COVID 'case' numbers meaningless

The number of COVID 'cases' do not speak of an advancing pandemic

... evidence suggests government pandemic policy based on false positive information?

Last Friday Total Health wrote to the Director of the Centre for Evidence Based Medicine (CEBM) and asked why there seemed to be an apparent obsession amongst media to quote the number of new COVID-19 cases. We referenced the daily news with reports emphasising the terrifying consequences of exponential growth in numbers of cases.

The fear agenda aside, there is also the accusation that the authorities and Boris in particular is losing his grip on the management of this pandemic. 

As we face further lockdown restrictions today, the news is all about the 6874 new cases in the UK (not including Scotland "for political reasons") and 34 people who have died "testing positive for coronavirus".

The implications of the political reaction to this pandemic go far beyond anything we have ever seen before - even with bird flu and the foot and mouth funeral pyres. They have made life a misery for millions, caused huge fear, prevented other diseases from being detected and treated, and wrecked the economy. So, has the reaction been proportionate? I think most of us got the need in the early days to 'flatten the curve', but is there any real scientific evidence to suggest that there will be a second wave, or that this is justification for what is happening?

Calling a PCR positive a "case" causes huge confusion, and is not correct.

Prof Carl Heneghen CEBMBack on the 2nd August, the CEBM said, "The government has restricted movements on millions of people in England: COVID is apparently on the rise. But what happens when you start digging into the data?".

Professor Carl Heneghen (pictured) then goes onto explain why the number of cases of COVID in the UK aren't rising.

So, with the fresh media frenzy over increasing numbers of cases, Total Health asked the following questions:

  • Do the latest testing data change things?
  • Shouldn’t media be explaining the difficulties with testing accuracy – including the PCR false positive rates?
  • Also explaining that even a true positive does not represent a sick person i.e. most asymptomatic or mild symptoms at best?
  • Shouldn’t number of fatalities be explained in context of prevalence of other concomitant pathologies?
  • The Lancet is talking about need for “meaningful” evidence when assessing the new vaccines.
  • What should be done to help media provide a 'meaningful' report i.e. one that explains that many of the so-called cases are probably false positives and not infectious anyway?

As of today, Total Health has not yet received a direct reply, however, the CEBM have obviously been busy and the original report has now been updated with their article PCR Positives; what do they mean? - and this answers our questions. Helpfully, the article also intimates how questions around these issues should be phrased.

So, what are the CEBM saying?

Top ten evidence-based observations relating to COVID-19 testing:

1. A positive PCR test does not mean you have active COVID-19 or are infectious. The result may be of interest to academics, but it is otherwise academic. There is nothing really meaningful to be gained.

2. The best test for active virus is a 'viral culture test'. This laboratory test can see if the virus taken from the patient is active and not just a piece of inactive RNA.

3. The manufacturers of the testing kits have got their caveats in, and admit that there is interference and cross-contamination from a host of other known viruses (who knows about the unknown ones?). These other viral fragments can be responsible for causing false positive results. The manufacturers are quoted saying, "the detection result of this product is only for clinical reference, and it should not be used as the only evidence for clinical diagnosis and treatment".

4. Even if the PCR test is a 'true positive', this does not mean the person has active virus or is infectious, or presents any danger to society.

5. Patients can remain 'PCR positive' long after the the virus is inactive. This is also true for many other viruses including flu, Zika and Ebola.

6. Calling PCR positives “cases” does not specify whether the persons have carried the virus for long or whether it is “active”. This could lead to the finding of many “cases” as a function of the number of PCR tests conducted. "PCR positives would therefore not speak of an advancing pandemic".

You test more, you'll find more

7. PCR positives simply measure the number of PCR tests taken on a given day, i.e. they might be somewhat proportional to the number of PCR taken on a given day,  and positives might or might not be “infectious” positives. Ultimately, this means PCR positives cannot be used to tell if the pandemic is advancing if for that we understand that deaths are to increase or decrease.

8. Viral culture is required as a reference to test for infectivity.

9. COVID-19 labelled deaths depend on subjective parameters whether excess deaths have the advantage of being a standard relative to a reference, namely, the number of deaths in previous years. Heatwaves have an impact on the number of excess deaths.

10. PCR positives do not correlate to excess deaths in the future and therefore lack predictive power.

See - COVID cases aren't rising

and - What do PCR positives mean?

In summary:

  • The number of positives detected is not a meaningful measure of the number of actual cases.
  • The PCR and blood tests are not sufficiently accurate, and should be replaced by viral culture.
  • The number of positive tests does not indicate or predict a second wave.

We have raised the point about misleading and unchallenged data previously and we ask again. Why isn't political policy being informed and underpinned by the right scientific and medical evidence?

Children demanding tests

According to BBC health reporter, Philippa Roxby Children are behind rising demand for tests in England. The report goes on to inform us that, "Only 1% of those children who had a test actually had the virus, compared with 3.5% in older age groups". However, what this reporting does not make clear is that stating, "actually had the virus" is different to saying "is a true, confirmed positive and is infectious", which is what this statement actually implies. The difference is fundamentally important - and needs to be made abundantly clear. i.e. How many of that 1% are false positives, or just inert fragments of RNA?

The report concludes, "Now that children throughout the UK are back at school, the need to understand this aspect of the virus is even more pressing". Well, yes, and understanding would be helped by making sure that reporting scientific data is backed by an evidence-base that provides some accuracy.

A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
The growth within a laboratory of microbes, organisms too small to be seen with the naked eye. Full medical glossary
The process of determining which condition a patient may have. Full medical glossary
One of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. Full medical glossary
A viral infection affecting the respiratory system. Full medical glossary
An organ with the ability to make and secrete certain fluids. Full medical glossary
An animal or plant that supports a parasite. Full medical glossary
An outbreak of infection that affects numerous people in different countries. Full medical glossary
Polymerase chain reaction, a technique that involves the isolation and analysis of genetic material or DNA. Full medical glossary
One of a class of drugs that inhibit cholesterol formation in the liver. Full medical glossary
A microbe that is only able to multiply within living cells. Full medical glossary
Microbes that are only able to multiply within living cells. Full medical glossary