Monday, April 6, 2020

Nothing better symbolises the UK's open defiance of the World Health Organization than the Chief Medical Officer returning to work when he might still be infectious

The World Health Organization's guidelines on isolation are quite straightforward and specific - an individual should not have contact with others until 14 days after symptoms end.  It's acknowledged that even this doesn't eliminate the risk of transmission entirely - it's estimated that around 1% of people might still be infectious after 14 days.  But the aim is to reduce the risk to an acceptable level, and clearly anything above 1% would be totally unacceptable, given how high the mortality rate of this virus is and how easily it spreads.

It's not hard to see that the risk must be much, much greater than 1% if people ignore the WHO and instead follow the UK's much laxer guidelines - which are only to isolate for seven days after symptoms begin.  In practice, that could be as much as ten days earlier than the WHO say is safe.  A string of senior people in the UK establishment, including Prince Charles and Matt Hancock, have already abandoned self-isolation when there was a significant risk that they were still infectious.  Their excuse was that they were following the advice of the government's Chief Medical Officer.

But today the Chief Medical Officer himself returned to work only around ten days after he first started showing symptoms.  So what's his excuse for putting his colleagues and the wider community at unnecessary risk?  Essentially he's defying the WHO through his own personal choice.

And of course the length of the isolation period is not even the most serious way in which the UK is defying the WHO on a daily basis.  Even more disgraceful is the abandonment of testing and contact tracing, which the WHO stress is the key to controlling the pandemic.

Sunday, April 5, 2020

Nicola Sturgeon must make 100% sure that whoever is appointed as the next Chief Medical Officer is not a "herd immunity" zealot

Before the UK went into lockdown, I felt like certain journalists and celebrities were missing the point somewhat by lambasting irresponsible individuals for ignoring social distancing advice.  However much self-righteous satisfaction might be gained from ranting at members of the public, the reality was that a percentage of the population were always bound to ignore the guidelines until they ceased to be guidelines and became enforceable rules.  So any pressure that wasn't on Boris Johnson to impose a lockdown was misdirected pressure.

In a similar way, I felt the media were missing the bigger picture today by getting on their high horse about Catherine Calderwood's hypocrisy in thinking her own strictures shouldn't apply to herself.  Yes, she deserved to be criticised, and yes, the ever-reliable Jason Leitch made his umpteenth gaffe of this crisis by initially trying to pretend that what she did was absolutely fine.  But the media outrage over a small personal misjudgement seems wildly disproportionate when you consider the far more serious strategic errors that ministers and their advisers (including Calderwood herself) have made in their response to the outbreak - most obviously the catastrophic 'herd immunity' idea, which apart from being immoral and unworkable, also directly led to us being woefully unprepared for a mass-testing drive when the change of direction came.

I must be a glass half full sort of person, because whatever Calderwood's personal responsibility for the mistakes that have been made, I tend to worry more about how her replacement could be a lot worse if the appointment is made in a rush and the wrong person is chosen.  It ought to go without saying that Nicola Sturgeon should make 100% sure that the new CMO is not a herd immunity zealot.  The ideal person would be someone with a good grounding in the basics of public health - such as testing, contact tracing, and quarantining.  Those are the prosaic methods by which (as South Korea has demonstrated) it's perfectly possible to eventually get on top of the virus without the majority of the population being infected.

Saturday, April 4, 2020

With a voice in London once again banging the "herd immunity" drum, the time has come for Nicola Sturgeon to follow Jacinda Ardern by loudly saying "no way, not EVER"

It's going to be a source of bafflement and embarrassment to SNP members for many years to come that the Scottish Government remained in lockstep with London during the period when Vallance and Whitty were quite openly planning to achieve 'herd immunity' by deliberately allowing 60%+ of the population to be infected - a crazy and immoral strategy that would have cost hundreds of thousands of UK lives, that wasn't seriously contemplated by more than a tiny handful of other countries, and that is considered so extreme that even Donald Trump eventually disavowed it. The charitable interpretation is that Nicola Sturgeon and her colleagues were only hearing the UK government's version of "the science" and therefore didn't realise how much of an outlier it was in international terms, how sharply it diverged from World Health Organization guidance, and how catastrophic the loss of human life would have been.

But there are no such excuses anymore. Anyone who has been paying attention over the last few weeks knows the score. So now that the UK government's "chief pandemic modeller" is suggesting that the lockdown should be lifted and that we should go back to allowing most of the population to be infected and put at risk of severe illness and death, we really do need Nicola Sturgeon to immediately knock this one politely and firmly on the head. We need to hear her echoing the words of Jacinda Ardern by saying that 'herd immunity' will never be acceptable to her or to any other Scot, and that the "Four Nations" approach will be immediately abandoned if London start flirting with it again.

The 'chief modeller' in question is not from the Imperial College team, incidentally - he's Graham Medley, the head of another team from the London School of Hygiene and Tropical Medicine who also advise the government. The language he uses is deeply disturbing - he effectively implies that the old should be sacrificed for the best interests of the young, which suggests that he knows full well that a biblical death toll would be unavoidable if he gets his wish. But of course the whole notion of generational sacrifice is bogus anyway, because we've seen large numbers of young people become seriously ill and dying. The two nurses that were mourned today were both in their thirties. The carnage that Medley wants to unleash would be no respecter of youth.

He suggests that people should be infected in the least deadly way possible - as if there's some kind of 'non-deadly' way to catch a virus with a death rate estimated as being as high as 1.4%. He rubbishes the idea that mass-testing might form the basis of an alternative exit strategy, simply because his mathematical modelling suggests that the virus will start spreading again as soon as lockdown is lifted - but that takes us straight back to the idiotic error that got us into this mess in the first place. During the early weeks of this year, the government were totally ignoring the real world experience in China and South Korea and were putting all their eggs in the basket of mathematical modelling instead. That led them to make two huge false assumptions - a) that the virus was much less deadly than it actually was, and b) that it was less controllable by means of testing and tracing than it actually was. South Korea has clearly demonstrated that the number of new cases can be kept persistently low by that method. It would be crazy to condemn hundreds of thousands to death without at least attempting that ourselves.

The message to the Scottish Government must be: don't even think about ending lockdown until there is a credible exit strategy in place that does not involve sitting back and allowing the majority of the population to be infected. Testing and tracing would inevitably be central to any such strategy.

Friday, April 3, 2020

Ipsos-Mori poll suggests the public are aware that Johnson was too slow in ordering a lockdown

It's often said that leader ratings are more predictive of election results than voting intention numbers.  Given that governments almost always have sky-high approval figures in the middle of a major crisis, I wonder if it's also true that we need to look at other polling questions to get a more accurate sense of what the fallout for the current government might be in the longer run.  (Tony Blair, for example, was given the benefit of the doubt by the public during the Iraq War, but that swiftly changed after major hostilities were over and no WMDs were found.)

There are already some worrying signs for Boris Johnson.  A YouGov poll suggests that 31% feel the UK is handling the crisis worse than other countries, and only 27% take the opposite view.  OK, those aren't disastrous figures for Johnson, but they do suggest that a substantial minority have wised up to the failings on PPE, testing and contact tracing.  Even more telling is an Ipsos-Mori poll showing that 56% of respondents feel that Britain didn't go into lockdown soon enough.  At present, that seems to be the mistake that has the greatest potential to come back to haunt the Prime Minister.

There can be little doubt that the majority are right on this one, because the hundreds of people who are now dying in the UK on a daily basis were largely infected at a time when the government were still saying that large gatherings were fine (and that there wasn't much risk in the open air!), that schools should remain open and that pubs and clubs could carry on with their normal business.

