Public Health

What the NHS can learn from Germany’s Hospital System

Post-Coronavirus, the UK should not shy away from debate over the NHS, and how to achieve better patient outcomes, argues Fred Roeder

When contrasting how countries around the world are coping with COVID-19, over the past few weeks one country has stood out. Germany’s health system has received regular praise for its resilience in facing the COVID-19 pandemic, but what are they doing right?

Germany is one of the most affected countries in Europe but the mortality rates are significantly lower than in most other European countries dealing with the coronavirus. Germany’s capacity to test widely and early has definitely contributed to this but an often underappreciated factor is its very competitive, modern, and often private hospital system.

While the UK currently has fewer confirmed COVID-19 cases, this is probably due to the lack of testing capacities of the NHS, the more interesting and shocking number is that the death rate per 1 million people is four times higher in the United Kingdom compared to Germany. Germany’s mainly private and decentralized testing infrastructure happens mostly outside of hospitals, in private laboratories, and has enabled Germany to conduct as many as 150,000 tests per week. To put that in comparison, the UK has managed less than 10,000 a day so far.

Being the relative of an NHS patient, I had to assist her to go through its byzantine and centralized testing regime, even for simple blood samples. GPs send patients to hospitals just to get their blood taken and analysed. Scaling up such a centralized testing system allows no mistakes to be made. A decentralized and independent system however allows for some parts in the chain to fail and the other still to perform, and crucially allows room for innovation.

Merely 28% of the roughly 1,950 hospitals that participate in Germany’s universal health system are owned by the government. 37% are private for profit hospitals that treat patients covered by the public health insurances and receive the same amount of reimbursement per case as the public ones or the 34% that are operated by churches and other charities. Despite charging the same as government hospitals private for-profit hospitals have the highest investment per case (about 64% higher than public hospitals), which leads to more state-of-the-art treatment and newer medical equipment.

It is also very interesting to look at how private hospitals perform better compared to government hospitals in Germany. Within the first four years one can observe an increase in efficiency of between 3.2% and 5.4% above those hospitals that had not been privatised. Despite its mainly private character Germany has nearly three times as many beds per 100,000 people compared to the UK. It gets even worse when looking at intensive care beds per 100,000. Germany has over 4 times the intensive care capacity compared to the NHS. In recent weeks Germany added another 40% additional capacity to its already high intensive care beds. This number is not reflected in the comparison.

Given that we are currently facing a massive pandemic it is shocking to see how poorly prepared the centralized NHS was, from a lack of protective equipment for clinicians, to its failure to prepare for mass testing. While the hard work of individuals within the health service has done what seemed impossible only weeks ago, and has prepared the NHS to cope with coronavirus, structural issues remain.

A pluralistic hospital system that endorses competition and patient choice such as the German one seems to be in a much better position to cope with potentially tens of thousands of severe COVID-19 cases.

Yes, also in this comparatively better German hospital system patients die and doctors contract COVID-19. Healthcare workers in Germany are also overwhelmed with the amount of cases and patients. But overall it looks like Germany can endure and face this wave in a much more prepared and resilient fashion compared to the NHS which is still facing huge problems mastering this mammoth task.

After we are all through with this we should not shy away from a debate if it’s not time to open up bigger parts of the NHS hospital systems, allow competition and make the health of British patients a priority.

Originally published here.


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

Testing – not lockdowns – may explain why some countries handle Covid-19 better

This is a post by a Guest Author
Disclaimer: The author’s views are entirely his or her own, and don’t necessarily reflect the opinions of the Consumer Choice Center.


There are ongoing debates about who has been better handling the Covid-19 pandemic: testing or lockdown?

Covid-19

With so many people confined to their homes, passions are running high, and there are ongoing debates about who has been better handling the Covid-19 pandemic. So much so that it feels like comparing and contrasting countries and their trajectories has become sort of a global pastime.

Nearly all developed countries (and others) have put their populations under severe lockdowns and emphasized social distancing as the silver bullet against the spread of the virus. Sweden, however, has recently been castigated for failing to put its population under a lockdown like every other country, especially other Nordic countries which it is compared and contrasted against. 

The problem is that it is quite hard to compare the performance of two randomly selected countries. For instance, on every level Norway seems to be doing much better than Sweden. That said, one can always find a bunch of other countries that are doing much worse despite having been under lockdown for some time.

It should be noted that Sweden has made some questionable decisions, regardless of social distancing. It failed to ramp up testing with increasing cases around March 20, and it only closed its nursing homes for visits in early April.

But aren’t lockdowns clearly working? 

Many people have still argued that lockdowns are clearly working because the epidemic has slowed shortly after their imposition. However, it is important that we are careful when inferring that lockdowns were responsible for the decline. There may be a correlation between the two, but as everyone should know, correlation does not necessarily mean causation, and there may be other intervening variables. It is vital that we not jump to conclusions too fast. While many people believe, and many epidemiological models assume, that unchecked epidemics just grow exponentially until more than half of the population gets infected, the evidence for Covid-19 increasingly suggests otherwise. 

