Wednesday, 11 March 2020

Covid-19: a deadly wake-up call to exponential growth?

With wall-to-wall coronovirus news now impossible to miss, I wanted to do a bit of a brain dump of my thoughts on and around this scary issue. For personal catharsis and reference, as much as to inform the few others who might read it. I think this will likely turn out to be the most significant event in my living memory, so far.😨


On the Curve: 

My perspective with this blog was very much underpinned by extropianism and the inevitability of exponential technological advances most famously expounded by Ray Kurzweil. So of course I've often been aware of how typical human thinking and expectations is unable to grasp exponential changes. E.g. how solar PV is due to come from seemingly nowhere to suddenly be providing abundant clean electricity for most of the globe.

I'm wondering if the exponential spread of the Covid-19/SARS-Cov-2 virus will be a turning point in public awareness for the power and immediate relevance of such non-linear growth rates. Certainly the initial spread appeared to follow an exponential curve [YouTube]:



China's figures now claim the rate of infection spread has peaked after their impressively agile response [Twitter thread]. Throwing up entire new hospitals in a couple weeks, switching (free!) healthcare provision and interaction to be more online, bringing in hospital staff from all over and locking down entire regions with high compliance.

It's great news, if accurate, given how much of the world's goods are supplied by China. There was much reporting (in Western media) of initial infection whistle-blowers being silenced/punished for descent against the state, perhaps frustrating potential for early containment (we don't know, and might not). But the virus was recognised pretty early and sequenced in record time. However, the heroic containment efforts [NY Times] may have only bought the rest of the world a few precious weeks to start preparing...


Epidemic Response: 

There's very good reason to be scared for a worst case scenario outbreak in the US, where testing has been abysmally lacking. Tests alone have been costing individuals thousands of dollars out of pocket and there's no protection for many workers to take sick leave (let alone as a precaution). Pretty strong incentives not to act responsibly.

Also, the Trump administration dismantled the pandemic response team, back in 2018, at the time of an Ebola outbreak [Independent, FP]. He put openly anti-science Vice President Pence in charge of the coronavirus response and Trump himself has been lying that the spread has been "stopped" [Independent].

A very similar situation in the UK, where Tory government has been defunding the NHS for a decade, purging international staff and heath workers with Brexit xenophobia and now with an untouchable majority PM Johnson is making terrifying babbling noises about the UK just "taking it on the chin" [Twitter Video] and allowing the infection to spread, effectively... 😱

The WHO's (arguably belated) declaration of a global Covid-19 pandemic, today (2020-03-11) sounds like a direct dig at these attitudes: "we were deeply concerned, both by the alarming spread and severity and by the alarming levels of inaction"! Complacency and lack of fear is arguably more scary than a little panic (although calm assertive action is the call of the day, now).
Whether our sociopathic kakistocrat leaders are just contemptuously uninterested in everyone's welfare, have an insanely myopic focus on short term appearances (e.g. upsetting stock-market/currency values), or are outright being controlled by Putin's Russia, it looks like there will be a deadly muted official outbreak response either side of the Atlantic.

Some modelling the incidence of new cases in the US are expecting the number of infected to double every week (a period somewhere between 5.1 to 8.2 days) [Twitter]. Healthcare failure seems inevitable, with millions simultaneously sick by mid May [Twitter thread]. It will probably look like this [YouTube]:


With no previous exposure to this virus only a lucky few people will be naturally immune, the main limiting factor to the rate of spread will come only when many/most of the population have already been sick and fought off infection. Estimates I've seen of the total number of people to be infected range from 20%-80%. And somewhere between 10%-20% will be severely ill, needing hospital care, lasting a week or two. The nature of exponentials means that, regardless of upper or lower end of this estimate, the time at which we run out of hospital beds only changes by a week or two.

We're just coming out of the end of flu season, in the global north, which helps free up only a small fraction of that needed amount. There'll be major additional staff shortages, due to the sickness itself. Supplies will be exhausted in mere days. We've already seen a general panic run on hand sanitiser create hospital shortages jeopardising vulnerable patients.

In the UK we have only 2.5 hospital beds per 1000 population [Wikipedia]. Under 170k total [statista], after a decade of cuts, with most unsuitable for the necessary care and isolation and almost all of them already occupied anyway. By the peak, we could well be seeing millions more people being infected per week. Even at just 10% needing urgent care, that demand could easily exceed the *total* number of beds we currently have. So the vast majority of the sick seem likely to receive no professional help.

We have to hope that, somehow, the rate of spread is drastically reduced to greatly spread out the peak, like this [via Twitter]:



But that graph's probably no where near to scale for our problem; our surplus NHS healthcare capacity's an impossibly low limbo bar. And it would take very politically uncomfortable measures to delay the peak by mere weeks. Currently we should be watching how effectively Italy copes with it's regional lock-downs, as to how the UK will fair (a few weeks behind). That kind of extreme regional quarantine response may drop the doubling rate of cases down from a week to ~20 days [Twitter speculation], depending on how people within it actually behave.

It looks like South Korea has done an impressive job of curbing their rate of spread, after a scary start [via Twitter], using a sophisticated response with a prodigious testing:

But they are a nation who take their government seriously and have a very well funded healthcare system - 10.9 hospital beds per 1000 population, as a rough indicator. 

Japan has apparently fared even better, truly containing spread right from the start (they have 13.3 beds/1000, the highest in the world). Note this graph has a log scale, so that continuous doubling of cases produces a straight line, and the shallower the line, the longer the period of doubling:

Graphic by John Burn-Murdoch from Twitter, made for this FT article.
Related to this blog's title, he discusses why the log scale is natural for these exponential stats.
Early indications are that US, UK and other EU countries are following Italy (badly affected earlier on), straight up the same doubling rate. This makes drastic widespread lock-downs inevitable here within a couple weeks, or so. Even if these measures are not proscribed from the executive, regional authorities, institutions and event organisers will have to take things into their own hands.

Some sporting events are to take place without spectator crowds present [Independent] and many more should follow. The Olympics this summer may well fall victim. Although, if any country has the capability to pull them off regardless, it looks like Japan could...


'Lies, Damn Lies and Statistics':

However, there were accusations that Japan has been under-testing [Financial Times]. The conspiratorial theory for this is to avoid having to cancel the games, into which a lot has been invested. But fundamentally, the more reliable PCR (DNA sequencing) tech used for the test is highly specialist, from very few lab facilities, with a national capacity around 4000 tests per day. Perhaps justifying why only those who'd been to Wuhan (the epidemic start point in China) were being tested, for quite a while.

The UK has apparently only been testing 1500 people per day, just now pledged to ramp that up 5 fold. Which explains why I've heard several reports of NHS (111 line) disinterest in anyone with symptoms unless they were abroad in an infected area or in direct contact with a confirmed case. And the same thing from the US, with patchy to non-existent testing.

So, it could be that what the suggestively slowing curve of the UK, on the log graph above, is actually just showing the saturation of available testing, rather than a fundamental lowering of transmission rate. Unlike South Korea (and China) where the far more aggressive testing and follow up may be giving a clearer picture.

In Iran, it seems certain that they have been massively under-reporting the number of infected. Some estimate that (from the high number of sick government officials and hospitals declaring that they're full) they may currently have as many as 2 million cases. 15 times more than the officially acknowledged number world wide! [The Atlantic.]

A small upside is that substantial under-reporting of infection cases would mean that mortality rates may be somewhat overestimated, too, given that deaths are harder to miss. But these lag behind infections by a week or two and a lot of other factors are still slotting into place, distorting statistics, with overall case numbers being relatively low, so more uncertain.


Old Nations Hit Hardest?:

In the west, with our feeble healthcare, ageing institutions, anaemic economic capacity and neurotically self-sabotaging politics, I feel like it will take a miracle to avoid a near-worst case scenario.

Just last night we've received SMS messages tell us to avoid going to healthcare services if potentially infected, but I'm not sure this messaging will be all that effective (especially for those of the older generation). Also, how long the "111" phone service will be able to cope with the increased demand.

To give an idea of how poorly provisioned we are, here's a local paper article about how our town of ~70k population is effectively being cut back to just one ambulance! So it looks like when it comes to crunch time, those self-isolating at home are going to need to make their own way to hospital (if they'll even be letting people in).

We'll soon be having to basically cancel all gatherings, across most of the country, for months. In Italy's restricted areas even weddings and funerals are postponed. Certainly sporting events and conventions will be cancelled, schools and universities closed (with some well prepared falling back on distance learning IT solutions).

Talk of 'social distancing' measures seems to be all the rage today. It seems like this individual citizen action will be our best hope for slowing the spread anywhere near enough. In fact, in Hong Kong, it may have been the people (and a medical workers strike) that lead the way (and forced the government's hand) [Twitter discussion].

This would involve strict self-isolation, if potentially ill. But also cutting out all unnecessary social interactions as much as possible. Necessitating an end of 'business as usual' that's permeated Western middle-class life since pretty much the end of WW2. It could be a difficult for many to grasp, a rude awakening.


