Scientists, government scientists, and criticisms of government policy in the UK. Includes special Reuters report of 7 April.
and interviews featuring leading scientists and doctors.
Of particular note is his clear explanation of the difference between personal risk (or personal perceived risk) and societal risk, something that, weeks later, the UK government finally accepted. However, probably somewhat too late, they tried to emphasise the importance of social distancing to avoid the NHS being overwhelmed by thousands of dying older people. Most of these people might have died anyway of course during the ensuing few years - but not all within a few weeks or months.
However, Dr Hatchett put forward a rather optimistic assessment of the present generations of 'The British People'. Many people did indeed show a little of the 'blitz spirit' by volunteering to help during March/April 2020, but others indulged in panic buying, tried to engineer scams and other money making schemes or continued their hedonistic lifestyles!
Later data tended to show that the
coronavirus was less deadly than Dr Hatchett had calculated - because it later became
apparent that many more people may have been become infected but remained asymptomatic
(showing no symptoms).
Osterholm of Minnesota University
One lengthy interview from the USA combines all the key elements - and also is
worth watching both for the discussion of Lyme's Disease and also the role of prion
proteins in causing so called 'mad cow disease'. The interview is one and a half hours
long (you need to skip the adverts and tolerate the style of interviewing!) but it is well
earliest Lancet article suggested that everything possible should be done to avoid
spreading the virus to areas and communities that were are unaffected. Once just about
everywhere became affected, then the rationale for avoiding travel would be reduced. An
early BBC reference is here.
Somewhat late in the day (having wasted a week to ten days of valuable time toying with a simplistic notion of herd immunity), the UK government switched to a 'delay strategy' - in effect trying to buy time to boost NHS resources and to cover up their own incompetence. The UK needed to avoid the red line on the graph in the Lancet article - achieving this would be expected to lower the death rate even if the total number of cases were to be the same, because cases needing ICU (and ventilators with suitably trained staff) might occur over a longer period. The blue curve is for severe population distancing (lock-down).
Early statements from the UK government sought to give reassurance about any possible pandemic: for example:
Diagnosis and analysis (UK government, (3 March 2020)
The UK is one of the first countries outside China to have a prototype specific laboratory test for this new disease. Healthcare professionals who are contacted by a patient with symptoms following travel to an affected area have been advised to submit samples to Public Health England (PHE) for testing. Individuals should be treated in isolation.
After the experience of severe acute respiratory syndrome (SARS) in 2003, PHE developed a series of diagnostic tests to detect any member of the family of coronaviruses. These have been used for several years, and were able to detect the first UK case of Middle East respiratory syndrome (MERS) in 2012.
With the first reported publication of the genome sequence of a 2019 novel coronavirus, PHE was able to rapidly develop further specific tests for this virus, working with WHO and global network of laboratories.
When a clinician suspects novel coronavirus (COVID-19), they take samples from the nose, throat and deeper respiratory samples, package and send them safely to PHE Colindale. PHE can provide a laboratory result from this specific virus on the same working day.
PHE also has the capability to sequence the viral genome and compare this to published sequences from China, if a case occurs. This will provide valuable information on any mutations in the virus over time and allow an improved understanding of how it spreads.
Some scientists in the UK, as well as ex-minister Jeremy Hunt were quick to critise the early approach of the UK government, for example:
Views of some UK based scientists in the earliest days:
Coronavirus: 'Surprised' scientists warn UK's measures don't go far enough
Professor Jimmy Whitworth of the London School of Hygiene and Tropical Medicine: "Based on evidence from other countries, the most realistic approach to this is to initiate the strongest public health measures that will be supported by the general British public. I am surprised that stronger measures haven't been introduced at this stage, but I anticipate that they will come in the next week or two."
University of Nottingham's Professor Jonathan Ball also warned that the government's advice on self-isolation doesn't go far enough: "There is emerging data that suggests that in as many as 70% of cases the infection will present with symptoms similar to a common cold. This is serious as it means that based on government advice - which specifies persistent cough and raised temperature - most people who can potentially transmit will not be aware of the risk they pose to others and will not self-isolate."
