Terrible news in this morning’s Sun: pubs won’t re-open until Christmas. More bad news elsewhere: according to the Times, Boris is cautious about easing the lockdown, with his “overriding concern” being to avoid a second wave of infections. (The Mail has its version of the story here.) Does this mean Professor Neil Ferguson’s proposal for “intermittent social distancing”, whereby we relax some of the restrictions in short time windows, then reimpose them when case numbers rebound, has been rejected? That was put forward in Ferguson’s March 16th paper as the only viable alternative to leaving the lockdown in place until a vaccine becomes available. Bad news on that front, too. On Saturday all the papers got excited about the fact that a vaccine might be available by September – Sarah Gilbert, Oxford’s Professor of Vaccinology, announced she was “80% confident” it would be work – and trials are about to get underway. But yesterday Sir Patrick Vallance poured cold water on that idea, pointing out that no vaccine can be approved until we know it’s completely safe. In an article for the Guardian he writes: “A vaccine has to work, but it also has to be safe. If a vaccine is to be given to billions of people, many of whom may be at a low risk from COVID-19, the vaccine must have a good safety profile.” Professor Gilbert has acknowledged that accelerating the approvals process to make the vaccine available by September might require emergency legislation so it can be given to high-risk groups before it’s fully licensed.
Gavin Williamson, the Education Secretary, gave the Government’s daily briefing yesterday, and refused to be drawn on the Sunday Times‘s claim that schools would reopen on May 11th. According to several papers today, the earliest they will re-open is after the summer half term, which is June 1st. That’s bad news for all sorts of reasons, not the least of which is that two-thirds of schoolchildren aren’t logging on for online lessons according to a report by the Sutton Trust and Public First. Here’s the killer finding, as reported by Camilla Turner in the Telegraph: “Half of teachers in private schools said they are receiving more than three quarters of work back, compared with 27% in the best state schools, and just 8% in the least advantaged state schools.” More evidence that the lockdown is harming the most disadvantaged.
Several readers have sent me links to articles casting doubt on the reliability of the computer models that epidemiologists, virologists and mathematicians have been using to predict the impact of the virus. This one by Michael Fumento, which is sceptical about statistical modelling in general, is particularly good. He makes the following points:
- The CDC’s model predicted that 1.4 million people would die from Ebola in Liberia and Sierra Leone five years ago. The final death toll was less than 8,000.
- The US Public Health Service predicted that at least 450,000 Americans would be diagnosed with AIDS by the end of 1993. In fact, the number was 17,325.
- In 2005, Neil Ferguson told the Guardian that up to 200 million people could die from bird flu. “Around 40 million people died in 1918 Spanish flu outbreak,” he explained. “There are six times more people on the planet now so you could scale it up to around 200 million people probably.” The final death toll from avian flu strain A/H5N1 was 440. (That’s 440 people, not 440 million.)
- In 2002, the same Professor Ferguson predicted that mad cow disease could kill up to 50,000 people. It ended up killing less than 200.
One reader – David Campbell, a law professor at Lancaster University – has given me permission to republish his paper, first published in 2003, analysing the Labour Government’s response to the foot and mouth disease epidemic in 2001. That, too, was informed by the work of Professor Ferguson. Needless to say, it’s very critical. You can read that paper here.
Some of you may recall the gloomy prognosis that Professor Anthony Costello gave to the House of Commons Health Select Committee on Friday, claiming we wouldn’t achieve herd immunity until after eight to ten waves of infection, with a death toll exceeding 40,000 in the first wave alone. This prediction was based on a Dutch survey of blood donors which showed that only 3% of them had developed antibodies to the virus. One reader has got in touch to point out that blood donors are unlikely to be a representative sample. He writes:
By definition, a blood donor has no known infections, has not had a recent illness, even a cold or flu, and I presume the blood banks are being particularly careful at present. Even if the tests are done from the initial samples rather than the blood collected (i.e. includes rejected donors), someone who is aware that they had a cough recently would either not have volunteered or been rejected at questionnaire stage before giving a sample.
Knowing how many people have been exposed to SARS-CoV-2 is important because without that number we can’t calculate the infection fatality rate (IFR). But we can be pretty confident it’s lower than the case fatality rate (CFR), which is worked out by dividing the number of people who’ve tested positive by the number of deaths. The CFR of H1N1 influenza (swine flu) varied from 0.1% to 5.1%, depending on the country. Its IFR turned out to be 0.02% according to the WHO. The IFR of SARS-CoV-2 is likely to be higher than that, but not nearly as high as the CFR in countries like Italy, Spain, Belgium, the UK and the US. Oxford’s Centre for Evidence Based Medicine (CEBM) has updated its estimate of the IFR, which it now puts at between 0.1% and 0.36%, i.e. in the same ballpark as seasonal flu. That estimate is still heavily contested, but as we do more serological testing and continue to revise upwards our estimates of the number of people who’ve been infected the IFR keeps falling. Dr Jay Bhattacharya, Professor of Medicine at Stanford and one of the architects of the serological survey in Santa Clara that showed the number of people who’ve been infected is between 50 and 85 times greater than the number of confirmed cases, has given an interview to Peter Robinson at the Hoover Institute that you can watch on YouTube here. The preprint detailing those findings estimated the IFR at between 0.1% and 0.2%. “It’s probably about as deadly as the flu, or a little bit worse,” Professor Bhattacharya tells Robinson. (If you want to read a detailed critique of that paper, see this comment in a Columbia University forum.)
Mike Hearn, a reader, has an interesting hypothesis about why deaths-per-million in Sweden (150) are higher than in Norway (30) or Denmark (60). He points out that darker-skinned people are over-represented in America’s death statistics. For instance, in Illinois 43% of people who’ve died from the disease and 28% of those who’ve tested positive are African-Americans, a group that makes up just 15% of the state’s population. Why should this be so? The most popular theory is that it’s due to America’s “systemic racism” – African-Americans have below-average incomes and less access to healthcare, they’re more likely to be discriminated against by healthcare professionals, they have less living space than Americans of European ancestry and are therefore less likely to self-isolate, etc. But what if it’s because people with darker skins produce lower amounts of vitamin D? A recent letter in the BMJ flagged up this possibility. The writer of the letter, Robert Brown, has co-authored a paper on this you can read here. If it turns out that darker-skinned people are more susceptible to the virus than light-skinned people, that would explain why there are a higher number of deaths-per-million in Sweden than its neighbours – because it has a higher immigrant population. Twenty-five per cent of Sweden’s population – 2.6 million of a total population of 10.2 million – is of recent non-Swedish descent, whereas only 14% of Norway’s population is of non-Norwegian descent. (There are ~70,000 Somalians in Sweden and only ~11,000 in Denmark.) Incidentally, the latest daily death toll in Sweden is 29.
A reader drew my attention to an interesting critique of the Government’s handling of the crisis by a couple of vets entitled ‘Vets would not manage the Covid-19 crisis this way‘. I wonder if any vets are members of SAGE? Judging from this paper, which draws on the experience of vets managing respiratory diseases in livestock, they should be.
I took the dog for a walk in Gunnersbury Park in Acton yesterday and it was more crowded than it has been at any time before in the last month. Other walkers seemed to be less circumspect about observing the two-metre rule, too. (Why metres and not feet, by the way?) My impression is that people are growing tired of social distancing, or perhaps they were just reacting to yesterday’s front pages saying that the Government is considering a phased exit.
There was one bit of good news yesterday: the latest daily death toll is 596, the lowest it’s been in a fortnight. It looks as though deaths have peaked in the UK, something that’s borne out if you compare the last seven-day average to the previous seven-day average.
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