COVID-19 and Ireland – Part 5

In the last article in this series, we saw that there was no excess mortality in the Republic of Ireland in 2020. It would be wrong to conclude from this that there was no excess mortality in any of the twelve months of that year. In fact, there most definitely was excess mortality in April 2020. All-cause mortality for the month of April in the years 2015-2021 is as follows:

Year	Deaths
2021	2694
2020	3469
2019	2645
2018	2677
2017	2441
2016	2564
2015	2401

Source: Kieran Morrissey and RIP.ie

Northern Ireland also experienced a spike in excess mortality in April 2020:

Year	Deaths
2021	1238
2020	1933
2019	1354
2018	1281
2017	1148
2016	1257
2015	1261

Source: NISRA

It is clear that something unusual happened in Ireland in April 2020:

The official explanation is that these spikes in excess mortality were caused by the Covid-19 pandemic. Even some independent researchers who have been critical of government policy—eg Ivor Cummins—are happy to concede that Ireland was hit by a contagious viral epidemic in the spring of 2020 and that this epidemic was responsible for the spikes in mortality. But do contagious epidemics produce spikes like these?

As I pointed out in the last article, the profile of the Republic’s Covid spike is quite different from that of the regular influenza-induced spike in mortality—the so-called winter burden. The Covid spike is unimodal (single-peaked), rises sharply to a peak over a period of a couple of weeks, and then falls just as steeply to a level lower than that observed before the spike. The winter burden, however, is typically multimodal (ie it has several peaks, giving it a jagged profile), is not nearly as narrow as the Covid spike, and is not usually followed by a drop in excess mortality to negative values.

Excess Mortality in Ireland December 2019 - April 2021

Modelling the Pandemic

An epidemiological curve, or epi curve, is a graphical representation of the course of an epidemic. Such a graph maps the number of new cases of the disease (y-axis) against the date of disease onset (x-axis). The shape of a disease’s epidemiological curve can reveal much about the nature of the disease, the mode or modes of its transmission, the length of its incubation period, etc:

Epidemiological Curve for Covid-19 in the Republic

In the case of Covid-19, a major weakness of using epidemiological curves to learn about this allegedly novel disease is that the PCR test commonly used to detect new cases has been shown to return a high number of false positives (cases where an individual tests positive for Covid-19 but does not actually have the disease). It is also undeniable that the more testing we do, the more cases we find. These are matters that we will return to in a later article.

Replacing Covid-related cases with Covid-related deaths does not resolve these difficulties. How can we be sure that a given death was actually caused by Covid-19 if we cannot be sure that the subject even had the disease?

The Gompertz curve is a mathematical function devised by the British mathematician Benjamin Gompertz to model human mortality. This sigmoid or S-shaped function describes processes in which growth is initially low before increasing sharply in the middle of the process and then declining at its end. Recently, however, the Gompertz curve has been used by epidemiologists to model the course of contagious diseases, such as Covid-19. The Gompertz curve provides researchers with a cumulative record of deaths over the course of the epidemic:

Gompertz Curve for Covid-19 in the Republic

Modelling contagious epidemics with the Gompertz curve makes perfect sense. Initially, as very few people are infected, the disease spreads slowly. Gradually, as more and more vulnerable people are infected, the death rate increases. Finally, as it becomes increasingly difficult for the pathogen to find vulnerable people to infect, the death rate declines.

If Covid-19 did not follow the Gompertz curve, we could conclude that it is not a contagion. But the converse is not necessarily true. If Covid-19 is not a contagion, it does not necessarily follow that it will not follow the Gompertz curve. Many processes that do not involve contagious pathogens can be modelled using the Gompertz function. In the Wikipedia article on this function, several such examples are given:

Mobile phone uptake, where costs were initially high (so uptake was slow), followed by a period of rapid growth, followed by a slowing of uptake as saturation was reached.
Population in a confined space. Birth rates at first increase, but then slow as resource limits are reached.
The growth of tumors.
Population growth in animals of prey, with regard to predator-prey relationships.

