Lessons from the Covid Scandal

We are now at a stage, where more and more people are accepting that the second “wave” is amounting to not much at all as it barely registers as any excess deaths. And with multiple signs of it peaking, those who look at the data are no longer scared. But what now?

Lockups increase covid deaths

It is now clear to me, that the only viable way to save lives in an epidemic like this which cannot be stopped and is going to infect most people before it is possible to create a safe vaccine, is to maximise the difference in R* between those who are most likely to die and those who are least likely to die. (I’m using R* as a measure of social contact & interactions so that it is proportional to R0).

The problem with government policy was it used a single policy to reduce R* across society as one nebulous mass, using a wishful undetailed plan that some academic thought up years ago for an imaginary epidemic. The result is that government ignored what was actually going on in this epidemic and mindlessly pursued a single entirely theoretical plan as if nothing else were possible. It did not adapt as evidence came in showing that lockups were not only not working but appeared to be making the death count HIGHER.

The theory is that the total infections needed to get community immunity is related to R* so that as R* reduces, the total infections for community immunity reduce. And indeed, that is a great plan in a theoretical epidemic which does come to an end. But in a real epidemic, unless the virus is very easily spotted, it will continue infecting people at a low level for years to come, long after people need to return to normal. And therefore, unless community immunity is achieved at the R* number that society normally has, the epidemic takes off again. And it keeps taking off, until society as community immunity at which point it will die off naturally.

The winter effect

Unfortunately, respiratory viruses tend to spread more easily in winter. As such R* effectively increases, thus the level of infections necessary for community immunity in summer is LOWER than that in winter. So, the time to kill off a virus is the summer – and what did SAGE do? They repressed it in the summer, ensuring that the virus would still be around in the winter to maximise deaths.

Shorter epidemics kill fewer (ageing)

Unfortunately, because covid preferentially kills those close to death and about 500,000 people die each year. That is up to 500,000 new candidates each year for covid to kill. So, the longer the epidemic continues, the more new vulnerable people are being created, so that a long epidemic lasting many years kills far more people than a short one. So, e.g. in the UK, the second ripple occurred about six months after the first. So, in that time about 250,000 people entered the last year of their life and became NEW prime candidates to die from covid.

Shorter epidemics kill fewer (effectiveness of isolation)

Because it is far easier to be completely isolated for a short period than a long period, it is far easier to minimise the R* for individuals in a short epidemic than a long one. And, because the R* that matters, is that which is current AT THE END of the epidemic, then isolation becomes much less effective the longer the epidemic continues. In particular, there is no point isolating completely for one month and then having to return to normal activity, if the epidemic is going to last a year. It is far better to modestly reduce R* (by e.g. hand washing) which is something that can be kept up for years.

Lockups focus the epidemic in the vulnerable and maximise deaths

The idea of academics was that reducing R* was supposed to reduce the number of deaths. But the reverse was true. The problem is that in this epidemic, 95% of deaths occurred in those with pre-existing conditions. So, there was a relatively small group who suffered most deaths. More problematic, is that this group of vulnerable get a huge amount of their social contact through people who are giving them help in some way. So, they find it incredibly difficult to reduce their social contact or R*. In contrast, the young and fit have a lot of discretionary social contacts (pub, dance, parties, etc.) and so find it far easier to reduce their R*.

Thus, the effect of government policy was to increase the relative R* between the vulnerable and fit, meaning far more of the infections occurred in the vulnerable and therefore the policy actively INCREASED the number of deaths that would occur before community immunity. And because covid could not be stopped from spreading so that most people were going to be exposed before a vaccine could have had any benefit, the effect of lockup was to focus the virus in the vulnerable (and those connecting them like carerrs and medics) and this meant that community immunity was achieved with a disproportionately higher level of infections amongst the vulnerable.

Because the idea that lockup killed people, may seem counter-intuitive I’ll try to explain what might be needed to MAINTAIN the SAME level of deaths when using lockup. Let us suppose the government implement measures to reduce R* amongst the fit by 50%. So the young are now seeing in close proximity half as many people. In order to maintain the same reduction in R* across the vulnerable, they now have to see half as many carers.

Now let us suppose the government decide to reduce R* to 10% of its normal value. Now the most vulnerable instead of perhaps 3 visits a day by nurses, only get visits once every three days. Of course face masks might reduce the R* marginally, but didn’t the government mandate face masks for the fit and healthy also!

An academic can easily sit on SAGE with their epidemic model saying “we must reduce R” but whilst such policies might easily reduce R* in the fit and young, unless a huge effort and planning goes into reducing it for the vulnerable it is inevitable that their R* will reduce much less than that of the fit and young. As a result, the lockup tends to focus the epidemic in those most likely to die from it.

