The Year the World Went Mad: A scientific Memoir by Mark Woolhouse, Sandstone Press, £12.75, pp.310 (February 2022)
Throughout history great events are both magnified and distorted by the immediacy of the moment. I have been certain ever since the pandemic broke out that it would be years, decades even, before we would be able to contextualize the experience. It would also take that long to be able to measure the effect of the actions, successful or disastrous, taken to ward off COVID-19. However, somewhat to my surprise, the focus has been dramatically sharpening of late.
For those with a general and sober intelligence and experience, it was clear that indiscriminate lockdowns were likely to lead to devastating and long-lasting outcomes. Those needed to be considered before we threw ourselves off a cliff to avoid a car crashing into us. This brazenly obvious consideration was overlooked with reckless disregard by people who really ought to have known better.
What was so difficult to understand two years ago was why that seemed to escape certain scientists who were supposed to have the knowledge and expertise to understand this in far more sophisticated detail. It also escaped the politicians who blundered into this mess, aided and abetted by the most irresponsible and craven public service journalism in decades.
Professor Mark Woolhouse OBE, Professor of Infectious Epidemiology at the University of Edinburgh, has, according to his new book’s blurb “been heavily involved with the UK’s response to COVID-19”. His The Year The World Went Mad is an excoriating attack on how governments around the world fixated on lockdown as the only solution and spurned the idea of quarantining the sick and vulnerable in favour of locking everyone in their houses. Yet perhaps the real curiosity is why it has appeared now and what his agenda is.
The blundering state
In Woolhouse’s view, governments blundered in, oblivious to the lack of any exit strategy or even the need to have one, and barely conscious of the inevitable fallout the lockdowns would have in terms of social and economic devastation. Not least was the likelihood that in the UK’s case, the economic collapse was likely to compromise the NHS’s budget, the very organization held up as the sacred cow to be saved at all costs. At one point he likens the lockdowns to using a flamethrower to destroy a rosebush to exterminate the greenfly on it.
In the science journalist Matt Ridley’s foreword to the book, he points out that Woolhouse’s advice “would be important even if these were lessons we could only have learned from hindsight. But this isn’t hindsight, this is the story of the advice that he was giving at the time as the crisis unfolded.”
The same was evident to me – and many contributors to this site – two years ago. How could it be that so many of the professionals charged with the public health of this nation and its political leaders made so many appalling errors of judgement (even if well-intentioned), and even suspended their professional discipline in favour of reckless and unsubstantiated predictions? One of the many reasons seems to have been a fixation with the belief that flu models would map out the shape of things to come.
How elementary principles of epidemiology were ignored
At the end of Chapter 1 Woolhouse spells out how he had not expected:
that elementary principles of epidemiology… would be misunderstood and ignored, that tried and tested approaches to public health would be pushed aside, that so many scientists would abandon their objectivity, or that plain common sense would be a casualty of the crisis.
This is also how he ends the book’s main text, adding: “I didn’t expect the world to go mad. But it did.” Back then I was as appalled as he says now that he came to be. Will many of us ever trust ‘experts’ again?
Imperial College and models
In Chapter 3 Woolhouse moves on to Models, slating the way the R number, which was always out of date by the time it was published, was allowed to turn into a “monster” which “detracted from the usual public health priorities of saving lives and preventing illness”. Woolhouse regards the doubling time as being of far more relevance. He explains that misunderstandings about herd immunity (which relies on a mathematical relationship with the R number) hinged on the fact that suppression slows the build-up of herd immunity, citing the epidemiologist John Edmunds who explained that the pandemic would only end when “enough people had been infected or vaccinated”.
There is far too much in the book for me to summarise conveniently here, so I will move on to his comments about Imperial College’s COVID-19 Response Team Report 9, published in March 2020. This was the notorious paper that predicted half a million deaths (among other outcomes) if we didn’t lockdown and the effects of interventions of different severity over two years. As Woolhouse says, “It was perfectly obvious that no-one could predict the course of this epidemic over such a long timescale, so what was the point in publishing these outputs?” It was a scenario that “wasn’t remotely realistic”.
The effect was to ignore other solutions and deem lockdown to be a necessity from the outset. All the caveats and assumptions in the Report were ignored, and the headline half a million deaths became the only focus, led of course heroically by the BBC in its mission to terrorise the public into gibbering wrecks. Woolhouse’s preference would have been for less severe measures to have been imposed far earlier and which could have been lifted much more quickly.
Back in May 2020, I wrote a summary of points about that Report for this site. This was one of my paragraphs. It anticipates exactly what Woolhouse now says:
Imperial College’s advice was predicated on a wholly artificial depiction of disease circulating in a population on a purely mathematical basis. While this might be replicated in a laboratory in some way, it could not possibly take into account the plethora of actual factors that would determine the true course.
