Risks and side effects, but no package leaflet. Corona containment threatens to cause more suffering than it prevents.
An article by Ralf Wurzbacher | Responsible: Editor
Preliminary remark from the NachDenkSeiten editorial team: Because the consequences of the Corona measures are obviously not in the view of the politically decisive persons, we asked for reports from our readers on the NachDenkSeiten on October 22 under the heading "You can't see those in the dark". We then documented these on October 26 and November 10. The field reports and relevant NachDenkSeiten articles on the risks and side effects of April and June will soon be published in a printed documentation. - Ralf Wurzbacher has written a very informative supplement on the topic of consequences, which we are publishing herewith.
Risks and side effects, but no package insert. Corona containment threatens to cause more suffering than it prevents.
by Ralf Wurzbacher
[This article published on Nov 20, 2020 is translated from the German on the Internet, Risiken und Nebenwirkungen, aber keine Packungsbeilage. Die Corona-Eindämmung droht mehr Leid zu verursachen, als sie verhindert. (nachdenkseiten.de).]
With the hard lockdown in spring and its "light" new edition in November, politicians are saving people from dying and the health system from collapsing, it is said. The announcement and the way in which it was implemented is open to doubt. There is, however, no doubt that the measures imposed will cause considerable consequential damage, which the federal government never had on its list. This applies to Germany, but even more so to the poorhouses of this world. One less death in our country can be set off against several starvation deaths elsewhere. Or you can leave it alone and, like the political leaders, keep quiet about it. At this point, the Thinking Pages provide an overview of the "blind spot" of the Corona crisis.
Seemingly small interventions in a system can have disastrous consequences. In 1958, China's Communist Party ordered the collective extermination of sparrows as a contribution to increasing agricultural productivity. The birds were disreputable for picking away considerable parts of the harvest. Ergo, in a national effort, up to two billion of the feathered "enemies of the people" were exhausted and killed in a short period of time by a noise attack. The state leadership had not considered that sparrows are the natural predators of insects, including locusts. These insects multiplied immediately and unhindered, attacking the fields en masse. The result was a humanitarian disaster with tens of millions of people starving to death.
An intervention in a grown order is undoubtedly also the strategy practiced in this country and almost worldwide to contain the Sars-Cov-2 virus. The measures taken - such as contact restrictions, quarantine, isolation of "infected", old and sick people, "occupational bans", closure of schools, universities, cultural institutions, restaurants and pubs, compulsory masks and the suspension of basic rights and freedoms - are far-reaching and affect a sensitive social fabric. Whether and to what extent all this can be justified in the light of the declared goal of saving the elderly from dying and protecting the health care system from overburdening itself has been repeatedly problematized by the NachDenkSeiten.
In addition to doubts about the sense of the undertaking itself, there are also doubts about its feasibility. A study recently published in the New England Medical Journal deals with a case of corona "fighting" under military supervision. In this study, more than 3,000 recruits of the U.S. Navy were subjected to an initially two-week strict quarantine at home in a large-scale test arrangement. They were then barracked for 14 days under the strictest hygiene regulations, distance rules, compulsory masks and contact minimization requirements, and meticulously monitored. The result after one month: Among the soldiers who initially tested negative as well as those who did not test beforehand, a positive rate of around two percent was found at the end. This either means that avoiding the introduction and transmission of the pathogen is practically impossible or that the standard PCR test does not offer the claimed reliability. Either way, the result puts a big question mark over the prevailing containment policy.
This is all the truer if one asks about the proportionality of the means, i.e. about the relation of the possible "gains" to the "losses" of a procedure that tries to deal with an invisible pathogen by prohibiting, disciplining, punishing and creating fear. In order to arrive at an assessment, it is necessary to look beyond the national horizon. In mid-September, for example, UNICEF calculated that an additional 150 million children were pushed into poverty as a result of the economic collapse provoked by the quasi-global lockdown in spring. Already in July, experts from the World Food Program (WFP) warned that the Corona crisis could threaten an additional 130 million people with starvation this year. For the Indian subcontinent, the State Bank of India stated in August that, depending on the state, the economic crisis would result in four to 20 times as many deaths as the Covid-19 disease. In poorer regions such as Uttar Pradesh, there were 0.16 Covid-19 deaths per 1,000 inhabitants, compared with 3.41 economically induced deaths statistically.