The Scottish Government of course moved slightly faster than the rest of the UK in ending large gatherings, but it's difficult to give them much credit for that, because even when the decision was taken they still perservered with the silly fiction that "the science" showed that big crowds did little harm and that the only good reason for stopping major events was to reduce the burden on the emergency services.  That simply wasn't true.  Even the modelling that ministers were relying on at the time clearly showed that banning big public gatherings would reduce the rate of infection, and that if done in combination with the closure of schools, pubs and clubs, the effect could be extremely substantial.

As late as 15th March - less than three weeks ago - the Scottish Government inexplicably allowed a Lewis Capaldi concert to take place in Aberdeen, even though the decision had already been taken to stop gatherings of more than 500 from the following day.  Infamously, Scotland's National Clinical Director Jason Leitch told Good Morning Britain that people "should have gone" to large gatherings on the weekend of the 14th/15th, and that he would have "gone himself".  When Piers Morgan reacted incredulously, Leitch sneered at him and asked when he had received his Masters in public health.  The clip was shared thousands of times by social media users who were excited to see the unpopular Morgan being "taken down" by a Scottish Government "man in the know", but my own reaction was very different -

"There's probably no other circumstance in which I'd be on Piers Morgan's side in a confrontation with a Scottish Govt spokesperson, but my guess is that much of what Leitch has been saying in his tour of the TV and radio studios isn't going to age well."

Tragically, that guess has been proved right extremely rapidly.  The reality is that there was never any public health justification for allowing the Capaldi concert, or the Scotland v France game a week earlier, or the Cheltenham festival, or the Liverpool v Atletico Madrid game.  The evidence was clear that these events would fuel the epidemic - and for ministers and their advisers that was the whole point of allowing them to go ahead.  They actively wanted infections to occur (albeit at a 'managed' rate) because their crazy objective at that point was not to stop or limit the epidemic, but rather to "land the peak" at what they thought was going to be the 'perfect' moment.  

However much Matt Hancock may try to rewrite history, there is ample on-the-record evidence that this was the government's motivation for delaying the introduction of social distancing measures.  One estimate suggests that the delay means there'll now be an epidemic three times larger than would otherwise have been the case, and as a result thousands will die needlessly.

It looks like the public aren't all that far away from joining up these dots.

Thursday, April 2, 2020

Dounreay offered large supplies of PPE to health workers in Caithness - but the bureaucrats said "no"

I was kindly sent some information yesterday about community procurement of PPE in the Highlands (from businesses, police and the like), which is intended to help plug the gaps in the totally inadequate NHS supplies.  I gather that some of the details were featured on Channel 4 News recently, but the most striking revelation is that Dounreay offered a large supply of PPE to the NHS in Caithness, and it was turned down by management because it hadn't followed the normal procurement guidelines.  Frontline staff were understandably furious that bureaucratic absurdities had left them needlessly at risk.  It seems pretty likely that supplies that are good enough for decommissioning Scotland's most dangerous radioactive site would be of great use to NHS workers.  [UPDATE: I see from a news story posted in the last few hours that a donation from Dounreay appears to have been accepted, so it looks like the original decision was reversed either wholly or in part.  A 'better late than never' moment - we've had quite a few of those during this crisis.]

There are also suggestions that the PPE that has arrived from central procurement is much inferior to the supplies that have come from local businesses - for example, glasses that fall off and gowns that don't cover elbows or the whole of arms.  There's a plea for the Scottish Government to follow the example of other nations by urging industry to donate their PPE to the NHS.

It's well-known that the shortages of PPE (and the inadequacies of the supplies that do exist) are a massive problem because they put health workers at grave risk of infection and illness, and also because seriously ill patients are much less likely to receive optimum treatment if a significant percentage of health workers are self-isolating after showing symptoms.  But there's also a third issue: lack of PPE is a significant factor in fuelling the overall epidemic.  I believe I'm correct in saying that in Italy, no fewer than 8% of all confirmed cases are health workers.  Many of those people have gone home and infected family members.

*  *  *

On a totally unrelated subject, I've been having a look at the datasets for the recent Scottish poll from Panelbase, and you might be interested to know just how close we came to a 50/50 split on the independence question.  After weighting, 415 respondents said they would vote Yes, and 424 said they would vote No.  That works out as Yes 49.46%, No 50.54%.  (Those figures are approximate, because I'm fairly sure that even weighted respondents are rounded to the nearest whole number.)  If the Yes figure had been 49.5% or above, it would have been reported as 50%.  So it looks as if just the tiniest smidgeon more would have kept Yes in the 50s - which is pretty incredible in the middle of the biggest international crisis since the Second World War.

Wednesday, April 1, 2020

The number of excess deaths caused in the UK by a "herd immunity" strategy would be comparable to the Hiroshima bombing

Among the dwindling band of enthusiasts for the "take it on the chin" / "herd immunity" approach, a favourite refrain is that it doesn't actually matter if an unimaginable number of people die, because (supposedly) "they would have died anyway". Incredibly, even the BBC tried that line the other week. The idea is that many of the deaths are elderly people with severe health conditions who would otherwise have had an extremely short life expectancy. Now let's be clear what we're talking about here: Imperial College estimate that without a full-on suppression strategy, around 250,000 people would die of the virus in the UK, and of those, around half to two-thirds "might" otherwise have died of another cause at some point this year - although of course that leaves open the possibility that they could have lived on for many months, and no price tag can really be put on that.

But even if those people are completely excluded, that means the real total of excess deaths would be "only" somewhere between 83,000 and 125,000. As we've seen, many of those victims would be relatively young, and a significant minority would have no underlying health conditions. We're talking about people who can reasonably expect to live a great many years or decades in the absence of a herd immunity strategy.

For comparison, the death toll from the nuclear bombing of Hiroshima in 1945 is estimated to have been somewhere between 90,000 and 146,000.

Tuesday, March 31, 2020

It looks like the Dr Strangelove-style "herd immunity" plan of Whitty and Vallance may need to be defeated for a second time

Here's the most disturbing thing I've read since the start of the lockdown - BuzzFeed says a source has told them that Whitty and Vallance are still privately plotting to deliberately allow 60%+ of the population to be infected with the virus in a deranged attempt to foster "herd immunity", albeit over a longer time-scale than they originally had in mind.  This apparently explains their appalling refusal to commit to sufficient levels of testing.  I must say that was the impression I formed when I saw the pair at a press event held several days after the Imperial College paper had forced a change of strategy.  It was as if, for them, nothing had changed at all - they were still talking about merely delaying the peak of the epidemic until the summer and spreading the infections out more.  Whitty at one point even went into a technical explanation about how delaying the epidemic could potentially reduce the overall number of infections somewhat by avoiding "overshooting".  That's unmistakeably the language of a mitigation strategy, not of the suppression strategy that the Imperial College paper told them was absolutely essential to avoid a catastrophic loss of life.

So what's going on?  I think it's professional arrogance - they're reluctantly going along with suppression for the time being, but still want to be proved right at a later date and so are refusing to modify their language or their objectives.  It would be psychologically too difficult to admit to themselves that avoidable deaths will now inevitably occur because the disastrous herd immunity strategy led them to delay vital decisions on social distancing and the ramping up of testing.  By continuing to gaslight us now, ie. by pretending that the WHO's recommendations on mass testing and contact tracing somehow don't apply to the UK, are they trying to put in place another self-fulfilling prophecy?  

We all know there is a perfectly viable alternative exit strategy that doesn't involve a mass epidemic.  It involves waiting until the lockdown reduces the number of infections to a low level, and then keeping them low by testing and contact tracing after the lockdown is lifted. Are Vallance and Whitty hellbent on leaving a mass epidemic as the only option by making sure sufficient testing capacity still won't be there when the moment arrives?  If so, we mustn't let them get away with it.