Boomer Bomb:

This is how the 3% mortality rate (in China) breaks down by age group. Children a generally impervious to the worst complications of infection and working age adults should also expect to be fine, but it's a very different prospect for those of retirement age:

From this Information is beautiful datapack.
As noted, there are compounding lung health problems in China that compound these figures. But also their population demographic bulges a little more with those in middle age, i.e. we have more OAPs.

Also, if/when a country saturates it's hospital capacity, standards of emergency care will plummet. There certainly aren't 10s of thousands of ICU places. Our initially low mortality rates will probably spike alarmingly. Italy's 6.2% is pretty scary. Fingers crossed that's due (at least in part) to widespread detection failure.

Information is beautiful (2020-03-11).
At any rate, it's time to look out for older individuals (and avoid infecting them). Especially those with serious pre-existing health problems, which massively increase risks. It seems likely that our end-of-year TV shows will have long segments commemorating national treasures lost to coronovirus (via pneumonia lung infection, most commonly).


Vaccine?:

There have been a lot of news headlines about (potential) vaccines being found. But these are only 'candidates', at best. Generally the vaccine development process takes years to screen the candidates down, looking at efficacy and side effects, while scaling up to bigger safety trials. Even on an accelerated time line, that could be 18 months [The Atlantic].

But there's likely to be a huge outcry for *something*, once the general populace realises that business as usual is over, here, with people they know ill and dying. So I wonder if there will be political intervention in this process, with (for example) the White House unilaterally ordering use of improperly screened injections.

Maybe we get extremely lucky with the huge parallel global effort researching and working on this problem, and someone comes up with something unprecedented - a medical miracle to kick of Kurzweil's predicted decade of big biotech advances. But the regular human trials necessarily take a long time and a widely used unsafe vaccine might be ineffective and potentially do more harm than good...


Parallel Realities:

I've had a bit of an eye-opening experience, talking with UK based anti-vaxers on Facebook recently, via posts about this from a childhood friend. I'm currently feeling like whatever happens, they will see events very differently. Given that they are currently convinced that all of this is a conspiracy to force dreadful, disease causing infections of Frankenstein crap into everyone and their poor children, continuing an exponential rise in autism. For the profit of pharmaceutical giants and the New World Order to control the population, etc.

A botched coronavirus vaccination program would certainly fuel this thinking, but so would a successful one. And anger at complete failure will likely be mis-directed. Although who knows where exactly, whatever conspiracy meme sounds most compelling. Maybe at the Chinese, if they get off likely compared to us, or at immigrants, if Trump/Johnson govs see fit to use them as scapegoats, somehow.


Cyber-warefare?:

It seems that Russian psy-ops have probably been exploiting fear of virus spread to sow misinformation about it [Guardian]. As always this will be aimed at destabilising US global hegemony (and its allies), but could have further reaching effects.

If the US (and EU) are as badly affected by this outbreak as I expect, I wonder if Putin's oligarchy might take it as an opportunity to commence covert (or overt) cyber attacks against infrastructure. Or opportunistic local military actions (as with seizing Crimea), if NATO country forces are pulled out to assist with domestic disaster relief efforts at home...?

Opposite to the Spanish flu following WWI, could WW3 be preceded by a global outbreak?


Political Impact:

By rights, Trump's anti-science, anti-healthcare incompetence should see him hammered at the ballot box, with many angry over lost loved ones. But with the US presidential election run-up in full swing, I worry if forthcoming event bans/cancellations will impact the democrats more than Trump. None of them are currently hinting at this possibility, with Trump also dependant on big rallies to whip up support.

But the Republican side is going to be fundamentally more united behind their single incumbent candidate, while the Democrats are still in the final round of selecting their ultimate runner. The Democrat vote may be more in need of hyped up public events, to solidify support. Otherwise the (hopefully Sanders) vote may be weakened, as with the split between progressive parties in the UK, which yet again led to a Tory government, despite a majority of progressive voters.

Trump may even use the outbreak to justify delaying the national vote in November, if it suits him. Depending if the course of events and fall-out even vaguely justify that. To be fair, suspending rallies is probably prudent, but I feel like that will come down to a game of political chicken between the 2 parties deciding what's more morally responsible.

Campaigning may move even more online, maybe more vulnerable to the corrupting effect of dark ads. Many more postal votes, too, depending how things are looking, come November.

A ban on large gatherings would naturally stifle large political protests, too.  Handy for our increasingly authoritarian overlords. Perhaps dragged out to dampen descent against a bad Brexit at the end of this year. Although, to be honest, the Tories had no problem ignore past 1M person rallies, back when they had a precarious majority, so no worries now they're untouchable.

Although demonstrations in Hong Kong have already evaporated, quite sensibly [Reuters]. Where people power may have been key to the successful response, so far.


Authoritarianism Boost or Break?:

In Iran, it seems that the fundamental incompetence of the religious (theocratic) authoritarian governance has been laid bear by the crisis, or it will be in time, if/when accurate figures emerge.

But I'm thinking it's not the authoritarianism itself that's the key problem. If we can assume that China is being far more truthful about it's current figures (after a wobbly start with knee-jerk information suppression). It's more about the governments philosophy and policies with regards to science and health policies.

As international warfare has long been a merciless proving ground for nation's technological and industrial prowess, this outbreak might be a similarly brutal test for the vitality of countries, and their grip on reality.


State Collapse:

If we legacy powers in the West fare as bad as I worry, we could be looking at unprecedented failure and even breakdown of some infrastructure, at peak. In our stagnation and slow decline, our nations are like the vulnerable elderly, systems responding too slow and weak to arrest infection.

Many of our essential systems, from power to supermarket inventory, run with wafer thin surplus capacity. Inventory optimised away to maximise profits. I'm hoping that Brexit related warehouse stockpiling (read for no-deal disruption) might buffer national supplies a little against international disruption of our food supply (on which we are totally reliant upon). Even if UK government is lying about Supermarket's preparedness [Independent].

If infection peaks hard and fast, here, the supermarket supply chain workers might well be incapacitated en-mass, preventing even nationally warehoused supplies reaching shelves. And being unable to supply a big uptick in demand for home delivery to the self quarantined. I hear (from others who are chronically ill and dependant on home delivery, that there are fewer slots already.

'Panic buying' (of e.g. toilet roll) has already caused a stir. But actually, on a systematic level, I think this might be a sane and helpful preparation - using household stocks to compensate for a lack of commercial inventory. Although, for those, like me, with special dietary requirements, dependant on fresh veg and meat (in order to function semi-healthily), stockpiling against supply shocks isn't all that feasible.

Even more scary is the prospect for power failures. Local or regional outages, if the minimal technical staff are simultaneously ill and unable to repair failures. Or if supply is impacted through difficulties with fuel supply or problems in the power systems of other European countries, who we buy a substantial amount of power from.

Imagine frozen food stockpiles rotting and IT and communications infrastructure entirely offline. Even if supermarkets weren't in trouble, they sure would be then. During brief power cuts in the past, my Sainsbury's has been unable to sell anything at all.

If food becomes a problem, particularly in certain regions, rioting/looting won't be far behind. And police forces are already understaffed by cuts, so significant amounts off ill will make controlling public order very tough. Things could fall apart fast, compounding problems. Ditto fire service.

Industries dependant on ageing experts, having failed to train/recruit (as was the case for UK nuclear, last I heard) may be hit hard by deaths of predominantly older people. But the direct impact of the viral illness itself shouldn't be underestimated - most would not call full-on flu symptoms as "mild" under any other circumstances. Two weeks of incapacity across a large percent of (a small) workforce could have devastating implications.


Financial Collapse: 

The 2007-2008 crash was due to a global financial blind-spot to systemic risk (with a glut of US sub-prime mortgage defaults as a trigger). A global pandemic disruption could cause an even bigger meltdown, with all economies dropping off simultaneously.

Certainly stock markets have been falling precipitously for a couple of days already [BBC], wiping value off pension funds, etc. A budget airline went bust [The Independent] and I expect we'll see several more go before long, with widespread flight cancellations and (foreign) travel looking very scary.

In the UK, Brexit seems likely to have a devastating economic impact 2-3 times worst than the last crash (thanks to our "Vote Leave" government pushing towards no-deal). So we should expect to be in an economic wasteland, by this time next year (if there's no further emergency delay). With the pound worth very little, everything expensive and unemployment soaring.


Global Inflexion:

The Trump administration seemed like a catalyst for expediting a more rapid decline of US power. I feel that Covid-19 might be seen as a prominent inflexion point in the shift of global power from West to East. With rising Asian powers fit enough to shrug off the impact, while we wheeze and fall down.

I just pray this shift doesn't spark major hot wars. Although it seems likely to exacerbate existing conflicts, and make hellish places worst (Yemen, Syria, Gaza, etc). Perhaps driving further flight of refugees, but with an even tougher clamp down on immigration, given infection fears and political scapegoating.