But in Germany itself, too, there are many and growing indications that the suffering caused by the first shutdown alone could reach a level that will exceed the benefits, measured in terms of the number of lives possibly saved, at least in the long term. For example, the large-scale postponement of operations to free up capacity for corona patients, which did not reach the clinics on the predicted scale. Or the dying in old people's and nursing homes who had to spend their last weeks, days and hours without their relatives. In addition, there are hundreds of thousands of people who have lost their jobs or suffered wage losses, countless solo self-employed persons, cultural workers and small entrepreneurs who are facing ruin. The federal government practically let them all go down in flames because it simply did not consider the possible consequential damages of its policies.
In May, an employee of the Federal Ministry of the Interior (BMI) was fired after revealing the internals of the Corona Crisis Staff. In his paper, which he prepared together with doctors and scientists, he complained that "the proportionality of interventions in the rights of citizens, for example, is currently not given because the state has not made an appropriate assessment of the consequences. Elsewhere, he judged the contents of an "interim balance sheet of the Federal Government": "At no point in the 22-page report is there a description of the dangers and also no documentation of a systematic weighing of measures with their side effects. In an earlier letter to his superiors in March, he stated: "It currently seems as if we are dismantling our community in order to prevent worse things from happening. But what could be worse than having our community dismembered?"
The question is all the more urgent today, since an end to the "state of emergency" is not foreseeable and the consequential damage is becoming greater every day. The "NachDenkSeiten" want to free this medially quite untroubled flip side of the corona measures from its shadowy existence. Following on from the NachDenkSeiten documentation "Die im Dunkeln sieht man nicht", here follows a compilation of studies, analyses and announcements from various associations that deal with medical "collateral damage" that has already occurred or is still threatening. The underlying research does not provide more than a snapshot without any claim to completeness. Neither could each of the sources be checked for their validity, scientific honesty, and for the interests that might be behind the publication.
According to an October report by the British statistics agency ONS, 26,000 more people than the long-term average could have died at home as a possible consequence of the corona measures. The figures are explained by the fact that "possibly fewer people were treated in hospital". According to these figures, men in particular died more frequently at home than usual when suffering from heart disease. For women, dementia and Alzheimer's were the untreated diseases that led to death in the private household. In contrast, fewer people died from these diseases in hospitals, according to the data.
As the Italian statistics agency Istat reported on May 4, only about half of the excess mortality measured up to that point in Italy was attributable to Covid-19. 13,710 or 54 percent of the 25,000 more deaths compared to 2019 had been tested positive for sars-cov-2. What the remaining 11,000 people died of is not mentioned in the report in question.
A current study by the Hochrhein Clinic in the Waldshut district of Baden-Württemberg has caused a sensation in Germany. In previous years, an average of 165 people died there in April out of 165,000 inhabitants. This year, the figure was 227, which corresponds to an excess mortality rate of 37 percent. According to the study, which has not yet passed through the expert review process, 34 (55 percent) of the 62 additional deaths can be linked to corona, the remaining 28 cases are due to other causes. As study author Stefan Kortüm, chief physician of the emergency department, explained to the press, almost half of the excess mortality "is related to the reduced use of medical emergency structures". Above all humans "with acute aggravations of chronic diseases, for instance lung or heart diseases, in addition, tumor illnesses, did not look for medical assistance in this period. Particularly tragic: More than twice as many people were found lifeless on their own.
Warnings from human rights and aid organizations about massively increasing numbers of victims due to poverty and hunger as a consequence of global supply chains that have been cut off for months were already mentioned at the beginning. In line with this, various civil society networks conducted a survey in mid-September with the result that in the coming year alone, 525,000 more deaths caused by tuberculosis could be recorded than usual. The information service AlphaGalileo wrote in response that measures and guidelines imposed to prevent the spread of Covid-19 had driven people with tuberculosis into poverty and social isolation and had increased the injustices and hurdles in the provision of care services. The Corona crisis and its aftermath would undo "ten years of progress in the fight against the scourge.
According to a recent study by the German Depression Aid, every second person suffering from depression "experienced massive restrictions in the treatment of his or her illness" during the first lockdown. As the "Germany Barometer Depression" states, one in two of those surveyed would have reported cancelled treatment appointments with a specialist or psychotherapist, and one in ten would have reported a broken hospital stay. In addition, those affected would have experienced the time "as significantly more stressful" than the average for the population. They suffered "almost twice as often from the lack of a daytime structure", and in domestic isolation they also stayed "in bed during the day much more often", which generally made their suffering worse.
