Please share this widely, to put pressure on UK to go back to the contain phase for COVIDー19, and potentially save thousands of lives: Many in the UK have been scared and appalled by Boris Johnson’s statement that “many more families are going to lose loved ones before their time.” Distinguished experts are also shocked and outraged by the UK's decision to stop containing COVID-19, stop detecting mild cases, and just use social distancing to delay it as it spreads through our population.
If you live in the UK and follow the mainstream media here, you may not be aware that the WHO's advice is diametrically opposed to this. The WHO say all countries need to act together in solidarity, to chase after the virus, go after all the cases, including mild cases, quarantine those who have the disease, trace all contacts and isolate them. The WHO say all this with every press briefing, and constantly reiterate that this disease can be contained and then stopped. We have had clear scientific evidence to support these conclusions for weeks now, and know how to do this. Here are some recent examples of the WHO statements:
Now that the virus has a foothold in so many countries, the threat of a pandemic has become very real. But it would be the first pandemic in history that could be controlled.
... Countries that continue finding and testing cases and tracing their contacts not only protect their own people, they can also affect what happens in other countries, and globally
Transcript for WHO Emergencies COVID-19 Press Conference, 9th March 2020
We are convinced that, although this is the first coronavirus to be labeled as pandemic proportion, at the same time we believe it will be the first also to be able to be contained or controlled.
Transcript for WHO Emergencies COVID-19 Press Conference, 11th March 2020
Yes most people have only a mild version of the disease, sometimes milder even than the flu. 80% recover quickly. Children under 10 won't die of this at all, and 99.8% recover under 40.
However for the less fortunate, this is a deadly disease, make no mistake about it. Boris Johnson wasn't exaggerating when he said his policy may lead to many in the UK losing loved ones before their time. Some in their teens and twenties do die, and then a higher percentage are at risk with each decade increasing to around 19% of those aged 90+ dying of this disease. .
This is not the first disease that the WHO has said can be contained without using a vaccine. As an example, before we had an Ebola vaccine, the only way to stop Ebola was to contain it. Containment is still a major part of the Ebola strategy. The WHO have just reached the end of another epidemic in the Congo contained in this way.
The Chinese successfully took the saner methods of quarantine, isolation and rigorous contact tracing from the Ebola response to stop COVID-19. Singapore, South Korea, Singapore, Vietnam, Japan and several other countries have done the same. This is the first pandemic caused by a coronavirus, and unlike SARS, there is no evidence yet of airborne transmission. This makes containment far simpler, and many countries in the Western Pacific region have shown they can do this.
The WHO is an evidence based scientific organization. The WHO say that the data and evidence is now clear.
COVID-19 is another epidemic or pandemic that can be stopped using containment measures, like Ebola.
Nearly all the countries in the world are following this advice, some more rigorously and energetically than others.
However the UK has turned their back on that advice. The UK's new strategy, is to stop testing mild cases, stop contact tracing (except for people who already know they are a contact before the change of policy) and just let the disease move through our society. People with mild versions of the disease will not be able to get tested. Only those that require hospitalization will be tested. The UK statistics for COVID-19 will now only have deaths and hospitalized cases.
Instead they are only aiming to slow down the rate of infection, leading to a delayed, but major outbreak in the UK which they expect to peak in mid April. This does make sense for flu as it can’t be contained. Delaying flu helps the health service. They aim to delay it to peak in April beyond the end of the flu season and to flatten the peak out to make it easier for the NHS to respond. They expect a large proportion of our population to get it, though they can't predict exactly in advance how much. Many thousands, tens of thousands or in the worst case, hundreds of thousands of us may die.
Scotland will have some level of community surveillance, but not with the aim of containing the disease. The aim rather is to understand how it is spreading and how prevalent it is in society. To help with this, they will test people who are ill enough to need out patient treatment by a GP, with COVID-19 like symptoms, even though not ill enough to go into a hospital. See COVID-19 testing update
With that background, several experts have made strongly worded tweets about the UK's decision. Here is an example online conversation between them on twitter:
Text on the image:
Devi Sridhar - Colleagues all think we are doing it wrong - Professor of global health, Edinburgh
Prof. Sunit K. Singh - Not ethical to make hunmans guinea pigs in name of "Herd Immunity" - Prof. and head of microbiology, BHU
James Smith - Italian colleagues opinion is not translatable in polite way - Vice principal and prof, Edin.
Martha - How do we learn about this disease and its transmission by only counting those in hospital? - BA (Hons). LLB. MSc.
[note for autistic readers -when Prof Singh talks about "human guinea pigs" it is hyperoble. He doesn't mean they are literally experimenting on us like guinea pigs. He means that the actions they are doing implementing an untested academic theory to deal with this outbreak, instead of the practical advice of the WHO, is like experimenting on guinea pigs in effect not in intention.]
The tweet itself is here:
Trying to explain the UK approach & objectives to colleagues in health security around the world & they all think we're doing it wrong. Do other governments think the same? If so we might be isolating the UK further when we actually need other countries' help more than ever.
— Devi Sridhar (@devisridhar) March 14, 2020
In case it goes out of sequence the replies to her tweet are here, by Professor James Smith, Prof Sunit K. Singh and Martha
The tweeters here are:
- Devi Sridhar Professor & Chair of Global Public Health, at the Medical School in Edinburgh, Director of Health governance, financing, policy, systems & security.
- James Smith, Vice Principal & Professor at the University of Edinburgh.
- Prof. Sunit K. Singh Molecular Virologist, Virus Hunter: Professor & Head Molecular Biology, Institute of Medical Sciences, Benares Hindu University.
- Martha BA (Hons), LLB, MSc.
They can expect 1 or 2 in 1000 of infected younger people under 50 to die and up to 19 in 100 of 90 year olds to die, when we could stop it in its tracks and avoid all those deaths. If these people are not exposed to the virus, none of them will die.
Nobody seems to know why it is yet, but for some reason babies or kids under 10 typically get a very mild version of it and they don't die of it.
Graph adapted from an analysis of 1016 patients who died in Italy and were tested positive with COVID-19. See my Deaths in Italy from Covid19 - similar to China - higher case fatality rate is due to more elderly patients affected
These are similar to the Chinese figures and in some ways better. Even at age 90+ then 81% recover - you are far more likely to recover than to die of this disease at any age. But all these deaths are unnecessary.
Death rate in China for comparison
First column, 21.9% for 80+ is based on a death rate for 55,924 laboratory confirmed cases
Second column is from 72,314 confirmed, suspected, and asymptomatic cases, in another report:
If we contain it then almost none of those people will be exposed to it, and we save the lives of thousands of people. If we don’t contain it, then many will die in the UK and it will lead to the UK being a source of COVID-19 to the rest of the world.
The WHO say emphatically that we CAN contain this, with every press briefing, that the scientific evidence is clear from the successes of China, South Korea, Singapore, Japan and many other countries with smaller outbreaks.
