 |
| Out for our 3rd weekly shop. |
• "Covid-19: a deadly wake-up call to exponential growth?"
• "Covid-19 (Part 2) - Daily Updates"
Index:
• 2020-04-18 Sat - Misplaced Animosity
• 2020-04-19 Sun - Divided States
• 2020-04-20 Mon - Food Shortages?
• 2020-04-21 Tue - Through the floor!
• 2020-04-22 Wed - Perspective
• 2020-04-23 Thur - More Science Sumaries
► 2020-04-18 - Misplaced Animosity:
 |
| [Daily Mail] |
That last coming from one of the most caring individuals I know, in response (I believe) to a litany of pictures like this one (right), from the [Daily Mail]. Flattened, zoomed in perspectives making everyone look far closer together. Seemingly just trying to stir up resentment and outrage, for viewership and quite possibly to undermine public solidarity and help usher in crony capitalist friendly authoritarianism (for the papers owners).
Above is closer to the real story of public spaces - drone footage of Birmingham city centre on a sunny Saturday afternoon. It's usually heaving with crowds, but is now deserted! [Twitter Video]It also looks like over 90% of rail travel is gone, 80% of London bus trips and 65% of other road travel too (right). [BBC]
78% of people self isolating, as of the beginning of April [Ipsos MORI]. Pretty impressive adherence to measures (and an unprecedented economic change).
Despite all this, UK public is still being focused on the rare black sheep amongst us, and bad optics in occasional photos and videos. It's our 10'000 year (or so) old memetic predilection for social scandal, coupled with a cognitive incomprehension for relative scale and rarity.
To be fair, police did break up hundreds of house parties in Manchester alone, over the course of 2 weeks [BBC]. But I'd hope that this mostly means there are thousands of citizens even less likely to contravene the new government rules now. Helping to bring down the infection numbers even quicker.
[FT] data shows the same story with UK retail + entertainment activity down 80%, transport down 70%, although a slight uptick in park use compared to a week before. But this still runs at ~30% below winter usage levels, in the middle of the pack of these Western countries [via Twitter]:
In fact, many local authorities have only just reopened their parks, after a couple weeks of closure following the initial lockdown orders [Guardian]. Something I welcome, in the context on ongoing caution. In fact, police and authorities have arguably been overzealous in moving anyone at rest in some parks, failing to give allowance for (invisible) disability, for an example [Twitter].
On a mechanistic side of health, vitamin-D from sun exposure may be significant (disused before, good levels potentially halving infections). Parks are most probably the safest open places to exist outdoors in large cities (better than sometimes crowded pavements). A far higher percentage of urban residents don't have access to their own gardens. (I now I'm very lucky in a nice part of a modest sized town's suburbs.)
The beneficial emotional impact should not be approximated to zero, either, compared to the infection risk. Good spirits raise immunity, and depression can be especially deadly in the context of enforced social isolation. One example on [Twitter] from today. I'm somewhat dreading the stats for this impact, predominantly on young adults (if we ever get anything definitive).
Here's another "Anywhere But Westminster" video from the [Guardian] article linked above which I think does a good job of giving some contextual examples of why the lockdown can be especially hard for some, dependant on public spaces, particularly with kids and with special needs [YouTube] :
• The public are taking the situation so seriously that people are avoiding emergency visits. A&E figures are down ~30% in the UK and far more regular (i.e. non-Covid-19) hospital beds are sitting empty than usual. Alarmingly, cardiac patients are down to half of normal [FT]:
 |
| [Financial Times] |
I also feel there will be a big toll from difficulties in seeing GPs - our surgery converted all existing (and future) visits to telephone appointments, since 16th March. It seems they must then be seeing some patients in person, if necessary, because they are also begging of donations of PPE (masks and gloves). I've not found any aspect of this reported on at a national level, as yet.
• Also from those friends (mentioned above) and others, there's a near universal lack of appetite for scrutinising our government. Not until a potential investigation after the pandemic is over, at least. Which I think is crazy! That there is an emergency is all the more reason for careful scrutiny.
Especially given that gov seems repeatedly to have only to acted after pressure was put on them, publicly. In fact, a cabinet minister has just been reported saying, in the [Telegraph via Twitter]:
“We didn’t want to go down this route in the first place – public and media pressure pushed the lockdown, we went with the science.
“The lockdown will only start coming loose when the public wants it to – not ministers.”
That quote raises some major questions, too, about what gov currently thinks "THE SCIENCE" is...?! Plus, the article spends most of its length quoting officials saying they're waiting for Johnson to return before making any big decisions, e.g. on lifting lockdowns. I think it's a factor that he has so much more public mandate heaped upon him than most PMs (in lieu of any particular policy positions during election, aside from Brexit, etc).
This decision making and accountability deferment is striking, given revelations that Johnson was absent from all 5 Cobra meetings from late February up to the beginning of March [Metro]!
 |
| Johnson famously hid inside a (walk in) fridge to avoid questions during the 2019 election [Reddit]. |
But far from being just a bad month, it seems he's as much a shirker-in-chief as Trump, who has been insistent on prioritising golf breaks. Johnson reportedly avoids chairing meetings, working weekends and doesn't read briefings over 2 pages long, in general.
In fact, one of his first acts after winning the December 2019 election was to disappear for 2 weeks, on a £15k Caribbean holiday controversially gifted to him, supposedly by a Tory donor [Indepenent]. "Where is Borris Johnson" was a cliche back when he was foreign minister, in 2018, when he dodged an awkward vote on Heathrow expansion [HuffingtonPost]. However, tonight #WhereIsBoris seems to be trending largely because of right wing trolls (ironically, or purposefully) jumping in to point out he was in hospital not long back:
Anyway, UK gov press briefings are still carefully filtered, with ministers flat refusing to appear on Channel 4 news for over 8 days (for one example). And there's still no parliament, despite it being our sovereign power, in principle, above the cabinet and executive.
Blind support of our leaders doesn't even make sense in an extreme emergency - during WW2 there was a change in leadership in 1940, with Chamberlain giving way for Churchill, who formed a government of national unity [Wikipedia]. Certainly David Cameron, in opposition during the 2008 Labour management of the financial crash, continued to grill the government [Twitter].
There's also a depressing apathy, amongst friends, that events would have unfolded the same under any party leadership... As if a Corbyn win in 2019 wouldn't have removed the Brexit idolisation obstacle to EU collaboration [TheNewEuropean]. Or a 2017 win wouldn't have reversed the worst of NHS defunding and likely shored up provision of PPE in our national pandemic stockpile, cut by 40% (~£325m) in the last 6 years of Tory rule [Guardian].
• SAGE (Scientific Advisory Group for Emergencies) has been coming under extra pressure to operate more openly [Guardian]. All their published evidence for decision making is well over a month out of date, with no plan to publish until after the pandemic [NewScientist]. While we know a fair amount about the NERVTAG sub-group, members of whom we heard a lot from in this previously discussed [Reuters] investigative piece, we still know less about SPI-M (the modelling group) and SPI-B (the behavioural group) [FT].
Membership is kept mostly secret, with the justification of avoiding "undue influence". I guess there's big potential for problems there, even more than for jury tampering in a high profile legal case. But pillars of real science are the accountability and transparency of scientists, standing up to expose their theories and data to withstand scrutiny.
It's also impossible to have any confidence that these groups definitely have a sufficient range and depth of expertise to draw from, to avoid having big gaps in their thinking (again). Many prominent scientists and experts saying there was far too few public health experts [NewScientist].
 |
| Vallance and Whitty [FT] |
For general reference, there's a great timeline of the decision making (and failures) of the conservative government during this crisis and before (back 4 years), compiled (and updated) by the [Byline Times].