The Gompertz function can be used to model the mortality of many diseases in which comorbidity is a factor. For example, if a population is exposed to a carcinogen, mortality will be initially low, as the least healthy individuals succumb to cancer. The associated mortality will then increase, as large numbers of people of average health start to succumb. Finally the mortality will decline, as fewer and fewer susceptible people are left.

The same drawbacks associated with epidemiological curves affect Gompertz curves. There is no infallible way of detecting Covid-19 or of distinguishing between Covid-related deaths and other deaths. One method of avoiding these drawbacks and their associated biases is to model all-cause mortality rather than Covid-related mortality.

Denis Rancourt, Former Professor of Physics at the University of Ottawa

Denis Rancourt

The Canadian researcher Denis Rancourt of the Ontario Civil Liberties Association was one of the first scientists to try and model the course of Covid-19 by tracking all-cause mortality in several different countries. His results are documented in his paper All-Cause Mortality during COVID-19: No Plague and a Likely Signature of Mass Homicide by Government Response, which was published on Research Gate in 2020. Recently, Rancourt’s paper was the victim of censorship, but his paper can still be accessed on the Internet Archive’s Wayback Machine. It is also available now on the Internet Archive’s main archive:

The latest data of all-cause mortality by week does not show a winter-burden mortality that is statistically larger than for past winters. There was no plague. However, a sharp “COVID peak” is present in the data, for several jurisdictions in Europe and the USA. This all-cause-mortality “COVID peak” has unique characteristics:

Its sharpness, with a full-width at half-maximum of only approximately 4 weeks;

Its lateness in the infectious-season cycle, surging after week-11 of 2020, which is unprecedented for any large sharp-peak feature;

The synchronicity of the onset of its surge, across continents, and immediately following the WHO declaration of the pandemic; and

Its USA state-to-state absence or presence for the same viral ecology on the same territory, being correlated with nursing home events and government actions rather than any known viral strain discernment.

These “COVID peak” characteristics, and a review of the epidemiological history, and of relevant knowledge about viral respiratory diseases, lead me to postulate that the “COVID peak” results from an accelerated mass homicide of immune-vulnerable individuals, and individuals made more immune-vulnerable, by government and institutional actions, rather than being an epidemiological signature of a novel virus, irrespective of the degree to which the virus is novel from the perspective of viral speciation. (Rancourt 1)

This is a very serious accusation. What is his evidence?

Rancourt first notes the “synchronicity” of the World Health Organization’s declaration of a Covid-19 pandemic on 11 March and the subsequent surge in Covid-related cases and deaths. By 11 March, according to the WHO, there had been 3162 Covid-related deaths in China and 1130 deaths outside China (including 631 in Italy and 291 in Iran).

Synchronicity of the Covid-19 Pandemic

Instead, in light of past epidemics, it is more likely that this remarkable synchronicity phenomenon arises from biased reporting, in the flexible context of using urgently manufactured laboratory tests that are not validated, clinical assessments of a generic array of symptoms, and tentative cause-of-death assignations of complex comorbidity circumstances. That is why rigorous epidemiological studies rely instead on all-cause mortality data, which cannot be altered by observational or reporting bias (as discussed in Simonsen et al., 1997; and see Marti-Soler et al., 2014). A death is a death is a death. (Rancourt 4)

In the next section of his paper, Rancourt discusses the winter burden—its seasonality and its possible causes. He concludes that this seasonal spike in excess mortality is associated with airborne pathogens (eg influenza viruses) and that the crucial factor controlling its seasonality is humidity:

In a landmark study, Shaman et al. (2010) showed that the seasonal pattern of respiratory-disease (P[neumonia]&I[nfluenza]) excess mortality can be explained quantitatively on the sole basis of absolute humidity, and its direct controlling impact on transmission of airborne pathogens ... It means that the seasonality of P&I mortality is directly driven by absolute-humidity-controlled contagiousness of the viral respiratory diseases ... It additionally implies that the transmission vector must be small aerosol particles in fluid suspension in air, breathed deeply into the lungs, indoors; not hypothesized routes such as actual fluid or fomite contact, and not large droplets and spit (that are quickly gravitationally removed from the air, or captured in the mouth and digestive system) ... And it means that social distancing, masks, and hand washing can have little effect in the actual epidemic spread during the winter season ... Furthermore, indoor airborne virus concentrations have been shown to exist (in day-care facilities, health centres, and onboard airplanes) primarily as aerosol particles of diameters smaller than 2.5 μm ... (Rancourt 6 ... 7 ... 8)

Aerosol particles of this size can remain suspended in the air for hours, are not subject to gravitational sedimentation, and can therefore be breathed deeply into the lungs (Rancourt 8). A single such droplet is sufficient to infect an individual.

