Will Jones

Boris Confirms “Nothing” is Ruled Out in Responding to Indian Variant. How Worried Should We Be?

Boris Johnson confirmed today that “nothing” is ruled out in responding to the Indian variant. Asked if local lockdowns are possible, the Prime Minister told reporters:

There are a range of things we could do, we want to make sure we grip it. Obviously there’s surge testing, there’s surge tracing. If we have to do other things, then of course the public would want us to rule nothing out. We have always been clear we would be led by the data. At the moment, I can see nothing that dissuades me from thinking we will be able to go ahead on Monday and indeed on June 21st, everywhere, but there may be things we have to do locally and we will not hesitate to do them if that is the advice we get.

Meanwhile, Professor James Naismith, from the University of Oxford, told BBC Radio 4 that local lockdowns will be ineffective at containing the variant and it should be viewed as a national problem.

I think we should view it as a countrywide problem. It will get everywhere. We keep learning this lesson, but we know that this will be the case. When we tried locally having different restrictions in different regions that didn’t really make any difference. So I don’t think thinking about a localised strategy for containment will really work.

An emergency meeting of Government scientific advisory group SAGE was convened this morning to address the rapid spread of the variant. One member reportedly warned that a delay to the June 21st lifting of restrictions is “possible”.

Is the Indian variant really something we should be afraid of? No doubt India is currently experiencing a surge in which the variant plays the dominant role. But that doesn’t mean the variant will pull the same trick everywhere – viruses aren’t as simple as that. There are all kinds of reasons one variant might come to dominate, and it isn’t necessarily accompanied by a surge in infections.

Italy is the European country currently most dominated by the Indian variant, having seen it quickly grow in the past few weeks (Indian variant in green).

Here’s what’s happened to the positive test rate in that time.

Clearly, the growth and dominance of the Indian variant does not necessarily lead to a new epidemic.

Meanwhile, in Spain (which has ended its state of emergency) the variant came and went very quickly.

New York Times Fact Checks “Deceiving” CDC on Masks and Outdoor Transmission

When the New York Times weighs in to fact check the CDC, you know something is in the wind. On Tuesday, reporter David Leonhardt wrote a scathing criticism of the U.S. Federal Health Authority’s recent advice that “less than 10%” of COVID-19 transmission is occurring outdoors.

Leonhardt points out that while this is technically true, it is like saying “sharks attack fewer than 20,000 swimmers a year” when the actual number is around 150 worldwide. “It’s both true and deceiving,” he says.

He calls this “an example of how the CDC is struggling to communicate effectively, and leaving many people confused about what’s truly risky”. The CDC places “such a high priority on caution that many Americans are bewildered by the agency’s long list of recommendations”.

They continue to treat outdoor transmission as a major risk. The CDC says that unvaccinated people should wear masks in most outdoor settings and vaccinated people should wear them at “large public venues”; summer camps should require children to wear masks virtually “at all times”.

However, in reality, “there is not a single documented Covid infection anywhere in the world from casual outdoor interactions, such as walking past someone on a street or eating at a nearby table”.

Leonhardt digs into the studies that supposedly underpin the CDC’s advice and finds layers of conservative over-caution.

Many of the instances of “outdoor transmission” in the literature turn out to be from construction sites in Singapore. This appears to be a classification issue.

The Singapore data originally comes from a Government database there. That database does not categorise the construction-site cases as outdoor transmission, Yap Wei Qiang, a spokesman for the Ministry of Health, told my colleague Shashank Bengali. “We didn’t classify it according to outdoors or indoors,” Yap said. “It could have been workplace transmission where it happens outdoors at the site, or it could also have happened indoors within the construction site.”

The decision that they were outdoors was made by researchers making conservative assumptions.

“We had to settle on one classification for building sites,” Quentin Leclerc, a French researcher and co-author of one of the papers analysing Singapore, told me, “and ultimately decided on a conservative outdoor definition.” Another paper, published in the Journal of Infection and Public Health, counted only two settings as indoors: “mass accommodation and residential facilities.” It defined all of these settings as outdoors: “workplace, health care, education, social events, travel, catering, leisure and shopping.”

