The Times leads with the news that remdesivir may be an effective treatment for COVID-19. Yesterday, Dr Anthony Fauci announced the results of a gold-standard trial showing the drug has a “clear-cut, significant, positive effect in diminishing the time to recovery”. In a trial run by the US National Institute of Allergy and Infectious Diseases involving 1,063 patients in hospitals around the world, the duration of symptoms was cut from 15 days to 11. The news sent the share price of remdesivir, an antiviral originally designed to combat ebola, through the roof.
The Telegraph‘s front page has bad news, by contract. The above-the-fold headline reads: ‘Johnson to dash lockdown hopes.’ The paper reveals that the Prime Minister will use his first Downing Street press conference since his return to work later today to explain why the lockdown must remain in place. The Telegraph links this to yesterday’s announcement that the cumulative death toll has reached 26,097, meaning the UK now has the third-worst death-per-head ratio in Europe after Spain and Belgium. The jump in numbers from the day before is partly due to the Department for Health and Social Care including non-hospital deaths from COVID-19 in England in its daily figures for the first time, bringing yesterday’s total to 765. These are all patients whose death certificates name COVID-19 as the cause of death and who tested positive for the virus.
Another reason Boris is intending to keep the lockdown in place for the foreseeable future, according to the Telegraph, is the news that Germany’s transmission rate has gone up since the lockdown was eased last week. At yesterday’s Downing Street briefing, Dominic Raab cited this as evidence that a second peak was “a very real risk” if we scale back the restrictions. “Chancellor Merkel has made it clear that they might need a second lockdown in Germany if the infection rate continues to rise,” he said, although he didn’t explain why that would be more disastrous for the German economy than keeping the lockdown in place, one of the Government’s arguments for why a second peak must be avoided. Raab said no decision about whether to phase out the lockdown, or what form that might take, would be taken until the review of the data on May 7th by the Science Advisory Group for Emergencies.
Any hope that Nicola Sturgeon would exert pressure on the Government to make an announcement before then was dashed last night when Scotland’s First Minister said on Peston: “I’m far from convinced that when we get to the next review point on May 7th we’ll be in a position to lift any of these measures because the margins of manoeuvre that we’re operating in are very, very, very tight.”
Is the infection rate in German actually rising? That’s a possibility sceptics need to take seriously because if it is that would suggest lockdowns are effective at suppressing infection. But it isn’t – at least, not any more. On Tuesday, Germany’s Robert Koch Institute (RKI) announced that the reproduction number (R0) for Monday had risen to 1, after having been as low as 0.7 in mid-April, although Lothar Wieler, the RKI’s President, later clarified that in fact it had risen to 0.96 so was still technically below 1. However, the latest data from the RKI is that the R0 has now fallen again to 0.75. In case Dominic Raab missed this announcement, here is a graph included in the RKI’s most recent bulletin showing a steady decline in the number of reported casts in Germany:
The latest official data in Germany shows that new cases of confirmed infections dropped below 1,000 yesterday for the first time in almost seven weeks, suggesting the easing of the lockdown has had no impact.
The blog Facts4EU has published a post on Tuesday’s ONS’s data, pointing out that COVID-19 is only likely to kill a fraction of the people killed by other diseases this year, such as cancer, alzheimers and ischemic heart disease. It also unearths this gem from the ONS’s website in which it explains that its definition of a death “involving” COVID-19 encompasses those cases “where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions. If a death certificate mentions COVID-19 it will not always be the main cause of death, but may be a contributory factor.” So there you have it: the ONS records a death as being from COVID-19 even if it’s not “the main cause of death”. No doubt we can look forward to another clamour about the discrepancy between the ONS’s figures and those of the Government – even though the daily announcements at the Downing Street press briefings now include non-hospital deaths – when the ONS releases it’s data for Week 17 (April 18th – 24th) next Tuesday.