Genocide?:

During a time of national emergency, with citizens fearful for their own well-being, there'll be even less care and scrutiny of conditions for undesirables. In the BBC's depressing "Years and Years" fictional near-future UK, they were (still) fixated on immigrants, with detention camps deliberately neglected to foster disease (and death).

Dumb as hell, given disease inevitably spreads to the rest of the population. But something we've seen hints of our governments already edging towards - e.g. with this (reversed) attempt to ban posters warning detainees about coronavirus spread [The Daily Beast].

Overcrowded prison populations are also a major issue. Another indication of the severity of problems in Iran - they granted furlough to 70k prisoners, temporarily releasing them [Reuters]. I wonder if prison staff and other shortages will trigger similar measures over here. What knock-on effects that might have, if they have insufficient support, etc.

Or if governments with a tough conservative stance will avoid that and be responsible for an additional humanitarian disaster. Although maybe one that eventually highlights the appalling and worsening conditions...?


Upsides:

• Sustained increase in working from home? In cases where it works out OK, emergency measures may act as a trial. Either breaking through unnecessary workplace dogma, or necessitating investment that wouldn't otherwise have been made. Reduced carbon emissions and traffic congestion. Maybe forcing some of the older generations to pick up video-calling their family or use internet connected media devices for the first time.


• Potentially massive boom for media streaming services, books, games industry and home entertainment electronics, with kids prevented from socialising as much and sporting and entertainment events cancelled, cinemas closed, etc. Plus general computing hardware for home workers if these can be supplied (production capacity got hit early on, in China, etc).


• Governments are all going to have to provide fiscal stimulus to shore up economies. Consumer spending accounts for ~2/3 of economic activity and is slumping drastically with social distancing measures and people generally hunkering down (after the initial supermarket panic buying). So to be most effective it will need to go direct to citizens [CBS news].

Republican/conservatives will be hard pressed to vote against such measures, given the emergency. And this could set a great precedent for more socialist measures, even basic income initiatives, if it's broadly seen to be affordable and effective, with perhaps unexpected bonus effects. Perhaps we'll shake loose the noose of the 'magic money tree' meme.


• Surge in ME/CFS cases bring helpful attention and funding to disease? OK, so a terrible thing directly, but a potential silver for those of us long trapped in this greatly under-acknowledged disease state, with very scant funding. That is, those of us who survive the infection and social instability side effects.

Also, with so many people becoming familiar with the miserable limitation of being isolated at home, sick with maybe unfamiliar fatigue, too, minds may be primed for empathy with those in similar positions on a permanent basis.


• Demographic swing towards more progressive politics, with the deaths being almost entirely older individuals. Certainly morbid, but perhaps this historical notch will be noted as a definitive end of the post-war 'boomer' era. Maybe our housing crisis will be eased noticeably, with 'released' stock. Although (financial) disruption to house building might be more significant. House building maybe a necessary target for government recovery stimulus.


• Strengthened appreciation for science and experts? Super-brain and professional pontificator on all things, Venkatesh Rao [Twitter], see this as "live referendum on the importance of institutional and expert responses in an age that has convinced itself both are irrelevant and have lost all trust and credibility" with even anti-establishment types suddenly singing from the same sheet as the US Centre for Disease Control.

Although, as I say above, I'm dubious about how conspiracy theory believers will perceive events. And wondering if our increasingly fascistic leaders will be able to divert blame and further hate on to minorities and outsiders (through convoluted intimations and insane right wing press headlines, etc). Of course, those countries failing to reacquaint themselves with reality could well be hit even hard in following outbreaks...


• Create an appetite for major change - immediate desire to invest in healthcare and biotech research to avoid repeat scenario. But hopefully more generally, the big lumps of money and dynamic actions being taken will make it obvious that our Governments are capable of doing a lot more, e.g. against climate change, poverty, inequality, etc.


• Other infectious illness (e.g. colds and flu) should be reduced by the distancing, containment and hygiene measures. This might also help alleviate a little healthcare capacity and reduce sickness related absenteeism. But there might well be a resurgence after covid measures have passed, probably in time for a bumper winter flu season. Although maybe populations will take more flu vaccines and some helpful habits will stick around longer.


Future Outbreaks:

There are an unprecedented number of humans alive today, living close together and closely networked with rising international travel. More outbreaks of novel viruses are inevitable.

Even though Covid-19 was probably an accidental trans-species transmission from bats (at a dodgy Chinese food market), there is an increasingly high likelihood of purposefully engineered infections in the future. Given the exponentially increasing capabilities of bio-technology, as it merges with computing, non-state actors, individuals even, may be able to cause devastation.

So here's hoping that this event scares up inspiration for global co-operation and efforts to build rapid response systems for such eventualities. A kind of global immune system, to detect, isolate, slow and treat such infections.


Medical Advice, Supplements:

• Cancel everything, now! [The Atlantic] - It's time for orderly social distancing.

• "Wash your hands thoroughly!" is already a ubiquitous meme. It might have a notable impact on slowing the spread (depending how many take it seriously and execute it appropriately). As simulated in a "2018 citizen science experiment: the BBC Pandemic" [Twitter]:



• Also standard wisdom: basic face masks only help to remind you not to touch your 'face holes' (until after washing hands), or if you put them on a sick person (a little).

[Update 2020-04-02 - it seems the usefulness of basic masks was downplayed in the west, due to low availability. They may in fact be very helpful in preventing spread, especially if enough people use them in public.]

• Those at risk, over 65 or with pre-existing breathing difficulties and other diseases, can get pneumococcal vaccinations, to reduced the likely hood of the deadly secondary chest infections [NHS]. Note: this is only against bacterial infection (and is only 60% effective, at best); Covid-19 causes direct viral pneumonia. But maybe one might have opportunistic infections during incubation treatment, etc.

• For bolstering your health and immune system, get plenty of sleep, avoid psychological stress and intense exercise/exertion, eat well and consider supplementing:

Vitamin D - made by UV-C on skin contact, so generally deficient during winter months in the northern hemisphere. It's essential in all bodily tissues, bolstering immunity. Probably contributes to the timing of the annual winter-spring cold and flu season.

Zinc - only mineral universally acknowledged to be necessary for and boost the adaptive immune response.

Vit C - although *perhaps* more as an anti-viral to be mega-dosed at the onset of flu symptoms - as per Dr Myhill's advice [YouTube].

Also (maybe): Vitamins A, E, B6, probiotic foods with live cultures (e.g. sauerkraut).



+ Addendum - More Thoughts, Ongoing Developments:


► 2020-03-12: This piece, "Bending the Curve", does a much more precise and well laid out job of explaining many of the key points I was grasping at. [LinkedIn]

Another article by them [LinkedIn] does a decent job of putting hard numbers on the lives to be saved, producing this info-graphic that might help motivate people (they're based in America):




2020-03-13 - BoJo finally had his COBRA meeting, holding this press conference afterwards, flanked by two actual health experts and not blathering too badly [YouTube].

I was initially relieved to hear them talking about many of the aspects I'd discussed above, and was even swayed to think they're probably right about not shutting all schools, maybe even about not cancelling major sporting events, or pressing too hard for social distance yet, in general.

Although the wisdom of this fairly soft approach comes down to intrinsically speculative psycho-social modelling (i.e. guess work) about how the population will react, overall. And, with only modest measures, it happens to be more sympathetic to economic interests (typically a Tory focus). Which, to be fair, are already taking a drubbing that could be more acute than the 2007 crash (although hopefully investment and stocks will bounce back afterwards).

They admitted that real infections were probably 10-20 times higher than official case figures (from testing). Up to 10K infected already in the UK. But were insisting that we're over 4 weeks behind Italy - it looks more like 2 weeks, from the above graph, so they must be assuming an even bigger number of unrecorded infection in Italy, I guess.

They were also insisting very precisely on a 1% mortality rate. But didn't split that down by age bracket at all, which would reassure parents of school age kids and make retirees sit up and pay attention, at the least. There was no hint of the very real potential for this figure (10x the rate of regular flu) to rise even higher in the event the health service exceeds capacity.


Their curve flattening graph seemed conveniently optimistic, too, given the very modest delay factor and little explanation of how additional "surge capacity" would be added to the NHS. Indeed, ex-NHS health expert, Prof John Ashton, criticised this Government response heavily, on Question Time (I think) and in this article [Guardian]. Also talking of the huge numbers of serious ill, zero spare capacity, too little action too late, failing to adopt a Hong Kong like community driven response with more transparency, etc.

So overall I still have a sense of growing unease/dread. To top this off, Trump declared a travel ban from EU countries, excepting the UK and Ireland, where he happens to own hotel facilities [Twitter]... So we could be seeing a major influx of international travel over the next few weeks.👀



2020-03-14:

• Labour [BBC] and WHO [BBC] amongst those strongly querying UK Gov's official coronavirus strategy (above). And sporting organisers take it upon themselves to cancel events themselves (RIP my Dad's Wales rugby match), causing the Gov to U-Turn and follow this line too [Guardian].