Several research papers (e.g. here and here) argued that the dynamics of the Covid-19 pandemic are well-described by exponential functions only at the early stage, after which so-called power-law functions are a much better fit. A detailed study of the outbreak in the initially hit communes in Lombardy also suggests that in each commune, it started slowly, then briefly became exponential and then slowed, all that before any significant intervention.

To help you better understand what the mathematical jargon above means and why it is so important, consider two simple functions, y=2x and y=x2. The first function is exponential and the second function is a power-law one. You will better see the crucial difference between them if they are plotted together.

If these functions were describing an epidemic, then the x-axis would mean rounds of transmission. In the beginning there is one infected person in both cases. Then, until the fifth round the functions seem to grow in at an almost similar speed but afterwards, they diverge dramatically.

When researchers talk about an epidemic growing first exponentially and then in accordance with a power law, they mean that the growth of the epidemic looks like the hybrid function (first, y=2x and y=x2 after round 5) below. Its growth clearly slows a lot after the fifth round.

Why could an epidemic grow exponentially, first, and then slow down on its own? Here, it is important to remember that real societies are complex. Instead of interacting with random people every now and then, people tend to form groups (or clusters, in scientific terminology) and live in local areas within which interactions are much more intense than outside of them. With obvious implications for infection transmission.

What probably changes at the early stage of the epidemic is that so-called superspreader events are much likelier. Such events, where single infected people spread the virus to scores, hundreds or even thousands of people, have clearly played an enormous role in Covid-19. It is enough to mention the Shincheonji Church of Jesus in South Korea, the tragic gathering of French catholics in Mulhouse and the first coronavirus-hit hospitals in Lombardy. At these events, infected people have an opportunity to spread the virus way beyond their clusters of interactions.

After the initial stage, when everyone becomes aware that the epidemic is in the community and significant events are cancelled, the infection may get increasingly isolated within clusters, first, grow slower and then start falling off. The available data is increasingly hinting at this process in play. In Italy, cases appear to have peaked on the day the national lockdown was announced. In the US, they appear to have peaked on March 20.  

Lockdowns could even be counterproductive

A more speculative but still plausible idea is that lockdowns could, in fact, not merely coincide with the slowing-down of Covid-19 without causing it but actually create more damage than they prevent.

Many people believe that if some social distancing (like closing bars or canceling events) is desirable than extreme social distancing like lockdowns that keeps most people at home most of the time must be even more beneficial. However, this potentially ignores two important facts about Covid-19 and viral diseases in general.

First, it is abundantly clear that Covid-19 overwhelmingly spreads in closed, often poorly ventilated spaces and through close contacts. Secondly, as Robin Hanson convincingly argued, there is a wealth of evidence that the severity of viral disease depends on the viral dose received. This means that if families are forced to stay at home together all the time, this may create perfect conditions for the virus to spread and especially cause severe disease.

The data from Google about actual social distancing patterns in several countries hit by Covid-19 shows that Italy, Spain and France have had by far the most extreme social distancing, and the UK was starting to catch up with them after its lockdown. Yet, these four countries have some of the highest fatality rates in the world per population and detected cases.    

Could testing explain things better?

A better way to try to make sense of the causation is to try to identify a bunch of countries that have something important in common. The most important thing in any epidemic is to minimize deaths, and there is a group of countries that seem to have far fewer deaths by population size, and per identified infections, than others. These countries include Iceland, Germany, South Korea, Taiwan, Austria, and Norway. You can see how low their case fatality rates are compared to other countries with a lot of cases here (see the “death rates” column).

What makes those countries succeed in driving down deaths? One would actually be surprised to learn that none of these countries is, or was, under total lockdown. South Korea hasn’t even closed bars and restaurants. This shows that extreme social distancing measures are not necessarily the best explanation.

The real answer may largely lie in how many tests those countries have been doing compared to others. Testing may reduce fatality rates by giving public health responders valuable information and helping to isolate and quarantine those that carry the virus before they spread it to vulnerable groups like the elderly.

Iceland is the absolute champion at testing. It has already conducted 28,992 tests, which is more than 8% of its entire population. It also has the world’s lowest case fatality rate from Covid-19 at 0.38%. Iceland isn’t an anomaly, and using Iceland as an example isn’t cherry picking. Researchers Sinha, Sengupta and Ghosal showed that country death rates from Covid-19 are significantly correlated with the intensity of testing. They did not, however, control for the potential impact of lockdowns and other stringent social distancing measures.

