Day: 14 December 2020

Is London set to join Kent and vast swathes of the North in Tier 3, and see its restaurants and pubs once again close their doors when the Tier system is reviewed on Wednesday? Sadly the answer appears to be “quite likely”. The Telegraph has the story:

It is “inevitable” London will go into Tier 3, health sources say, amid warnings that the latest data on infections in the capital is “catastrophic”. MPs from London and the surrounding areas are due to be briefed on Monday on figures that show the rate of infection is now doubling every four days.

One health source said the latest data was “terrifying”, with rates in the capital worse than those of Liverpool or Manchester when they entered Tier 3, giving the Government little choice but to introduce the harshest restrictions. In spite of some variations between different parts of the capital, he said the London boroughs were seen as “far too interconnected” to each other to be split up.

“The new data makes it likely London will go into Tier 3,” said another Government source, describing the latest figures as “catastrophic”. Another Government insider said: “Boris will be very against putting London in Tier 3. But I think it’s more than 50% likely London will go into Tier 3.”

The move is forecast to cost the economy £3 billion, pushing businesses that have survived thus far to breaking point. The Guardian describes what it could mean for a restaurant owner in Upminster:

Festive lights twinkle on the outside terrace of Upminster’s Osteria Due Amici Italian restaurant with outdoor tables placed beneath heaters, and indoor tables separated by Perspex screens.

Owner Edward Xhetani, 38, has done everything to entice customers and be Covid-compliant. It was due to be fully booked on Friday night. “But if we go into Tier 3, I’m done. That’s the truth. I don’t have a chance,” he said.

At the furthest eastern reach of the District line, Upminster lies in the London borough of Havering, where coronavirus infection rates are among the highest in the capital. Xhetani was banking on pre-Christmas trade. Instead, he faces the prospect of closing down and letting his 20 staff go. Takeaway deliveries, permitted under Tier 3, are not financially viable. “I don’t think we will survive.”

Opposition to the move is growing among Tory MPs, especially those representing London constituencies, with many calling for the city to be split into different tiers. From the Mail on Sunday:

London’s Tory MPs have urged Boris Johnson not to inflict “untold damage” on the capital by moving it into a Tier 3 lockdown this week. In a letter seen by the Mail on Sunday, the MPs urge the Prime Minister to spare the capital because shutting it down would hurt not just Londoners, but “people across the nation” who depend on the “wealth and prosperity generated by our great city”…

In a pre-emptive strike ahead of a review of the capital’s restrictions, six senior Conservatives signed the letter, organised by Harrow East MP Bob Blackman, which warned that many London Tory MPs could vote against the Government’s COVOD-19 [sic] approach when it is reviewed next month if the city is plunged into Tier 3.

Separately, Nickie Aiken, the Conservative MP whose constituency includes the West End, said Tier 3 would be a “disaster” for London and destroy livelihoods.

Mr Blackman said last night he supported the proposal to split London into different tiers, adding: “The least-affected areas should not be governed by the worst-affected areas.” He said he would vote against renewing the current anti-Covid regime next month if London was forced into Tier 3, and warned that many other London Tory MPs would do the same.

However, former Tory leader Sir Iain Duncan Smith said it would be a “mistake” to put even some London boroughs into Tier 3. Sir Iain, MP for Chingford and Woodford Green in North-East London, warned that the virus increases in his area were among schoolchildren, not the elderly population more at risk.

And Ms Aiken said the approach of dividing the capital into different restriction zones would be “near impossible to police”.

Chancellor Rishi Sunak and Business Secretary Alok Sharma have raised concerns over plunging the capital into Tier 3. 

The MPs’ letter highlighted the Government’s own estimate last month that 550,000 jobs would have been at risk if London had been put in Tier 3 last month. They warned: “It would be a false choice to pit lives against livelihoods when it comes to deciding which Covid restrictions should apply in London. We believe the Government can both protect lives and livelihoods with a more measured approach of keeping our capital open while also bearing down on this terrible virus.”

Officials have confirmed that London will be treated as a whole, with Matt Hancock stating that “narrow carve-outs” of areas with lower rates of infection often leads to them catching up or overtaking areas with a higher prevalence of COVID-19.