For example, South Korea is down to less than 100 cases a day. Peak of over 1000. China has just about eradicated it - and that is genuine, not falsified figures - they have now closed 14 entire hospitals that they set up in Wuhan to treat Covid-19 patients. Hubei province had only 4 new cases yesterday.
Dr Tedros Adhanom, Director General of the WHO said:
"Several countries have demonstrated that this virus can be suppressed and controlled. The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same; it's whether they will."
Transcript for WHO Emergencies COVID-19 Press Conference, 11th March 2020
He also said:
"If anything is going to hurt the world, it’s a moral decay. And not taking the death of the elderly or the senior citizens as a serious issue is one of the moral decays."
It is not a question of if we can stop it. We know we can. It is a question of whether we will. Many countries including Italy are acting vigorously to stop it- all of them following the WHO guidelines. Yet the UK is ignoring this advice and the clear scientific evidence that these methods work.
Also what about our hospitals? Without testing mild cases how do they stop health care workers getting COVID-19 or patients? At a recent match in Liverpool supporters came from Spain, some of them will have the virus but they were not tested. They stayed in hotels in the city, they mingled in pubs, and it is now a certainty that the virus is now present in the community in Liverpool.
It is going to get into old people's care homes. Professor John Ashton (former president of the Faculty of Public Health in the UK and now involved in the COVID-19 response in Bahrain) says that the government has projections that one case infecting a care home will lead to 30% of them dying. They are not sharing their planning data such as this with the public, so there is no way to check this statement. But it is credible given the data on mortality for those of 90 or older and the effects of comorbiditie and given that only the most frail of the elderly will be in care homes. Many in the UK are condemning this policy. For professor John Ashton's remarks see my transcript here:
Do share this article and try to spread awareness as I think few in the UK yet realize what the WHO advice is.
It is almost never reported here even though with every press conference they have said, right from the start that it can be contained, and more and more emphatically as the evidence has built up that it not only can but is being contained.
Video for this article:
(click to watch on Youtube)This is another article I'm writing to support people we help in the Facebook Doomsday Debunked group, that find us because they get scared, sometimes to the point of feeling suicidal about it, by such stories.
Do share this with your friends if you find it useful, as they may be panicking too
HOW TO PROTECT YOURSELVES FROM COVID-19 IN THE UK
If you are in the UK don’t worry, it doesn't matter what our government does, you can protect yourself and your loved ones by taking the right precautions.
Learn the proper hygiene instructions and make it into a habit so that you do it automatically, like brushing your teeth and you will be very safe from this virus. If everyone washes their hands regularly - and avoids touching their face with unwashed hands and keeps a distance it will stop it from spreading as well and together we can save many lives.
Be sure to check out the details of what you need to do:
Check out the WHO Advice for public for details. I describe them here:
These methods really do save lives. People in the UK are largely ignoring these instructions, or treating them as a joke - but they are real.
This is the main thing you can do about COVID-19 on a personal level. Learn how to protect yourself and tell everyone else how to do it too. This not only protects you but stops chains of transmission that go through you. This is not flu. This advice does also reduce your risk of flu. But for COVID-19, a different disease, this advice can pretty much stop it altogether.
You will be able to say like Dr Bruce Aylward, joint leader of the WHO-China investigation after returning from touring China for 9 days, including Wuhan for a day and a half:
"I don't have COVID-19 - I am very low risk".
(72:58 into his presentation on 25th February)
Those I help over the internet often worry about me because I am 65 and am in the UK. Don’t worry. I know what to do and would be safe even in Wuhan :). You all can be too if you do the right things rigorously.
OPEN LETTER FROM SCIENTISTS IN ITALY TO SCIENTISTS IN OTHER COUNTRIES IN THE EU
This is a letter from Italian scientists to other scientists in the EU to ask their leaders to act promptly to contain and stop their outbreaks. They say if they had responded promptly to the Italian outbreak with strong measures 10 days earlier it would never have got this bad. They say it is hard for most people to understand exponential growth - every day of inaction matters!
From our data, about 10% of patients require ICU (Intensive Care Unit) or sub ICU assistance and about 5% of patients die.
We are now in the tragic situation that the most efficient health system of the richest area of the country (Lombardy) is almost at its full capacity and will soon be difficult to assist more people with Covid-19.
...
This is an appeal to you, as a member of the scientific community, to urge your government to act now for actively stopping the virus!
In most EU countries you have enough time to make a lockdown similar to China or South Korea to quickly slow down and stop the contagion with much less effort and cost of what is now needed in Italy.
If Italy had strongly acted just 10 days ago, and that is more or less where you are now, there would have been much fewer deaths and economic tumble.
South Korea and China should be taken as the example to follow to stop this epidemic.
There is no other way.
So please, make your best effort to urge your government to act now! Time is our common enemy as the virus is very fast and really lethal.
Every minute is exceptionally important as it means saving lives. Don’t waste it!
Take care.
Open letter to the scientific community (click through to see the letter, signed by many professors)
Italy is starting to bring its epidemic under control. They are doing everything they can to stop it.
They may have peaked in their cases per day or will peak soon. They could have done this weeks ago if they had acted more promptly.
The message is not that we can't stop it but that we can stop it much more easily if we act faster.
THEORY OF BEHAVIOURAL FATIGUE - WHY THE UK GOVERNMENT RECOMMEND BEHAVIOURAL CHANGES SUCH AS HAND WASHING MORE VIGOROUSLY
One thing that is very striking in my attempts to help UK residents scared of COVID-19 by PM is that many of them treat the instruction to wash your hands, as a bit of a joke, don't take it seriously. They know they are supposed to do it but don't think it is likely to make much of a difference.
It can sometimes take a fair bit of discussion back and forth before they take it seriously.
It is no surprise really - the main instruction we get on TV is an occasional a mention from time to time of the need to wash hands frequently. The other details of not touching your face, keeping a distance from someone sick, not shaking hands etc are rarely mentioned. Also it is not stressed at all, not made to seem important, and not really explained unless you hunt around on the BBC website and find the page explaining it all.
We should have ads on TV all the time to promote the hand washing, social distancing, not touching your face etc. Like the Clunk Click road safety ads of the 1960s
(click to watch on Youtube)
So, why isn't the UK government showing non stop ads and videos encouraging us to wash our hands, not touch our faces, stop shaking hands, keep social distance, etc. like they do in other countries? They say it is because of "behavioural fatigue".
The government know these measures work but they don't think we, the British public, are capable of keeping this change of behaviour up for long. So, they are reserving this message of urgency for later in the outbreak when they think it will be more useful.
The government think it is impossible for us to contain it in this way because they don't think the British public will be able to keep to this change of behaviour for long enough to stop it.
This is an open letter by 455 behavioural scientists in the UK strongly criticising them for this and telling them that not enough is known about behavioural fatigue to support this hypothesis.
These behavioural scientists say there is evidence that even for simple things like washing hands, there is likely to be more uptake the more urgent the situation seems to be.
These behavioural scientists also say that experience in China and South Korea is sufficiently encouraging to suggest that we should at least attempt this.
