Category Archives: Health

Millennials get their revenge on the Boomers

I’ve been concerned about increasing generational conflict for many years. Some of it is justified, some isn’t, but in an era of fake news and conspiracy theories, it’s hard to resist having some fun with the idea. There’s too much reality right now. In any case, reality counts for little while perception is everything, and if your bubble tells you to feel aggrieved, that’s a lot easier than doing actual research on the figures. So here goes. Don’t take it too seriously.

The boomer generation had an easy ride through life, buying their big houses cheaply and getting fat index-linked pensions from their late 50s, lazing around on golf courses, while millennials and zoomers are having to pay too much for their homes, won’t get the nice pensions and will have to work far longer. Also, the boomers trashed the environment and wrecked the climate, filled the world with nuclear weapons, and did nothing to reduce racial or LGBT oppression. They even forced the UK to leave the wonderful EU, so now all our businesses will die and it won’t be long before we’re all on minimum wage with nothing to eat but recycled cardboard. Millennials are having to fix everything, absorb all the debt and pay all the bills, and won’t even inherit anything until we are old and grey.

So, payback time then. What mechanisms are available to punish the horrible boomers and restore fairness for millennials.

Sadly, we can’t just go and murder them all, well not unless we defund the police first anyway. We could try that, and see how it works, maybe some scope for experimentation with different approaches. A few manipulated riots and who knows how many we can get rid of?  We could do with some sort of  Logan’s Run style carousel, where the over 60s are ceremoniously terminated. Too obvious in that form, but applying some basic PR gumption,how about a system that allows them to be killed for their own good, with us making the decisions of course? So we needs a nice name that sounds compassionate and caring. How about Liverpool Care Pathway?, Yeah that’ll do, maybe we can tweak that now and then if people start to get wise to it. Perhaps design a nice form and smile sweetly while asking them to sign it so they suspect nothing. After all, a nice doctor from the wonderful NHS, what could possibly be wrong. They’ll assume DNR is just another medical term, like check blood pressure or something. Most of them won’t know what resuscitate means anyway. “Do not resuscitate”, they’ll think we mean not to wake them too early in the morning, let them lie in a bit or whatever. They grew old trusting the NHS so won’t suspect a thing. So, a couple of forms and we can get rid of quite a few of the old scroungers.

Oh look, a virus, that kills old people. Who’d have thought? If anyone suspects it was commissioned by Obama funding research in the Wuham virus lab, adapting a bat virus for human transmission, we can just dismiss that as a conspiracy theory – the Chinese are good at hiding stuff anyway so there won’t be any proof, they’ll just disappear anyone that might give the game away. Nobody would ever believe it and the media will all help to keep it quiet. So all we have to do is let it come over in planes and ships, not do anything at all to stop if until it’s everywhere and boomers will start dropping dead. If we say we need space in hospitals, we can chuck lots of infected boomers out of hospitals into old folks’ homes where they’ll infect loads more. Keep feigning incompetence, make sure the infection gets all the best chances of spreading, keep the old people in homes and delay any promising medications for any that get to hospital and before you know it, tens of thousands of them will be history. Think of all the pensions and benefits and the huge care and medical costs we’ll save. And all the inheritances that will be passed on years earlier.

But there will still be millions left, so we’ll need more viruses every few years.

Meanwhile, we still need ways of transferring their money. Boomers have loads of savings and investments so we need a way to transfer that to the state so we can have low taxes but still get all the good things. Taxes would work, but they’re too obvious. This idea of printing money is pretty good though. Let’s call it quantitative easing so people won’t pay attention and will just get bored if they investigate. So we borrow loads or money and increase public services, but then print loads of money to pay off the debt instead of raising taxes. That means any existing money is diluted, so its value falls, but the debt is worth less. Magic! Sure the existing money is worth less, but the boomers have most of that, we don’t have much yet, so they pay, and we don’t, our taxes stay low and the boomers pay. Serves them right. Everyone sees inflation of course, but the we will get pay rises to keep up, but the horrible boomers that didn’t work in the public sector probably won’t have their pensions index-linked, so will see their pensions worth less and their savings evaporate as the value transfers to the state, keeping our taxes low. In fact, while we’re at it, if we can persuade them to swap their pensions for cash, let’s call it transferring out, the quantitative easing will work much faster so we can get their money even quicker. The public sector boomers will still get their index linking, but we’ll still get their savings, and they’ll carry on voting for the left too – what’s not to like? So, suppose we do £1 Trillion of QE, that’s a decent start, but probably won’t even get any headlines. 15k per capita if it was everyone paying, but 50% don’t pay net tax and most of the rest only pay a bit, so that’s like a £50k Boomer tax, £100k for a couple. And we can do that every few years, and most will never notice, they’ll just carry on whining about increasing prices and we’ll just carry on making fun of them.

So we get to legally kill off a lot of them, and as for the survivors, we get to take their pensions and their savings. Best of all, we still get to make them feel guilty about how awful they’ve made it for us.

Revenge is sweet!

 

 

Some lingering impacts of COVID

COVID and lockdown will one day be history. Some of its effects will linger for a long time. Here I will look at just a few that spring to mind.

Introduction

Millions of people worldwide have been infected by the coronavirus Sars-CoV-2. A quarter of a million have died from it. Overlooking the platitudes about each being a personal tragedy, in the grand scale of things it isn’t very many, just 1 in 31,200 people, perhaps eventually rising to 1 in 20,000. At some point in the future humans may have to cope with a plague that kills as many as 1 in 4 people. We’ve known about the huge pandemic threat for decades, especially how fast it can spread around the world and in our big cities, but it has still caught some countries unforgivably unprepared.

Governments have behaved very differently. Some, like South Korea, did the sensible things at the outset, restricting its means of entry, tracking down and isolating people with symptoms and those they had been in recent contact with. Others, like the UK, watched as large numbers of infected people entered the country, allowed them to infect lots of other people, allowed large sports events to continue, infecting many more, and took no actions to limit people being crowded together in transport systems, such as in London underground and airport passport control. Only once infection rates were already sky high and many people were dying did government act and because they were far too late, the only option they were left with was lockdown, effectively shutting down much of the economy for months.

 

Easing Lockdown

Lockdown can’t last forever, since the economy takes a big financial hit every day. In the UK, the headline cost is £2.5Bn but that needs to be doubled to account for the interest costs in the decades paying it back, and it will be decades. £5Bn per day is a lot. Government still refuses to say when they will start to lift it, even saying that discussing it is too early. It is therefore realistic to assume it will stay in effect for a few more weeks, 10 weeks total with a gradual lifting over several more, we could optimistically assume an effective economic shutdown of 13-15 weeks. Lockdown may start to be lifted gradually for some small sectors such as DIY/garden centres in the next week or two, and in restricted form with extra spacing in restaurants and pubs later. People will be slowly encouraged to return to work. My prediction is that a return to work in cities will cause another large rise in infections, and government will panic and reintroduce lockdown for a few more. Government seems locked in to a mode of thinking that forces everywhere them to treat everyone the same, so the concept of having different controls in areas of different risk seems beyond them. A more sensible approach would be to restrict travel between areas of different infection rates and greatly restrict use of public transport in cities to limit cross-infection.