In an interview with the "Deutsches Ärzteblatt" on October 21, the president of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology (DGPPN), Andreas Heinz, warned of considerable psychological stress as a result of the corona measures as well as an overtaxing of the self-healing powers. "The danger is that severely ill patients cannot bear the lack of personal contact for long," Heinz said. He pointed to the need for research into the psychosocial effects of isolation and quarantine, especially for older and very elderly people, and how social inequality will increase under pandemic conditions. He also said that there is "too little knowledge" on aspects such as the occurrence of psychoses, somatization, suicidal tendencies, substance abuse, computer game addiction or changes in social behavior (aggressiveness and irritability).
But even psychologically stable people suffer from the increased excitement in the Corona crisis, which is undoubtedly also due to the panic stirred up by the undifferentiated handling of case and death figures in the political and media world. Researchers for New Zealand, for example, have found out that one third of those surveyed in New Zealand suffered from psychological stress, where at times a much stricter shutdown than in Germany prevailed. According to Susanna Every-Palmer, head of the Department of Psychological Medicine at the University of Otago in Wellington, 30 percent reported moderate to severe mental stress. 16 percent complained of moderate to severe anxiety, while about 40 percent said their overall well-being was low.
According to a preliminary evaluation of the so-called NAKO Health Study, the mental health of many people in Germany has deteriorated as a result of the lockdown in spring. Anxiety, stress and signs of depression had increased significantly. The mental stress was particularly high in the age group of 20 to 40 year olds, especially among women in their late 30s, while the researchers did not register any relevant upward rashes among those over 60. The study is scheduled to last several decades and is being conducted by a network of German research institutions such as the Helmholtz Association, the Leibniz Association and various universities.
According to a survey conducted by the specialist journal "Medscape" on November 10, an increasing number of doctors are reacting to the ongoing pandemic with signs of excessive demands in the form of depression and burnout. Every second respondent would have stated that the feeling of being overburdened and in a bad mood has been intensified by the crisis. "Just like everyone else in the world, doctors are plagued by uncertainty about the constantly changing rules of conduct and work processes," the magazine wrote. "The future is uncertain. Relying on a vaccine as a panacea for the pandemic is probably too naïve a notion. This causes psycho-stress."
A team from University College London has studied the health consequences of loneliness experienced by many people, especially the elderly, due to the isolation measures taken to contain the virus. According to the findings of the long-term study, being alone significantly increases the risk of cardiovascular disease (CVD). "The increase by one point on the loneliness scale was accompanied by a five percent increase in the risk of CVD," the "Deutsches Ärzteblatt" summarized the results. The risk of hospital admission due to cardiovascular disease thus increased by eight percent with each higher point. The newspaper quoted cardiologist Hans-Joachim Trappe as saying: "People of all ages should therefore try to maintain social contacts, keep themselves busy and communicate with other people, even in the difficult 'corona times'.
A study presented in May by the University Hospital Essen came to similar results. Socially isolated people are more than 40 percent more likely to suffer a heart attack, stroke or other major cardiovascular disease. In addition, the risk of dying of any other disease is almost 50 percent higher among socially isolated people.
An "epidemic of loneliness" through contact bans and distance rules is feared by the Hamburg educationalist and futurologist Horst Opaschowski. Since the "stay at home" recommendations of politicians, more and more people in Germany are living and living "alone at home", Opaschowski told the "Redaktionsnetzwerk Deutschland" (RND). To prove this, he referred to a survey conducted in mid-March this year, when the lockdown began. Here, 84 percent took the view: "For many older people, contact poverty will in future be just as burdensome as money poverty". In an earlier survey in January 2019, only 61 percent had expressed this opinion.
In the aforementioned RND article it is also reported that the Hamburg Telephone Emergency Service received 25 to 30 percent more calls than usual during the first phase of the pandemic between mid-March and mid-May. "Many calls are an expression of deep loneliness of people," said Stefan Deutschmann of the Diakonisches Werk der Hansestadt. Nationwide, the approximately 100 telephone chaplaincies supported by the two large churches have recorded a similarly large increase in call contacts, RND wrote. At the end of October, Ralf Meister, Bishop of the Evangelical Lutheran State Church of Hanover, told the newspaper "Die Welt": "Yes, the old problem of loneliness at Christmas threatens to escalate this year.