• Chinese manufacturing is scrambling to ramp up production of PPE (personal protect equipment) that western hospitals are crying out for. As shown in this interesting [YouTube] video of a medium sized operation:
They produced ~50% of the worlds face masks before the pandemic and had already increased that number 12 fold as of a month ago [NY Times]. Of course, their initial lockdowns paused much production, and domestic demand was initially consuming much of the increased supply.
 |
| 540,000 face masks from China to U.S. [Xinhua Twitter] |
And Chinese media are putting on a show of helping us out [XinhuaNet], with non-standard equipment shipments published by west facing state news (above right).
 |
| WHO's funding breakdown [BBC]. |
Trump had a fling with with the idea of defunding the WHO, over a week ago, which he backtracked on [Guardian]. Maybe just another random 'trial balloon'. But then circled back to call a halt of funding (while investigating WHO's actions). Something widely condemned as ludicrously dangerous and which no other nations have echoed, thankfully [BBC].
Trump's claiming they've been too biased towards China, helping them (supposedly) cover up the problem. Specifically, he cited WHO initially advising against flight restrictions (a measure Chris Whitty has previously said is damaging far in excess of its usefulness) and declaring no clear evidence for human to human transmission, back on 14th January [Twitter].
A bemused WHO CEO, Dr Michael J. Ryan, explains the timeline of their actions, here in this conference video [Guardian YouTube]:
- Virus announced to world on the 5th January (triggering all country's incident management systems and direct briefing the next day).
- Virus sequence shared on 12th; picking out a cluster of 41 cases of "atypical pneumonia" so early was actually pretty impressive given so many similar cases all over the world constantly.
- Confirming human to human transmission is very tricky because this is often entirely context dependant (e.g. avian flu spreads very poorly or not at all outside of very close quarters contact); but WHO made clear even before the 14th that respiratory precautions needed to be taken.
- They are very keen to see the "after action" reports (which always happens to evaluate such events).
- Flight restrictions are all country's sovereign rights, who only works as a go between to assure other countries that such measures are justified for health reasons (not for purely political reasons, etc).
 |
| [NY Times] |
Peak Prosperity [YouTube] criticises the WHO for failing to declare a "pandemic" explicitly until March 11th, despite reaching "Phase 4" of their own (influenza) pandemic checklist on 24th January and "Phase 5" a week or so after (with sustained human-to-human transmission within multiple countries). This lack of officially declaration explicitly using that magic word (pandemic) does seem like an odd omission. But they were being very specific with good, specific advice for countries, the whole time describing it as a "global emergency".
I'd personally felt they'd probably held off declaring "pandemic" under pressure from US (and UK), who started making their first big move *right* afterwards. Not heard any evidence to that effect though. But the WHO has extremely limited powers, funding and capabilities. It relies on it's members resources and co-operation to get anything done [Wikipedia].
So, yes, it's deferential to China, but in the same vein that it always bends over backwards to avoid criticising any governments. It walks an impossible line, between taking flack for causing unnecessary economic damage by being too alarmist (usually more common), verses under-stating. Which may have been the case here, in not quite screaming bloody murder at the top of its lungs - a more measured use of language.
The key issue in China, early on, was the local suppression of outbreak information by Wuhan’s mayor, Zhou Xianwang, wanting to avoid interrupting major social events. This was brought to a close abruptly by national celebrity epidemiologist, Dr. Zhong, on 20th January, with a national TV announcement of the cover up and declaration condemning any other future attempts to suppress information. Which I'm inclined to believe - its pretty clear China couldn't contain this embarrassment, so worst still to look entirely clueless. The WHO were still not permitted to tour the affected areas for themselves for another 3 weeks, though, which leaves a lot of ambiguity.
But it's more directly to divert attention and hard questions about his very obvious failings, by moving the controversy on to a different set of questions with more ambiguous answers, that is easier for him to defend against [TheAtlantic].
 |
| A Fox reporter on [Twitter] |
The ramping up of rhetoric was accompanied by displays of military power, e.g. lining up all US Airforce B-52 bombers and drones in Guam [Twitter], right.
The situation kind of feels like the US is a (racist) old granddad in a care home, waving a gun about while shouting incoherent nonsense at the 4 staff members busy seeing to his needs.
I'm not seeing this reported anywhere reputable, but the [Daily Mail] claim the show of force is in response to China sailing its first aircraft carrier somewhere near Taiwan, while (as previously mentioned) US aircraft carrier, Theodore Roosevelt, is out of action, at Guam. But we know the Daily Mail has a fanciful imagination [previous blog post].
• More troubling than the WHO distraction, in terms of number of people convinced, is the Chinese cover-up narrative, that they must have had massively more cases and deaths than officially acknowledged [Metro | BBC].
Disbelief that the US (and west) is seeing so many more deaths than China, despite its far bigger population, seems to be bolstering the popularity of this idea. Assumed superiority in all things still taken as a given (wrongly). Witness this tweet with over 100k likes [Twitter]:
Even thinkers who I greatly respect seem to keep getting caught on this mental dissonance. Venkatesh Rao [Twitter1], dividing the national death counts by their total population, which is meaningless, as FT data visualisation artist, John Burn-Murdoch, explains [Twitter] in his recurrent threads tracking the pandemic in (mostly log) graphs: "As I’ve been saying, population does not affect pace of spread. All per-capita figures do is make smaller countries look worse."
 |
| Pure scatter plot, no correlation [John Burn-Murdoch Twitter]. |
More specifically, people [e.g. Venkat on Twitter] are referencing reports claiming Chinese deaths might have been under-reported by a factor of 5-10 times. E.g. US funded [Radio Free Asia] talking about the number of urns used by crematoriums and some running continuously, possibly implying ~46k deaths.
This all seems to stem from this weak Washington University paper from the 18th Feb [SSRN]. Or the same information sources, at least. Namely a quickly censored Tencent post (Chinese social media) report of ~233k cases, which would put the death toll at ~7k with their stated ~3% fatality rate (closer to double official). And some 'back of the envelope', very rough looking calculations taken from reports of crematorium operation, etc, which I think are ridiculously presumptuous.
Even if they were playing catch-up, 24-7, that makes sense if they had been closed for some days (just in terms of the backlog from other deaths). Or if the extra load is all Covid-19 deaths, it's likely that bodies had been stored in freezes for days before hand, then taken care of in bulk, at as few locations as possible (due to contamination risks, etc). Flimsey. Paper [PDF].
• To catch up on some general political developments (during the last week I've missed making updates):
 |
| [FT] |
He's taken pains to avoid sniping at the government's coronavirus response [Mirror], asking how Labour can help the response, but staying coy in terms of courting calls for a national government of unity. Something I think would be as much of a mistake for Labour, as the Lib Dem's 2010 coalition was, in unfairly taring the more progressive party with (most of) the blame.
(2) A leaked internal Labour report (looking at much reported antisemitism) has shown that senior party staff deliberately sabotaged Corbyn in the 2017 general election [Guardian]. It was a narrow loss that Corbyn has also recently said could have been averted but for the (failed) 2016 leadership coup [NewStatesman].
How different recent events might have played out with Labour since 2017...: A properly funded NHS, bigger PPE stockpile, EU cooperation (instead of Brexit BS), more chance of an earlier shut-down (presuming greater concern with human lives than big business). Maybe we'd now have a universal basic income on the way in, like Spain. Although, they would have been fighting a hostile right wing press the whole time. Certainly if they'd only come in as of December 2019, there would be a lot less deferential treatment of the government response.
 |
| [Federalist] |
However, presumptive nominee, Joe Biden (Obama's Vice President), is perceived as not progressive and there's general acrimony. Personally, I'd be feeling a complete loss of motivation to vote, too. So things don't look great for avoiding a second term (or more) of Trump insanity. Sanders has generally argued far better against Trump on stage, Biden a far easier establishment figure to pull down. I think Bidden should make Sanders his running mate, personally. Unprecedented times, unprecedented measures.
► 2020-04-19 - Divided States!