Jeremy Hunt: "personally surprised that we're still allowing external visits to care homes. I think it is surprising and concerning that we're not doing any of it at all when we have just four weeks before we get to the stage that Italy is at. You would have thought that every single thing we do in that four weeks would be designed to slow the spread of people catching the virus."
The fact remains, the UK govt seems to be following an audacious attempt to see whether they can get the population immune, and manage the cases it brings. However, is seems likely the plan will come under extreme pressure to pivot, either from the strain on hospitals, or from unacceptable numbers of deaths relative to other countries.
Sir Patrick Vallance, chief scientific adviser: "We've got a panel of world leading scientists across epidemiology, mathematical modelling, virology, clinicians, and we're taking input from leading academics to try and come up with a plan that actually does what we want it to do.
"It doesn't mean the others are doing something wrong, in fact much of the advice, much of the actions - if you look at them - are trying to achieve the same thing. That is to try to reduce the peak of the epidemic, flatten it and broaden it, so you don't end up with so much intense pressure on healthcare systems at one time.
"That's one aim; to reduce transmission and try to make sure we end up with a broader epidemic, not a very sharp one that overloads the system. The second aim, of course, is to protect the elderly and vulnerable and make sure, during that peak, they are protected as well as you can."
University of Nottingham's Professor Keith Neal backed the government's approach so far: "The plans are sensible, it is very easy to say more needs to be done, but there is little evidence to make any decision."
The early 'herd immunity' stance was
altered when Professor Ferguson's early predictions found that the mitigation strategy, as
they called it or scenario 1 that the government had just announced would
lead to 260,000 deaths in the UK - and (critically) occurring over a short period of time.
That would be not just deaths from the virus, but from other illnesses that the NHS would
be too hard-pressed to treat. This led directly to adoption of the suppression or delay
strategy - lockdown for several weeks at a time and with attendant horrendous economic
implications. There was also emphasis on PHE as the sole testing facility - something that
was to be overturned within a few weeks, and with PHE being severely criticised for
'playing power politics'. Professor
Julian Peto was one of the scientists calling for a broader approach. Another was Sir
Paul Nurse who invoked images of 'all the little ships' used during the wartime evacuation
Some of the most severe criticism of the UK government's early approach was published in The Lancet. All coronavirus coverage in this Journal was also made available free of charge.
Amongst the plethora of scientific articles and videos of mid March 2020 that sought to explain advances in understanding of the new virus was a lucid explanation of why people on medication for high blood pressure might be more susceptible to a severe infection with Covid 19: the role of the ACE2 receptor is said to be a key factor - it is all made to sound so simple to understand!
major special investigation by the Reuters News Agency from 7 April 2020 is well worth
reading as it gives a lot of the background to subsequent unease with how the UK
government has accepted the advice of scientists. In case the internet copy disappears, the full article is reproduced here.
Entitled "Johnson listened to his scientists about coronavirus - but they were slow to sound the alarm" it suggests that not all blame for the UK's disastrously slow response can be laid at the door of Boris Johnson. Scientists should have been more pro-active in sounding the alarm - and Johnson (even on the basis of the early information he had been given) should have been far more engaged in demanding to know what were the likely or worst possible outcomes. It seems he failed to do this.
|Critically, the UK
government was warned at an early stage about the consequences of adopting the 'herd
immunity' approach - yet persisted with the idea for a period of about 10 days - a delay
in changing policy that led directly to the severity of the subsequent lockdown in the UK,
and all its associated economic consequences. The absurdity of the UK's early and
immunity' approach was discussed on 21 March 2020.
The UK does not have a clear exit strategy yet for resuming normal life
following the nation-wide lockdown imposed in March, according to a leading scientist
advising the government on its response to coronavirus.
Extract form article in The Independent 7 April 2020 (emphasis added).
criticism of the UK government came from the editor of the Lancet, Richard Horton.
