covid-19 Ongoing disaster from Shambolic Clots

I’m working on an eventual series of posts on above theme but currently focussed on current pretence at preparing for mRNA vaccine production in Australia that requires catching up on technical details.

Meanwhile Dominic Cummings started a twitter storm on 17 May, fully documenting from inside just how Shambolic the UK response was.

The 59 tweets (so far) are well worth reading and thinking about carefully.

https://threadreaderapp.com/thread/1394245014440529921.html

There may well be more coming and the original thread view shows what he is responding to so here’s a link to that:

https://mobile.twitter.com/Dominic2306/status/1395010951452237829

It also includes some responses on his own responsibility for helping promote that government.

More immediately relevant is a warning from Cummings that UK preparations for dealing with variants could be likewise shambolic and that transparency is vital to enable earlier reversals of wrong policies protected by official secrecy.

Naturally the “business case” for mRNA manufacturing in Australia is beiing witheld and an 8 week “process” is being rushed through to ask local manufacturers to confidentially provide detailed costings for know how and supply chains they don’t have. An engineering task needs to be recruited immediately (from anywhere, worldwide) to actually work out what can be done and who needs to be recruited and trained to do it. That will be difficult but is the obvious first step which simply is not being taken. They are instead talking to managers of the non-existant Australian BioPharma industry to fill out forms about matters they know nothing about.

I’ll write about that as soon as I can:

https://www.industry.gov.au/news/enabling-australias-onshore-mrna-manufacturing-capability-approach-to-market

Meanwhile here’s the text of the 59 tweets, although it is better to read them with accompanying graphics at links above:

1/ Covid… Summary evidence on lockdowns. For UK political pundits obsessed with spreading nonsense on Sweden/lockdowns, cf. SW econ did a bit WORSE than Denmark which locked down, AND far more deaths in Sweden:

Yes, lockdowns were good
It’s a moot point now, but let’s set the record straight
https://noahpinion.substack.com/p/yes-lockdowns-were-good
Image

One of the biggest misunderstandings, spread by political pundits even now, is the ‘tradeoff’ argument. Fact: evidence clear that fast hard effective action best policy for economy AND for reducing deaths/suffering
4/ Best example: Taiwan. Also shows that if you REALLY get your act together not only is econ largely unscathed but life is ~ normal. But SW1 (Remain/Leave, Rt/Left) = totally hostile to learning from East Asia
5/ There’s a general western problem based on nonsense memes like ‘asians all do as they’re told it won’t work here’. This is what many behavioural science ‘experts’/charlatans argued, disastrously, in Feb2020. This nonsense is STILL influencing policy, eg our joke borders policy
6/ Another confusion re Sweden: data shows despite no official ‘lockdown’ behaviour changed enormously. The closer your measures are to ‘welding people inside homes’ (per Wuhan at peak) the >> effect on transmission. Semantics of ‘lockdown’ obscure this really simple point
7/ If you are going to have to do measures ≈ lockdown to avoid health system collapse then the harder/earlier the better & the sooner they can be released. Pseudo ‘lockdowns’ w/o serious enforcement are hopeless: econ hit & people die anyway, nightmare rumbles on
8/ Waiting room, 1st jab. Remembered Vallance 24/3 amid disaster: will u support taking vaccines out of DH & a new Taskforce, we need different leadership & skills to drive it? CABSEC supported divvying up DH tasks. If not, normal Whitehall process, probably normal result