The good news is that Whitty and Vallance aren't the only scientists advising the government.  Professor Neil Ferguson set out a much saner way forward last week - he said that he had been told that testing capacity would soon improve markedly, and that this would allow us at some point to safely come out of lockdown while keeping the number of new infections at an acceptably low level.  My guess is that Jeremy Hunt has been having private conversations with other experts on SAGE who are exasperated with the attitude of Whitty and Vallance, and that might explain why he's been doing his best to use his influence to steer the government in the correct direction.

The Whitty/Vallance plan no longer even makes sense on its own terms.  One of Whitty's original excuses for herd immunity was the supposed impracticality of asking people to maintain social distancing over a very prolonged period.  But part of the plan was always to "cocoon" the most vulnerable people during the "managed epidemic", and sure enough my elderly mum belatedly received a letter today telling her to avoid all face-to-face contact for 12 weeks.  As things stand, that will probably mostly cover a period of lockdown and suppression.  If Whitty and Vallance then get their hearts' desire of a slow-motion human tragedy of biblical proportions (you know, just to avoid losing face), will that mean vulnerable people actually have to avoid all social contact for 78 weeks until the carnage is finally over?  An intelligent hamster could spot the flaw in that plan.

Once again, if you feel as strongly about this as I do, it might be a good idea to contact your MP or MSP (or both).  Here are the most important points to make -

* The government must commit to mass testing and contact tracing as its strategy for eventually bringing lockdown to an end.  If the testing capacity isn't there at the moment, they should be honest about that, and undertake to reach that capacity as soon as humanly possible.  It should be an all-out effort with no more delays and no more excuses.

* A hazy promise of "more testing" is NOT sufficient. We're not just talking about testing health workers (although of course they should be first in the queue).  We're not just talking about community surveillance.  The WHO recommendation is absolutely explicit - all countries should test every suspected case.  If the test is positive, that person should be quarantined and their close contacts should be traced and tested.  Until a vaccine arrives, that is the only way to break the chains of transmission and avert a mass epidemic.

* Deliberately allowing 60%+ of the public to be infected is not an acceptable alternative exit strategy, and will not become acceptable under any circumstances whatsoever.  It would cause an unimaginable number of deaths, and ironically might well fail to produce 'herd immunity' anyway.  Many experts believe that people who recover from the virus might be susceptible to reinfection after a few months, or a year, or a couple of years.  Not enough is known about the virus to be sure, and allowing huge numbers of people to die in the vague hope that it might possibly produce some speculative benefit at a later date is totally outrageous and downright immoral.

* Perhaps most importantly of all, there should be no question of lifting the lockdown until there is a commitment to mass testing and contact tracing, and until the ability is there to carry it out.  Disturbingly, Scotland's Chief Medical Officer suggested the other day that suppression measures might be relaxed when the NHS has enough spare capacity to treat more patients.  The idea that it's somehow OK to needlessly allow people to become seriously ill just because there's a hospital bed ready for them is, let's be honest, utter lunacy.

*  *  *

I criticised Robert Peston earlier in this crisis for regurgitating government propaganda on herd immunity, but he's done a splendid job tonight of exposing government propaganda on the lack of testing...

"Michael Gove said just now that the difficulty in increasing number of #COVID19 tests was due to a shortage of the relevant "chemcial reagents". Well I've just talked to the Chemical Industries Association, which represents the UK's very substantial chemicals industry. It has contacted its members, and they've said there is no shortage of the relevant reagents. So the Association has now been in touch with Michael Gove's office to find out what he means, because it is stumped. The Association also points out there was an industry chat with a business minister today, who made no attempt to find out if there was a supply problem for the vital ingredients of Covid19 testing kits. So this question of why there aren't enough tests for the virus is an even bigger mystery. Also, if it turns out there is a shortage these manufacturers are more than happy to increase their production. But they need to be asked, which has not happened. PS It was Labour MP Bill Esterson who initially spotted this gap between what Gove said and what the industry believes to be true."

So there you have it - the failure to build up testing is not unavoidable, it's a choice. That choice must now be relentlessly challenged, and reversed.

*  *  *

This is superb from Jacinda Ardern, the Prime Minister of New Zealand and someone who I know that Nicola Sturgeon admires greatly -

"There were some countries that initially talked about herd immunity as a strategy.  In New Zealand we NEVER EVER considered that as a possibility EVER.  Herd immunity would have meant tens of thousands of New Zealanders dying, and I simply would not tolerate that, and I don't think any New Zealander would."

New Zealand has of course got roughly the same population as Scotland (in fact it's marginally smaller), so we'd be looking at tens of thousands of deaths as well.  And yet this is the outcome that the UK government's Chief Medical Officer and Chief Scientific Adviser are apparently still privately hankering after.  And this is what the Scottish government are effectively still in lockstep with as part of the so-called "Four Nations" approach.

We've got to put a complete end to this madness once and for all.

Monday, March 30, 2020

The time has come to accept Alex Salmond's innocence, and to welcome him back into the SNP fold

Those of you with very long memories may recall that when cameras were first allowed into the Scottish courts, one of the first televised criminal trials (in fact I think it might have been the very first one) featured Alex Salmond's future defence counsel Gordon Jackson.  He was defending a client against a charge of murder, and he gave a brilliant explanation to the jury of the concept of "beyond reasonable doubt".  He said that if they were 90% sure the defendant was guilty, the correct verdict was to acquit.  The point he was making is that a lot of people would assume that 90% certainty is more than enough for a guilty verdict, but in reality a 10% doubt means that guilt has not been proved beyond reasonable doubt and that acquittal should be inevitable.

That's why it's wrong to say "if Alex Salmond was acquitted, it means the jury think his accusers were lying".  It may have been that the jury weren't sure whether the accusers were telling the truth, in which case they had to give the benefit of doubt to the defendant.

But the flipside of that coin is that there is no justification whatever for treating an acquitted defendant as if he is essentially guilty.  As I understand it, the position of Rape Crisis Scotland and certain commentators is as follows -

* If someone is accused of sexual assault, he must by definition be guilty.

* The accused person is worsening the ordeal of his 'victims' if he tries to defend himself in court.

* The jury is worsening the ordeal of the accused person's 'victims' if it returns a not guilty verdict.

* An accused person who is acquitted should still be assumed to be guilty in every non-legal sense and his professional and social life should effectively be extinguished in much the same way that would have occurred if the verdict had been guilty.

That attitude is quite simply incompatible with the principles of the justice system.  The returned verdict means that society must regard Alex Salmond as innocent, not merely in a criminal sense but in every other sense too, except to the extent that certain facts were accepted by both prosecution and defence.  Do those agreed facts justify the continued demonisation of Mr Salmond?  Predictably, the SNP's highly controversial Equalities Convener Fiona Robertson believes that they do, but I'd suggest that's exactly the kind of extreme puritanism that led to the US Republicans over-reaching themselves two decades ago by attempting to impeach Bill Clinton.  

The Panelbase poll yesterday suggested that, against the confident expectations of a great many people, the SNP have come through the Salmond trial totally unscathed - indeed SNP support seems to have increased even further.  Having miraculously dodged a bullet, now is the time to bring unnecessary division to a definitive end by welcoming Alex Salmond back into the fold.  I know not everybody likes him, but we don't all have to like each other to be part of the same party.  There are one or two Russia-obsessed SNP parliamentarians who will probably never get over Mr Salmond's association with RT, but to the best of my knowledge there is no party rule that prohibits appearances on certain TV channels.

*  *  *

The coronavirus crisis has marked a new nadir for British journalism, and I think this tweet sums it up best -

"I've seen journalists be full of s*** before but I have never seen anything quite like this thing with UK journalists rallying around 'herd immunity', patting themselves on the back for understanding THE SCIENCE (everybody gets the virus), and then pretending it never happened."

