Thursday 12 March 2020

Meeting Coronavirus with Complacency

"I must level with the British public. Many more families are going to lose loved ones before their time." This was how Boris Johnson began his press conference this afternoon, flanked by Chris Whitty, the chief medical adviser, and Sir Patrick Vallance, the chief science advisor. And the advice they iterated was, well, not reassuring. Folks with some sort of respiratory illness, no matter how mild, should stay at home for one week, carrying on washing your hands, work from home if you can and, um, that's it. Meanwhile, Nicola Sturgeon announced a ban on big public gatherings and over in the Irish Republic, Leo Varadkar has moved to shut down the schools. Scandinavian countries have gone into full lock down, with the Danish state abrogating a series of authoritarian powers to enforce effective quarantine, and Italy is tightening the screws on movement. Compared with these, the UK appears almost lackadaisical in its approach.

"Everything we do is guided by the science", say the Prime Minister, as if there's a unanimity of opinion. In truth, he is not so guided. Where the science does agree is COVID-19 Coronavirus is easily communicable, manifests with varying degrees of seriousness, and the best means of preventing its spread is "social distancing". That is the science, What Johnson and his advisers are wrestling with is the social impact - the bio- and necropolitics of the virus. Therefore the differing responses to the outbreak, from China to Iran to Spain to the United States are informed by traditions of political control and, whisper it, policy objectives not entirely concerned with stymieing the spread of contagion.

Unfortunately, it is becoming difficult to give the government's handling of this crisis the benefit of the doubt. There are serious logistical reasons for not copying the Irish and the Danish. Emptying schools means huge numbers of medical staff are suddenly no longer available, for instance. But rather than a straight explanation from Johnson pointing out these difficulties, we get waffle and nonsense about people's enthusiasm for preventative measure running out early. Fair enough, but in the mean time for all the press releases about pushing the peak of infection further down the road to warmer weather, "containment" in practice has meant putting a few dozen people in isolated units for treatment while the world goes about its business as usual. Unless you're a stock market. Undoubtedly the hammering home of handwashing advice has frustrated transmission, but for the millions who cram themselves on to public transport every day, this risk vector, with the potential to rapidly spread disease, has gone largely unaddressed. A couple of verses of the national anthem with soapy water won't mitigate much after half an hour on a packed bus.

As Robert Peston suggests, the tardiness of the government response is deliberate. Talking up the science and the infection bump is simply hot air. If we look at the government's actions (or, more accurately, inaction) we're seeing a hands off approach. The money is available and contingencies are in place for massive medical demand, but this massive mopping up operation after the fact is regarded an inevitability. This reinforces the view the government would rather have the public health emergency over with quickly than drawing it out - effectively gambling with other people's lives. The official view is the population has to build up "herd immunity" lest similar diseases of this type emerge in the future (a virtual certainty), but at what price? One cannot get away from the sense this is a distraction from the grid Dominic Cummings had programmed in for the year ahead: grandstanding over Brexit, puerile brinkmanship, a celebrated US trade deal. How inconsiderate that a life and death question for tens of thousands of people gets in the way of the Johnson juggernaut.

This is high stakes. Johnson is gambling that somehow Britain will ride out the worst of it without firm preventative action, risking the uncontrolled shut down of the country by the virus and the swamping of the NHS by the sick. And the worse it is, the worse it will be for him, seen to be dithering in the face of serious threat. What a time to be saddled with a part-time, absentee Prime Minister.


Unknown said...

Ken said
Look at the final graph

Unknown said...

From this link

Graham said...

I would not normally defend anything the Tories do but you are totally wrong.

The medical and scientific advice is clear and backed up by the epidemiology models. The pandemic can not be avoided but the number affected at any onetime can be reduced.

The advice as be carefully modeled to balance the effect of any action compared to that of inaction, for instance allowing open air sporting events to still take place in public against people watching the same events in pubs.

Other approaches such as that in Ireland are not backed by the science and look like making steps so you are seen to be doing something.

This is not the time to play politics.

Ignore Boris, who is obviously quite rightly shit scared and instead listen to and understand the science.

Dipper said...

Opinion in my Tory Brexit circle is split right now on whether the PM is doing the right thing. Personally I think Graham (and hence the PM) is right.

