Everyone in the UK - please share this widely, this and other posts that explain what is happening in the UK. We have to act, and act promptly. Every day of delay makes things worse.
First if you are in the UK you may be unaware of what the WHO themselves say as it is not normally reported here in the UK since it conflicts with what our scientists say.
There is so little understanding of this in the UK. Few seem to know about it in the general public.
The WHO are the world experts on this topic and are responsible for overseeing the eradication of polio, also eradicating malaria from many countries and near eradicaton of smallpox, also in stopping many outbreaks of Ebola and they respond to 200 or more epidemics every year. These people are absolute experts on this topic. Meanwhile the UK experts base their experience for dealing with COVID19 mainly on flu.
The WHO are to be respected and listened to.
Dr Tedros, director general of the WHO said on monday in his “test test test” speech that we all have a duty to stop this virus not just for our own countries but also for the other countries with weaker health care systems that it could spread to.
He is especially concerned about what happens if it spreads to countries with people weakened by AIDS or with malnourished children or refugee camps - and any country that doesn’t stop it becomes a source for it spreading more easily to those countries. The WHO is acting to reinforce their health systems to cope and unlike Europe most of those countries have been preparing with the greatest urgency for this disease for weeks now. Still, they will struggle to contain this disease if it gets to them in large numbers, for instance, from the UK.
This is the video of the WHO press briefing on 16th March with my summary of opening remarks and official transcript
It may be a good one to share to raise awareness of what the WHO themselves say.
The good news is that China contained it and many other countries are already containing it. We can too. We can stop it,and must..
The UK however have abandoned the approach of the WHO.
They have started to do tests again but they have not yet come around to say they are going to try to find all the mild cases, contain them and trace all the contacts and isolate those, as the WHO say has to be done.
Please don’t be scared by this. You can protect yourself and your loved ones, and protect others too by breaking chains of transmission that pass through you. The government are not yet explaining this to us properly.
Then, if we act together we can get our government to change its direction and save lives. A government is made up of MPs and the MPs for the large part care deeply for their constituents. They need to be made aware what is going on. They are objecting already, but they are not well informed about the background of the WHO.
Here is one MP showing how feelings are strong already about the risk for our health workers and old people with this policy:
https://twitter.com/BBCPolitics/status/1240255298423717889Here Boris Johnson responds that he is acting on the best scientific advice. I think he may well be unaware of what the WHO are saying - politicians are not expert on science, often are not especially scientifically literate. Boris Johnson has a degree in the classics, ancient literature and classical philosophy and he then went on to be a journalist.
He is relying here on his chief medical adviser who never talks about what the WHO recommend in his briefings to the general public and probably doesn’t mention this to Boris Johnson either.
Of course Boris Johnson, and Dr Whitty too for that matter, want to slow iti down. If they though they could stop it this would be their top priority.
Yet the WHO say it can be stopped and this is where it gets strange.
Even politicians here are unaware of what is going on. For instance Jeremy Corbyn would surely criticise Boris Johnson on this point if he knew about it, but he doesn't mention it.
It is the same for many experts too - and it sounds like it is the same in the Netherlands who are following the UK's lead here. These experts don't seem to be aware of what the WHO say. Or they are discarding it because it doesn't fit their paradigms for flu (more at the end of this post)
Out of basic scientific integrity, they should make it clear that what they say differs from what the WHO say. They should say something like:
“In every press briefing the WHO say that this disease can be stopped and that it is not a queston of wether we can any more but if we will. Also there was a joint WHO-China report with an international team of 13 experts lead by Bruce Aylward and 12 Chinese experts and they also concluded that itcan be stopped after studying it on the ground in China including a day and a half in Wuhan.
However I believe the WHO are incorrect and the expert report is incorrect when they say it can be stopped for x y z and …”
That then would be scientific integrity. Then our PM would then assess for himself whether to follow the advice of his chief medical officer or of the WHO in full awareness that they are giving different advice. Also we as a country would know what is going on and all this would be explained on the TV news and in the media.
It is okay to disagree but if they have good reasons to do so, they should tell us all upfront why they are doing this.
Not just that, they should say in detail what they think is wrong with the WHO's analysis and advice, and why.
They should also explain clearly to the British Public that in the opinion of the WHO this course of action endangers people not just in the UK but also in countries with weaker health care that we may infect with our outbreak. They should explain to us why it is they are continuing with this plan faced with this warning from the WHO.
And then explain to us why they think this is not a concern.
I live in the UK and nobody is doing any of this in the UK. There are letters from experts and politicians outraged by what is happening but though mentioned, they are basically dismissed.
There seems to be almost no awareness that the WHO are even saying this.
I don't think any of our politicians know this either. Nobody is challenging Boris Johnson on this basis or even mentioning it, on the BBC, even the Guardian usually very critical of the government, the experts on twitter etc.