Tim Spector, a leading epidemiologist and the creator of the COVID-19 Symptom Study app, has also warned against putting the capital in Tier 3. From the BMJ:

Speaking at a Royal Society of Medicine event, Spector said, “This on-off business is a total disaster, and we should avoid it. In London the decrease has stopped and is flat or slightly increased. Most of the cases are in north London at the moment. It would be a big mistake if London goes into Tier 3. I think everyone should be coming down a tier and stay somewhere between Tier 1 and 2 until April, when we see the vaccine taking effect.”

Spector said there was a danger that people would engage in risky behaviour if they thought their freedom was about to be curtailed even further. “Drinking and festivities will happen if people think that in two days’ time that is it for another six weeks. It would be madness to do that.”

“We need to think about these tier systems. The whole point should be the capacity of the NHS to deal with it locally. At the moment, according to our data, London has plenty of spare capacity [in hospitals]. We know we aren’t going to get rid of this virus before the vaccine, so we need to make sure the NHS is under control and that people over the age of 60 are not getting it at bad rates and have some clear criteria.”

He said the Government should stop treating people like “cattle” to be led and instead give them better information and trust them to do the right thing. “Just having this league table of who is being relegated and promoted and this on-off effect is madness,” he added. “We need a much more consistent pattern that we can all relate to. If you tell people the truth and what is going on in the area, they will behave responsibly. They need to be part of the discussion not treated as if they are cattle.”

Here, as a point of reference, is the latest critical care bed occupancy numbers from the Spectator’s COVID-19 data tracker.

Stop Press: The data from Tim Spector’s Zoe Covid Symptom study is well worth looking at for a detailed and nuanced picture of rises and falls in cases. The most recent data press release (dated December 11th) presents findings that though cases are rising in Wales and London they are falling in much of the rest of the country:

• There are currently 19,190 daily new symptomatic cases of COVID-19 in the UK on average over the two weeks up to December 6th (excluding care homes). This compares to 20,497 daily new symptomatic cases a week earlier.
• The UK R value is 0.9. Regional R values are: England 0.9, Wales 1.1, Scotland 0.8.
• Age groups: cases in the over-60s that contribute to hospital admissions continue to slowly decrease over time 

That press release also provides details of the survey’s new English Tier Dashboard, which uses data from both the app and other publicly available sources to rank regions according to the criteria of the tier system. Commenting, Tim Spector said:

The new English Tier Dashboard aims to provide information to the regions based on the Government’s own criteria. Key parameters in changing tiers is the rates in the over 60s and the percentage of hospital beds occupied by COVID-19 patients. Currently we have no data that suggests that the NHS in England is at risk of being overwhelmed. Before increasing restrictions I believe a full  cost-benefit evaluation should be made, that accounts for other factors such as mental health, the economy and employment. The good news is that in all the key regions, the dashboard is either trending down or staying the same, so things aren’t getting worse.

Worth reading in full.

A Senior Doctor Writes…

The senior medic who’s a regular contributor to Lockdown Sceptics isn’t impressed by the scare-mongering that NHS panjandrums have been doing about the current risks to the service.

Take John Hopson, the CEO of NHS Providers. He produced a Twitter thread on Saturday to publicise a letter he and his deputy, Safron Cordery, have written to the Prime Minister.

Firstly, why is Hopson allowed to give a running commentary in the media about communications to Government? He is employed by the NHS and should not be doing this. Any normal employee would be dismissed for acting in that way.

Or is it just NHS employees who dissent from Covid orthodoxy who are disciplined or fired for speaking out in public?

Hopson and Cordery claim the number of COVID-19 inpatients has increased in the past fortnight – but as you can see from the graphs above, there’s little evidence of that. Their gloomy prognosis depends on trusting the notoriously unreliable community testing data in various hotspots – Essex, Kent, London and parts of Lincolnshire – and predicting that London and the South East and South West are about to witness the same levels of infection and hospital admissions that were seen in parts of the North in September and October.

Number 12 of 18 in Hopson’s interminable twitter rant exposes the real reason behind the NHS pressure on the Government for further lockdown intensification.