• New UK legislation being written into law for the end of the month with give government extreme powers (detaining anyone, forcing schools to stay open, etc) for the next 2 years [Telegraph]. Pretty scary when the Government is composed of sociopaths who lied, milked xenophobia and broke the law to win the Brexit vote (and faced no consequences for any of that).

• Similarly, Trump's EU travel ban had clear xenophobic undertones. Some think it's likely he'll give himself emergency powers and abuse them, stirring up hatred to bolster his support base, after he gets his bearings again. Perhaps he'll even refuse to acknowledge the result of a lost election, if this disaster kills his chances of winning [Guardian].

• With the Democrat race down to two candidates, there are calls to shortcut further events and just award it to Joe Biden, is marginally ahead of Sanders for delegate nominations [Twitter]. As with the previous US election, I strongly feel that the party apparatus will be throwing the election straight to Trump if they denying Sanders. His popular movement for addressing inequality is probably necessary for the energy and momentum needed to tip a win. And policies necessary to avoid national calamity from continuing unchecked extreme wealth. But that money influence may well sow things up again, behind the scenes.

• The West (i.e. Europe) is being officially recognised as the new centre of the pandemic, already being more badly affected than the continent of origin [BBC].

• Gordon Brown highlights how the world is so much more disparate (nationalistic and uncooperative) than when he helped co-ordinate the global response to the financial crash [Guardian]. Kinda worrying for the financial fallout. Will a less sophisticated response mean more reliance on 'printing' money? Therefore inflation? Not necessarily a bad thing at all, if somewhat gradual. Wiping value off assets would help re-balance wealth inequality, to an extent (though hit regular pensioners unfairly hard).

• Others also musing on if this outbreak will help reality to reassert itself in public discourse [Guardian].



2020-03-15:

• Ibuprofen *might* worsen the course of the infection, according to French health officials [Guardian | Twitter]. So paracetamol (for fever) might be best for symptom mitigation. (No anti-virus effect.) Although this over-the-counter pain killer is already reported to be in short supply.

France has just closed all schools and banned gatherings of over 100 people, but excepted large (authorised) political protests.

• This TEDx talk [YouTube] seems pretty good, summarising a basic overview of the virus, spread and calling for major investment in world-wide health system to combat the inevitable outbreaks of new virus:

• Brexit will very likely delay the UK receiving a vaccine, with large pharmaceutical companies dealing with EU requirements first [Guardian].

• Private hospitals are offering to 'help' the NHS with covid treatment [Guardian]. Which will mean a large chunk of the Government's extra NHS budget spending going to for-profit organisations, as they will of course have intended. Great PR for rapidly speeding privatisation of healthcare provision, over here.

I wonder how it will go...? Means testing so you *have* to buy healthcare if you can afford it (but get access to nicer facilities). Or just the current optional system, with ever more inaccessible free provision, as with NHS dentists slowly dwindling (we transferred over to private care over a decade back).

• A senior consultant at a leading hospital for respiratory conditions laments that NHS beds are currently 98% filled and no significant actions are being taken to free up and reallocate space, ready and train staff or acquire sufficient equipment and supplies [Guardian]. So it looks very much like we're about to have a worst case scenario in 2 weeks time when we catch up with Italy and can treat almost none of the massive case influx.

• Pre-symptomatic infected may be more contagious that so far appreciated. For some clusters, over 50% of patients were confirmed infected this way [CNN].

• Another example of a confirmed infected patient who recovered and was released testing negative, but then got ill and tested positive again [Reddit]. This doesn't necessarily say anything about lack of immunity, because the tests themselves are so inaccurate (i.e. under 90%) and need to be repeated for a decent certainty level.

• I received an email from Sainsbury's CEO Mike Coupe to reassure shoppers that "if everyone shops normally, there will be enough for everyone." [Evening Standard]. Not sure exactly how reassuring that is, given the "if". But an inside source tells me that their warehouses have plenty of stock, they're just struggling to pick and ship it out to stores fast enough. Hence many of my friends (and news) reporting shelves empty of toilet paper, rice, bread and various other long life food products. With the population quite sensibly stocking up ready for potential self-isolation, etc.

• Dating/hook-up apps are probably not doing enough to warn users about coronavirus infection in that context. And a boom in babies seems likely with so many shut in at home with nowhere to go for weeks/months [Engadget]. Especially given that condoms (predominantly made in China) are already in short supply and many could run out of other birth control measures.

More seriously, STIs and even AIDs may spike, with interruptions in controlling medications.  And we've no idea yet what affect Covid-19 infection will have on pregnancies. Zika virus can infect babies in the womb, causing serious birth defects. Also, maternal and infant infections may cause (or contribute risk of) autism (and maybe ADHD). From the work of Dr Robert Naviaux (proponent of cell danger response being stuck in ME/CFS). So that could spike a few years after covid-19 sweeps through.

• ADHD sub-reddit post "Who else needs to stop hyperfocusing on coronavirus?" [Reddit] Lol! Yes, I'm guilty. It is a pretty serious situation, though.



2020-03-16:

• President (of zero sum thinking) Trump attempted to outshine the awfulness of the outbreak by offering a cash bribe to a German pharmaceutical company for exclusive US access to their potential covid-19 vaccine [BusinessInsider].

• Replacement incubator valve is 3D printed by local company in Italy for ICU in emergency failure situation [Twitter]. Interesting because the manufacturer refused to provide schematics, but he reverse engineered it successfully anyway. What precedents might be set for this type of intellectual property during this crisis, if this kind of situation continues to happen more.

Could additive manufacture turn out to be any use in UK Gov's desperate request to increase our stock of ventilators? [Reuters] Johnson's due to formally ask Rolls-Royce, today, to interrupt their production lines for this. We will likely need an order of magnitude more than the 8000 ventilators in the NHS. But given the specialist nurse needed for each ICU bed, staffing seems like a more inflexible issue.

• Anecdotes like this from around the world, with revellers go out for a last hurrah as social distancing measures are announced all over [Reddit].

A potentially major paradoxical effect, especially if this demographic infection data from South Korea holds true for other countries - a massive 30% of infected in the 20-30 age group [Twitter], which US, UK, etc, don't see because of only testing severe (now only hospitalised) cases, who skew older:


But cinema box-office sales have slumped massively, so that's reassuring, at least [Variety]. If a nail in the coffin for public cinemas, verses rising home media consumption.

• Labour health secretary during 2009 H1N1 Swine Flu pandemic, Andy Burnam, recounts his difficulties with communicating the scary numbers to the commons and public [Twitter]. Our relatively new gov seems to have struggled to the same conclusions, declaring there will now be daily TV briefings [BBC]. Rather than leaking major info anonymously through private messages to favoured high profile reporters [Twitter1Twitter2].

• Journalists finally starting to talk about the magnitude of the Government's numbers, following Public Health England document [Guardian].
- Outbreak may last a whole year (until next spring).
- 80% likely infected (as per original press briefing).
- 15% requiring hospitalisation.
- That's 7.9M! (66M population * 0.8 * 0.15) At about 2 weeks per patient, that would be an *additional* 111M bed-days. When there's only 52M bed-days currently available in total (if all 142k NHS beds are always occupied, which they usually are). But this will not be spread evenly across 12 months, it's going to peak precipitously in a month or two's time!
- Chief medical adviser insists mortality rate will be close to 0.6%, meaning around 320k (additional) deaths. At a higher estimate of 1%, that's 1/2 million. But with additional (specialist!) demand likely to more than double total capacity, even during a spread-out peak, I can't see how we avoid being far closer to all 5% critically ill, with pretty much all in need left to drown in their own fluids at home or in hellish, ill provisioned, improvised isolation wards...

• Certainly some epidemiologists have harsh words for the UK's apparent 'herd immunity' plan [Guardian].

• But some with social psychology insight see that UK plan may well be a more refined strategy than other countries [Twitter thread]. If very risky and heavily reliant on various assumptions, plus politically 'risky' if indeed relying upon using schools as reactor control rods (my analogy), opening/closing to tweak the infection rate (as an initial measure, at least).


2020-03-17:

• I'm wary of people drawing attention to the destructive power of super-spreaders, as with this popular [Twitter / Reddit] post about how a single case in South Korea was responsible for 80% of total infections. It's like that bad, sensationalist coverage of mass shootings, hyping them up to would-be mass murderers. I can see this kind of thing hampering efforts in America, somehow.

• Here comes Trump's hate stirring, already. Seems like he'd start WW3 with China to distract from his rampant domestic failure, here [Twitter].

Scarily, blaming China is a sentiment being echoed by some popular (pseudo-)intellectuals on the right - Matt Riddley broaching that they might pay reparations [Twitter].

• Lot of people dependant on home delivery of essential groceries currently unable to book in slots as demand skyrockets (from people social distancing and probably still stocking up) [Twitter].

• The Twitter community started memeing in earnest to promote and support social distancing (at home). Arnie got cossie with his miniature pet donkeys [Twitter]. Smart one man developer gave away free copies of his indie game to those proving they were taking things seriously, staying home [Twitter].