The UK government expects the economy to bounce back very quickly, everyone united in wartime spirit, all pulling together, the economy leaping back on its feet and everyone enthusiastically rebuilding every sector, leading to an even bigger and better economy that will easily pay back the debts built up. The future will be even brighter than before.

That is naïve at best.

 

For sure, there are a few winners

With most of us working from home, the big IT companies have done well so far. People have needed buy more IT kit and more subscriptions to more products and services. Getting involved in development of COVID tracking apps and AI assistance will create extra revenue streams for the likes of Google and Apple, while simultaneously giving them more of our intimate data and grater market control. With huge cash reserves and increasing income, they are perfectly placed to buy up many other companies and further increase their scope and power. Other rich people and companies in other sector with good reserves can similarly capitalise, increasing market share and breadth at the expense of those less well placed or able. The rich will get even richer, by eating the poor (albeit it not quite literally). So there will be some winners.

We might even spin the coming turbulence as a weeding out of the economy, allowing greater efficiency, enabling engagement in new technology, new systems, throwing away the old and putting in the new, steering us towards the lands of milk and honey. But it is mainly just spin.

 

Massive redundancies ahead, but entrepreneurialism has also taken a big hit

With a gradual lifting of lockdown, sectors gradually being reintroduced, social distancing very gradually eased, and some groups such as older and vulnerable people kept isolated for months longer, the economy will not bounce back quickly. Many companies are already going bust, their staff made redundant. Very many more will follow. Business owners in some sectors have received government grants, but most have had to take out loans or use their own money to keep their businesses alive, hoping for an early end to lockdown. A prolonged lockdown will find many of those companies running out of money and going out of business. Many people have been furloughed, but that is only a holding stage before redundancy if their company isn’t restored to normal working soon, and for many that furloughing will soon become a redundancy notice. There will be millions of redundancies, and a lot of previously comfortable or wealthy people now poor or very much less wealthy. Very many small businesses have found they were excluded from any government support. Self-employed people using Limited Companies would only have received compensation on the small part of their income taken as salary so would have seen incomes reduced enormously, other self-employed earning more than the £50,000 threshold would also have been abandoned. Having been burned badly by government, those businesspeople will think hard before deciding to take on such huge personal risk again, knowing it is they themselves to will have to bear the risk of government reintroducing another lockdown. It seems fair to assume that a lot of entrepreneurs have already made that personal assessment and will pull out and close their companies while they still have enough wealth left to survive. Their staff will be left jobless, and they will not be rushing to rebuild. Large market segments will be left empty, full of potential, but with very few entrepreneurs willing to take big personal risks to address that potential. Of course, some dead or dying companies will be bought out by better-funded competitors, but with such high risks and so little guarantee of survival, the enthusiasm to do so might be limited.

The post-lockdown economy will therefore have very high unemployment, a lot of dead companies and a shortage of willing entrepreneurs. Many low and medium income people will be on welfare, many previously wealthy people now unable to afford their previous luxuries, with reduced income and reduced savings. Older people with high savings might remain locked up for much longer, greatly delaying their much-needed cash injection.

 

Looking forward to the sales?

Most people on lockdown have been on full or 80% salaries and many seem to believe they will be unaffected; some are even asking for lockdown to continue much longer until it is totally safe. They have saved lots of spare cash and are eager to go back out and spend, and for a short time that will offset the impacts of the many others on much lower incomes, but it will be a short term boost. While they may reasonably expect to encounter lots of closing down sales and fill their wardrobes, it may come as a shock to them that many of the places they want to spend at will no longer exist. Beyond clearance sales, any remaining outlets will have higher infrastructure costs to cope with social distancing, some will have to pay higher prices on the markets and all will have to repay large bills, so they will have no choice but to greatly increase their prices. Those high prices might well deter much of their enthusiasm, and even in areas where prices don’t sky-rocket, buyers will soon catch up with their spending. So there will be some clearance sales, some high prices, a lot of companies closing down, much merging and acquisition activity and a huge amount of shrinking, with national chains closing many of their outlets.

In short, a lot of turbulence for several months while the post-lockdown economy settles down. All of that is already guaranteed, the only remaining question being how much worse it will get as lockdown lingers. Not quite something to look forward to.

 

Some secondary effects are obvious too:

Again, most people have remained employed, on full pay of 80%, and many feel unaffected economically. However, at a cost of £5Bn per day, national debt during a 15-week lockdown will increase by £525Bn, let’s say £500Bn since accuracy here is impossible. The economy will also have shrunk significantly. Many dead companies will take years to replace. Lost savings will greatly impede recovery in luxury sectors. Even supermarkets will not be safe, even though they sell essentials. Sainsbury’s has just announced that although it made a lot of extra sales during the panic buying, it has taken a £500M hit overall, already. Other supermarkets likely have been similarly affected. With several million more people unemployed and on universal credit, sales of absolute basics may remain, but premium brands will have reduced markets. Premium brands normally account for much of the profits, so it will be harder to cross-subsidise basic prices. Prices across the board are likely to rise, especially as other costs are increased.

Prices will also rise in restaurants, pubs, bars and coffee shops, where people will need to be far more spread out. Rents and rates may fall somewhat, but prices will still need to go up. This will ripple through into hotel and tourism costs, where air travel will also be much more expensive, a double hit.

We can therefore expect to see much higher prices for many of the things we buy, especially on the high street. In many town centres, cascading effects of closing stores and high prices elsewhere will lead to less footfall, less income and even more closures and redundancies, for at least several months after lockdown is lifted. That means less business rates and car park income for councils, leading to higher council taxes for us all. Combined with many closures of business right across the economy, government income will also be greatly reduced. Money available to pay public sector workers their traditionally generous premium over their private sector counterparts will not be there. With severe austerity ahead, public sector wage rises will be squeezed badly, except perhaps for NHS staff (annoyingly, probably even the administrators whose incompetence got us into this mess) and MPs, who will likely be able to keep their extra expense allowances.

Income tax and many hidden taxes will have to rise a lot to make up for greatly reduced income to government, while costs will remain higher than normal for some time. Faced with massive extra debt, we can also be certain government will resort to printing money, or quantitative easing as they call it, effectively stealing from people’s pensions and savings even more than a decade of near-zero interest has already done.