9/ Success seems to have blinded SW1 to important Qs. a/ We did it much better than Brussels, obviously, but Brussels is not a good comparison. How well did we do relative to ‘how well wd General Groves who ran the Manhattan Project have done it?’
10/ I think we’ll conclude we shd have done Human Challenge trials immediately & cd have got jabs in arms summer. This is not criticism of the VTF which has been constrained in ways they shdnt be. It’s cnctd to b/ where is the public plan for how the VTF will deal with variants?
11/ One of the most fundamental & unarguable lessons of Feb-March is that secrecy contributed greatly to the catastrophe. Openness to scrutiny wd have exposed Gvt errors weeks earlier than happened
12/ So why are MPs accepting the lack of a public plan now for VTF viz variants? Especially when rumours reach me that the silent entropy of Whitehall is slowly turning VTF back into a ‘normal’ entity?
13/ The best hedge re a variant escaping current vaccines is PUBLIC SCRUTINY of Gvt plans. This will hopefully show it’s been taken seriously. If not, better learn now that the Gvt has screwed up again than when ‘variant escapes’ news breaks
14/ I can think of no significant element of covid response that wd not have been improved by discarding secrecy and opening up. This was symbolised by e.g how COBR cd not be used: a constrained STRAP environment cd not cope with the scale/speed, another important lesson

15/ Having watched classified elements of covid response, Gvt cd make the vaccine plans 99% public without risks, ‘national security’ almost totally irrelevant to the critical parts of the problem, a few things cd be withheld while publishing all crucial parts of the plan
16/ These issues are relevant to c/ Who is writing the plan for ‘how we deal with something worse than covid?’ If we get this right now, we do not need to have this sort of disaster again. We’ll also be hedging vs future bioterrorism risks: cf:

Andy Weber on rendering bioweapons obsolete and ending the new nuclear arms race
Bioweapons are terrifying but scientific advances leave them on the verge of becoming an outdated technology.
https://80000hours.org/podcast/episodes/andy-weber-rendering-bioweapons-obsolete/
17/ The covid plan was supposed to be ‘world class’ but turned out to be part disaster, part non-existent. I urged inside Gvt to do a review of other contingency plans for more dangerous things than covid, a largely open process with e.g @wtgowers helping. Happening?
18/ MPs shd force publication of vaccine/variant plan & require mostly open review of other contingency plans before we find out the hard way they’re as ‘world class’ as the covid plan…
19/ Such reviews shd seek out those were right & early on covid. Such people are more likely to spot that other plans have errors, gaps, that institutional planning has blind spots, failure to look at crucial operational details etc. E.g @MWStory
20/ P Vallance & I supported opening up SAGE much earlier than it happened. I argued before 1st lockdown to open up the CODE of SPI-M models for scrutiny. Barrier = SW1 cultural hostility to openness & this barrier means SAGE still too closed & too little of its workings public
21/ Looking at minutes does not give good insight to reality of discussions. E.g looking at minutes of crucial 18/3, which I attended, does not convey true situation, discussion, atmosphere, effects
22/ With something as critical as variants escaping vaccines, there is no justification for secrecy, public interest unarguably is open scrutiny of the plans
23/ This point is critical re Groves/Manhattan/vaccines & wider covid & wider issue of gvt performance: our civilisation is abysmal at seeking Groves/Bob Taylors & getting them into critical roles, bureaucracies exclude & expel them, as they did with Groves/Taylor!
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24/ The public inquiry will at no point ask: how does the deep institutional wiring of the parties/civil service program destructive behaviour by putting the wrong ppl in wrong jobs with destructive incentives? It will all be about relatively surface errors
25/ If SW1 wanted to ‘learn’ there wd already be a serious exercise underway. The point of the inquiry is the opposite of learning, it is to delay scrutiny, preserve the broken system & distract public from real Qs, leaving the parties & senior civil service essentially untouched
26/ J Phillips, a brilliant young neuroscientist I recruited to no10, argued for immediate Human Challenge Trials, as did others. We were far too slow to listen to such advice. The science ‘misfits’ who urged this early were clearly right, the ‘ethicists’ disastrously wrong
27/ So true from @paulg, it’s amazingly rare to find people who deeply care about results at senior levels in politics/gvt, those who do are seen as mad/unreliable & are weeded out. SW1 incentives are ~all about rewarding process + fake signals. V relevant to covid fiascos
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28/ Of the 20 ppl who I saw do most to save 1000s of lives, it’s striking how many gone or leaving or planning to leave, & how many who were disastrously wrong/useless been promoted to jobs they can’t do/given honours etc
29/ @pmarca on the west’s covid failures (‘the harsh reality is that it all failed’) & the General Groves mentality needed, influential in no10, 4/20, as we pushed thro the vaccine taskforce