Sunday, March 29, 2020

Sensational Panelbase poll shows SNP have further increased their enormous lead over the Tories

A few people have mentioned over the last few days that they'd just taken part in a Scottish voting intention poll for Panelbase. My assumption was that it was probably a private poll that would never see the light of day, because I couldn't believe a newspaper would commission such a poll in the middle of an unprecedented global crisis, but amazingly it turned out to be for the Sunday Times. The Holyrood figures are almost unbelievably good for the SNP - they're marginally better even than the figures in the previous Panelbase poll, which was commissioned by this very blog in late January.

Scottish Parliament constituency voting intentions:

SNP 51% (+1)
Conservatives 26% (n/c)
Labour 14% (n/c)
Liberal Democrats 6% (-1)
Greens 3% (n/c)

Scottish Parliament regional list voting intentions:

SNP 48% (+1)
Conservatives 26% (+1)
Labour 13% (-1)

I'll have to wait a few hours to find out the list numbers for the Lib Dems and the Greens, because I don't pay the Murdoch Levy and the preview of the article cuts out at that point!  But there's no doubt that the SNP would win a comfortable outright majority on results such as these.

I know from what people have said that the poll also asked about independence and the Alex Salmond trial (the latter possibly explains the weird timing of the exercise), but I can't see any information about those results yet.

I have to say I feel slightly cheated, because until I found out about the Panelbase poll a few minutes ago I was all set to write a blogpost entitled: "Hello!  Is it me you're looking for?"  One of our resident trolls had left a comment on the previous thread saying he couldn't wait to see how I would "spin the poll showing a 9% swing from the SNP to the Tories".  It turned out there was no such poll - he was referring to a tweet by a journalist from Hello! magazine (I'm genuinely not making this up) who apparently couldn't tell the difference between a poll and a tiny subsample of 99 people.

UPDATE: Many thanks to Paul Martin for sending me the full Sunday Times article.  The Liberal Democrats and Greens are both on 6% of the list vote - that's a 1% drop for both since January.

The independence figures are...

Should Scotland be an independent country?

Yes 49% (-3)
No 51% (+3)

Luckily the Sunday Times are measuring percentage changes from their own previous poll in November, rather than from the more recent Panelbase poll commissioned by this blog, so they're very helpfully reporting this as a 2% increase for Yes!  For my money the Yes vote has held up remarkably well given that people tend to be much more cautious and conservative in the middle of a crisis.  A virtual 50/50 split in the current circumstances suggests there is considerable potential for Yes to build up a sustained lead if and when the attention of the public returns to the Tories' plans for an extreme Brexit.

Respondents to the poll feel that Nicola Sturgeon is responding better to the current crisis than Boris Johnson - she gets a net rating of +54 compared to Johnson's rating of +17.  That's highly significant, because fieldwork took place entirely after Johnson's much-lauded TV address announcing the lockdown.  Bear in mind, though, that it may be harder for Ms Sturgeon to keep such a high profile going forward, now that BBC Scotland are cutting back on TV news bulletins.  (It's hard to be too critical of that decision given the need for social distancing and to keep the number of people travelling for work to an absolute minimum.  Nevertheless, it does illustrate again that the BBC tend to regard London-based news as 'essential' and Scottish news as an optional extra.)

On the Alex Salmond trial, the poll finds that the impact on Nicola Sturgeon's reputation has been more or less neutral.  Mr Salmond himself fares somewhat less well, but it's scarcely a disaster for him - a majority of the sample either say that their opinion of him has not been changed, or that they now have a more positive view.

Saturday, March 28, 2020

As the UK continues to defy the World Health Organization on mass-testing and contact tracing, the Deputy Chief Medical Officer attempts to gaslight the public into thinking the WHO's recommendations somehow don't apply to us

Friday, March 27, 2020

The latest right-wing American conspiracy theory that could lead to millions of deaths if it goes unchallenged

As we all know, Imperial College published a paper ten days ago stating that if the UK persevered with its mitigation strategy (ie. the notorious 'herd immunity' strategy) the NHS would be overwhelmed and there would be a totally unacceptable number of deaths - at least quarter of a million.  However, if the government switched to a full-on suppression strategy with radical social distancing measures, deaths could be kept to a much lower figure of 20,000 or below.  

A day or two ago, the lead author of the Imperial paper, Professor Neil Ferguson, went before a parliamentary committee and reiterated the figures.  He noted that because Britain had now implemented the recommended social distancing measures, the lower maximum figure of 20,000 would now apply - as long as we stay the course, and that's the crucial caveat.  A three-week lockdown won't be enough to have that effect, it'll have to be extended, and extreme social distancing will have to go on for a very prolonged period.

Because journalists are unable or unwilling to read, Ferguson's comments to parliament were apparently misreported in some quarters as Imperial "walking back" on their estimate of quarter of a million deaths.  That led to Trump supporters in the US pushing the entirely bogus claim that Imperial were admitting they got their sums wildly wrong - when in fact all Ferguson had done was reiterate exactly what had been in the original paper.

Most disgraceful and sinister of all, though, was Dr Deborah Birx of Trump's task-force lying through her teeth at a White House press conference by claiming that Imperial had radically changed their projections, and that she was "trying to understand" how that could possibly have happened.  I simply don't believe she's that stupid - it's pure propaganda on behalf of Trump, intended to undermine the overwhelming scientific evidence that millions of Americans will die needlessly if social distancing is prematurely abandoned, as Trump apparently wants to happen.

The irony is that right-wing American conspiracy theorists are trashing Ferguson as if he's some sort of "liberal" hellbent on ruining the American economy, when the reality is that it was earlier Imperial modelling that had been partly responsible for leading Britain down the disastrous herd immunity path in the first place.  When new data came in from Italy and the UK, the modelling was updated and Ferguson's team concluded that a suppression strategy was the only viable option.  Trump supporters are shooting a messenger who originally told them what they wanted to hear, but who can no longer do so for the simple reason that the evidence in front of him no longer supports it.

It may be that nothing can save America from itself, but it's important that the Trump propaganda isn't allowed to take root in this country.  Professor Ferguson has put out a crystal-clear clarification which you can see below, so there shouldn't be a problem as long as people can read.  But here's the thing: can they read?

"I think it would be helpful if I cleared up some confusion that has emerged in recent days. Some have interpreted my evidence to a UK parliamentary committee as indicating we have substantially revised our assessments of the potential mortality impact of COVID-19.

This is not the case. Indeed, if anything, our latest estimates suggest that the virus is slightly more transmissible than we previously thought. Our lethality estimates remain unchanged.

My evidence to Parliament referred to the deaths we assess might occur in the UK in the presence of the very intensive social distancing and other public health interventions now in place. 

Without those controls, our assessment remains that the UK would see the scale of deaths reported in our study (namely, up to approximately 500 thousand)."

Wednesday, March 25, 2020

Why are the most vulnerable people being forced to work and put themselves at risk?

I received this email earlier...

"Hi James,

Imagine being told you are an essential worker when you are blind, forced to travel in taxis and/or on trains, then placed in a building with 100 others. Even though spaced farther apart, you can’t see the hand sanitisers.

My friend who is blind (visually impaired people sometimes have a little sight but she does not) has been told her work is necessary.

This is because she works for a sub-contracted industry for financial services and they are regarded as essential workers. She does not want the specific agency mentioned though it’s not hard to guess what service a blind person can perform so I’m a bit limited in what I can say.

She is concerned that many disabled people work in sub-contracted services for utilities and banking and, though they are providing services for vulnerable people, they are themselves vulnerable. It can’t be right that they have been told they must come in to work.

She thinks this is a loophole in the current situation – forcing disabled people to work. She’s writing to her MSP. I know MSPs will be inundated at this time. Can you help?  People to contact?"