These behavioural scientists say we should at least try to encourage long term radical changes in behaviour, to see if we can stop the virus here in the UK in the same way they did in China and South Korea.
I thought I’d do a satirical meme about it:
Just as with brushing your teeth you can learn new habits too. If you are given clear instructions about when and where to do them, they are cued by the situation you are in rather than by your memory, and become habitual, require less use of memory and become easier, not harder to do as you get used to them. See implementation intentions.
Soon you give it no more thought than you do to put one foot before the other when you walk, or to keep a bicycle upright as you cycle.
Anecdotally for the last week or so I have been teaching myself not to touch my face and it has got easier as time goes on to do this. For another example, if you learn a musical instrument then things that were hard to do at the start become easier the longer you play it as you become more proficient. There are many other examples like that.
Here is the complete letter:
We are writing as behavioural scientists to express concern about the timing of UK delay measures involving social distancing. As is clear from the disaster unfolding in Italy, there is a unique window for delaying the spread of COVID-19. Current government thinking seems to crucially involve the idea of “behavioural fatigue”.
This is the worry that, if implemented too early, measures limiting social contact will be undercut just at the point at which they are most required, because people will have tired of the limitations and will revert to prior behaviour –in part precisely because those measures are effective in reducing spread and hence perceived risk.
While we fully support an evidence-based approach to policy that draws on behavioural science, we are not convinced that enough is known about “behavioural fatigue” or to what extent these insights apply to the current exceptional circumstances. Such evidence is necessary if we are to base a high-risk public health strategy on it.
In fact, it seems likely that even those essential behaviour changes that are presently required (e.g., handwashing) will receive far greater uptake the more urgent the situation is perceived to be.
“Carrying on as normal” for as long as possible undercuts that urgency.
More broadly, it appears that concerns about behavioural fatigue lead the government to believe that halting the spread of the disease is impossible, and the only solution is to slow the progress of the disease across most of the population, until herd immunity is achieved.
But radical behaviour change may be able to do much better than this, and would, if successful, save very large numbers of lives. Experience in China and South Korea is sufficiently encouraging to suggest that this possibility should at least be attempted.
If “behavioural fatigue” truly represents a key factor in the government’s decision to delay high-visibility interventions, we urge the government to share an adequate evidence base in support of that decision. If one is lacking, we urge the government to reconsider these decisions.
These though are
I will give the link again. I can't stress this enough - if you can follow these simple instructions in the weeks ahead, they will save many lives. Check out the WHO Advice for public for details. I describe them here:
BASIS FOR SOME HOPE
My main hope here is that they do succeed in delaying it - and that meanwhile Italy contain their outbreak.
The WHO expect Italy to bring its outbreak under control eventually, and start reducing numbers of cases some time in the next few days.
The WHO have mentioned Italy several times as a country that is responding appropriately to the crisis - doing everything including contact tracing leveraging local community organizations to do the tracing. Other European countries that are responding appropriately according to the WHO include Spain, and Ireland. The US with its new $8.3 billion fund and rolling out millions for COVID-19 is another country with close historical ties to the UK that is mounting a strong response following the WHO guidelines.
If the UK are successful in delaying their outbreak to April that is long enough for us to notice that these other countries have controlled their outbreaks while ours is still continuing.
Or, if we can raise awareness within the UK, maybe weight of opinion can stop this in its tracks before it gets worse.
With this in mind I have made a new petition to the UK government to ask them to reconsider this decision.
It is not yet ready for signing - the petition has to be checked first which can take up to 7 days. I will post again when it is open for signing. You can read my draft of it here:
Many countries in the Western Pacific, like Singapore, Vietnam, Japan, and the Republic of Korea have not only contained it - considered as a whole the Western Pacific outbreak is well past its peak of cases per day. Sadly,with the Italy outbreak still on the rise, these successes are not getting much publicity in the UK.
However the WHO could not be clearer, Those countries in the Western Pacific are not unique. There is nothing they did that we can't do. Europe is just as able to contain its outbreak as the Western Pacific has been.
Italy is showing by example that a European country can use the same measures to control this outbreak. The WHO expect these measures to soon show fruition with similar results to the countries in the Western Pacific region. It is normal for the numbers to increase rapidly and rather alarmingly as you bring the outbreak under control, because of the mild cases you turn up through aggressive case finding.
THAT THE DISEASE IS IN EVERY CONTINENT AND MOST COUNTRIES DOES NOT MEAN IT IS ENDEMIC OR THAT IT CAN'T BE CONTAINED
This disease was in every province in China, and on 23rd January all were at red, the highest level of alert, and recently they have had days with no transmissions locally in China outside of Hubei province, and they are close to reopening Hubei as well. This break down of the situation outside of China may help make the world situation clearer. This is the epidemic curve for confirmed new cases outside China by the date of the report and the region through to 14th March 2020:
from
You can see, for instance, that the epidemics in the Western Pacific region (which includes the Republic of Korea, Japan, Singapore, Australia, Malaysia, Philippines, and Vietnam as the top seven countries) are largely contained. The cases per day in this region reached their peak at the end of February and there is some prospect of this region becoming largely virus free within a few weeks.
South Korea has reduced its cases per day down to below 100 from the peak of over 1000 on the first of March and is continuing to reduce this number. South Korea never used lock down, mainly contact tracing, quarantine, isolation and case finding.
The total cases in the Western Pacific region peaked in at the end of February and is now declining (this includes Singapore, Japan, South Korea, Malaysia and Indonesia). That entire region may be nearly virus free in a few weeks.
The epidemic in Europe is growing rapidly (though from now on won’t have reliable figures for the UK for this chart because we no longer report the mild cases).
The Eastern Mediterranean epidemic is growing somewhat.
The total for the Americas remains low and is growing but not by so much.
Africa thankfully has few cases yet. The WHO say that their response is strong now after the work they have done helping them.
We can turn this back in the same way in all the global regions outside of China. The increases are for the most part related to the outbreaks in Italy and Iran, for instance the Mexican outbreak is from Italy and is really part of the Italian outbreak spread to another country. If Mexico contains it and Italy contains it at its source, then it can be turned back and they can end this.
What matters is the story behind the numbers. These large outbreaks happen mainly because the countries hadn't been sufficiently prepared for them, in particular weren't doing community surveillance. They also often don't respond decisively enough in the first few days. This often happens in emergencies - if they haven't been preparing for them in advance, they can lose precious days at the start of the epidemics.
We don't have to contain it everywhere. If a few get through but we find them that is fine. For instance suppose that you have transmission chains starting from 1000 cases that infect 2000 which in turn infect 4000 and so on.
If you can break 3/4 of the chains of transmission then instead it goes from 1000 to 500 to 250 and tops out at less than 2000 altogether. In that case the outbreak is soon over though there may be a few cases linger for weeks or months..
This needs case finding, contact tracing, isolation of contacts, quarantining of cases and then also community surveillance to be sure to pick up on any index cases that slip through the net. Do that and keep interrupting 3/4 of the chains of transmission and it will be over.