IT’S TIME TO BUILD – Andreessen Horowitz
Every Western institution was unprepared for the coronavirus pandemic, despite many prior warnings. This monumental failure of institutional effectiveness will reverberate for the rest of the decade, …
https://a16z.com/2020/04/18/its-time-to-build/
30/ Crucial data generally ignored by those who want to downplay covid danger, many 1000s will have serious health problems for years because of our failure to act faster/harder in Feb/March & Sep. Those who predicted this issue wd be ‘Gulf War syndrome bollocks’ were wrong
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31/ There was a PHE exercise called Exercise NIMBUS in a hypothetical future 14/4/20 with mock COBR slides. Assumed peak week 13/5 and >33M cases over 16 week wave, hospitals full by 14/4, >800K deaths, schools told stay open(!!). A/one know when exercise happened (think 3/20)?
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32/ This, evening of 31/10 re lockdown2, from @wtgowers who was ahead of the game in 3/20, was spot on. If mass testing had been developed properly earlier in year as cd/shd have been, wd probably have avoided lockdowns 2&3 while awaiting vaccine
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33/ True but also UK gvt did v badly, turned out we cd/shd have had these tests at millions p/day scale by Sep latest, instead of seriously starting in Sep, which wd have greatly changed q42020. Those screaming from ~Feb/March were ignored, months/lives/£ needlessly lost
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34/ Mass testing same story as elsewhere: some brilliant/dedicated relatively junior officials (e.g Alex Cooper) + great young scientists (e.g @gaurav_ven) + entrepreneurs held back by senior management/DHSC/PHE (particularly awful) & Whitehall legacy procurement & HR horrorshows
35/ Even tho the PM/CABSEC/I all told 9/20 most senior HR & procurement officials to treat mass testing ‘like a wartime project’, ignore their usual bullshit multimonth processes, mass testing hugely hampered by Whitehall’s optimisation for ‘[awful] process over results’
36/ So much ‘lockdown’ confusion. Obv they’re ‘destructive’. But if you have to do it cos alternative is 100s of 1000s choking to death + no NHS for months for everybody else + econ sunk cos everybody hiding in terror then earlier/harder is better for health AND econ
37/ If we’d had the right preparations + competent people in charge, we wd probably have avoided lockdown1, definitely no need for lockdowns 2&3. Given the plan was AWOL/disaster + awful decisions delayed everything, lockdown1 became necessary
38/ Media generally abysmal on covid but even I’ve been surprised by 1 thing: how many hacks have parroted Hancock’s line that ‘herd immunity wasn’t the plan’ when ‘herd immunity by Sep’ was literally the official plan in all docs/graphs/meetings until it was ditched
39/ Yes the media is often incompetent but something deeper is at work: much of SW1 was happy to believe Hancock’s bullshit that ‘it’s not the plan’ so they didn’t have to face the shocking truth. Most political hacks believe in ‘the system’…
40/ In week of 9/3, No10 was made aware by various people that the official plan wd lead to catastrophe. It was then replaced by Plan B. But how ‘herd immunity by Sep’ cd have been the plan until that week is a fundamental issue in the whole disaster
41/ All those referring to the Sunday Times story 22/3/20 re me dramatically ‘changing my mind’ at SAGE on 12/3: there was no SAGE on 12/3! It’s an invented meeting & invented story repeated for a year by political hacks as ‘fact’
42/ No10 decided to lie: ‘herd immunity has never been… part of our coronavirus strategy’. V foolish, & appalling ethics, to lie about it. The right line wd have been what PM knows is true: our original plan was wrong & we changed when we realised
43/ Lots of hacks have lost their minds. Herd immunity wasn’t ‘a secret strategy’, it was THE OFFICIAL PUBLIC EXPLAINED ON TV/RADIO STRATEGY! Halpern, on SAGE, literally explained it on radio explicitly, 11/3/20, as did others!!
