Lockdown Sceptics‘ readers have had their fill of Dominic Cummings stories in the last 24 hours. However, his claim, repeated yesterday in front of MPs, that without a lockdown last March “the NHS is going to be smashed in weeks” cannot go unanswered.
These are the words that, according to Cummings, data analyst Ben Warner said to Boris Johnson when he confronted him with “evidence” on Friday March 13th 2020 that a lockdown was necessary to prevent the NHS being imminently overwhelmed.
March 12th and 13th 2020 are notable for being the days when various Government advisers did the media rounds to sell to the public the idea of “building up some kind of herd immunity“, as Chief Scientific Adviser Sir Patrick Vallance put it on Radio 4’s Today programme. Prior to this, the Government had been sticking to the script of their action plan and pandemic preparedness strategy that did not talk about herd immunity (even if it implied it) but about mitigation of the impact of the disease.
Whose idea it was to start talking about building up herd immunity by infection is not clear, and, despite pontificating for seven hours yesterday, Dominic Cummings did not enlighten us on that point. The move was, however, disastrous for Government public relations, as the concept jarred with the public. Worse, it was criticised by scientists and health care professionals, who argued that herd immunity through infection was not a sound policy aim even if it would be the inevitable result of the mitigation strategy. Dr Adam Kucharski from the London School of Hygiene and Tropical Medicine put the matter succinctly on Twitter:
I am deeply uncomfortable with the message that U.K. is actively pursuing ‘herd immunity’ as the main COVID-19 strategy. Our group’s scenario modelling has focused on reducing two main things: peak healthcare demand and deaths.
For me, herd immunity has never been the outright aim, it’s been a tragic consequence of having a virus that – based on current evidence – is unlikely to be fully controllable in long term in the U.K.
Sadly, even large-scale changes (like those other European countries are making, and we may very soon) may not control Covid for long. We must flatten the curve as much as possible, but there could still be many infections (and hence immunity).
The communication about Covid science has generally been clear in the U.K., but talk of “herd immunity as the aim” is totally wide of the mark. Having large numbers infected isn’t the aim here, even if it may be the outcome.
A lot of modellers around the world are working flat out to find best way to minimise impact on population and healthcare. A side effect may end up being herd immunity, but this is merely a consequence of a very tough option – albeit one that may help prevent another outbreak.
Clearly we cannot finely tune the path of this outbreak. The best we can do is identify actions that have highest chance of effectively and sustainably reducing impact on the population and burden on NHS.
No wonder ministers are now trying to paper over the brief herd immunity period of Government messaging (it lasted two days) by arguing it wasn’t actually policy, just what they were saying to the public to help them understand how it would all pan out.
Perhaps the bigger mistake, though, was not just talking about herd immunity, but putting a figure on it: 60% would need to be infected to bring the virus under control, they said. This allowed any mathematically half-literate armchair data analyst to plug the numbers into a pocket calculator – if the IFR is 0.9% then if 60% of the UK gets infected, given a population of 67 million, that means around 360,000 will die. It didn’t take people long to conclude that a public health catastrophe was about to hit.
Combine that with the reports of a hospital capacity crisis in parts of Italy and panic quickly set in.
This is not so far away from what Ben Warner did when he did his sums based on the new idea the Government was throwing around – infect 60% to end the pandemic – and concluded a drastic change of course was required.
In hindsight, the confidence these data analysts (armchair or otherwise) were putting in these figures was misplaced. They didn’t really know that 60% of the population would need to be infected to end the pandemic. That was a guess based on the mistaken notion that everyone was equally susceptible, rather than the truth which is that people have varying degrees of prior immunity to COVID-19 through the interaction of the many parts of their immune system. The estimate of the infection fatality rate at that time was also way too high.
To not know this at the time is perhaps forgivable – though actually the truth about the virus was known since at least February 2020, when there was an outbreak on the Diamond Princess cruise ship. The virus circulated freely for two weeks in the confined environment of the ship and its infection curve among passengers peaked and declined at least two days before quarantine was imposed (see graph below – the graph assumes a mean incubation period of four days but the current estimate is five to six days, which would shift the infection peak earlier). The infection curve for the crew peaked after the quarantine was imposed because crew members continued to interact. In both cases, the quarantine was evidently immaterial to the peak and decline of the outbreak. 19.2% of those on board (712 out of 3,711) tested PCR positive at some point (around 18% of those without symptoms). Fourteen passengers died out of 567 infected for an infection fatality rate of 2.5%, though the median age of the passengers was 69 so a higher fatality rate than in the general population was to be expected.
Thus it was known since at least mid-February that a COVID-19 epidemic would decline naturally well before 60% of people were infected even though all or almost all were exposed, presumably owing to varying degrees of susceptibility in the population.
But let us allow that this data had not made it to No. 10, and refrain from further criticism of what was done then. What really is unforgivable is not knowing now the truth about COVID-19 and sitting before MPs still spouting the misapprehensions and mistakes of March 2020, as though nothing has been learned since then.
It has, for example, long been known that infections in England peaked and began to decline well ahead of the lockdown on March 23rd, with Professor Carl Heneghan pointing this out in the Daily Mail as early as April 20th 2020. In fact, new daily infections were peaking around March 16th, as Professor Simon Wood has shown (see below). The peak in London was a couple of days earlier, putting it around March 13th or 14th – the exact time that Cummings and Warner were pushing the panic button over the need to lock down to save the NHS.
The same then happened for the next two lockdowns: new daily infections peaked and began to decline ahead of the start of the restrictions. The ONS Infection Survey also shows new infections in England peaking in the week ending December 26th, well ahead of the lockdown on January 6th. How this is not by now common knowledge among ministers, MPs and journalists is baffling.
This means that Cummings cannot be correct. There was no imminent catastrophe looming that only lockdown averted, and infections were declining anyway so locking down a bit sooner wouldn’t have helped. Confirming this observation, an international comparison study in the Lancet found that there was no association between the timing or severity of lockdown measures and Covid deaths: “Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.” There is also the evidence from America, where states which didn’t impose lockdown restrictions, such as South Dakota and Florida (over the winter), fared no worse and often better than the states which imposed the strictest measures. Sweden also shows how a country imposing much lighter restrictions does not suffer any worse. Boris was right: he should have behaved like the mayor in Jaws last March.
Perhaps the most depressing thing of all, though, is that it’s not just Dominic Cummings who still believes in these long-debunked lockdown myths. Most of the MPs he was speaking to and the journalists reporting on it do too. Almost none of them is challenging the lockdown orthodoxy with evidence and facts.