Even with this conservative definition, however, the studies still found only a maximum of 1% of infections were caught outdoors.

So where did the CDC get 10% from? Leonhardt enquired and received this statement:

Boris Tells Commons that Pandemic is Currently at Peak and U.K. Should Expect New Surge in Autumn

Speaking in the House of Commons, Prime Minister Boris Johnson has said the Indian coronavirus variant is of “increasing concern” as outbreaks have been detected across the country. 

He said that despite increasingly encouraging data in the U.K, the threat of the virus remains “real” and new variants “pose a potential lethal danger”.

The end of lockdown is not the end of the pandemic. The World Health Organisation has said the pandemic has reached its global peak and will last throughout this year. The persistent threat of new variants, should these prove highly transmissible and elude the protection of vaccines, would have the potential to cause greater suffering than we had in January.

He added there is “high likelihood” of a new surge in infections and hospitalisations this autumn when “the weather helps the transmission of respiratory diseases, when pressure on the NHS is at its highest”.

Earlier today, junior minister George Eustice said that local lockdowns and tiers could make a comeback in response to local outbreaks.

What happened to the lifting of restrictions being irreversible? Wasn’t that supposed to be the reason it was happening so cautiously and slowly?

Despite the fast vaccine rollout and the example of states like Florida and Spain that have ended the state of emergency, the noises coming from the U.K. Government increasingly suggest they have no intention of returning the country to a normal footing any time soon. Perhaps a permanent state of emergency, and a posture as saviour, is good for elections?

Telegraph’s Global Security Correspondents Claim No Trade Off Between Lockdowns and the Economy

The Telegraph‘s Global Health Security correspondents Paul Nuki and Sarah Newey claimed this morning that there is “no trade off” between the economy and public health when it comes to COVID-19 and lockdowns.

Writing in the newspaper, the correspondents (whose coverage is partly funded by the Bill and Melinda Gates Foundation) write that the “‘health v economy’ trade-off” is “false” because “countries where the virus was swiftly contained – such as Vietnam – have seen less economic damage, plus far fewer deaths”.

This claim, based on one country, fails to acknowledge that the entire South East Asian region, regardless of the measures taken, has had a much milder experience of COVID-19 than some other parts of the world, particularly Europe and the Americas. Furthermore, while it may be true that Vietnam’s early border closures produced better outcomes (there is some evidence of this), that bird has well and truly flown for most of the world so the example of Vietnam is now irrelevant as far as this pandemic is concerned.

Perhaps, though, they have a future pandemic in mind. In fact, the peer-reviewed evidence is that lockdowns have no impact on the epidemic death toll (although it’s worth noting that Vietnam, which Nuki and Newey hold up as an example we should follow in future, has never imposed a full, country-wide lockdown). It’s also not clear how countries which close their borders to an endemic virus can ever hope to open them again – a problem Vietnam is currently experiencing. Vietnam is also not exactly an international global hub.

The article is part of the Global Health Security team’s promotion of an agenda to give the World Health Organisation more funding and more power to declare pandemics faster and be more proactive in ensuring compliance amongst states with public health edicts. They note approvingly that the pandemic has “thrust health to the centre stage, and may be an opportunity to promote a ‘green and healthy recovery'”. They appear to like the idea of a fast-acting global government imposing lockdowns so we can all be like Vietnam and “contain” the virus quickly, supposedly without suffering economic damage despite the vast disruption to the global economy this would bring.

Nuki and Newey highlight the problem of “viral misinformation” as one of 13 “mistakes” made early in the pandemic, though they blame the internet and social media rather than the WHO, despite its part in promoting myths about the virus such as that it doesn’t spread between humans and it doesn’t spread via aerosols.

But are Nuki and Newey engaging in disseminating misinformation of their own, making the bizarre claim that public health containment strategies have no trade-off with the economy based on a single unrepresentative country? When the U.K. economy shrank by a record 9.9% in 2020, this claim is frankly ridiculous and such claims are at odds with the Telegraph‘s overall coverage of the way different countries have managed the pandemic, which has been quite balanced. Should the paper really be allowing a team of journalists whose work is partly funded by the Bill and Melinda Gates Foundation to use its platform to promote an agenda of enhanced global control in the name of public health?

