26 June A tale of three countries and one city

Fri, 06/26/2020 - 14:29
  1. A very thorough analysis of COVID-related death in Belgium by Niels Hens, showing in precise numbers what we already suspected.
  • The Sciensano registration of mortality (including the non-confirmed, but suspected COVID deaths) is very accurate as compared to total over-mortality.
  • April 2020 is the “deadliest” month since World War 2.
  • Overall “infection-related mortality” is around 1 %, but there are huge differences according to age and residence in nursing homes.

Everything in nice graphs, ready for a morbid presentation!

  1. SARS-CoV-2 diagnoses in Sweden (9 million people) now have surpassed Belgium (11.5 million), despite the fact that they did less testing (!).  Mortality in Sweden is still lower, but did they include the “suspected” cases?  Seroprevalence at end of May restricted to 6 %.


Please find a nice (an frightening) study on the potential susceptibility of the entire Swedish population to severe COVID.  Two million (22 %) have at least 1 “bad” prognostic factor; 150,000 (1.6 %) have 3 combined.  Very worrisome with an epidemic that is still NOT going done.


Recipe for disaster: count on “herd immunity”!


  1. The bright side is on the opposite side of the world: New Zealand (4.8 million inhabitants): they have 1519 infections, 2 deaths and the virus is gone!


Recipe for success: see p. 12 

  1. Border controls with high-quality quarantine of incoming travellers;

2.    Rapid case detection identified by widespread testing, followed by rapid case isolation, with swift contact tracing and quarantine for contacts;

3.    Intensive hygiene promotion (cough etiquette and hand washing) and provision of hand hygiene facilities in public settings; 

4.   Intensive physical distancing, currently implemented as a lockdown (level 4 alert) that includes school and workplace closure, movement and travel restrictions, and stringent measures to reduce contact in public spaces, with potential to relax these measures if elimination is working;

5.   A well-coordinated communication strategy to inform the public about control measures and about what to do if they become unwell, and to reinforce important health promotion messages.  


(This dates from April 3th: now everything is much more relaxed).


Obviously, New Zealand is a far-away island and they had some more time, but yet, what we know for sure now: the virus is quick and you have to stay one step ahead. 



  1. Although Switzerland as a country did not have a heavy epidemic (3660 infections ands 226 deaths per million as of today versus 5260 and 840 in Belgium and 6325 and 520 in Sweden), the Geneva canton (500,000 inhabitants) was hit early with over 5000 confirmed cases (hence > 10,000 per million) already at the end of April.  As can be seen in Fig 1 p. 9, most diagnoses were made in the second half of March already. A seroprevalence study during April shows a nice increase from 3 to almost 10 %, with most infection in children and young adults (Table 1 p. 10).  Clearly, these simple data emphasize:
  • That the real number of infections is about 10 X higher than the confirmed diagnoses. 
  • That, even at high infection rates, disasters (massive spread, high mortality) can be prevented if health and political authorities as well as the population are well organized and disciplined. 
  • The question about the role of children in the epidemic is raised once more.


Best wishes,