At 1% fatality, if this goes through 80% of the UK population in the course of a year that's somewhere around 500,000 deaths which looks like a massive death toll of primarily the old and ill. Annual mortality is about 1% anyway, so about 600,000 people primarily the old and ill will die anyway this year, and those two groups are largely the same.

The main concern is that if the disease spreads rapidly then health services become overwhelmed, and the knock-on effect on inability to save lives that would otherwise be saved becomes the primary consequence. Hence the concern to slow the spread and push it into summer when for a couple of reasons it is more manageable.

Shutting schools seems a daft response. Young people seem largely unaffected when they catch it. If schools were shut someone would have to look after the children, probably grandparents so that right there is the interaction you want to avoid, and NHS Staff become unavailable for child care reasons just when you need them.

Boffy said...

The real problem is not the spread of the virus, but preventing people like me, in at-risk groups from being infected, which then results in either serious (and costly to remedy) illness, or death.

Suppose we were talking about a condition that resulted in people getting a nasty rash for a couple of weeks, but which for the vast majority of the population was just a mild inconvenience. Would you close down the economy on that basis by trying to prevent the spread of the rash, knowing that, in doing so, the other consequence would be an economic catastrophe, and a health catastrophe for thousands of people that depend on the economy and on health care system as part of it for their survival. I would hope its easy to see that the answer is no.

Now, suppose that a tiny proportion of the population have an exaggerated response to this rash, such that they might die if infected. Would you still close down the economy, and risk the lives and health of those same thousands of people that depend on it, or, instead, would you identify that tiny proportion that might die from the infection, and enable them to be isolated from it to prevent them being infected, meanwhile allowing a quick sharp spike in infections for the rest of the population to get it over and done with, and killed off as those infected recovered, and built up a natural immunity.

But, that is essentially the case with coronavirus. 80% have such mild symptoms that many do not even know they have had it. Children are either immune or suffer no symptoms. Of the remaining 20% who do suffer more pronounced symptoms, only a minority, in at-risk categories such as the elderly or with underlying health conditions are likely to die. So, its clearly better to identify the latter, isolate them from the risk of infection, and provide whatever support is required to achieve that, and let the virus rip amongst the rest of the population, who only suffer very minor symptoms, to get it out of the way, immunity built up, and the virus killed off, so as to prevent further infection.

The reason the latter is not being done is because a moral panic has been created that requires a blanket response, and panic measures, and because ten years of austerity, and destruction of health and social care systems, means that the infrastructure to implement it is not there. Moreover, many of those that are required for that health and social care system are immigrants, the same immigrants that the economic nationalists seek to blame for everything, including the spread of the virus. They are the same people, in the case of EU migrants, who are going home, and so will make the health and social care system even less able to respond.

Dr ZoJo said...

So apparently our science is right and their science is wrong? Or everyone else is over-reacting? So, the outlier states, the UK and USA are the ones handling this best, while places like Sth Korea, Singapore, Hong Kong, Denmark, Ireland are all doing it wrong. According to...who exactly? As far as I can see, advice here is keep calm and carry on (unless you feel ill in which case stay at home). Meanwhile newspapers put out scare stories, people panic buy and empty the shops, and big public gatherings carry on as before. Except where they don't. The response is chaotic - leaving it to individuals and organisations to decide what to do - whether to hold or attend meetings, gatherings etc. At least in those countries who "aren't following the science" the government are ensuring consistency and clarity.
Our lot are just leaving it to the market and to natural selection.

Concerned Citizen said...

Boffy is literally dangerous. A moral panic, is this idiot for real? It confirms everything i have always thought about this individual, a Social Darwinist neo liberal masquerading as a Marxist. A pro war, pro imperialist uber nationalist posing as an internationalist.

From Vietnam, China, through South Korea, Singapore, India, Israel, Bahrain, Russia, Poland, Italy, France, Ireland, the USA, Spain, Ireland there are the most draconian measure we have possibly ever seen.

Not all these nations went through austerity, in fact dumb fuck was telling us only recently that the US did not go through Austerity.

This is a major public health emergency, this is a not a moral panic.