In short, everyone will have to pay higher taxes, higher local taxes, higher inheritance taxes, higher VAT, higher prices, and have their cash reserves eroded away by inflation and quantitative easing. Even if you’ve worked from home on full pay throughout, you are still going to take a big financial hit. Your pay will not rise as fast, but your outgoings will accelerate and you’ll get less for your money.

 

The UK will tumble down the world tables

The UK government has made some very bad and expensive decisions. With very many dead and badly wounded companies, and some sectors barely functioning, with a lot of missing and broken links, our economy will be greatly reduced in size, our national debt will be greatly increased, and the severely ill economy will be far less able to recover quickly than government assumes. For many years, the UK will be much less prosperous than it was. We started the COVID crisis in early January in 5th place in the global wealth table. By not doing anything but watch until March, the UK government and its poor advisers have badly damaged our economy. Many other countries that made better decisions earlier will have overtaken us. I have no models to predict how far we will fall, but it will be several places at least.

 

Social gains and losses

After months of near solitary confinement, most people will be looking forward to seeing their families and friends again. Lots of hugs and kissed are ahead. We will almost certainly value our friends even more, and feel closer as a result of being kept apart so long. How long that will all last is anyone’s guess. A month? A year? We’ll see.

On the downside, lots of relationships are breaking up or suffering due to the stresses of living together constantly. Many marriages will die, many children will see their parents split up. There have already been lots of mental breakdowns and suicides and there will be many more. Some people will suffer many years from mental problems arising from this crisis and the lockdown. Even though children have been virtually immune to the direct effects of COVID, many of them will suffer mental effects for years, perhaps the rest of their lives.

There will be some lingering resentments. Some people have been able to work normally, still going out and meeting colleagues, still having lots of social interaction. Some have worked from home doing their normal job. Some have been furloughed so are at home doing no work but remained on full pay, others on 80% of pay. Imagine if you work for a company with 50 workers and 25 of them are at home furloughed, being paid the same or 80% while you still have to go to work and risk being infected for no extra pay. You might well feel resentful. Bad feeling between workers or between neighbours treated very differently by the state might last for a long time.

Young people will face economic consequences for decades to come. Given that the people most vulnerable to COVID were older people, and that the economy was wrecked to protect them, they may well feel justified resentment to older people, especially since many of those older people were the Boomers who younger people already considered to have had an easy go in life. Inter-generational conflict will inevitably rise, permanently.

Immunity passports could cause issues too, creating two tribes, clean and unclean. Some people want them because they imagine they’d be in the clean camp and can use their passport to resume normal life again, while laughing at the others held in captivity. It’s pretty obvious they are not a good idea, but our leaders may well add them to their already long list of bad decisions.

Privacy is threatened by the NHS COVID tracking scheme. As with many previous NHS decisions, they have gone for centralisation in spite of history repeatedly showing that is the wrong way to go. They are also sharing all their data with GCHQ. Once they have an extra means of gathering masses of personal data, they are unlikely to relinquish it, so privacy loss may well be permanent. Such schemes might even be adapted and extended as future crises of various kinds emerge.

The police will also see a lingering drop in respect as a result of their sometimes questionable behaviour during lockdown.

Perhaps the biggest cost though is the knowledge that our government is quite prepared to put the entire population under house arrest on the flimsy recommendations of proven inaccurate computer models and advisers new to their posts. We used to think the UK superior to countries like China who would treat their people in such a way. Now we know as fact that our country really is no better.

 

COVID and the NHS

It’s impossible to ignore current demands to go out and clap for the NHS. It’s often been noted for some years that the NHS is the UK’s replacement for religion, and this conspicuous NHS worship certainly suggests so. Some of us find this worship mis-targeted at best. The NHS as a huge organisation is not the same as the dedicated staff looking after COVID patients. Its unpreparedness to cope with the pandemic has been the main reason the government has enforced lockdown, to ‘flatten the curve’, to ‘protect the NHS’. Given the magnitude of damage resulting from that, I did some googling to find some stats that question whether the NHS is really a world-leading health service full of heroes risking their lives to save us all.

The death rate in the UK under the NHS is far higher than most countries

The UK death rate so far, estimated at 29,000 deaths out of 66M population, is 440 per million

(https://www.telegraph.co.uk/news/2020/04/27/uk-coronavirus-death-toll-january/),

compared to 37 deaths per million in the rest of the world (https://www.ft.com/content/6bd88b7d-3386-4543-b2e9-0d5c6fac846c).

The UK is seeing 12 times more deaths per capita than the rest of the world!

There are very many factors that cause this terrible UK result. High population density is one, London being a global business hub may arguably be another, but lethargic and incompetent government led by poor advisers, and badly administered, relying on an poorly managed, poorly prepared NHS must account for much of the difference.

In this blog, I have done some data diving on some stats, lengthy because appropriate figures are often very hard to find.

NHS deaths are actually lower than average

The UK media frequently emphasises the number of NHS deaths but surprisingly the death rate for NHS staff is lower than for the population as a whole:

The latest figures I can find show that 106 NHS staff have died from COVID (not counting retired workers). That’s a rate of 1 in 17,452.

This compares to 20,626 out of 64.2M in the rest of the population, and adding in the estimated 40% more who have died in care homes, that’s 7.86 times higher than that for NHS workers.

However, most of those deaths are old people (86% of COVID deaths are people over 65). A like-for-like comparison should include only those of working age and exclude the ‘extra’ 40% extra older people dying in care homes.

If only deaths of working age people are included, the non-NHS death rate stands at 1 in 13,000, still a third higher than that for NHS workers.

NHS workers’ death rate is only 75% of that for the normal working age population. I offer no hypothesis to explain why you’re 25% less likely to die from COVID if you work for the NHS.

NHS staff numbers – how many are the heroes?

I have my own good reasons for being critical of the NHS, but I am far from alone in finding the current NHS worship annoying. The NHS is very bloated, badly managed, inefficient and ineffective. Many people gladly cheer the doctors and nurses but not for the useless managers.

According to

https://fullfact.org/health/how-many-nhs-employees-are-there/

1,850,000 work for the NHS, not counting dentists and opticians. That’s 4.5% of the UK working age population!

You may have seen lower figures. Some work part time, and the 1,400,000 NHS workers you often read about are the full-time equivalents. That’s probably why.

Around 900,000 of these are medical and medical support staff such as doctors, nurses, radiographers, hospital physicists, pathology staff and so on. The rest aren’t. Over the last 20 years, as a response to criticism of its near half million managers and administrators, the NHS has gone to some lengths to reduce the numbers of its staff it officially classifies as ‘managers’, managing to get the estimate down to a laughable 3.5%.

It is extremely hard to find how many ‘front line’ workers there are dealing with COVID patients. However, it is estimated that if fully operational, the 4000 bed Nightingale hospital would require 16,000 staff in ‘clinical and ancillary roles’, so that’s a neat 4 staff per bed.