Which countries this all happens in is beside the point - it makes no difference to the end result. That is why we need solidarity and a united approach across the world and be able to continue the contact tracing from one country to another. Sadly countries will now no longer be able to trace their outbreaks any further once the contacts they are tracing go to the UK.
HOW CAN WE KNOW THAT THE WORLD HEALTH ORGANIZATON ASSESSES THE SITUATION CORRECTLY AND THE UK INCORRECTLY?
Here I am of course assuming the WHO have assessed the situation correctly and the UK incorrectly.
The WHO have extensive experience in many areas including eradicating smallpox, stopping Ebola outbreaks, eradicating malaria from many countries, responding to 200 disease outbreaks every year and the head of the China study Bruce Aylward was head of the campaign that lead to almost complete eradication of Polio.
Meanwhile UK experts as far as i can tell are basing their advice only on experience with flu. At least they didn't mention any other disease in the presentation. Professor Whitty is an expert who has written about Ebola - but for some reason he does not seem to think he can apply the methods that were proven to work for Ebola to COVID-19 (case finding, contact tracing, quarantine and isolation). At least he doesn't mention Ebola in his presentation.
For me, there is no contest about who to go with as the most reliable source here.
I am also scientifically literate and able to read the sources the WHO cite. The evidence is clear. Meanwhile from the video presentation he gave to MPs in Westminster, the UK seems to be ignoring that evidence and basing their decision on information about flu which is not the same disease.
Meanwhile, if scared - to remind you again, you can totally stop yourself from getting this, and your loved ones too.
I know this may seem incredible. Few realise it - but even with flu, this advice reduces your risk, to a minimal level.
But COVID-19 is radically different from flu, not the same virus at all. This advice will reduce your COVID-19 risk down to a very low risk, close to zero.
Only the government can resume the case finding, contact tracing and quarantine and self isolation. But as individuals we can all do the hand hygiene, social distancing and respiratory etiquette.
UK EXPERTS BUILT THEIR EXPERIENCE WITH FLU EPIDEMICS - BUT THIS IS NOT FLU
The UK are saying this is not a virus that can be contained. But the UK experts only have experience with flu outbreaks. This disease is not flu. It is the first ever coronavirus pandemic and what’s more covid19 behaves very differently even from SARS.
COVID-19 is
- Not airborne - it doesn’t transmit to distant passengers in a plane - indeed it doesn’t seem to transfer to anyone at all. Although as a precaution, they test anyone who gets sick sitting within 2 meters of recognized case - so far here have been no examples of this happening. The big international report said
Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission” WHO - China joint mission on COVID-19 final report - Almost no symptomless spreaders - clear evidence from China, Singapore and South Korea
- It is only spread to prolonged or close contacts and can be stopped by contact tracing and containment (unlike SARS or the flu) - for instance nearly all of South Korea’s 7000 cases are in clusters that can be traced through close contacts all the way back to China.
- China, and South Korea have shown that it can be contained even at thousands of cases.
For details see the
The UK decision with covid19 is NOT guided by the science from China / SK or the WHO.
It is ignoring all the evidence that COVID-19 is different from flu. Are just treating it as if it was flu.
Sadly the UK have decided they won’t contain it, just try to delay it
Their actions may mean it takes longer to reach numbers similar to those in Italy.
THE WHO ARE EXPERTS ON STOPPING DISEASES - ANYTHING FROM EBOLA TO SMALLPOX
The WHO are the experts here. They just stopped Ebola again in the Congo. They say that at the height of the outbreak the Ebola tracers were tracing 25,000 contacts in the Congo within a war zone with people shooting each other.
China traced half a million contacts at the height of its epidemic of covid19
The WHO were responsible for eradicating smallpox. With co-operation of many countries, they are close to eradicating polio. They have eradicated malaria from many countries. The expert who lead the team of experts that recently returned from China, Bruce Aylward, was in charge of the polio eradication team.
The WHO know what they are talking about. Why isn’t the UK listening to them?
UK CLAIMS LIKELY 5000 TO 10,000 INFECTED BUT SO FAR HAVE NO EVIDENCE OF THIS
The UK are claiming that based on 500 known cases, probably 5,000 to 10,000 people have it already, i.e. they are claiming we already have it worse than South Korea or Italy.
The UK claim that many other countries with similar number of confirmed cases to them also have thousands with it already.
This is based on modeling, not on data. Such a model is always no more than a hypothesis until it is tested. It needs to be tested to find out if the modeling assumptions are accurate.
Until a model is tested against real world data, it is a mere scientific hypothesis. An unverified, untested model should never be used for prediction, though it can be useful for framing ideas to explore.
By that I mean - if for instance a model says there are 5,000 hidden cases, that is just a hypothesis. If you do the community testing and find 5000 cases then that's a point in its favour though likely not a proof. If you find 50 cases that disproves it. If you haven't looked, it is just an untested hypothesis and means little, especially as such models normally are based on many assumptions that you can't check directly with the data available so far.
Singapore is the country with the most reliable data on this virus since they
- test samples for the presence of viruses from everyone with a fever or cough throughout the country. they get these samples from general practitioner clinics and polyclinics for respiratory viruses.
- They test 300 to 600 cases a month for flu, colds etc - in a population of over 5 million, similar in size to Scotland
- Since Jan 28 2020, they have added a test for COVID19.
(Summarizes some of the information from WHO 'very impressed' with Singapore's COVID-19 response)
They have no cases of COVID19 outside their known clusters. This is perhaps the clearest and most striking example, but there is extensive data from China, Hong Kong and others that if you follow the Chinese example of rigorous case finding, contact tracing, quarantine and isolation then there is very little by any “hidden iceberg” of undetected cases.
For more details:
The UK has the capability to do the same to confirm or refute their hypothesis. Yet not only have they not done any testing, they are abandoning testing altogether. This makes this a completely untested hypothesis.
The UK could have done these checks weeks ago. The WHO have been saying this for weeks, to check with community surveillance.
On 25th February the international team lead by Bruce Aylward recommended to all countries to:
Immediately expand surveillance to detect COVID-19 transmission chains, by testing all patients with atypical pneumonias, conducting screening in some patients with upper respiratory illnesses and/or recent COVID-19 exposure, and adding testing for the COVID-19 virus to existing surveillance systems (e.g. systems for influenza-like-illness and SARI)
Two weeks later and the UK still haven’t done any community surveillance for COVID-19. As a result, we have no idea how many cases we really have.
BORIS JOHNSON SAYING WE NEED TO BE PREPARED TO LOSE OUR LOVED ONES
This is what is scaring so many of the members of the group.
If you are scared by this - remember - your loved ones won’t get the disease if they take those simple precautions. You can protect them and yourself by making sure they know what to do.
However many of the people I talk to via PM in the UK are not fully aware of this advice. It is not widely understood that you can stop this disease in this way or the details of how to do it.