44/ The whole ‘flatten the curve’ plan A was to get herd immunity by summer & avoid 2nd peak during annual NHS winter crisis. That’s why our official graphs had ONE peak over by summer! COBR docs/graphs describe herd immunity as ‘the optimal single peak strategy’ etc
45/ What happened is a/ panic about the phrase, ‘comms disaster’. b/ We ditched the herd immunity plan and shifted to Plan B, suppression, which previously the Gvt said/thought would be worse cos it wd lead to a 2nd peak in winter 2020 during the annual NHS crisis
46/ A COBR doc from week of 9/3/20 explains official thinking behind Plan A: ie. suppression either won’t work or wd lead to 2nd peak during NHS winter crisis, so the advised herd immunity approach was what DHSC/Cabinet Office described as ‘single peak optimal strategy’
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47/ In that week it became clear neither Hancock/CABOFF understood herd immunity effects: 100s of 1000s choking to death + no NHS for anybody for months + dead unburied + econ implosion; so we moved to Plan B: suppression + Manhattan Project for drugs/vaccines + test&trace etc
48/ Critical as I am of the PM in all sorts of ways, it’s vital to understand the disaster was not just his fault: the official plan was disastrously misconceived, DHSC/CABOFF did not understand this or why, & a PlanB had to be bodged amid total & utter chaos
49/ Jenny Harries told us, the same week herd immunity was the official plan, masks are a ‘BAD idea’, ‘we don’t want to disrupt people’s lives’, acting ‘too early we will just pop up with another epidemic peak later’. So Whitehall has promoted her, obviously
50/ ‘Herd immunity’ was officially seen as UNAVOIDABLE week of 9/3. It wd come either a) in a single peak over by Sep, or b) in a 2nd peak in winter. (a) was seen as easier to manage & less of a catastrophe so it was Plan A. Cf SAGE 13/3: ‘a near certainty’ suppression>2nd peak
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51/ It was in week of 9/3 that we started to figure out Plan B to dodge herd immunity until vaccines. Even AFTER we shifted to PlanB, COBR documents had the ‘OPTIMAL single peak strategy’ graphs showing 260k dead cos the system was so confused in the chaos, see below
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52/ Hodges = wrong: there was neither an intention to lockdown nor as of Fri13/3 any official plan for doing so. The SAGE minutes show the opposite of what Dan says they say…
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53/ Dan says the SAGE minutes show ‘The strategy was to wait for the optimum moment to lockdown’. No. SAGE said literally the opposite: lockdown = suppression = ‘near certainty’ of 2nd peak & this was thought to be much WORSE than single peak/herd immunity by Sep, hence graph
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54/ On 14/3 one of the things being screamed at the PM was ‘there is no plan for lockdown & our current official plan will kill at least 250k & destroy the NHS’. Cf the graph: ‘optimal single peak strategy’ with 3 interventions. That was the official plan, which was abandoned
55/ Another reason we ditched Plan A was it became clear the official system had given ~no thought to all the second order effects of 250k dying, almost all without ICU care. True deaths wd clearly be much >250k cos there would be no NHS for anybody for months
56/ On 12/3, the most surreal day of 18 months in Gvt, it was argued to the PM that a/ individual isolation be delayed (‘we’re not ready’), b/ we might not do household quarantine at all, c/ given Halpern’s interview on 11th, the PM shd publicly explain the ‘herd immunity’ plan
57/ Re D Halpern: a/ on 11/3 he was simply explaining the OFFICIAL plan, not freelancing; b/ unlike many he supported the switch to Plan B in the next week & told the CABSEC & DHSC that…
58/ NB. Even at SAGE on 18/3 it was not all clearly agreed ‘must do national lockdown ASAP’. Halpern supported it with others. Senior DHSC officials were saying even on 18/3: lockdown just means it pops back up again in 2nd wave so why change strategy?
59/ Even at SAGE on 18/3 some argued: even if lockdown needed, delay, finesse timing. Others argued: there’s no alternative so sooner must be better. The latter were right (I think) & that argument prevailed
• • •