Do not listen to dumb fuck!

I do think the government are basing their decisions on the available science, however that includes behavioural science, these scientist usually try to work out where supermarkets should place a can of beans. Let us hope that the pseudo babble is not being factored into any of the modelling!

Britain is certainly an outlier though, most of the nations and the WHO think more draconian measures are required. That is what the majority of science is saying. Britain made a mistake not to stop major sports events, they should have known that events would quickly lead to them being postponed anyway. How their sophisticated modelling didn't pick up that is anyones guess!

Concerned Citizen said...

The lancet have done detailed research on the actual data for coronavirus. here are the headline figures:

"mortality rates would be 5·6% (95% CI 5·4–5·8) for China and 15·2% (12·5–17·9) outside of China"

Now while the denominator is an unknown in these stats, it is the same measure used for FLU.

Might be an idea if when quoting mortality rates people provided sources rather than bandying around their own back of the fag packet assumptions.

This strikes to a vital point, data scientists are literally pouring over this data in real time and the picture changes. What we are seeing is not some crazy overreaction but increasing alarm at what the data is saying.

And please can someone stop Boffy commenting!

James Semple said...

I agree with Graham. Even Tories can be correct if they listen to the experts: it seems Cummings has some utility after all.

What is rather unnerving is the chosen strategy - herd immunity. There is no cure, no vaccine and no-one is immune to this virus. So,you arrange for the healthiest 60% of the population to catch it and become immune (usually while surviving). The virus then cannot move around as before and it dies away. If the oldies are kept locked-up until this point they can be let out again in reasonable safety. Job done.

This is established epidemiology. Don't worry about the patient as an individual; see him/her as an immunity factory and all will come right.

I wonder what Lysenko would have made of it.

Anonymous said...

'Herd immunity' is shorthand for the absence of a strategy. The schools aren't being closed not because they are concerned about children, or grandparents, but because the NHS (down 50K nurses) and police (down 20K) cannot afford the loss of manpower. Because children are usually regarded as 'super-spreaders' the battle against infection is already lost.

There is no strategy to save lives, instead, there is a strategy to deflect responsibility - hence presenting the 'no strategy' as a deliberate choice ('herd immunity'). The deaths of hundreds of thousands of loved ones will be presented as regrettably unavoidable.

The only strategy, therefore, is the cover-up: it begins with presenting the consequences of a lack of capacity as a deliberate choice ('herd immunity') then removing the tools with which to expose culpability - for example not testing those outside hospitals. How long before a diktat to 'save resources' by not conducting post-mortem tests on pneumonia cases?

Ultimately, the only measure will become statistics, discussed perhaps with outrage in places like this, but ignored - possibly with the help of the media - elsewhere.

There is no strategy to combat the coronavirus, only to preserve political and professional careers.

Boffy said...

James, as an oldie and asthmatic, I am happy to be self isolated for a month, or even a couple of months, if that's what is required to avoid being infected. I have just told my son and his girlfriend not to visit for the duration, as I see no reason why they should not continue to go to work, where they will be in contact with dozens of other people. All the scientific advice is that as young healthy people, they will suffer mild or no symptoms, so why should they not continue as normal, earn money to live, and continue to provide goods and services to society that it requires?

To put it in another context. My son has a fairly serious nut allergy. Neither he nor me expects nuts to be removed from sale, or a blanket ban on people eating nuts to be implemented. Instead, he avoids nuts, and should have a reasonable expectation that he be enabled to do so by the state requiring proper allergy information on products etc.

As another parallel, when I was a kid, it was common for parents to send their kids round to play with others who had mumps, chicken-pox and other such childhood diseases, so that they could catch it, and develop immunity to it. In doing so, it prevented them coming down with such diseases in later life, when they have far more serious consequences.

Finally, while I am happy to self isolate for a month or two whilst the virus has time to die off, I think it would be difficult to do that for say six months or more, which is what would be required if the infection rate is slowed down, and it continues to be around for much longer. Moreover, I have the resources and support to be able to do that. Many more do not. Therefore, what is required is to focus the resources on that minority who are most at risk, so that they all have this ability. If the economy is closed down, by blanket bans, closing schools that means that parents - including parents who work in the NHS etc - have to stay at home to look after them, then the resource simply will not exist to focus on anything. Not only will it mean that more people will die from the virus than need to, but thousands more will die from other causes, simply on the back of economic chaos.