• Meanwhile, in Trumpland... He's wasted no time politicising the lockdowns. 5 days ago, there was the announcement of his "Council to Re-Open America", composed of his family members, close advisers and no a single health expert, scientist or epidemiologist [Twitter]:
He's also wrongly claimed that he has the power to force states to reopen business [Twitter via Vox]. That control officially rests with the governors of each state, who have been (quite sensibly) banding together to co-ordinate easing measures in a sane fashion. Starting with California, 3 west coast states formed a pact [Washington Governor] and a 6 state, then multi-state, East coast council, too [Twitter].
 |
| [GITS Wiki] |
There are chilling science fiction dystopia parallels whenever one starts looking at carving up the US. E.g. Snow Crash, Shadowrun, Gamma World, Judge Dread [Twitter].
Personally I'm most reminded of Ghost in the Shell's "American Empire", etc [GITS Wiki] (right). That fiction is set in the 2040s after a third world war.
I think these groupings are just pertaining to pandemic related public orders. But NY governor Cuomo has previously complained about the insane medical equipment acquisition system (of states bidding against each other, etc), so there may at least be moves to coordinate that better too.
But it's easy to imagine these new regions seeding new formal divisions and alliances in a far more wide reaching sense. Especially as Trump duels with Cuomo and other state authorities [April 13th Variety, 18th Vogue].
It seems like Trump is trying to take personal (and familial) glory, by associating himself with reopening. Trying to be seen to push for it, despite being in charge of the shut-downs himself, officially at least. He may also have some fanciful notion of restoring the (real) economy to its previous health by the time of election voting in November. There's just no way employment can go back to where it was a month ago inside of several years, but maybe if it's trending up well
At any rate, he's also been directly agitating unrest in tweets urging protests in Minnesota, Michigan and "LIBERATE VIRGINIA, and save your great 2nd Amendment." [Guardian]. These were loud, scary, fairly well orchestrated demonstrations, with many participants toting automatic rifles. They've given us this searing image, spawning endless Zombie movie mash-ups (e.g. Shaun of the Dead):
Maybe Trumps tweets are not thought out, just knee-jerk declarations to sound good to his base and rally them. Maybe they are largely petty, vindictive partisanship (all aimed at democratic governors). Maybe even a deliberate ploy to worsen the pandemic's impact in the democratic states he's targeting, as partially indicated by his highly uneven distribution of federal medical equipment. Increasing death and disorder with an aim to decrease trust of democrat voters and stir up motivation of republican voters.Many of the things that interviewed protesters are complaining about are frivolous, like haircuts or seemingly ice cream, from the look of this equally bizarre photo (right). So it's easy to dismiss them as idiots, and those spouting inflexible rhetoric about civil rights and amendments as die hard right wing Trump supporters with an axe to grind (in democrat controlled states, particularly). An excuse to be angry and feel powerful, showing off their big guns, etc...
The situation certainly makes UK seem quaint, right now. We just have the oligarch/press-barons trying to foment the public to loose patience (right). We know that newspaper's ad revenue's dried up at least 50%, so there one extra reason to stir.
Maybe all the US protests are predominantly 'astroturfed' by wealthy employers, claiming that they "want to be able to work again", when what they mean is they want to be able to make their workers earn them money.
But... I feel there is going to be widespread tolerance and even support of such (seemingly insane) protests because of the gaps in financial support for many Americans (see below).
What's perhaps reassuring, in terms of virus spread, is that the vast majority, about 80%, of American's "would wait to resume activities after government lifts coronavirus restrictions" [TheHill via Reddit]. Although, that's as things currently stand, after just a month of restrictions. And it would mean very sluggish return to economic activity, of course.
• Like the response to 2008, the US financial measures are boosting inequality. The government's initial package worked in a $500Bn "slush fund" for the Secretary of the Treasury to distribute to corporations and states with no accountability or oversight, as yet [Time]. Propping up big business and who know what else, on the side.
£250Bn went into the Paycheck Protection Program [Guardian]. Including a $1200 emergency payment to all adults, but that's a one off and won't last people long. Unemployment benefits were also expanded fairly substantially, to pay a little more and include self employed and gig workers. But that won't help those paid in cash, undocumented, homeless or the millions who've not filed their tax returns (recently, as in the UK). While some workers could theoretically receive more unemployment pay than in their work, most will be substantially down, I think.
The $350bn allocation to finance small business loans is failing to be taken up, with insufficient money to pay certain types of employee (e.g. restaurant staff) enough to make it worth their while, and also pay rent on their premises, plus too many strings attached and too much uncertainty about the length of shut-down and the unlikely eventually of business immediately bouncing back at the end [TheAtlantic].
 |
| "When late stage capitalism takes a selfie" [AOC Twitter] |
Admittedly the stock market rallies do come off the back of record breaking drops. But the fundamentals behind this upward movement are not a good look and pretty worrying.
 |
| Stock market climbs back up as unemployment also soars [Peak Prosperity YouTube]. |
• An bastion of sanity, France's President Macron waxes philosophical on the nature of multilateralism, globalisation, inequality, human nature, etc, in the context of current events - (subtitled) FT video [YouTube]:
It seems that he's struggling to convince Germany and Netherlands to allow financial backing of Italy, Spain and Greece, to survive the economic shock. Tensions presumably being much the same as when I looked into the Eurozone problems with Greek bailouts (aka EU debt laundering) in this post [Blogger] starting from Yanis Varoufakis' perspective, that the EU is half finished (monetary union without financial union).
Now Macron's saying the EU project may be over if the nations don't come together and support each other. Authoritarian populists will win if not. But he sounds pretty hopeful, that events are showing us our vulnerabilities, will prompt reassessments, that we'll no longer accept dirty air, etc (in the context of questions about climate change). Kinda wish he was our Prime Minister...
► 2020-04-20 - Food shortages?
• We talked previously about the looming lack of migrant farm workers for picking produce. But there's also been a major shock to meat and dairy supply.
In the US, there have been several major closures of abattoirs/meat packing business due to sick employees, who often have to work physically close to each other, so shortages may be fairly imminent [BusinessInsider].
 |
| [FT] |
Much milk is simply having to be pored away, and (again in the US) talk of flocks of chickens slaughtered without sale, wasted due to staff shortages [Independent].
Closures have hit beef and lamb production awkwardly, with demand for expensive cuts from restaurants gone, but many more wanting supermarket mince meat (i.e. cheaper off-cuts) [Independent]. Impossible to supply without huge wastage and financial loss, or drastic price changes to force demand to re-balance.
From the above linked article, an acclaimed 35% of food (~70M meals per day) usually came from restaurants, caterers and canteens (e.g. at schools). Aside from the odd take-out/home delivery, that's all gone. So for one thing, there's struggles all over the place trying to get potentially wasted food to hungry mouths. Vegetable farmers scratching their heads over what to plant for totally new types of customers and how to distribute it to them. Massive growth potential for veg boxes right now - a tiny green grocer around the corner from us has seized upon this, taking boxes to home isolating retirees (as well as his usual care home supply business).
What's interesting (and a little concerning) to me, is that it looks like there hasn't been a persistent 30% increase in supermarket sales, as yet:
 |
| [BBC] |
In part everyone staying at home may be eating through some of those (predominantly longer life) foods. Maybe a lot of eating out was smaller meals, cheaper to replace. But there still seems like a mismatch in supply/demand, which implies cupboards and freezers may be going bare in a lot of homes. Certainly I've heard of those (permanently) housebound getting pretty desperate, waiting for home delivery slots, their supplies run out. And foodbank use has certainly spiked in some areas [SkyNews]. Although I heard we have a large surplus of stock, locally.
Maybe part of the reduction in home wares, clothes and toiletries, etc, will cover part of this discrepancy in food. In that, expenditure (after lockdown) has stayed roughly normal, but purchases have shifted to a higher percentage of food (as above right graph).