7 thoughts on “covid-19 Ongoing disaster from Shambolic Clots

  1. I watched the first hour of DC’s testimony to joint parliamentary committee (7 hours in total) … v interesting exposure of how government gets it wrong

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    • Please add link. I plan to watch and will definately read transcript which I assume has nearby link. BTW his twitter feed does go beyond 59 tweets in that series now.

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  2. I haven’t watched the video but have listened to or read the whole 118pp transcript:

    26 May 2021
    Inquiry Coronavirus: lessons learnt
    Witnesses Dominic Cummings, Former Chief Adviser to the Prime Minister
    Committees Science and Technology Committee, and Health and Social Care Committee
    Published 27 May 2021 Oral Evidence
    https://committees.parliament.uk/oralevidence/2249/pdf/

    Lots more related documents at pages linked from:
    https://committees.parliament.uk/committee/135/science-and-technology-committee-commons/publications/

    I haven’t read any others but the evidence from Dominic Cummings is VERY important (and easy to listen to or read). Not only important issues re current pandemic but also on why the state machine requires smashing.

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  3. WHO briefings Feb -March 2020 (just a quick cut and paste from a collection of quotes that seemed important). They are disorganized .. I seem not to have consistently dated them or tried to order them properly)

    https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

    see March briefings and also those from Feb 24 -28 when the WHO Mission to China first became influential )

    Some selected quotes:

    I seem not to have consistently dated them or tried to order them properly)

    NB The explanation for not calling a pandemic earlier is interesting.

    The contrast with a flu pandemic is made a number of times. However the fact that Covid 19 is “overdispersed” and that’s *why* it’s possible to contain and even eliminate community transmission, may not have been known at the time.

    https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/
    https://www.pnas.org/content/118/14/e2016623118
    etc

    (I’ve been thinking that the Delta variant may be spreading more like flu …… )

    ——————————————–
    Feb ?
    “we must protect countries that are the most vulnerable by doing our utmost to contain epidemics in countries with the capacity to do it ”

    March 3

    ” Countries like Korea, like Japan, like China have implemented very, very strong measures that have affected their own economies and their own societies, and that has bought time for others. And it is really the duty of others to use that time that’s been bought.”

    ***** “And there’s a very dangerous and I think unhelpful alignment in people’s minds between this pandemic word and some sort of major shift in approach. This is not the case. ”

    ” Remember China has moved back along the chain. China started with individual cases, China moved to large clusters and then moved to very serious sustained community transmission, and now many of the provinces have moved back to single cases; all the way through clusters back to single cases. That is not a reverse you can achieve with influenza. Korea, Japan are making progress towards the same goal. We need to support all the other countries to try and do that. And yes, if we fail and if that is a failure, we will have slowed down the virus. We would have significantly given time to other health systems to be ready, and it is time for health systems to be ready. ”

    (in response to a journalist question)” I don’t even understand why the person who you indicated is saying we should surrender. There is no reason to do that. We have to go for containment. ”

    “If I can just add to that, we’ve said in this press room many times the experience that China has had needs to be shared, and this is an excellent example of that in peer to peer and sharing what has been done, what can be done in other countries, and having them as part of this mission and having direct interaction with another country, sharing those experiences whether it’s about case and contact finding, whether it’s about the care and management of patients, whether it’s about how they’re readying hospitals and PPE and infection prevention and control. ”

    “I’d like to remind you all again that we’re eight weeks into this and we have serologic assays. I think this is unprecedented, and someone needs to correct me if I’m wrong here, but this is unprecedented to have a virus identified, a sequence shared a few days later, PCR assays to be ready a week or so later after that, and to have serologic assays in use eight weeks into an outbreak. ”

    March 5

    “The experience of these countries, and of China, continues to demonstrate that this is not a one-way street. This epidemic can be pushed back, but only with a collective coordinated and comprehensive approach that engages the entire machinery of government. We’re calling on every country to act with speed, scale, and clear-minded determination. Although we continue to see the majority of cases in handful of countries, we’re deeply concerned about the increasing number of countries reporting cases, especially those with weaker health systems. However, this epidemic is a threat for every country, rich and poor, and as we have said before, even the high income countries should expect surprises. The solution is aggressive preparedness. We’re concerned that some countries have either not taken this seriously enough, or have decided there is nothing they can do. We’re concerned that in some countries the level of political commitment and the actions that demonstrate that commitment do not match the level of the threat we all face.