Testing and outcomes by region

In addition to national data, one can also look at regional data where it is available and see if the testing/fatality relationship still holds. Italy has been publishing detailed regional statistics on Covid-19 starting from February 24. If we plot tests per confirmed cases in each region with reported fatalities per million inhabitants, we get the following picture:

The chart surprisingly shows us that Italy’s worst hit region isn’t Lombardy, and that it is actually the little-known Aosta Valley. We also see that there is a clear negative relationship between the intensity of testing and fatality rates. In fact, the former seems to explain more than half of the variation in the latter, and the regression coefficient is statistically significant (the p-value is 0.0003).

To conclude, it will take a long time and careful research to sort out why some countries and regions have gone through the Covid-19 pandemic much less damaged than others. That said, one thing seems to be increasingly clear. When the dust settles it will be clear that testing will be a significant factor, and that the importance of social distancing will be diminished. 

Guest Author: Daniil Gorbatenko


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

Il Sistema Lombardo Funziona

Nelle ultime settimane la gestione dell’emergenza in Lombardia è stata oggetto di grande dibattito. Le critiche maggiori sono state rivolte al sistema sanitario regionale. Gli aspetti problematici potrebbero, però, risiedere altrove e le cause di una gestione non ottimale andrebbero ricercate più a fondo.


PERCHÈ È IMPORTANTE?   Una polemica oramai quotidiana riguarda il ruolo della sanità privata, soprattutto in Lombardia, e di come il sistema di cooperazione tra strutture pubbliche e private avrebbe fallito. Proviamo a capire se veramente è il sistema sanitario lombardo a non aver funzionato oppure qualcosa d’altro.

LA RIFORMA   La sanità privata è figlia di una riforma voluta dall’allora maggioranza di centrodestra guidata dal Presidente Roberto Formigoni, che pose erogatori privati e pubblici sullo stesso piano, purché il sistema rimanesse universale (tutti i cittadini hanno accesso alle cure nello stesso modo) e solidale (le prestazioni sono pagate dalla fiscalità generale e non direttamente dal singolo paziente).

Per il paziente nulla cambia, ci si può rivolgere agli ospedali pubblici o privati senza distinzione. Al contrario, secondo i dati ANGES – Regione Lombardia del 2018, gli ospedali lombardi sono parimenti nei primi 10 ospedali italiani, come per esempio il San Raffaele di Milano, il San Matteo di Pavia, l’Istituto dei Tumori di Milano e il Papa Giovanni XXIII di Bergamo.

INVESTIMENTI E RICERCA   Inoltre andrebbe considerato che questa competizione tra pubblico e privato ha fatto sì che la spesa sanitaria privata e pubblica dedicata alla ricerca e alla cura della persona crescesse di quasi il 28% annuo (dati UniBocconi), creando centri di eccellenza riconosciuti in tutto il mondo, sia privati sia pubblici, come ad esempio gli Spedali Civili di Brescia, il Gruppo San Donato, Humanitas e tanti altri.

Questo è un tempo di emergenza, come dimostrano le parole di medici ed operatori sanitari che parlano di una vera e propria guerra, guerra nella quale combattono a nostra difesa sia operatori privati sia operatori pubblici.

Gli operatori privati si sono impegnati a mettere a disposizione il proprio personale sanitario nelle strutture pubbliche, nonché le loro stesse strutture. Regione Lombardia ha riorganizzato la rete ospedaliera creando hub specializzati divisi per patologia e prestazione sanitaria, al fine di liberare posti per pazienti COVID-19.

IL PRIVATO FUNZIONA?   Se tutto questo è stato possibile lo si deve anche alla capacità della sanità privata di riorganizzarsi in tempi brevissimi per poter ospitare il maggior numero di pazienti provenienti dalle strutture pubbliche sommerse dall’ondata di pazienti affetti da Coronavirus, spesso fatto senza attingere a risorse pubbliche, come dimostra il nuovo reparto di terapia intensiva realizzato con donazioni private al San Raffaele di Milano. Ovviamente, la sanità privata è in prima linea anche nella gestione diretta di pazienti COVID lombardi, con circa il 30% di quest’ultimi ospitato presso strutture private.

COME LA COREA DEL SUD   Se il sistema è andato in tilt non è per colpa della competizione pubblico privato, la quale ha fatto sì che i lombardi potessero ancora usufruire di cure ospedaliere di qualità, grazie alla maggiore flessibilità della quale l’erogatore privato è portatore. Ad ulteriore prova dell’assoluta bontà dell’apporto privato nella gestione della crisi dovuta al Coronavirus, andrebbe ricordato che il sistema sud-coreano, portato da molti come modello, è costituto per la grande parte da operatori sanitari privati, e dove la ripartizione della spesa sanitaria tra pubblico e privato è quasi paritetica.

Purtroppo, restano le migliaia di morti e quindi la necessità di porsi una domanda: perché la politica lombarda non ha attuato una strategia di contenimento e di prevenzione come quella veneta, fondata su un intervento di test preventivi, che è risultata più efficace? Se finora non lo si è attuato, perché, alla luce degli evidenti risultati, ora non si procede in questa direzione?