The experts in the UK are doing projections which they create with simple adaptations of models they previously developed for influenzau. They change none of the assumptions in the models about how influenza is transmitted and expect them to work for this very different disease that is not a version of flu but a coronavirus and is alos different in how it transmits from SARS too.
Their models are only validated against influenza outbreaks and not against data for COVID19. It doesn't necessarily follow that actions that help suppress an influenza outbreak will also be optimal for COVID19 without testing a model. A model is just a hypothesis and should not be used for prediction until it is validated against the data you are modeling.
They should explain this too to the general public too and then tell us why we should believe their conclusions from their theoretical models based on flu over the practical experience and the direct research in China and the findings of the experts in the big report co-lead by Bruce Aylward, an epidemologist who was a lead of the global polio eradication campaign for many years.
This, for instance, is the model that has been headline news in the UK recently which they say has lead to the UK government modifying some of its ideas - but still nowhere near the WHO approach and nowhere near contain.
You may have seen this graph reproduced from their paper which leads them to predict a second surge if we don’t let it spread a bit now:
They say in the paper itself that they basic structure is as previously published and they say nothing about modifying the spread dynamics to model for COVID19 instead of influenza:
We modified an individual-based simulation model developed to support pandemic influenza planning to explore scenarios for COVID-19 in GB. The basic structure of the model remains as previously published. In brief,individuals reside in areas defined by high-resolution population density data. Contacts with other individuals in the population are made within the household, at school, in the workplace and in the wider community.
Paper Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand
Popular exposition here:
3 charts that helped change coronavirus policy in the UK and US
There the main difference is that flu spreads easily in the community amongst large groups of people, in schools, and has symptomless spreaders, about a third of us are which makes contact tracing impossible.
Meanwhile COVID19 almost only spreads through prolonged or very close contact e.g. families visiting each other or in hospitals, prisons, old people's homes and some religous situations. These people know each other, or the organizers of the events know them all.
This is why COVID19 spreads mainly through easily traceable close contacts - a method that wouldn't work for flu.
A model of spread designed for flu would not be expected to work unmodified for COVID19.
Their model also doesn’t include any attempt to predict the effect of contact tracing, isolation and aggressive case finding.
This is the model that they are using to predict that the cases will surge in China maybe 8 weeks from now. But this is not flu.
This is the real data from the world:
Though COVID19 is a new disease there is little evidence that it will surge up again. Also it can’t become a second Wuhan in China, becaue the Chinese are all set to catch new cases right away. If anyone previously infectious who has got over it gets a resurge of the virus still somehow hidden in their bodies, 8 weeks from now, it won't be anything like the first one but just stopped in its tracks. These people will be isolated within 3 days and quarantined and all their contacts isolated too just as before.
But so far there is no evidence that COVID19 will resurge like this.
Also COVID19 could transfer to humans again from its original reservoir, perhaps in pangolins (not discovered yet). But if so, again, the Chinese will spot it within days now they know how to detect it.
They are prepared to fight it again if needs be, retaining the beds and ventilators and ready to detect any cases. This is what kept it from growing in the other Chinese provinces in the way it did in Wuhan and this will stop a new Wuhan from happening if this viruses does resurge.
Here is Dr Bruce Aylward talking about the Chinese response and comparing it with the UK response. The Chinese are preparing for a second surge to make sure it is ready to stop it if this happens.
https://youtu.be/vsV_PJ3txn8?t=465All of our governments advice seems to be based on measures they know from experience help with flu rather than the new measures developed in China, Singapore, South Korea, Italy etc that work with COVID19.
For instance they are asking people with mild symptoms to self isolate at home for 7 days if they are on their own, but if they isolate with a family that they should all stay at home for 14 days.
This seems a recipe for infecting everyone in the family with COVID19. Close contact with a family all cooped up for 14 days in winter is the perfect situation to infect as many as possible - unless they know how to self isolate the one with the symptoms. Going out in the community is much less risk if they do social distancing than staying in the house and infecting others in the house. Then at the end of those 14 days, if it is COVID19, they are still infectious, for up to 14 days after they have completely recovered. Some of the others in the house may have only just got COVID19 at that point and not yet showing symptoms. And at that point they can all go out and start infecting others again. It may be good advice for flu but how is this good advice for COVID19?
Then there is the way they are doing almost nothing to protect care homes, hospitals, surgeries, and dentists from patients who may have undetected mild cases of COVID19. Or prisons. These are not their center of attention and they have even downgraded the level of protective equipment recommended to doctors working with known COVID 19 positive patients.
See my
This is not a theoretical study, it is real life with real people’s lives at stake. These places have been involved in spreading and amplifying COVID19.
I am sure eventually they will notice their measures are not working - but they need to get up to speed fast and change their ideas rapidly. It needs to be evidence based, based on evidence for COVID19 rather than influenza.