What Second Wave? Total Deaths in UK and Sweden Now Average for 2021

New figures from the ONS released yesterday show that deaths in England and Wales are running 7.3% below the five-year average for the week ending April 30th. This is the eighth consecutive week that registered deaths have been below the five-year average.

While the UK’s winter epidemic has been over for some months now, Sweden, like much of the continent, has seen a spring wave.

ICUs have been busier in spring than they were in winter.

Majority of Covid Hospital Admissions Over Winter Were Vaccinated, PHE Study Shows

The Government announced results from two new vaccine studies from Public Health England (PHE) yesterday. One looks at how much protection the vaccines offer against death once a person is infected, the other at how much protection against hospitalisation with COVID-19 the vaccines offer.

The study on deaths is the more straightforward of the two. It looks at PCR positive cases in England between December 8th and April 6th. It finds among 80+ year-olds: 16.1% (1,462/9,105) of unvaccinated cases died versus 9.2% (99/1,072) of cases at least 21 days after their first Pfizer dose, 11.3% (33/293) of cases at least 21 days after their first AstraZeneca dose and 4.7% (6/128) of cases at least seven days after their second Pfizer dose. These correspond to unadjusted relative risk reductions of 43% (Pfizer 1), 30% (AZ 1) and 71% (Pfizer 2) respectively.

Among 70-79 year-olds it finds 4.0% (1,147/28,875) of unvaccinated cases died versus 2.7% (15/549) for Pfizer 1, 2.1% (10/484) for AZ 1 and 0% (0/7) for Pfizer 2. This corresponds to unadjusted relative risk reductions of 33% (Pfizer 1), 47% (AZ 1) and 100% (Pfizer 2).

Once adjusted for sex, clinical risk factors, age and being a care home resident, these become relative risk reductions of 44% (Pfizer 1), 55% (AZ 1) and 69% (Pfizer 2). This level of reduction in the mortality rate among the vaccinated over-70s once infected is encouraging. The lack of data on deaths within 21 days of the first jab and seven days of the second jab is disappointing. Why do we have yet another study on vaccine efficacy with no accompanying analysis of safety?

The second study looks at whether vaccination protects against hospitalisation. Unlike the first study, it doesn’t look at those already infected (testing positive) to see whether they are hospitalised, but at those who are hospitalised to see whether they’ve been vaccinated. It analyses 13,907 admissions in trusts participating in a surveillance programme between December 8th and April 18th. It excludes those who caught the virus in hospital. It also excludes those whose positive PCR test was more than five days before admission (1,230 cases), the reason for which is not explained. The breakdown of admissions by sex, age and vaccination status is shown in the table below.

Notice that a majority of admissions in this period – 57% – had received at least one vaccine dose. An earlier study that I noted before, from the ISARIC4C consortium, had found just 7.3% of hospital admissions over a similar period had received at least one vaccine dose. The reasons for this huge discrepancy are unclear, but given that the earlier figure made headlines for showing how effective the vaccines are, and for the sake of clarity in data, it should be cleared up.

The Maddening Mystery of Imperial’s Invulnerable Reputation Despite its Dire Record of Failed Model Predictions

Phillip W. Magness in AIER has crunched the numbers and shown how poor Imperial College’s modelling has been at predicting the outcomes of the COVID-19 pandemic under different policy responses in every country in the world (well, 189 of them). Yet for some unexplained reason Neil Ferguson and the rest of the Imperial team remain respected authorities on epidemic modelling and management. Magness writes:

COVID-19 has produced no shortage of doomsaying prophets whose prognostications completely failed at future delivery, and yet in the eyes of the scientific community their credibility remains peculiarly intact.

No greater example exists than the epidemiology modelling team at Imperial College-London (ICL), led by the physicist Neil Ferguson. As I’ve documented at length, the ICL modelers played a direct and primary role in selling the concept of lockdowns to the world. The governments of the United States and United Kingdom explicitly credited Ferguson’s forecasts on March 16th, 2020 with the decision to embrace the once-unthinkable response of ordering their populations to shelter in place.

