Unsupported: The claim that PCR diagnostic tests generate a lot of false positives is vague. Assuming that the claim refers to the proportion of false positives among positive results, key parameters such as the type of test and the virus prevalence would be necessary to support the claim, yet they are not presented.
BEHAUPTUNG: COVID-19 is a type of flu and is not a pandemic; PCR tests are up to 94% false positive; only 98 COVID-19 related deaths have been reported in Ireland.
REVIEW
A video showing a press conference from a group calling itself World Doctors Alliance circulated on social media in mid-October 2020, receiving hundreds of thousands of views on YouTube. Among some of the speakers at this conference was Elke De Klerk, the founder of another group named Doctors for Truth. In this conference, De Klerk and other individuals made claims about the COVID-19 pandemic, the nature of the virus, as well as diagnostic tests for the disease which are inaccurate and unsupported, as Health Feedback explains below.
Claim 1 (Imprecise): “We do not have a medical pandemic or epidemic”
A pandemic is generally defined as the worldwide spread of an epidemic, which is the occurrence in a community or region of cases of an illness or health related event clearly in excess of normal expectancy. Contrary to what may be a common assumption, the classification of a disease as a pandemic is not related to the severity of the disease. Rather, the term is reserved for a simultaneous worldwide propagation of a disease. Indeed, the classical definition of a pandemic is “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.”
In addition, the WHO’s definition of a pandemic also includes the aspect of disease novelty, considering a pandemic as “the worldwide spread of a new disease.” On 11 March 2020, the Director-General of the World Health Organization officially declared that COVID-19 was a pandemic based on the observation that it was due to a novel virus and had already caused 118,000 cases in 114 countries by then. As of October 2020, WHO reported 37 million cases and 1 million deaths. The geographical distribution of COVID-19 shows that all the regions of the world are affected, albeit to different extents, justifying its qualification as a pandemic.
In addition to its worldwide spread, COVID-19 has also caused a marked increase in mortality in multiple geographical regions. The comparison of the number of deaths from all causes in 2020 with the average mortality of the previous years demonstrates the presence of excess death in 2020 in countries as diverse as Ecuador, Britain, and Russia. Therefore, it is inaccurate to claim that the current situation does not qualify as a pandemic.
Claim 2 (Inaccurate): COVID-19 is “a normal flu virus”
The claim that SARS-CoV-2 is a type of flu virus is inaccurate. As Health Feedback previously explained, both the flu and COVID-19 are viral respiratory infections, but are caused by two completely different viruses from two separate families of viruses. The virus responsible for COVID-19 is SARS-CoV-2[1]. Similar to living things, viruses are classified based on a system of biological taxonomy, which contains multiple ranks or levels, named Domain, Kingdom, Phylum, Class, Order, Family, Genus, Species, and Strain. SARS-CoV-2 belongs to the family of viruses named Coronaviridae, to the genus—which is a further subdivision of the Betacoronavirus family, and to the subgenus Sarbecovirus. It is the same classification as SARS-CoV-1, which was responsible for the 2003-2005 SARS outbreaks. Like the other members of Coronaviridae, the genome of SARS-CoV-2 contains a single strand of RNA.
On the other hand, flu is caused by four genera of influenza viruses: Alphainfluenzavirus, Betainfluenzavirus, Deltainfluenzavirus, and Gammainfluenzavirus, all belonging to the family Orthomyxoviridae. Their genome is also made of RNA, but as opposed to the Coronaviridae family, it is not single-stranded. Instead, it is segmented into separate strands. These features altogether demonstrate that SARS-CoV-2 is not a strain of influenza and COVID-19 is not a type of flu.
In addition, the flu and COVID-19 differ in the type or duration of symptoms and the category of people at risk as explained by the U.S. Centers for Disease Control and Prevention (CDC). For instance, loss of smell or taste has been associated with COVID-19 whereas it is not a symptom of flu. Therefore, it is both virologically and clinically inaccurate to describe COVID-19 as a type of flu.
Claim 3 (Unsupported): “89% to 94% of those PCR tests are false positives. They don’t test for COVID-19. The rest [are] false negative[s].”
This claim refers to the diagnostic tests based on the real-time polymerase chain reaction (RT-PCR) technology that detects the presence of the genetic material of SARS-CoV-2 in a person’s tissues or fluids. In the video, the comments of the speaker, Elke de Klerk, refer more specifically to the situation in the Netherlands. De Klerk alleges that those tests are unreliable because they either present false positive or false negative results. A false positive result occurs when the test reports the presence of SARS-CoV-2 in an uninfected person. Conversely, a false negative result occurs when the test reports the absence of SARS-CoV-2 when the person was indeed infected.
De Klerk’s declaration is vague and could be interpreted in different ways. First, it could mean that 89% to 94% of all diagnostic tests performed in the Netherlands returned false positive results.
This is inaccurate. In fact, if this claim were true, we would be able to see this high rate of positive results reflected in the positivity rate in the Netherlands—the percentage of tests returning a positive result—which would be at least 89% to 94%, regardless of whether the tests are true or false positives. However, the National Institute of Public Health and the Environment of the Netherlands reports that the percentage of positive tests in October 2020 is around 10% to 13%, far away from the 89% to 94% that we would expect if the video’s claim were accurate.
Another interpretation of De Klerk’s claim is that 89% to 94% of all positive tests are in fact false positives. To assess the likelihood that a positive test is a true positive, a parameter called the positive predictive value of the test can be used. A high positive predictive value indicates that there is a high chance that a person with a positive diagnostic test is indeed infected. Conversely, a low positive predictive value indicates that the test is not very reliable as there is a high chance that the result is a false positive.
The positive predictive value depends on the characteristics of the test. In addition, the positive predictive value of a given test changes depending on the prevalence of the disease, which is the proportion of infected people in a population. Indeed, the CDC indicates that the positive predictive value of a given test decreases when the disease prevalence is low. In summary, it is not possible to make claims about the positive predictive value of a test without considering the type of test and the estimated prevalence of the disease. Yet De Klerk does not present this data, thus her claim remains unsupported.
Claim 4 (Inaccurate): “Up until April 2020 there was zero death [from COVID-19 in Ireland]”; “In the whole country in 2020 we have 98 deaths [from COVID-19]“
A second speaker, Dolores Cahill, who has shared misinformation about COVID-19 in the past, claims that the first COVID-19 related death in Ireland occurred in April 2020. According to Cahill, these are official statistics from the Central Statistics Office (CSO) of Ireland. However, the CSO of Ireland indicates that the first officially recorded death was on 11 March 2020. And between 11 March to 15 May 2020, there were 1,287 confirmed and 231 suspected deaths due to COVID-19. As of October 2020, 1,801 deaths from COVID-19 have been registered in Ireland, based on data from the CSO. The aforementioned claims regarding the COVID-19 death toll in Ireland are thus inaccurate.
In summary, the press conference relayed by the video compiled several inaccurate and unsupported claims. COVID-19 is a pandemic and has hit many countries in the world, leading to an excess of deaths in 2020. This Nature news article reports that for a subset of 32 countries with reliable mortality reporting systems, there were 600,000 excess deaths by the end of July 2020. COVID-19 is not the flu, as both diseases are caused by viruses from entirely different families and produce medically distinct diseases. In addition, the group presents no evidence to support the allegations that the PCR diagnostic tests for COVID-19 are generating mostly false positives. Finally, the number of deaths from COVID-19 in Ireland reported in the video does not match the country’s official data.
REFERENCES
- 1 – Coronaviridae Study Group of the International Committee on Taxonomy of Viruses (2020) The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiology.
