‘The pandemic that never was’ – Dr Nathi Mdladla breaks down the REAL reasons for excess deaths

Throughout the Covid-19 pandemic, Dr Nathi Mdladla, former Associate Professor and Chief of ICU at the Dr George Mukhari Academic Hospital and Sefako Makgatho University, has consistently stood out as a rare voice of reason. Despite the potentially career-ending risks, Dr Mdladla has admirably opted to vocalise his concerns in respect of the unprecedented and arbitrary response to Covid-19. In this article, Dr Mdladla turns his attention to excess deaths, a term which has gained notoriety by virtue of its use as a pivotal indicator of the ‘real’ impact of the virus. Dr Mdladla provides an astute breakdown of the real causes of excess deaths, plausibly refuting the global narrative that continually purports to attribute these to unaccounted for Covid-19 deaths. Dr Mdladla’s conclusion that “maximum exposure to the original Wuhan strain of SARS-CoV2 would have and could have ended the pandemic in the first wave, with the virus doing what it’s doing now as a common seasonal respiratory virus” intensifies the nagging question: how much was lost and destroyed due to the nonsensical mismanagement of Covid-19. – Nadya Swart

“Excess deaths” – a weaponised term that needs elucidating

By Dr Nathi Mdladla*

You may have come across the term “excess deaths” numerous times on social and mainstream media, and wondered what it really means. The Cambridge Dictionary describes excess mortality as,“deaths during a particular period above the usual, expected number of deaths under normal conditions, which can show the effect of something like a disease or a harmful event”. 

In Covid-19 this number has sadly been abused to exploit whatever narrative one believes in. Those who are pro-lockdown, pro-forced-masking and pro-mandatory vaccination would like to convince you that we did not do enough of these interventions and therefore this explains our high number of excess deaths as being unrecorded Covid-19 deaths. Those against the aforementioned measures will point out how these measures may explain the excess mortality numbers. Upfront, I would like to disclose that I do not for a second buy the narrative that Covid-19 is responsible for the “observed excess mortality” in South Africa. Below I share my take on this…

Do note that the definition says “something like a disease or a harmful event” could explain excess deaths. To then track and explain excess mortality, proximity to an “event” should be first priority. The next association does need a degree of deeper searching and elucidation as it requires matching exposure to the negative outcome. This is where, on the normal order of things, biases should not come in, yet they do. In my engagement with top university academics, I’m despondent that we’ll ever address this conclusively because some aligned themselves emotionally with a certain approach and left no room for discussion or at least accepting they got things wrong.

Three events have occurred in South Africa since March 2020: 

  • A hard lockdown to “flatten the curve” (which was supposed to be two weeks, but ended up being 3months)
  • Curtailment of elective consultations, diagnoses of problems and the administration of life-saving procedures/interventions 
  • Vaccine rollout and mandated vaccines in certain workplaces, institutions of learning and for sports people 

Each of these may have contributed towards excess mortality one way or another. Let’s tackle them one by one.

Excess deaths are uncounted Covid-19 deaths?  

The first reason for excess mortality I’ll label a “myth” that says the number of  excess deaths is due to Covid-19 cases that are being undercounted. This is the easiest myth to explain and dispel, especially if one has been on the frontlines. The initial wave of Covid in South Africa resulted in a shockingly low number of deaths with a positive SARS-CoV2 PCR swab, in spite of the fact that we were testing at a similar rate to the UK at the peak of that wave.

In a hospital and ICU setting, this was also easy to see and appreciate. In fact, in my hospital and ICU, for the first 3-4months of lockdown where we had no Covid-19 cases but saw enough patients dying from neglect, it made me wonder what would be the long-term consequence of lockdown, the effect of cutting back theater time and elective medical consultations. What would the consequences be in the intermediate to long-term of locking down the population, in terms of delayed treatment and intervention? The impact of conditions like delayed cancer diagnoses and heart problems would take more than 6 months to eventually emerge.

Subsequently, as we started admitting patients with a positive swab, it became clear that a significant number of these patients had something else resulting in admission and a positive swab was a coincidence in the majority. So what was really the cause of the excess mortality? These patients either presented with advanced medical problems too late and died with or without a positive swab, or died at home fearing contracting Covid in hospitals.