Ferguson openly boasted of his team’s role in these decisions in a December 2020 interview, and continues to implausibly claim credit for saving millions of lives despite the deficit of empirical evidence that his policies delivered on their promises. Quite the opposite – the worst outcomes in terms of Covid deaths per capita are almost entirely in countries that leaned heavily on lockdowns and related nonpharmaceutical interventions (NPIs) in their unsuccessful bid to turn the pandemic’s tide.

Assessed looking backward from the one-year mark, ICL’s modelling exercises performed disastrously. They not only failed to accurately forecast the course of the pandemic in the US and UK – they also failed to anticipate COVID-19’s course in almost every country in the world, irrespective of the policy responses taken.

Time and time again, the Ferguson team’s models dramatically overstated the death toll of the disease, posting the worst performance record of any major epidemiology model.

Magness has put together a table of all the countries with the predictions ICL made for them and their actual outcomes. The results should be fatal for the reputation of anyone whose job it is to make accurate predictions of the future course of events. But not ICL it seems, whose credibility appears to be invulnerable despite repeated and consistent failure. Magness wonders why.

Why is Ferguson, who has a long history of absurdly exaggerated modeling predictions, still viewed as a leading authority on pandemic forecasting? And why is the ICL team still advising governments around the world on how to deal with COVID-19 through its flawed modeling approach? In March 2020 ICL sold its credibility for future delivery. That future has arrived, and the results are not pretty.

Worth reading in full.

Study Claims Pfizer Vaccine is 95% Effective in Over 65s. But Should That Be 74%?

A new population study from Israel, published in the Lancet on Wednesday, finds that the Pfizer vaccine is 95.3% effective against SARS-CoV-2 infection once a person is fully vaccinated (defined as being a week past their second dose). It also finds the vaccine is 94.8% effective in those aged 65 or older once fully vaccinated.

This is in line with other studies and is a very encouraging result. However, as with previous studies, it’s not clear how well the researchers have taken into account the fact that infections were declining anyway during the study period and whether this has led to an over-estimation of vaccine effectiveness.

To test this I accessed the data available from the Israeli Government. I looked at how many cases occurred in each age group each week alongside the proportion of that age group that had been fully vaccinated by that week. This allowed me to calculate how many infections we would expect to occur among vaccinated people in each age group each week if you assume the vaccines don’t have any effect. I then added these together to give a baseline number of cases in each age group to compare against the number of actual cases among the vaccinated as reported in the study. The results are shown below.

I calculated we would expect 43,826 infections among the vaccinated out of a total of 237,700 in the study period (January 24th to April 3rd) if the vaccines have no effect, which is 18.4%.

The study reports 6,266 infections among the vaccinated out of a total of 232,268 during the study period, or 2.7%. (I wasn’t able to discover why the study had about 2.3% fewer infections than the Israeli Government data broken down by age, but by using proportions we can avoid this discrepancy affecting the calculation.)

A proportion of 2.7% is 85.4% lower than a proportion of 18.4% that we estimated if the vaccines had no effect. This suggests a vaccine effectiveness of more like 85% than 95%.

Looking now at the crucial older age group, if the vaccines had no effect I have calculated we would expect 11,332 infections among the vaccinated aged 60 and over out of a total of 29,489 infections in that age group during the study period. The study found 2,201 infections among the fully vaccinated aged 65 or more. (It doesn’t state how many infections there were in total in this age group so we can’t calculate a straightforward proportion from the study.)

We need to adjust our expected figure of 11,332 to allow for the fact that it includes those aged 60-64 (the study uses different age brackets from the publicly available Government data). From the table above this will be about half of the infections in the 60-69 age group, or 2,834. We also need to reduce the expected figure by around 2.3% to allow for the different infection totals of the study and Government data. This gives us an expected figure of 8,329 infections among the vaccinated over 65s.

The 2,201 figure from the study is 73.6% smaller than 8,329, suggesting a vaccine effectiveness among the over 65s of more like 74% than 95%.

It’s not clear why the authors of the study did not do an analysis similar to this one. Taking into account the background prevalence of the virus should be basic, to avoid over-estimating the effectiveness of vaccines when they are rolled out during the decline of the epidemic.

