Reading this interesting BMJ letter recommended in the news feed on Lockdown sceptics.org...
https://www.bmj.com/content/370/bmj.m3410/rr-2
... a thought occurs: Why are policymakers who have their hands on splendid data seemingly unwilling to consider a policy that focuses action on the most vulnerable, when that seems, broadly speaking, the most reasonable and normal thing to do?
In the absence of a clear reason, the fudging and dissatisfying answer we are tempted to give is simply "hysteria", and some sadly are tempted much farther into ridiculous conspiracy theories that cloud thinking and undermine potential for healthy debate. My theory is that "hysteria" is to general to be a sufficient explanation, that conspiracy theories are too crazy to warrant consideration, and that the reason may be that there are some considerations that policymakers find unsafe to discuss out loud.
What might such considerations be?
Well, who are those most vulnerable groups? The aged is the group most frequently mentioned, perhaps because it is least controversial to say so. There is a simple reason we all know why most 90-year-olds should not ride bulls, or swim free in high rough surf, or get exposed to COVID: age has rendered their bodies generally more fragile. So we are comfortable talking about the aged. But what about measurably higher vulnerability among other population categories that are politically more sensitive, such as relative wealth, ethnic background, or genetic difference?
If policy were statistically to identify vulnerable groups and treat them differently on a purely rational scientific basis, would this result in disparate treatment on politically sensitive (and indeed unacceptable) bases such as poverty and ethnicity? Any Government policy proposal, or even any policy consideration, in that direction would be terribly destructive and we all know it without needing to say so. However, it may be worth saying so in one limited context: for the purpose of providing a partial explanation of why a rational policy of disparate treatment for the statistically more vulnerable does not seem to be on the table.
The high risk group for SARs CoV 2 are exactly the same as with other human-corona viruses (HCOVs) and Influenza A/B, those with a high CURB-65 scores. Everyone else is a low risk / no risk group.
The only thing unusual about the mortality demographics with SARs 2 is the almost complete absence of those under 60. When you only count actual SARs 2 severe viral pneumonia deaths. Not so true with with other HCOV's and Influenzas but the over 60's account for at least 70% to 90% of mortalities from sever viral pneumonias most years. But the under 60's do die.
As the high risk group for SARs 2 is basically just the old with with already serious impaired life expectancy the strategy to reduce SARs 2 morality rates to basically zero is very simple. Lock up and isolate all old people with high CURB-65 scores until they die of old age or their prior serious medical conditions. Should take about 5 to 7 years.
Now do you see the problem? Politically impossible with the current laws and political class. Can you image how the BBC News division would run with that kind of story given what they have been doing the last six months.
So instead everyone else is stripped of their basic human rights and huge sections of the economy is destroyed. The old sick people will still die in the next five years, the final epidemic death toll will still remain the same, and the final infection rate for SARs 2 will be around 35%. No matter what they say or do.
jmc, This is interesting, thanks. Are you in epidemiology?
> jmc, This is interesting, thanks. Are you in epidemiology?
Not an epidemiologist. But someone who comes from a hard science background (very heavy duty math) and most of whose professional career is taking apart and putting together de-facto very complex mathematical models that had to work in the real world. For paying customers. A lot of projects involved researching the published academic literature and trying to filter out the stuff that does not actually work (most of it) and the stuff that with serious revision could be made work. Not much of the literature.
I also have a chronic non-treatable medical condition since my teens and as it turned out an undiagnosed second (treatable) medical condition for many years so I have had a lot of experience in reading the published medical literature and filtering out the bad data sets, bad mathematics, bad methodology, and bad conclusions , in published medical papers and exacting the small amount of actually usable treatment information in the whole corpus. In cases like mine the only way to lead a normal life is self-management of the condition as all current treatments have placebo level of efficacy and high levels of serious side effects.
Those of you in a similar medical situation will be familiar with the informed self-management route as the only way of leading any kind of normal life. The medical system does simple and straight forward very well. It does complicated, ambiguous and complex very very badly.
So I had the mathematical, scientific and methodological background to very quickly up to speed with the relevant published literature surrounding SARs 1/MERS, HCOV's, immunology etc back in early January when I first started following the story of the mystery pneumonia in Hubei province and Hong Kong. In my case it was ascertain both personal health risk and risk to my old parents and one close family member who was very high risk of respiratory illness relapse .
By late March / early April when the first reliable data from South Korea and Taiwan was published my worries about personal medical risk for both me and my parents became nil and very low for my high risk family member. Since then I have been utterly aghast and now very seriously worried about the utter incompetence of the lockdowns and almost all national governments descent into mass hysteria. Which is where we are now.
In t he same way that following very closely the lead up and collapse of the financial system in 2006 to 2008 made me understand what the the 1927 to 1931 Great Depression crash was really like the last six months have made me understand for the first time what the utter insanity of the summer of 1914 was like. As Europe slipped into the Great War.
We are currently living through the worst mass hysteria since 1914. That really scares the hell out me.
