Quick stats update for those who asked…(oops, they’re getting longer, and with more brackets!)…
This will soon be overshadowed by Boris on Sunday 7pm of course. But let’s stay grounded to watch what’s happening between the lines.
What we do with the virus and its data depends on our societal structure and norms. That’s why different countries are dealing with it very differently. Compare the response of South Korea to Sweden to Brazil to Thailand to USA to Vietnam. Countries are following their usual societal assumptions quite predictably – whether they are functional for this situation or not. South Korea had MERS and learned and prepared PPE/test/track/trace/isolate from before Day 1. Vietnam too. It was the best way, but only because their publics also understand the need to play ball and physically distance while working on. And their economies are set up better than ours to do this. This enables the ‘silver bullet’ of slower fatality rate while maintaining some economy. Sadly, we’ll have to wait until the next UK epidemic to be ‘ready next time’. Geography/demography also matters a lot. Low population makes it so much easier to eradicate; so does low population density. New Zealand eradicated it because these numbers are so much in its favour. In Sweden, ‘collective volunteerism’ means no lockdown or new laws. In a nation of 10% of our population, 10% of our population density, and no city over a million (and even that is 14 islands) I support them in that policy. Though their care-home epidemic has been a nasty and shameful surprise to them too, as has ours. UK, Italy, France, Spain, USA – were not at all prepared either physically or psychologically, and UK has the highest population density among these, plus London. We’re not used to this and deep in our collective unconscious is our arrogant Empire past which looks down on the East and its plights as foreign and distant. And we think will-power and grabbing a sword will beat the virus. Futile – the virus is not negotiating. Add Belgium to that list – they fit this group nicely – and actually it’s they who have easily the worst deaths per population on the planet right now. A big job to fix then. In the traditional West the genie is out of the bottle. ‘Twas always going to be the case without a changed mentality. Austerity apart (0.5% of additional GDP in NHS was not enough to make much difference to this situation) I didn’t see ‘PPE’ etc in any Party manifestoes in the last decade. But then it’s not a Donkey Derby. To paraphrase sports talent identification, “In the early days of emergence, current performance is not a good predictor of long-term success”. Let’s see if high-density areas of Asia can keep it down long-term, and which nations deal best with post-lockdown-lite. We are now far enough into this pandemic that UK Ministers are starting to admit they could have done some things differently, while maintaining the overall approach was right. If the UK public are as diverse in view and indisciplined as some think, then without the reality shock of this virus for next time, containment and eradication Asia/Oceania-style was never on the cards here. Therefore blame for lack of containment can’t be laid at the feet of Ministerial decisions, and we go with a hybrid ‘herd’/economy/suppression model. But logistics and production/distribution has been poor despite late scrabbling.
For UK, our relatively democratic ‘first-past-the-post’ Constitutional monarchy has its weaknesses (concentrated privileged power) and many strengths. It’s lasted hundreds of years for many good reasons and to good effect many times in the end. It means we pretty much get the Government we deserve, except it’s normally skewed to the right by the concentrated privileged power bit. And a system creates a culture. The government leads a bit but then has to listen to the electorate and so follows a bit too, or it knows it will get thrown out at next election. Normally we say that’s a good thing. The UK Government didn’t really lock us down. The public did it by consent, even demand, and Government desire was aided by some predictable servile mainstream media messages clearly targeted at us in the right critical periods (eg. lots of disproportionate young dying patients just before lockdown messages etc). That’s OK, to make the point – we’re not stupid. We understand and tolerate the message. That’s not to say there’s not been a bit of new legislation to compel us, but every week we legislate a lot in many areas of life to regulate and steer collective action and societal expectations. It doesn’t make us a police state suddenly, as long as restrictions are lifted later. This is what the libertarians of the right-wing continue to warn about – here and especially in USA. One part of this is it’s hard for digital personal data to be ‘forgotten’ later, I get that.