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

What we should be thankful for: A CORONA SELF HELP GUIDE

The last couple of weeks were probably some of the strangest times in most of our lives. Only few of us have seen such a massive restriction of travel and social life prior to the coronavirus. Even as an aviation geek and frequent traveler, the grounding of entire fleets of planes is something I haven’t even seen in the aftermath of 9/11.

Physical business meetings, conferences, or sports events seem to be off for at least the next six to eight weeks. It is probably only a matter of time until most countries close down gyms and pubs. This will not only be a challenge for the economy but also for our social lives. Keeping up morale and mental health will be important and I figured out that regular but very casual video chats with friends and colleagues (over a drink) can help a lot to ease the anxieties built up by media hysteria and the feeling of not being in control of the situation (helplessness).

So while we are all trying to adjust to a new reality for the next 6-10 weeks there are also reasons why I am very happy that this crisis happens in 2020 and not in 2000. There are many innovations that happened in this new millennium we should be extremely thankful for.

First and foremost we should of course be thankful for all the nurses and doctors helping patients at the frontlines of the outbreak. This will be some challenging months for all healthcare professionals and they should receive all necessary support.

And before diving into medical innovation and the search for a vaccine let’s look who else is helping us to social distance, self-isolate, and flatten the curve.

Remote working tools such as Zoom, Asana, or Google Suite have already revolutionized the workplace. Most meetings can be switched to a video call. So at least the knowledge economy or advocacy jobs such ours can still keep being productive. But obviously there’s also life beyond work and that needs to be taken care of (including child care).

Thanks to grocery delivery services such AmazonFresh and Ocado I was able to build up a good amount of supplies of canned and dried foods and bathroom supplies even without having to fight for the last products in some nearly empty supermarkets. For the next few weeks we have regular deliveries of fresh foods so I won’t run fully on Mac n Cheese until corona is defeated. 

Food delivery services make it even easier to work from home, still create value, and being fed by Papa John’s, Nando’s, or our local Indian restaurant. Domino’s Pizza went even further and just sent me an email announcing ‘Contact Free Delivery’ in the UK and Ireland:

“By introducing Contact Free Delivery, we believe that we will give our customers peace of mind when ordering a Domino’s, while also protecting our delivery drivers.

You can select a Contact Free Delivery at the checkout on our app or website when placing your order. Your driver will call you when they arrive to agree where you want your food left. Once the order has been placed in the agreed location, the driver will stay at least two meters away while you collect your order.  To ensure the service is truly contact free, all Contact Free Delivery orders must be pre-paid online or over the phone.”

Having taken care of all the pizza and toilet paper I need for the foreseeable future it is now time to look at what entertainment needs will be important. Netflix and Amazon stream directly into my living and as my colleague Maria pointed out “It’s a plague with WiFi”. So no need to go to the defunct video rental store but be excited to stream all seasons of Buffy (and if this goes longer than expected even Angel) directly into your home.

My gym just emailed me that they had a case of COVID-19 and they are currently shut down for deep cleaning. Good that Kelli and Daniel of Fitness Blender have over 500 free workout videos on YouTube. Get your Yoga Mats out!

But there’s only so much of Buffy and HIIT you can take a day. Fortunately video games (which I haven’t paid attention to for a long time) are now mainly also being streamed or downloaded. My social media friends recommended me Red Dead Redemption 2, The Witcher 3, and Europa Universalis IV (probably too complicated for me). So I think we are all set here as well!

Now to one of the greatest inventions of the past decades: Online pharmacies! Coming from Germany and having worked in health policy I am always puzzled how much vested interest fights against online pharmacies and e-prescriptions. In times of self-isolation and social distancing these two words sound like music to my ears. 

I was able to reorder and stock up all sorts of prescription only drugs such as asthma medicine, proton pump inhibitors, and antibiotics without even leaving my flat – and all of this LEGALLY (disclaimer: I do have asthma)! You just have an online consultation with a doctor or take a quiz and receive an electronic prescription. This is definitely a massive relief on the already challenged health system as patients don’t flood clinics just to ask for prescriptions and pharmacists can focus on producing more sanitizers.

Most of these above mentioned services and companies did not even exist two decades ago. Thanks to innovation and competition entrepreneurs carved out these new ways of servicing customers. This is amazing and while it might have been a mere gimmick some weeks ago, everything from videoconferencing to electronic prescriptions makes this crisis much more manageable. We should be thankful for that!

Obviously there are vulnerable groups and many people will suffer heavily from the virus. That’s why we need more innovation. There’s already a race to the first vaccine and other pharmaceutical companies are working on repurposing antivirals that are being used for instance in fighting the Ebola Virus. Some studies suggest that certain Malaria medication might be helpful to boost the immune system of severely sick corona patients. These are often recently discovered drugs that require a lot of time and capital to be developed. 

