Coronavirus 5

This is the fifth in my series of short blogs about Covid-19. Maybe read the others first here.

It's three weeks on and much of the uncertainty I wrote about is still there. We still can't be sure whether the outbreak will peter out with only a few thousand deaths or result in a hundred million fatalities. But each day's news shifts the probability a little towards the bad end of the spectrum.

What is clear is that individual behaviour change is sensible and responsible. Let's not think so much about saving our own worthless hides but rather do it to slow the spread to the elderly and those with weaker immune systems. That's the responsible thing.

Mindful of the uncertainties, it's worth assuming that the most likely way to spread the virus is with close contact, touching other people or surfaces recently touched by others and then touching ones mouth, nose or eyes.

So it's time to ditch the embarrassment of breaking social norms and conventions.

When we meet and greet avoid the kisses, hugs and handshakes.
Touch as few public surfaces as possible.
Wash our hands.

Flooding is not a government priority.

Six years ago, in February 2014, I wrote a couple of pieces relating to the floods then affecting particularly the Somerset Levels. At the time the then Prime Minister, David Cameron, standing in a puddle in his wellies, spoke of money not being a barrier and promising sufficient government spending to deal with the issue.

Today government ministers and Environment Officials are again standing in soggy spots wearing wellies assuring the public they are on the case, spending more than ever and planning to spend even more to keep us all dry in our homes.

Nearly £5bn is earmarked to be spent on flood defences in England over the next six years. Compare and contrast with spending on HS2. I'm not saying it is necessarily an either/or question, but when numbers involving billions are concerned it's useful to have some comparisons to get a handle on the magnitudes. (NHS spending is about £130 billion per year.)

The data are here.

Are government priorities correct? How should government compare the misery and economic harm of ordinary folk flooded out of the homes with cutting journey times from London to Birmingham and beyond?

Dealing with uncertainty is a critical feature of our times, but little attention is given to its serious consideration. The Royal Society is addressing this with its conference 'Confronting Radical Uncertainty' in April 2020.

What we can reasonably assume to be certain is that global heating will continue through this century, sailing through the 1.5° and 2°C targets. For the British Isles the consequence will be to increase the frequency of extreme weather events and to increase their severity.

With the current 1°C of warming, we ain't seen nothing yet.

What About the Miners?

I was at a little climate demo in Horncastle yesterday, a bit of joint affair between FridaysForFuture, Extinctinction Rebellion The Labour Party and others, under the banner of Horncastle Climate Action.

I got chatting about future XR actions, particularly at the Pont Valley coal mine in County Durham to somebody carrying a Labour Party placard.

She was, she explained, someone who absolutely understood the climate emergency. But (is it something deeply ingrained in the psyche of Labour members?) she was concerned about the jobs and livelihoods of the coal-miners.

Well, yes, I sympathised, but there will be no jobs and livelihoods for anyone if we don't stop burning the black stuff. Stopping coal mining comes first and then we must address the issue of social justice and the rest that is at the core of Labour's existence.

My conversation should not have stopped there. We should have gone on to discuss the fact that everything has to change. But I'm not sure that some folk, even though they say the 'get' the climate issue, are not ready for this, Everything has to change. It's not just a handful of coal-mining jobs. There are oil workers, gas workers, gas fitters, people who make car engines, car salesmen, aircrew, travel agents... every job in every industry in which fossil carbon is burnt. And that is very nearly every job.

It's not about the miners. Everything has to change.

Coronavirus 4

(Maybe read the previous items in this series on coronavirus first - links on the right.)

Professor Julian Hiscox is Chair in Infection and Global Health at the University of Liverpool, so that's about as expert as they come. He was talking on Radio 4 Today Programme this morning and a 7.56 said this:

"To me this virus is more like a slightly bad strain of influenza virus and between 6000 and 10000 people each year in the UK die of flu depending on the particular flu strain through the flu season and I think if you're worried about something make sure your flu shots are up to date and then worry about this disease afterwards."

There's a fine line between not frightening the horses and being complacently unprepared for a potential disaster, and Professor Hiscox seems to have decided that this is not the moment to point out that 2019-nCoV might be as deadly as the flu pandemic at the end on World War One that killed between 50 and 100 million, between 3 and 6 % of the then global population.

Of course it might not turn out anything like that serious, but the truth is that we don't yet know.

Were we to apply the precautionary principle enthusiastically, we would be making personal preparations now, planning how to avoid infection in our daily lives. Such planning might be a waste of effort or it might ave lives

Meanwhile, the Department of Health and Social Care issued this press release, announcing new regulations to impose restrictions on any individual considered by health professionals to be at risk of spreading the virus.