Tuesday, March 24, 2020

The UK's boneheaded refusal to accept the World Health Organization's central recommendation on testing and contact tracing remains the missing piece of the jigsaw

First of all, credit where it's due - the government have moved much further than seemed conceivable a few short days ago when they were still talking openly about the desirability of sitting back and allowing 60%+ of the population to be infected.  What's been announced is really lockdown-lite, though, and experience from countries like Italy and France strongly suggests that people will exploit the weaknesses in the rules, and that even more stringent measures will then have to be brought in to achieve the intended effect.  You're still likely to see large numbers of people out and about in the morning as if the lockdown hasn't happened, and if challenged by the police they'll just claim they're out on their permitted 'one daily period of exercise'.  We'll just have to see if Boris Johnson is determined enough to close the loopholes in the way that will almost certainly prove necessary.

But an even bigger issue is the glaring contradiction between the government's actions and their words.  The Imperial College paper which proved such a turning point made crystal-clear that 'mitigation' (ie. an enormous managed epidemic) was no longer a viable strategy, and that 'suppression' would have to be attempted instead - ie. keeping the number of cases as low as possible by means of drastic social distancing measures, and then holding on for a vaccine.  The actions the government have taken over recent days are consistent with a suppression strategy, and yet their language remains that of mitigation.  Although Boris Johnson didn't specifically use the phrases "lower the peak" and "flatten the curve" in his TV address, he did use words that appeared to have a very similar meaning.  And as for the Blighty Knows Best duo of Vallance and Whitty, they've carried on talking without reservation about a mitigation strategy as if nothing has changed at all, while insisting that they're aiming for no more than 20,000 deaths - something that the Imperial paper adamantly stated would only be possible with a suppression strategy.  It really doesn't make any sense.

The obvious way out of this mess would be for the government and their advisers to drop their superiority complex and actually start listening to the World Health Organization's central recommendation of mass testing and contact tracing, which has proved so decisive in turning the tide on the epidemic in both China and South Korea.   Incredibly, this New Scientist piece reveals that the scientific advice the government has been receiving in recent weeks has completely ignored the whole concept of test-and-trace.  Not rubbished it, not advanced reasons for why it might not work, but simply ignored it.  The arrogance of taking it as read that the central recommendation of the relevant international body isn't even worthy of discussion is just breathtaking.

Instead the government apparently intend to eventually ramp up testing but without contact tracing, which makes no sense at all.  It seems the main purpose of the testing will be to attempt to prove Whitty's pet theory about there being a very large hidden number of asymptomatic cases out there, and if that happens to get those people back to work - ie. the 'solution' the government have in mind still appears to be a solution for the economy, not for people's health.  But let's hope a bit of common sense creeps in at that point.  Even if there isn't the manpower for proper contact tracing, it's not beyond the wit of man to find ways in which the public could do some of the work themselves.  If someone tests positive during the mass testing, they could be urged to have a friend or relative ring round their close contacts and suggest that those people should be tested as well.  In that way, the chains of transmission might gradually start to be broken.

Oh, and let's knock on the head Whitty's repeated 'truthy' claim that there's no point in any country trying to suppress an epidemic that is almost everywhere in the world.  The virus does not fly across oceans on its own propulsion - if it's successfully pushed back in the UK it could then be kept at bay with suitable quarantining arrangements until a vaccine arrives.  It's just a question of whether the will is there to actually get on top of this thing as the South Koreans and Chinese have done, or whether the government are still hankering after the impossible goal of 'managing' a mass epidemic with a mortality rate that Scotland's Chief Medical Officer now estimates to be 1.4% - much, much higher than Whitty 'confidently' predicted a couple of weeks ago on the basis of his dud modelling.

*  *  *

For anyone who wants to know more about the crucial role that contact tracing played in stemming the Chinese epidemic, let me once again recommend this excellent interview with the WHO's Bruce Aylward.

Wings-to-English translation

Monday, March 23, 2020

Alex Salmond and the future of Scottish politics

Alex Salmond is my biggest political hero.  I think I've previously recounted the story of how I was converted to the cause of independence about a billion years ago when I watched him one morning on an edition of Election Call with Nick Ross.  He spoke up for millions during the Iraq War, and of course was largely responsible for giving Scotland its first pro-independence government in 2007 - a government that remains in power to this day.

So I was heartbroken when Mr Salmond was charged with a number of sexual offences.  I didn't make any prejudgements about whether the allegations were true or untrue, but I was certainly very much hoping he'd prove to be innocent, and I'm extremely relieved that's turned out to be the case.  After the verdict, I said on Twitter that he should now be able to rejoin the SNP without any stain on his character whatsoever, and a number of people immediately said "he won't be rejoining the SNP, he'll lead Scotland to independence with his own list party".  Stuart Campbell seemed to be vaguely hinting at the same thing with the closing line of his own blogpost.  Is this based on wishful thinking or on inside knowledge of Mr Salmond's intentions?  I've no idea.

What I would say, though, is that when I've pointed out the impossibility of "hacking the Holyrood voting system" with a list-only party, I've sometimes added the caveat that there are a very, very small number of people (you could probably count them on the fingers of one hand) who are high-profile enough and have enough of a following that they might just about be able to tear up the normal rulebook and make it work.  Stuart Campbell isn't one of those people, but Alex Salmond is.  There's certainly no guarantee he'd be able to pull it off - history is littered with charismatic, well-known politicians who set up their own parties and got absolutely nowhere.  (David Owen and Robert Kilroy-Silk are two obvious examples.)  But you could at least make a plausible case that Mr Salmond would be given a hearing by SNP voters and might be able to convince a sizeable proportion of them that they'd be serving the cause of independence by voting for the SNP on the constituency ballot and for another party on the list.  With anything above 5% of the list vote, that other party would start winning seats.

Would Mr Salmond be remotely wise to attempt that?  In my view, no.  Movements that are divided against themselves, particularly along the lines of personal feuds, tend to fail.  I think he'd be much better advised to return to his political home in the SNP (a party he was leader of for almost one-quarter of its entire existence to date) and to fight the good fight from within.  That course of action would also have the added bonus of annoying the controversial journalist David Leask, who for several years has been trying to gaslight us into believing that there is something called "the real SNP" which Mr Salmond and his associates are not part of.

YouGov poll shows overwhelming public demand for lockdown

You probably saw this a few days ago, but I suspect now is an important moment to reinforce the point: a YouGov poll was conducted on Thursday to test support for a lockdown in London, and found that people were overwhelmingly in favour.

At this time, would you support or oppose London being placed under a "lockdown" where people are not allowed to leave their homes except to go to work or get essential supplies?

Support: 64%
Oppose: 17%

There was strong support even among the subsample of London residents, ie. those who would be directly affected - 57% of Londoners were in favour, and only 27% were opposed.  It's reasonable to assume that majority will just keep getting bigger as people wake up to the scale of the catastrophe that is unfolding.

Hopefully also the narrative has moved on since the poll was conducted, due to the disgraceful scenes all over the UK of people ignoring social distancing guidelines and acting like they're on a bank holiday break.  Any lockdown self-evidently needs to be UK-wide.  If there's any suggestion of it being confined to London, Nicola Sturgeon should insist (publicly if needs be) that it's expanded to cover Scotland.

The public demand a lockdown.  The science favours a lockdown.  (Needless to say I mean the international science associated with the WHO, not the discredited Blighty Knows Best "science" pushed by the herd immunity triumvirate of Cummings, Vallance and Whitty.)  What remaining excuse has Boris Johnson got for not acting decisively to save hundreds of thousands of lives?

Saturday, March 21, 2020

A suppression strategy is the ONLY way to protect Scotland's rural communities

Over the last 24 hours or so, I've noticed an increasing number of senior SNP politicians quite rightly criticising people for going to rural areas (for example in camper vans) and putting vulnerable local residents at great risk.  Angus MacNeil posted a photo of preparations that had been made in Barra for anyone requiring emergency medical treatment, and he described them as "third world" in nature, lacking almost all of the necessary equipment.  He begged people to stay away from the island.