The number of patients admitted to intensive care units has been doubling every 2 days. Deaths are so frequent that hospitals have created emergency mortuary space, often in car parks, moving bodies at night to avoid media scrutiny.
also at end of this article:
For those who believe now is not the moment for criticism of government policies and promises, remember the words of Li Wenliang, who died in February, aged 33 years, fighting COVID-19 in China I think a healthy society should not have just one voice.
When this is all over, the NHS England board should resign in their
entirety. So wrote one National Health Service (NHS) health worker last weekend. The
scale of anger and frustration is unprecedented, and coronavirus disease 2019 (COVID-19)
is the cause. The UK Government's ContainDelayMitigateResearch strategy
failed. It failed, in part, because ministers didn't follow WHO's advice to test,
test, test every suspected case. They didn't isolate and quarantine. They didn't
contact trace. These basic principles of public health and infectious disease control were
ignored, for reasons that remain opaque. The UK now has a new
As analysis of events started to unfold in early April 2020, the role that China played became more heavily criticised - because of their delays in notifying WHO of the progress of the disease, other countries, including the UK were slow to initiate defensive programs. Indeed, it has even been suggested that China deliberately allowed flights to continue in and out of Wuhan airport for several weeks after they knew of the human to human transmission of the virus - as a deliberate ploy to ensure that Covid-19, as it later became known, did not remain a problem for China alone. the role played by China will be examined - an early analysis was given in The Atlantic magazine. Blame is apportioned both to China and to the WHO for their failure to suspect that what China was telling them was far from the whole truth.
But there are further accusations also,
including that the virus might have escaped by accident from a laboratory in Wuhan that
had been studying coronaviruses in bats. There are some useful references in this
In addition, according to a CNN report from the USA in mid April 2020, "China's government wont answer even basic questions on the topic, and has tried to suppress investigations into the possible involvement of the two labs in Wuhan. Beijing has yet to provide US experts with samples of the novel coronavirus collected from the earliest cases, A Shanghai lab that published the virus genome in January was quickly shut down by authorities for rectification.
In essence, China withheld critical information on human to human transmission for 3 weeks to a month. Human to human transmission is what makes a pandemic possible. WHO were slow to act anyway but were deceived, so the article alleges. These two factors primarily determined how the pandemic later spread across the world. Once it did spread, actions or omissions in specific countries did much to determine their fate, together with factors such as population density and the existence of ghettos where poor and generally unhealthy people lived close together. This was seen particularly in areas of New York.
In Switzerland spread was facilitated via a ski resort populated by a wealthy and drunken 'apres ski' group. Local officials were perhaps slow to act because of the money involved. In Germany and elsewhere similar 'parties of the inebriated' gave rise to clusters of cases because of the very close social contact, including drinking from the same glasses.
Predictably, some UK politicians argued for a 'day of reckoning' with China but this is unlikely to happen for one simple reason - China is now the 'workshop of the world'. It produces a vast quantity of cheap consumer goods for the major economies of the world. All the pollution and carbon emissions associated with the manufacturing processes are within China and do not therefore count within simplistic calculations of carbon budgets of western countries - whose governments claim to be abiding by limits set down by the Paris Accord and similar 'carbon reduction' schemes. If manufacturing of all these goods were to brought back to within European countries the true emissions associated with consumerist western lifestyles would be exposed. A webpage dealing with carbon emissions associated with travel to folk dancing events is here - and once again there are many pitfalls along the road to understanding. Simple calculations can give misleading answers.
|As a seasoned career civil
servant England's deputy chief medical officer of health Dr Jenny Harries will be an
expert at avoiding answering awkward questions.
On 30 March 2020 speaking on the 8am BBC R4 news, she several times side-stepped a question about the privacy implications of using mobile phone tracking to undertake in the UK what had been done in China, Taiwan, and South Korea especially.
These governments had been open about their abilities to track the whereabouts of every citizen in real time using mobile phone masts. The UK also may have the technology but clearly didn't want to admit it.
It was obvious to anyone who has worked in the UK Civil Service that Dr Harries was here reading from a carefully prepared script during her radio interview.
The single most important and lasting consequence of the Covid-19 pandemic will probably be an enhanced capability for repressive governments world-wide (and including in the UK) to track every citizen all of the time and to know with whom everyone has been meeting. The only option will be leave your phone at home - but this is already illegal in China? Privacy implications have already been discussed, for example here within a BBC report.
