Monday 11 May 2020

Another Armchair Virus Expert Writes....

Hello everyone - long time no see, and all that. Two and a half years in mothballs, and after nearly two months stuck indoors I've finally been compelled to write a new edition of this blog to capture my thoughts on the dreaded Coronavirus, given social media is currently awash with armchair experts (especially in light of the Prime Minister's statement announcing how the lockdown will be gradually eased) - if you can't beat 'em, join 'em!

Now, I should caveat this post at the outset by stating a couple of things. Firstly, and I don't think this should come as a shock to anyone reading this, I am writing this from the perspective of a Conservative Party activist (with the lofty title of Deputy Chairman - Membership and Fundraising for the Osterley and Spring Grove ward of the Brentford & Isleworth association); Secondly, and this is a "well, duh!" statement, I am no scientific expert, as my A-Level grade for Chemistry will testify. What I do have in the credit column, however, is that I have spent most of my working life in the field of data analysis, which means I don't take numbers at face value without forensically examining the story behind the numbers. This, in particular, is where I hope to be able to impart at least a little knowledge.

At a Crossroads - To Ease or Not to Ease?

It is clear the UK has reached a crossroads in terms of moving from lockdown back to something related to "normal", however that will look. With the announcement ahead of the weekend that the Prime Minister was to make a statement about easing the lockdown, my social media feed went into overdrive, which moved into hysteria mode after the statement - to the extent I've considered taking a break from the book of face until it's all over.

It would seem there are five main strands emerging. The first is those who prior to the statement were yelling that any easing of the lockdown will immediately kill everyone ever. The equal and opposite strand is those who didn't believe the lockdown should have taken place at all, and therefore anything short of just cancelling the whole thing would be too little. A third strand to consider is those who consider Boris Johnson to be the Antichrist and therefore whatever he announced would be wrong. The equal and opposite also applies in this case for the fourth strand, those with a slavish devotion to his every word. The final strand is those complaining about people complaining.

So, what was announced? At the time of writing the full guidance has yet to be published, but it's pretty small potatoes: From Wednesday, if you can't work from home you should go to work provided they have in place appropriate social distancing measures. To get there you should avoid using public transport if possible. Instead of being allowed to leave the house once a day you can now come and go as you please, again as long as you follow social distancing guidance - this now includes being able to exercise in parks (e.g. playing sport) with members of your household, as well as playing Golf (again either alone or with a member of your household). 

Assuming the "r" number continues to be below 1, and cases/deaths continue to fall, the restrictions will be further eased in June, the biggest announcement being that primary schools can open to Reception, Year 1 and Year 6, while Secondary schools could be open to Year 10 at some point. 

Finally, and again assuming the above, from July we might start seeing a return to the "new normal", with the hospitality sector gradually reopening.

Naturally, the reaction from the strands above has been: First strand - he's going to kill us all, aaaarrrgghhh! Second strand - he's going to kill the economy, aaaaarrrggghhh! Third strand - Boris is the Antichrist, aaaaarrrrggghhh! Fourth strand - Boris is God, aaaarrrrggghhh! Fifth strand - just shut up will you, aaaaarrrrrggghhh!

The Numbers Game

I don't know about you, but I've been following the numbers around this awful virus pretty closely, in fact I keep a running tally of daily cases and deaths, with a 7-day rolling average globally and in the UK, using the excellent Worldometers site.  Now, this is where it gets tricky.

The official numbers show that currently the UK has the highest death toll in Europe and is second only to the USA overall. This is, of course tragic - every death from this virus is a death too many. The generally anti-Boris / anti-Conservative mob have got very busy with their vitriol and memes decrying this. There are several factors and potential caveats at play here.

Total numbers vs comparative totals: Who'da thunk the death toll in one of the highest populated nations of Europe would have been higher than that of nations with a fraction of the population? Deaths per million of population shows a different picture, although again there are caveats, as per below.

Population and population density: It stands to reason that if you have a contagious disease, the contagion is worse in areas of high population density (the more people you come into contact with, the more people you can infect). Of all the larger populations of Europe, the UK is third to the Netherlands and Belgium (two other countries particularly hard-hit) in terms of population density. However, England's population density is higher still than these two nations at 430 per sq/km.  Compare this with Germany (233), Italy (200), France (123) and Spain (93). Sweden, held up as an example of a far looser lockdown, has a population density of just 2, although Stockholm's density is broadly comparable with that of London, and has been the major epicentre of the country's outbreak.

How deaths are recorded in the UK: This is where it is impossible to compare apples with apples, and therefore why simply bemoaning the fact the UK's official death toll is second to the USA is fraught with data flaws. Since April 29th we know that the UK's official death toll is of all cases where the deceased tested positive for the virus. On the one hand, this therefore doesn't record deaths where no test has taken place, which could raise the numbers. On the other hand, however, the UK records deaths "with", rather than "of", which means that if the virus is present, the deceased is recorded in the official numbers even if the virus is not what killed them. The independent fact checking site Full Fact stated that in March 14% of deaths where Coronavirus was listed on the death certificate, the virus was not the underlying cause of death. Full Fact also said that other common causes of death (especially heart disease) dropped substantially, suggesting that some of those recorded as dying of Coronavirus would have died anyway of their underlying condition.

