At times, the argument about lockdown has been described as a choice between saving lives or saving money. But this is a false equivalence. A weak economy leads to weakened citizens: it means less tax revenue, less money for the NHS, and poorer families – wealth and health are all too-closely linked. Just look at the difference in height between Koreans, depending on which side of the 38th parallel their grandparents happened to be caught on.
It’s easy to measure money, but it’s far harder to measure the indirect results of a richer or poorer economy. It’s also hard to work out how much money you should spend to save a life. Ban cars, and you’ll end road deaths. But you’d also hit the economy. So a balance has to be struck somewhere.
Matt Hancock, the Health Secretary, has gone back to Plan A, reviving his ‘protect the NHS’ message from March and now wears a facemask with those words on it. The Prime Minister is repeating the slogan. It’s deeply controversial with senior doctors who fear that it discourages the sick from seeking help – which might explain the 28,000 excess at-home deaths over the last few months. The NHS is worried about this and has countered with its own advert, urging people to seek medical help. I looked at this in my latest Daily Telegraph column.
The NHS has learned much from the first wave of Covid. PPE equipment, for example, is now in bountiful supply. Basic medical techniques – better use of blood thinners, oxygen therapy, steroids etc – are having a big impact on survival rates. When Boris Johnson went into intensive care, his survival chances were about 50 per cent. Now, they would be closer to 70 per cent. The trajectory this time is nowhere near as daunting – the below graph shows the rise of Covid patients needing critical care. As the data shows, intensive care unit (ICU) usage is 13 per cent of what it was at the end of March. (These figures are from the Intensive Care National Audit & Research Centre.)
The Greater Manchester ‘local lockdown’ and the more extreme economic lockdowns have both failed to control the number of positive tests within the Borough of Bolton, which has inexorably risen.
During the lockdown, Bolton has seen 20,000 fewer GP referrals to hospital when compared to last year, while many others have not accessed vital treatment because they have been too frightened to do so. By taking our current approach to Covid-19, we are creating many other health problems that are leading to pain, suffering and death.
We have had plenty of anecdotes about people failing to be diagnosed with serious diseases during lockdown. This is thanks to either to hospitals cancelling appointments, GP surgeries stopping face-to-face meetings or people picking up the message that they should protect the NHS by trying not to use it.
Has the Covid ‘second wave’ already run out of steam? On 9 July, just when Britain was reopening the hospitality sector and other businesses, the World Health Organisation announced that the pandemic was ‘accelerating’. Much of the coverage in Britain also implies that we are possibly in the early stages of a second wave. But that talk is lagging behind the data. Globally, the number of new recorded cases peaked on 31 July at 291,691 and has shown a slight downward trend ever since. In terms of deaths, they peaked at 8,502 on 17 April and have also been on a slight declining trend ever since. On the worst day in the past week – 2 September – 6,312 deaths were recorded. Most of the worst-affected countries are now showing downward trends in both daily cases and deaths, including the US, Brazil, Russia, Peru, Colombia, South Africa, Mexico, Chile and Iran. Among the top dozen worst-affected countries, only India is now showing an upwards trend in deaths. Spain and Argentina are showing slight upwards trends in new cases, but not deaths. All these figures, of course, have to be read in conjunction with a huge increase in testing – so a slight increase in new cases does not necessarily imply that the disease is in fact spreading.
As for Europe’s ‘second wave’, that, too, has fizzled out – with new cases now declining in Germany, and Sweden, and remaining flat in Italy, Ireland and Belgium. There is no obvious trend either way in Poland, Denmark or Portugal. The country with the clearest rising trend is Croatia. There was, until last week, a sharply-rising trend in Greece, although this has flattened off in recent days. You can follow country by country data on new infections and deaths here.
Such is the quality of decision-making in the process generating our lockdown narrative. An early maintained but exaggerated belief in the lethality of the virus reinforced by modelling that was almost data-free, then amplified by further modelling with no proven predictive value. All summed up by recommendations from a committee based on qualitative data that hasn’t even been peer-reviewed.