    If we take the approach that there is nothing we can do, that will quickly become a self-fulfilling prophesy. It’s in our hands. WHO has published step-by-step guidelines for countries to develop their national action plans according to eight key areas, which are supported by detailed, technical guidance. ”

    __________

    “All countries now need to take a very close look at what are their objectives in responding to the epidemic; are they accepting that the disease can now spread completely in an uncontrolled fashion to all corners of their country and they’re going to focus on just trying to keep the health system moving forward and trying to keep the health system from collapsing? That’s what’s known as mitigation and the focus is on effectively supporting the health system to reduce fatality.”
    _______________________________

    In a flu pandemic you are mitigating in the sense that you don’t have an element of controllability. You can’t stop the virus in any meaningful way. So you focus on reducing the impact of the virus. A control strategy says you have an element of control, and what you do is both seek to control the virus and reduce its impact at the same time. And I think we’ve had this unfortunate emergence of camps around the containment camp, the mitigation camp, and different groups presenting and championing their view of the world. 00:57:33 And frankly speaking, it’s not helpful. I think we need to now look at the last eight to ten weeks, we need to look at what we’ve learnt about this virus, both negatively in terms of its concerns and positively around what can be done about the virus, and we need to put our heads together and evolve our strategy. Not to live on strategies of the past, and the past may be years ago, but the past right now with this virus is eight weeks ago.

    _______________________
    “If we look at China, today, 20 provinces in China have today downgraded their public health emergency risk level. That’s 20 of 31 have actually gone in the reverse. 00:21:25 They’ve gone from red to yellow, or from yellow to green. Now that’s flying in the face of that prediction. I’m not saying which one is correct. What I’m telling you, in the real world today, China is moving back towards the green. In their… 11 provinces in China today moved to green, which is their lowest level of risk. They’ve five levels of risk. On the 29th January, all provinces in China were at level one risk, the highest possible risk. Red, red, the whole of China was red. So there’s hope in that. Today there were only four cases of… Or yesterday, the last 24 hours, only four cases of confirmed COVID-19 infection outside Hubei, were actually from China. Most cases outside Hubei, in China yesterday, came from other countries. So when I look at that, which is happening in the real world, and then I look at predictions, I need to look, and we need to look at both of those.
    ________________________________________

    I just wanted to say that one of the things we’ve learnt is that the fundamentals work. The fundamentals of public health work. The fundamentals of identifying your cases, identifying your contacts. I’m an epidemiologist. This is epidemiology at its core. You need to look for your cases aggressively. You need to find all of those contacts, and find those contacts. You need to mobilise your population.
    ____________________________

    Just because you have cases, doesn’t mean you’re going to have clusters. It doesn’t mean you’re going to have large outbreaks. It doesn’t mean that it’s going to go out of control. We’ve seen not only in China, we’ve seen these fundamentals being used in Singapore, being used in Vietnam, being used in many countries, and they’re bringing that back down. And it comes back down to these fundamental public health measures. And that is something every country can do.
    ___________________________

    “Here we have a disease for which we have no vaccine and no treatment. We don’t fully understand transmission. We don’t fully understand case fatality, but what we have been genuinely heartened by is that, unlike influenza, where countries have fought back, where they’ve put in place strong measures, we’ve remarkably seen that the virus is suppressed or at least the clinical appearance or the number of clinically apparent cases has been greatly suppressed.  It’s not influenza and it’s not behaving like influenza. It is behaving like COVID-19. The problem is, we don’t know exactly how COVID-19 behaves, but we know it’s not transmitting in exactly the same way as influenza and that offers us a glimmer, a chink of light that this virus can be suppressed and pushed and contained. ”

    ______________________________

    Can I just add, the DG has used two very important words there, in terms of the difference between uncontrollable and uncontrolled. And I think it’s an important and very precise distinction that he’s used. In an influenza situation, pandemic situation, the usual assumption is that the disease is uncontrolled. The spread is uncontrollable. Regardless of what we do. So we focus on saving lives. We focus on saving lives by treating cases or developing a vaccine to protect the most vulnerable in our population. That’s the approach. In this case, what some countries are demonstrating, that it is possible to control the spread. It’s possible to slow it down. And in that calculation you now have two chances to save lives. If you contain and suppress the virus you save lives by making sure that vulnerable people in your society are not exposed. And then if they are exposed, you have more time to get your system ready to save their lives. You get another shot at lifesaving interventions
    __________________________
    March 6 ??