Real cause of  excess deaths in the 1st and 2nd waves = POOR CARE AND NEGLECT (from fear of a “deadly” virus!)

Before the vaccine era, the obvious and clear cause of excess mortality were the principles of management and advice given by the WHO and many societies around the world:

  • Isolation of those with a positive swab
  • Quarantining of contacts 
  • Closure of facilities and deep cleansing when a positive person had been in a building/facility
  • Focusing the management of positive individuals to specialist centres 
  • Countrywide lockdowns 
  • Forced NPIs (non-pharmacological interventions of masking, physical distancing and sanitizing)

The fact of the matter is that it was known and obvious from China that we were not dealing with a deadly virus, the mortality of which was out of proportion of, say, a worst influenza season. The numbers from China pointed to a mortality rate of less than 5% of “symptomatic” people who tested positive for SARS-CoV2 – this for a disease where, in that country, 85% of “symptomatic and positive” individuals had mild disease. Secondly, there were clear categories of those worst affected by the “disease” – the elderly (>70years old), those with cormobidities (especially the obese, those with a combination of diabetes and hypertension, and those with malignancies on renal replacement therapy).

From the beginning of the pandemic, this therefore called for a nuanced approach in managing the disease by individual nations with unique circumstances, meaning a cut-and-paste approach would not be applicable to all countries uniformly. Yet this is exactly what nations did, including SA!

  1. Delayed care

SA locked down at the end of summer (March 26, 2020) for a respiratory virus that predictably would not have a significant impact and escalation until June/July of that year. As per WHO and local Ministerial Advisory Committee (MAC) advice, elective consultations and interventions were to be curtailed and delayed “to flatten the curve” – initially for two weeks which became 3 months in SA and >6months elsewhere in the world. 

It was a well a appreciated fact that many people with urgent problems that would have previously been attended to timeously were not having this done from March 2020:

  • Early cancer diagnosis and treatment 
  • Early pick up of cardiovascular diseases to intervene and prevent strokes and heart attacks 
  • Diagnosis of TB and HIV – so that early treatment could be started
  • Access to clinics for tablets to treat the above two diseases that have caused the longest epidemics in this country 
  • Refusal by staff to treat patients presenting with emergencies that resembled Covid-19 (fever and respiratory distress) until a PCR result was known
  • Staff running away from those with a positive swab believing it meant instant death from exposure (often meaning remote care and management of these patients)

The combination of all the above spelled certain doom and death for those who initially presented with symptoms that could be mistaken for Covid-19. And when testing became reasonably better in the middle of the 1st wave, it did not alleviate the plight of those who would inevitably test positive but presented with problems completely unrelated to Covid-19, as the healthcare staff had been made to believe it was a deadly virus that would exterminate them and they could forgo emergency interventions until they felt safe (which was not possible).

Focusing care on highly specialised centres with ICU capabilities in a pandemic of a supposedly “highly deadly virus” is a mistake that should never be repeated. This ensured maximum stress for a few, mental and physical exhaustion for a few, and maximum anxiety and depression for a few. Nothing could be more shortsighted than this recommendation. Had the management of people with a positive PCR swab and/or Covid-19 been widely distributed in the population, with as many healthcare workers involved in the care of these patients as possible, we would have had a rested and level-headed health worker contingence available and able to deal with these patients. The health care system was never overwhelmed anywhere in the world during this pandemic, including SA. A few centres saw more than their justified fair share of patients resulting in suboptimal care of patients. 

We had learnt some lessons from SARS-1 of 2009, yet we either failed to adopt the lessons learnt or deliberately tried to forget them for the benefit of a “live human experiment on germ warfare”. What we learned from the original SARS epidemic was the impact of natural immunity from those who got infected, the uselessness and dangers of lockdowns, and the importance of early treatment. The patented expensive drugs that we stockpiled at a massive cost went unused and had to be destroyed, while the rushed vaccines to SARS had too many challenges to warrant circumspection in future. The failure of epidemiology modelling and forecast, laboratory interventions based on simulation was evident in that pandemic for all to see, yet with this pandemic we repeated these mistakes exponentially, and naturally with the expected catastrophic result which is EXCESS MORTALITY! 

