Tomorrow, February 21, 2022, the Senate will debate a law that makes it possible to place corona on the list of diseases with A status. That is why we have decided to send this open mail to the Senators, so that they are at least well informed about the current facts of Omicron.
Dear Senator,
On Monday you will debate the granting of A status to the covid-19 virus and on Tuesday this law will be voted on. Apart from the proportionality of all measures regarding the fight against the Covid-19 pandemic, it is now the case that Covid-19 has been supplanted by Omicron. Omicron is not a variant of Delta, but a Wuhan variant mutated in at least 50 places with a completely different character.
The fact that Covid-19 was placed on the A-list at the time is understandable, given the uncertainty that prevailed at the time. It had to be possible to intervene quickly and decisively, and that was enough ground at the time to place Covid-19 on the A-list – not the scientific substantiation of the disease itself. It simply wasn't there yet. There is now sufficient scientific basis to NOT place the current virus, Omicron, on the A-List.
For example, until recently, Omicron was assumed to be 2.5 times more contagious, due to the exceptionally rapid increase in infections among a small number of unvaccinated people who had not yet experienced the disease, despite the high immunity rate. This was the most threatening aspect of Omicron because all other signs pointed to a mild course of the disease caused by the virus.
Meanwhile, neither the vaccinations nor previous covid infections appear to offer solid protection against Omicron. Almost the entire population can therefore be considered susceptible again, which also explains the infection numbers without there being an exceptional contagiousness compared to previous variants, on the contrary: it is even lower. This, in combination with the mild course of the disease, deserves further consideration.
Most of the Dutch population has now been reinfected with Omicron. This is masquerading as a new virus in a new flu season. Not highly contagious as was first assumed (because a high immunity rate was assumed), but about as contagious as the Wuhan variant with a reproduction number of about 2.5. What we also see is:
- The number of cases in which infection with Omicron leads to illness is much lower,
- the clinical picture is considerably milder,
- hospitalization is shorter,
- ICU admissions are falling and
- mortality is a fraction of the Wuhan variant.
We are now two flu seasons further than Covid-19. It is purer to consider Omicron as a new virus in its own right. In order to arrive at a consistent policy with regard to Omicron, we need to consider how the severity of the Omicron disease compares to previous epidemics such as Covid-19 and influenza.
Epidemics compared: Covid-19 and Omicron
First Covid-19. We make two assumptions here. These have to do with estimating the actual number of infections based on the registered number of positive tests. We take two extremes. A realistic estimate is that the actual number of infections is 3 to 5 times as high. In the scenarios below, we calculate with a factor of 4. The other extreme is the hypothesis that the number of positive tests exactly reflects the number of infections.
Assumption 1: Covid x4, Omicron x1
We assume that the actual number of Covid-19 infections is 3x as high as the number of positive tests. After all, many asymptomates have been missed and not everyone with (mild) symptoms has been tested, especially when there was no recovery certificate.
A similar assumption can also be made for Omicron because many Omicron infections go unnoticed. In the first scenario, let's assume that with Omicron, every infection has resulted in a positive test.
Even in this comparison, which is unfavourable for Omicron, we see that the percentage of hospital admissions due to Omicron is only one-third of that due to Covid-19, compared to the total number of infections.
In fact, mortality is about one-sixth (17%) of that of Covid-19.
| Virus | Positive tests | Infections estimated (Pos. Testing x4, x1) | Hospital admissions | ZHO / Infections | IC recordings | Deaths | Deaths / infections |
|---|---|---|---|---|---|---|---|
| Covid-19 | 2.700.000 | 10.800.000 | 83.000 | 0,77% | 12.000 | 21.000 | 0,19% |
| Omicron | 4.000.000 | 4.000.000 | 10.000 | 0,25% | 1.000 | 1.000 | 0,03% |
Assumption 2: Covid x4, Omicron x3
If we assume that the number of Omicron infections is three times the number of positive tests (which still results in a realistic infection rate), then we see the percentage of hospital admissions by a factor of 9 compared to Van Eyck. Covid-19 relapses (i.e. 12% of Covid-19 hospitalisation) and mortality by a factor of 24, i.e. only 4% of Covid-19 mortality. Shown in table:
| Virus | Positive tests | Infections estimated (Pos. Testing x4, x3) | Hospital admissions | ZHO / Infections | IC recordings | Deaths | Deaths / infections |
|---|---|---|---|---|---|---|---|
| Covid-19 | 2.700.000 | 10.800.000 | 83.000 | 0,77% | 12.000 | 21.000 | 0,194% |
| Omicron | 4.000.000 | 12.000.000 | 10.000 | 0,09% | 1.000 | 1.000 | 0,009% |
So if Covid-19 is already an A-status disease, that says nothing about the status of Omicron. The severity of the clinical picture is too different for that.