    China is bringing its epidemic under control, and there is now a decline in new cases being reported from the Republic of Korea. 00:11:38 Both these countries demonstrate that it’s never too late to turn back the tide on the virus.

    The rule of the game is never give up. I’ll repeat that. The rule of the game is never give up.
    ________________________________
    In other words, I said in the press conference here a number of weeks ago, *****if this was influenza we would have called a pandemic ages ago. Because we know something inherently about the transmission dynamics of influenza. 00:14:22 So it’s not an avoidance of the word. But the word is important because in many situations the word involves countries moving to a purely mitigation approach. And what we’ve seen is that moving to a purely mitigation approach is essentially saying the disease will spread uncontrolled, in an uncontrolled fashion. But we’ve seen other countries, like Singapore, like China, demonstrate real success in turning the disease around. ****

    The contradiction to that is unlike flu we can still push this back. We can still significantly slow down this virus. So the word for us is not a problem. ****The issue is what the reaction to the word will be. Will the reaction to the word be, let’s fight? Let’s push? Let’s push this disease back? Or will the reaction to the word be, let’s give up? And for me, I’m not worried about the word. I’m more concerned about what the world’s reaction will be to that word. Will we use it as a call to action? Will we use it to fight? Or will we use that word to give up? *****
    ___________________
    We have several countries now who have demonstrated the ability to turn the tide, to reduce transmission in countries and to bring these outbreaks under control. Korea is a good example. I’ve seen first-hand the approach that the Republic of Korea can take in terms of really aggressive case and contact finding. What we’re seeing that is successful are the fundamentals of public health. There’s nothing special, nothing unique to this; it’s just the rigorous application of public health measures which include activating your emergency mechanisms, taking this seriously from the start.
    …………
    Why do we say containment works? One, a good number of countries – around eight – have actually not reported cases in the past two weeks, more than two weeks, although they had cases before that they have reported and then they were able to contain it, but in addition to that, if you see what’s happening in China, it shows from the result so far that this outbreak can actually be contained even where there are many cases. So it would be safe to assume that, especially in countries where they have less number of cases, it’s even more possible to contain it.
    ………….
    What everyone expects is that you go from cases, you go to clusters, you go to communities, and that’s it. What we are actually seeing is that we’re seeing community transmission in some countries actually bring this back down to seeing clusters again and that is something that we need to learn from, and we are learning from. That is the hope. That is where we can see that you can drive this down. You can bring it back.
    _________________________
    And I think it’s very important when we make the sometimes brutal calculations of herd immunity and delaying of spread and achieving herd immunity, and how maybe we should let the wave pass over us and then more people will be immune, and this will all go away, that there are many vulnerable people in our communities for this still will not go way. And turning to face that fire is very important. Our elderly, our people with underlying conditions, people with cancer on chemotherapy and others, are precious members of our society, and the arithmetic of epidemiology, as I said, for me, in epidemiology we talk about the n, the size of the population we’re dealing with. We often say the n is the population of the country or the population of the world. So is n 7.8 billion? Well, for me, as a medical professional, n equals one. Every person matters.

    I think this particular issue, especially about our senior citizens or the elderly is very, very important. 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. And Mike has said it. 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.

