Questions for the Minister of Health, Welfare and Sport

We would like to help our representatives ask (chamber) questions. With their busy schedules, they do not always have the opportunity to spend a lot of time on them. However, asking the right questions is the instrument par excellence to get thought processes going (mathematics), also in the run-up to the parliamentary inquiry. In addition: MPs represent the voice of the people, a voice that also raises questions, questions that the people ask the parliamentarians. Below are a few, who knows, they might be picked up by this or that.

Questions fromn Anton Theunissen, 8 February 2021

Questions from Herman Steigstra, 17 February 2023, with answers from Minister Ernst Kuipers.

8 February 2023

Question 1

The minister has already indicated that he is aware of the continuing unexplained excess mortality. Does the Minister agree that targeted independent research into the cause of these deaths is an extremely urgent matter of both public health and national importance?

Question 2

Can the Minister explain why research proposals are being accepted that concern interventions that have now been completed for more than a year, when the only intervention that is still being practiced and promoted by relevant policymakers, vaccination, was not initially given special attention in relation to excess mortality?

Question 3

Does the Minister realise that this intervention (vaccination) is the only one on which policy can still be changed and that such a change could affect the future course of excess mortality, i.e. the only research that could also save lives in the short term?

Question 4

Does the Minister agree that statistics can, or at least should be part of the guiding principle, in assessing the urgency of further experimental research and/or more specifically data-analytical research?

Question 5

Is the Minister aware that several statistical regression analyses and projections by various independent statisticians have found exceptionally high correlation coefficients between vaccinations and excess mortality? (sources: see "Citations and references")

Question 6

Does the Minister see this urgency reflected in the selection made by ZonMW with regard to the subsidies granted in the context of the search for the cause of the excess mortality and, if so, can the Minister give the correlation coefficients for the chosen subjects of the selected studies into the cause of the excess mortality?

Question 7

If the urgency of the selected subjects does not have a numerical basis, can the Minister indicate on what grounds the studies have been embraced, how the chosen subjects can help to counteract the cause of the aforementioned national excess mortality among all age groups as it is still taking place at the moment, and substantiate why these grounds have been prioritised over a subject with a correlation coefficient of 0.8 and above, All this in the light of current public health and the national interest?

Question 8

Is the Minister aware that urgent scientific research often benefits more from longer periods to be investigated than from shorter ones, because more data are available over longer periods and sub-periods can be filtered out or compared here, should that prove useful?

Question 9

Is the Minister aware that the Omtzigt motion was tabled on 1 December 2021 to conduct an independent investigation into the causes of excess mortality up to and including November 2021, which was the most recent achievable end date at that time, given the latest CBS report? If so, will the Minister explain, in view of the continuing and still current excess mortality, why he is not acting in the spirit of the motion by requiring every investigation that there should be no formal date restriction and that therefore the most up-to-date dates should also be included in the investigations?

Question 10

Noting that

• the title "Excess mortality in the Netherlands 2020-2021" temporally does not do justice to the intention of the Omtzigt motion
• the unexplained excess mortality only became strikingly visible in summer 2021, with which the period to be investigated effectively covers only the first months of the unexplained excess mortality that has risen since then
• the unexplained excess mortality in 2022 was exceptionally high and is therefore still urgent
• A wealth of data is missed because the 2022 data is ignored
• the unexplained excess mortality may continue in 2023, after the flu-under-mortality
• the epidemic is coming to an end or is almost over

the question arises as to why the Minister, or ZonMW, has decided to neglect the excess mortality data in 2022 and to limit the period to be investigated to December 2021, such as can still be read on the ZonMW website?

Question 11

Does the Minister not consider it premature that the sub-programme "Excess mortality in the Netherlands 2020-2021" is presented as "Covid-19 subprogramme", when the aim of the investigation should be to determine the cause of the Unexplained excess mortality?

Question 12

Does the Minister understand, in view of his answers above, that not sufficiently encouraging independent research into plausible and statistically very likely causes of excess mortality may give the impression that it is already known internally that such research will produce unwelcome results, and is the Minister prepared to take this risk?