The UK are doing the opposite of what the WHO recommend - they are stopping testing even for mild cases with travel history to other countries.
They say we need to just let it travel though the country and develop immunity to it. Boris Johnson went as far as to say we need to be prepared to lose loved ones before their time!
I must level with the British public, many more families are going to lose loved ones before their time.
The WHO spoke up about this approach several days ago as deeply unethical.
If anything is going to hurt the world, it’s a moral decay. And not taking the death of the elderly or the senior citizens as a serious issue is one of the moral decays.
Any individual, whatever age, any human being, matters. And it pains us to see, actually, in some places, when they want to move into mitigation, because the virus kills seniors or older people only
That’s dangerous. Whether it kills a young person or an old person or a senior citizen, any country has an obligation to save that person.
So that’s why we’re saying no white flag. We don’t give up. We fight. To protect our children, to protect our senior citizens. At the end of the day, it’s a human life. We cannot, I have said this many times by the way, we cannot say we care about millions when we don’t care about an individual person who may be senior or junior. Who may be young or old.
So that’s what WHO is saying. And for all countries, a comprehensive approach, a blended approach, an approach that can help contain this outbreak, is very important, because the death rate from this outbreak is high.
We shouldn’t categorise it by young or senior. Of course, to understand the epidemiology it’s fine to do that. But for action I think every life matters. Every individual life matters. If we don’t care about one individual, whether it’s old or young, then we’re not serious. And that’s why we’re saying this is a moral decay, if we try to categorise it that way. A moral decay of the society.
The official transcript is here: WHO Emergencies Coronavirus Press Briefing 09 March 2020
The video is here:
ROUGH ESTIMATE OF HOW MANY WOULD DIE IF WE DEVELOPED HERD IMMUNITY
This is just to give you a rough idea of the sorts of numbers we are talking about. It is not meant as a precise forecast if we continue along this path. All I've done is to apply 50% infection rates to the UK population figures along with the Italian case fatality rates for the first 1016 cases (which are better than the Chinese ones)
The idea of “Herd Immunity” is that so many are get the virus and develop antibodies to it that it can’t spread any more.
They didn’t give any figures for the numbers that would need to die to achieve this. But suppose that enough of the UK population are infected to achieve their “Herd Immunity”. For SARS the range of values is 50 to 80%. Let’s take the lowest number, 50%.
Let’s suppose it’s the same percentage for each age group. Using the Italian figures, these are the number would die to achieve this level of “Herd Immunity”
90+: 55,000
= 19% of 50% of 579,77680 – 89: 167,000
= 16.6% of 50% of 2,012,91770 – 79: 190,000
= 9.6% of 50% of 3,956,21960 – 69: 82,000
50 - 59: 20,000
= 6% of 50% of 6,785,60940–49: 4,100
1% of 50% of 819961530 - 39: 3,700
= 1% of 50% of 7,416,076Total: 520,000 deaths
(rounded to two significant figures)I used the numbers in each age group from these figures: Age groups
These don’t include 90+ so I took the number for 2017 in Estimates of the very old, including centenarians, UK and subtracted them from the 80+ to give a rough idea of those figures. I know they are for different years so those numbers may be out a little, probably there are more over 90 and less in 80–89 than these figures suggest.
They would try to save the lives of some of those older people by asking them to stay at home at the height of the outbreak for a few weeks until it had passed them by.
With that rough estimate, the total for 70+ is 412,000
(190,000+167,000+55,000)
Under 70 there are 91,800
(3700+4100+2000+82000)
So you can see why the UK government plans to ask all those of 70+ to self isolate for up to three months at some point in the outbreak: Virus isolation for over-70s 'within weeks' (Virus isolation for over-70s 'within weeks')
However many would still die and surely tens or even hundreds of thousands die eventually if we do achieve “Herd Immunity”. If fewer get it, fewer die but then we do not achieve this “Herd Immunity”, and more die next time it resurges.
NOT YET CERTAIN THAT THERE WILL BE ANY LONG TERM IMMUNITY
Actually we don’t yet know how long immunity to COVID-19 lasts. Coronaviruses are known for not always conferring life-long immunity.
The British Society of Immunologists made this point in an open letter to the government: They sent this letter to Professor Chris Whitty, Chief Medical Officer, Sir Patrick Vallance, Chief Scientific Officer and Rt Hon Matt Hancock, Secretary of State for Health & Social Care.
The world faces a huge challenge in light of the SARS-CoV-2 outbreak. The UK’s public health strategy differs from many other countries, with an aim to build herd immunity to protect the population. Within the immunology community, we have significant questions about this strategy. The ultimate aim of herd immunity is to stop disease spread and protect the most vulnerable in society. However, this strategy only works to reduce serious disease if, when building that immunity, vulnerable individuals are protected from becoming ill, for example through social distancing. If not, the consequences could be severe.
Additionally, there are many unknowns in how the SARS-CoV-2 virus interacts with the human immune system and how this might play into current scenarios. For example, we don’t yet know if this novel virus will induce long-term immunity in those affected as other related viruses do not. Therefore, it would be prudent to prevent infection in the first place. More research is urgently needed on this front.
The UK leads the world for the quality of our immunology research. Given our current lack of knowledge on SARS-CoV-2, our community of immunologists have two asks. Firstly, we feel more needs to be done to ensure social distancing to limit the number of COVID-19 cases in the short term, especially for vulnerable members of our communities. This will enable us to buy time until we understand the virus better and can begin to develop therapeutics. Secondly, to aid efforts, we call on the government to release their modelling data to allow scrutiny from the scientific community to better predict the course of this outbreak.
We have a small window of opportunity to protect our nation, to learn about this new emerging virus and to deal with this unprecedented threat to global health.
Professor Arne Akbar
President, British Society for ImmunologyBSI open letter to Government on SARS-CoV-2 outbreak response
THE UK’S RECOMMENDATION TO EVERYONE TO SELF ISOLATE WITH COLDS OR FLU FOR 7 DAYS
Their approach is to ask people who have any symptoms of flu or cold to stay at home for 7 days, self isolate. This obviously can’t be enforced, so they will be hoping people follow this advice.
They think that covid19 may be most contagious during the first few days of the mild version of the disease.
Nobody has tried this approach before for covid19 and it is not based on any recommendation by the WHO.
Some COVID-19 patients have such mild symptoms they never even feel sick.
(click to watch on Youtube)
1:02 No, I never really fell unwell - I had a little bit of a cough when they told me - and when I got here I had a bit of a fever but all of that has normalized and I have no symptoms.
She would probably not even self isolate in the UK, and if she did it would be for an arbitrary 7 days.
The WHO say that if you have COVID-19 you should be quarantined until you get two negative tests for COVID-19 two days apart. You can feel well long before that happens.
Also, why ask everyone with a cold and flu throughout the UK to self isolate for 7 days, when we could just quarantine those who have it, and ask those who are contacts to self isolate for14 days? It’s far fewer people, far fewer working hours lost, far less disruption to society.
