This personal Blog starts on Good Friday, April 10th several days after our Prime Minister Boris Johnson was admitted to Intensive Care at St Thomas’ Hospital in London, where he stayed for 3 days, thankfully discharged back to a general ward yesterday. This was a truly shocking moment during the Coronavirus Pandemic crisis. It showed how Covid-19 has no respect for boundaries, with the most powerful man in the UK fighting his own personal battle against a pernicious virus that China, and now the whole World, has been fighting since the start of 2020. It is a War against an invisible enemy and there are many battles ahead.
I have been keeping a diary since early February on the evolving Pandemic which I predicted at the time, and to which I will refer to on occasion. The real purpose of this Blog is to pull together and curate alternative views that are not always covered by the relentless 24 hour News coverage of the Mainstream media.
There will be no Fake News, no Conspiracy theories no Disinformation and no Misinformation in this Blog I hope, although one can never be totally sure in this day and age.
To be clear, Disinformation is one of the many tactics deployed online to deceive and spread false information, whereas Misinformation can be as a result of disinformation, and refers to inaccurate information or content that is mistakenly shared.
Changing views – Madam I’m Adam
My views have changed many times during the last 3 Months or so, backwards and forwards – hence the Palindrome strapline “Madam I’m Adam”. Sometimes after watching the Press Briefings when high numbers of deaths are reported, or watching a TV news item from an Italian or UK Intensive Care Unit, I think that the Lockdown measures and social distancing measures are reasonable and justified.
Then I read alternative articles, and I think that perhaps we have gone too far, and the economic calamity wrought by Covid-19 could be far worse than the consequences of the disease itself. For 80% of the population, including children and adults in good health, the disease can be relatively mild and not life threatening (with a few tragic exceptions, usually those with underlying medical conditions). Also, some people infected with Covid-19 are asymptomatic with no symptoms of the disease whatsoever.
The mortality profile of Covid-19 also remains unusual from a virological point of view because, in contrast to the influenza viruses, children are mostly spared and men are affected about twice as often as women. However, this corresponds to the profile of natural mortality, which is close to zero for children and almost twice as high for 75+ year-old men as for women of the same age.
There needs to be a reasoned and balanced Public debate on the view first expressed by President Trump at a Press Briefing on 25th March, when he said “We cannot let the cure be worse than the problem itself”. Public Health experts around the World were horrified, but the question Trump posed needs to be taken seriously.
On one side of the debate is the view that we establish “herd immunity”, where Covid-19 is allowed to rip through the population, building up immunity, thus allowing the young, healthy and immune population keep the economy functioning as normal. Imperial College London modelling, used to inform Government, suggested that 500,000 could die by August in the UK if such a policy was followed.
As Bill Gates put it “it’s very tough to say to people, ‘Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts.’”
The initial policy of the UK Government’s strategy was to slow the spread by asking those with symptoms to self-isolate and to shield the most vulnerable, until Professor Neil Ferguson from Imperial college pointed out that this could kill 250,000 and hospitalise hundreds of thousands more, with the NHS unable to cope.
Clearly, this policy was not realistic or sensible, and the Government quickly switched to the current policy of suppressing the infection rate to “flatten the curve”, by closing schools, partial Lockdown, Social Distancing measures and shielding the most vulnerable from March 24,th,with the familiar mantra hammered home by every politician, medical and scientific expert at every opportunity :
“Stay Home, Protect the NHS, Save Lives”
It is hoped these measures will limit deaths attributable to Covid-19 to 20,000 in the UK.
To put the death rate into perspective, the overall natural mortality rate in the UK is over 600,000 per year, an average of approximately 1,700 per day. The frail and elderly are most at risk, just as they are if they have Covid-19.
Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter, at the University of Cambridge, points out, and the risk of them dying, if infected with coronavirus, is almost exactly the same. That does not mean there will be no extra deaths – but, Sir David says, there will be “a substantial overlap”.
Many people who die of Covid-19 would have died anyway within a short period. “Knowing exactly how many is impossible to tell at this stage” said Sir David. Prof Neil Ferguson,at Imperial College London, suggested it could be up to two-thirds. But while deaths without the virus would be spread over the course of a year, those with the virus could come quickly and overwhelm the health service.