But my local supermarket has seemed less busy than normal on each visit, with half the points of sale closed and shorter opening hours. I don't see how this (apparently) reduced usage can be sustainable. Maybe shopping is more evenly distributed (no quiet times). I don't think home increased deliveries are accounting for enough of the shortfall (and usually those are picked from in-store anyway).
There must be a rise in sales and customers soon, as people realise lockdowns aren't going to end and they're running out of food... That could make it really difficult to maintain distancing in shops if demand rises 30%. Maybe supermarkets will go the other way and extend opening hours again, to spread customers out better.
 |
| [Guardian] |
With 211M citizens, Brazil had only 2000 deaths, as of a few days ago. But could easily loose 1M souls, according to modelling. I'd expect far worst, if that's a naive (full treatment) number and things get out of hand. I guess they may have to test out how well more tropical temperatures slow transmission (if at all), and how much the public can socially distance off their own backs.
• In his press conference yesterday, Trump was certainly pushing a misuse of figures we talked about above - dividing the country's death toll by the total population. Both to minimise the fact that US now has the most deaths in the world and to be able to point at China because that makes it's number look implausible, by comparison. It's not, as discussed. Also, having an epidemic start from a single location is probably cleaner to suppress (if acting decisively) than it being seeded all over at random by travellers flying in, etc.
 |
| [Guardian YouTube] "Look at this misleading chart, it makes no sense!" (To paraphrase.) |
• Overview of the current current global situation: US and UK death rates seem to have finally just passed their (initial) peaks...:
 |
| [FT] |
 |
| [FT] Note: the dip oscillations coincide with weekends, when reporting is lower. |
It could be predominantly that deaths, in lagging infections substantially, are very smeared out. Many taking a long time to become critically ill and then longer still on ventilators, etc.
But maybe my friends were right, in wanting lockdown measure even more strongly enforced, To get infections under control more quickly. There's no sign of those coming down yet, from testing. But obviously that became saturated a good while ago, so it might well be unrepresentative.
Although maybe an ongoing maximally manageable infection & death rate is exactly what some in power want... Michael Gove was reportedly quoted in the Sunday Times saying “we need to run this hot” [FT]. Either brazenly oblivious (quite possible) to the fact that any level of infection/deaths can be sustained for the same imposition of distancing measures, yielding the same R0 transmission value. So an initially low death rate could be kept low for the same amount of 'economic damage' as a high one. It will just take a couple months to bring it down, first. Or he's still stuck on trying for full infection 'herd immunity'...
Either way, it's Gove and Sunak in the cabinet, apparently, pushing to reopen sooner. Unsurprising position for the Chancellor, given he has to keep signing off on more enormous government spending, the longer disruptions continue. While Health secretary Hancock and Cummings want to crush the infection level first. Perhaps the brains behind Johnson is smart enough to see the intrinsic merits of not making a huge percentage of the population seriously ill... Or he's just more savvy, that opinions dead set against infections and likely to crush anyone seen to be pushing the wrong way.
► 2020-04-21 - Through the floor!:
 |
| [Twitter] |
Apparently they refused to acknowledge the issue, then the accounts were bulk deleted. Now the official DHSCgovuk Twitter account is out posting in reply to any share of this post that it is "Disinformation" (below) [Twitter].
 |
| [Twitter] |
And potentially to censor critical social media content calling them out, starting perhaps under the cover of measures to suppress damaging conspiracy theories (e.g. 5G masts). It casts this next in a slightly more sinister light...
• The "Boris missed 5 cobra meetings" story (I posted about above) has actually been making a big splash across all media. Very widely reported (other details summarised, right). Enough that an anonymous "spokesperson" wrote a lengthy rebuttal to the [SundayTimes] article, and published it on the Department of Health website [DHSC].
Some consider this use of this outlet to defending the executive startlingly strange [Carole Cadwalladr Twitter]. Given the above, it made me wonder if this odd departmental use is not just to sheaf the defence of government ministers in a veil of health and science legitimacy, but maybe also if it could aid in censorship. E.g. by enabling government critical content referencing these posts to be removed (automatically) on some platforms...? I think this is overly paranoid, for now.
But all the above calls further into question the kind of communications strategies will be worked on by the election campaign gurus called to No.10 by Cummings [Campaign]. Given the vapid information in press conferences, I feel like it's more likely about spinning damage control to protect government's reputation [Twitter], than to better articulate the reality of the situation to the public.
• It was also just confirmed by Foreign Office’s top civil servant, Sir Simon McDonald, that ministers made a political choice to ignore EU offers for joint procurement, as they were definitely informed and aware of them [TheEuropean | Twitter]. So the "missed emails" revisionism really is a massive, barefaced lie. Arguably government topplingly big, if we run out of PPE in the next few days - it's extremely close, and many NHS staff deaths have already been blamed on rationing its use.
[Update: Sir Simon then retracted this in a written statement [Twitter]. What the actual...?! No way he wasn't pressured into this. Hard to he sure he even signed the document, given how brazen the gov's dishonesty has been.]
This [Guardian] article highlights the Brexit distraction too. And also how Cummings was (known to many) waging a war on civil servants in Whitehall, pushing various ones out (I'd add, including ousting the former chancellor by axing *all* his advisers). Unsurprising that gov were distracted. I could imagine Boris was told he might as take a break while his fixer cleaned house...
• The Excel Centre Nightingale hospital is barely being used, largely a good thing, but also turning away patients due to a lack of ICU nurses [Guardian]. No surprise there (that it's another shiny distraction).
As well as imminent PPE shortages in some regions (with a shipment from Turkey delayed), a number of the muscle relaxant drugs used to sedate patients on ventilators are in short supply. Cisatracurium is days from running out, with no restock scheduled in at all [Channel 4 YouTube].
Rehabilitating ventilated patients is also a major growing issue. They are generally badly deconditioned, with a list of neurological problems and other issues. And this capacity was already badly under-resourced, before this big influx (as is typical for non-acute care, cut back). So boosting ventilator capacity, it seems, was always going to be largely irrelevant.
• Crude oil prices hit negative $37 per barrel! To be more specific, this is for the May futures contracts in the US specifically, for which "at expiration [today], you must take physical delivery of 1,000 barrels of oil at Cushing in Oklahoma" [Twitter].
So with all refineries who are able to physically take delivery currently full up, those traders who only want to own oil on paper are struggling to get rid of that liability (I think). These negative prices account for a very small percentage of the market and the futures contracts for crude another month out are still trading for ~$21. But have also dropping, of course. From [CNBC]:
In early March Saudi Arabia actually increased production, in a power move to pressure other nations [FT]. But just over a week ago, OPEC+ (including the US, currently the worlds biggest oil producer) finally managed to agree record 10% overall reduction [BBC].
But as I mentioned in my previous post [Blogger], overall global oil demand appears to be 25% down (75% on jet fuel). That BBC article estimates fall by about 1/3. So there's still a dramatic over-supply and the agreed reductions only come into effect on the 1st of May.
This is an industry that's been loathed to build significant storage capacity (expensive), previously leading to many hard price spikes when supply is hit, because demand is usually so inflexible. With full tankers unable to unload, I'm not sure where the extracted oil is physically going to go. Extraction operations may not be trivial to turn off (like a tap), so could there be substantial volumes of fuel burned off (or spilled)...? I think just the gas is burned to relieve pressure, normally [Wikipedia].
• Lower electricity demand is anticipated to put a strain on the UK national grid [Guardian]. Of course, many factories, offices, retail, restaurants and hospitality have gone dark. Easter weekend demand, a yearly dip, was even lower than the original forecast of 17.6GW, down to 15.2GW.
This is a potential problem because production must always be managed to balance demand at all times. Excess power leads to rising mains frequency (and grid voltage), as there is less electrical load 'pushing' back against the large generator motors, traditionally linked to steam turbines, with heating from fossil fuels, etc. As an oversimplification. In practice most of our power often comes from non-turbine generators (weather dependant).