Health Secretary Matt Hancock said:

I will do everything in my power to keep people in this country safe. We are taking every possible step to control the outbreak of coronavirus.

NHS staff and others will now be supported with additional legal powers to keep people safe across the country. The transmission of coronavirus would constitute a serious threat - so I am taking action to protect the public and isolate those at risk of spreading the virus.

Clinical advice has not changed about the risk to the public, which remains moderate. We are taking a belt and braces approach to all necessary precautions to ensure public safety.

Our infection control procedures are world leading – what I am announcing today further strengthens our response.

The regulations have been put in place to reduce the risk of further human-to-human transmission in this country.So that's all right then.

This is a molecular illustration of a 2019 novel Coronavirus comparative model

Source: Gianluca Tomasello 

Coronavirus 3

9th February 2020

In Part 1 and Part 2 of these little thoughts on 2019-nCoV, I discussed some key issues where the data is still woefully lacking, the case fatality rate and the reproduction number, RO, which tells us how easily the infection spreads.

The outbreak is a live experiment in how humanity deals with the precautionary principle. We still lack the basic information that leads to any certainty between an epidemic that quickly loses its virulence and peters out relatively harmlessly, or one that becomes a global pandemic, infecting a large proportion of the world's population, not ending until most folk have either recovered with their resistance built up or are dead.

It's instructive to consider for a moment the rather different pandemic around the end of the First World War. Between 1917 and 1920 H1N1, known as 'Spanish Flu' infected over a quarter of the world's population. Estimates of fatalities range from 50 to 100 million, some 3 to 6 % of the then population. For background on this start at Wikipedia.

Of course medical science has progressed over the past century. Patient care and treatment of secondary consequences has improved. Some of the already available anti-viral drugs may prove effective against 2019-nCoVn and a vaccine may be developed over the coming month. Or it might not.

The precautionary principle demands, in the face of a potential catastrophe facing a billion people or more, that everything potentially useful be tried to slow and halt any emerging pandemic. Now is perhaps not the moment to worry about the supply chain of parts in the motor manufacturing industry, but rather to ensure that the pharmaceutical industry has all the resources that it can usefully use, that the healthcare systems are as good as they can be and that population are kept informed with the best information available.

Picture Source

Coronavirus 2

8th February 2020

In the previous blog I suggested that a key issue in determining the mortality rate of 2019-nCoV was the lag time between infection and death.  We are not yet sure what it is, but the longer the gap the greater will be the likely mortality rate. And neither do we know the true number of people who have been infected. It is bound to be much higher than recorded but the bigger the number the lower will be the likely mortality rate.

Another key issue is how easily the virus jumps from person to person. In the case of the current outbreak we don't yet have good data on that though it seems to spread more easily than MERS did. The MERS virus seemed to peter out after spreading to several successive people. There's no sign that 2019-nCoV is doing that yet.

The key measure is the reproduction number, RO, the average number of other people that any individual with the virus will infect. We don't yet know what this is, but estimates have put it between about 2 and 4. For an epidemic to stop the RO number needs to be less than 1. The common influenza has an RO just about 1.3 and the value for SARS was 2.

Noting that all data are subject to error, accidental or deliberate, the Woldometer  website  is supplying a constantly updated set of data on the progression of this coronavirus outbreak.

Coronavirus

7th February 2020

When it was first suggested that UK nationals should be flown out of Wuhan, I remarked that it might be better if all international flights were grounded, reducing both the speed of infection spread and our carbon emissions.

There is a key point being missed in the reports about the death of Li Wenliang, the doctor who called, in late December, for greater measures to prevent the infection spreading, and was criticised by his government for his pains.

This report in the Guardian ends thus:

"But in early January he treated a woman with glaucoma without realising she was also a coronavirus patient; he appears to have been infected during the operation."

The time between infection and death in this single case appears to have been around five weeks.

One of the major factors determining whether 2019nCoV peters out relatively harmlessly or becomes a global pandemic that kills ten of millions of people, is the mortality rate. This has not yet been confidently determined. It is likely to be higher if there is a big time-lag between the time of infection and the time of death. If there is a longer time-lag then more of people who have been infected already will succumb and the eventual outcome worldwide looks more grim.

People should know about this sort of stuff.

Picture from Medscape

Here's an interview, from 5th February, with Professor Neil Ferguson of Imperial College, discussing the situation and how we deal with uncertainty when the stakes are so high.