Conclusion: The impact of Omicron on society cannot be equated with that of Covid-19. We can think of a factor of 10 or more lower. An A-Status due to the label "corona" is therefore no longer applicable.
Epidemics compared: flu and Omicron
Of course, there has never been intensive testing for flu. Estimates of the number of infections will have to be revised on the basis of the knowledge gained with the Coronavirus. There is no clear picture of the number of asymptomates and people who have just gotten rid of their flu at home without a visit to the doctor have never been registered.
The hard key figures we do have are Hospital admissions and Deaths (source: rivm). Let's take the heavy flu season 2017-2018. This could be considered an upper limit for a situation where absolutely no special measures need to be taken. It should be noted that the average flu season costs 6,500 lives and that it has never given rise to the wearing of face masks or other measures, despite the overburdening of the healthcare system.
| Virus | Positive tests | Infections estimated | Hospital admissions | ZHO / Infections | IC recordings | Deaths | Deaths / infections |
|---|---|---|---|---|---|---|---|
| Flu (RIVM) | unknown | 900.000 | 16.000 | 1,78% | 10.000 | 9.500 | 1,056% |
| Flu (infections x4) | unknown | 3.600.000 | 16.000 | 0,44% | 10.000 | 9.500 | 0,264% |
| Flu (peil.nl) | unknown | 5.500.000 | 16.000 | 0,29% | 10.000 | 9.500 | 0,173% |
| Omicron | 4.000.000 | 4.000.000 | 10.000 | 0,25% | 1.000 | 1.000 | 0,025% |
The RIVM estimates that approximately 900,000 people were infected in the 2017-2018 season (rule "Flu"). Without questioning the expertise of the RIVM here, the rule "Flu (infections x4)" shows what the results would be if four times as many people had been infected.
According to polls by Maurice de Hond, even 5.5 million people would have had flu-like symptoms. Rule: Flu (peil.nl)
- Here too, we see that Omicron leads to an admission in about half to one-eighth of the number of infections, compared to a flu season that has passed without a single measure.
- Omicron causes 10x to 40x fewer deaths than we have seen with the flu of 2017-2018, in relation to the number of infections.
Please note: in this calculation, we assume that the number of infections does not exceed the number of positive tests. Of course, that is not the case in reality. If the number of infections is actually higher (x4, for example), the severity of the disease drops to a quarter of the values stated. After all, the number of hospital admissions and deaths remains the same.
Finally
Griep is not included on the A-list, despite what we have seen in 2017-2018. Society accepts the existence of illness and mortality at least to this extent, even in the elderly and vulnerable.
Conclusion: For flu, the A-Status has never been considered. It is not justifiable to place a virus that leads to fewer hospitalisations, has a lower mortality rate and as such has less impact on society and healthcare on the A-list.
We wish you much wisdom in the debates and the vote.
Drs. Herman Steigstra
Drs. Anton Theunissen
Sent on request:
| Subject: | Re: Debate A-status covid-19 |
| Date: | Mon, 21 Feb 2022 11:28:37 +0100 |
| From: | E-122C-VWX E-122C-VWX < E-122C-VWX > |
| To: | E-122C-VWX E-122C-VWX < E-122C-VWX > |
Good morning sir E-122C-VWX best E-122C-VWX ,
The data we use are the public sources. These are:
- The website of NICE (number of admissions/day)
- The website of the LCPS (bezetting IC & ziekenhuis)
- Corona Dashboard (number of positive PCR tests)
- Website allecijfers.nl(numbers of deaths and many other information)
- OurWorldInData (international key figures, this link as an example)
The problem is combining all these figures. There is a small part of the information everywhere, which we bring together in a large spreadsheet. I can send you these, but without explanation it is difficult to fathom.
If there are any more specific questions, I am always willing to answer them. Possibly by phone if convenient: 06-E-122C-VWX
There is also a lot of uncertainty in the figures. For example, the number of people admitted WITH corona is according to NICE 27% and according to Rivm 48%. Bovendien is volgens RIVM bij 40% van de opname de reden onbekend (grafiek "Opnamereden....verpleegafdeling", vinkje "opnamereden (nog) onbekend" aanzetten), dus slechts van ruim 30% is de echte reden "vanwege corona". Dus de schatting van "vanwege corona" loopt van 30% tot 73%.
It is also unknown what the ratio is between the actual number of infections and the number of positive tests. Based on the development of the epidemic (too complicated to explain) there seem to be 4X as many Infections with covid-19 if Positive PCR tests. Because a green tick is the reward for a positive test in Omicron, that ratio seems to be 1:3 there.
It is also chaos at the RIVM when it comes to keeping track of the PCR figures. The sky-high 350,000 positive tests in 1 day is exemplary.