The extensive use of facial recognition cameras in Russia has also been reported by the BBC.
For the moment, the impartiality of the BBC is assured and it is still allowed to report these concerns!
People like Dr Harries are also arguably responsible in part for the appalling incidence of poor diet and lack of overall fitness amongst large numbers of UK citizens For years officials and governments have paid lip service to the processed food industry - where sale of often sugar rich junk food brings easy profits. Poor underlying health is one factor in many of the deaths from Covid-19.
Dr Jenny Harries also said it could be six months before life in the UK returns to "normal" and encouraged us in the interim to 'keep fit'! Bit late for that maybe? Presumably by 'normal' Dr Harries meant eating the grossly unhealthy diet that has become a way of life (and death) for a large fraction of the population and that government for all its sanctimonious platitudes does so little to discourage?
Also, governments could do more to improve the quality of outdoor air, pollution of which has been blamed for an increased risk of dying of Covid-19.
England's Deputy Chief Medical Officer, Jenny Harries, said
on March 20, 2020: The country has a perfectly adequate supply of PPE.
History and prognosis for pandemics: the importance of testing.
of pandemics in a useful chart:
The importance of testing (report about Italy from Irish Times !!)
importance of acting early - the wasted weeks in China owing to political suppression.
Both the US and UK governments had been warned by scientists about the possible consequences of slow reaction to any new pandemic disease.
For example in the USA:
On Wednesday, October 10, 2018, the Strauss Center welcomed Dr. Robert
Kadlec, Assistant Secretary for Preparedness and Response (ASPR) at the
U.S. Department of Health and Human Services, to give a talk on the
"Evolution of Biodefense Policy." The talk was part of the Strauss
Center's Brumley Speaker Series and was co-sponsored by the
Intelligence Studies Project.
South Korea: the government took the science seriously at an early stage.
And an early stark warning from Italy (10 March) predicting the collapse of the health system.
Contrarian and other interesting views - and more on China covering up the facts.
A substantial summary of how scientific advice was ignored or misinterpreted by the UK government - failings that led directly to the high UK death rate - can be found in an analysis published by the Guardian newspaper on 29 April 2020.
Not all scientists agreed with tearly analysis or indeed with social distancing measures. Among these are the following - ones I found interesting!
John P.A. Ioannidis - an article from USA, this argues that we have a fiasco in the making - as we are making decisions without reliable data.
A very interesting article, again from the
USA and by Tomas Pueyo: The
hammer and the dance. this article is a 'must read' for its range of analysis and data
presentation. In criticising Professor Ferguson's paper (from Imperial College 16 March),
Pueyo states when he discusses the possibility of severe long term lockdowns:
"But this doesn't need to be so. This paper (by Ferguson) , driving policy today, has been brutally criticised for core flaws: They ignore contact tracing (at the core of policies in South Korea, China or Singapore among others) or travel restrictions (critical in China), ignore the impact of big crowds
An opposing view from a Swiss
doctor - well argued.
One of many youtube videos by a hospital doctor in the UK - arguing here to let fevers rip - they are part of the bodies response to an infection. Very highly rated by many viewers. In another of these videos Dr John Campbell praises Taiwan for its prompt and effective action against the virus - actions that he notes wryly were probably the result of the Taiwanese having no trust whatever in their Chinese neighbours.
Many scientists from the UK signed an early open letter demanding more government action - 14 March 2020.
John Hopkins university summary of world-wide number of cases, regularly updated.
An alarming prediction that the UK might be the worst hit country in Europe was published on 8 April and reported in the Guardian and other newspapers. The methodology used by the study was immediately criticised by other scientists.