That is a tacit acceptance of planning failure – all these problems were entirely predictable (and indeed predicted) in the summer. Hopson and his associates failed to do anything effective about it. They only had five months…

They are clutching at straws to conceal their own incompetence – effectively blaming the public for the problem and implying that locking everyone up again is the only solution.

The rational approach if they are short of beds is to scale back routine work – annoying I know, but that’s less bad than crashing the economy again. NHS executives don’t want to do that because it exposes their woeful inadequacies as managers. They prefer to blame the public – hence a lockdown of convenience. I seriously expect them to play this card each and every winter from now on.

I do know there are current bed problems in London but they are not due to increased Covid admissions on the basis of their own figures released up to 8th Dec.

It’s the usual increased winter admissions from the elderly “acute on chronic” maladies.

Needless to say, Hopson fails to mention the 20% nosocomial spread – mainly among the elderly, spread by infectious staff and patients who have not been properly segregated.

This is a problem of their own making and the shroud waving is a classic NHS management tactic to divert attention and avoid accountability.

Rather than listen to these doom-mongers, the Government should scrap PCR mass testing altogether and replace it with lateral flow tests as a mass screening tool with any positive cases thrown up by LFT verified by a PCR test done in a proper NHS lab (not an ersatz Lighthouse Lab) with a cycle threshold below 35.

Of course, there will be a lot of resistance to that because it would require the DOH to accept it had squandered £22 billion of taxpayers’ money, handing it out to Dominic Cummings’ mates for no proper reason.

How Many People Are Really Dying of COVID-19?

Lockdown Sceptics regular Guy de la Bédoyère has done a cracking piece of analysis of deaths in Week 48 (the w/e November 27th). Guy used to be a statistician in a former life and he’s used those skills to put some of the Government’s alarmist data into perspective.

He points out that comparing deaths in England and Wales in Week 48 to the five-year average, and concluding that they are alarmingly high, is misleading. Why? Because the population of England and Wales has increased and aged in the past five years, so you would expect deaths in Week 48 to be higher than than previous years as a matter of course.

This year, there were 12,456 deaths in England and Wales in Week 48. Sounds a lot, right? But Guy calculates that if you compare deaths this year to deaths in Week 48 in the previous 10 years and allow for population growth and the fact that deaths are increasing at a rate of 1.2% per annum, the number of deaths this year, absent Covid, should have been 11,145. But the ONS would have us believe that 3,040 of the 12,456 registered deaths in Week 48 were due to Covid, implying that had it not been for the dreaded lurgy only 9,416 people would have died. Guy thinks that’s implausible.

Anything less than 9,416 in absolute terms has not been seen in a Week 48 since 2013. When weighted for the lower size of population we can see that Week 48 in 2020 has allegedly seen the lowest death rate from all causes other than COVID-19 for over a decade.

The ONS is thus claiming that 24.4% (1:4) of all deaths in England and Wales in Week 48 were attributable to COVID-19 at a time when, by some extraordinary chance, deaths from all other causes dropped so dramatically that had it not been for COVID-19 we would have been exhorted to dance in the streets for joy at the nosedive in UK deaths to the lowest level for more than a decade, if not longer.

The ONS also claims that the deaths in Week 48 were 20.3% higher than the five-year average. This of course conveniently masks the fact that, as I have shown, there has been an apparent steady increase in the rate of death in Week 48 (and doubtless other weeks) for years. And there’s nothing special about Week 48, I can assure you. Looking at one week in one year on its own is of course potentially flawed, but not when one looks at that week over a much longer period of time. The ONS and SAGE make much of the idea that this year’s figures for many weeks are ‘higher’ than the five-year average. But since, as I have shown, the trend was rising anyway then of course this year’s figures will be ‘higher’ than the average. The question is how much of that rise is attributable to Covid and how much to existing trends.

The alternative way of looking at that is to refute this on the grounds that it is impossible. Therefore, we must consider that whatever remains, however improbable, must be true, which is that the figures have been presented in a way that exacerbates the impression of Covid’s impact.

