Sometimes it is hard to obtain a list of the things that can go wrong after or during surgery, though best practice dictates that patients should be provided with full information in order that they may give informed consent to the intervention – it occurs to Coco that perhaps the insurance standard of the utmost good faith should be applied to the contract – but at the ITALF 2024 conference held in the auditorium at the Atheneum Pontificium Regina Apostolorum in Rome we were presented with such a list,
Trattamento riabilitativo termine e getione dei problemi: E Fiengo, Pomezia, RM
Complicanze Incompleta risoluzione del dolore Dipendenza dall’indumento compressivo Parestasie, ipoestasie, iperestasie, e compressioni nervose Discromie e disturbi circulatori distrettuali Linfedema secondario Edema e fibrosi post-operatoria Cicatrici e alterazioni fasciali Lipedema regrowth
It goes without saying that the list itself is ‘incompleta’ and there are other perhaps much more serious risks which are not listed here, but which are not directly related to the problem which the surgery is attempting to solve, but it is good to hear an acknowledgment that some of the outcomes may be considered to be a complete failure of the surgery itself, for the final condition of the patient will be worse than at the beginning. Surely it is not inappropriate that the words of our Lord may be paraphrased about them:
Woe to you, scribes and Pharisees, hypocrites! For you travel land and sea to win one proselyte, and when he is won, you make him twice as much a son of hell as yourselves. Matthew 23:15
Coco leaves it as an exercise for the reader to produce a suitable paraphrase. Please leave it in the comments should you think it apt.
Incomplete resolution of pain Compression garment dependence Parastasia, hypostasia, hyperastasia, and nerve compression Dischromia and district circulatory disorders Secondary lymphedema Postoperative edema and fibrosis Scars and fascial alterations Lipedema regrowth
The following post may provoke a response from the censers(sic!), and a lockdown which is far from useless, though perhaps needless, may be imposed here, after which you shall be glad never to hear from me again.
The article posted by the BBC Digging riverbeds in Zimbabwe in desperate search for water reminds us of the dire famine in much of south central Africa. The Zimbabwe Partnership Trust has for several years supported communities in Zimbabwe including by financing the drilling of bore-holes to provide water for agricultural projects and schools in remote regions. ZPT is focussed this year very much on the relief of famine in those communities where it has been working through trusted local partners.
Coco had only visited the site in order to check whether British or US spelling was being used to describe the class of medical facility which are called health centres, and not to examine whether fake news were being promoted, and whilst the video may contain much accurate information about the response of the government to the outbreak of covid-19, it began on a rather bad foot.
It is at 19 June 2024 on the home page of the Ministry of Health, Uganda but may be replaced at any time.
In the Ministry of Health Covid-19 response documentary, which was released on the 1 September 2023 we hear: This virus killed more people in the first twenty-five weeks than HIV/AIDS has killed in twenty-five years. These words, corrected here by Coco, appear in the transcript at c0:18
That is an interesting claim. It was followed by a reference to the 1918 Spanish ‘flu death toll after which you may see 100,000,000 appear briefly on the screen. Read that carefully: More than 100,000,000 infected. In the context you may be forgiven for thinking that it was a claim that there were 100 million deaths. Coco thought to investigate the claim. Be patient we have to look at a number of sources, some of which may be more reliable than the others.
In brief
According to a study in PubMed: Estimates of global SARS-CoV-2 infection exposure, infection morbidity, and infection mortality rates in 2020 (https://pubmed.ncbi.nlm.nih.gov/34841244/) in which it is stated that If left unchecked with no vaccination and no other public health interventions, and assuming circulation of only wild-type variants and no variants of concern, the pandemic would eventually cause 8.18 million deaths. According to Wikipedia the estimated actual number of deaths to June 2024 was 7.05 millions.
On the other dies of the coin we have the table at Deaths from HIV/AIDS by age, Worldhttps://ourworldindata.org/grapher/deaths-from-hiv-by-age which provides figures for all years since 1980. The total number of deaths since 1980 taken from these tables is c.34 millions.
Using these statistics, if we take the first twenty five years of AIDS there were 16m deaths. In the last 25 years there were 28m deaths. Both of these numbers are greater than both the estimate provided by the PubMed paper for the potential total number of deaths, and the actual number reported by Wikipedia from Covid-19.
On what basis then can the YouTube video claim that Covid-19 has killed more in 25 weeks than HIV/AIDS in 25 years? Is this not fake news?
Further resources
By way of comparison, there are other tables of statistics available for both Covid-19 and HIV/AIDS related deaths, which give higher figures than Coco has used above.
According to the Global HIV & AIDS statistics — Fact sheethttps://www.unaids.org/en/resources/fact-sheet40.4 million [32.9 million–51.3 million] people have died from AIDS-related illnesses since the start of the epidemic. This data does give range rather than simply one figure, into which, though at the lower end, the figure on ourworldindata.org falls.