Lockups destroy society and economy and lead to many many more deaths

It is estimated that the lockup will cost the UK about £500billion. Nice guidelines suggest that a drug is worth taking if  costs less than ~£1million per average life saved. On that basis, we could have saved about 500,000 lives for the cost of the lockup. The worst estimates of total lives that could be lost going into the lockup were about 300,000. There never was a cost benefit for lockup.

Never ask an academic to do an engineer’s job

I have joked that people get promoted to committees like SAGE because they are the type of people no one wants around when doing real research. But it’s true. The type of people who put themselves forward are arrogant social manipulators who usually have a very poor grasp at practical science. Worse still – these people are “flappers” in a crisis. They have little practical ability themselves, need to be “in control” and when they are being flooded with new, poorly understood and difficult to interpret time, cost or safety critical data they make a complete Rs of it.

In contrast, the people who got this epidemic right – were the front line doctors and engineers used to data analysis in time, cost, safety critical environments who are the type of people any reasonable person wants around them in a crisis. They don’t flap, because:

there’s always an alien battle cruiser, or a Corellian death ray, or an intergalactic plague intended to wipe out life on this miserable little planet. The only way these people can get on with their happy lives … is that they DO NOT KNOW ABOUT IT (Men in Black)

When you’ve been an engineer with management jumping up and down on your desk demanding when the production machinery is going to be up and working again, or you’re an A&E doctor seeing yet another drunk who thinks their head wound demand immediate treatment ahead of the heart attack victim … you learn to ignore what people are saying and focus on the important and often contradictory information.

More importantly, those with frontline experience, know how important it is to have an open mind. Often, a crisis that appears to be due to one thing, can be caused by something that was entirely unexpected. So, someone used to working in a frontline role, will force themselves to keep an open mind. In contrast, academics come from an environment, where it is often the practice to vigorously fight your own corner and push your views against all others. Academics work by forming alliances with others to get their ideas promoted ahead of the opposition. It’s a siege mentality – constantly pounding on the doors of journals to get your papers to the top spot. Thus, when academics get into a crisis situation, they can tend to focus on their one and only “idea”, act like they are under siege and defend it to the death (at least of other people).

The initial failures

SAGE were worse than useless throughout this epidemic, PARTICULARLY at the beginning where in January they said the risk was “VERY LOW” … which any reasonable person would take to mean that there was no reason to do any preparation, and then later (Feb, Mar?) when they assured us it could be stopped using track and trace (even when this had clearly failed to stop it in numerous other places).

The result of this criminal incompetence is that no one seriously considered Covid would spread throughout the UK until a very late stage, by which point it was probably a matter of days before a possible “tsunami” flooding the health service. That undoubtedly was the initial reason for the mass panic, that lead to the insane lockup which was so deadly.

I suggest the problems were:

  1. SAGE were incompetent
  2. SAGE were the wrong type of people to put anywhere near a crisis
  3. SAGE failed to monitor available sources like social media
  4. SAGE failed to develop a “what if” scenario based on track and trace failing
  5. SAGE failed to consider the epidemic and economic & social aspects as a whole

Basically, criminal prosecutions should be brought against key members of SAGE and it should also be disbanded completely.

Instead, we NEED a new form of monitoring and advisory agency staffed by people who do have frontline experience and never again allow incompetent arrogant academics anywhere near control. Whilst it would be useful for this organisation to be staffed by those who understand virology, unfortunately, the next crisis is likely to be something else entirely different. And whilst a virologist would be useful when the next pandemic arrives, a person may be employed and work their whole career before anything more than a once in a decade virus appears.

As for government … when eventually SAGE admitted that they were incompetent and had failed to warn about the epidemic … what I could see of government reaction was reasonable given the appalling situation they had been put in by SAGE. Except for some insane reason, they kept going to those who had so failed them …

Specific points

Just a few odd points

  • We need to think about a stockpile or strategic rapid manufacturing of PPE.
  • We need a strategic stock of hand sanitiser
  • We ought to encourage people to maintain a stock of critical items … or a strategic stock and think about how to go quickly from “normal” to “isolated”.
  • We need to have ways to increase the flow of fresh air, so that all spaces like supermarkets, transport, police stations, parliament, courts, hospitals, GPs, etc., have air flows that means that any virus is quickly removed from the space.
  • We need to amend human rights legislation to make it clear that “health reasons” does not include the mass lockup of society.We also need a debate, about how we ENSURE AND MAINTAIN human rights if there ever were a real crisis.
  • We also need to include explicit provisions REQUIRING regular judicial review of measures, particularly anything censoring the free flow of information which was one of the most destructive aspects because it created this insane group-think that caused so much harm and damage.
  • There is strong evidence that coercion was counter-productive and led to fewer people going along with the lockup. We need to know how this appalling idea that people had to be treated like children developed and who was responsible … and we need to ensure that it never is allowed to happen again.

 

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