The 3,040 deaths attributed to COVID-19 by the ONS can be reduced immediately to 1,311. This is achieved by taking the 12,456 recorded deaths for Week 48 and subtracting the deaths we might have expected that week anyway, based on the last 10 years and the mean increase as weighted against a rising population. Since that figure, 11,145 deaths, does not take into account 2020’s attested increase in deaths from suicide, untreated conditions and so on we could theoretically reduce the 1,311 further by assuming at least some of those additional deaths are attributable to non-Covid factors. Deductions could also be made for those whose deaths have been attributed to Covid when in fact they died from something else and/or thanks to false positives (although, to be fair, we may have already stripped them out by reducing the number of Covid deaths in Week 48 from a putative 3,040 to a more realistic 1,311). Needless to say, all these are impossible to unravel and take us into the realms of probability and speculation.

This is a brilliant piece of statistical analysis which demonstrates, pretty persuasively, that the number of people the Government believes is dying from COVID-19 have been greatly exaggerated and that the majority of the deaths ascribed to the virus are due to other causes.

Worth reading in full.

Hey, Teacher, Leave Those Kids Alone

With London Mayor Sadiq Khan calling for London schools to close ahead of the looming shift to Tier 3, and Greenwich schools closing already, it is worth highlighting two recently-published articles on children and COVID-19.

The first is from Nature – “How kids’ immune systems can evade COVID-19” – and details the growing body of evidence to explain why young kids account for only a small percentage of infections. It begins by highlighting an interesting point about testing:

One clue that the response of kids to the virus differs from that of adults is that children develop COVID-19 symptoms and antibodies specific to SARS-CoV-2 but never test positive for the virus on a standard RT-PCR test. In one study, three children under 10 from the same family developed SARS-CoV-2 antibodies, and two of them even experienced mild symptoms, but none tested positive on RT-PCR, despite being tested 11 times over 28 days while in close contact with their parents, who had tested positive.

It goes on to offer some explanations of the differences between the immune system response to COVID-19 in kids and adults:

Kids’ immune systems seem to be better equipped to eliminate SARS-CoV-2 than those of adults. “They are well adapted and very well equipped to respond to new viruses,” says Donna Farber, an immunologist at Columbia University in New York City…

Farber says the types of antibody children develop offer clues about what is going on. In a study of 32 adults and 47 children aged 18 or younger, she and colleagues found that children mostly produced antibodies aimed at the SARS-CoV-2 spike protein, which the virus uses to enter cells. Adults generated similar antibodies, but also developed antibodies against the nucleocapsid protein, which is essential for viral replication. 

Farber says that the nucleocapsid protein is typically released in significant quantities only when a virus is widespread in the body. The kids lacked nucleocapsid-specific antibodies, which suggests that they aren’t experiencing widespread infection, says Farber. Children’s immune responses seem to be able to eliminate the virus before it replicates in large numbers, she says.

Farber suggests that the reason children can neutralize the virus is that their T-cells are relatively naïve. T-cells are part of the body’s adaptive immune system, which learns to recognize pathogens it encounters over a lifetime. Farber says that because children’s T-cells are mostly untrained, they might have a greater capacity to respond to new viruses. She is studying this phenomenon in more detail.

Meanwhile, there is evidence that when children are exposed to the virus, they receive a smaller dose than adults, because their noses contain fewer ACE2 receptors, which the virus uses to gain access to cells. This might also explain why COVID-19 is less prevalent in children than in adults, say researchers.

The article in Nature is worth reading in full.

The second piece comes from National Geographic and reports on a recent study carried out in Iceland suggesting that: “Kids catch and spread coronavirus half as much as much as adults.”

National Geographic was given exclusive access to the results from an Icelandic study that provides definitive evidence of how much children contribute to coronavirus spread. Researchers with the nation’s Directorate of Health and deCODE genetics, a human-genomics company in Reykjavik, monitored every adult and child in the country who was quarantined after potentially being exposed this spring, using contact tracing and genetic sequencing to trace links between various outbreak clusters. This study found that children under 15 were about half as likely as adults to be infected, and only half as likely as adults to transmit the virus to others. Almost all the coronavirus transmissions to children came from adults.

“They can and do get infected and transmit to others, but they do both less frequently than adults,” says Kári Stefánsson, the chief executive of deCODE.