  1. Inappropriate or suboptimal care 

There were many recommendations without proof or substance that gained traction and made their way into national guidelines for the management of Covid-19:

  • No use of anti-inflammatories like aspirin in the outpatient setting
  • Discouraging the use of traditional anti-flu remedies that many people previously used to either make their flu symptoms better and to limit disease progression 
  • Discouragement of early steroid use, which eventually became the norm 
  • Advising patients to test, go home and isolate if positive (while doing nothing) and come back only when out of breath or blue on the lips 
  • Avoidance of non-invasive ventilatory modalities for fear of “aerosols” that resulted in inappropriate intubation and ventilation which often resulted in mortality
  • No CPR in positive patients or suspects unless the staff was fully clad in PPE – many patients died from ventilator disconnections with staff fearful of exposing themselves!
  • DO NOT RESUSCITATE orders for certain age groups and patients with advanced comorbidities 

This was never only an ICU disease or high level care centre disease. In fact, when most guidelines and protocols were drawn, the assumption was of a deadly disease that needed ICU care in many, if not all, in spite of the mounting evidence from China, Italy, France and the UK. The disease disproportionately affected the elderly with the average age of mortality of 79 for males and 80 for females in Italy. Most patients should have, and could have been, managed in the out-of-hospital setting with old and traditional flu remedies that limit disease progression and settle symptoms. Had family members who had already been maximally exposed to the sick been instrumental in taking care of their loved ones, mortalities could have been less and treatment centres spared.

In addition to this mode of inappropriate care was the fear-mongering that encouraged isolation of the sick. It’s been known for decades of allopathic medicine that the “placebo effect” of any medical intervention resides in the positive psychological effects of believing that the intervention you have received is beneficial to you and will heal you. The estimated benefit of this effect is deemed to be around 30%, which is why there is an assumed requirement that any medical intervention must be more than 30% better than placebo to be declared effective. Yet what we did with the management of Covid-19 was to actually attack the positive brain feedback of family support, human touch and caring to ensure the maximum number of sick people died. By promoting isolation, when for most family members exposure and possible infection had already happened, we ensured that the index patient faced a certain death, alone with no support, and removed the 30% benefit of positive belief. 

What we could have done for those exposed but not sick, positive but not ill, and those recently recovered but healthy, would have been to beneficially use them in ensuring the continued care of patients that were either sick at home or requiring hospitalisation. There was never a need to close buildings and hospitals just because a positive person or contact had been there. With all these unscientific interventions, we ensured maximum fear from those capable of saving lives, reduced numbers of those who would be available to save lives and a reduced number of facilities that could save lives. 

Cause of excess deaths in the second and third waves

The original Wuhan virus really carried a low and predictable mortality, meaning “focused protection” of the vulnerable and getting on with life would have ensured maximum natural immunity gained by the majority of the less vulnerable, which would translate into high community immunity that would progressively result in significant protection for even the vulnerable. This focused protection would have to be an individual choice and respect the autonomy of those who sought it as per traditional modalities of assessing risk. This model does not assume zero mortality in all age groups but seeks to balance out the impact of the harms of total lockdown against those of the disease at hand.

In this author’s opinion, maximum exposure to the original Wuhan strain of SARS-CoV2 would have and could have ended the pandemic in the first wave, with the virus doing what it’s doing now as a common seasonal respiratory virus. The false control and reduction of numbers ensured the continuation of the existence of the vulnerable, and less community natural immunity. This is why, when one compares countries with draconian lockdowns and desperate societies like SA with a highly locked down wealthy (working from home) community against the poor (unable to work from home or physically distance) community, we see the many different waves of differing susceptibility. The poor were hard hit in the first wave with very low mortality, which made the middle class and rich feel adventurous to venture out in the festive season with no natural immunity and the second wave wreaked havoc in the middle class. The third wave coincided with the availability of vaccines and the wealthy going offshore to procure these, which saw that part of the population being bolder and coming out believing in superior protection but still with low natural immunity in the winter of 2021. 

There was ample proof of beneficial and efficacious treatments for Covid-19 as early as the first wave. But when vaccine fever grew and Big Tech realised that this was not a deadly virus to wipe out humanity at the beginning of the second wave, the natural business instincts of ensuring one profits maximally out of a crisis kicked in. Solidarity in vaccine technology dissipated instantly, the rush to come up with the first patented therapeutics also got into swing. With this came the natural survivor’s instinct of ensuring the competition was buried in the ground or at least left eating dust! The rush was on to suppress non-patented medications that held promise while sabotaging the competition of patented medicines.