Having endorsed the mainstream theory of viral epidemiology, Rancourt next proposes that mortality in infected populations has more to do with the underlying health of the subjects—specifically, the robustness of their immune systems—than with the virulence of the pathogen:

Instead, it is possible that mortality, in a given population exposed to these highly contagious viral pathogens that invade the lungs, is predominantly controlled by the population’s distribution of immune-system capacity and preparedness ... The immune response is extraordinarily demanding of the body’s metabolic energy resources (which is why you “feed a cold”, “rest”, and “stay warm”). The demand in metabolic energy is prioritized, and can compete with the demands of essential bodily functions and immune responses to other pathogens. This is why individuals with “aging” diseases and comorbidity conditions are particularly at risk: their rate of metabolic energy supply to the immune-system is limited by their co-conditions, and the demand is not met at a sufficiently high rate to win the “war”. (Rancourt 10)

Rancourt concludes that differences in mortality between populations for a given viral pathogen are determined by differences in the underlying health states of the infected populations (Rancourt 12). Having concluded this preliminary discussion, he next turns to the central question of his paper: the weekly all-cause mortality of Covid-19.

Analysis of All-Cause Mortality

Rancourt examines the all-cause mortality data from several countries—USA, England & Wales, and Europe (ie those European countries participating in the EuroMOMO project). In each case he found similar features in the mortality graphs:

[England & Wales] Importantly, the total number of winter-burden all-cause “excess” deaths for the season ending in 2020 (area above the summer baseline) is not statistically larger than for past years, and it remains to be seen how low the summer 2020 trough will be. What can be called “the COVID peak” is a narrow feature (Figure 5). Relative to the summer baseline, the full-width at half-maximum of the peak is approximately 5 weeks. It has the distinction of being late in the infectious season, and of climbing far above the broader winter-burden hump. This “COVID peak” is a unique event in the epidemiological history of England and Wales. Does this unique feature arise from an unusually novel viral pathogen, or does it arise from the unique, unprecedented and massive government response to the WHO declaration of a pandemic? (Rancourt 14)

All-Cause Mortality for England & Wales

[Europe] An analogous “COVID peak” occurred in the EuroMOMO hub data for Europe (Figure 6). Here again, the total number of winter-burden all-cause excess deaths for the season ending in 2020 (area above the summer baseline) is not statistically larger than for past years, and the date of declaration of the pandemic is shown by a vertical red line. What looked like a concluding and “mild” 2020 season turned into a “COVID peak” immediately after the WHO declared the pandemic. (Rancourt 14)

All-Cause Mortality for Europe

[USA] Here, again, we see that the total number of winter-burden all-cause deaths for the season ending in 2020 (area above the summer baseline) is not statistically larger than for past recent years. There is no evidence, purely in terms of number of seasonal deaths, to suggest any catastrophic event or exceptionally virulent pathogen. There was no “plague”. The winter burden, in these years, is consistently in the range of approximately 6% to 9% of total yearly all-cause mortality, and the year to year variations are typical of historic variations. On the other hand, there is again a “COVID peak. (Rancourt 15)

All-Cause Mortality for the USA

In this case, the “Covid peak” has the same features as before (Rancourt 15-16):

It is remarkably sharp or narrow, having a full-width at half-maximum of the peak, relative to the summer baseline, of approximately only 4 weeks. By comparison, the sharp peaks in the infectious seasons ending in 2015 and 2018 have such full-widths of 14 and 9 weeks, respectively.
It occurs later in the infectious season than any other large sharp peak ever seen for the USA, surging after week-11 of 2020.
Its surge occurs immediately after the WHO declared the pandemic, in perfect synchronicity, as seen in both Europe, and England and Wales, which are an ocean apart from the USA.