    ___________________

    Feb 25 Bruce Aylward https://www.who.int/docs/default-source/coronaviruse/who-audio-emergencies-coronavirus-press-conference-aylwardb-25feb2020-final.pdf?sfvrsn=9d732ce3_0

    FEB 25 Press conference (Bruce Aylward)

    The world needs the experience and materials of China to be successful in battling this coronavirus disease. China has the most experience in the world with this disease, and it’s the only country to have turned around serious large-scale outbreaks. But if countries create barriers between themselves and China in terms of travel or trade, it is only going to compromise everyone’s ability to get this done. And those kinds of measures need to be anything that goes beyond what’s been recommended by the IHR committee, has got to be reassessed, because the risk from China is dropping, and what China has to add to the global response is rapidly rising

    There’s really important lesson about speed here and the aggressiveness of these. These are not control measures that people know how to do anymore. They don’t do case finding or contact tracing, except for Ebola in West Africa or in DR Congo. This is old fashioned stuff using really modern tools like these to try and that’s what China did.

    Teams in Congo were chasing 25,000 contacts a day in the middle of a shooting war and doing it every day under fire and they did it so I think we need to reach a bit further into how far can public health measures be used, how far can we push contact tracing and case finding and quarantine of contacts because countries like Korea, countries like Singapore and countries like China have shown that sticking harder to that strategy has resulted in benefits.  
    ………
      We’ve seen some countries use technology to help them with contact tracing. There are a lot of tools that are out there. It’s not a matter of tools; it’s a matter of will. It’s a matter of, how do we use our best efforts to drive this down. There’s no excuse to say that we cannot do this. We have shown in many countries… Not we. Countries themselves have shown that they are able to do this and we must push countries, all of us, to fight as hard as they can to suppress this virus because by doing so you are saving lives, by doing so you are buying more time for your hospitals to prepare.   
    ……..
    Someone asked it here earlier; how can we continue to invest in the very expensive business of contact tracing? Contact tracing is not an expensive business, contact tracing is a very basic public health intervention. It does involve interrupting the lives of a small proportion of the population in terms of quarantine, of contacts, isolation of cases and that’s very tough on those individual families. 
    …….
    For contact tracing you don’t need a trained medical professional. You can accelerate and amplify the number of contact tracers almost instantly using other civil servants, using volunteers, using community organisations. 

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  4. Chris Whitty, March 20 2020

    On March 20 last year Chris Whitty  spoke to journalists and at one point made it clear that he was against trying to stamp out community transmission. What he said (see quote below) is a bit garbled – maybe because he was speaking off the top of his head . He didn’t even attempt to give a coherent explanation for his position, he just asserted it. Perhaps he wasn’t clear in his own mind.   (He and Vallance had been pushing the herd immunity position less than a week earlier )

     “it is my judgement that the idea that we’re going to make this virus go away whilst not theoretically impossible, seems so improbable that basing scientific (sic) evidence on the theory that that is something we’re trying to do seems to me a mistake. The reason I say that is if what you’re trying to do is get rid of an epidemic completely, the most important thing you do in public health terms is you try and find all the cases, isolate all the cases, lock it down, or play for time till you’ve got a vaccine. There are a variety of other things you can do, but there’s one set of strategies you follow – based on the principle that actually  we  want this epidemic to go away. So for example the stuff that we’ve done in W Africa on Ebola  was predicated on the idea that our aim was to get the epidemic to go away . 

    You do completely different things if what you’re saying is that actually however much we might like that to happen, and however much we would like there to be a vaccine riding to the rescue in 6 months time, currently we think that’s improbable so now we’ve got to work on a different theoretical framework for actually managing this epidemic.  …… People say why are you not trying to get this virus to go away using the standard methods to do so??   My own view on this is that the science does not support that as the right theoretical framework at this stage of the epidemic. It’s a perfectly reasonable thing to do at the **beginning, and for some countries it may still be the right approach, but I want to be really clear that   in my view we’re probably not quite in the right stage of the outbreak to be debating that.”

    (transcribed from this video:

    ____________________________________________________________________________
    ____________________________________________________________________________

    During January and February 2020, Boris Johnson favored the “Yes Minister Approach”:

    And in September he went for the “Hands, Face, Space Approach” (“Hands, face, space, that’s how we’ll defeat the virus”) This in NOT a spoof!

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