We should be thankful for innovation in medicine and acknowledge that these breakthroughs are only possible thanks to keen researchers and a risky appetite for innovation shown by the private sector. This is why we at the Consumer Choice Center keep fighting (from our laptops) for choice, innovation, and evidence-based policy making. We will benefit in the next crisis from it (a child care robot included)!


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

Fight Viruses by releasing the Gene Scissors: What is Gene Editing and why should we get excited about it?

Understanding gene editing with comic book figures

Humanity is currently facing a huge challenge imposed by the Coronavirus. Borders are being shut down, planes grounded, and factories closed. At the same time, scientists and public health professionals are working on tests, treatments, and vaccines to soon provide a medical response. Coping with corona might be one of the largest tests humans have faced in the past decades but it won’t be the last virus we need to defeat. It is time to embrace bioscience and allow more research and applications of genetic alteration methods.

For the layman, all this technobabble about mutagenesis and genetic engineering is difficult to comprehend and it took me personally a good amount of reading to start grasping what different methods exist and how these can massively improve our quality of life.

Let’s first look at the four most common ways to alter the genes of a plant or animal: 

  • Dr. Xaver – Mutations per se just happen regularly in nature – This is how some amino acids ended up being humans a billion years later. Biological evolution can only happen thanks to mutations. Mutations in nature happen randomly or are caused by exogenous factors such as radiation (e.g. sun). For the comic book readers among us, X-men have mutations that (in most cases) occurred randomly.
Mutations occur in nature all the time
  • The Hulk – Mutation through exposure (mutagens): One of the most common ways to manipulate seeds is exposing them to radiation and hoping for positive mutations (e.g. higher pest resistance). This method is very common since the 1950s and a very inaccurate shotgun approach aiming to make crops more resistant or palatable. It requires thousands of attempts to get a positive result. This method is widely used and legal in nearly every country. In our comic book universe, the Hulk is a good example of mutations caused by radiation.
Your daily veggies and the Hulk have much more in common than you would think
  • Spiderman – Genetically Modified Organisms (transgenic GMO): This often-feared procedure of creating GMOs is based on inserting the genes of one species into the genes of another. In most cases, GMO crops have been injected with a protein of another plant or bacteria that makes the crop grow faster or be more resistant towards certain diseases. Other examples can be seen in crossing salmon with tilapia fish which makes the salmon grow twice as fast. Spiderman being bitten by a spider and suddenly being able to climb skyscrapers due to his enhanced spider-human (transgenic) DNA is an example from the comicverse. 
Combining genes across species: When spiders and humans come together
  • GATTACA/Wrath of Khan – Gene Editing (the scissors): The latest and most precise way of altering an organism’s genes is so-called Gene Editing. In contrast to traditional GMOs, genes are not being implanted from another organism but changed within the organism due to a precise method of either deactivating certain genes or adding them. 
Gluten-free Super Villain: Gene Editing is not so much about super-humans but more about keeping and making us healthy

This can be even done in grown humans that are alive, which is a blessing for everyone who suffers from genetic disorders. We are able to “repair” genes in live organisms. Gene editing is also thousands of times more accurate than just bombarding seeds with radiation. Some applied examples are deactivating the gene responsible for generating gluten in wheat: The result is gluten-free wheat. There are several methods that achieve this. One of the most popular ones these days is the so-called CRISPR Cas-9. These ‘scissors’ are usually reprogrammed bacteria that transmit the new gene information or deactivate defunct or unwanted genes. Many science fiction novels and movies show a future in which we can deactivate genetic defects and cure humans from terrible diseases. Some examples of stories in which CRISPR-like techniques have been used are movies such as GATTACA, Star Trek’s Wrath of Khan, or the Expanse series in which gene editing plays a crucial role in growing crops in space.

What does this have to do with the Coronavirus?

Synthetic biologists have started using CRISPR to synthetically create parts of the coronavirus in an attempt to launch a vaccine against this lung disease and be able to mass-produce it very quickly. In combination with computer simulations and artificial intelligence, the best design for such a vaccine is calculated on a computer and then synthetically created. This speeds up vaccine development and cuts it from years to merely months. Regulators and approval bodies have shown that in times of crisis they can also rapidly approve new testing and vaccination procedures which usually require years of back and forth with agencies such as the FDA?

CRISPR also allows the ‘search’ for specific genes, also genes of a virus. This helped researchers to build fast and simple testing procedures to test patients for corona.

In the long term, gene editing might allow us to increase the immunity of humans by altering our genes and making us more resistant to viruses and bacteria. 

This won’t be the last crisis

While the coronavirus seems to really test our modern society, we also need to be aware that this won’t be the last pathogen that has the potential to kill millions. If we are unlucky, corona might mutate quickly and become harder to fight. The next dangerous virus, fungus, or bacteria is probably around the corner. Hence we need to embrace the latest inventions of biotechnology and not block genetic research and the deployment of its findings.