• This whole ordeal is going to take a whole huge amount of mutual support and coming together online, for us to get through. I'm seeing the mental health toll this is all taking on vulnerable people already. With indications of a general rising in public hostility.

I'm expecting all mental health illnesses will be greatly exacerbated with the stress and gloomy outlook, atop the politically depressing UK situation of more Troy rule and Brexit imminent. It seems likely to put additional stress on the health service, although much provision for support has been cut over the years, so it's likely to spill out more into law and order issues and suicides. People (mostly women) more stuck in domestic violence situations, too.😟

• Yesterday's second UK Gov press conference I found reassuring again, on first reflection, with:
- They're starting daily TV briefing now.
- Case doubling time confirmed to be 5 days - scary fast, but as I'd picked up others had worked out, near the top of this blog post.
- Clarified we appear 3 weeks behind Italy, not 4 as said previously. So we're about 2 weeks, now, from regional lock-downs and triaging ventilators en-mass.
- Starting stronger social distancing measures across the board, with advising pub and venue closures and event cancellations, etc. (Although without a mandate neither customers or business owners can claim refunds or insurance compensation.)
- But they avoided answering a question about the potential scale of additional ventilators they'd urgently requested British firms to whip up for them. Or talk about expanding the tiny ICU ability at all.
- Failed to make clear that they are effectively making a massive shift from a relatively fast but partially mitigated 3-month infection (for herd immunity around the cocooned), to instead effectively fall in line with WHO advice and the rest of the world in taking more extreme measures to fully suppress infection spread...

• This official updated UK infection modelling report [from Imperial College] to Government, was revealed online after the conference [via Buzzfeed, via Twitter]. It gives exactly what I've been after for days, with it's correctly scaled graphs that show the hopeless scale mismatch between ICU availability (8 beds per 100k population, ~6000 total in UK, flexing up from the usual 4200) verses the enormous incoming peak in demand!:



Above: a mitigated epidemic under various social interventions to slightly control rate of spread.

The report notes that ICU surge capability figures were just firmed up. Also data-sets updated with latest Italian figures showed a doubling of ICU demand for Covid treatment, according to Mike Galsworthy's explanation for Government's about turn [Twitter].

Below: transmission rate can probably be brought down below 1:1, allowing the spread to be fully suppressed, provided schools and universities shut or there's substantial social distancing across all ages. Far more comprehensive and problematic, but what all Western countries and now moving into:



Unfortunately, the infection would almost certainly re-peak as soon as these measures are ended, so they'd need to run indefinitely, until an effective cure/treatment is available. Which could look like 18 months to 2 years of this - full social distancing for 2/3rds of the time, resuming once the hospital case load reaches capacity:


• There's all kinds of massive questions hanging over this. I personally think the gov may have anticipated this situation and favoured doubling our national mortality rate (around 610k last year [MacroTrends]), rather than get stuck in a hellish economic limbo.

I don't think this is truly feasible - the social tensions it would create, even if our country's didn't just implode from the death of the hospitality industries, airlines, etc. A real generation war is already taking voice, given that the vast majority of the vulnerable are Boomers and the most badly affected by social restrictions are the younger generations supporting them, stuck in smaller, rented apartments (while Brexiting and failing to take action on climate because of the older vote, etc).

No way I can see half of America having their liberties curtailed like this. Not without an actual full-on war... With all the panic gun buying, it's pretty clear how badly things could go there. Could it seed a civil war, even, under Trump's stirring...?



2020-03-18:

• Online gaming usage is up 75% in the US [Hollywood Reporter], with Blizzard experiencing difficulty logging players in (although that could be partly a DDOS attack).

While Marvel's "Black Widow" blockbuster movie is being pushed back indefinitely [Variety] and "Birds of Prey" is getting an early digital release [Metro]. So the death of cinema and predicted swing to online games/media is already well under way!

• Elon Musk chimed in, proclaiming that Chloroquine might help with Covid-19, talking about how it saved him from Malaria, after an exotic holiday [Business Insider]

Indeed, the UK Gov banned the "parallel export" of this and 2 other drugs (Aluvia and hydroxychloroquine) in anticipation of their usefulness in coronavirus treatment [Pharmaceutical Technology].

• With the hording of facial masks, the top-down messages about their ineffectiveness, though well intended, may have exacerbated the situation. Not fully trusting authority, the populace may have perceived them as trying to manage scarcity, rather than dealing with the reality of the situation. [NY Times] I felt it may have been similar with Sainsbury's reassurances.

• Idris Elba announced [on Twitter] that he'd tested positive, provoking further anger that wealthy individuals with no clear symptoms were able to buy private tests, while front-line medical staff were being denied any [Twitter] (and rationed/refused masks).

• I'd assumed that UK (and US) were just woefully slow at spooling up enough test kits and capability... But there are reports from the manufacturers that NHS is just not ordering any [Wired]. That also talks about the PCR (DNA sequencing) nasal swap test (good accuracy early on) verse antibody test (can tell who's previously been infected).

But chief medical adviser, Chris Witty (also chief medical officer), announced NHS are reserving existing testing to hospitalisations, only. And NHS England developing their own test (that sounds like an anti-body type).



► 2020-03-19: The clamour over UK Government's handling of the situation is ramping up. Of both failing to act quickly and decisively as it could, wasting the bonus time we were gifted, and how uneven and impractical the financial measures are. Plus various other details.

• Chief editor of prestigious The Lancet medical Journal, Richard Horton, heavily criticising PM for wasting the last week (at least), pointing out that the supposed 'change in the science' [Twitter vid] relating to the (higher) number of critical patients requiring ventilators had, in fact, been known here and published for gov to read in January [Twitter, Guardian].

• Some think Gov misunderstood the ITU (itubator) percentage required by critical patients to be 1/2 as much as it was recently clarified to be in Italy [e.g. Mike Galsworth - Twitter]. Which I din't believe could be the whole story; the peak demand of the best case mitigated UK epidemic would still have required 4x our ICU's capacity to ventilate.

The bigger factor seems to me that the number of available ventilators was massively over-reported. E.g. we have Chris Hopson (Cheif Executive of NHS Providers) saying on Newsnight [BBC from 11th March at about 9mins] on ICUs: "So we are talking literally about being able to, I think relatively easily, double capacity that we need. We're now talking actually about, could you increase it 4 fold, 5 fold, 6 fold?"

At best he was glossing over ventilator numbers, as a separate thing to ICU beds. At worst grossly misleading, given it now seems we can field less than 50% additional surge capacity. And are crying out to various UK industries to rush manufacture more ventilators [BBC].

• A 2016 Government run influenza pandemic simulation (named Cygnus), to test the existing Gov plans, resulted in a big virtual death toll, with comments about "inadequate ventilation" [New Statesman]. But no action was taken to improve readiness, of course. Which is why Jeremy Hunt (ex Health Secretary) pandering to the camera interview today was so galling [Twitter].

That NS article also lays out the scale of the problem: 400k-530k patients likely needing ventilation during outbreak, 50% of which during the 3 week peak. With 60k-100k vying  for 5000 ventilators (also used by other patients), clearly most would die. Even if there were bed space in hospitals, which there likely won't be. Dealing with the dead bodies would be a substantial issue in itself, as is happening in Italy, with this convoy of army vehicles transporting them to crematoriums in other regions [Calgary Herald]:


All of these apparent missteps, delay and lukewarm interventions seem odd, given how on-the-ball the Gov scientific advisers are. Like Whitty in this 2018 presentation [YouTube] about various types of epidemic that do and don't threaten the UK. With an Influenza-type viral outbreak being the highest impact *and* most likely danger! (Top right of grid in this lecture slide.):




• Our government seems stuck on less effective financial support for the country, ideologically opposed to paying out-of-work employees an income, as other countries have [New Statesman]. I guess that to conservatives it's an alarmingly slippery slope towards something revolutionary, like Basic Income, that might be hard to put back in the can, once shown to be workable.

Paul Mason [New Statesman] lays out Rishi Sunak's plans (as chancellor) to be too timid and grossly lacking in some areas. Certainly, I don't see how government backed loans are going to be repaid by businesses that had to totally shut up shop for 3 months. Or what renters are supposed to do after the moratorium on evictions ends, when they've burned through any savings to eat (and pitiful state unemployment pay, if they can get it). There's a major financial meltdown coming for UK (and the world). And we've not even reached Brexit, which is ever more certain to be a no-deal, as our PM smirks childishly at any question of potential delay, even while our EU counterpart is taken ill, infected [Independent].

• Schools are definitely closing tomorrow (Friday), for most children, and will be reopened as daycare for essential personnel (medical & social care and supermarket workers, etc). We have 20k army personnel on standby, ready. And (good news, but not for us) China is seeing no new cases, now [Huff Post].

• Finally, but potentially just as terrifying - government was due today to bring into law, via parliament (with minimal oversight and no chance of opposition) a huge boost to its powers, in the name of dealing with this crisis, but extending for 2 years [Twitter].