- According to Office for National Statistics, this year comes only eighth in terms of deaths in past 27 years.
- The spread of viruses like Covid-19 is not new. What’s new is our response.
- The whole Covid drama has really been a crisis of awareness of what viruses normally do, rather than a crisis caused by an abnormally lethal new bug.
- Modelling is not science, for the simple reason that a prediction made by a scientist (using a model or not) is just opinion.
- To be classified as science, a prediction or theory needs to be able to be tested, and potentially falsified.
- A problem with the current approach: a wilful determination to ignore the quality of the information being used to set Covid policy.
- Most Covid research was not peer- reviewed.
- In medical science there is a well-known classification of data quality known as ‘the hierarchy of evidence’: a seven-level system gives an idea of how much weight can be placed on any given study or recommendation.
- Randomised controlled trials (RCTs) form the highest, most reliable form of medical evidence: Level 1 and 2.
- Virtually all evidence pertaining to Covid-19 policy is found in the lowest levels (much less compelling Levels 5 and 6): descriptive-only studies looking for a pattern, without using controls.
- Level 7 is at the bottom of the hierarchy (the opinion of authorities or reports of expert committees) because ‘authorities’ often fail to change their minds in the face of new evidence.
- Committees often issue compromise recommendations that are scientifically non-valid.
- The advice of Sage (or any committee of scientists) is the least reliable form of evidence there is.
Antibody tests on random samples of the population have so far shown much lower levels of general infection than the government’s scientific advisers claimed would be necessary to attain ‘herd immunity’. In London, for example, tests have shown that 17 per cent of the population have antibodies to Sars-CoV-2, the virus that causes Covid-19. In New York, the figure is 21 per cent. At the beginning of this crisis, on the other hand, Sir Patrick Vallance, the chief scientific adviser, suggested that at least 60 per cent of the population would have to be infected in order to achieve herd immunity.
By now, we ought to be seeing some evidence of increasing Covid-19 cases from the mass protests. The fact we are not raises very serious doubts about the coronavirus lockdowns and other non-pharmaceutical interventions, many of which are still ongoing.
…The third explanatory hypothesis is that we have vastly overestimated certain risks from Covid-19, limiting fundamental civil liberties of law-abiding citizens and getting it wrong. It finally took unsanctioned mass protests to prove this point.
All through the Covid-19 pandemic we have been hampered by a lack of data on just how many people have had the disease. Given that several studies have indicated that as many as 80 per cent of people who are infected show no symptoms whatsoever, it is extremely difficult to estimate this crucial figure – which determines the mortality rate of Covid-19 and also how far away we might be from achieving a position of herd immunity.
Today, however, comes some very substantial data. The Medical Research Council’s Biostatistics Unit has published estimates of infections derived from serological studies on samples collected from the NHS Blood Transfusion Service.
It is remarkable how many deaths during this pandemic have occurred in care homes. According to the Office for National Statistics, nearly 50,000 care home deaths were registered in the 11 weeks up to 22 May in England and Wales — 25,000 more than you would expect at this time of the year. Two out of five care homes in England have had a coronavirus outbreak; in the north-east, it’s half.
Not all these deaths, however, have been attributed to Covid-19. Even when death certificates do mention it, it is not always clear that it is the disease that was the ultimate cause of death. The data refers to people who died with Covid-19 present in their bodies, whether or not it was the direct cause. This raises questions about whether there’s another reason for many of these deaths which has gone largely unnoticed while attention has been focused on Covid-19. This is not just a British phenomenon, but one seen across Europe.
One of the key things about science – obvious to its practitioners, but often obscure to outsiders – is that it is fuelled by doubt, not certainty. When the ‘facts’ change (as they often do), and when original assumptions are qualified or overturned, then any scientist worth their salt re-examines and, if necessary, alters their conclusions. The presence of cross-reactive helper cells in maybe half the population means that ideas about a possible second wave must be rewritten. This finding must make a second wave less likely, probably much less likely. And the fact that there has been no ‘second wave’ (as opposed to isolated outbreaks) anywhere where lockdown has been released also fits this hypothesis. It may well also explain why the first wave didn’t infect much higher proportions of the population.