Total number of AIDS-related deaths worldwide from 2000 to 2022 (with Coco’s interpolations)
This table provides smaller figures for the most recent years, but the differences between the two sources amount to less than 500k, which is an insignificant difference in the context of several millions.
Concerning totals deaths from Covid-19 Wikipedia reports https://en.wikipedia.org/wiki/COVID-19_pandemic_deaths: There have been reported 7,050,691 (updated 17 June 2024) confirmed COVID-induced deaths worldwide. As of January 2023, taking into account likely COVID induced deaths via excess deaths, the 95% confidence interval suggests the pandemic to have caused between 16 and 28.2 million deaths. Even if these higher figures are correct, which we must remember are for a period of more than three years, then it is unlikely that This virus killed more people in the first twenty-five weeks than HIV/AIDS has killed in twenty-five years. In the first 25 weeks the highest figure we could have for Covid-19 deaths is 28,2*25/156, say 5 millions, and the lowest estimate of HIV/AIDS deaths over twenty-five years is 16 millions.
Perhaps the effect of the interventions has saved less than 1m lives (the earlier estimate was for 8 millions but the outcome was 7 millions) over the four years if the PubMed figures are to be believed.
The economic impact
An article in the Grauniad reminds us of the value of a prevented fatality (VPF): £2m in the UK US$11,6 in the USA: Are Smart Motorways Safe
On the basis of those figures the amount to be spent to save those 1m lives would be £2 billion in the UK or US$11,6 billion in the US (which in unconventional language would be £2 or US$11,6 million million). We may well want to ask, How much did they actually spend?
Reports indicate that the US has figures of US$8-14 billion (The COVID-19 Pandemic and the $16 Trillion(sic.) Virus (this article provides alternative measures which indicate lower values of a life), the UK up to £400 million (Covid-19: How much has it cost?). Both of these figures are of course open to discussion and argument. It is likely that the basis on which they have been prepared is far from agreed, though there may be a consensus amongst those who prepared the reports. That they are large and not insignificant costs is hardly however disputable, and as we shall see even if they are out by as much as 50% (ie twice the actual real cost) they are significantly higher than we would expect using the VPF figures.
Extracted from the actual data set on GitHub which is presently called owid-covid-data.csv
Conclusion
Assuming that the number of deaths saved in each of these two countries is proportional to the actual number, and that the estimate provided by PubMed is reliable (but we have no other), then the expected spend, based upon the VPF figures would have been US$2,2 billions and £70,000 millions. Both countries based upon their own working VPF models (whatever shortcomings may be seen in the computation of those figures) have spent six or seven times those amounts.
Post-script As noted elsewhere, the covid-19 infection was not the Spanish ‘flu in its impact. The death rate has settled down to about 2% of those infected. Contrariwise influenza causes 200-500,000 (possibly as high as 700,000 as we see at the end of the article) deaths per year according to data provided by Our World in Data. A different article in Our World tells us that Yet, data on the flu is limited but such as there is suggests that Influenza occurs all over the world, with an annual global attack rate estimated at 5-10% in adults and 20-30% in children (WHO). Taking these estimates there would be about 300-600 millions in adults and 400-600 millions in children of infections each year.
Yet again Coco finds himself in agreement with a sociologist. Robert Dingwall has written about the inappropriate use of fear to coerce specific behaviours at the beginning and during the passage of the covid-19 crisis. Coco must admit to being one of those complacent ones who did not ‘feel sufficiently personally threatened’ due to a personal examination of ‘the low death rate in [the] demographic group’ to which Coco belonged. Coco must confess however that Coco has been taken to task several times by more than one individual of more than merely competent medical standing for holding such a position.
Coco had long thought that the language used to convey the message promulgated by governments and their advisors promoted fear, and that therefore a different language should have been used, given that it always seemed to magnify the risks and dangers of the virus. Coco was not ready to conclude that the language had been deliberately chosen by governments and their advisors to promote such fear.
Richard D concludes very clearly in the opposite way and Coco is quite inclined to agree with him.
At the Makerere University Environmental Health Students’ Association 19th Scientific Conference in April 2024 Dr Arthur Bagonza presented qualitative results from a study funded by the ILF into the burden and prevalence of lymphatic filariasis in Uganda.
You may have heard the expression: Rubbish in, rubbish out.
Forty years ago Coco used a early version of SuperCalc (SC2 – a spreadsheet like Excel for those who cannot remember) for the preparation of monthly reports under the operating system C/PM. It was ‘cutting’ edge at the time using simple lists of transactions which were converted into a report showing monthly, cumulative and projected figures against a flexible budget. Coco shall not go into the technical details of this. It was not many months before Coco noticed that the report sometimes did not balance.