The study (which was funded and approved for publication by Pfizer) briefly mentions lower vaccine effectiveness 2-3 weeks after the first dose, but does not give any information about effectiveness or infection incidence in the first 14 days. This means it gives no more information about the post-vaccination infection spike observed in other studies, though the silence here may be telling.

A further question is why the researchers gave no finer-grained detail about those older than 65 when they must have had the data to do so, and more than half of Covid deaths are in those aged over 80.

An effectiveness of 85% overall and 74% among the over 65s is still good, but it is not as good as the 95% figures in the study. As so often with vaccine studies, on closer inspection you’re left wondering whether you’re getting the full and accurate picture.

“The Toxicity of Some of the Chemicals Found Raises the Question of Whether Face Masks are Safe to be Used on a Daily Basis” – Study

A new peer-reviewed study in the scientific journal Water Research has called for a full investigation into face masks as it raises serious questions about their safety for daily use and their impact on the environment.

The study, “An investigation into the leaching of micro and nano particles and chemical pollutants from disposable face masks – linked to the COVID-19 pandemic“, investigated the impact of disposable plastic facemasks (DPFs) on the environment by submerging masks from seven different manufacturers in water then testing the water for chemicals. The researchers found lead, cadmium, antimony and various plastic and organic substances in the water. They expressed concerns about the contribution disposable face masks are making to the world’s plastic problem.

While the focus of the study was on the impact on the environment, the authors were clear about the implications of their findings for the safety of masks for public health. They write: “The toxicity of some of the chemicals found and the postulated risks of the rest of the present particles and molecules, raises the question of whether DPFs are safe to be used on a daily basis and what consequences are to be expected after their disposal into the environment.”

The problems arise from both the toxicity of the chemicals present and how easily they detach from the mask. The authors call for a full investigation into the risks to the environment and public health.

There is a concerning amount of evidence that suggests that DPFs waste can potentially have a substantial environmental impact by releasing pollutants simply by exposing them to water. DPFs release small physical pollutants such as micro and nano size particles; mainly consistent with plastic fibres and silicate grains, which are well documented to have adverse effects on the environment and public health. In addition to the physical particles, harmful chemicals such as heavy metals (lead, cadmium and antimony), and organic pollutants are also readily released from the DPFs when submerged in water. Many of these toxic pollutants have bio-accumulative properties when released into the environment and this research shows that DPFs could be one of the main sources of these environmental contaminants during and after the COVID-19 pandemic. It is, therefore, imperative that stricter regulations need to be enforced during manufacturing and disposal/recycling of DPFs to minimise the environmental impact of DPFs.

Secondary to environmental concerns, there is a need to understand the impact of such particle leaching on public health, as all DPFs released micro/nano particles and heavy metals to the water during our investigation. One of the main concerns with these particles is that they were easily detached from face masks and leached into the water with no agitation, which suggests that these particles are mechanically unstable and readily available to be detached. Therefore, a full investigation is necessary to determine the quantities and potential impacts of these particles leaching into the environment, and the levels being inhaled by users during normal breathing. This is a significant concern, especially for health care professionals, key workers, and children who are mandated to wear masks for large proportions of the working or school day (6–12 hours).

The full article is behind a paywall but the abstract is publicly available and can be found here.

Looks like the makings of another public health calamity with the potential for some very expensive litigation. If I was in Government, given how weak the evidence is for their effectiveness, I’d be looking at phasing face masks out round about now.

Why is the World’s Most Vaccinated Nation Locking Down Again?

Seychelles, an archipelago nation in the Indian Ocean with a population of about 98,000, is locking down again – even though it has fully vaccinated more than 60% of its adult population with two vaccine doses, more than any other country in the world including Israel.

The country has banned the intermingling of households, closed schools, imposed curfews on bars and cancelled sporting activities for two weeks as infections surge.

The country began vaccinations in January using a donation of Chinese vaccines from the United Arab Emirates. According to Bloomberg, by April 12th, “59% of the doses administered were Sinopharm vaccines and the rest were Covishield, a version of AstraZeneca’s shot made under licence in India.”

The Government put the surge down to people being less careful, particularly over Easter. However, setting aside whether population behaviour is a plausible explanation, this doesn’t explain why the vaccines are not preventing transmission or infection.