Damage to grid equipment (transformers, etc) is entirely possible, or blackouts/brownouts could be triggered, ironically. Large power plants hard to turn off and on - nuclear taking around a day to do so properly. So the onus is usually on renewables (e.g. wind) to stop, as that's physically easier. Purchases from other European countries, via various undersea interconnects, too. Also, (relatively small) pumped hydro electric systems are used to fine tune, storing excess power and releasing it quickly on demand.
But with falling demand comes falling prices, which makes fossil fuel plants uneconomic to run first (you don't want to be burning fuel that cost more than you recoup). Whereas, solar and wind have virtually no production costs, so would be happy to run at any market price, in theory. Which is where the national grid comes along and effectively pays producers to stop.
It's more complex, in practice - the grid is more like an orchestra conductor, contacting generators to tweak output. The coordination of supply is via a complex virtual marketplace for power, where producers bid to supply and face financial penalties for under or over supplying. Prediction of consumption is vital, with long term, day ahead and half hourly time slots resolved.
When short term supply is in excess, there's still a "bid offer acceptance" system, where wind producers offering to cut production get could money reallocate to them for reducing output. But that might be achieved by a pumped hydro system, moving water up their mountain, instead. Depends who's cheapest. Energy supplier companies would take the financial hit for their customers using less than the supplier bought. [Source - a friend involved with grid energy trading.]
The price of electricity production in the UK has typically followed gas wholesale, given that's been the prominent fuel source. Although, it seems the majority of its capacity is only used to compensate for windless days, now. Gas and electric prices had overall been dropping for the last couple of years, from around £60 per Mwh in 2018, down under £30 before the shutdowns this year.
I'm not sure how much natural gas production is tied to operations simultaneously extracting crude oil. Simply burning off gas at oil sites via "routine flaring" has been discouraged/reduced, for obvious environmental reasons [Wikipedia]. So there must be a significant overlap. Which makes me wonder how a crash of oil production will knock onto gas availability and and price. Hopefully not an issue, when power use is down simultaneously.
It surprised me a bit how big a proportion of our power now comes from wind (mostly off-shore, thanks to Tory schemes and a ban of cheaper but ugly on-shore). Although it's been exactly a decade since I blogged speculating about a "green energy bubble" in the decade just gone [Blogger]. I don't think we've had one..? If anything we've just seen an oil price bust, of course. But it's going to be impossible to judge what markets were in a bubble, given the circumstances of everything crashing at once and bailout money everywhere. Also no sure if solar PV is as big as I would have expected (in sunnier countries, anyway). Might have to take a look back into that some time...
At the end of last year, thousands of homes on new smart-energy tariffs were actually paid to use power, one windy night, when wind turbines were producing a record 16GW of power, on their own [Guardian]. A little like the US oil market was paying to offload oil just now. Smart consumption is certainly a promising and potentially important way to help balance diurnal variation in power demand, particularly by tweaking timing of electric vehicle charging (or home power walls, etc). I don't know how that would feed into the main grid markets (mentioned above). Perhaps that complexity has been an obstacle to implementing this with domestic customers, so far.
Anyway, with the UK's now thankfully aborted deadly full infection gambit, that would have meant "energy network contingency plans are likely to be tested to the limit" [Guardian]. Hopefully we don't have to worry about that now (fingers crossed). I'm not sure if power companies are still putting off non-essential maintenance. If so, I hope that doesn't drag on over the whole course of the epidemic suppression, potentially building up dangerous technical arrears.
► 2020-04-22 - Perspective:
• Peter Kolchinsky (biotech investor, virologist and author) has compiled an excellent FAQ super-thread of the (technical) coronavirus topics he's explained for non-experts [Twitter].
- Why we have no vaccine for common cold causing coronaviruses [City-Journal]. They're entirely possible to develope but not economic; coronaviruses only cause ~20% of colds, but you'd need far higher coverage to be able to market to customers. Symptoms too mild to motivate people and headaches with anti-vaxer claims add a burden to anything.
- A Sars-Cov-2 vaccine (and immunity) should last for a fairly long time [City-Journal]. It has a single strand of RNA code, unlike flu viruses which have 8 separate sections (which is rare). Those are able to swap sections with other flu viruses to make totally different species very rapidly. Bad flu years happen when a strong strain picks up an unusual part (e.g. from an animal flu) and the yearly vaccine doesn't protect against it (takes 6 months to reformulate). Both virus types have very slow genetic drift from random individual mutations, but all Sars-Cov-2 (so far) still looks essentially the same to our immune systems.
- Why Sars2 virus is worst than Sars1 (2003) [Twitter thread]. It takes it's time replicating in the upper respiratory tract (e.g. throat), being infectious before causing symptoms. Unlike Sars1, that hit the lungs hard immediately, much more distinctive. 50% of infected develop serum antibodies within 7 days, all within 14 days [Nature].
- Antibodies and antibody tests, false positives and negative [Twitter thread]. Vaccines train the immune system to identify and respond to the real virus by showing it pieces of the virus particle. Characteristic protein structure features identified by (and so stimulating) the immune system are called antigens. Antibodies bind to specific antigens. Antibody tests contain virus antigens (bits of it's key features) stuck to a test plate. Antibodies from patient blood will stick to them after washing away the rest of the serum. A additive then binds to any antibodies remain (should be just ones for Sars2), highlighting them visually.
- Flaws in high asymptomatic prevalence studies [Twitter Thread]. Analogy of a town mayor mistakenly declaring getting shot in the head is far more common than we thinks and hence less deadly. Statistically, a test with (an extremely high) 99% sensitivity will return a negative result for 1 out of 100 infected. A test with 99% specificity with return a positive result in 1 out of 100 uninfected. A huge problem with random sampling population prevalence studies, given that if only 1% actually have it, your results will on average show 2 out of 100 positive results. Massively skewing results, or burying them inside error bars. Some of the tests used in these studies have <90% specificity! Plus other major study design issues. In this Santa Clara study [MedRxiv] they recruited subjects by them volunteering for a free test (going to get more with symptoms), then scaling the very disproportionate subject demographics to match general population.
- Apparent reinfections are probably just testing errors [Twitter Thread]. See above. Also basic testing errors with swab sample collection. Plus the PCR tests can be so sensitive as to detect lingering bits of inactive virus material that that body's not finished cleaning up. Genuine re-infection after just a couple weeks doesn't make sense, because of the fundamental way in which the body revs up antibody production to fight pathogens.
- Is gargling effective to prevent and treat? [Twitter thread] Some studies show, maybe a little bit, although iodine gargling may have increased risk of infection in one study.
- Hydroxychloroqine (HCQ) and other anti-malarials, probably don't work and we should stop testing them [Twitter thread]. Two studies [MedRxiv | MedRxiv] showed it doesn't work (and has dangerous side effects). Chris Martenson [Peak Prosperity YouTube] points out for the continued (5 total) studies with negative findings, that none seem to have used zinc as part of the treatment (which may be essential to HCQ's action and deficient in many people).
- Virus physically enters cells within seconds to minutes [Twitter thread].
- We should permanently stop shaking hands [Twitter thread].
• "Silent Hypoxia" - is how an ER doc in New York is describing the core symptom of Covid-19. That patients can be sat their on the mobile phone with blood oxygen saturation at a terrifyingly low 50%. Breathing doesn't become overly laboured because the lungs are still able to remove CO2 (carbon dioxide) from the body, which is usually the physiological trigger for such things.
His explanation is a burgeoning understanding that the "coronavirus attacks lung cells that make surfactant" that helps alveoli stay open between breaths. Inflammation collapses the 'air sacs' further, worsened by unconsciously more intense breathing. Yet lungs remain "compliant" (not stiff or heavy with lots of fluid), until oxygenation takes a precipitous dive and the condition goes south potentially very rapidly. It's a fairly mundane sounding, simple structural mechanism, no fancy new heme attack mechanism involve or anything.