How could that be? The original data was complete, and balanced. Careful examination of the code indicated that nothing had been left out. It was only when Coco had set the code to run step by step, updating the display at each step, that quite by accident the problem revealed itself. As you will know, and if you do not, ledger accounts have two sides, a debit (on the left) and a credit (on the right). The code identified separately each debit total and each credit total for every account. This is important for the grand total of the debits and the credits must agree. In order to obtain the balance on the account for the report, the difference between the debits and the credits on each account must be determined. That was a very simple action. Put the debits into column A, the credits into column B, calculate the balance in and pick it up from column C.
This is where the mistake occurred. As SuperCalc accepted the values in column B it erased the value in every 16th row, and only every sixteenth row, in column A.
It is said that, for a given set of inputs a computer will always give the same result. You may give it that set of inputs any number of times, nothing will ever be different. If something is different, then it you must look at the programme not the inputs.
Coco never found out what it was in the SuperCalc code that prompted it to do this, but it was consistent. The correct solution was to fix SuperCalc, but my solution was not to try to fix SuperCalc but to fix the data to work around the error. Coco added dummy accounts into the system, each of which would have no data assigned to them and would fall onto these 16th rows. After that the reports balanced. It was a concern however that there might be something else lying around which would creep up unawares. We found such things were lurking later, when the then victorious Excel now and again got an arithmetic calculation wrong. The problem is still with us today if we expect say +(1-0.1-0.1-0.1-0.1-0.1-0.1-0.1-0.1-0.1-0.1) to be 0, it is not quite zero.
So we consider the mRNA vaccine, where it is reported (Covid study: mRNA vaccines could be fine-tuned) that there is a one in three probability that the ribosome will incorrectly read the data held in the mRNA. The solution is, so they say, to use non-slip mRNA, which will eradicate the incorrect reading of the data. They speak of the data as code, and code it is, just as this note is itself written in an alphabetic code which we read with our eyes and interpret with our brains.
The data, the code, however is read (just as Coco’s data was read by the SuperCalc code) by a ribosome, which is itself a complex chemical machine with its own code that interacts with the data in the mRNA. If one in three times the reading of the data produces a different result it suggests that it is something in the ribosomes that are reading the data that is different. Changing the data may, as it did for Coco, skip the thing that we do not understand that actually makes the difference, but the thing we do not understand is still there waiting to catch us out in different circumstances.
There is another possibility. Coco mentioned above that a given set of inputs will always yield the same output. We have seen many situations in the electronic world where this did not seem to be the case. Careful examination showed however that the starting conditions, which we thought were identical were not. A prior process, which may or may not have taken place, influenced the results of the later inputs. There was, if you like, an unknown input over which we had no control, which changed the result. This was unlike Coco’s SuperCalc problem.
Should we not try to understand why the same set of data, the same code, produces different outcomes one in three times before we say we have fixed it? Coco did not fix his problem, Coco merely worked around it, not knowing what other problems may arise later. What is it that causes the ribosome to read the data ‘incorrectly’ one in three times? Or is it that it is the two in three times that it does what we want it to do that is the incorrect result?
The unintended result of the misreading, or possibly correct reading, of the mRNA is the production of a few unintended proteins. Coco thinks that the implication is ‘harmless’ proteins, but that is not actually said. So the workaround is to change the mRNA, the data, in such a way that the ribosome will always read the data as we want it to: but do we understand why it read the original data in two different ways, not just occasionally but quite regularly? What else was going on? What was the unknown input that caused the data to be read in either of the two different ways? We have not addressed that, have we?
To address the matter with a workaround in the data is both reckless and negligent. When Coco used a workaround, he was only dealing with the reporting of how money gathered and how it had been used, the reporting is important, yes, but mRNA affects people’s lives.
There is excitement in the world as the ILF begins an epidemiological (for those of you who do not understand that word, let Coco stand alongside you) study to ascertain the prevalence of lymphoedema in Uganda.
It is well known that lymphatic filariasis is endemic in tropical countries, alongside other mosquito borne diseases, but the real extent of the problem and its expression among the people is not properly understood.
Lymphatic filariasis is only one of the causes of lymphoedema in East Africa, all of the other causes, whether primary or secondary are also present, though the mix will be different than in Europe, and other parts of the world.
The International Lymphoedema Framework, through its chairman, has provided funding for the study which will be lead by Dr Arthur Bagonza of Makerere University in two districts in the village regions of Uganda.
Basic training in the identification of three stages of progression of the disease has been completed in Kampala this week and the lead field workers are ready to take the tool out into the field to complete their survey. Dr S Narahari of the IAD, India, and Professor Christine Moffatt will act as referees to confirm or vary the stage assessments made by the field workers.
The survey will assess the numbers and proportion of individuals in the community affected together with the impact of the disease upon the quality of life of the sufferers. The results will be used to inform the Ministry of Health, who have given their unqualified support to the study, in the allocation of resources to combat the problem and relieve the suffering.
The Ugandan framework, lead by Dr Arthur Boganza and Lydia Kabili, is a newly formed framework within the International Lymphoedema Framework and benefits from a longstanding relationship with Prof. Linda Gibson and Makerere University.