25,000 beds are required for COVID patients according to https://www.independent.co.uk/news/health/coronavirus-nhs-england-intensive-care-beds-lockdown-uk-a9462276.html

If they were are all in use and needed 4 staff each, i.e. Nightingale staff levels, that would mean around 100,000 staff, 5.4% of the NHS. In practice, up to half of beds are unoccupied, and many don’t need so many staff, so that suggests that as few as 2.5% of NHS staff may be realistically considered to be on the COVID front line. 2.5%-5%. In the absence of accurate up to date figures, let’s call it a few percent.

I definitely applaud the few percent of the NHS who are working long and stressful hours doing their very best to keep COVID patients alive, taking personal risks while doing so. I am very happy to agree that they are heroes.

However, I refuse to conflate that few percent with the NHS as an organisation and thus treat as heroes the many percent of NHS managers whose negligent planning and incompetent administration got us into this mess. They deserve strong criticism and once it’s safe to do so, government should look hard at why the NHS wasn’t ready to cope with this long-predicted pandemic, roll some heads and design a new health service that is fit for purpose.

Antibody test results could be bad news

Another ‘I’m not an epidemiologist but’ article. As usual on this theme, please don’t read too much into it, it may well be nonsense.

Progress on producing antibody tests have shown that many under-40s don’t produce many antibodies. It is possible that instead, their T-cells simply destroy the virus without requiring antibodies. 

https://www.telegraph.co.uk/news/2020/04/15/uk-coronavirus-antibody-test-validated-results-show-under-40s/

That might at first look like good news – young people don’t even need the antibodies, they have such wonderful immune systems that they just deal with the viruses directly – but it isn’t.

As the article points out, this may firstly hinder the possibility of producing virus immunity certificates, because it would be difficult to prove that a young person has had the disease, and secondly, may indicate likelihood that that person may become infected again. If that is true, herd immunity might be impossible to achieve.

Immunity certificates are problematic in any case, making two tribes with conflicting interests:

https://timeguide.wordpress.com/2020/04/03/when-two-tribes-go-to-war/

The second effect is much more worrying, and even more so if you believe (as I do) that the virus resulted from meddling with one from bats to produce versions that can better attack humans.

Viruses use proteins to fuse with target cells. The gp41 protein used in the coronavirus is the same as that used in both HIV and its sister virus HTLV-1. Both of those target T-cells, a major part of the body’s immune system, and remain permanently in the body for life. By infiltrating and sabotaging the immune system in this way, they cause repeated and sometimes serious illnesses by disrupting the immune system.

If we were to indulge in pure speculation, a military looking to produce a virus that could bypass the human body’s immunity might well consider using such a proven mechanism. It would be somewhat consistent with early candidate shortlisting for future bioweapon research. At such early research stages, military intent could easily be hidden. Investigating classes of viruses and their impacts on humans could be entirely benign, looking for potential new medicines for example. At early stage investigation, it is perfectly possible that it might take place in a medical research establishment, staff might well not be fully aware of the purpose of their research, and full precautions might not be taken, hence the unfortunate researcher infection, release and the resulting pandemic. The accidental release at such an early stage could explain why the disease only has weak lethality and infection compared to high infection, high lethality you might expects from a military virus.

Without the speculation, the virus does nevertheless exist, does have its particular properties, and is causing its problems, regardless of its origin. It does not have to have been deliberately created to be harmful.

If the virus does work similarly to HIV/HTLV-1 in young people, that is bad news. They may initially escape the worst effects of the virus immune response, not becoming seriously ill immediately, but that doesn’t mean they are safe. If the virus stays in their bodies for life, there will be plenty more opportunities for it to flare up. Worse, by effectively sabotaging the immune system, HIV and HTLV-1 can cause other diseases such as cancer, neural degradation, loss of consciousness, severe pain, angina and many other problems.

The lack of antibodies could therefore be an early indication that the virus is not so much destroyed by the young people’s T-cells as merging with them and infiltrating the immune system in a similar way to HIV or HTLV-1, that both use the same gp41 fusing protein. The bad effects we see now on older people showing severe immune reactions might be followed down the line by large numbers of younger people exhibiting AIDS-like problems.

It might also be bad news for development of a vaccine. I suspect that a vaccine for COVID-19 might use similar principles to one for HIV or HTLV-1. However, we’ve spent 40 years looking for an HIV vaccine, and have barely even started looking for one for HTLV-1. There have been some successes on HIV vaccines, but most have been disappointing: http://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-broadly-neutralising-antibodies-passes-first-safety-and-proof.

A vaccine against SARS-CoV-2, the virus that causes COVID-19 might well face the same problems, but progress in HIV viruses might speed up search for COVID vaccines. However, looking at the results of the antibody tests, it could well be that a vaccine only works for some people.

It’s too early to say. All of this might be nonsense. But I think it’s also too early to say that until we know more about why young people are not generating antibodies. It might be that the problem will stay with us far longer than we had hoped, and that we’re only seeing the first stage of its effects.

 

Face masks don’t have to be 100% effective to be useful

There are apparently two sides to the argument on face masks.

One thing all sensible people would agree on is that those health and essential workers on the front line should be prioritized if there is a shortage.

The World Health Organisation said very recently that there is no point in wearing them because there is no proof they stop infection. It has changed its mind and now says that people with the symptoms should wear them. Matt Hancock still insists the evidence they are useless has been very clear right from the start. Sadly, he is still in office, making other poor judgments too, such as threatening to punish the whole class if the one or two at the back don’t behave.

This ‘masks are useless’ side of the argument relies on the fact that viruses are small, whereas holes in thin fabric masks are big. Viruses can pass through them. The tiniest droplets can too, or some of them at least. That is all true. A cheap thin fabric mask will not give you total protection. Accepted. However, I do wonder if advocates of this argument have any idea how breathable waterproof coats work. They block rain, big clumps of water molecules in one direction but allow individual water molecules of water vapour to pass through. Not perfect. You’ll still sweat and get damp, but breathability will help.

The US Centers for Disease Control (CDC) urges all Americans to wear them. Not only that, but to make makeshift masks out of their scarves etc in public transport or supermarkets. The argument relies on the fact that firstly, even a thin porous membrane will reduce the number of viruses a person breathes in, so will reduce the chance of infection, but far more importantly, that they can stop most of the droplets other infected people will give off as the speak, cough or sneeze and therefore greatly reduce the number of airborne particles in an area that are infested with virus. Infected people will emit such infected droplets even before they experience symptoms, so waiting for symptoms to develop means many infected people still infecting others because they weren’t wearing masks. This is all true.