Current downside: 4-5,000 new cases per day despite lockdown. But with more testing of Mild cases of key workers now, these lead to maybe around 2-300 fatalities per day at end May (unless the virus is self-sustaining within the NHS long-term), not the 600-1,000 we’ve been having in March/April. But it does indicate the virus is waiting to be unleashed again. The 4-step, 4-week-ish time lag from infection to ‘new case’ to hospitalisation to fatality will make any initial de-lock look hugely successful at first. Like any form of complacency, this time-lag is a big danger. Unfortunately this will encourage indisciplined social behaviour in segments of the public, eg young adults with no elderly relatives to care for, or that they care much about. With the now-famous ‘R’ value (reinfection rate) at around 2.5-3.5, a de-lock could put us back to a doubling of cases every three days again and overrun the NHS with thousands of acute hospitalisations per day before we can reverse the de-lock. We have no data to say we are anywhere near ‘herd immunity’ yet. In fact, we have little reliable evidence on anything much yet. Government will still be in chaos mode. Loads of data coming in but lots conflicting. Far too many equations for the constants to put into them. No accuracy on how many people have been infected, how people are catching it, how transmissible it is (the now-famous ‘R’ value) depending on each transmission-reducing measure, how many people are naturally immune, how many people have had the virus, the degree to which infection has led to immunity and for how long, what the fatality rate is, either overall, or for specific demographics. We don’t even know whether different countries are fighting the same mutation and transmission rates. This makes the problem ‘complex’ rather than ‘complicated’ – lots of unknown variables rather than just too many sums to do. Add an unreliable ‘free’ public mood and indiscipline, and this takes it from a ‘complex’ to what’s called a ‘wicked’ problem. Wanna be PM right now with this set of stats?
What will happen next: Boris speaks Sunday 7pm. At PMQs this week in the House of Commons, Boris talked of, “suppress and keep suppressing the virus”, and also, “getting the economy back on its feet”. He made it sound like these horses are reasonable friends, but of course they are galloping in opposite directions. Boris is riding two horses with only one backside. Any PM would have to. And yes, he said these in the same sentence. Luckily Boris is a natural facilitator rather than a conviction politician so he’s good at doing the splits (to a fault). So he’s balancing a trade-off. Last week I said though, that the politicians won’t be able to make any other choice than lockdown-lite for remainder of 2020 with the goal of no less (yes less, not 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. The embarrassment and political exposure of overwhelmed NHS (and with its attendant 5x fatality rate without treatment available) would be unacceptable and it means that a stronger ‘herd immunity’ policy was never planned, countenanced or tolerated in my view. Of course, Boris can’t say all this. You’d tear him apart for approving death. So he’ll waffle with some ‘clarity’ and it will be an implied psychological contract with enough of the electorate realising it’s a balance, to move ahead. Alongside there will be detractors from both wings with good arguments (but insufficient data to guarantee their arguments). Then fatalities go down (due to past lockdown), then people get giddy where offered an inch they take a mile, then new cases goes up, then we get warned about increased lockdown again. Large dangers plus time-lags naturally leads to Yo-Yo effects.
Final thoughts: To those who say the old and sick have had nearly all their life and are expendable, an ethical statistician has to at least countenance the question. What’s the human cost of the opposite? Might be far worse. But just in case you were feeling a bit callous, careless or Darwinistic, VE-Day quickly reminds us what we owe the older generation. Everything. And an Actuarial society estimates the average fatality had 5 years’ life left. It’s both a practical and a values-based question. The irony of BBC revelling in covering VE street celebrations yesterday with clear social distancing breaches, and the hypocrisy of younger people partying closely while supposedly out respecting our ageing war heroes, just left me cold. You? Slightly less seriously, having bought the Genesis concert tickets for December, Phil Collins, Tony B and Mike R had better put on 15 extra concerts in December to allow all the fans to see Genesis live but with a coffee table between each attendee. Hope all this helps as you track Boris next week. Stay lucky.