How deaths are recorded elsewhere: The simple answer is we don't know for sure, or the data is sketchy and/or inconsistent. For example, some countries have not declared the setting of Coronavirus deaths, so their tolls could be much higher than the official numbers state. Full Fact (above) showed that some countries had big "unexplained" spikes in deaths which suggested under-reporting, while others didn't. The official US guidance is to report "suspected" deaths, although at time of writing I believe only three states have followed this. Other countries are believed to follow a more strict "of", rather than "with", recording of deaths. Belgium, whose deaths per million is the highest of all major nations, is thought to record "suspected" deaths in all settings. At this point there's no point speculating about certain countries and their death tolls (and whether they are accurate).

What would have happened without lockdown, or had we been stricter?

Again, this is a case of "who knows". Sweden has been held up as the European example of a less strict lockdown (although there was a lockdown of sorts there). Their death toll stands currently at 319 per million. This is compared with 747 in Belgium, 569 in Spain, 505 in Italy, 469 in the UK and 404 in France. So far so "good". However, neighbouring Denmark, which had a strict lockdown, has recorded just 91 deaths per million. So, had Sweden locked down as strictly as Denmark, would their death rate per million be comparable? Or vice versa? Again we're not comparing apples with apples (and we have no definitive insight into the recording of data), so it's hard to tell, although it does give credence to the view that strict lockdowns have been saving lives.

The UK's lockdown has been strict, but not as strict as in other of the more stricken countries - in France it has been illegal (until today) to leave the house without a signed affidavit explaining why they're out. In Spain children were housebound for several weeks. 

One major bone of contention has been around people entering the UK and the need for a quarantine period - in essence I'm a little uneasy with previous lax restrictions (although what many are not aware of is that anyone passing through our airports is subject to a temperature check by surveillance) and the announcement of quarantine measures to come soon are in my opinion too little too late. That said, it would appear the overwhelming majority of inward travel in recent weeks has been the repatriation of UK citizens and the continuation of essential trade. This shouldn't be cut off completely.

The availability of testing has been a massive issue, although again should carry some caveats. Firstly, we look over to Germany and their testing regime, but overlook that they had access to the testing in the first place due to the country being the EU's designated producer of testing kits. It's easy to forget that in the early stages of the European virus wave that Germany came under intense criticism particularly in Italy for being slow to come to their aid. Secondly, the test is like an MOT, it's only good up to the point of the test. Had we had 70 million tests available, we could have tested everyone in the UK, only for many testing negative today to become positive tomorrow. At one point there were German officials who broke ranks to say they believed they should have adopted the UK's stance of targeted testing. However, this point is moot in the end. We simply didn't have enough tests to hand to do widespread testing immediately.

The UK's Public Health Crisis

One final factor to be considered is the condition of this nation's health and its contribution to the overall death toll. It's a sad fact that the UK ranks poorly in terms of physical health, whereas were you to look at countries in the far east which have largely had a low ratio of cases to deaths, these are nations who rank more highly in terms of public health and life expectancy. The virus has thrown a spotlight over the UK's public health crisis, but this is something where as a small "c" conservative I believe it's something that the people, as well as the government, need to address. 

We need to move away from our dependency on fast, processed food in favour of fresh produce. And it needn't be costly - I made a conscious decision a few years ago to incorporate more home cooking into my lifestyle having lived off microwave meals previously, and my food bill actually went down quite considerably, thus making a mockery of the argument that people cannot afford to eat healthily. 

We need to look after our bodies better. I don't exercise enough, I know that. I'm 3-4 stone overweight. That's entirely my fault, not the government's. I'm trying to drill into myself to walk where walking's possible, and not to overindulge (this is the harder bit!). It is incumbent on us all to look at what we're putting into our bodies, and how we're maintaining them. It might need a generational shift to do this, but it's a lesson for us all. The disease isn't generally killing healthy people.

Conclusion

Well done for reading this far. I hope I have been informative in terms of understanding the numbers, if nothing else. When all is said and done, and we have beaten this horrible illness once and for all, we can look back and take stock of how we as a nation "performed" in dealing with the crisis. Hindsight remains a wonderful thing, you only need to see the baffled ramblings of Piers Morgan to know this (look at his dismissive attitude around the time of lockdown and that now to see a volte face of epic proportions!).

Also, the picture would only become less muddy with a full understanding of the figures, and for some uniformity across nations. This, I fear, will be lost in a fog (as it is already), and will be used as a stick to beat nations with depending on one's own confirmation bias. 

So let's take a deep breath, keep following the rules, and let's emerge the other side a chastened, but positive, nation ready to embrace the "new normal".