This analysis is one in a recent flurry of large-scale studies that support the conclusion that infected adults pose a greater danger to children than kids do to adults. These studies could help inform officials who are struggling to decide when, or if, to close schools, knowing that such shutdowns are harming children. In addition to vital academic lessons, schools provide many critical services to communities, so last week, the U.S. Centres for Disease Control and Prevention recommended that schools should be both “the last settings to close” and “the first to reopen”.

Worth reading in full.

The UK’s COVID-19 Passport Plan

The Spectator’s Steerpike has an interesting piece on the Government’s plans in respect of COVID-19 passports.

On Monday, minister James Cleverly would not say if immunity cards or passports were on the table, as he toured the broadcast studios in the morning. Could the confusion lie in the plans the Government has to issue passports for those who have tested negative for the disease instead?

Mr S has obtained documents which show that the UK’s plans for negative Covid test ‘passports’ have progressed much further than previously thought.

While the Prime Minister merely hinted in late November that so-called “freedom passes” could allow members of the public to be free from restrictions, the documents show that at the beginning of November, the Department of Health was asking businesses to build a “minimum viable product” for the “Covid certification/passport” scheme.

The document explains that: “Negative Covid Test Status Evidence for citizens will be provided if they have obtained a negative COVID-19 test within a specific timeframe in addition to meeting other criteria.”

The Department of Health told those building the passport system that: “The Government wishes to enable workplaces, educational centres, health and social care services and places of business to open to members of the public who have tested negative for COVID-19.”

Worth reading in full.

Steerpike notes that while the DOH has ruled out immunity passports for the vaccinated, it would not take too much to adapt the new system so those who’ve had the jab can also get a “freedom pass”.

From the point of view of a public health official, there’s a certain logic in attaching the passport to a negative test result, rather than to the injection, given that it is still unclear how long immunity from the jab will last, or whether it prevents transmission.

Stop Press: The Government’s intentions on COVID-19 passports may, in any case, end up being overtaken by the country at large. A reader has written in:

I noticed a comment in the current newsletter of a small hotel in Scotland offering “Wildlife Holidays” where we have stayed on occasion in the days pre COVID-19.

“Should a vaccination programme be rolled out in the next few months, then it is likely we will require all guests to have been vaccinated before arrival,” it says.

2020 has undoubtedly have been a hard year for the hotel and they have already put in place a wide range of COVID-19 related “safety” measures which will have had significant cost and massively reduced their occupancy rates. They will be balancing the requirements of both the Government and their customers, and, in respect of the latter, they clearly envisage that their customers will expect the highest possible levels of “safety” and will, on the whole, regard this vaccination requirement positively!

I fear that, whatever the science and whatever Government might say, we are all going to be forced inexorably into a situation where “Vaccination Certificates”, de facto if not de jure, become necessary to lead even a reasonable life in the months (years?) to come.

Stop Press 2: Bill Gates predicts that even with the mass rollout of Covid vaccines, it is still “sadly” appropriate for bars and restaurants to be closed for the next four to six months.

Australia: Surge in Eating Disorders in the Wake of Lockdown

The Sydney Morning Herald has a report on a tragic consequence of the State of Victoria’s response to the coronavirus.

The COVID-19 pandemic and Victoria’s protracted lockdown to contain the virus has triggered a wave of destructive eating disorders in teenagers and young adults, with the demand for treatment overwhelming available services and spilling into hospital wards and emergency rooms.

Christine Morgan, the Chief Executive of the National Mental Health Commission, who advises the Prime Minister on suicide prevention said that data provided by hospitals and support services showed a national surge of between 25% and 50% in presentations for eating disorders across the public health system.

In Victoria, the situation is so dire that some of Melbourne’s leading private practices specialising in eating disorders have been forced to close their doors to new patients.

Kevin Barrow, the chief executive of the Butterfly Foundation which runs a national helpline for people with eating disorders, said a shortage of trained clinicians was aggravating what is likely to be a long-term health consequence for young people.

“If you are in need of care you just can’t get in to see somebody”, Mr Barrow said. “The evidence suggests the earlier you get into treatment, the better chance of recovery. Unfortunately the converse is also true. I think we are going to be dealing with these challenges for quite some time to come.”