Of the smaller countries, Iceland instituted a large testing protocol and maintained some 'social mobility' in contrast to the severe 'lock-down' protocols seen in Italy, Spain and (somewhat later than was advised) in the UK. Critically, had China released data to the WHO when it should have done, many western countries might have avoided both severe lockdown and all the associated economic consequences. It is probably too extreme to argue that this was always the Chinese master plan. There is a very watchable video Sky News report centred on China having failed promptly to notify early cases to the WHO. Later an altruistic Chinese doctor who did much to notify early the spread of the disease disappeared - presumed she was either imprisoned (maybe for life), taken away for 're-education' or maybe even killed. Despite widespread distrust of China a group of their medical experts arrived in the UK in April 2020 to 'assist' with the UK's response to the pandemic.
Many Chinese citizens were 'disappeared' during this period, for example. A journalist from Wuhan 'went missing' in February and may never be seen again. He subsequently reappeared after a period of being 'quarantined'. So he was one of the lucky ones. A bookseller from Hong Kong feared for his life after he was charged with selling books that critical of the Chinese government. He later set up a new shop in Taiwan, supported by large donations from wellwishers.
Several videos showed the deep breathing exercises that might
assist in recovering from Covid-19 - some basic advice being to lay in bed on your front
to relieve pressure on already stressed lungs. Other videos showed a 32 year old patient struggling to breathe, and another example.
Also worth watching was a video of a 60 year old medical doctor fielding questions from Piers Morgan!
A potentially very important study undertaken in New York showed the possible importance of using pulse oximeters to measure blood oxygen levels.
The Infection Thats Silently Killing Coronavirus Patients Dr. Richard Levitan, April 20, 2020, New York Times
The NYT article cited above (well worth reading) provides an important new
insight into Covid-19. Dr Levitan was an emergency doctor and specialist in airway
management for 30 years. He worked during April 2020 as a volunteer for 10 days at
Bellevue Hospital, New York, treating Covid-19 pneumonia.
Highlights from a radio interview included the following:
"There are many asymptomatic people with Covid pneumonia."
Early oxygen treatment is much better than a ventilator. Patients are presenting at hospital very late.
Covid pneumonia is unusual in that oxygen levels fall silently for days, down to shocking and dangerously low levels, while the person does not feel short of breath, despite developing serious pneumonia. This is because of the type of lung cell targeted by SARS-CoV-2.
By the time patients are admitted to hospital, blood oxygen can be as low as 50%, lungs already damaged. Early oxygen treatment brings better outcomes, and often avoids a need for onerous ventilator treatment which has poor results.
Dr Levitan recommends anyone experiencing cough, fatigue and fever during this pandemic should monitor their own oxygen levels at home using a cheap pulse oximeter that clips onto the fingertip, even if they do not have a Covid-19 test, or test negative (the swab test returns around 25% false negative).
If oxygen level drops to the low 90s or below, people should seek telephone advice from 111 or a GP.
Early oxygen treatment will save lives. In the interview, he relates the case of a Spanish lady who monitored her oxygen level at home. She had been told only to return to hospital if she experienced shortness of breath. Her oxygen was in the 80s for several days while she felt fine, watching TV. When she returned to hospital, her oxygen saturation was 62%. Sadly she passed away. Had she been treated with oxygen during those days when her oxygen was in the 80s, she would likely have lived.
Dr Levitan relates examples of doctors with Covid-19 who self-identified their low oxygen and were successfully treated.
Pulse oximeters cost around £25 on Amazon (or maybe ebay) - there are hundreds available but best perhaps to buy direct from a manufacturer (usually in China!)
Adequate levels of vitamin D in the body have been cited as having a beneficial effect in limiting the severity of Covid-19 pneumonia. One early study (basic data only and not scientifically rigorous) showed remarkable results:
0. Index page. 1. Wet markets, abuses of
wildlife, organised crime and the origins of the virus.
2. Folk dancing and the importance of other 'super-spreader' events - experience overseas.
3. Scientists, government scientists, and criticisms of government policy in the UK.
4. How many people will die - no-one can tell until the final reckoning.
5. Policing of lockdown in the UK - the need for police reform
(starting at the top?).
6. Religious nutcases and despotic governments (often the same people!)
7. Economics vs. Health - the lockdown cure being worse than the disease?
8. Ventilators and cures.
9. Shaggy dog stories - and wash your hands.
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