Question 13

Looking at his answers, does the Minister think that scientific transparency or lack thereof will have an effect on vaccination readiness and, if so, does the Minister think that the desired transparency will have a positive or a negative effect?

Bonus question: Request from (insufficiently) informed citizens

There are commitments that open data is being worked on, which has raised expectations. In order not to be faced with surprises in terms of restrictions or foreclosures, the investigating part of the population would like to ask the minister whether he will ensure that independent researchers for an initial exploratory follow-up study in any case have access to historical and current core data, and the Minister can promise that this will be the case within one month (original target date: end of January) for:

• Date of death (time indication maximum per week no.)
• Date of birth of the deceased (per month number, possibly only the year of birth. Day date not necessary)
• Vaccination dates of the deceased (vaccination history, preferably day date, maximum week number)
• Scope: Deaths since 1 January 2019 up to a maximum of 1 month before the time of retrieval (incl. possibly provisional figures)
  (Note: In the next phase of the follow-up study, more specific data may be required if there is reason to do so, such as causes of death, comorbidities, region of death, gender, country of birth, etc.)

If the Minister does not do so by this deadline. jug can the Minister indicate on a point-by-point basis when this is possible? If the minister does not do this will would he then like to indicate what the reason is for him not to want that, without falling back on the delay that ZonMW's Covid19 set-up now provides for independently determining the cause of the still current national excess mortality, as referred to in Mr. Omtzigt's unanimously adopted motion?

For question 7

Grants have been awarded for research on "(pre)dementia patients living at home", "change in care use", "Lifestyle", "vulnerable groups and lung covid", "delayed screening for cancer", "socio-economic effects of Covid-19", "excess mortality among people with mental disabilities", "individual and environmental factors in Amsterdam", "organisational characteristics of nursing homes". As further reminder to the Minister, we quote one phrase from each description of the ZonMW studies. The urgency and national interest are not always clear from these descriptions. Most ZonMW studies even need to collect the figures to confirm or not confirm a suspicion. Research for which convincing numerical analyses are already available is not included. Quotes from the studies that are part of the ZonMW programme:

1. The COVID-19 pandemic may therefore also have led to more deaths among (pre)dementia patients.
2. There may have been an increase due to late or undiagnosed diseases.
3. We calculate the probability of dying from a COVID-19 infection and death from a deteriorating lifestyle during the pandemic.
4. Less treatment for other conditions or postponement of this may explain why there is still additional mortality, while the epidemic is in calm waters.
5. These researchers hypothesize that patients diagnosed with cancer during the COVID-19 pandemic and lockdown periods were more likely to die than in the previous two years.
6. Quantifying socioeconomic inequalities in the health burden of COVID-19.
7. Preliminary analyses indicate that health inequalities between people with and without VB have been further exacerbated during the pandemic due to more causes than COVID-19 alone, including higher overall mortality.
8. This project investigates the differences in excess mortality between neighbourhoods in Amsterdam in 2020 and 2021.
9. We investigate to what extent medical history and socio-demographic characteristics are associated with excess mortality.
10. This project investigates the role of organizational characteristics of nursing homes (such as staffing, quality and size) in explaining excess mortality during the pandemic.
11. This study investigates the relationship between care avoidance during the first phase of the COVID pandemic and the observed mortality.

Quotes and references

Herman Steigstra

The trolls keep repeating "correlation is not causality". That has never been claimed. We will sharpen our communication towards correlation as an urgent alarm signal. Where the highest correlations can be found, start with specific research with more detailed data.

A correlation coefficient of 85% between vaccination and excess mortality is particularly high, especially given the 'noise' that we know is in the data. After applying a noise filter, the correlation even increases significantly.