There are signs of this already. Look at the deaths from COVID19 in the UK doubling every 2 days. Usually it is every 3–4 days. Their measures may be making things worse.
With a doubling time of 2 days it would continue
200, 400, 800, 1600, 3200, 6400, 12800.
We could have 12,800 deaths by two weeks from now, at this rate, increasing 64 fold every fortnight.
NOTE I AM NOT SAYING THIS WILL HAPPEN
There is no way we go as far as that.
But exponentials increase very fast. The UK strategy is not evidence based on experience with COVID19 and we have no previous experience of anyone else to show that it works. It may be making things worse as I said.
If we don’t stop this approach RIGHT NOW, it will soon be in a situation as difficult as Italy and if we do nothing for another 10 days it can easily begin to get as bad as WUHAN or worse.
I know the government is introducing many major measures but are they the right ones.
Here is a bullet list:
The governments increase in testing to 25,000 a day is a welcome step in the right direction. But there is far more they have to do.
Also for specific vulnerable populations:
So far they are not doing any of these things, and every day counts.
They are doing many other radical things that would work for flu but for the most part are untested for COVID-19
Details here:
We don’t really know the number of cases infected now until they do rapid and extensive testing. But if the cases are doubling only every 3 days instead of every 2 days, then that would be a ten fold increase every ten days. 1000 cases become 10,000 ten days later, then 100,000 then within a month, 1 million, more than ten times worse than the total cases for Wuhan.
We crossed 1000 cases on the 14th of march. That makes it the 24th when we may hit 10,000 cases and 3rd of April when we may hit 100,000 cases. If the government’s actions are actually accelerating spread due to using the wrong paradigm of flu instead of COVID19 it may even happen faster.
WHY DON’T THEY SEEM TO SEE ANY OF THIS?
I think myself it is an example of a paradigm shift as in Thomas Kuhn's "The Structure of Scientific Revolution".
Paradigm shift - Wikipedia
They are using the flu paradigm and everything else is checked according to how it fits that paradigm and they are discarding information and advice that doesn't fit it.
This can often seem puzzling to non experts because you are not invested in the old paradigm. You can't see things the way they do with their decades of experience working in great details with all the intricacies of transmission mechanisms of flu.
I think it is also related to Thorstein Veblen's idea of "trained incapacity". He has a rather unflattering analogy with chickens:
By trained incapacity he meant that state of affairs where one's very abilities can function as blindnesses. If we had conditioned chickens to interpret the sound of a bell as a food-signal, and if we now rang the bell to assemble them for punishment, their traiing would work against them. With their past education to guide them, they would respond in a way that would defeat their own interests.
Thorstein Veblen - Wikipedia
These are highly educated very intelligent “chickens”.
However paradigm shifts can be tricky for even the most intelligent. I have a special interest in the history of Maths.
Back in Sumerian times then they put a mouth picture over a number, meaning “part” to turn e.g. the number 5 into 1/5
This method of notation didn’t permit the notation of e.g. 3/5.
So they would express other numbers as unit fractions i.e. 1/n.
For instance they couldn’t notate 3/4. Instead they had to notate it as
For centuries an entire civilization of people with the same genes as us, as intelligent as us, never invented the idea of a ratio. It would have made many things so much simpler for them, but the idea never occurred to them. Not even their equivalent of our best scientists or mathematicians were able to think of this idea. Put Albert Einstein back into Sumerian times, raised as an orphan there, and he wouldn’t think of it either.
That’s an example of a paradigm shift.
There are many others in maths. There was huge resistance in the middle ages to the introduction of negative numbers in equations.
Before negative numbers were accepted by mathematicians - then they had many different forms for the quadratic or the cubic. You always had to rearrange the equaation to make sure all the coefficients are positive. As they went through the steps to solve the quadratic, they had to keep everything positive because they didn’t think negative numbers were valid numbers. This lead to many different techniques you had to learn to solve a quadratic and even more so for the cubic with this clumsy notation.
It took until the fifteenth century for negative numbers to take off in Europe.
As late as 1758 the British mathematician Francis Maseres wrote that negative numbers
"... darken the very whole doctrines of the equations and make dark of the things which are in their nature excessively obvious and simple" .
Now we learn about negative numbers as children. Back then it was an advanced subject for their equivalent of university level maths with the experts arguing about whether it was valid to use them or not.
I hope this helps you have more sympathy for these experts. They are not stupid, or arrogant or unethical. Just facing a paradigm shift, and their vast experience of influenza has caused a “trained incapacity” that makes it really tough for them to change this paradigm. So they are discarding the evidence against their ideas over and over.
Their own erudition is the thing that is causing them problems.
They will come around eventually. But we don’t have time for this; we must stop it now.