Erica Pruett said...

Why isn’t every advert on TV related to public health information?

Why can’t these useless celebrities be put to useful work by taking part in public health adverts?

The government does not have a grip, if it did every advert would be driving home these health messages. Get George Clooney, get all the sportspeople who now having nothing to do to star in public health information films.

Boffy, the idea that a nut allergy is an appropriate analogy to a worldwide pandemic is ridiculous.

As for your assumption that blanket bans will be less effective than the game theory approach of the government, this will be put to the test because many nations are doing precisely that, i.e. locking down. In Spain and many other places only those shops that are essential are opening, food, chemists.

If the infections don't spike again when China turn on the taps we will know that lockdown is the correct policy, if China turn on the taps and the numbers sky rocket then there isn't much we can do. The Most nations are taking the very sensible approach of taking no chances, locking down and see what happens in China before reassessing. The Tories and their game theorists are gambling with all our lives.

But your approach has a good analogy put by a virologist on the TV last night, there is a fire raging and rather than pouring water on the fire you want the fire to rage. As the virologist stated, a fire that is left to rage gains strength!

Concerned Citizen said...

Trying to compare infections we have known about for well over a century and have existed for even longer with a brand new virus that no one has ever been infected with until recently is problematical but to some extent necessary but to then take the leap and say therefore we must just do with Coronavirus what we do with Chickenpox is seriously dangerous and borders on utter lunacy, at best its moronic.

So the disease cycle for Chickenpox, Mumps etc is very different to this new virus.

Comparing the two is the sort of armchair Immunology that one would expect from dumb fuck.

Exponential growth requires drastic measures, otherwise the entire health service will collapse putting everyone who has any kind of illness in more danger. Frankly if that means Mcdonalds can't serve their shit to people for a few months I won't be crying.

As the WHO strongly recommends, Lockdown now!

Boffy said...


I didn't compare a nut allergy to a global pandemic. I compared the response of those small minority who suffer serious consequences of having a nut allergy, to the fact that similarly only a small minority in at risk groups will have a serious consequence from contracting the virus. The comparison is that in both cases resources should be focused on protecting that small minority rather than blanket ban that affects a vast majority uneccessarily, who will not be affected, and the consequence from which is itself more serious, i.e. closing down a large part of the economy on which that same minority depends.

On closing everything down. With a forest fire it assumes you have caught every last ember. Hundreds of millions in China have no immunity. Eventually, people in China will go about their business, and it takes only a few people still with the virus for it to quickly spread once more, not to mention China will need contact with other countries. Its why countries went for herd immunisation on an industrial, scale by developing vaccines.

One good way of preventing fires spreading is by producing fire beaks, often done quickly by controlled burning.

As for Spain, what happens when the food shops and chemists run out of stock? If factories have been closed down as part of your blanket ban, then within literally days, stocks run out. What happens with electricity supply workers staying home, so that electricity supply stops including to hospitals for ventilators etc.

Analogies, such as with fires are all very well if considered rationally, but otherwise misleading. As I said, its often the case that to prevent the spread of a fire, more fire is used, hence the phrase fighting fire with fire. But, the spread of a fire generally has negative consequences. Given that 80% of the population suffer either no or only very minor symptoms from the virus the comparison with a fire falls down. Why is it a problem for something that causes no serious ill effects for this 80% to spread amongst them and thereby create immunity? That after all is precisely how vaccines work.

Those that are opposing that scientifically well grounded theory are in effect putting themselves in the same camp as the conspiracy nuts who opposed vaccination, and so led thousands of children to suffer unnecessarily from measles etc.

Erica Pruett said...

The government are putting business as usual above peoples lives.

A professor from Harvard, who literally looks at these viruses through microscopes for a living, has said herd immunity is an utterly crazy concept as articulated by the government and their game theorist/eugenicists, as he pointed out if herd immunity happened as a result of mass infection every viral disease would never require immunization and vaccines, because by the time they have developed them everybody would in theory be immune!