Because of this scarily stealthy progression, he recommends that anyone with early Covid-19 symptoms should monitor their blood oxygen levels closely. Hospitals are generally accepting patients at less than 92% SpO2. A nice solid, proactive piece of advice that was picked up a couple of places I saw [HealthRising | Twitter]. But given that the cheap consumer devices were already sold out for a month or so, with the remaining listings being overpriced (and potentially dodgy), I wonder if other systems to assess hypoxia (remotely) might be deployable, as in the 2017 paper that links it to voice stress analysis [JASMS].
• The Financial Times has extrapolated ahead using weekly ONS figures for total UK deaths to produce a conservative estimate of 41,102 excess deaths, to date, due to the pandemic [FT]. Plot on the right.
More than double the 17,337 officially confirmed dead from the virus (in hospitals). With the additional deaths split between homes and care homes.
The care home deaths will peak after hospital deaths, as they are largely being seeded by recovering Covid patients being moved out for ongoing care. Where workers are even less well provisioned with PPE and have largely been overlooked by the public focus on NHS.
It's A massive, glaring flaw in our overall pandemic strategy, that makes a mockery of the original notions of "cocooning" the elderly and vulnerable (explained by Valance at the first conference where they were planning a full scale unsuppressed outbreak).
This new analysis validates all the anecdotal reports in this [Channel 4 YouTube] about hidden care home deaths. Apparently GPs so overworked that they sometimes don't even see the deceased before writing death certificates and even when they are pretty sure a death was Covid-19 related they may leave that off the certificate in favour of some generic cause associated with old age. Of course, there's no testing to confirm anyway. Discussion also of the national guideline criterion for deciding who to discount from ICU care (e.g. if too frail):
It's clearly an horrendous position to be in, as a care worker. Knowing that you may be killing those in your care just by looking after them, when unable to access equipment or testing, ti know if you should isolate. And the hopelessness of containing spread, once it's in a home, when the hospitals won't even take the elderly sick.
As of a week ago, there were 25% of care homes (350) in London had officially seen cases in residents [SkyNews]. And Sweden is in a very similar position, where there's anger at lack of protective measures as the virus ravages the vulnerable [Guardian].
An non-predictive look at excess deaths across a 10 countries was published in [TheNewYorkTimes]. Greatly varying levels of extra deaths, with Belgium and Sweden currently show a very small negative number, which may be largely due to greater efforts to include non-hospital deaths in the official figures, but could also mean people aren't avoiding emergency care.
► 2020-04-23 - More Science Summaries:
• Why we should avoid anyone being infected (not just vulnerable):
German doctors found that 6 scuba divers, who each home quarantined with very mild infection symptom, all showed substantial lung damage upon examination [Google Translate Rainews]. It would be very dangerous for them to participate in scuba diving again, because of the effects it has on lungs.
The doctors are extremely dubious that such extreme damage will ever heal. 2 showed substantial decrease in oxygen saturation 2 weeks after, due to lung shunt. For 2, their bronchi behaved like asthmatic's.
• Covid-19 is far from being just a lung disease. Here's an article giving a quick overview highlighting some of the various major organs being attacked in severe Covid-19 cases [AAAS ScienceMag].
A whole system perspective is certainly needed, with the progress of the disease so varied and many hypothesised mechanisms for systemic damage: atypical hypoxia, increased blood coagulation/clotting, treatment drug side effects, or just direct viral attack of the various tissues expressing more ACE2, including parts of the brain. (Brief summaries, right.)
Kidney damage is so prevalent that a shortage of dialysis machines is sometimes more of an issue than ventilators. A Wuhan cohort had 27% kidney failure. Another the 59% had signs of severe damage and those with acute injury more the 5 times more likely to die.
Heart and vasculature may be direction infected, with signs of damage very common and those with high blood pressure and heart conditions the most likely to suffer worst complications and death. Many have drastically higher D-dimer levels, a breakdown product of blood clots, which may cause heart attacks, pulmonary embolism in lungs, or stroke in the brain.
Liver damage, seen from elevated enzymes of about half of some patient studies. Could be largely from treatment drugs.
Diarrhoea common, at least 20% (as mentioned before), with gut very high in ACE2. But this symptom may prevent diagnosis with Covid-19 in many instances.
Major neurological problems (encephalitis, seizures, sympathetic storm, stroke) seen in at least 10%, but may be far high for those unconscious on ventilators. Any of the above systemic issues could cause/contribute to these. The common loss of smell suggests that virus might spread to brain direct through olfactory bulb, then there's ACE2 expressed in the neural cortex and brain stem.
• Focusing on the Brain, this [Wired] article explains 1/3 of all patients (of 200 in Wuhan) had neurological issues. It's important to recognise this, to avoid missed diagnoses. Also to change treatment modalities, given that most drugs don't penetrate the blood brain barrier. But it's hard to tell if neurological symptoms are secondary just to other issues.
Michael VanElzakker, who studies ME/CFS (and PTSD) highlights that in general "Virus' ability to move along nerve tissue is a really underconsidered and important phenomenon" [Twitter]. His hypothesis he's been trying to test, for the cause of ME/CFS, is ongoing vagus nerve viral infection, causing a permanent spurious illness response of the entire body's innate defences.
• WHO warn about disruption to regular immunisation programmes [WHO via Twitter]. While social distancing is almost certainly going to be cutting down on the transmission of many other communicable diseases, this factor could contribute to a resurgence after Covid responses end. Or there could be parallel outbreaks in countries unable to take social distancing measures. Covid outbreak interfering with e.g. suppressing a new Ebola outbreak (hopefully not).
• The Republic of Ireland is acting as a kind of control group for the UK, as it follows WHO advice while the North (part of UK) takes directions from London [IrishTimes via Twitter]. It's not looking good for the North, despite a larger population and very close epidemic starting conditions, the South has only 2/3 the death rate. They had quicker lockdowns, expanded testing provision and persisted with contact tracing.
► Coming up...
• Contact Tracing, privacy and authoritarian over-reach....
• CD147 receptor is a second cell entry mechanism for the virus...
• Some recovered patients lack immunity...
• Treatment, vaccine and testing development...
• Network Theory...
• The "Boris missed 5 cobra meetings" story (I posted about above) has actually been making a big splash across all media. Very widely reported (other details summarised, right). Enough that an anonymous "spokesperson" wrote a lengthy rebuttal to the [SundayTimes] article, and published it on the Department of Health website [DHSC].Some consider this use of this outlet to defending the executive startlingly strange [Carole Cadwalladr Twitter]. Given the above, it made me wonder if this odd departmental use is not just to sheaf the defence of government ministers in a veil of health and science legitimacy, but maybe also if it could aid in censorship. E.g. by enabling government critical content referencing these posts to be removed (automatically) on some platforms...? I think this is overly paranoid, for now.
But all the above calls further into question the kind of communications strategies will be worked on by the election campaign gurus called to No.10 by Cummings [Campaign]. Given the vapid information in press conferences, I feel like it's more likely about spinning damage control to protect government's reputation [Twitter], than to better articulate the reality of the situation to the public.
• It was also just confirmed by Foreign Office’s top civil servant, Sir Simon McDonald, that ministers made a political choice to ignore EU offers for joint procurement, as they were definitely informed and aware of them [TheEuropean | Twitter]. So the "missed emails" revisionism really is a massive, barefaced lie. Arguably government topplingly big, if we run out of PPE in the next few days - it's extremely close, and many NHS staff deaths have already been blamed on rationing its use.
[Update: Sir Simon then retracted this in a written statement [Twitter]. What the actual...?! No way he wasn't pressured into this. Hard to he sure he even signed the document, given how brazen the gov's dishonesty has been.]