So there's a growing awareness in the SNP that the only way to protect rural communities is by means of a suppression strategy, ie. by stopping those communities from being exposed to infection in the first place.  That being the case, it's extremely hard to understand why Holyrood was, until only a few days ago, in complete lockstep with the insane "herd immunity" strategy of the UK government which would have entailed deliberately allowing 60%+ of the population to be infected over the coming weeks.  I'm sure you don't need me to paint a picture for you: if that had happened, there's no way rural areas would have been spared.  How did we get into such a grotesque position?  Did people in the SNP just not join up the dots and realise what they were signing off on?  Were they too in awe of a handful of London scientists to ask even the most basic questions?

Even now, it's far from clear that the UK government's chief advisers Chris Whitty and Patrick Vallance are actually sold on a suppression strategy.  Reading between the lines of today's illuminating BuzzFeed piece, it seems that they're reluctantly going along for the time being with the suppression measures described as absolutely essential by the Imperial College paper, but are refusing to acknowledge that anything has really changed.  That leaves open the disturbing possibility that their influence could see the UK backslide into a "take it on the chin" approach.  Can we be assured that the Scottish Government are privately making representations to ensure that doesn't happen, and that rural communities (and the rest of the country, for that matter) are protected?  

I must say that Jason Leitch's Grand Complacency Tour of the TV studios hasn't inspired any great confidence that the Scottish Government's own advisers are doing anything other than showing total deference to whatever the London "science" happens to be today.  I'd suggest it's time for SNP backbenchers to speak out and urge that the UK should start following the real science and adopt the recommendations of the World Health Organization on suppressing and controlling the virus - which are about as far removed from Whitty's and Vallance's reckless outlier views as it's possible to be.

(By the way, none of this should be interpreted as a criticism of Angus MacNeil, who I know has been speaking out.)

Friday, March 20, 2020

UK continues relentlessly with its wholesale defiance of the World Health Organization

I've just been watching a news briefing by the UK government's Chief Medical Officer and Chief Scientific Adviser, and it was an extraordinarily disheartening spectacle - it was as if time had stood still and the widely-briefed change of strategy from a few days ago had never even happened.  Yet again, Chris Whitty talked dismissively about the key recommendation of the World Health Organization to test every suspected case and trace all contacts as if it was some sort of fringe position taken by those who were "critiquing the science", rather than the international gold standard that it is.  He used a straw man argument to justify the abandonment of test-and-trace, suggesting that the practice is only supported by people who want "to make the virus go away" - but of course that's not the stated objective of the WHO, who merely suggest that the pandemic is "controllable" by means of test-and-trace.  Although testing in the UK will be ramped up, it doesn't seem to be with the intent of actually trying to control the epidemic - to a large extent it seems the aim is merely to prove Whitty's pet theory that a massive hidden wave of asymptomatic cases brought the outbreak in Wuhan to a natural end, which if true might be a get-out-of-jail-free card in this country.  But from what I can gather, that theory is regarded by most experts as optimistic at best and downright eccentric at worst.

And the situation is now worse than one of Whitty merely defying the WHO.  He also appears to be ignoring the recommendations of his own modellers, because of course the Imperial College paper reached the definite conclusion that a suppression strategy would have to be followed until a vaccine is available.  Incredibly, Whitty once again rubbished any suggestion of holding on for a vaccine.  If the modelling is right, that means inevitably at some point that the UK government's lack of sufficient action will lead to the NHS going into meltdown, with the potential for hundreds of thousands of needless deaths unless there's a change of course.  My own view is that a change of course would be bound to happen sooner or later in those circumstances, but I had been nursing the hope that the Imperial College paper marked the decisive turning point and that we no longer needed to rely on the UK advisers seeing the light when calamity struck.  It seems that may have been too optimistic.

There were a few crumbs of comfort - I didn't hear any mention of 'herd immunity' as a goal, or of the idea that it's actively desirable to let the virus spread as widely as possible in case it pops up again in winter.  (I didn't quite watch the entire briefing, though, which means there's a small chance those things may have been mentioned in the part I missed.)  So perhaps the impossibility of 'herd immunity' working has been grudgingly accepted.  Vallance also reiterated the objective of keeping deaths down to a few thousand.  But that leaves us with a mystery, because the Imperial College paper was adamant that such a 'low' death toll would only be possible with a full-on suppression strategy.  Do we just have two very stubborn men here who can't quite bring themselves to pull their public narrative into line with the steps that they privately know will have to be taken?  We'll have to hope that's what's going on, because the alternative is too horrible to contemplate.  There was some vague chatter about international technological progress providing the solution, so maybe what we're looking at is a modified version of the Imperial College recommendation, with some sort of suppression-lite strategy for a while, followed by the development of effective therapies as an exit strategy, as opposed to the farther-off development of a vaccine.

None of this exactly inspires confidence, though, and there must be a high probability that the weird mix of half-measures we've seen from the government thus far means we're hurtling headlong towards an Italian-style catastrophe, and a total lockdown as an emergency reactive step.  If a lockdown is near-enough inevitable anyway, it would be far better if it happened in an effort to stop us getting into a deep hole, rather than in an effort to get us back out of it.

Thursday, March 19, 2020

It's simply a fact that, until a few days ago, the UK government were pursuing a strategy that would have led to a large number of avoidable deaths

I've just had another exchange with Iain Macwhirter, who seems extremely muddled about the distinction between a 'herd immunity' strategy and a 'suppression' strategy - he thinks that herd immunity will somehow still be pursued during suppression.  That's not the case.  Although suppression doesn't wipe out the virus completely, it keeps the numbers so low that herd immunity is not achieved until a vaccine is available.

This tweet of mine seemed to particularly anger Iain -

"Herd immunity was a trade off. It did accept a number of deaths and severe illnesses as a price worth paying for getting back to normal more quickly. The only thing that has changed is that the numbers involved were far greater than the govt realised."

Iain replied that there was never any "callous calculation" in the herd immunity strategy that would have led to people dying needlessly.  He claimed it was "disgraceful scaremongering" to suggest otherwise.  But I'm afraid it's simply a fact that belatedly accepting that a suppression strategy is viable constitutes a tacit acknowledgement that the infections, illnesses and deaths associated with the herd immunity strategy had never actually been unavoidable.  Until a few days ago it was being pretended (not least in Jason Leitch's grand tour of the TV studios and in Iain's own Sunday column) that they somehow were unavoidable.

It's worth taking a look at this video from 11th March by Professor Neil Ferguson, the lead author of the Imperial College paper.  He sets out absolutely straightforwardly that the herd immunity (ie. "mitigation") and suppression strategies are binary choices, and that each option has its downside.  The downside of suppression is the length of time that social disruption will have to last, and the downside of herd immunity is the avoidable loss of life.  The politicians had to decide which was the lesser of the two evils, and until last week the government were plumping for the excess deaths.  Iain may or may not believe that was justified based on the known facts at the time, but to claim that the choice never even existed is deeply disingenuous (or delusional).

So what changed?  It's quite simple: a few days after he made that video, Professor Ferguson and his colleagues told the government in no uncertain terms that there was essentially no longer any choice at all, and that suppression was now the only game in town.  New modelling showed that pursuing herd immunity would have broken the NHS.

Tuesday, March 17, 2020

Imperial College paper: "managed epidemic" / "herd immunity" strategy would kill quarter of a million people in the UK

As you may have seen, a paper from Imperial College has concluded that the "managed epidemic"/"herd immunity" strategy followed by the government until now is simply not viable, because demand on the NHS would exceed surge capacity many times over, resulting in the deaths of 250,000 people in the UK.  For comparison, the UK death toll over six years of the Second World War was 450,000.  We all know Boris wants to be Churchill, but that would be taking it to an extreme.