Right now a lot of red tape and even outright bans are standing between lifesaving innovations such as CRISPR and patients around the world. We need to rethink our hostility towards genetic engineering and embrace it. To be frank: We are in a constant struggle to fight newly occurring diseases and need to be able to deploy state of the art human answers to this.

DIE WELTGESUNDHEITSORGANISATION VERSAGT MAL WIEDER: DIESMAL CORONAVIRUS

Letzte Woche, während des Weltwirtschaftsforums in Davos, konnte man den Generaldirektor der Weltgesundheitsorganisation (WHO) Tedros Adhanom Ghebreyesus noch lachend und entspannt über die Davoser Promenade schlendern sehen. Zu diesem Zeitpunkt sah die WHO noch keine internationale Gefahr in dem chinesischen Coronavirus. Trotz Berichten aus China von rapide ansteigenden Ansteckungen und Unklarheit darüber, wie offen die kommunistische Regierung in Peking mit den wirklichen Zahlen umgeht, gab sich der Chef der Genfer Behörde entspannt.

Mittlerweile hat die WHO ihre ursprüngliche Einschätzung der Lage revidiert. So wird nun weltweit von einem hohen Risiko ausgegangen. Geschichte scheint sich hier wieder einmal zu wiederholen, schon 2014 reagierte die WHO mit monaten Verzögerung beim Ausbruch des tödlichen Ebolavirus in Westafrika.

Die wichtigste Aufgabe der WHO sollte in der internationalen Bekämpfung von Epidemien gesehen werden. Doch leider verbringt sie zu viel Zeit mit Konferenzen und thematischen Auseinandersetzungen in ganz anderen Bereichen.

Nächste Woche tagt der geschäftsführende Vorstand der WHO vom 3. bis 8. Februar in Genf. Anstelle sich nun wirklich auf die wichtigsten Themen zu konzentrieren, wie zum Beispiel eine zeitnahe und fehlerfreie Antwort auf den sich ausbreitenden Coronavirus, zeigt die Tagesordnung dieser Sitzung, wie die Behörde Zeit und Steuergelder mit peripheren Themen verschwendet.

Die Tagesordnung verbringt eine ganze erste Seite mit Reformvorschlägen für Gesundheitssysteme hin zu universellen Krankenkassen. Solche Themen sollten zwar eher Teil von Innenpolitik sein, die WHO scheint aber ideologische Grabenkämpfe wichtiger zu finden als die globale Bekämpfung von Killerviren.

Auf den hinteren Seiten der Tagesordnung findet sich dann neben “gesundem Altern” und der “Renovierung der WHO Zentrale” auch ein Krisenplan für globale Pandemien.

Bevor es zu Krisenbewältigung auf der Agenda kommt, wird es wahrscheinlich erstmal einige Tage und die Bekämpfung von Patenten und geistigem Eigentum gehen. In den letzten Jahren hat sich die WHO zu einem zentralen Sprachrohr gegen Innovation und Privatwirtschaft gemausert. Die Verwässerung und langsame Abschaffung von Patenten auf Medikamenten sieht die WHO als bestes Mittel um steigende Gesundheitskosten zu verhindern. Dass Einfuhrzölle und Verbrauchssteuern auf Medikamente gerade in Schwellenländern oft 40% des Preises ausmachen, erwähnt die WHO lieber nicht. Allein in China geben Patienten über 5 Milliarden Euro pro Jahr nur für Zölle auf importierte Medikamente aus. Gerade in Zeiten eines massiven Virusausbruchs sollten solche unethischen Steuern in Frage gestellt werden.

Es war auch die Privatwirtschaft die parallel vier unterschiedliche Ebolaimpfstoffe in den letzten Jahren schnell und effektiv entwickelt hat. Ähnliches wird nun beim Coronavirus benötigt. Die Strategie der WHO Anreize bei der Medikamentenentwicklung zu entfernen könnte extrem negative Auswirkungen für die Weltbevölkerung haben.

Es wäre dem WHO Vorstand zu raten, sich weniger mit der Verschönerung seiner Büroräume auszusetzen, sondern eher mit der sofortigen Antwort auf massive Bedrohungen für die weltweite Gesundheit und globale Handelsströme, wie Ebola und das Coronavirus. Mit einem Budget von 2 Milliarden Euro pro Jahr und über 10% davon für Reisekosten veranschlagt, muss sich die WHO die berechtigte Frage stellen, ob die Behörde nicht massiv geschrumpft und auf ihre Kernaufgaben ausgerichtet werden muss.

Selbst als Befürworter des schlanken Staates sollte man die Notwendigkeit eines internationalen Koordinierungs- und Aktivierungsorgans im Bereich transnationale Epidemien sehen. Leider kommt die WHO dieser Aufgabe nur wenig nach.

Originally published here.


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

The World Health Organization fails us again: This time Coronavirus

Fred Roeder, Health Economist and Managing Director of the Consumer Choice Center

Last week when visiting Davos during the World Economic Forum, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, casually walked down the main street of the small alpine town without a worry in his face. At that moment, his organization saw  no international threat in the Chinese-originating coronavirus. This was despite worrying reports from China and questionable legitimacy of the official numbers provided by the Chinese Communist government.