If you sneeze, you probably sneeze into a tissue or handkerchief, both of which are very porous, but it still stops you filling half the room with infected water droplets, and even stops your hand getting soaked. That’s everyday example proof enough – I don’t need to wait for a massive 5-year peer-reviewed study. How many of those saying masks are useless would be happy for you to sneeze of cough in their face without making some effort to use your hanky or even your hand to intercept most of the blast? Zero I think. Not 100% effective for sure, but one hell of a lot better than useless.

So although both sides of the argument are based on truth, you should still wear a mask if there is a big enough infection risk of infecting or being infected. It will reduce the chances of both, and even if the reduction isn’t complete, it’s still sensible. If there is only a tiny risk, you might reasonably judge that the inconvenience isn’t worth the bother. The overwhelmingly important point is that a mask does not have to be 100% effective to be useful. If it’s 50% or 10% it is still useful. The more it can filter out the better, obviously, but even a simple mask will do some good. Keep the best ones for those that need them, but make others available for everyone else asap. Saying they’re useless is just wrong.

 

Lockdown must end very soon

It seems inevitable that the government will soon announce an extension to lockdown, and that it will be made more severe. Most of us will have several more weeks of being confined to homes, probably only except for trips to the supermarket or doctor. For many people, that means solitary confinement, in small flats with no garden. Even murderers in prison area allowed out for daily exercise.

Lockdown is due to be ‘reviewed’ soon, but it must end soon. The ongoing costs will be too damaging if it is allowed to continue, not just economic cost but extra deaths, mental health issues and lingering social and political damage

UK Health Authorities and Government negligence got us into this mess, but they are still making serious blunders

The handling of COVID by both the government, the health authorities and the police has been pretty poor so far. If you disagree, consider the following.

Experts have been warning frequently for decades that one of the biggest risks faced by humanity this century would be pandemics – every competent futurist has certainly always had it in their top three risks. They have been warned frequently that global travel and large city living would enable the very rapid spread globally of any new virus and that any time, a new outbreak could happen that would mean millions could die. Government cannot claim they did not have good warning that we would face a major pandemic. In fact, we’re fortunate this one only kills 0.66% of those it infects, it could have been far worse, it might have been 30%. Yet government and especially its Department of Health was very badly unprepared, with far too few incubators, intensive care beds, even face masks, let alone ensuring the ability to rapidly develop testing capability or vaccines. This unpreparedness goes back several governments. Hancock is doing his best and can reasonably claim he hasn’t been in that job long, but his many predecessors can’t escape condemnation. For example, I could never understand how someone who believes in homeopathy could possibly be be made Minister of Health, or why a PM would expect someone with such beliefs to have good analytical skills.

We knew COVID was a such a potential risk before the first cases were allowed to enter the UK.

In the weeks following, even though they knew large numbers of infected people were coming into the country, government did nothing. It didn’t close the airports. It made no attempt to prevent flights from infected areas, no attempt to check passengers even for obvious symptoms such as fever. It didn’t even give passengers any appropriate health guidance other than weakly suggesting they should consider self-isolating if they develop symptoms. It allowed passengers from infected area to be huddled closely together with others at passport control, greatly facilitating cross-infection. It made no attempt to quarantine anyone likely to be infected or to track their contacts. In short, government sat and watched as the virus spread beyond control, even helping it to do so.

During all that time, while it asked vulnerable people to isolate themselves, it allowed the idiot mayor of London to reduce tube services, forcing those who needed to travel into close proximity on platforms and trains, again facilitating the spread of the virus.

Faced with the choice to limit the virus coming into the UK, finding, isolating and contact tracking the manageable number of infectees, our government negligently watched as the virus became widespread. Its early policy was to achieve ‘herd immunity’, which needs 80% or more people to become infected. Many would develop serious symptoms and suffer terribly and many would go on to die horrible deaths. The estimated 250,000 deaths from a herd immunity approach contrast starkly with the few dozen that might have resulted from the alternative early action approach.

The governments response then changed to a ‘flatten the curve’ approach, still accepting that most people would be infected, but limiting the number of simultaneous cases to the small numbers the unprepared NHS could cope with. Because of their previous actions, they had little choice. They hoped that eventually, a vaccine might be developed, in 18 months or so.

When the virus seemed to be spreading too quickly, instead of reducing the rate of spread by concentrating on the gaping holes in their approach – allowing people to be crammed together in tube stations and passport control, and still letting others enter the country – they decided instead to introduce lockdown for a large part of the population, regardless of the level of infection in different areas, varying by as much as a factor of 20. Those people would suffer lockdown, while many others would still be crammed together spreading infection. In low infection areas, that lockdown could only reduce a small figure by a small amount. In other areas with high infection, a stricter lockdown would have achieved far more.

Many areas of London have very high infection rates. Given the 75% reduction in traffic, it would be extremely simple to lift London traffic controls and encourage as many as possible to use their private cars, especially for those living in the most infected areas, greatly reducing cross infection in the tube system. Instead, one of the heads of Public Health England made the comment that she was ‘slightly alarmed’ by the switch of travel from public transport to private vehicles. PHE has also stated that there is no point in wearing masks (a simple mask may not prevent you catching the virus, but they will greatly reduce how many virus-laden particles people emit when they talk, cough or sneeze and therefore will reduce the rate of infection. It may well be the case that PHE wants to reduce demand by the public for scarce masks so that enough will be available for those who need them, but if so, they should say so and not talk rubbish). I find it more than slightly alarming that people with such poor analytical skills should be in positions of decision making. Masks should be worn, prioritizing availability if need be to high infection areas.

People are still travelling between areas of very high infection and areas with very low infection. Many people in low infection areas will be needlessly infected. This will increase deaths. If we must have lockdown, there are far better ways to arrange it. Cellular lockdown, restricting travel between areas of markedly different infection rates would greatly reduce spread.

Even separating people from high and low infection areas in public transport would only require a simple ‘red and green’ trains system. Yet it seems beyond the comprehension of our authorities.

Some police forces have been intimidating people who are driving to open areas to exercise. Although a very few areas might attract occasional crowding greater than town footpaths, generally, urban footpaths will have far more joggers, walkers and cyclists, so exposure during exercise will generally be far higher by forcing people to exercise locally. That will increase cases and deaths. Closing parks and National Trust Gardens is similarly stupid and counter-productive. People will die because of that stupidity. Rather than take the side of common sense and logic, government threatens the people with stricter confinement if they continue to try to enjoy the outdoors, even when they are spread out.

Making it very hard to exercise away from other people will deter many people from doing so. Just when they have the greatest need to maintain peak fitness in case they become ill, their ability to do so is being reduced by officious police and busybodies. That will result in more deaths.

Watching such ongoing stupidity and negligence, I have very little confidence left in our government to make good decisions. I do not believe continuing lockdown is the right policy.