The referendum campaign team that lied and cheated to swing the Brexit vote, who tried to suspend parliament to evade oversight, who continue to sit on the official Russian election interference report, and are now currently making secretive, halting progress on addressing the outbreak, will, after a decade of Tories centralising police (and other) powers to the executive, be giving themselves the ability to order anyone detained, surveilled, and whatever else in the name of "national security", and a load more powers we don't know about.

Certainly there's been talk (by international health experts) of the need to "contact trace" back through the social interactions of those found to have been infected. And mobile phones (apps) are a great way to do that. But people might (rightly) distrust up front government tracking, like in East Asia, so I expect they'll be working quietly with tech companies to do it via the back door. Then use gagging orders to suppress the ability to disclose exactly what's going on.

I hope this is all overly paranoid, but we really are at the total mercy of whims of a small cabal of sociopaths. And I can't help but think of how much this situation is perfect cover for a full authoritarian power grab/coup. Like, why would they want the virus bogie-man to go away, when it makes all protests trivial to ban. Is this how we get to be one of those disappointingly generic movie dystopias with anonymously gas-masked mooks...?



2020-03-20:

• A Chinese doctor official visiting the crisis area of Italy is of the opinion that there *still* isn't a full and effective lock-down in place [Reddit]: "People don't wear masks, there are still too many people around, public transport is still active and you eat too much in restaurants and hotels."

I don't think there's a realistic chance that Western countries could implement all the measures seen on the ground in China. As in this video by a Japanese man, of an area thousands of miles away from the main outbreak [YouTube]:


We just don't have the social order mentality to fit that. And it's doubtful we could implement the smart phone app tracking procedures, even if there were the political will.

• So it makes an awful kind of sense that our chief scientific Government advisers are openly talking about the impossibility of "put[ting] this virus back to going away completely" or getting a vaccine in 6 months time. Which means we're probably still headed for a terrifying, mitigated 3 month (or so) outbreak. As per Chris Whitty speaking for SAGE at an Academy of Medical Sciences news briefing [YouTube]:


It makes me think that Downing Street, in playing down and avoiding talking about how much of a calamity this will be, are not only trying to maintain public calm and order, but also setting up these science advisers to be sacrificed as scapegoats, once the bodies pile up to the point of doubling our annual mortality rate.

At best, Gov are hoping for the reality of widespread medical emergencies to bring home to the population how serious this is, to get a sufficient number to comply, that we can drop the transmission rate to a sustainable level.

I'd certainly agree that the social distancing measures being implemented have massive downsides (beyond the abstract of economics): Reduced exercise and sunlight exposure, for vitamin D and mood. There's already a huge up-swing in anxiety and depression, no doubt. I've heard of multiple social contacts unable to sleep because of events, which is bad for immunity and so counterproductive. The additional supermarket activity and checking in with family, etc, has probably been a net negative so far, too, in terms of increasing the rate of spread. Hopefully just temporarily, but we're likely to see a painful spike in death rates in a couple weeks, I think.


• State side, Senators have been found out using their situational briefings (back in January) to get ahead on the stock market, dumping millions of dollars worth and buying that might benefit from more distance working [The Daily Beast]. Then turning around and downplaying fears to the public [NY Times]. Some majorly bad conflicts of interest coming to light, with our kleptocrat rulers and their chums. Here's hoping it helps catalyse some meaningful long-term changes.


• What's also scary is that even Elon Musk is now spouting magical thinking [Twitter]. Seemingly imagining that infections in the US are about to plummet because they did and China. And because US is better than China...? No matter that far weaker actions are being taken so far...


• Actual first hand accounts, either side of the Atlantic, are of doctors dropping all appointments, health service phone lines flatly refusing to acknowledge people's severe symptoms and patients surviving through pure luck. E.g. this man driving himself to the ER in a fever delirium and passing out in the parking lot [Twitter]. Note: DON'T TAKE IBUPROFEN! - definite association with far worst viral progression.


• I'm really struggling to see how the situation, with millions of Americans dead, can avoid precipitating military action by the US against China. Trump is continuing to ramp up blame rhetoric against them [YouTube], lining them up in the cross hairs for when the powder keg inevitably explodes...

... Maybe if they can jump in to help manufacture a boat load of extra ventilators, masks and other protective equipment. I don't think they are in a position to demonstrate the effectiveness and safety of a vaccine, even if they miracled on up in a Manhatten Project, it would need our health approval process. So maybe just bribing Trump by booking hotel rooms all over the world for the next year...?



2020-03-21:

• Updated picture of the outbreak across the world [via Twitter]. Italy's death toll surpassed China's total (which seems to be coming to a close, with no new cases) and looks to be on a trajectory for about 4 times more deaths before levelling off. If such is even possible, there. Spain's rate is also scary, as with most other European countries and the US.


• Death statistics are probably more reliable than cases which are massively skewed by the differences in relative frequency of testing. Russia may even be hiding these, given a suspicious uptick in pneumonia deaths [Reuters].

• It looks like the US also ignored a gross failure of preparedness, last year, to deal with a simulated "Crimson Contagion" influenza virus type infection, originating in China [NY Times].

• Pubs were indeed ordered closed on Friday, for the weekend on-wards, thankfully. And chancellor Rishi Sunak [Twitter] has been receiving plaudits from the press (explicitly grooming him for the role of next PM) as he announced further financial support. Now paying 80% wages for employers and boosting statutory sick pay.

• While gladly welcomed by opposition and many on the left, the piecemeal announcements mean self employed and others aren't yet covered. Backbench Tories are pushing for this. And a large number of parliamentarians have officially requested an immediate start to a universal basic income [Independent]! So maybe some miracles will drop out of this catastrophe.

• UK Health minister, Matt Hancock, has been appealing for retired and lapsed nurses and doctors to return to the NHS to help staff the emergency [Twitter]. Given the insanely high exposure risks, there seems likely to be a high mortality rate for those returning beyond retirement age. Very brave and selfless souls.

• As with test kit manufacturers, a British ventilator manufacturer has been reported as saying on BBC News Night that Gov has not made any orders for more units, as yet [Twitter]. Given the publicised desperate outreach for emergency manufacturing, this seems confusing. Have they determined they would take too long, or is are there some crossed wires...?

But given the lack of engagement with EU on the joint procurement scheme that they are offering [Independent], there a definite whiff of bumbling born of political/ideological aversions.

• More damning still are reports from inside of government recounting the turbulent decision making processes that delayed the UK following suit with the stronger suppression strategies being rolled out across Europe [BuzzFeed].

Apparently Vallance and Cummings were on the same page in betting on the advice of a small number of experts, in aiming for a mitigation approach (and seeded rumour of 'herd immunity'). Despite the growing alarm from other of the experts and in contradiction to the WHO advice and the rest of the world's actions.

It makes me wonder how closely Prof Whitty has truly agreed with the direction of government actions, verses how much he's toeing the line and defending for unity of messaging, while carefully explaining and defending.

Also some wanting Johnson to be more explicit and solemn with his warnings, given that many don't appreciate how bad things are about to get...

• This prominent [BBC] article [via Twitter] reads as propaganda pushing towards giving up on suppressing the outbreak, in favour of returning to a modest mitigation to push through quicker! It suggests that many/most who will die are the frail who would have died anyway, ignores the fact that the hypothetical 250k death toll is with *100% treatment rate* (more likely to be closer to 1/4 currently), and again trumpets the potential to boost ICU capacity (which I think is already considered in Imperial's, worrying low, surge capacity number)... 😲


Certainly the shut-down measures are going to be hard to bear, as a nation and individually. Continual assessment of the negative impacts of these measures should be made and balance actions as impartially as possible. But this sure feels like an exercise aimed to start nudging the public towards opportunistic eugenics, via discontent, complacency and a tragic calamity.



2020-03-22 - Some good news on Mother's day (some not so good):

• Steam (PC game ecosystem) has also been seeing soaring numbers [Reddit], breaking it's record for concurrent users by a million day on day (20M, 21M, 22M...).

• The Folding@Home virtual super-computer, distributed network has had so many more people donate their surplus computer processing power to it that it's grown 1,200%, with many Bitcoin miners throwing in. At 470 PetaFLOPS, that's more than double the power of the worlds most powerful (single site) supercomputer, Summit, which is also now working on Covid-19 problems. Folding@Home has already discovered "77 different small-molecule drug compounds that might be useful to fight the virus" [Tom's Hardware]. Heartwarming and awesomely impressive, but the major bottlenecks will be with the wet-work and validation, so to speak.

• Analysis confirms that the Chinese mortality rate in Wuhan was not truly over 3%, as the initial figured indicated (in not testing many mildly infected). In reality, they were closer to 1.4% [NY Times], fitting much more closely with the expectations of our experts for ~1% to 1.3%. Although, because of only testing intensive care patients, it will look worst over here, too, for now.

• The Sunday Times reported senior Tory sources claiming that Cummings had been pushing for the deadly (and hopefully abandoned) "herd immunity" strategy (as I'd speculated above) [Guardian]:

Via Owen Jones [Facebook].
No.10's totally denied this, of course. Indeed, Cummings has made many enemies within the Tory party, too. So it's hard to be sure of anything except that there's a sickening battle at the top of the ruling UK party (and within the right wing media), during this time of unprecedented crisis. Many want to scapegoat Cummings and it's honestly hard to say which side is worst.