As Covid-19 vaccines started being rolled out, a clear picture, even in the believers of vaccines who were ethical enough and in the frontlines, emerged. What became clear was “they were not effective against preventing infection, severe disease requiring hospitalisation or death from Covid-19”. So, if efficacy was a concern, the next concerning problem was the rate of adverse events that necessitated that, in the absence of irrefutable benefit, caution about widespread rollout to low risk groups and those where marginal benefit could be expected (like the previously infected) should have been standard. There were too many alarm bells ringing with each vaccination drive to ask for questions, yet this was taboo. There were observed immediate Covid-19 infections after vaccination, complications pointing to immune suppression after vaccination (Shingles as one example), emergence of new tumors or reactivation after remission, the emergence of accelerated coronary artery disease and heart attacks in those who had been vaccinated. There’s many more…

So what could explain the rate of excess deaths in South Africa beyond the 2nd and 3rd waves:

  • Suppression of early treatment with repurposed therapies. Actually one could argue that the uptake and off-label use of these therapies explains the low Covid-19-related deaths that we have experienced. It is the doctors that risked their reputations and lost their jobs, plus the public and patients that in desperation sought to use these that possibly accounts for low Covid-19 deaths 
  • Late presenting diseases and cancers that would  have been taken care of earlier had there not been lockdowns, and reduced attention towards these common ailments while we were focusing on one disease 
  • The consequences of the stress visited upon the population through isolation, job losses and depression, increased substance abuse, suicides and general personal health neglect
  • The media-suppressed adverse effects of the currently available vaccines that do not stop spread but are responsible for an array of emerging and known harmful effects related to thrombogenesis (clotting resulting in strokes and heart attacks), immune suppression (increasing the risk of regular infections including Covid-19, and poor cancer cell suppression resulting in new cancers and reactivation).

Omicron and beyond

A natural vaccine, some call it the disease that is not Covid-19 and should be called COVID-21/22, should have ushered in a new era of the removal of all fears around Covid-19. It should have undone all emergency measures set up for that inconsequential virus that held no worse outcomes than a worst influenza season.  

Omicron should have been a recalibration and a reset of the narrative, but we failed as we have failed in this whole entire pandemic and before. The WHO should have ended the need of all non-pharmacological interventions to intervene against this virus, required the end of all emergency use authorisations for the vaccines and new treatments, encouraged the world to open up, and for productivity to return to pre-pandemic levels with no restrictions. That countries are doing this individually due to citizen pressure or lack of trust in the official narrative is a blight and massive negative indictment on the WHO and health authorities all over the world. 

Omicron is mild for everyone, vaccinated or not… It is possibly a virus so distant to SARS-CoV2, we should not be using its cases as additions to that lineage. We need to end the fear, the interference with normal human living and the deleterious effects of repeated unnatural NPIs, that have no proven benefit but increase human suffering and mortality, now. 

The pandemic that never was ended in March 2020. Big Tech knows it! What we’ve experienced is the worst experiment on humanity possible. That world leaders and the WHO allowed and abated it is the point of discussion that will go on for decades. The question is “how long are the abaters willing to align themselves with this false narrative” before the inevitable equivalent of the Nuremberg Trials begins? 

*Dr Nathi Mdladla is the former Associate Professor and Chief of ICU at the Dr George Mukhari Academic Hospital and Sefako Makgatho University. He has worked on the creation of the Gauteng Province Covid-19 ICU Guidelines that informed the national guidelines. He has been the site principal investigator on two pivotal trials on Covid-19 in South Africa – the WHO’s SOLIDARITY Trial that looked at repurposed therapies – and the African Covid-19 Critical Care Outcomes Study (ACCOS) which looked at factors affecting outcomes in Covid-19. He has been a commentator and constant contributor on meaningful strategies to improve health care in South Africa, with a recent focus on the impact of SA’s strategies in managing the Covid-19 pandemic. He has sat on one of the workstreams of the Covid-19 Vaccine-MAC on vaccine rollout and has presented and shared opinions to the Gauteng Covid-19 Advisory Committee on his critical take on the various interventions recommended. He is currently a Cardiac Anaesthetist in private practice who is still passionate about the factors that influence the trajectory of SA’s future beyond Covid-19.

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