Critique of UK Government’s “herd-immunity” scheme.

The UK government has u-turned on the rules for large gatherings.

We predicted they would u-turn yesterday; but it has happened sooner than I thought. I assumed that the “let everyone get infected in order to build up immunity” strategy would be overturned once the mass casualties started coming in. However it is beginning to fall apart for a different reason (and with hindsight totally predictable). Organisations and individuals – faced with no direction from government – are beginning to take actions into their own hands. People can read what the WHO is saying and see what every other European country is doing. They can also see what is working in China. This is quarantine and self-isolation on a large scale.

So; some sports organisations have voluntarily cancelled events. BUPA and other care homes have banned all external visitors from its care homes.  Some elderly people are reportedly already staying at home and not going out.

It does appear to be a matter of science that “herd immunity” is achieved if 60% of the population get the virus and as a result develop immunity. I can’t follow the maths but this is apparently the figure at which any one person with the virus will infect < one other person. In such a situation there is no epidemic; just isolated cases. As with normal flu. This is confirmed by this scientific paper in The Lancet.

However; the more people take measures on their own initiative to quarantine and “socially distance” themselves the more the government’s lunatic and unscientific plan for 60% of the population to catch the virus unravels. If, as a result of people protecting themselves and their loved ones, only 50% of the population get the virus there will be no herd immunity – and everyone who dies (1% at the most conservative estimate) in achieving 50% infections (approximately 330,000 people) will have been sacrificed in vain. The government’s thinking has not moved on since Ypres.

The whole plan for letting 60% of the population get infected so as to achieve “herd immunity” depended on people not realizing this was happening. This website picked up before the mass media that the government’s strategy appeared to be to allow as many people as possible to get infected, though, it is true, I didn’t work out the reason. (I thought the inaction could be explained fully by not wanting to damage the economy; which is still, obviously, a major driver). This is why the government initially tried in their briefings to hide what they were doing. The line was that “quarantine measures don’t help”. But this was a lie. It isn’t factually true. The actual reason the UK was not implementing quarantine measures and extensive testing, as recommended by WHO, was because there was a secret plan for everyone to catch the virus. According to multiple reports in the media government strategy is being driven a a group within government called the Behavioural Insights Team who use “insights from behaviour psychology” to inform policy. In brief the idea is that you can change behaviour in the population by “nudging” people.  For example; rather than ban sugary drinks for teenagers the idea might be to increase the price e.g via taxation and thus manipulate behaviour in the desired direction. This team really exists, is supported by the UK government, and really informs government policy. However; this manipulation of people’s behaviour works best when people don’t know they are being manipulated. The idea that you could con the entire population into catching coronavirus in order to build (a possibly entirely fictitious) herd immunity was clearly not going to work.

The other main flaw in the lunatic and unscientific plan for everyone to get infected is that the whole idea depends on the assumption for which there is no scientific evidence  that having the virus will confer immunity. If it doesn’t (and this is the case with flu) then, again, the huge sacrifice the government was planning for us will have been in vain.

The current situation then in the UK is that organisations and individuals are beginning to implement autonomously the recommendations of scientists and the WHO. In doing so they are undermining and working against the government’s strategy of letting as many people as possible (including those in the most at-risk groups – see next paragraph) catch it. This means that the situation in the UK right now is a mess. A confused state with no unified strategy. As a result of this abject failure of government many people will needlessly die. The chief culprits appear to be the Prime Minister, Sir Patrick Vallance (Chief Scientist) and Chris Whitty (Chief Medical Officer for England). We would expect a group dedicated to manipulating people for political and economic ends – the ‘Behavioural Insights Team’ -to be ill-equipped to manage a medical emergency so the fault is not so much theirs as that of those who are consulting with them. The Labour Party has failed to provide opposition. The media has come late to the game though they are beginning to at least give airtime to people who are exposing the government’s unscientific strategy; even while, at the same time, the editorial line is still on-message and supportive of the government.

The government advice is apparently that people can still visit care homes for the elderly. [1][2] Staggeringly it appears that the advice is that only people who feel unwell or who show symptoms of coronavirus should be banned from visiting care homes. [3] This is staggering because it appears that the government still hasn’t understood that people can be transmitting coronavirus for 1 – 2 days before they fall ill themselves. (Maybe longer; the authors of the linked paper note that there is not yet enough data to be sure of exactly how long this period of asymptomatic transmission may be). This is really some kind of inexcusable recklessness. Even in the context of the unscientific, lunatic, and now failing, plan for mass infections there would be no reason for this. Are we run by people who secretly want to send as many people needlessly to their deaths as possible? For some sort of kick?

Let’s end with these words of warning from Richard Horton, editor of the leading medical journal The Lancet:

The evidence is clear. We need urgent implementation of social distancing and closure policies. The government is playing roulette with the public. This is a major error.

Just as a footnote and to show some of the  idiotic thinking around this I have just seen this in the Spectator magazine. The author, someone called Ross Clark, is trying to argue that the the government’s strategy is “scientific”. One argument he puts forward is:

But the virus in Italy doesn’t appear to be responding to quarantine zones and – from earlier this week – complete lockdown across the country.