I am a historian and a writer. I am not a scientist or an epidemiologist or mathematical expert of any kind. But I do know theoretical codswallop when I see it. If this shortcoming was so obvious to me and other people on this site and elsewhere, why was it not obvious either to Imperial College or people acting on the Report?
Indeed, Woolhouse goes as far as to say that going into lockdown was a failure. It was “merely swapping one problem for another; we were jumping out of the frying pan into the fire”. Lockdown “was bound to cause immense harm and… it did”. It only kicked the can down the road “and it did so at great cost… sooner or later we’d be back where we started”. Er, yes.
Politicians
Woolhouse turns his attention to the politicians as a driving force behind the madness. A favourite target is Nicola Sturgeon (whose name I noticed some time back is appropriately an anagram of Contagion Rules). Here he is in Chapter 5:
During the pandemic several politicians, Nicola Sturgeon for one, adopted the position that “no death from coronavirus is acceptable”. This isn’t a surprising thing for a politician to say – it sounds compassionate, reasonable and unarguable – but political rhetoric should not be confused with practical health care policy. Taken literally, the idea that no coronavirus-related death is acceptable makes it impossible to tackle the novel coronavirus epidemic in a rational manner. Unfortunately, it was taken literally, and not only in Scotland, and that’s a large part of the reason why we ended up in lockdown… We were never going to get the balance right if our starting point was “no death from coronavirus is acceptable”.
In that chapter Woolhouse points out that the “standard health economics tool” was jettisoned when we went into lockdown in 2020. For example, “future deaths as a result of lockdown” were ignored “as if their lives were of no value. This could only skew the argument in favour of lockdown and it shouldn’t have happened.”
Woolhouse then itemises the consequences of this recklessness which hinged on a comprehensive failure to balance harms:
• It instigated the collapse in health care provision during the first wave, which was inevitable when the NHS was being asked to prioritise novel coronavirus above everything else.
• It devalued the psychological and mental health harms of imposing severe social distancing rules on an entire population.
• It legitimised the closing of schools even though – as we shall see later – this had limited public health benefit, and almost none to the children.
• It ignored the long-term impacts – not least to future NHS funding – of the economic damage caused by lockdown.
• It justified the shutting down of society on the grounds that nothing was more important than preventing deaths due to novel coronavirus.
Exactly the sort of points that have been made by numerous people on this website in the last 23 months or so. Yet we were cursed and damned to all eternity by mainstream media, politicians, and scientists who are now, one by one, changing their spots. It was impossible to have any sort of constructive argument since the automatic assumption was that to question lockdown was a murderous religious heresy.
Fixations and naivety
Woolhouse is committed to the idea that COVID-19 is a potentially dangerous and deadly disease, and I do not dispute that. It has patently been so for huge numbers of people, even if it has been far less severe for many more. But we knew from the outset that the dangers were far from equally distributed throughout the population. Woolhouse sets this against the harms caused by lockdown, first of all as I have outlined through the “fall-off in health care provision throughout the UK”, followed by education and the impact on the economy which itself is bound to impact on the NHS. Instead, of finding a balance, says Woolhouse, many scientific advisors were “all too willing to dismiss those indirect harms” with a fixation on the belief that their sole responsibility was the minimise “the harm done by novel coronavirus and nothing more”.
In my view he could have gone further and described that for what it was: irresponsibility on a scandalous scale, a kind of true engrained crassness that it is difficult to believe could carry so much weight and force. And these are the people we permit to direct our lives?
A personal experience of the stupidity we have had to deal with came for me almost a year ago. Keen to learn and understand more, I had some correspondence with some of the nation’s most prominent scientists. One, who shall remain nameless, appeared on the World at One and I questioned why he had adopted the line he had. His reply (April 2021) included this memorable sentence: “I had a lot I might have said in addition to what [the presenter] guided me to say – I’m sure your experience as a broadcaster will tell you that you are part of a narrative and your role is to fit in with the show (to a greater or lesser extent).”
I was staggered by the naivety that scientist exhibited about declaring it is his responsibility to go along with a journalist’s narrative and what that could, and did, lead to. Having worked for the BBC for almost 20 years I was already rattled by the appalling lack of objectivity and inquiry some of its hacks (with some notable exceptions) exhibited during the pandemic. But to discover a scientist of his status could be so foolish as to believe it was his duty to “fit in” with a show’s agenda was a new one even for me.
Woolhouse cites his own frustrations with the Corporation’s coverage, including how the BBC’s Science Editor David Shukman used an animation that was designed to show how a single cough could infect a whole restaurant. Despite it being pointed out by Woolhouse that such a possibility was exceptionally rare (if it had been routinely possible, then by definition COVID-19 would have been unstoppable), Shukman “persisted with the animation”.