More information about the Steigstra method: https://www.maurice.nl/2023/01/31/oversterfteanalyse/

Follow him on Twitter and on maurice.nl. Other virus varia articles with and by Herman: https://virusvaria.nl/author/herman/

Ronald Meester

We discuss the interpretation of These results, and conclude that they urgently call for further research into the effects of vaccination, and publication of the potential risks of vaccination against COVID-19.
(PDF) COVID-19 vaccinations and mortality – a Bayesian analysis (researchgate.net)

We apply the Bayesian method to the COVID-19 booster campaign in the Netherlands during week 38-47 in 2022, which occurred under the 65+ age cohort. The scenario in which this campaign in the short term will have a opposite effect on mortality caused in the order of 1000-1500 cases seems best supported by the data.
(PDF) Bayesian analysis of short-term vaccination effects (researchgate.net)

Andre Redert

We did find a 4-sigma significant mortality-increasing effect during the two periods of high unexplained excess mortality.
https://www.researchgate.net/publication/361818561_Covid-19_vaccinations_and_all-cause_mortality_-a_long-term_differential_analysis_among_municipalities

A small selection of other alarm signals in studies

Zwarte, Latijns-Amerikaanse en Aziatische volwassenen van <65 jaar waren allemaal sterker gevaccineerd dan blanken van dezelfde leeftijd gedurende het grootste deel van de aanzienlijke en aanhoudende Delta-griep in Minnesota en alle daaropvolgende Omicron-grillen. De sterftecijfers van blanken waren echter lager dan die van alle andere groepen. Deze verschillen waren extreem; op middelbare leeftijd (leeftijd 45-64 jaar), tijdens de Omicron-periode, hadden meer gevaccineerde bevolkingsgroepen een COVID-19-sterfte die 164% (Aziatisch-Amerikaans), 115% (Latijns-Amerikaans) of 208% (Zwart) bedroeg van de witte COVID-19-sterfte op deze leeftijden. In zwarte, inheemse en gekleurde bevolkingsgroepen als geheel was de COVID-19-sterfte in de leeftijd van 55-64 jaar hoger dan de sterfte onder blanken van 10 jaar ouder.
https://pubmed.ncbi.nlm.nih.gov/36653101/

The mortality rate [increased significantly over the study period] for vaccinated patients from 4.6% (95% CI, 3.9-5.2%) to 6.5% (95% CI, 6.2-6.9%).
https://pubmed.ncbi.nlm.nih.gov/36652098/

We present the autopsy findings of a 22-year-old man who developed chest pain 5 days after the first dose of the BNT162b2 mRNA vaccine and died 7 hours later. [...] The primary cause of death was determined to be myocarditis, causally associated with the BNT162b2 vaccine.
https://pubmed.ncbi.nlm.nih.gov/34664804/

17 February 2023

Question 1

Is the Minister aware that CBS reported 8415 deaths diagnosed with corona in the first quarter of 2021, while there was an excess mortality of 1589 in that period? See Chapter 3.1.1: https://www.cbs.nl/nl-nl/longread/statistische-trends/2022/sterfte-oversterfte-en-covid-19-sterfte-in-2020-en-2021?onepage=true

Answer by Minister Ernst Kuipers to question 1.

Yes, I am familiar with this.

Question 2

Are the above two figures, as far as the Minister can ascertain, correct and was the Corona mortality therefore five times greater than the excess mortality? If not, what are the correct figures according to the Minister?

Answer from Minister Ernst Kuipers to question 2.

These figures are correct. The report also mentions that in the second excess mortality wave (which lasted until the beginning of 2021), more people died from COVID-19 than there was excess mortality. Statistics Netherlands (CBS) refers to excess mortality when the observed number of deaths is higher than the expected number of deaths in the same period. Because it is possible that some of the expected deaths will eventually die from COVID-19, it is therefore possible that more people die from COVID-19 than there is excess mortality.

Question 3

Does this mean that 80% of deaths that were previously not diagnosed with 'Deceased from corona' now apparently do receive this diagnosis, whether or not in addition to a diagnosis from someone else? Or perhaps the Minister has another explanation for this?

Answer by Minister Ernst Kuipers to question 3.

No, it doesn't. Causes of death are determined at death and not adjusted later. Your overview only shows the number of deaths (due to COVID-19 and other causes) versus the expected mortality in the relevant period based on historical figures.