More on the model I mentioned yesterday created by the three Israeli professors, one an epidemiologist. According to their model, if a country adopts a mitigation strategy – social distancing as much as possible, including at work; 14 days self-quarantine for every person with symptoms; face masks, hand washing, etc. – then in most cases there’s no need for a lockdown. They caveat this by saying it only applies to those countries that have more than 60 ICU beds per million; those with less might have to partially quarantine high-risk populations for a short period. (NHS England is above this threshold and was before it increased its surge capacity.) Supporting their conclusion is the fact that the healthcare systems of countries that haven’t imposed general lockdowns – such as Japan, Sweden, Taiwan and South Korea – did not reach full capacity and in those countries that did – Spain, Italy, UK – infections peaked after mitigation strategies were adopted but before lockdowns were imposed. You can read the preprint here. (For a through demolition of the case for lockdowns, I also recommend this long essay by Ryan Kempber, a software engineer based in Santa Barbara.)
One of the more entertaining aspects of the crisis has been watching the world’s most eminent experts in infectious diseases fighting like cats in a sack. Last month saw the public spat between rival teams of epidemiologists at Oxford and Imperial – and thanks to Hector Drummond for unearthing the fascinating backstory to that dispute – and now we have the bust-up between Professor Ferguson and Professor Johan Giesecke, the Swedish Government’s ex-chief epidemiologist. When this is all over, Quentin Tarantino should make a film about epidemiologists. What should he call it? Once Upon a Time in Wuhan? Science Tsar Dogs? Ingloriuus Beardies? Suggestions please.
In the latest skirmish, Giesecke has hit back at Neil Ferguson after his dismissal of Sweden’s approach to managing the crisis in last Saturday’s UnHerd interview. Speaking to the Swedish daily Svenska Dagbladet, Giesecke said: “I know [Ferguson] a little and he is normally quite arrogant, but I have never seen him as tense and nervous as during that interview.” He dismissed Ferguson’s prediction that deaths in Sweden will start to rise again, claimed the infection fatality rate is closer to 0.1% than 0.9% and said New Zealand’s draconian lockdown meant it would have to continue quarantining incoming visitors until a vaccine is found. Good to see Professor Giesecke – surely the hero of this saga – holding his ground in spite of attracting widespread criticism, including from 2,300 academics who wrote a letter last month calling for the Swedish Government to switch tack.
Sweden’s answer to Bruce Willis attracted an unexpected ally yesterday in the form of the World Health Organisation (WHO), which lauded Sweden as a “model” for battling the virus. Dr. Mike Ryan, the WHO’s top emergencies expert, said there are “lessons to be learned” from the Scandinavian nation. This, from the organisation that originally praised China for imprisoning everyone who tested positive for the virus in purpose-built hospitals, whether they needed hospital care or not, and boarding up in their homes those who tested negative. The New York Post has the story.
The Guardian reports on its front page today that NHS England is considering removing black, Asian and minority ethnic (BAME) staff from frontline roles, given that they appear to be dying in disproportionately high numbers compared to non-BAME NHS workers. Last week, I flagged up some preliminary research into whether there’s a connection between how much vitamin D a person’s body produces and their susceptibility to coronavirus – one possible explanation for why BAME people appear to be dying in greater numbers. Since then another paper has appeared, this one by a doctor in the Philippines who studied the relationship between vitamin D and clinical outcomes for 212 COVID-19 patients. His conclusion: “Vitamin D status is significantly associated with clinical outcomes.” You can read his paper here. (And here’s another paper making the same argument.)
Evidence continues to mount that the lockdown is taking a toll on our mental health. A blog called Mental Health Today ran a harrowing piece yesterday by Joy Hibbins, the CEO of Suicide Crisis, a registered charity which runs Suicide Crisis Centre. You can read that here. And photographer Laura Dodsworth has documented the loneliness that a variety of people are experiencing while being trapped in their homes in a piece for Spiked.
The Independent reports that police in Norfolk are hunting a man who takes daily walks in a Norwich suburb dressed as a “terrifying” plague doctor, complete with pointed beak-like mask. Nice to know there are still some freeborn Englishman out there who have kept their sense of humour during the crisis. No doubt he’ll be clapped in irons if the Norfolk constabulary ever catch up with him.