Also isolation of contacts of known COVID-19 patients is enforceable. There is a clear public risk and the UK has in fact made it enforceable by law.
This new guideline is based on people voluntarily noticing that they have symptoms and then self isolating. There is no way it could be enforced. People who have urgent things to do may make executive decisions not to self isolate. They can suppress the symptoms so nobody notices with remedies for colds and flu's.
Even if the UK already had 10,000 people with COVID19 it would be far more cost effective to find them with aggressive case finding, quarantine them and trace their contacts, than to do this.
If what they do does delay the transmission then it may reduce the rate at which the numbers in the UK increase. Perhaps it will do that for long enough to notice that Italy, the US, Ireland etc are having success in following the WHO strategy. That plus the already successful containments in China, South Korea and Singapore may eventually be enough weight of evidence so they can no longer ignore what the rest of the world is doing, successfully
WE WILL BE ABLE TO REVERSE THIS, EVEN WEEKS INTO THE FUTURE, BUT THE MORE WE DELAY, THE MORE DIFFICULT IT IS TO DO
A few weeks down the line, it will still be reversible with rather heroic efforts. We will need to aggressively test everyone with flu-like symptoms, since we have lost track of the virus.
The UK can do this. Singapore has done this, also China, and even some sub-Saharan African countries have done so, tying it into their already existing network for monitoring influenza like symptoms (ILI), according to the WHO press conferences.
We would need to have free tests for everyone, and no checking of backgrounds, an amnesty as for the Grenfell fire victims. We would need to offer free health care for COVID-19 for all, too, again with no checking of background.
That is necessary once it is widespread, to be able to find illegal immigrants, rough sleepers, etc. We would need to test the prison population too - it is bound to get into prisons and will spread easily in such a setting.
But it is so much easier to stop this genie from escaping from the bottle than to try to put it back in again later.
In my view as well as for many others, we need to reverse this decision now, promptly, with no delay. This will save numerous lives and vast amounts of suffering.
WISE DECISIONS SHOULD BE BASED ON DATA
To make wise decisions we need data. The WHO are an evidence based organization. The UK experts are not, apparently, they go by hunches based on zero data and ignore the data gathered by other countries!
The evidence from the WHO study in China is that it can be contained, it is being contained, and that there is almost no symptomless spreading.
DR WHITTY HAS NO DATA TO SUPPORT HIS HYPOTHESIS
Yes, Dr Whitty has an alternative hypothesis. He thinks that in the UK, counter to all this evidence, that it is now spreading in the community with 10,000 people already have it.
We have PCR tests, we are a wealth country, we can afford to do the data collecting to test this hypothesis. That is how you do science it has to be evidence based.
Many countries have done that and turned up nothing. Singapore tests everyone and finds nothing.
If Italy had done this they could have turned up their outbreak before it started. They should prove this first before acting as if there are 10,000 already infected.
The UK has ignored the WHO’s repeated advice for weeks, to do community level surveillance and is just declaring that it probably has 10,000 undetected cases without looking for them.
UK CLAIMS THAT IT WILL SURGE UP AGAIN IF STOPPED NOW
They claim that if they stopped it completely now it would surge up again months later.
However, China has reduced it so much that it has days with no native transmission cases inside China and it is on the point of re-opening Hubei province.
The evidence is absolutely clear. For instance Hubei province has now closed all 14 of the temporary hospitals it built to treat patients at the height of the epidemic.
There is no surge, there are almost no cases at all.
China's Xi Jinping pays first visit to coronavirus epicentre Wuhan
13 international experts and 12 Chinese experts toured the worst hotspots in China for 9 days and they were unanimous in agreement that the Chinese by their prompt action were stopping it and had saved hundreds of thousands of infections in China.
I can't understand why scientists are ignoring the very clear scientific evidence. They are treating it as if it was flu and ignoring all the details about Covid19 that make it different from flu.
These scientists in the UK have not been to China, not studied this disease in detail, and haven’t collected more than minimal data from the UK either. They are just not trying to collect this data.
MANY COUNTRIES ARE CONTAINING IT AT A FRACTION OF A PERCENT OF THE POPULATION
In China, it is nearly over at 0.006% (100*80,796/1.386 billion)
Even in Hubei province it is only 0.116% (100*67781/58.5 million)
South Korea is close to containing it at 0.015% infected (100*7,869/51.47 million)
Singapore is containing their outbreak at 0.003% (100*187/5.612 million)
This is not flu. You could not do this with flu.
PROBLEMS FOR DOCTORS' SURGERIES
Up to now, if you had covid19 or were a contact, you knew. But now, nobody knows if they have it if they have mild flu symptoms or fever.
So what do you do if you have flu and it turns to pneumonia? I have heard some GPs are now doing consultation via the internet because they don’t want to treat people in person.
After all if someone with COVID-19 comes into a surgery they could infect the other patients waiting there or the doctor, and the doctor has to treat anyone with mild respiratory disease as a possible COVID-19 patient, and yet they can’t get them tested for COVID-19 unless they have severe symptoms resembling COVID-19
People with mild symptoms coming from Italy, Iran or South Korea are not going to be tested at all, even if they have a fever. They will only test them if they reach the point where they need hospital treatment. So again what do these people do if they want to go to their local GP for help with something minor, that could be to do with COVID-19 but is not serious enough for hospital treatment?
What a mess? How can they stop nosocomial infections - infections spreading in hospitals and surgeries?
I can't believe that such distinguished people can say such things not based on science.
Why do they ignore what the WHO say?
NOT POLITICS JUST SCIENTIFIC CONSERVATISM
I think it is scientific conservatism - not conservative politics, I just mean being used to a particular scientific mind set.
They have developed scientific ideas based on one set of evidence and when they find facts that contradict their ideas they constantly doubt the facts even when there is clear evidence against their hypothesis.
In this case their hypothesis is that this disease is like flu. All the evidence is against this hypothesis but they have never had to deal with a respiratory disease that is not like flu.
So, because of their scientific conservatism, instead of recognizing this as a new type of disease they just say the evidence against it being like flu must be wrong.
They have a particular mindset and ways of handling such epidemics from the influenza epidemics and are being very resistant to changing this in response to new scientific data.
Instead of adjusting ideas to the data, they are continuing to doubt the data when faced with the clearest possible evidence.
I don't think this is politically motivated. Just bad science.
MORE ABOUT THE RISK FOR HOSPITALS AND DOCTOR’S SURGERIES
To try to reduce the risk that people with COVID-19 infect health facilities GPs are being told to do as many as possible of their consultations online rather than in person.
“To mitigate any risk that potentially infected patients book appointments online and attend the practice when they should be receiving advice to self-isolate or go through testing, all practices are now being advised to change face-to-face appointments booked online to triage appointments via telephone or video,”
Coronavirus: GPs urged to go digital to prevent spread of COVID-19
However there are several issues with this.
First, since people with mild symptoms are only being asked to self isolate for 7 instead of 14 days, and contacts are not traced and not tested to see if they have the virus, many may still be infectious and not know they are. They may also
You cant self isolate with a mild flu if you need doctor's attention for a heart attack.