Lockdown

The current one-size-fits-all policy of lockdown is highly questionable, another mistake in a long line. A smarter form might have been justifiable to recover from the mess poor previous decisions got us into, but looking from where we are now, lockdown must be lifted soon, or it will cost far more than it saves.

Mental Health Costs

I was already self-isolating before lockdown, being ‘at risk’ but I don’t find isolation difficult. I’m introvert, normally work from home, and don’t normally leave my home more than a few times a month. I have a nice house and garden and a fantastic partner. So I have barely felt any change and am not suffering. Many are not so fortunate.

Many people live in tiny homes with no gardens and must find it distressing, especially those accustomed to going out frequently. Others live alone and many of them will be feeling very lonely. Still others will be experiencing relationship breakdowns, some of which will not mend when it’s all over. Lockdown will already be taking a severe toll on many people’s mental health. As lockdown continues the mental health costs will grow enormously. Some have already died via suicide and murder. Many more will follow, many will suffer extreme stress or fall into severe depression and start to suffer the wide range of ailments associated with those, especially many who are watching their business collapse.

Loneliness is a terrible problem that affects millions, particularly the old, and is known to contribute to ill health and death. Lockdown obviously is increasing loneliness for very many people, and will result in an unknown number of extra deaths.

Relationship breakdown as people are forced to live with each other 24/7 is inevitable. This is a well-known cause of stress, suicide and health reduction and will cause deaths directly and via reduced ability to deal with infection. Families of those concerned will also be affected.

Domestic violence is likely to increase similarly.

People’s energy bills will increase as they are confined to home. Many who already struggle to pay them will be greatly stressed by increased costs. Stress directly contribute to illness and deaths. If some old people who are already vulnerable have to turn down the heating because of worrying about energy bills, that will make them more physically vulnerable and mean even more deaths.

Death Costs

We now have some figures on the nature of the infection and its lethality. The Lancet suggest that 0.66% of those infected will die. If everyone were to be infected, that would be 430,000 UK deaths, and we’ve heard estimates around that before. On the other hand, the coronavirus app results suggest that as few as 25% of people have already been infected, suggesting future deaths due mainly to COVID might only be a few thousand (the majority of people dying who have COVID on their death certificate had other underlying issues and many would have died anyway, or soon).

Without testing of statistically large enough randomized samples in each area, we really have no idea and the government is flying blind. Letting everyone out and not doing anything at all to limit infection might result a few thousand or a few hundred thousand more deaths caused primarily by COVID. We simply don’t know. What we do know is that to be at the higher end, the mortality figures would need to be that high and almost everyone would need to be infected, but firstly, we can strongly limit infection by implementing sensible policies, and secondly, if we do that, we will have a vaccine in time to prevent most people becoming cases. So the high end is far too high. If we lifted lockdown now in low infection areas and later in higher infection areas after we have significantly reduce infections by better policy implementation and some optimised testing, future deaths would likely be between 5000 and 20,000, a wet-finer estimate, but probably no wetter than the models government seems to be relying on.

Not everyone lives in homes with good ventilation. Some in poor quality housing will have a higher infection rate from both COVID19 and other diseases due to poor ventilation.

Many people still rely on coal or wood fires, both of which produce particulates that can cause breathing difficulty and contribute to respiratory-related deaths.

The deaths costs from the above causes will be high, probably running into hundreds if it is allowed to continue more than another week or two, and that has to be offset against any gains. But there is an even bigger factor that will worsen if continued lockdown causes severe economic damage. As well as the factors above, some economists have done their analyses and suggested that due to the inevitable recession – up to 17% drop in GDP – far more future deaths will result from economic decline than will be saved by lockdown. For a change, even though they’re economists, I’m not inclined to disagree.

Economic Costs

In terms of saving lives, there are many ways to save lives so with finite funds, we should spend where the most lives can be saved for given funding. If we only save 5000 lives, but spend £500Bn to do so, that works out at £100M each! The NHS currently won’t provide a drug unless it is likely to add an extra year of quality life for less than £30,000. A typical 65-year old dying of COVID today would only expect to have another 20 years of life on average, so the NHS won’t pay more than £600k to keep them alive if they were dying of something that isn’t COVID. Many of those dying are much older than 65 and most have other underlying factors that make their life expectancy much less than normal. Using the same valuations,, an average spending limit of £250k seems more realistic. At £250k each, even the highest current estimate of 250,000 deaths would have a cost limit of £60Bn. On harsh economic terms, we could save more lives by helping those with other illnesses if the cost will exceed £60Bn. If you look a little further, various studies over the last decade have shown that tens of thousands of deaths in hospitals result from negligence, errors and poor hygiene. We could reduce those even more cheaply.

So the cost of lockdown makes no sense in terms of the economic cost of saving lives – there are more cost-effective ways. We could save far more for the same spend.

Social Costs

But there is still another major cost: society. If you are on social media, you will have noticed the rising tension, the conflicts between those who believe in this policy versus those who believe another one, the ones who want to comply versus dissenters, the rule violators versus the snitches.

Confidence in the police is being strained to breaking point, as is confidence in government. NHS worshippers abound, but so do those who believe shelf stackers and binmen are just as important.

Inter-generational conflict will increase. The young see their futures being thrown away to buy a few more years for the very elderly who would die soon anyway.

There will be strong resentment of the private sector worker watching their pension evaporate while the public sector worker next door has their gold-plated pension protected. People who were laid off and have to survive on Universal Credit will likely resent others having 80% of their previous income paid by the state, as will those who had to watch their businesses thrown under a bus with receive no compensation at all. Everyone will have to pay, but only some were protected.

Many of these growing tensions, resentments, conflicts and tribal conflicts will not vanish when it’s all over. Scars will remain for decades. The lingering social costs may well be as high as the economic and death costs.

Political Costs

Finally, we should consider that politics will change too.

Privacy, freedom, free speech and respect for the authorities will be permanently damaged. Social cohesion is an important part of the foundations of democracy.

Respect for the police and the principle of  ‘policing by consent’ has already been eroded by some police gleefully abusing their power like bullies appointed school prefects.

Being left with enormous bills and a trashed economy, with many businesses dead, it will take decades to recover. We already know the huge effects of austerity in politics, but are rapidly adding enormously to the already massive national debt so future austerity will be deep and long-lived.

We can also be sure that this will not be the last virus. In a year or two there will be another, and because of the poor handling of this one, reactions by society and the markets will be even more panicky, and we may take more economic hits. We may take generations to get back to ‘normality’.

Summary

Whichever angle you look at it, lockdown is the wrong solution. It has high mental health costs, it saves fewer lives than freeing everyone, and costs more per life than almost any other way of saving them. And it comes with very high social and political costs.

Whether you look at it from an economic angle, a pragmstic angle or are trying to be compassionate, it still makes no sense.

It should end soon.