• UK Supermarkets continue to reassure shoppers of sufficient inventory, despite struggling to keep some shelves stocked. Sainsbury's, for example, has been trying to prioritise vulnerable people for an hour at the start of trading on several days per week, and now NHS and social workers half an hour before that. But with more restricted hours (8amm to 8pm), to allow time for shelf stacking, and more public focus on grocery shopping, there have been reports of queues (and mobs [BBC]) forming. Also friends telling me of insane check-out queues (in a Tescos). All of which is going to be extremely counter-productive for reducing viral transmission rates.

• Outdoor locations have also been packed, this mother's day, with record numbers at Snowdonia national park [BBC], busy beaches [BBC] and parks. It seems like people's thinking is converging, under the same limitations. And it's going to be hard to stay penned up with spring now breaking. The sunshine is going to be especially bitter-sweet for those ~15% of households without any garden to go out in [via Google].

Overall I feel like the measures and public reaction so far may still have been net negative. Some are estimating (fairly) that we're about 9 days behind Italy's current 3000 death toll [Twitter], accelerating faster than them. ICU pressure on London hospitals is already biting and looking to get exponentially more intense in coming days [Twitter]:


• The spread of the virus in America is certainly very uneven, too. With metropolitan areas being seeded far more with external cases flying in. Also with more social connections and closer living conditions, public transport, etc. But they are also generally more progressive, much more likely to believe in the dangers (73% verse 42% of Republicans) and have Democrat governance that's more likely to enact protective measures (sooner). So the progression of spread and illness is going to be complex, potentially turning against the rural areas in the longer run. [The Atlantic]

• Yesterday's dubious (and flawed) BBC article seems like it's seeding references to it - I saw a friend post this Medium article, which is more noncommittal, but links without criticism [Medium]. It's interesting that the age mortality risk profile of the virus very closely matches that for all cause mortality, peculiar. So all contracting it would have double the mortality risk, over the course of this year. (And double the number of deaths in total for the year, if spread is no substantial suppressed.)

• At this point I have a few online contacts who've been ill and recovered, or just become ill and one in america who was hospitalised with a very high fever and delirium. All young(ish) adults, so far.

• In general, I'm seeing a lot of positivity, online. People trying to supporting each other and reaching out for social contact. For me, there's actually been a substantial *increase* in social interactions, compared to normal times (although more stress about being able to cope with added responsibilities and risks).

We also had our first family video call this evening. I think many are taking this new motivation to get to grips with unfamiliar communications technology. Hopefully a lasting beneficial change.

• This animated graphic [thespinoff] does a great job of intuitively illustrating the power of social distances verses exponential growth. I hope many more come about to help everyone grasp the nature and magnitude of the situation :





2020-03-23 - All those other people causing the problems...

• News coverage and condemnation is rising, with more shots of the general public queuing outside of supermarkets [Twitter1, Twitter2]:


Such generalised demonisation of the general public is almost certainly unhelpful and counter-productive, as individuals and families will always perceive the problem being *other people*. Also raising anxiety buying, which many will now be even more focused on, while self isolating at home.

This Mirror article, for example, is totally ridiculous [Mirror, via Twitter]:
Of course people are going to need to buy more when they've been told by government that they may, at any time, need to totally isolate for 2 weeks. That they should try to shop only once per week. An extra 50% on a regular shop is pretty modest in that context. Even before considering that there's no home delivery slots available for at least 2 weeks, or the scary coverage of empty shelf and zombie hordes... 

What we're seeing is a systematic weakness of our food delivery infrastructure, that's designed to minimise inventory, shop floor and staff wages, by always running as close to capacity as possible. 

Plus there's a substantial demand rise from closing all restaurants. At least 70% of people eat out or take away food at least once per week [food.gov.uk]. 30% of people at least 3 times or more. Although much of this is take-away food (like good old fish and chips), which may still be available, in theory. That could add up to 15-30% extra meals at home (my estimation). But restaurant use will be particularly high in more metropolitan areas, putting the maximum extra strain on supermarkets that may already have higher turn-over of stock, due to more limited space.

I think that limiting opening hours might be the wrong approach, given the inflexibility of demand, it just raises the pressure and packs people closer together.


• Similar story with the Tube closures causing worst over-crowding for essential workers [Twitter]. Definitely counter-productive in the short run. Not sure if there's some sense, if they are keeping a supply of tube drivers isolated for during the worst of the outbreak.


• UK rail operators have effectively been nationalised, en-mass, by the government, to save them collapsing [Guardian, via Twitter]. It may possibly have happened anyway, but I image that a Labour gov doing this would have triggered endless hysteria from our right-wing press. As usual, with major infrastructure, this shows that only profits get privatised, while risk remains a public liability.


• Homelessness in London was effectively abolished overnight, using spare hotel rooms [Twitter]. Funny how easy that is once the problem potentially affects wealthier parts of society.


• Lupus (and other) patients have been unable to access the hydroxychloroquine they need to manage their illness, after (excessive) hype over its trial in Covid-19 treatment [ProPublica]. Largely from Trump talking it up. Medical professionals have been trying to self proscribe it for themselves, improperly [Twitter]. And a couple died after taking a fish tank cleaning agent with a similar name [Daily Mail].


• Digestive symptoms may be massively underappreciated as significant symptoms in almost 50% of cases [CBSnews]. Loss of appetite and diarrhoea may precede respiratory symptoms and be associated with worst illness.


• Face masks may actually be somewhat useful in mitigating risk of infection, from low exposure situations. More than we were lead to believe by authorities trying to avert panic buying [Twitter].


NICE - has rushed out guidelines [Independent] to help UK doctors decide how to triage their limited ICU resources in anticipating of Covid-19 patient triage (which seems likely in London in the coming week and beyond).


• Emergency powers legislation was debated today and passed with only one major amendment demanded by Labour, for parliamentary review and renewal after 6 months, instead of 2 years [Independent]. So these should hit the statute books by the end of the week, lending legal clout to Johnson's more serious talking head announcement tonight , of national lock-down, effectively [BBC]. But the 329 page bill was created very rapidly and we won't understand its implications, errors or oversights for months.

No mention tonight of suitable pay protection for the self-employed who will need to stop working, or rent support. But many in all parties were pushing for this.


• There should be a massive Gov mail-shot + phone calls should be reaching the 1.5M most vulnerable people, as identified from NHS records, instructing them to fully isolate.


• Brazil's right wing authoritarian leader is being even more strongly criticised than our own leadership. There have been 6 days of loud protests as he continues with his own Trumpian reaction of belittling the danger, labelling all local measures and media reporting as a conspiracy against him [Guardian]. Thankfully this does at least seem to be destroying his previously untouchable lead in opinion polls.

Perhaps a good omen for American politics; like Trump's "drain the swamp" Bolsonaro was elected after a socialist government were toppled (in something not entirely unlike a coup), accused of being part of the endemic corruption they were trying to weed out, of which he was probably far more guilty off.


• And Trump himself is pushing back against outbreak suppression on account of guests on Fox news pointing out the huge damage the suspension of work will do (to economy and some lives). With faithful supports largely seeing these measures as an attempt at sabotaging Trump's political position [BBC].




2020-03-24 - The sun shines on day 1 of UK lock-down:

• I hear from a friend in industry that there's now a consortium of UK engineering companies working together to attempt to make 10K ventilators in the next 3 weeks (up from 60/week). This is reported along with procurement from established manufactures and the extensive feature requirements list for the devices [Guardian]. These a fairly sophisticated machines that can not be improvised.

Fingers crossed for success. But these won't be in time for the imminent wave in some parts. And this big ticket ICU item is just the tip of the iceberg of missing health care capacity. With NHS beds sometimes spilling out into corridors, already, it seems likely we'll be seeing scenes of sick laid out on hospital floors, as in Spain [Metro].


• John Burn-Murdoch continues to update his excellent tracking graphics [Twitter]. Yesterday's logarithmic chart of cumulative deaths (the most reliable metric), by country, compares the points at which each locked down:


UK death toll currently doubling every 2-3 days. Even though it seems to be curving off, it may well tweak back upwards, as France's and other have. I'm wondering if a kink will show from *increased* transmission during the chaotic week(s) of 'panic buying' and progressive government announcements.

Of course, cases are not spread out uniformly, and here we can see just how much more scary the progress looks in some major cities. Like New York, where deaths are currently doubling every single day! Far faster than Wuhan's ever did:



• The Netherlands has also just implemented extra distancing measures, after a similarly delay to the UK. But Sweden's prime minister is apparently still intent on playing 'herd immunity' Russian roulette [Guardian].


• Our large, Western countries are highly connected to each other and the rest of the work, via tourism and business, etc. But this outbreak is likely to hit pretty much everywhere, eventually. Developing nations and war zones could be hard hit, like Syria and Yemen, which has no ICUs at all, but no reported cases yet [Twitter].