You can’t postpone going into a hospital if you have accidentally sliced off your thumb and need it reattached. If you are pregnant you cant self isolate with a flu when your baby is due. If you have a heart attack you need emergency care right then.
This happened in Wuhan. They had separate hospitals for covid-19 patients and for ones without. However, sometimes a patient would go to the non covid-19 hospital not knowing they had it for something else and this sometimes lead to hospital workers being infected as they were in the wrong hospital where the health workers were not using personal protection equipment.
Wuhan gradually developed procedures to stop this happening. But we won't be doing anything to stop this.
It will also spread from families of health workers to the health workers and then into the hospitals. That also happened in Wuhan and was more significant than the better publicized but rarer infections of health workers inside the hospitals.
For details see the WHO China joint mission on COVID-19 final report
and the live press conference from the WHO from 25th February 2020.
(click to watch on Youtube)
So based on the experience of the Chinese in Wuhan, this is bound to happen. Some hospitals are going to get infected. Then COVID-19 will spread to doctors, nurses and other patients.
From there, the infection will spread out again to society. The WHO says this is often one of the main drivers of an epidemic in their experience.
CAN ITALY’S EXAMPLE CHANGE THE UK’S DECISION IN THE FUTURE?
Italy’s outbreak is expanding in an apparently uncontrolled way. But Italy is doing a lot to contain it.
Maybe the UK will switch back to contain once they see that Italy is containing its outbreak?
Italy looks like the start of the South Korean outbreak, but they noticed it much later and it is a larger outbreak, so it will take a while for it to turn around.
2020 coronavirus pandemic in Italy - Wikipedia
2020 coronavirus pandemic in South Korea - Wikipedia
I am using Wikipedia as a source here because they have proved to be accurate on this topic of the COVID-19 statistics. They tend to be good when there are lots of eyes on it and a high profile page.
Although the cases per day for Italy are still rising, if you look at the percentage increases from the previous day you see a slightly different story:
Let’s ignore the first few figures of 90% or more.
From 24th February through to 1st March the Italian cases rose by between 27% and 51% a day. Average increase for those 7 days is (51 + 41 + 39 + 46 + 37 + 27 + 50)/7 = 41.57%
In the next week from the 2nd through to the 9th, it ranges from 20 to 27% with an average of (20 + 23 + 23 + 25 + 20 + 27 + 25)/7 = 23.29%
We only have 5 days after that but it ranges from 11 through to 23% with an average of (11+23+21+17+20)/5 = 18.4%.
Or looking at it another way, at the doubling time, from 227 on the 24th it took just two days to nearly double to 445 on the 26th. It took 5 days to approximately double from 10,149 on the 10th March to 21,157 on the 14th March.
It is too soon to be certain, but a reduction in the daily percentage increase and an increase in the doubling time both suggest it is coming under control and may be nearing its peak.
I expect Italy to peak and see the cases reduce some time in the next week or two, since the WHO say they are doing everything right.
By then the UK is likely to have thousands of cases, and since they won’t be testing mild cases any more, won’t even know how many cases they have.
But we will still have records of deaths from COVID-19. Here they are so far:
For the figures and detailed breakdown:
Perhaps their eccentric measures will slow down the rise somewhat, but if it doubles even every 5 days, as Italy is doing now, then by 10 days from now that’s 82 deaths per day and by 15 days it is 164 deaths per day. It’s unlikely to be slower than Italy with multiple lock downs and the Italians singing from the balconies in solidarity.
On the other hand given that there is little to prevent infection of hospitals which would endanger the lives of the most vulnerable and then spread out into the society at large, it could easily be a lot faster than for Italy.
If their measures are not so effective and it doubles every 3 days, say, then by 9 days from now we’ll be running at 164 deaths per day and by another 9 days after that, at 1312 deaths per day.
So it is not impossible that by, say, 23rd March the UK is running at over 1000 deaths per day - with COVID-19 largely eliminated in the rest of the world with the outbreaks in Italy, Iran, South Korea, Japan, all close to under control or nearly controlled.
EACH OF THESE LIVES IS A REAL PERSON - EVERY LIFE MATTERS
Each of these lives is a real person, someone’s child, partner, parent, grandparent, doctor, boss, nurse, scientist, gardner. Some might be future world leaders in their field. Some may save the lives of thousands, some may be like Bruce Aylward and lead a campaign to eradicate a disease from our world.
Every life matters. Just one life too many is too many to be risking through a theory based on a model only, and with that model just a scientific hypothesis never tested against any real world data for COVID-19 in the UK or anywhere.
NOT TOO LATE
Even then, it won’t be too late to contain it, if they then use measures similar to the ones used by Italy and go back to finding cases, contact tracing and isolation.
You don’t see the effects right away - in this image then the actual cases are in gray for the onset of symptoms but the detected cases are in orange because most people are not detected right away when they first get symptoms. The numbers with onset of symptoms for COVID-19 peaks almost immediately after the start of the lock down (it can take up to 14 days for onset but half the patients get symptoms within 3 days).
The dates of diagnosis though peaks 12 days later.
Adapted from figure 1 of The Coronavirus Disease 2019 (COVID-19) Outbreak in China—Summary of a China CDC Report
Later on the Chinese managed to get the time to diagnosis down to an impressive average of 3 days. But this requires on educating the public to go to a fever clinic right away as soon as they have a temperature and on having the capability to test large numbers of people safely in the fever clinics.
LARGER GLOBAL PICTURE
A larger picture can help too
China can get new cases from Italy, say. But China now detects cases very quickly so it can't start an outbreak, not unless the numbers outside of China get really huge. China is also quarantining people from Italy.
China is now doing the same thing to other countries that they originally did to China.
In the same way South Korea can contain its outbreak and then be watchful about any cases from other countries. Then Italy and so on.
It doesn't really matter how many there are in how many countries. It is the overall pattern that matters in the end.
Here is the epidemic curve so far again. The cases per day in the Western Pacific are decreasing strongly, in Europe are increasingly strongly, in Eastern Mediterranean are increasing slightly and in the Americas then increasing quite strongly but early days yet. In South East Asia outside of China, most of the new cases were over by the middle of February and Africa hardly has any yet.
This is the epidemic curve for confirmed new cases outside China by the date of the report and the region through to 14th March 2020.
from
It helps to take this larger picture. When you divide it right down to the country level, it is confusing, because many countries have very porous boundaries and because cases splosh over from one country to another.
It doesn't really matter how many countries it spreads over if the cases in those countries are well contained and all the contacts self isolating. That country might as well have zero cases.
Some countries often have no new cases for 2 weeks at a time - then get reinfected from another country. Countries like that aren’t really contributing to the global trend as the disease never gets a foothold and never actually replicates there.
So now suppose that Europe turns it around and starts shrinking like the Western Pacific, that would make a big difference already. If the other regions decrease too - then soon it will get less and less and then there won't be any cases left.