 

 

Great news from the coronavirus app

NOTE: The first version of this article was based on the Daily Mail article:

https://www.dailymail.co.uk/news/article-8186479/Coronavirus-symptom-app-suggests-1-9-MILLION-Brits-Covid-19.html

CORRECTION

Looking at the video by the researchers, for which I’m grateful to Kate Brewer) to the link:

https://covid.joinzoe.com/post/covid-research-update-uk

it says that 25-30% of respondents reported ‘some COVID-like symptoms associated with COVID’. It also usefully clarifies that most of the early respondents were likely younger people. This is very different from the 1.9M reported in the DM article and which I re-used in my blog. Humble apologies, I didn’t check the source. Now that I have, I am still unable to find the other figures the DM quoted, so perhaps they used a different source.

So, using the revised figures ….

The coronavirus symptom tracking app results suggest, according to Tim Spector, that 25-30% of respondents reported ‘some symptoms associated with COVID’. Without proper testing, it’s as good an estimate as we’re likely to get. Extending to the whole UK population, there could be 16-20M people who have already had the disease. (As an aside, and I don’t trust Chinese figures, some reports suggest that 20% of people who are infected develop symptoms. For 25-30% to report symptoms, that would mean almost everyone in the UK would need to have been infected).

The app is a sort of self-selected, self-reported test, but presumably proper tests on a proper sample of the population would reveal more. If you’re trying to solve a problem, knowing its dimensions can make a huge difference to the solution you will pick.

If their figure is true, then only 0.2% – 0.25% of people who have had the disease developed into official cases. But we have no idea how many have been exposed to the virus and not even had enough symptoms to become part of their 25+%. It could be anywhere between 25% and 50% (as other studies have cited).

If true, we might already be a quarter or even half of the way through. We might only see another 40,000 – 80,000 cases, even if lockdown is lifted

So far, 3605 deaths have been announced in the UK from 38,168 cases, but the ONS says the death toll could be 20% higher, at 4325. That gives an 11.3% death rate in the UK but that doesn’t include documented cases that will die later (the numbers that have been listed as ‘recovered’ are only a tenth of the deaths, so that is an important caveat). So the UK figure is likely to be much higher than the 11.3%. On the other hand, as Peter Hitchens has often pointed out, that figure is for all deaths that occurred of people who had the disease, not those who died mainly because of it, very different. Large numbers of elderly people die every year. Every day, around 1650 people die in the UK. Any of those who died from the usual causes but also had COVID would appear in the COVID deaths figures, along with any who did die because of it but would have died in a few months of something else anyway.

Without proper testing of a large and representative sample of the population, we really have no idea how many people have actually already had the disease or are resistant, and without proper recording of deaths, how many known cases are still going to die. Only when we have proper large scale test results will we be able to estimate how many future infections, cases and deaths there might be as the result of lifting lockdown before the disease has been eliminated.

However, a simple calculation using the above suggests that if lockdown were lifted, there might only be 10,000 – 13,000 more deaths that might list COVID on the death certificate, and the number of deaths primarily due to COVID would be far less. Perhaps only a very few thousand more people will die because of COVID if lockdown is lifted.

If it really is only 3000 – 5000, there are far better ways to save that number, such as cleaning hospitals better.

 

Will China be the global winner from COVID?

A joint blog by Tracey Follows, Bronwyn Williams and ID Pearson

Will China be the global winner from COVID?

There have been many conspiracy theories about China suggesting that the virus was deliberately made. We may never know the whole truth.

Regardless of that, it is clear that, however unlikely, there is a greater than zero chance the virus could have been man-made. More importantly, a new virus could be man-made. Now that the West has shown its economically suicidal response to this one, there is a massive temptation for any rogue regime or terrorist group to produce a GM virus variant that is as or more lethal, as or more contagious. Death cults that want population reduction (such as environmental reasons) might well consider sponsoring such virus production in secret labs.

There is already one clear win for China: No-one is really debating democracy versus authoritarianism as it pertains to Hong Kong any more. But then no-one is really debating that choice anywhere because nation-states like the UK, France and USA, built on the core notions of freedom, have removed liberty and imposed a lockdown. Indeed, the few governments who have resisted – or even just delayed draconian encroachments on hard-won human rights to freedom of speech, movement and trade have found themselves cast as at best ignorant and at worst downright villainous by the popular press. This, despite the fact that the epidemiological and economic data and models projecting the socio-economic costs of the various paths of action (or inaction) available to authorities are questionable at best, downright misleading at worst. Perhaps Friedrich Hayek put it best when he said “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”. In other words, when faced with incomplete information, the first priority for any government should be to do no harm. When it comes to complex systems, seemingly simple solutions can have serious unintended consequences. This, however, is easier said than done in the face of an imminent threat when citizens, accustomed to having their every need met by their leaders are baying for someone to do something. This may well prove to be the biggest threat of all because populations can get awfully content being told what to do and relying on authorities to make all the tough decisions for them. Some may even be persuaded that this kind of big state, this kind of total state, isn’t really so bad after all.

The trouble is that authoritarian measures – such as state surveillance of health and cellular data and restrictions on freedom of movement or trade – adopted during times of crisis do not tend to simply disappear after the short term threat is passed.. As military men and women will tell you, it is much easier to get into wars than to get out of them. Likewise, it is much easier to lose civil liberties than it is to regain them. Have any governments who have removed or restricted citizen rights outlined any form of exit strategy for how to return those privileged post pandemic? No. The long-term normalisation of surveillance and authoritarianism driven by short-term fear threatens to create a global generation of Stockholm syndrome sufferers, grateful to the generosity of their gilded cage key keepers.

Result: China 1  – West 0

Perhaps what is most notable is that there have been several pandemics in recent memory: Zika, SARS, Ebola, swine flu, bird flu. None of these caused similar panic. The question is why. The answer lies in the way the current crisis has been handled by both mainstream and social media, both of which thrive on the spread of panic (a viral disease in and of itself), and panic, in turn creates an opportunity for authorities to capitalise on the crisis and consolidate both power and capital to their own ends. New deadly diseases emerge from nature frequently and next time the first news breaks on a future outbreak, the panic cycle we have witnessed in recent months is likely to repeat itself. Panic buying will follow, the media and the public will demand action, stock markets will fall, governments will be tempted to rush to close airports and print more money and take on more debt, and so on so as not to be the last man standing. That means that future outbreaks, however caused, will likely cause panic, confusion and likely major economic damage.

After spending tens or more likely hundreds of billions of pounds to get through COVID19, it may well be the case that the economy is only starting to recover before the next outbreak. The economy may not recover properly until we can end that cycle.

However, China, with its now proven technology to control its people, its centralised economy, and its much more compliant populace, conditioned over centuries of dictatorial rule to obey or face the consequences, would be more able to avoid such crashes.