What are we to draw from these startling comments? Are we wrecking the Economy for no good reason, when the majority of people dying are elderly with underlying medical conditions, who would have died anyway within a short period?
Testing (Swab and Antibody)
Testing for Covid-19 has also been one of the main problems of managing this Pandemic. There is an old adage that says “If you can’t measure it, you can’t manage it”, and this remains true in this crisis.
On 3rd April, the Health Secretary has promised testing to increase to 100,000 Covid-19 tests per day in England by the end on April, with a five action point plan, involving :
The “five-pillar” plan involves:
- Swab testing at Public Health England and NHS laboratories;
- Using commercial partners, including universities and private businesses, to establish more swab testing;
- Introducing antibody blood tests to determine whether people have had COVID-19;
- Surveillance to determine the rate of infection and how it is spreading across the country;
- Building an “at-scale” diagnostics industry to reach 100,000 tests by the end of April.
What is not clear is : what proportion of those 100,000 tests will be swab testing (to see if NHS staff or individuals have Covid-19) ? and what proportion of those 100,000 tests will be antibody blood testing (to see if either NHS staff or individuals have had Covid-19).
Moreover, how are the results going to be modelled to establish a strategy for a phased lifting of the Lockdown ?
Clearly, Trade -offs need to be made in managing this health and economic emergency. The longer the crisis continues, there is a danger that the “Cure” will in fact be worse than the original problem, with the World economy wrecked for many years, leaving an economic situation worse than the Great Depression of the 1920s,with unemployment at record levels, taking decades to recover.
I came across this web site this morning, also hosted by a concerned citizen, but far more sophisticated than my blog. I commend this site to you (click above : Covid-19 in Proportion ?.
Is the cure worse than the disease?
To deal with the threat of COVID-19 the UK Government has ordered unprecedented shut-downs and quarantines, and many support this in the spirit of “better safe than sorry”. However, this overlooks the fact that shutdowns and quarantines also kill. The economic, social and health costs will almost certainly include:
- Earlier deaths for cancer sufferers due to diagnosis and treatment delays
- Business failures leading to more business failures
- Job losses leading to poor health, social problems and suicides
- Fewer taxpayers available to fund an increasing need for social benefits
- Reduced funding for the NHS and the rest of the public sector
- Lost educational opportunities and disruption to exams and graduations
- Inflation as Government “prints” and “borrows” more, while tax revenues fall
- Pension values reduced by stock-market crashes
- Reduced life expectancy for people moving deeper into poverty
Or in the words of a former UK Supreme Court Judge:
“The real question is, is this serious enough to warrant putting most of our population into house imprisonment, wrecking our economy for an indefinite period, destroying businesses that honest and hard-working people have taken years to build up, saddling future generations with debt, depression, stress, heart attacks, suicides and unbelievable distress inflicted on millions of people who are not especially vulnerable, and will suffer only mild symptoms or none at all?”former Supreme Court Judge , Lord John Sumption, discussing the UK response to COVID-19, BBC interview 2019-03-30 
Back in August last year, I posted about a hypothesis that herd immunity had been reached in a Manaus Brazil, the Amazonian capital city with a population of 2 million people, where only 20% of the population of had been infected by covid-19. Manaus was once a symbol of the threat that the virus mightContinue reading “Brazilian variant causing a surge of covid-19 cases …..in Brazil !”
Its hard to believe that less than a year ago in early February 2020, we flew into Rio de Janeiro to start our South American cruise. There were no cases of Covid-19 in Brazil, and our cruise to Santaigo Chile via Cape Horn went ahead without incident. We were so lucky. In response to theContinue reading “Covid-19 : Brazilian variant sparks South America travel ban”
Nearly twenty years ago, I wrote a paper recommending that the large regional hospital where I worked build a “patient hotel” to help alleviate the winter pressures that the hospital experienced each year. Even then, this was not a new idea. Since the late 1980’s, hotels—not hospitals—specifically designed for sick people have been popping up throughout Scandinavia.Continue reading “Hotels to free up beds for critical Covid-19 cases”
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