German Cancer Aid had already complained in the summer that the first lockdown in the spring had postponed around 50,000 cancer operations between March and July. This corresponded to almost a quarter of the treatments, and preventive examinations such as mammograms had also been cancelled. As a result, German clinics and medical practices are facing a "bow wave of postponed therapeutic and diagnostic measures", which could lead to life-threatening situations for some patients, complained association head Gerd Nettekoven at the time.
In an earlier announcement in June, the German Cancer Aid and the Federal Association "Haus der Krebs-Selbsthilfe" (HKSH) also pointed out the financial hardships of cancer patients, which had been exacerbated by the crisis. This affected above all people who were worried about their livelihood because of short-time work or because they had already been given notice," explained Ernst-Günther Carl, Federal Chairman of HKSH. "We assume that such inquiries will increase considerably as soon as the economic consequences of the pandemic become more apparent".
With a view to the first lockdown, doctors from various countries reported in October in the trade journal "Medscape" that there were considerable restrictions in the field of cancer treatment and the associated loss of life. Karol Sikora of the University of Buckingham Medical School in London said: "Cancer diagnostics came to a virtual standstill, partly because patients did not seek help, but it was also very difficult to get scans and biopsies at all. Even patients who had an emergency referral under the 'two-week waiting period rule' were refused. Benjamín Domingo Arrué of the Hospital Universitari i Politècnic La Fe in Valencia, Spain, commented: "I believe that the 'stay home' message we sent was too rigorously followed by the patients who should have come to the emergency room much earlier and who were therefore admitted with a much worse general condition".
A model study by the UK National Health Service, reported by Medscape in July, suggests that delayed emergency referrals with suspected cancer will lead to thousands of additional deaths and tens of thousands of years of life lost. If "social distancing" measures are continued for a period of twelve months, the researchers predict additional casualty rates ranging from 4.8 to 16.7 percent compared to "normal times" within the next five years, depending on cancer type. For the United Kingdom, this would correspond to the loss of up to 63,229 years of life.
According to the German Alzheimer Society, people with dementia and their relatives suffer particularly from the pandemic due to the restriction of social contacts. During the lockdown in spring, many support options, such as day care, would have been lost, the head of the association, Monika Kraus, complained to the "Deutsches Ärzteblatt" in September. Michael Rapp, President of the German Society for Gerontopsychiatry and Psychotherapy (DGGPP) said that the cohort of dementia patients now living in nursing homes will experience a significant loss of quality of life and a faster progression of the disease. "Omission of a therapy means loss of its effectiveness, especially over three, six or more months". Research has also suffered. Clinical examinations of patients have been interrupted, research projects have been stopped and the ambulance service has been massively reduced.
The suffering and problems of a health, social and financial nature that arose in the course of the Corona crisis could increasingly lead to suicidal acts, experts warn. For Germany this cannot be statistically determined so far. Figures from Frankfurt (Main) even point to a decline in suicides in the first half of the year, as reported by the "Deutsches Ärzteblatt". However, the corresponding data situation is not representative and the topic is also subject to many uncertainties. For example, it can be assumed that the number of suicides in connection with Corona could increase if the distress continues to prolong, for example because people remain stuck in unemployment and poverty in the long term or go bankrupt with their company.
As a study conducted by the Technical University of Munich (TUM) shows, people with previous psychological burdens are particularly at risk of suicide during the crisis. In the 2020 study period, 49 out of a total of 231 psychiatric cases were related to Covid-19, suffering from acute confusion, loneliness, fear of infection with or strain from exit restrictions. Eleven of them attempted suicide, which significantly increased the proportion of attempted suicides (22 percent) compared to patients without a history of COVID-19 exposure (six percent), according to the medical portal Univadis in late July.
The foreign press does, however, provide evidence of an increase in the number of suicides. In May, for example, the US news channel ABC wrote of a dramatic increase in suicides and attempted suicides. "This is without precedent. We have never seen such numbers in such a short period of time," said Mike DeBoisblanc, director of the emergency room at the hospital in Walnut Creek near San Francisco, and continued: "I mean, we have seen suicide attempts on a scale we have seen in an entire year in the last four weeks.”
The forensic scientist Michael Tsokos of the Berlin Charité has even identified a new suicide motive in connection with Corona. "Namely, that people choose death as a way out because of fear of death." He had never seen this before with HIV, cancer or influenza," the doctor told "Focus" in May. In concrete terms, he reported on his experiences with eight such deaths. "The tragedy is that these people we examined did not even have Covid-19."