The West will learn that the only way to avoid coming off second best in a crisis is to emulate its opponent, further eroding human rights and freedoms in the process. 

That is, of course, the rub: liberty has proven to work for the West in the long run. However, in the short run, there are trade offs. Authoritarians can do things that free men and women will not. From current events and reactions, it does not appear that the West has the short term courage (or citizens with the personal responsibility) to pay the price of long term liberty.

China 2 – West 0

Even as it becomes clear that China covered up the initial outbreak, denying other nations the benefits of foresight, and manipulated mortality rates, skewing economic and epidemiological models that could have been used to make better policy decisions, we may never know the full extent of China’s responsibility for this one. However, we can be sure they won this round, and will be the long term winners too, if our response here in the West is anything to go on.

About Tracey Follows

company: https://futuremade.consulting

twitter: twitter@traceyfutures

Forbes contributor: tracey follows 

About Bronwyn Williams

Bronwyn Williams is a futurist, economist and trend analyst, who consults to business and government leaders on how to understand the world we live in today and change the world’s trajectory for tomorrow. She is also a regular media commentator on African socio-economic affairs. For more, visit http://whatthefuturenow.com

Twitter: twitter@bronwynwilliams

About ID Pearson

Dr Pearson has been a full time futurologist for 29 years, tracking and predicting developments across a wide range of technology, business, society, politics and the environment and is a chartered Fellow of the British Computer Society and Fellow of the World Academy of Art and Science

twitter: twitter.com@timeguide

timeguide.wordpress.com

Don’t listen unquestioningly to ‘experts’

Listen to the experts! Follow the science! Shut up, you aren’t an epidemiologist! You’re probably as sick of hearing those remarks as I am.

An expert is generally regarded as someone who has been doing something for so long (10k hours or more) that they have become highly proficient at it. If you do a task 5 hours a day for 200 days a year, it takes about 10 years before you could be regarded as an expert. Nevertheless, there are many experts in every field, and some have a lot more than 10k hours. However…

The vast majority of experts are specialists, working in a particular field. They have vast knowledge and expertise – in that field. They may be somewhat knowledgeable in some other areas, especially if they are closely related, but their degree of knowledge generally becomes lower as you move further away from their core field.

Other experts are generalists. In engineering circles, they are often called systems engineers. In medical circles, they might typically be GPs or general surgeons, or vets. They typically have similarly sized brains, intelligence and knowledge to specialists, but their expertise is spread more thinly across a broader domain, often a much broader domain. Depending on career history, they may still have some regions where they are more knowledgeable than others, but their most important skill is considering many different but interacting parts of a system simultaneously.

“Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations.” Epidemiologists are therefore exactly the sort of people we need right now to advise on the distribution, patterns and determinants of health and disease conditions. I wouldn’t dare to think I know better than an expert epidemiologist in that regard and neither should you.

Outside that well-defined domain, their expertise quickly evaporates and they quickly lose their claim to expertise. I would not bother to ask an epidemiologist for their advice on many other important factors such as politics, economics policy, nutrition, cardiovascular health, exercise or mental health factors of lockdown, loneliness, transport policy, policing, sociology, relationships, divorce or family breakdown.

COVID affects all of the above areas so we need people who can consider all of them, considering all the interactions within the system. That means generalists, not specialists, since no human brain can be expert in all relevant fields. Generalists can make informed decisions on the best overall approach. They would consider inputs from epidemiologists of course, but also inputs from experts in all the other fields too, assimilate and then consider the entire system.

I would suggest therefore that government and media are giving far too much attention and power over decision making to one particular expert group – epidemiologists – and giving far too little consideration to the whole system and the generalists who are the appropriate experts in that domain.

Indeed, even politicians are somewhat generalist. Few have any particular field of expertise other than those skills needed to persuade people to vote for them.

However, an intelligent PM like Boris should be able to make a good overall judgement on the best overall approach to dealing with COVID, taking due account not just of ‘the scientific advice’ but of all the relevant factors – the pain, suffering and deaths resulting from the spread of COVID, social and health issues related to lockdown, the many factors governing the health of the economy, the massive future debts that will need to be repaid and the inevitable severe austerity resulting, social cohesion, the trust in the police, justified fears about state intrusion, mass surveillance, loss of liberty, and many more.

He should certainly not be abdicating decision making to people who are only expert in one of those areas.

And neither should you.

 

Reducing infection rates – common sense

We could greatly reduce suffering, deaths, economic damage and duration of lockdown if the authorities were to apply some basic principles.

Restrict travel between high and low infection areas

Some areas are much more highly infected than others. Travel from highly infected areas to much less infected areas should be severely restricted. The gain from doing so is far higher than by restricting other travel.

Restricting travel within high infection areas will also achieve greater gains than doing so in low infection areas.

Red and green trains

Instead of all trains being made available to everyone, red trains would carry groups more likely to be infected and would be used by people who either live or work in a high-infection area. Green trains would be used by those who both live and work in low infection areas. There doesn’t need to be a very high difference before statistical gains are achieved. Any station would receive a few red trains, then a few green ones.

A further derivative would be to have red and green supermarket hours to separate those who work exposed to high risk from those who aren’t.

Both of the above rely on separating groups that have very different infection rates and both are quite robust against moderate cross-infection.

Travel profiles indicate most effective use of limited testing

We already target health workers and carers, but what about the rest of the population?

The faster we can identify infected people and isolate them, the more we can reduce the rate of spread, the number of total infections, overall suffering, and deaths. Given very limited testing capacity, we must optimise our approach. Some simple reasoning applies.

First, there is little point in testing those in lockdown. It would be nice in an ideal situation but we aren’t in one. The few who become infected will still emerge if they become ill enough.

The rest fall in two categories. One group travels mostly alone in private vehicles. A few will come into contact with large numbers of people through their work. If we can identify those high-contact groups, they can be allocated a higher priority.

Those travelling most on public transport are much more likely to become infected, coming into more frequent contact with infected strangers and once they become infected, are likely to infect many more. Concentrating testing on them will achieve the greatest efficiency at finding (and removing) infected people from the mix. The more infected people that can be found and removed from public transport, the faster the virus will be controlled. We know who uses public transport most via their payment cards. We  also know that those using red trains will have higher incidence than those on green trains.

Simple logic therefore shows that limited testing should therefore be applied in the following priority:

  1. Front line carers
  2. Most frequent travellers on red-train public transport
  3. Less frequent travellers on red-train public transport
  4. Most frequent travellers on green-train public transport
  5. Less frequent travellers on green-train public transport
  6. Those living in red areas who travel mostly using private transport
  7. Those living in  green areas who travel mostly using private transport
  8. Those in lockdown who must still venture out sometimes
  9. Those in total isolation

This isn’t 100% optimised, but it is close enough.