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".