Peak or No Peak?

Rancourt next notes that in the case of the United States of America, the mortality curves of some states (eg New York) feature pronounced Covid peaks while those of other states (eg California) have no Covid peaks:

The NYC data makes no epidemiological sense whatsoever. The “COVID peak” here, on its face, cannot be interpreted as a normal viral respiratory disease process in a susceptible population. Local effects, such as importing patients from other jurisdictions or high densities of institutionalized or housed vulnerable people, must be in play, at least. What is also striking is that some of the largest-population states in the USA, having large numbers of measured and reported cases, and large numbers of individuals with the antibodies, do not show a “COVID peak”. (Rancourt 16)

All-Cause Mortality for California

This discrepancy is at the heart of Rancourt’s thesis:

Also, none of the seven states that did not impose a lockdown (Iowa, Nebraska, North Dakota, South Dakota, Utah, Wyoming, and Arkansas) have a “COVID peak”. The presence of a “COVID peak” is positively correlated with the share of COVID-19-assigned deaths occurring in nursing homes and assisted living facilities ... I postulate that the “COVID peak” represents an accelerated mass homicide of immune-vulnerable individuals, and individuals made more immune-vulnerable, by government and institutional actions, rather than being an epidemiological signature of a novel virus, irrespective of the degree to which the virus is novel from the perspective of viral speciation. (Rancourt 18 ... 19)

Finally, Rancourt cites several institutional documents, media reports, and scientific articles in support of his thesis. Among these are reports of elderly Covid-19 patients being transferred to nursing homes and assisted-living facilities, with disastrous consequences for the residents of those facilities. Other reports blame the widespread use of ventilators for the high mortality of Covid-19 in the initial weeks of the pandemic.

Dr Marcus de Brun

Marcus de Brun

Ireland’s all-cause mortality graph also exhibits a pronounced Covid-peak in April 2020. Was this caused by a virulent pathogen or was it the result of government policy?

Dr Marcus de Brun was a member of the Medical Council when the pandemic was first declared. In April 2020, however, he stepped down from his position in protest at the government’s failure to protect the most vulnerable members of society during the initial outbreak of the disease.

Because of his controversial stance, Dr de Brun has become a pariah in the Irish medical community. He even had to close his private practice in order to avoid being struck off for malpractice:

A Dublin GP says he has decided to close his practice after being threatened with suspension by the Medical Council over his anti-lockdown and anti-mask views on Covid-19. Dr Marcus de Brun said he decided to end his HSE contract and to step back from public speaking “under duress”, in order to avoid being struck off. Dr de Brun was a member of the Medical Council until last April, when he resigned over what he felt were failures to protect nursing home residents earlier in the pandemic. He is the third doctor to come under pressure after expressing anti-lockdown views. Dr Martin Feeley resigned as clinical director of Dublin Midlands Hospital Group last month after advocating the shielding of vulnerable groups and the lifting of general restrictions. Limerick GP Pat Morrissey was this week removed as chairman of ShannonDoc after criticising the National Public Health Emergency Team (NPHET) and saying he treats patients with hydroxychloroquine against official guidelines. Last week, Medical Council president Dr Rita Doyle wrote to Dr de Brun on foot of complaints received from other doctors after he spoke at an anti-mask rally in August.

Dr Doyle said the council was “concerned about your attendance at public events where social distancing is not observed and your public statements, whether via social media or otherwise, which would tend to undermine the regulations and guidelines published by the State in respect of the wearing of face coverings”. She stressed that “doctors must continue to advocate for their patients by actively promoting the public health guidance, especially the three core actions of hand washing, social distancing and the wearing of face coverings”. They have “a duty to ensure compliance with all laws and regulations relating to their practice”, she added. She also took issue with guidance on Dr de Brun’s website advising vulnerable patients and those over 65 to wear masks. All patients are required to wear masks, according to HSE guidelines, she pointed out. She said the council was “very concerned that you might continue to engage in events and public statements” which would undermine the State’s public health guidelines and was considering what further steps it may take, “to include considering its powers under Section 60 Medical Practitioners Act 2007”.

Section 60 provides for the suspension of a doctor “to protect the public” by way of an application to the High Court.