A reader flagged up an excellent comment piece in Derry Now by Anne McCloskey, a retired GP and a councillor on Derry City and Strabane District Council. She describes the ongoing lockdown on both sides of the Irish border as “non-evidence-based insanity”. I nominate Cllr McCloskey as my Sceptic of the Week.
John Rhys, a Senior Visiting Research Associate at the Environmental Change Institute at Oxford, has referred me to a blog post he’s written that rebuts some of the assumptions underlying the sceptical case which is well worth a read. His best argument is that the economy would have taken a massive hit whether the Government imposed a lockdown or not:
Countries have taken approaches that differ in detail, but most have been essentially similar in their approach. Even where fewer formal restrictions are imposed, as in Sweden, actual behaviours and outcomes are not so very different. Tellingly, many in the UK were already modifying their behaviour, and creating their own forms of social distancing before formal lockdown was imposed. With a full-blown explosion of cases and deaths, and hospitals collapsing under the weight of new cases, it is inconceivable that we would not have seen massive changes in personal behaviour, seeking the same outcomes, albeit in uncoordinated and less effective ways, and very likely a degree of panic, with broadly similar damage to economic activity. The difference is that the damage would have been the result of individual consumer choice, not of government imposed restriction. Most of the economic damage therefore became inevitable as soon as the virus spread into much wider national populations. In reality there never was any way of avoiding the shock and its economic consequences, although there were and remain ways of handling the crisis well, badly or very badly.
I get quite a few emails from readers beginning, “My mum works in a care home…” or “My daughter-in-law works in a hospital…” followed by some hair-raising anecdote. But I thought this latest one worth passing on, given the hue and cry about deaths in care homes:
My mum works in a care home in Nottingham. They’ve had three deaths in the past two weeks, which is a normal number for them (they offer end-of-life care). The local GPs have recorded the cause of death as COVID-19 in all three cases, even though the people in question were showing no symptoms of the virus and had previously been tested and found to be negative. The residents of the care home are being frequently tested by Public Health England. No cases of COVID-19 have been detected so far. The care home manager was quite proud that their strict infection control procedures seemed to be working and is now quite upset that COVID-19 deaths are being recorded at the home. In this area of Nottingham at least, it seems that GPs are assuming the cause of death is COVID-19 without any evidence at all. I’m not sure how widespread this practice is, but if it’s even moderately repeated across this UK, this has obvious implications for the accuracy of the national statistics.
Some readers with a background in medicine or statistics may be shocked by just how poor their daily paper’s coverage of the crisis has been. But do they then turn to other parts of the paper and take everything else they’re reading as Gospel? If so, they’re suffering from what the late science fiction writer Micael Crichton called the Gell-Mann Amnesia Effect. Here’s Crichton explaining what that is:
Briefly stated, the Gell-Mann Amnesia Effect is as follows. You open the newspaper to an article on some subject you know well. In Murray’s case, physics. In mine, show business. You read the article and see the journalist has absolutely no understanding of either the facts or the issues. Often, the article is so wrong it actually presents the story backward—reversing cause and effect. I call these the “wet streets cause rain” stories. Paper’s full of them. In any case, you read with exasperation or amusement the multiple errors in a story, and then turn the page to national or international affairs, and read as if the rest of the newspaper was somehow more accurate about Palestine than the baloney you just read. You turn the page, and forget what you know.
Tim Bidie, one of our regulator commenters, asked for suggestions of theme tunes for this website. One reader has sent this YouTube video of ‘The Lunatics Have Take Over the Asylum’ by Fun Boy Three. And if you’re looking for some more light relief, I can recommend the latest video from Comedy Unleashed, the politically incorrect comedy club where I made my stand-up debut in February. (So far, YouTube hasn’t censored it, but it may not be long according to Tucker Carlson.) And if you’re really bored, you can watch my debut here.
A huge thanks to those who donated to pay for the upkeep of this site yesterday. If you feel like donating you can do so by clicking here. And if you want to flag up any stories or links I should include in the site, you can email me here. See you tomorrow.
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