Just to explain to Mr Clark; the quarantine measures take time to take effect. The incubation period for this virus is up to 14 days. (In a few cases longer than 14 days). The full nationwide quarantine has only been in place in Italy for 4 days. It will take time to show an effect. This is why quarantines should be implemented at an early stage in the epidemic. Further; because of an irresponsible leak in the media and the selfish behaviour of individuals the opening hours of the initial regional quarantine  in Lombardy, which was ordered 6 days ago (8/3), were characterised by a large exodus of people who spread themselves – and the virus – all over Italy thus, quite probably, creating multiple nodes of infection. Furthermore; even after 2-3 weeks you could not, scientifically, just say that the number of cases in Italy are still rising and therefore quarantine hasn’t worked. You don’t know to what extent they would have risen without the quarantine. To assess this you need to study details of the infection rates and infection patterns, (and, of course, make a comparison with some kind of control group which was not quarantined if possible). The scientific rationale for quarantines and “social distancing” is that the virus transmits from person to person. If you can reduce the number of people any one person with the virus infects then you can slow the epidemic. Mr Clark obviously does not grasp the science and is in no position to be saying that the UK government’s strategy is scientific.

The editor of The Lancet tweeted:

The UK government—Matt Hancock and Boris Johnson—claim they are following the science. But that is not true.

I would recommend readers to be guided by Richard Horton, FRCP, FMedSci and not by Ross Clark in the Spectator, a magazine for which Boris Johnson was once the editor.

Update – WHO openly criticizes Britain

The WHO has stopped dropping hints about the UK’s unscientific plan for coronavirus and have now openly criticized the country:

World Health Organization spokeswoman Margaret Harris has questioned the UK’s approach to developing “herd immunity” against Covid-19.

Dr Harris told BBC Radio 4’s Today: “We don’t know enough about the science of this virus, it hasn’t been in our population for long enough for us to know what it does in immunological terms.

“Every virus functions differently in your body and stimulates a different immunological profile. We can talk theories, but at the moment we are really facing a situation where we have got to look at action. [3]

Update 2 – considering the argument for ‘do nothing’ because the virus is here to stay

This is a useful article on the New Scientist about the UK’s crackpot “let’s infect everyone scheme”. Notice especially that there have been studies which have confirmed that social distancing worked in Wuhan.

The one voice in the article supportive of the UK government’s strategy is Mark Woolhouse, from Edinburgh University. Mark Woolhouse is a Professor of epidemiology and a specialist in infectious diseases. One wonders if he isn’t one of the people advising the government. The New Scientist describes him as being “broadly supportive of the government’s approach”. [4] Apparently he believes that the virus is here to stay and thus the UK government’s plan is more realistic than the WHO’s. The argument, basically, is that you can’t have complete lockdowns and strong quarantines indefinitely. We have to learn to live with this and so we might as well start now. However, as we discussed above, this view would only be valid if there were no possibility of a vaccine being developed and/or no possibility of a successful treatment being found. But there is a real possibility of a vaccine being found within 12-18 months so it makes complete sense to try to reduce infections now and to do so radically. (There is also some possibility of success with anti-viral drugs in treating covid-19). This is especially the case if, of course it is an if, the virus transmission rate slows of its own accord during the summer. Furthermore, as another author interviewed for the article comments, at least the UK could be protecting the vulnerable; which they are not doing.  Furthermore even if the only goal is to “flatten the curve” (rather than eradicate the virus) so as to give the health service more breathing space then even so much more robust “social distancing” measures are called for. [5] One of the specific problems of covid-19 is that it can present with serious but potentially treatable symptoms and thus a rapid escalation in cases can overwhelm public health facilities. This report in The Independent shows that Italian hospitals are overwhelmed and “hard choices are having to be made”. There is the potential for knock-on effects on other health provision. Note, especially, that the Italian doctor interviewed for The Independent says “No holidays, no restaurant, no schools, no gym. With a few weeks of restrictions, we can save thousands of lives.” Flattening the curve is a valid socio-medical response. It will save lives.

Of course it is true that it will not be possible to maintain the level of lock-down such as we are seeing in Italy indefinitely. Here the experience of China will be extremely interesting; they have, it seems, brought the epidemic under control in Hubei province and Wuhan where news cases in recent days are minimal. It will be instructive to see what happens when they start to reduce restrictions and get people back to work. Woolhouse is right in as much as in the end a balance may have to be found between quarantine measures and just letting the virus wash over the population and and allowing people to (hopefully – there is in fact no guarantee) develop immunity. But that is no reason not to take robust measures to reduce the number of infections in this phase of the epidemic whether this is done in the hope that a vaccine will provide immunity or simply to prevent the NHS becoming overwhelmed. And in any event it is simply scandalous that the government is taking no measures to protect the elderly and vulnerable.

Notes

  1. https://www.theguardian.com/world/2020/mar/13/do-you-know-a-care-home-not-closing-due-to-coronavirus
  2. https://www.theguardian.com/world/2020/mar/13/care-homes-uk-ban-family-visits-stem-spread-coronavirus
  3. https://www.theguardian.com/world/live/2020/mar/14/coronavirus-live-updates-uk-us-australia-italy-europe-school-shutdown-sport-events-cancelled-latest-update-news?page=with:block-5e6c9e8a8f085c6327bbfcb8#block-5e6c9e8a8f085c6327bbfcb8
  4. It is difficult to comment fully on Professor Woolhouse’s views as they are not given in detail in the article. My comments therefore are a general response to this viewpoint rather than a specific rebuttal of Professor Woolhouse.
  5. “I can’t see that any of these measures are going to have a big impact … none of that is really going to affect transmission in the UK” Paul Hunter, Professor of Medicine at the university of East Anglia – https://www.theguardian.com/world/2020/mar/12/coronavirus-as-many-as-10000-in-britain-may-already-have-it-says-pm

 

 

 

 

Author: justinwyllie

EFL Teacher and Photographer