Since then, the WHO has apologized and corrected their initial assessment. The virus is now seen as a high risk to the East Asian region and globally. 

History is repeating itself once more During the Ebola crisis in West Africa in 2014, it took the WHO months to finally declare an emergency. They were too tied up in fighting non-communicable diseases. 

The most important task, and the founding reason, of the WHO should be combating international diseases and coordination of rapid crisis responses. But unfortunately the Geneva-based agency spends much of its time with topics such as road safety, secondhand smoke, vaping, and the renovation of their own offices.

Next week the body’s executive board will convene from February 3rd-8th. Instead of revamping their agenda and fully focusing on how to contain the coronavirus, the current agenda prioritizes many other points before dealing with an international crisis response.

While our taxes should be spent on keeping us safe from this virus, the WHO’s board will instead spend the first couple of days discussing ideological ideas of universal healthcare reforms in emerging markets and how to limit patents of pharmaceutical companies. This is apparently more important for an agency that spends 10% of its 2 billion annual budget than figuring out how to effectively combat killer viruses. 

Once you scroll down the agenda of the meeting, you will finally find crisis response next to topics such as ‘aging in health’ and ‘renovation of the WHO Headquarters’.

So instead of putting the very real and scary threat of the Coronavirus first, the board members will prioritize how to limit incentives for the private sector to come up with treatments and vaccinations for the virus. Scrapping patents and limiting intellectual property rights are key pillars of the WHO’s priorities these days. Limiting patents is seen as a solution to curb health costs in emerging markets. For the international governmental organization, this seems to be an easier way than actually calling out their member states who often increase drug prices by 10-40% through import taxes and sales taxes paid by patients.

Chinese patients alone pay over 5 billion dollars a year on tariffs for drugs they import. In times of a massive health crisis in China, the WHO should urge the Chinese government to drop all of these tariffs momentarily.

After the Ebola outbreak in 2014, the private sector quickly reacted and several companies developed and delivered Ebola-vaccines at the same time. Now we need a similarly quick response for the coronavirus. Therefore, the WHO should not limit the innovative potential of the pharmaceutical industry but encourage them to invest in finding vaccines.

The coronavirus has already taken too many human lives and the situation will worsen. International trade and the global economy can also easily take a massive hit from a worsening situation. Instead of debating how to make the WHO’s offices better looking for natural light, its board should focus 100% on how to contain and combat the coronavirus. That’s priority number one.

Over and over, we see how the WHO fails to respond in an accurate and timely manner to such pandemics. It is high time for the agency to focus on its core mission: Protecting us from trans-national diseases.

How a coronavirus epidemic in China could ripple through the global economy

An international outbreak of respiratory illness sparked by a novel coronavirus has spread from its origins in central China to at least 11 countries, with more than 1,200 confirmed cases — including a presumed case in Canada — and over 40 deaths.

Like previous outbreaks, including the SARS virus 17 years ago, the flu-like disease poses a risk to economies around the world as fear and confusion lead to abrupt changes in behaviour, decreased economic activity and a ripple effect across sectors that threatens everything from productivity to consumer prices.

The Severe Acute Respiratory Syndrome pandemic of 2003 cost the Chinese economy up to US$20 billion, according to the Asian Development Bank, as travel warnings and transit shutdowns discouraged consumption, foreign tourists stayed away and local residents stopped going out.

“The travel and tourism sectors were most obviously hit, although that ripples through the entire economy,” said Richard Smith, a professor of health economics at the University of Exeter Medical School.

“But many effects are short-lived during an outbreak as once the panic is over people go back to business as usual.”

Chinese authorities clamped down on mass transit during the SARS outbreak, hampering commutes, shopping runs and social outings. The national securities regulatory commission closed stock and futures markets in Shanghai and Shenzhen for two weeks to prevent viral transmission. And Beijing ordered movie theatres, internet cafes and other venues to shut down temporarily while hotels, conference centres, restaurants and galleries saw visitors almost disappear completely.

China’s response to the current crisis appears to be swifter, and the disease less virulent, but the country now boasts a far more extensive high-speed rail network than it did in 2003, and its economy is six times larger, upping the risk of transmission and the repercussions of an epidemic.

“China is the engine of the global economy, churning out goods,” said German health economist Fred Roeder.

Its critical role in international shipping may be thrown into disarray as authorities begin to hold back some ships from entering the port at Wuhan, a key hub on the Yangtze River.

“If they cannot leave it creates huge delays in the supply chain and value chain of businesses all across the world,” Roeder said. “It could actually hit the latest generation of smartphone if ports are shutting down.”

Manufacturing could also feel the crunch as supply chains stall, he said.