I don't want to tempt fate in the way that some journalists have done tonight by taking it as read that the government will actually take heed of this paper.  Admittedly, it's hard to see how they can ignore it, because it's essentially an update of exactly the same modelling that gave rise to the "herd immunity" strategy in the first place.  But if we're now going to see movement towards a Chinese/South Korean-style suppression strategy, it's puzzling that there has been no sign yet of any U-turn on the decision to give up on testing of suspected cases and subsequent contact tracing, which the WHO have repeatedly made clear is the key part of any suppression drive.  Hopefully we'll see progress on that as time goes on.

It's incredibly frustrating that it's taken this long for the penny to begin to drop, when simply observing the experience in China could have provided a short-cut and saved many lives.  I recall watching an interview on the BBC News channel with a young doctor in Wuhan a few weeks ago, and he said the following -

"It turned out to be a pretty good idea to clamp down on travel, right?  If it had been done earlier, it might have had a bigger effect."

"The mortality rate with this disease is still far too high."

"Other countries need to be very, very careful with this virus."

We should have listened to him from the start.  But better late than never.

Monday, March 16, 2020

The UK is *choosing* to have a mass epidemic. It's not a necessity.

It's worth taking a step back at this point and recalling where we were a few weeks ago.  Why did the UK decide in the first place to start defying the World Health Organization by no longer taking sufficient steps to suppress the virus?  The main argument seemed to be that there was no point in any single country trying to control the virus within its borders (as both China and South Korea have shown can successfully be done) when spread is global - in other words, in an interconnected world, a country cannot protect itself from a pandemic.

But you may have noticed that the world has changed a fair bit over the last few days, let alone over the last few weeks.  Countries within the EU's Schengen passport-free zone have either closed their borders entirely or introduced strict border controls.  Remarkably, even Germany have done the latter, in spite of Angela Merkel insisting only a few days ago that free movement was sacred.  Countries further afield that have relatively low infection rates, such as New Zealand, have introduced quarantining for all arrivals.  Many of these measures are billed as temporary, but the likelihood is they'll be extended again and again.  Some countries may well try to stick it out until there is a vaccine, or at the very least an effective treatment.  The interconnected world is essentially gone for the foreseeable future, so that excuse for UK inaction no longer exists.  If we took South Korean-style measures to suppress the virus and then introduced quarantining to prevent it from being reimported, we would not become international pariahs - we'd be applauded for doing the right thing.

Once again, I recommend this interview with the WHO's Bruce Aylward for anyone who wrongly thinks that the virus cannot be controlled, or that it can only be controlled with authoritarian measures that would not be viable in this country.  The key is large-scale testing and meticulous contact tracing - something that the UK has just inexplicably turned its back on.  We were told by Chris Whitty that the "early stages of delay" would be very similar to "contain", with continued testing-and-tracing, but that turned out to essentially be a lie.  We've gone direct from "contain" to "mitigate" without passing Go - something which the WHO begged all countries not to do and warned would lead to the health system being totally overwhelmed.  Ironically, that just makes the most authoritarian outcome (total lockdown) more likely, not less so.

As far as the Scottish Government's role in all this is concerned, it's true that devolution means there are some things they can do and some things they can't.  But to the extent that their actions are helping to facilitate the UK government's plans to allow the virus to spread, they need to urgently look at themselves in the mirror and ask themselves why they're doing that.  If it's because they think there's more political cover in mostly going along with whatever the UK government decide, or if it's because they fear being lambasted for breaking a UK consensus, then those are the wrong reasons.  Nicola Sturgeon and her ministers should be taking every possible step to suppress this virus and to protect the people of Scotland, no matter what the political cost.

Sunday, March 15, 2020

The precautionary principle dictates that you do everything necessary to keep people alive for now, and that you solve hypothetical future problems if and when you face them

It's been interesting watching the evolution of Iain Macwhirter's views over the last few days about the UK's "herd immunity" strategy - which defies the wishes of the WHO by deliberately allowing the virus to spread and infect 60%+ of the population, in order to avoid a hypothetical "second wave" later on.  When I first spoke to Iain about this, I think he hadn't quite grasped the scale of what was being talked about - he thought that only a limited proportion of people would have to be infected to generate herd immunity.  A couple of days later, the penny seemed to have dropped and he started wondering aloud whether it was the UK or the rest of the world that was making the huge mistake (a useful rule of thumb when you ask that sort of question is that the answer is most likely to be the UK).  But now he's come full circle, and has penned a column today praising Nicola Sturgeon to the skies for ignoring 'people on Twitter' and listening to the UK scientific advisers instead.  The point he neglects to make is the one he made himself only the other night - ie. that first and foremost it's the experts of the rest of the world she's ignoring, not just 'people on Twitter'.  I don't doubt for a moment how difficult it would be for her to depart from the advice she's receiving directly, but when there is such a huge difference of view between the UK advisers and the leading experts of the World Health Organization, there comes a point where it's necessary to consider the strong possibility that the WHO are right and that the UK advisers are wrong.

Iain said to me a few minutes ago that Nicola Sturgeon would be guilty of dereliction of duty if she ignored the UK advice and people died as a result.  But that point is completely upside down.  The UK advisers want deaths to occur on a mass scale over the next few weeks and months to avoid the hypothetical second wave.  The WHO say the opposite - that the most stringent measures should be taken over the next few weeks and months to keep people alive.  Given that the second wave is an untested, unproven theory, the precautionary principle dictates that you keep people alive for now and then solve the hypothetical problem when and if you actually face it.  I strongly recommend this article in the Guardian by an epidemiologist (who thought the herd immunity strategy was "satire" when he first heard about it).  About the second wave, he says -

"Let me be clear. Second waves are real things, and we have seen them in flu pandemics. This is not a flu pandemic. Flu rules do not apply. There might well be a second wave, I honestly don’t know. But vulnerable people should not be exposed to a virus right now in the service of a hypothetical future."

Incidentally, you may have heard that community testing is being rolled out in Scotland to monitor the spread of the virus.  That's better than nothing, but it's important to be clear that it doesn't come even close to bringing us into line with the recommendation of the WHO, who want every suspected case to be tested, with close contacts traced (if the test is positive) to interrupt the spread of the virus.  We still won't be doing that.  Community surveillance mainly seems to be a passive exercise to help us "predict the peak".

UK lockdown petition

A commenter on the previous thread asked me to publicise the petition on the UK parliament website calling for the UK to implement an Italian-style lockdown, and I'm happy to do that - you can sign the petition HERE.  I know there might be a debate over whether now is the time for a full lockdown or merely for a French-style 'lockdown-lite', but regardless of whether you agree with every dot and comma of what the petition organiser is calling for, I think it's still very worthwhile to sign.  It's a good way to demonstrate the strength of feeling against the UK government's reckless and dangerous decision to completely disregard the recommendations of the World Health Organization on how to tackle this outbreak.

It's worth stressing that although the WHO acknowledge that lockdowns can play an important role when the situation has spiralled out of control, they don't think lockdowns are sufficient.  The most important thing of all is to interrupt the transmission of the virus by detecting every case and tracing all close contacts.  So even if the government agree to a lockdown (or more likely are forced into it by an Italian-type catastrophe), a second U-turn would then be needed - because they've essentially given up on testing-and-tracing.  They've announced that in future only hospital admissions will be tested, which means that mild cases will be completely missed and the close contacts of those people will continue spreading infection still further.  The excuse given for this crazy decision is that the world gave up on containment when the virus spread beyond Asia and that a mass epidemic is now inevitable.  Which is an odd claim, because the WHO are loudly repeating day in, day out, that this is a controllable pandemic and that every country can and must pull out all the stops to control it in the way that China and South Korea have demonstrated is entirely possible.

