COVID – why terminology really, really matters, by Dr. Malcolm Kendrick

You can’t get the coronavirus science and the coronavirus story straight if you don’t understand the terminology. From Dr. Malcolm Kendrick at

When is a case not a case?

Since the start of the COVID pandemic I have watched almost everyone get mission critical things wrong. In some ways this is not surprising. Medical terminology is horribly imprecise, and often poorly understood. In calmer times such things are only of interest to research geeks like me. Were they talking about CVD, or CHD?

However, right now, it really, really, matters. Specifically, with regards to the term COVID ‘cases.’

Every day we are informed of a worrying rise in COVID cases in country after country, region after region, city after city. Portugal, France, Leicester, Bolton. Panic, lockdown, quarantine. In France the number of reported cases is now as high as it was at the peak of the epidemic. Over 5,000, on the first of September.

But what does this actually mean? Just to keep the focus on France for a moment. On March 26th, just before their deaths peaked, there were 3,900  ‘cases’. Fourteen days later, there were 1,400 deaths. So, using a widely accepted figure, which is a delay of around two weeks between diagnoses and death, 36% of cases died.

In stark contrast, on August 16th, there were 3,000 cases. Fourteen days later there were 26 deaths.  Which means that, in March, 36% of ‘cases’ died. In August 0.8% of ‘cases’ died. This, in turn, means that COVID was 45 times as deadly in March, as it was in August?

This seems extremely unlikely. In fact, it is so unlikely that it is, in fact, complete rubbish. What we have is a combination of nonsense figures which, added together, create nonsense squared. Or nonsense to the power ten.

To start with, we have the mangling of the concept of a ‘case’.

Previously, in the world of infectious diseases, it has been accepted that a ‘case’ represents someone with symptoms, usually severe symptoms, usually severe enough to be admitted to hospital. Here, from Wikipedia…. yes, I know, but on this sort of stuff they are a good resource.

‘In epidemiology, a case fatality rate (CFR) — sometimes called case fatality risk or disease lethality — is the proportion of deaths from a certain disease compared to the total number of symptomatic people diagnosed with the disease.’ 1

Note the word symptomatic i.e. someone with symptoms.

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