Other frustrations included the implementation of the rules in ways that were bound to lead to what was really important being overlooked. The enthusiastic pursuit of hill-walkers and beach-goers, Woolhouse argues, was pointless because the risks are negligible, but the collateral damage of failing to deal with real risks was overlooked.
Variable impact
In the chapter titled ‘A Disease of Old Age’ Woolhouse explains the exceptionally strong bias in susceptibility to COVID-19 among the elderly and vulnerable. He adds the crucial observation that young adults and teenagers are twice as likely to become infected as the elderly, showing that the latter’s susceptibility to serious illness and death is even more pronounced, though this is complicated by accumulating co-morbidities as one gets older. The result is that 91% of deaths occurred among the 15% of the nation most at risk, and that therefore measures should always have been focused on that group.
Yet instead what happened is that the media focused disproportionately on COVID-19-related deaths among healthy and middle-aged adults, impacting on the public’s “perception of the threat”. This was compounded by exaggerating “years of life lost”, achieved by treating everyone of the same age equally and ignoring “that underlying frailty and infirmity are key drivers of mortality due to COVID-19”.
Sowing deliberate panic
Later on, Woolhouse tackles the way the government’s advisors knew that “the actual risk to more than half the population was extremely low” and therefore advised the deliberate ratcheting up of the perception of personal risk to improve the acceptance of lockdown. “The BBC News backed this misperception up by regularly reporting rare tragedies as if they were the norm.”
His next target is the “damaging and disruptive” closing of schools. The evidence showed that teachers, despite their supposed exposure to walking virus factories in the form of schoolchildren, were not at “elevated risk”. “None” of the concerns surrounding schools “were surrounded by the epidemiological data” for COVID-19, which was in direct contrast to that for flu where there is evidence that children infect others.
It’s at this point Woolhouse found himself up against people, including parents and teachers, who actively wanted to believe otherwise, even to the extent of sending off a fusillade of hate mail, insisting that he was misinterpreting the data or that it was wrong. This was one aspect of a wider phenomenon which bewilders Woolhouse because he came across it among scientist colleagues. My belief is that while we might live in what purports to be a more rational and scientific, evidence-based world, the ancient/medieval mindset is not only still alive and well but is also much closer to the instinctive nature of human beings.
Unfortunately, one of the consequences today is some scientists – like the terrified teachers and parents – confused their own natural and instinctively emotional responses to challenging situations with what they believe to be their modern scientific and rational response. Accorded the power of a latter-day priesthood, the pronouncements of some such scientists can (and indeed did) lead to exactly what you describe. And so it will again. Rational and scientific thought is like flying by instruments; it is not intuitive or natural to humans and requires constant discipline and retraining to maintain. Never before have we seen it break down so comprehensively, to be replaced by totemic and even superstitious responses.
This is not something Woolhouse really goes into but the book lays open the possibility of developing that theme. It shows how the COVID-19 crisis was something of an artifice, a manifestation of the human struggle to cope with forces greater than ourselves and our desperate belief that we can control the future. He criticises the reliance on clinicians and public health specialists who didn’t look at the bigger picture because they were neither asked to nor had the competence to do so. Educationalists and ethicists were ignored, leading among other consequences to serious harm being caused to children and young adults.
Conclusion
What I have done here is set out some of the main points Woolhouse makes in the first half of the book. There is an enormous basis for discission and it’s an essential one to have. The only possible good that can come out of this fiasco is making sure that the next time a highly infectious disease emerges (and it will) the response is fast and focused. The science needs to be honed and not afflicted by baseless assumptions and panic, making “a global crisis even worse”.
The book is written in an easy style in the first person. The real question then is why has it been written now? Woolhouse seems to be keen to mark out his position, and distance himself from the recriminations to come. One can hardly blame him, but I expect there will be a lot more of this to come, while others retreat into the long grass, never to be heard from again.
Perhaps it’s also true that only now is there going to be wider preparedness to listen to what Woolhouse has to say.
I can’t help but feel some anger when I think of the dreadful consequences for my own family. My mother-in-law died in a care home, having earlier in her life buried two husbands and two of her three children. Thanks to lockdown she spent the last year of her life unable to touch her only surviving daughter and was denied the chance to meet two of her great-grandchildren – one of them, our eldest grandson, is still cut off from us in Vietnam and we have yet to meet him. The point is that such considerations were brushed aside by governments and advisors who had become fixated with a single risk.
Is the book worth a read? Yes, I’d say so. The book is very much a product of the now and will serve as an interesting artefact of the immediate aftermath of a bout of collective insanity. I haven’t set out here to pick holes in it or indulge in disingenuous criticisms – they are for others to decide for themselves.
But for those who contributed to this site, especially in its early days, Woolhouse’s book provides some vindication that we were not off our heads in being profoundly concerned about the nation turning into one run by headless chickens. For that we can at least be grateful, though it’s not much consolation for the pain and misery caused and which is still yet to come as a result of “the year the world went mad”.
