Quick?! stats update for those who asked…
Hi again. In the last post, before the Prime Minister’s de-lock statement last Sunday 7pm, we said, “So he’ll waffle with some ‘clarity’ – it will be an implied psychological contract with enough of the electorate realising it’s a balance, to move ahead”. That seems to be about right. ‘Stay Alert’ and ‘Control the Virus’ were the new mantras, clearly designed to put the responsibility on the population not the Government. In situations like this a lot of people will freeze or panic and expect government to solve everything on its own. The idea of a couple of dozen Ministers (local elected MPs) running the country top-down, making all decisions brilliantly, is a common fallacy, but ludicrous. It takes tens of thousands of decision-makers (and track and tracers we still don’t have yet) to run a country or a pandemic reduction project. Ministers mainly just set direction. So two goals were activated. 1. Get the focus of responsibility away from Ministers and onto the public’s own behaviour (yes, partly for their own political survival as we move from shock/denial to the anger/blame stage of the change process – some rightly), and 2. ’Alert’ and ‘Control’ are very active words (one quite Brexit-y), designed to get us moving again for fear of a dead economy otherwise.
Industrial Relations: The wording was deliberate again to force people (workers, Unions, employers) to have their own conversations and make their own choices – the government saw this as their optimal choice of communication. So the next two weeks will be messy with industrial relations conversations and the less powerful (as always) pressed into less distanced work. And let’s be clear. If our population were just healthy children and non-vulnerable adults to age 50 we’d just live with COV19 – it’s less troublesome than the flu for them. Ultimately it’s for the over 50s and vulnerable that this whole costly effort is for. Of course, those with vulnerable relatives and friends, and those who value all these lives and more immediately, go more for ‘safety’ than ‘relaxed economy’. I’m among them. We owe the elderly everything and this is a team game. We can’t just dance away and bring infection closer to them, dropping the problem in their laps while there is hope of new treatments, controlled ‘herd’, vaccine, etc before too long.
Individual circumstances apart, there are the usual detractors of government policy from both left and right political wings. The left want more ‘safety’, and the right want more ‘economy’. It’s interesting to see how the left-wingers honestly think the now-famous ‘R’ value is high (because they want to believe in the power of collectivism and it suits their political cause to lock down more and create socialistic solutions) and how the right-wingers honestly think the now-famous ‘R’ value is low (because they focus on so-called individual responsibility and it suits their political cause to open the economy and re-create more individual agency and capitalism). I’m simplifying these political philosophies, but in aggregate I’m fascinated how this a great example of ‘confirmation bias’ at its finest from both sides! This common bias affects our decisions and life chances in many ways, so it’s always good to check our own.
The next concern was for the impact of re-opening more of the economy. We said last week, “The politicians won’t be able to make any other economic choice than lockdown-lite for remainder of 2020 with the goal of no less (yes no less, not no more) than 50-80% of NHS capacity taken up with new cases as we move slowly towards ‘herd’. The remainder of NHS can do some non-Covid work.” Hence the de-lock is to regain some economy and to take up the newly-constructed Nightingale capacity around the country – potentially 10,000+ extra beds, but that stretches our NHS and key workers hugely near this level. There is no doubt in my mind that ‘go back to work’ will inevitably create an increasing rate of new infections (R>1). In my town our biggest manufacturers are now seeing internal outbreaks. Nature, eg ‘herd’ and ‘sunlight’ alone is not nearly enough yet to slow it below R=1. And forget a vaccine for a long time – wishful thinking in the very short term, and remember we still don’t even have one at all for the common cold.
Looking back, new hospitalisations were doubling every 3-4 days until we got to 1,000 fatalities per day (that’s 30,000 per month and rising, if allowed to continue), which was only slowed by 23 March lockdown with a 3-6 week lag. The R-slowing factor now will be millions of individual decisions to ‘Stay Alert’ and just being personally careful, plus the more middle-class ability to do so. I expect it will now become a jungle of virus in the populated indoor or crowd environments out there. And so the risk of bringing the virus home to vulnerable loved ones. With original R=2.5-3.5 (=doubling every 3-4 days) and individual avoidance now bringing new effective R down, by June it may become R=1.5-ish. But no chance of less than R=1 in my view despite the Government’s optimism on this. I hope I’m wrong. So no doubling of new hospitalisations every 3-4 days again, but perhaps a doubling every week or two during June and July. But with a low current base, that buys the Government and statisticians until maybe 31 July to observe and suffer a steep-ish incline in cases, which may well delay further openings of the economy. There are only 24 new cases per day in London now, they say. Sounds like we’ve beaten it? No. With a doubling of infections each week (slower than before) that’s still enough to gradually fill all the Nightingales through July-September once the genie is out of the bottle again.
The good news is that we are ending the chaos period and getting some decent data now – you’ll have seen this with new and more useful charts this week on the Government updates. Also from independent Universities. Better predictive information will come as antibody/serological testing finally becomes reliable. These tests are easy to make but hard to ensure are valid and reliable. As we sample the population with good antibody testing, this will tell us what % of the population has had COV19 and recovered. This provides two important datasets at last: 1. Fatality rate, including fatality rate per demographic segment, and 2. Predictions of how long this pandemic will last before sufficient herd immunity slows it. That will be very useful for all of us to know. But we won’t know for a while how easy it is to catch it twice, and how badly. This is a major question remaining for a while.
So in summary I see an increase in cases and a long and bumpy Summer, but a gradual control of what we’re doing long-term. If you are older or vulnerable, I hope you are one who can choose their level of exposure to any increased infection. Not all will be able to – that’s what the rest of us should help with.