Deaths with (not of) coronavirus

No, not that coronavirus

Jan 31, 2022

Over the past two years we have been regularly reminded of impact of covid via statistics of deaths with covid. Now, each death will be a tragedy, and many deaths will be because of covid — but in practical terms what does deaths with tell you?

But I’m not going to talk about covid; the authorities have been very careful to not collect data properly, resulting in the ludicrous position where people don’t actually know who died with covid and who died from.

So, instead I’m going to talk about coronavirus OC43. For those who don’t know, the common cold is caused by a number of viruses, including rhinovirus, adenovirus, human respiratory syncytial virus, parainfluenza viruses, human metapneumovirus and, yes, coronavirus. The most common cause is rhinovirus, but coronaviruses are responsible for approximately 1 in every 5 infections of the common cold, and of these coronavirus infections, a majority are caused by the OC43 subtype, with three other subtypes causing the rest of the infections (covid-19 will undoubtedly become the fifth endemic human coronavirus).

I selected OC43 out of the coronavirus subtypes on purpose. There is considerable evidence that human OC43 didn’t exist before 1889. Up until that time what was to become OC43 was bovine coronavirus, which is a endemic virus of cattle to this day. The evidence suggests that at some point it infected an animal which also had an infection with porcine hemagglutinating encephalomyelitis virus, causing a recombination, or mixing between the two virus’s RNA. This rapidly found that it was particularly good at infecting humans, and the result was the 1889 -1891 Russian flu epidemic. Note that it was called an influenza back then, but we now suspect that it was the first emergence of coronavirus OC43 into the world.

The 1889-91 epidemic was very much like our covid-19 pandemic — a disease that caused a moderately high number of deaths compared with the usual winter respiratory viruses. After the two years of the epidemic the impact of the disease more or less disappeared. At the time people thought it was because the disease went away, but we know know that what probably happened is that the virus mutated to become less pathogenic, and became just another cause of the common cold. In addition, the immune system of those recovered from an OC43 infection offered a long term protection from serious symptomatic disease; as the years went by young people got their first infection with OC43 and the immunity developed protected them from serious disease later in their life. As an aside, the human immune system doesn’t seem to even try to develop long term immunity to coronaviruses — instead, it seems content to simply allow regular reinfection and just have protection from serious symptomatic disease. It is possible that this is done via an immunological tolerance mechanism — that is, it seems that the immune system learns to tolerate coronavirus rather than eliminate it. Quite why the immune system prefers to take this approach to coronavirus (and some other upper respiratory tract infections) remains unanswered.

Anyway that leads me back to the point of this post: we’re now over 130 years after that first emergence of OC43 — how many people die with OC43 every year?

Well, the evidence is that people get infected with coronaviruses once to twice every year, and that they get repeat infections with each sub-type on average every two years. Like most upper respiratory tract infections, OC43 is seasonal, with most infections during the winter — but most deaths are during the winter, so I’m going to assume that the seasonal factor ‘just averages out’. In the years before covid approximately 550,000 to 600,000 people died every year in the UK — let’s call it 575,000 a year for the calculation.

We’ll do the calculation using the above data along with the assumption that deaths with occur within 28 days of an OC43 infection, which would be the equivalent of within 28 days of a positive test, if people were being tested for OC43 all the time and most certainly every time they entered hospital (which is where most people die).

That gives an annual death rate in the UK ‘with OC43’ of: 22,000 deaths a year.

In recent months the UK has been keen to report ‘deaths within 60 days’ — using 60 days would give a death rate with OC43 of almost 50,000 a year.

I suggest that once covid-19 becomes a fairly harmless virus that’s ‘just another cause of the common cold’ we might expect to see around 20,000 to 25,000 deaths in the UK every year with covid. Well, that’s if they bother to keep on testing.

In the above I’ve only discussed deaths with. What about deaths of?

In general we think of ‘the common cold’ as a benign disease, however it is implicated as being the cause of a large proportion of cases of ARDS in the UK every year. This is a severe auto-immune disease related to sepsis that’s responsible for over 10% of ICU cases and approximately 25,000 deaths in the UK every year (although it is an under-reported condition, so it might be more).

ARDS is essentially the disease that puts those infected with covid-19 into ICU. How many people before 2020 were put into ICU directly as a result of having a ‘cold’ — we just don’t know, but it won’t be zero. Perhaps someone should do this research.