Early on in the outbreak it was the responsibility of China and by swift and decisive action they greatly reduced the infections for everyone else. The WHO - China joint mission concluded that China prevented several hundred thousand infections with those actions. After that it was the responsibility of the Western Pacific, especially South Korea which has contained its outbreak with very little spill over to other countries. Now it is the responsibility of Europe to contain our outbreak and bring it under control.
The others have shown it can be done and we can too. Italy should control its outbreak soon. Then, sadly, the focus is likely to turn to the UK as the last remaining major outbreak in the world if the others succeed in controlling theirs. We become the fourth line of defence and I very much hope we change our policy before then, not only for ourselves but as part of our responsibility not to reinfect the entire world with COVID-19.
The WHO say that everywhere can contain it - it is not a question of whether they can but if they will.
SUMMARY
This is my take on the UK situation: Italy may already be on the cusp of controlling their outbreak - 17,000 cases, likely to increase a fair bit more, maybe to 20,000 or even 30,000. However the Italian outbreak does already show signs that it may be approaching its peak number of cases per day.
It shouldn’t make any difference but I think the UK may be more impressed by a geographical neighbour - another country in Europe than the successes of the more remote countries in the Western Pacific.
If Italy controls its outbreak following the methods of the WHO experts, it will be hyper embarrassing - we are very proud of our NHS - our free health care system which enjoys pretty much 100% support by the public and politicians.
For the UK to be the one country in the world with increasing cases while everyone else is decreasing would be acutely politically embarrassing here.
The worst is that we have abandoned testing mild cases. We can't give accurate numbers to other countries or the WHO, except hospitalized patients and deaths. So - it will be impossible to compare our outbreak with Italy directly.
However, if we have increasing numbers of deaths from COVID-19 while everyone else has decreasing numbers of deaths, say, mid April then it would be very embarrassing.
Also, it seems that the policy seems not well designed to protect health care workers, something that the Chinese in Wuhan discovered needs a very high level of care to prevent.
If we get health care workers dying of COVID19, and hospital patients that are in hospital for unrelated conditions - when this has stopped everywhere else in the world - then that would be quite a scandal too.
I can't see us continuing with this “delay” policy after that and it would likely lead to resignations and investigations.
We certainly have the capacity to roll out tests by the million, like the US is doing, and test everyone with fever and respiratory symptoms for COVID-19.
We could respond like that rapidly in a crisis and then find everyone with the virus who is showing symptoms and then go on to quarantine, isolation, lock down of regions with high case loads and then work back to lower numbers just as Italy is doing.
We might end up locked up in our communities and singing from the balconies as Italy did and as China did.
(click to watch on Youtube)
Here is the Wuhan take on it
(click to watch on Youtube)
We can certainly stop it, even at tens of thousands of cases. This may be Birmingham or Glasgow or London by the end of March.
But the more this is delayed the more cases we are likely to have before it stops and the harder it will be and the longer our outbreak will continue. Also the longer this continues, the longer the UK continues as a source of infection of the rest of the world with COVID-19.
I see the potential for this to become a big scandal in the UK, leading to resignations and investigations.
The media have a lot to do with this debacle. All the way through they have consistently only reported the negative story. Although with every single press conference the WHO have said that the pandemic can be brought under control, and with more and more emphasis after the detailed China report lead by Bruce Aylward and , I have yet to see any clear statement on the BBC website that the WHO consider that the outbreak can be contained.
They have simply not reported them. Especially, there is no mention that I can see of their statement that it i not a question of whether we can but only whether we will.
UK politicians are naturally most influenced by the UK media, so that may well be a factor too.
WE CAN STOP THIS NOW!
We can stop this by reversing this potentially disastrous policy RIGHT NOW!
Please especially if you are in the UK do share this to try to put pressure on our government to act - and to try to get the press in the UK to publicize what the WHO say.
PETITION TEXT - THE UK GOVERNMENT MUST IMMEDIATELY RETURN TO THE CONTAIN PHASE FOR COVID-19
I have submitted this petition but it has not yet passed moderation. When ready it will be available to sign here:
The text says:
Summary: The UK should immediately restart contact tracing, containment and testing of mild cases of COVID-19. Also, following recommendations of the report from the WHO-China Joint Mission headed by Dr Aylward & Dr Liang on 25th February, we should do widespread surveillance in the community to find cases.
Details:
Dr Tedros Adhanom, Director General of the WHO said:
"Several countries have demonstrated that this virus can be suppressed and controlled. The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same; it's whether they will."
He also said:
"If anything is going to hurt the world, it’s a moral decay. And not taking the death of the elderly or the senior citizens as a serious issue is one of the moral decays."
Those two quotes are from:
WHO Emergencies Coronavirus Press Briefing 09 March 2020
Virtual press conference on COVID-19–11March 2020
The recommendation from the China report was:
Immediately expand surveillance to detect COVID-19 transmission chains, by testing all patients with atypical pneumonias, conducting screening in some patients with upper respiratory illnesses and/or recent COVID-19 exposure, and adding testing for the COVID-19 virus to existing surveillance systems (e.g. systems for influenza-like-illness and SARI) WHO China joint mission on COVID-19 final report (page 12)
MIGHT THE UK DO AN ABOUT TURN?
Perhaps with all the criticisms of the government response from so many eminent people they may do an about turn?
It hasn't got that far yet, but there will be some missing gaps in the chains of transmission, now they have had several days without contact finding and with people coming into the country not reporting based on travel history.
However we know there are some gaps anyway in our understanding. What would be brilliant would be if they were to find all the mild cases and test everyone. We can certainly afford to do it as a country. It is just a case of a swab from each one, two swabs. Then testing in a lab. And of course many more people to man the NHS 111 or perhaps better a dedicated COVID help line to phone in to ask to be tested. China has a system of some sort that lets them test anyone with fever symptoms for COVID-19 and they typically diagnose it now within 3 days of onset of symptoms which is very fast. There is no reason why we can't do the same.
YOU CAN HELP TO STOP IT
I know I have repeated this several times, but a final reminder: if everyone washes their hands regularly - and avoids touching their face with unwashed hands and keeps a distance it will stop it. Be sure to check out the details of what you need to do:
If the government is not going to act we can at least do our darndest as individuals to protect our own communities both in real life and online by following those instructions.
Until the UK government acts to change its posture we have to assume that anyone we meet in the UK might be infected with COVID-19.
That includes doctors, nurses and other health workers.
So - do those precautions even if examined by a doctor - they would be careful and doing whatever they can to avoid getting infected - so hopefully they don’t have it but they have to make close contact with many patients and could get infected. This is doesn't happen that often but when you have a lot of COVID-19 patients it will happen from time to time - it happened multiple times in China in the early days.
See my
- WHO declare Covid19 as a pandemic that CAN BE CONTAINED - not a question of if we CAN but if we WILL
See also my:
- Where to go for reliable sources on the Coronavirus COVID19
(also has a list of some of my posts at the end)
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