If this situation wasn't so unutterably tragic, it would almost be laughable.  The people who deliver pious lectures about "following the science" are the ones who are blithely ignoring the pleas of the world-leading experts of the WHO, and yet they seem oblivious to that irony.  Instead they're putting all their faith in a handful of UK scientists who are firmly in the minority of international scientific opinion.  And let's be frank - the Scottish government are as guilty of that as anyone.

Saturday, March 14, 2020

Don't follow the herd, Nicola, and don't let's "take it on the chin" - untold numbers of lives will be needlessly lost unless we radically change course and move into line with the WHO's recommendations

Here's a thread from Twitter that destroys the myth that the UK government are somehow just "following the science" with their insane plan to deliberately allow 60%+ of the public to be infected with a virus that has a reported mortality rate of 1-2%. It's written by Anthony Costello, a British former director of the World Health Organization, and it makes plain what has already become frighteningly clear to so many people over recent days - that the UK, and the UK alone, is ignoring the WHO's recommendations and is hellbent on letting the virus spread at the cost of heaven knows how many lives. Costello clearly doesn't think the strategy will 'work', even on its own warped terms, and understandably feels that the huge loss of life will be ethically hard to justify. I think we all know how hard it is for the Scottish government to move out of lockstep with London in a time of crisis such as this, but let's not mince words - it's simply got to be done, and it's got to be done quickly. If we don't change course and move into line with the WHO's advice, we'll be sleepwalking into catastrophe. This would be a man-made tragedy of unimaginable scale that would haunt Scotland's collective memory for decades to come.

(Note: I've copied and pasted the tweets below, because embedding a full thread is a bit tricky. You can see it in its original form HERE.)

"Unlike all other countries, the UK strategy aims to build herd immunity by allowing the steady spread of #COVID19. The government argue it will block a second peak in several months time. Here are EIGHT questions about this HERD IMMUNITY strategy: 

1. Will it impair efforts to restrict the immediate epidemic, and cause more infections and deaths in the near term? Evidence suggests people shed virus early, and those without symptoms may cause substantial spread...
...this argues for policies against mass gatherings, for school closures, and for strict national and local measures for social distancing. 

2. Will it weaken containment systems (testing, screening, radiography, isolation)? China quickly built a robust nation-wide system of mobilised communities/workers for identifying cases promptly, isolating contacts + treating vulnerable people promptly to contain the outbreak. 

3. Does coronavirus cause strong herd immunity or is it like flu where new strains emerge each year needing repeat vaccines? We have much to learn about Co-V immune responses.

4. Doesn’t this herd immunity strategy conflict with WHO Policy? After the announcement of this being a pandemic, Dr Tedros, Director General WHO, said “The idea that countries should shift from containment to mitigation is wrong and dangerous.” 

5. Shouldn’t we wait to see the China situation? They've contained the epidemic after 7 weeks of intense national effort. Will their strengthened systems not contain outbreaks quickly? What is their herd immunity? We don’t have serology available yet? It might be substantial. 

6. Without an all-out national mobilisation plan for social distancing, are the UK government behavioural and nudge strategies really evidence-based to flatten the peak? Or simply based on models? 

7. On the precautionary principle shouldn’t we go all-out to snuff this UK epidemic out, with national mobilisation at all levels, using all possible preventive measures (whether evidence is strong, uncertain or weak) and worry about herd immunity when we have more evidence? 

8. Vaccines are a safer way to develop herd immunity, without the risks associated with the disease itself. Is it ethical to adopt a policy that threatens immediate casualties on the basis of an uncertain future benefit?"

Friday, March 13, 2020

World Health Organization: "Do not just let this fire burn"

Thursday, March 12, 2020

How the government are playing Russian Roulette with the public's lives by ignoring the World Health Organization's advice on containment

This is something that a lot of people haven't woken up to yet.  The World Health Organization's position on coronavirus is clear - it can and must be controlled, suppressed, contained, pushed back, got on top of...choose whichever form of words you prefer.  They point to China and South Korea as examples of countries that had significant outbreaks and still got the situation back in control.

The UK government are ignoring that advice.  The view of the government's advisers (which the likes of Johnson, Cummings and Hancock are all too eager to accept) is that containment isn't possible and that we therefore shouldn't even try.  We should instead deliberately have a large-scale 'managed epidemic' that affects a huge percentage of the population and thus builds up 'herd immunity' so there's much less chance of a second outbreak.  That will condemn untold numbers of people to a needless death.  The excuse for this utter insanity is that the NHS will be better equipped to deal with the epidemic in the summer than it would be if there's a second wave next winter.

If you want to know what a 'managed epidemic' will actually look like in this country, take a look at the situation in Italy, where the health system is already in virtual collapse in spite of the fact that the numbers infected are still relatively small compared to what we'd be facing here at the height of an epidemic.  In a nutshell, a 'managed epidemic' is in current circumstances a contradiction in terms.  The NHS is not equipped to cope with it in summer any more than it is in winter.

Who is more to blame for this impending catastrophe - the ministers, or their advisers?  Ultimately it comes from the advisers (particularly the Chief Medical Officer and the Chief Scientific Adviser), but it's not hard to see why it suits the Tories down the ground to go along with it.  The alternative is to face a much longer period of disruption to keep the virus under control - in other words something akin to the situation in China and South Korea at the moment.  And that would get in the way of Johnson's plans for a glorious post-Brexit future, which is what he'd much rather be getting on with.  That's essentially what he meant the other week by his jaw-dropping musings about "taking coronavirus on the chin" and getting it over and done with by letting it move through the population.  That might suit him, but I don't think it suits the rest of us.

So what about the argument that the containment achieved in China and South Korea is a) not replicable here, and b) not even sustainable in those countries anyway in the context of a pandemic?  It's worth looking in detail at what the WHO have actually said about how containment worked in China.  I particularly recommend this interview with Bruce Aylward, who led the WHO's mission to the country.  He makes clear that in most of China containment wasn't achieved by total lockdown, but by the same public health measures that can be applied anywhere - closing of large gatherings, large-scale testing, fast and meticulous tracing and isolation of close contacts, and above all a high level of public awareness about the virus so that ordinary people can be used as a surveillance system.  It's exactly that high level of vigilance that will enable the Chinese to smother any fresh outbreak much more quickly - and just in case they're unable to do that, they're also using the time they've bought to dramatically build up the capacity of hospitals.  They're also testing and quarantining arrivals from other countries to prevent the virus being imported back in.  These are all steps we could take here if we actually got the virus under control by social distancing measures, and by ramping up testing to South Korean levels and tracing all the contacts quickly.

Instead, the government are trying to put you in a trance by making you think that what they are about to do by design is completely unavoidable.  The most despicable thing Matt Hancock said yesterday (and it was dutifully parroted by Robert Peston as if it was fact) was that the WHO's characterisation of the outbreak as a "pandemic" meant they were saying that nothing could stop it and that it would now reach every corner of the globe.  He must have known that was a lie when he said it - because in their press conference, the WHO were at pains to point out that the word "pandemic" was NOT an excuse for governments to give up on containment efforts and that they did NOT believe the virus would affect every part of the world, as long as the correct steps were taken.  They even specifically made the point that any government that gives up on containment and moves wholesale to "mitigation" will effectively be creating a situation where the health system will be overwhelmed.

If you agree with me that it would be better to put up with a year or two of moderate disruption rather than have God knows how many pointless deaths over the next few months, you could think about contacting your MP or MSP - in some cases, they may not even know that what is being presented to them as "the best scientific advice" is actually completely at odds with the WHO's directives.  Another thing you can do is keep an eye on Rory Stewart's Twitter account and retweet some of the things he's saying to ensure they reach the maximum audience.  I know I've criticised him many times in the past, but at the moment he does seem to be the only senior politician who truly "gets it".