or illness COVID-19 rates!

Many medical experts are questioning the death numbers per day.
With so many of the fatalities the elderly, we do not know if they died from the coronavirus, or just with the coronavirus in their systems.
Nor do we know how many deaths have occurred or been accelerated by the deceased having undiagnosed COVID-19 in their systems.

Some answers should be provided soon as soon when statisticians can compare enough funerals with the same period last year. It would appear from preliminary studies the funerals in areas of New York were about 25% higher, but in other areas they decreased.

Dateline 19 April 2020.
Newly published literature shows COVID-19 much more widespread than thought, and NO MORE DEADLY THAN FLU, a new Stanford study suggests.

What the study concludes is the fact that the mortality rate is much lower than it now believed and that many people have symptoms so mild they don't need to seek medical treatment and recover rather quickly.
The WHO estimated the COVID-19 death rate at 3.4%, while the Stanford study puts it at .14%, about the same as flu.
A Danish study published earlier this week using similar methods arrived at the same conclusion.
The low German death rate, currently at 1.6%, is partly explained by a high rate of testing, giving further credence to the belief that the high death rates are misleading without extensive testing.
In 2003 when there was a heatwave in France, first reports said that there were dozens of deaths, mostly in care homes, later corrected to 100's. Some years later, when the funeral numbers were analysed, the estimate was about 15,000 extra deaths from the heatwave.

Source https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ

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