[I]f you believe herd immunity is only reached at 60 per cent, you should be terrified at any loosening of lockdown. If you don’t, then you must reconcile antibody testing that says 80 per cent are still susceptible with the difficulty the virus seems to encounter in marching very far past 20 percent of the population.
That is the reconciliation my hypothesis achieves. I propose that there may exist forms of human resistance to this virus that don’t show up in Covid-19 antibody tests.
[I]n focusing on that Covid antibody test alone as indicating a pass-or-fail immunity, we could be overlooking important ways in which humans may be endowed with, or acquire, other kinds of resistance.
Currently, over 8 per cent of people who were tested in ‘pillar two’ have been told that their test result is ‘unclear’. Pillar two is the strand of the government’s testing strategy that deals with at-home tests and those carried out at drive-through centres. This pillar is designed for certain key workers and those who have been randomly selected for testing.
Yet the NHS instructions given to Sarah make clear that while the test might be ‘uncomfortable’, patients should stop if they ‘feel strong resistance or pain’. In other words, she was told to stop swabbing if it hurt. The tests may be accurate in a clinical setting but the problem comes when people are expected to try to carry out the procedure themselves in the real world.
COVID-19 Infection fatality rate (IFR) estimated between 0.02% and 0.4%.
With ministers and officials involved with the country’s coronavirus strategy braced for an eventual public inquiry, this week we’re being given a glimpse of how it might play out. During a morning broadcast round on Tuesday, Work and Pensions Secretary Thérèse Coffey set the cat among the pigeons when she was asked about mistakes the government may have made. It’s clear that this is a row No. 10 does not wish to be having right now.
Coffey replied by saying ministers can ‘only make judgments based on the advice’ they are given. She went on to say that on issues such as testing capacity, if the scientific advice at the time was ‘wrong’, she would not be surprised if people think ‘we made the wrong decisions’. Those comments were quick to gain traction – with critics claiming Coffey was attempting to scapegoat scientists for the government’s U-turn on testing.
The argument that vitamin D deficiency may contribute to more severe cases of Covid is gaining ground. It is now reaching the point where it is surprising that we are not hearing from leading medical officials and politicians that people should consider taking supplements to ensure they have sufficient vitamin D.
One reason why the models failed is that they – just like most countries’ politicians – underestimated how millions of people spontaneously adapt to new circumstances. They only thought in terms of lockdowns vs business as usual, but failed to consider a third option: that people engage in social distancing voluntarily when they realise lives are at stake and when authorities recommend them to do so.
As countries plan how to leave lockdown, they can look at Sweden and ask: what happens if you don’t involve the police, if you don’t issue edicts about how many of your relatives or neighbours you can visit, and just ask people to be careful? Might that work? The Swedish experiment casts huge doubts on the models, and makes the case for trusting the public.
For maintaining a precious sense of proportion, check out some other annual global fatalities: influenza, up to 650,000. Typhoid fever, up to 160,000. Cholera, up to 140,000. Malaria, 620,000 in 2017, almost all in Africa (so who cares, right?). In 2018, tuberculosis, developing treacherous antibiotic resistance, killed 1.5 million people. Why haven’t we closed down the whole world for TB?
What is destroying lives and livelihoods is not predominantly the illness. The UK economy is not in a tailspin because it can’t survive without the labor of the 32,000-plus fatalities, however much we may miss them as individuals. This is not a natural disaster but a manmade one.
Today’s figures for the first quarter of 2020 show Britain’s economy shrunk by two per cent, but that takes into account just a few days of lockdown (and suggests that the recession started some time before). The March figure is more like it: despite only formally being in lockdown for eight days in March, the UK economy contracted 5.8 per cent that month alone. As Capital Economics puts it ‘in just one month the economy has tumbled by as much as it did in the year and a half after the global financial crisis.’