Dr Louisa Hoey, a clinical psychologist who consults almost exclusively with people with eating disorders at the Health Psychology Centre in Kew, said that there was a two to three-month waiting list for new patients. She said one of the biggest factors behind the surge in new diagnoses was the loss of social, work and school activities through the pandemic which normally help keep eating disorders in check. “That structure not being there has been overwhelming for people”, she says. “People talked about just feeling suffocated at home.”

Claire Finkelstein, who works as part of a team of psychologists and dietitians specialising in eating disorders at the Nourish, Nature, Thrive clinics in Ivanhoe and Mornington said that her books had been closed to new patients for all but one week this year. “Prior to the pandemic we were already having huge trouble in finding clinicians who wanted to work in this field or had this skill set”, she said. “The treatments we have can be quite effective if they are delivered early. That is really hard to do when there is a bottleneck in the system. That is the tragedy of what is happening at the moment.’’

For those already diagnosed or recovering from eating disorders, the long COVID-19 winter was equally challenging. “It has taken away their capacity to balance their lives”, said Christine Morgan. “For all of us that causes anxiety and distress. For somebody with the psychopathology of an eating disorder it is horror on steroids.’’

Worth reading in full.

Round-up

• “Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine” – A study in the New England Journal of Medicine concluding that, over a median of two months, the Pfizer vaccine has a safety profile similar to that of other viral vaccines
• “When do we start coming out of the COVID-19 mass hysteria” – Michael Fumento asks something we would all like to know for the AIER blog
• “Why distractions are serious issues for guide dogs and their owners, especially during COVID-19” – A report on Sky News on how COVID-19 has affected the blind, whose guide dogs are not trained for two-metre social distancing
• “The truth about that No 10 COVID-19 briefing” – Freddie Sayers in Unherd on the Sunday Times piece which attempted to criticise the Prime Minister for paying too much attention to Gupta, Heneghan and Tegnell and not being sufficiently interventionist in his response to COVID-19. The Sunday Times‘s charges were almost the exact opposite of the truth
• “Blindly following every rule strips us of our humane and caring instincts” – A thought-provoking piece in the Guardian by Nicci Gerard, who founded the John’s Campaign for the right to stay with people with dementia
• “Ho Ho Humbug: Christmas display shut down by police after onlookers break social distancing” – Plug pulled on a spectacular winter wonderland display at a private home in Somerset when it was thought that passers by might be enjoying themselves
• “Why this campaign of terror?” – Never in peacetime has there been such an onslaught of Government propaganda, writes Gillian Dymond in Off-Guardian
• “COVID-19 in Wales: Mass testing a waste of resources” – Report from the BBC on public health official Dr Angela Raffle’s comments on mass testing in Wales
• “Germany to close shops and schools in COVID-19 Christmas lockdown” – The Guardian reports on developments in Germany. Closing bars and restaurants didn’t work, so they’re closing shops and schools as well
• “Essential facts about COVID-19” – A thorough and sceptical summary of COVID-19 on the Watts Up With That blog
• “Find out how many people caught COVID-19 inside your nearest NHS hospital trust” – More than 10,000 people contracted COVID-19 while in hospital for other illnesses. Find out how your local trust performed with this postcode tool in the Telegraph
• “2020 was especially deadly. COVID-19 was not the only culprit” – There have been 356,000 more deaths in the US than normal this year, more than a quarter of them from increased mortality in cases of diabetes, Alzheimer’s, high blood pressure and pneumonia. An interesting feature for the New York Times
• “Claire Craig’s talk on COVID-19 testing and T-cell immunity in children and young people” – Watch Dr Claire Craig’s lecture to a large gathering of concerned parents
• “Princeton Prof tells students America is a ‘settler colonizing nation founded on genocide’” – Professor Ali Valenzuela explains why America is riddled with racism from top to bottom. From Campus Reform
• “Cambridge may have won the battle for free speech, but the war is far from over” – FSU member Zoe Strimpel, in the Telegraph, on the ongoing need for vigilance and care in the battle for freedom of speech