He stressed that immunization does not come from infecting the whole population, he further stressed that the quickest way to get coronavirus to evolve into something more dangerous is to precisely let everyone catch it very quickly! He stressed even further than the best way to deal with this was a total lockdown as as happened in many countries, this was suppressing the virus, suppressing its evolution until better treatment measures are put in place and a better understanding of the virus is established.

And be under no illusions the government are hell bent on infecting everyone as the scene of a packed pub and people drunkenly spilling out shows. The level of recklessness on show is a damning indictment of this nation.

Why are they doing this? To reduce the surplus population and getting everybody back to work as quickly as possible. 19th century mill owners have nothing on these people.

The British medical establishment is full of inbreds who are drawn from a very narrow band of the population. This is not the case in most other countries. For example France have twice as many doctors as the UK. The demographic of the UK medical profession is middle and upper middle class, in other words people imbued with a neo classical education and all its prejudice.

If self isolation wasn't required I would be advising a mass revolt! The new catch 22!

Boffy said...

"as he pointed out if herd immunity happened as a result of mass infection every viral disease would never require immunization and vaccines, because by the time they have developed them everybody would in theory be immune!"

This is idiotic! No serious scientist would suggest that the answer to say Ebola is to encourage its spread so as to build up herd immunity!!!! Why? because 90% of people that get Ebola die. That is also why its preferable to deliberately vaccinate people against things like measles, or small-pox, because a large proportion of those that contract the disease will suffer serious consequences, including death.

But, how does that compare to COVID19. rather than a 90% mortality rate, its around 1%, and that 1% is concentrated almost entirely within a known group, i.e. those over 60, or who have existing respiratory or immune system disorders. In contrast to Ebola, Measles, Small-Pox and so on, 80% of those that contract the disease have no symptoms or only very mild symptoms! So, until we actually do have a vaccine, the best means of producing widespread immunity is for that 80% to produce their own natural immunity.

Boffy said...

"He stressed that immunization does not come from infecting the whole population, he further stressed that the quickest way to get coronavirus to evolve into something more dangerous is to precisely let everyone catch it very quickly!"

But, no one is suggesting that "everyone" be allowed to catch it. That is only the nonsense being put out by the conspiracy theory nuts, who think that its all a means of killing off unwanted sections of society, as some form of social Darwinism, or a means of collapsing the NHS, or else was created by the CIA or US military to undermine the Chinese economy.

They are the same people who think its probably being spread by chem-trails in aircraft vapour trails. And, they are the same people who support Brexit and economic nationalism, and are highly delighted that by closing down the economy it brings about an end to free movememt, and autarky. They are often the ame people who delude themselves into thinking that the resultant economic crisis will somehow bring about a socialist millenium, rather than the more likely consequence of misery for millions of workers, and the imposition of reaction.

Boffy said...

All virology shows that viruses evolve as a result of being able to infect populations over a long period, and so to mutate. The best means of preventing mutation of viruses is to kill them off quickly, which is why a rapid build up of herd immunity to kill off the virus quickly is essential.

"Why are they doing this? To reduce the surplus population and getting everybody back to work as quickly as possible. 19th century mill owners have nothing on these people."

Absolute nonsense. Marx showed long ago that capitalism depends upon a surplus population. Where a surplus population doesn't exist it creates them by introducing labour-saving technology, encouraging women and children into the workplace, encouraging immigration and so on. In fact, with current levels of employment it needs a larger surplus population, and that will get worse as a result of Brexit, and the end of free movement.

As for people spilling out of pubs, for those at risk from the virus its easy to avoid such places, and so not be infected.

Concerned Citizen said...

The mortality rate in Britain is at this moment is 3.7% and its only just begun.

In Italy it is much higher.

Dumb fuck, who claimed this was a moral panic and nothing worry about, should stop spreading fake news based his his own interpretation of the data.

Please read the lancet if you want to know what the mortality rate is, stop listening to dumb fuck.

Boffy said...

I'm over the Moon that more than 12 years on I'm still getting under the skin of the inbred Sentinel and his current disorder of multiple personalities! And, I'm doing it without even trying or bothering to respond to him. It makes getting up in a morning all the more worthwhile.