Dr de Brun said he was “shocked” and “amazed” to learn that the council considered him a danger to public health, but felt forced to take remedial action. “If I’m struck off, I won’t be able to practise—period.”

As well as resigning his HSE list of patients, he has shut down his Twitter account.

He said it seemed to be “okay” for the Government or Tánaiste Leo Varadkar not to follow the advice of the NPHET but this was not the case for doctors. “I’ve a family, I believe Covid-19 is real and I’ve worked in nursing homes and seen my patients die, but I don’t think they’re going about it in the right way,” said Dr de Brun, adding that he believed the Swedish approach (of lighter touch regulation combined with allowing immunity build in the population) “has some merit”. He said he planned to continue working in out-of-hours and locum positions but his income would suffer a “serious blow”. (Irish Times 8 October 2020)

Doctors de Brun, Morrissey and Feeley were all guilty of joining COVID-19 Ireland - A Scientific Approach, a group of like-minded Irish doctors promoting an evidence-based response to Covid-19. The group’s website covidrecovery.ie is no longer accessible. There was a time when people were commonly advised to seek a second opinion if they were unhappy with the medical advice they were being given. Those days, it seems are over. In post-Covid Ireland, having a second opinion can be enough to get a doctor struck off.

Shortly after he resigned from the Medical Council, Dr de Brun issued a scathing denunciation of the Irish government’s response to the declaration of a pandemic, entitled COVID-19 Mismanagement in Ireland. In this paper, de Brun does not question the fundamentals of germ theory or viral epidemiology, or the science underpinning vaccines. He accepts that Covid-19 is a contagious disease of the respiratory tract and that it is caused by a novel coronavirus SARS CoV-2. What led him to resign was the government’s decision to simply follow the advice of the WHO and implement the same “one-size-fits-all” policies that were being implemented across most of the Western World: lockdowns, stay-at-home orders, social distancing, obsessive hand-washing, surface sanitization, etc. He believes that these policies do more harm than good. The government’s response to the epidemic ought to have been tailored to the unique conditions found in the state:

To summarize, the main points of this article; are as follows. Demographic distinctions between jurisdictions need to be considered in respect of the current management strategy. Certain significant advantages may be available to a jurisdiction such as [the Republic of Ireland] with its significantly smaller at-risk population. These advantages are potentially lost in respect of a ‛one size fits all’ response.

Significant questions need to be asked in respect of the Government’s response to date, in particular, the gross overestimation of the national case burden, and subsequent actions and directives in light of these overestimations. The presence or influence of political bias must be considered and reviewed. Guidance from Public Health, the ICGP and the National Public Health Emergency Team must be held to account, and reviewed, in respect of its estimations and figures, and the mishandling of tests and testing criteria. The poor consideration of the vulnerable especially those in Nursing homes, needs to be accounted for at the highest possible level.

The constituent level and type of expertise presently advising the Government must equally be questioned. Social anxiety and its consequences must be addressed. There can be little doubt that many mistakes have been made to date. Given the cost of the crisis and the cost of the response, the most crucially lacking ingredient in respect of this crisis, may not in fact be guidelines, ‘experts’, ICU beds and resources etc. but rather a fundamental lack of questions. (de Brun)

The claim that the spike in excess mortality in April 2020 was not caused by the spread of a deadly viral contagion but was actually the direct result of government policy is far from proven. But neither can it be lightly dismissed. But do lockdowns cause deaths? That is what we will investigate in the next article in this series.

And that’s a good place to stop.

References

Marcus de Brun, COVID-19 Mismanagement in Ireland, 14 April 2020 Online, (2020)
Brendan Kennelly et al, The COVID-19 Pandemic in Ireland: An Overview of the Health Service and Economic Policy Response, Health Policy and Technology, Volume 9, Issue 4 (December 2020), Pages 419-429, Elsevier Ltd, Amsterdam (2020)
Kieran Morrissey, Ireland: Study of COVID-19 Deaths, Global Research (2021)
Denis G Rancourt, All-Cause Mortality during COVID-19: No Plague and a Likely Signature of Mass Homicide by Government Response, Research Gate (2020)

The First Wave