This [Guardian] article highlights the Brexit distraction too. And also how Cummings was (known to many) waging a war on civil servants in Whitehall, pushing various ones out (I'd add, including ousting the former chancellor by axing *all* his advisers). Unsurprising that gov were distracted. I could imagine Boris was told he might as take a break while his fixer cleaned house...
 |
| Much satirised ominously dystopian scene at the London Nightingale [Guardian]. |
• The Excel Centre Nightingale hospital is barely being used, largely a good thing, but also turning away patients due to a lack of ICU nurses [Guardian]. No surprise there (that it's another shiny distraction).
As well as imminent PPE shortages in some regions (with a shipment from Turkey delayed), a number of the muscle relaxant drugs used to sedate patients on ventilators are in short supply. Cisatracurium is days from running out, with no restock scheduled in at all [Channel 4 YouTube].
Rehabilitating ventilated patients is also a major growing issue. They are generally badly deconditioned, with a list of neurological problems and other issues. And this capacity was already badly under-resourced, before this big influx (as is typical for non-acute care, cut back). So boosting ventilator capacity, it seems, was always going to be largely irrelevant.
• Crude oil prices hit negative $37 per barrel! To be more specific, this is for the May futures contracts in the US specifically, for which "at expiration [today], you must take physical delivery of 1,000 barrels of oil at Cushing in Oklahoma" [Twitter].
So with all refineries who are able to physically take delivery currently full up, those traders who only want to own oil on paper are struggling to get rid of that liability (I think). These negative prices account for a very small percentage of the market and the futures contracts for crude another month out are still trading for ~$21. But have also dropping, of course. From [CNBC]:
 |
| [CNBC] |
But as I mentioned in my previous post [Blogger], overall global oil demand appears to be 25% down (75% on jet fuel). That BBC article estimates fall by about 1/3. So there's still a dramatic over-supply and the agreed reductions only come into effect on the 1st of May.
This is an industry that's been loathed to build significant storage capacity (expensive), previously leading to many hard price spikes when supply is hit, because demand is usually so inflexible. With full tankers unable to unload, I'm not sure where the extracted oil is physically going to go. Extraction operations may not be trivial to turn off (like a tap), so could there be substantial volumes of fuel burned off (or spilled)...? I think just the gas is burned to relieve pressure, normally [Wikipedia].
• Lower electricity demand is anticipated to put a strain on the UK national grid [Guardian]. Of course, many factories, offices, retail, restaurants and hospitality have gone dark. Easter weekend demand, a yearly dip, was even lower than the original forecast of 17.6GW, down to 15.2GW.
This is a potential problem because production must always be managed to balance demand at all times. Excess power leads to rising mains frequency (and grid voltage), as there is less electrical load 'pushing' back against the large generator motors, traditionally linked to steam turbines, with heating from fossil fuels, etc. As an oversimplification. In practice most of our power often comes from non-turbine generators (weather dependant).
Damage to grid equipment (transformers, etc) is entirely possible, or blackouts/brownouts could be triggered, ironically. Large power plants hard to turn off and on - nuclear taking around a day to do so properly. So the onus is usually on renewables (e.g. wind) to stop, as that's physically easier. Purchases from other European countries, via various undersea interconnects, too. Also, (relatively small) pumped hydro electric systems are used to fine tune, storing excess power and releasing it quickly on demand.
 |
| Total UK energy production on 2020-04-20. [GridWatch] Grey = nuclear, orange = gas turbine, = light blue = wind, yellow = solar (not all used). |
It's more complex, in practice - the grid is more like an orchestra conductor, contacting generators to tweak output. The coordination of supply is via a complex virtual marketplace for power, where producers bid to supply and face financial penalties for under or over supplying. Prediction of consumption is vital, with long term, day ahead and half hourly time slots resolved.
When short term supply is in excess, there's still a "bid offer acceptance" system, where wind producers offering to cut production get could money reallocate to them for reducing output. But that might be achieved by a pumped hydro system, moving water up their mountain, instead. Depends who's cheapest. Energy supplier companies would take the financial hit for their customers using less than the supplier bought. [Source - a friend involved with grid energy trading.]
 |
| [Elexon] 2 to 52 week ahead forecast for demand (top lines) and forecast surplus production (bottom lines). Note the notch in the domed winter peak is the Christmas period, where many businesses usually close. |
 |
| [Nord Pool] grid price data graphed by a friend (£ per Mwh). |
I'm not sure how much natural gas production is tied to operations simultaneously extracting crude oil. Simply burning off gas at oil sites via "routine flaring" has been discouraged/reduced, for obvious environmental reasons [Wikipedia]. So there must be a significant overlap. Which makes me wonder how a crash of oil production will knock onto gas availability and and price. Hopefully not an issue, when power use is down simultaneously.
It surprised me a bit how big a proportion of our power now comes from wind (mostly off-shore, thanks to Tory schemes and a ban of cheaper but ugly on-shore). Although it's been exactly a decade since I blogged speculating about a "green energy bubble" in the decade just gone [Blogger]. I don't think we've had one..? If anything we've just seen an oil price bust, of course. But it's going to be impossible to judge what markets were in a bubble, given the circumstances of everything crashing at once and bailout money everywhere. Also no sure if solar PV is as big as I would have expected (in sunnier countries, anyway). Might have to take a look back into that some time...
At the end of last year, thousands of homes on new smart-energy tariffs were actually paid to use power, one windy night, when wind turbines were producing a record 16GW of power, on their own [Guardian]. A little like the US oil market was paying to offload oil just now. Smart consumption is certainly a promising and potentially important way to help balance diurnal variation in power demand, particularly by tweaking timing of electric vehicle charging (or home power walls, etc). I don't know how that would feed into the main grid markets (mentioned above). Perhaps that complexity has been an obstacle to implementing this with domestic customers, so far.
Anyway, with the UK's now thankfully aborted deadly full infection gambit, that would have meant "energy network contingency plans are likely to be tested to the limit" [Guardian]. Hopefully we don't have to worry about that now (fingers crossed). I'm not sure if power companies are still putting off non-essential maintenance. If so, I hope that doesn't drag on over the whole course of the epidemic suppression, potentially building up dangerous technical arrears.
► 2020-04-22 - Perspective:
• Peter Kolchinsky (biotech investor, virologist and author) has compiled an excellent FAQ super-thread of the (technical) coronavirus topics he's explained for non-experts [Twitter].- Why we have no vaccine for common cold causing coronaviruses [City-Journal]. They're entirely possible to develope but not economic; coronaviruses only cause ~20% of colds, but you'd need far higher coverage to be able to market to customers. Symptoms too mild to motivate people and headaches with anti-vaxer claims add a burden to anything.
- A Sars-Cov-2 vaccine (and immunity) should last for a fairly long time [City-Journal]. It has a single strand of RNA code, unlike flu viruses which have 8 separate sections (which is rare). Those are able to swap sections with other flu viruses to make totally different species very rapidly. Bad flu years happen when a strong strain picks up an unusual part (e.g. from an animal flu) and the yearly vaccine doesn't protect against it (takes 6 months to reformulate). Both virus types have very slow genetic drift from random individual mutations, but all Sars-Cov-2 (so far) still looks essentially the same to our immune systems.
- Why Sars2 virus is worst than Sars1 (2003) [Twitter thread]. It takes it's time replicating in the upper respiratory tract (e.g. throat), being infectious before causing symptoms. Unlike Sars1, that hit the lungs hard immediately, much more distinctive. 50% of infected develop serum antibodies within 7 days, all within 14 days [Nature].
- Antibodies and antibody tests, false positives and negative [Twitter thread]. Vaccines train the immune system to identify and respond to the real virus by showing it pieces of the virus particle. Characteristic protein structure features identified by (and so stimulating) the immune system are called antigens. Antibodies bind to specific antigens. Antibody tests contain virus antigens (bits of it's key features) stuck to a test plate. Antibodies from patient blood will stick to them after washing away the rest of the serum. A additive then binds to any antibodies remain (should be just ones for Sars2), highlighting them visually.