Roeder has felt firsthand the disruptive power of a pandemic. In the summer of 2003 the teenage Berliner was eagerly gearing up for a United Nations youth conference that would take him to Taipei, but the event was cancelled a few days beforehand due to SARS.

The epidemic also sparked layoffs and time away from work. At one point Singapore Airlines asked its 6,600 cabin crew to take unpaid leave. Children stayed home from school, prompting more parents to shirk their job duties and further reducing productivity, said AltaCorp Capital analyst Chris Murray.

“I was losing guys left, right and centre as people were quarantined,” recalled Murray, based in Toronto — the epicentre of the SARS pandemic outside of Asia. The disease infected 438 Canadians in total and caused 44 deaths in the Toronto area.

The economic damage culminated with World Health Organization’s one-week travel advisory for the city in April 2003, costing the Canadian economy an estimated $5.25 billion that year.

The outbreak of H1N1, or swine flu, in 2009 also sparked work “dislocations,” Murray said. “It went from, ‘Maybe it’ll be okay,’ to sheer panic.”

Freelancers and gig economy workers such as musicians or ride-hail drivers may feel the pinch more acutely, since they can’t rely on a steady wage when demand shrinks.

“It’s something that unfortunately has happened before in a similar way and it tends to affect areas like retail,” said Carolyn Wilkins, senior deputy governor of the Bank of Canada, said this week.

“People don’t go out, they don’t fly in planes, they don’t do as much tourism to the affected areas,” she said.

The fallout makes workers ranging from servers to wholesale bakers to non-unionized hotel staff more vulnerable. Meanwhile spending or investment plans by larger companies may have to be delayed, said Roeder.

It is not clear how lethal the new coronavirus is or even whether it is as dangerous as the ordinary flu, which kills about 3,500 people every year in Canada alone.

Originally published here.


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at 
consumerchoicecenter.org

We must resist Public Health England’s brave new world

We must resist Public Health England’s brave new world

In a remarkable authoritarian parting shot as she left her post as Chief Medical Officer, Dame Sally Davies published a report entitled Time to Solve Childhood Obesity, which was warmly welcomed by Health Secretary Matt Hancock.

The report’s recommendations would create a positively dystopian world. Public Health England want to outright ban eating on public transport. Inflated VAT rates would make simple food and drinks purchases seem rather more extravagant than before.

There would be no more junk food ads, and buying fast food would become an ordeal and a luxury. But if the government opts to follow the report’s recommendations – which is a real possibility, whoever wins the election – this Brave New World could soon become a reality.

The supposed childhood obesity epidemic has been slowly but surely taking over British public health discourse. It began around 2005, with Jamie Oliver’s televisual lip service, and eventually resulted in George Osborne’s sugar tax eleven years later.

With over one in five English 10 and 11-year-olds suffering from obesity according to the latest available data from the NHS, the government has understandably set alarm bells ringing.

The domineering, restrictive approach being proposed by Public Health England, however, brings to light some deep-seated issues.

The key one has to do with individual freedoms. Radical measures like taxing ‘unhealthy’ foods, banning ads and enforcing plain packaging would fail to tackle childhood obesity, while also harshly affecting adults and their personal choices.

This kind of nannyism is remarkably cross-party, differing only in degree. While Jeremy Corbyn’s support for sin taxes and junk food ad bans comes as no surprise, it is quite baffling to witness Tories persistently meddling with individual choices too.

Considering the party’s ideological roots, you would expect the Conservatives to be more mindful of the dangers this approach poses for the fundamental freedom to choose.

Plain packaging of tobacco products and the ban on plastic straws signalled a drastic shift away from core Conservative values, and it seems that things are only getting worse.

Public support appears dishearteningly high for such approaches. A YouGov poll from a few months ago showed that 55% of the public believe we need additional taxation on unhealthy foods and drinks. Alarmingly, the figure among Conservative voters is 54%.

The poll also found that nearly two thirds of British adults would be in favour of banning junk food TV ads before the 9pm watershed, with only 20% opposed. Almost three quarters support restrictions on food advertising on YouTube and social media.

In this context, ad bans and harsh authoritarian restrictions are seeming less and less draconian. It would appear that infringing on individual choices is politically profitable in Britain today.

It is little wonder, then, that the Conservative party continues to err on the side of greater state interference, despite the ideological mismatch it causes.

Whether we will truly find ourselves waking up one day to be greeted by Public Health England’s brave and healthy new world remains unclear.

Back in July, Boris Johnson vowed to review sin taxes and put an end once and for all to the “continuing creeping of the nanny state”, but since then, solid commitments or steps in that direction have not been forthcoming.

Perhaps, the nanny state seems appealing to many at the moment because we have not yet experienced fully-fledged nannyism in action.

If the current trend continues, we may find out by 2024 whether following Public Health England’s programme of taxes, ad bans and plain packaging will be enough to fight childhood obesity, or if yet more restrictions on choice will be on their way.

Originally published here.


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at 
consumerchoicecenter.org

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