- Flaws in high asymptomatic prevalence studies [Twitter Thread]. Analogy of a town mayor mistakenly declaring getting shot in the head is far more common than we thinks and hence less deadly. Statistically, a test with (an extremely high) 99% sensitivity will return a negative result for 1 out of 100 infected. A test with 99% specificity with return a positive result in 1 out of 100 uninfected. A huge problem with random sampling population prevalence studies, given that if only 1% actually have it, your results will on average show 2 out of 100 positive results. Massively skewing results, or burying them inside error bars. Some of the tests used in these studies have <90% specificity! Plus other major study design issues. In this Santa Clara study [MedRxiv] they recruited subjects by them volunteering for a free test (going to get more with symptoms), then scaling the very disproportionate subject demographics to match general population.
- Apparent reinfections are probably just testing errors [Twitter Thread]. See above. Also basic testing errors with swab sample collection. Plus the PCR tests can be so sensitive as to detect lingering bits of inactive virus material that that body's not finished cleaning up. Genuine re-infection after just a couple weeks doesn't make sense, because of the fundamental way in which the body revs up antibody production to fight pathogens.
- Is gargling effective to prevent and treat? [Twitter thread] Some studies show, maybe a little bit, although iodine gargling may have increased risk of infection in one study.
- Hydroxychloroqine (HCQ) and other anti-malarials, probably don't work and we should stop testing them [Twitter thread]. Two studies [MedRxiv | MedRxiv] showed it doesn't work (and has dangerous side effects). Chris Martenson [Peak Prosperity YouTube] points out for the continued (5 total) studies with negative findings, that none seem to have used zinc as part of the treatment (which may be essential to HCQ's action and deficient in many people).
- Virus physically enters cells within seconds to minutes [Twitter thread].
- We should permanently stop shaking hands [Twitter thread].
 |
| Typical pulse oximeter, usually cheap and reliable, but already on back order or overpriced online. |
His explanation is a burgeoning understanding that the "coronavirus attacks lung cells that make surfactant" that helps alveoli stay open between breaths. Inflammation collapses the 'air sacs' further, worsened by unconsciously more intense breathing. Yet lungs remain "compliant" (not stiff or heavy with lots of fluid), until oxygenation takes a precipitous dive and the condition goes south potentially very rapidly. It's a fairly mundane sounding, simple structural mechanism, no fancy new heme attack mechanism involve or anything.
Because of this scarily stealthy progression, he recommends that anyone with early Covid-19 symptoms should monitor their blood oxygen levels closely. Hospitals are generally accepting patients at less than 92% SpO2. A nice solid, proactive piece of advice that was picked up a couple of places I saw [HealthRising | Twitter]. But given that the cheap consumer devices were already sold out for a month or so, with the remaining listings being overpriced (and potentially dodgy), I wonder if other systems to assess hypoxia (remotely) might be deployable, as in the 2017 paper that links it to voice stress analysis [JASMS].
 |
| [FT] |
More than double the 17,337 officially confirmed dead from the virus (in hospitals). With the additional deaths split between homes and care homes.
 |
| [FT] Total deaths far in excess of average for this time of year. |
It's A massive, glaring flaw in our overall pandemic strategy, that makes a mockery of the original notions of "cocooning" the elderly and vulnerable (explained by Valance at the first conference where they were planning a full scale unsuppressed outbreak).
This new analysis validates all the anecdotal reports in this [Channel 4 YouTube] about hidden care home deaths. Apparently GPs so overworked that they sometimes don't even see the deceased before writing death certificates and even when they are pretty sure a death was Covid-19 related they may leave that off the certificate in favour of some generic cause associated with old age. Of course, there's no testing to confirm anyway. Discussion also of the national guideline criterion for deciding who to discount from ICU care (e.g. if too frail):
It's clearly an horrendous position to be in, as a care worker. Knowing that you may be killing those in your care just by looking after them, when unable to access equipment or testing, ti know if you should isolate. And the hopelessness of containing spread, once it's in a home, when the hospitals won't even take the elderly sick.
As of a week ago, there were 25% of care homes (350) in London had officially seen cases in residents [SkyNews]. And Sweden is in a very similar position, where there's anger at lack of protective measures as the virus ravages the vulnerable [Guardian].
An non-predictive look at excess deaths across a 10 countries was published in [TheNewYorkTimes]. Greatly varying levels of extra deaths, with Belgium and Sweden currently show a very small negative number, which may be largely due to greater efforts to include non-hospital deaths in the official figures, but could also mean people aren't avoiding emergency care.
► 2020-04-23 - More Science Summaries:
• Why we should avoid anyone being infected (not just vulnerable):
 |
| [Rainews] |
The doctors are extremely dubious that such extreme damage will ever heal. 2 showed substantial decrease in oxygen saturation 2 weeks after, due to lung shunt. For 2, their bronchi behaved like asthmatic's.
• Covid-19 is far from being just a lung disease. Here's an article giving a quick overview highlighting some of the various major organs being attacked in severe Covid-19 cases [AAAS ScienceMag].
A whole system perspective is certainly needed, with the progress of the disease so varied and many hypothesised mechanisms for systemic damage: atypical hypoxia, increased blood coagulation/clotting, treatment drug side effects, or just direct viral attack of the various tissues expressing more ACE2, including parts of the brain. (Brief summaries, right.)
 |
| [AAAS ScienceMag] |
Heart and vasculature may be direction infected, with signs of damage very common and those with high blood pressure and heart conditions the most likely to suffer worst complications and death. Many have drastically higher D-dimer levels, a breakdown product of blood clots, which may cause heart attacks, pulmonary embolism in lungs, or stroke in the brain.
Liver damage, seen from elevated enzymes of about half of some patient studies. Could be largely from treatment drugs.
Diarrhoea common, at least 20% (as mentioned before), with gut very high in ACE2. But this symptom may prevent diagnosis with Covid-19 in many instances.
Major neurological problems (encephalitis, seizures, sympathetic storm, stroke) seen in at least 10%, but may be far high for those unconscious on ventilators. Any of the above systemic issues could cause/contribute to these. The common loss of smell suggests that virus might spread to brain direct through olfactory bulb, then there's ACE2 expressed in the neural cortex and brain stem.
• Focusing on the Brain, this [Wired] article explains 1/3 of all patients (of 200 in Wuhan) had neurological issues. It's important to recognise this, to avoid missed diagnoses. Also to change treatment modalities, given that most drugs don't penetrate the blood brain barrier. But it's hard to tell if neurological symptoms are secondary just to other issues.
Michael VanElzakker, who studies ME/CFS (and PTSD) highlights that in general "Virus' ability to move along nerve tissue is a really underconsidered and important phenomenon" [Twitter]. His hypothesis he's been trying to test, for the cause of ME/CFS, is ongoing vagus nerve viral infection, causing a permanent spurious illness response of the entire body's innate defences.
• WHO warn about disruption to regular immunisation programmes [WHO via Twitter]. While social distancing is almost certainly going to be cutting down on the transmission of many other communicable diseases, this factor could contribute to a resurgence after Covid responses end. Or there could be parallel outbreaks in countries unable to take social distancing measures. Covid outbreak interfering with e.g. suppressing a new Ebola outbreak (hopefully not).
• The Republic of Ireland is acting as a kind of control group for the UK, as it follows WHO advice while the North (part of UK) takes directions from London [IrishTimes via Twitter]. It's not looking good for the North, despite a larger population and very close epidemic starting conditions, the South has only 2/3 the death rate. They had quicker lockdowns, expanded testing provision and persisted with contact tracing.
► Coming up...
• Contact Tracing, privacy and authoritarian over-reach....
• CD147 receptor is a second cell entry mechanism for the virus...
• Some recovered patients lack immunity...
• Treatment, vaccine and testing development...
• Network Theory...
No comments:
Post a Comment
I'm very happy to see comments, but I need to filter out spam. :-)