• Similarly vulnerable and overlooked are our captive populations. There was a first confirmed case in Yarl's Wood immigrant detention centre, a couple days ago [Twitter].

Similarly prisons, with overly cramped conditions at least as bad as cruise ships and an aging population of inmates. UK had its first confirmed case 5 days ago [Guardian]. Various countries have already released prisoners early to ease the burden. But prisons are notorious as infection incubators and spread seems inevitable with perpetual lock-down of inmate in cells for months horrendous, even if order is maintained.


• Matt Hancock, UK's minister for health, today called fro 250k volunteers to support support the NHS and vulnerable people. And announced 12k retired staff returning (doctors, pharmacists and nurses), plus 24k final year medics and nurses skipping straight to the front lines. Plus a 4k bed temporary hospital inside central London's ExCel (exhibition) Centre [ITV].

But on the other hand, current front line staff are terrified of the lack of protective equipment with many threatening to quit [Twitter]. There are already added dangers with so many rookie staff and older retirees. If the infection rate is not brought under control relatively quickly, now, and equipment is (again) depleted, we could be looking a real collapse in morale, staffing and capability, at the worst possible time.


• Stock markets around the world have been making huge gains today, in conjunction with financial bail-out packages going through [BBC]. London's FTSE 100 up 9% (biggest jump since 2008). US Dow Jones up 11.4% (most since 1933).

But that also directly after Trump's worrying tweet (probably in conjunction with watching a Fox News show on this topic [Twitter]: "WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF." With the deluded notion of giving up on distancing measures in just a couple weeks time, in order to save the economy. A worryingly successful 'trial balloon', that could mean the unnecessary death of millions of Americans. I kinda hope it was just the mother of all insider trading scenes, and he'll let the experts talk him down from enforcing fully fledged domestic genocide. Even if long-haul suppression could get very ugly too, in time...



2020-03-26 - Shopping in the sun:

• My first weekly Sainsbury's supermarket shop and it was the quietest I've ever seen it in the middle of the day. No queues, even with half the self-service checkouts closed, wiping them each down between users.

Usual I'd go every 3 days, buying just for myself (needing freshest food due to histamine intolerance), so I ended up with 4x more than usual, with a bunch of items for my parents (also shielding at home). Only chicken was totally missing from shelves.

I wore a 3 ply medical/dust mask we had spare, but only saw one or 2 other people taking a similar precaution. Din't get any stares, really. Everyone was taking the 2 meter distancing seriously. But very chill.

Seems that all the 'panic buying' business was down to media hype, confused Gov messaging and in reality was mostly just people logically stocking up on necessities in case of 2 weeks at home.

I feel like there's an overall positive and pro-social attitude right now. Maybe it's a bit of a honey-moon period, maybe it's my perception on this sunny spring day, but we'll see.


• The daily Government press conference certainly started more upbeat, trumpeting the 400k applicants they'd already had to yesterdays appeal for 250k volunteers to support vulnerable people and NHS activities [Twitter]. Now 500k [BBC].


• With press questions turning up the pressure on the lack of testing (particular for NHS staff) we heard slightly more in-depth on this: 3.5 million test kits have been bought, but NHS England are verifying their accuracy before deploying them at all [Guardian]. These would be finger prick home tests for IgM and IgG antibodies that produce results in minutes. Boots chemist is interested and Amazon's been tapped to distribute them, rather than Royal mail (an interesting reflection on contemporary Britain).

Certainly these could be game changing and reassure a lot of people/staff. And hopefully put an end to profiteering from private firms over-charging for the few test that can currently be scrounged up [NY Times].


• All the heroic health and social care and emergency engineering efforts of the nation, would have been far less necessary, had the Government initiated social distancing and the current (pseudo)lock-down just 3 or 4 days earlier. That would have halved the height of the incoming demand (and death) peak, as we've seen above, with the exponential growth rate, prompt timing is everything!

But what they are apparently expert at managing is public opinion: this YouGov poll which seems to say that 87% of the vast majority of the population thinks that the majority of the population is not taking the pandemic seriously enough [Twitter]... 😵


Presumably based on the footage of various public gatherings and crowded outdoor tourism spots on Mothering Sunday, just 2 days after the Boris finally closed schools, pubs and restaurants, with very ambiguous and contradictory strong suggestions. While they'd squandered weeks on the herd immunity folly. 


• In minor developments: our heir to the throne caught coronavirus [BBC]. Gov also ordered 10k ventilators from Dyson that have been redesigned from scratch [BBC]. The houses or parliament are shutting for a month [BBC], with Labour leader Jeremy Corbyn stepping down (sadly). And off-licences are declared essential as supermarkets sell out of beer [BBC]...


• National arsehole Brexiteer, Tim Martin, who previously told his 43 Weatherspoons pub staff to "get a job at Tescos" [Independent] instead of retaining them through the governments furlough support scheme has backtracked somewhat, agreeing to pay them on 3rd April, with the promised 80% of salary. However, they're now trying to weasel out of paying their supplies [Guardian].

This highlights how uncertain the situation is, even for those workers supposedly covered by the financial schemes declared so far. 9% of the population have already had their work hours reduced due to the crisis with 5% being made unemployed [YouGov Twitter]. With the chancellor's delay in coming up with an 'affordable' payment scheme for the many self employed who are out of work (that's careful to preserves the existing pay inequalities), and with Job Centers closed, there's clearly many people stuck in an online bureaucratic hell [Twitter]:




2020-03-26 - Alternative realities...

Heartwarming moments all over the nation at 8pm with an organised clap (and shout) for the NHS and social workers. I could even hear a few others from the back, in our neighbourhood of quiet detached houses. Certainly a moment of patriotism and social pride, but also undertones of hypocracy from a Tory Government that's consistently defunded and under-provisioned our essential care workers to the point were they are heroic just for turning up to work.


• In this 4th coronavirus blog post, ME/CFS community legend, Cort Johnson, goes into detail about how things have been unfolding in the US [Health Rising].

He also touches on other countries, contrasting Germany's lower mortality rate. As I've seen others elsewhere, linking this article, for example: [NPR]. The problem, in both cases, is that they are are comparing apples and oranges, in talking about the greatly different death rates: 0.5 in Germany verses France around 5% and Italy Around 10%. As mentioned previously, its worthless speculation without addressing the 2 big factors biasing these naive statistics:

(1) Germany’s low rate is primarily due to its *much more* prevalent testing, for much longer, detecting and confirming way more cases than e.g. UK which only test critically ill in hospitals.

UK’s only just started fielding about 5k tests/day (~35k/week), compared to Germany’s 120k/week. So, yes, UK’s 4.3% death rate definitely an *overestimate*, due to only testing the most sick, but…

(2) Deaths lag 2-3 weeks behind detection. So you should divide the *current* number of deaths by the number of confirmed cases from at least 2 weeks back, to get a true sense of the fate of the confirmed cases. Which will increase mortality rate by a few doublings.

This [Wired] article goes into more meaningful analysis on why Germany's doing so well. But I suspect their case mortality rate will eventually tend towards South Korea's (at around 1.3%), even if their relatively high testing and well provisioned healthcare system suppresses the outbreak fairly effectively.


• It is clear from Cort's writing (above link) that the idea of the American shutdown being unaffordable is becoming pervasive. Which is pretty worrying. E.g. linking to this piece, sowing doubt over the deadliness of the disease by doing a kind of journalistic version of the cups game, swing the currently observed statistics around until the read is dizzy [Wall Street Journal].

We have more "medicine worst than the cure" style rhetoric from Swedish mega-rich 'industrialist' Jacob Wallenberg, preaching doom from containment measures. Potentially creating devastating long term economic and social damage and unrest [FT]. Which might explain Sweden holding out as one of last European countries not to lockdown (mentioned above).

And a fairly widely reported Oxford study that supposedly claims that 50% of the UK is already infected with Covid-19 [FT], but it's just massively less symptomatic than everyone's been been observing everywhere, somehow...

Apparently it's largely hypothetical, only, starting from some big, questionable assumptions. And shouldn't really have been released to the press. [Wired] does a good job of debunking this. About all the study does, aside from undermining nation's resolve to properly suppress the explosive spread, is that we *really* need accurate mass testing, ASAP!


• Anti-vaxxer, conspiracy theory types were seizing on UK government guidelines removing Covid-19 status as a "high consequence infectious disease" (HCID) [gov.uk]. This classification (I'd never heard of) is usually reserved for the likes of Ebola (averaging 50% fatality rate), which would require case isolation at a couple of specialist facilities, here. Obviously that's not a possibility anymore for Covid-19, given the large number of cases. I imagine they're also satisfied that it's not drastically *more* dangerous than expected, rather than the implied interpretation, that it was exaggerated or hoax.


• Mexicans using boarder wall to block entry of Americans [BBC]. Lol!


• UK Gov finally announced the financial support package for self employed [BBC]. Which may be a relief for some, but looks like a half-baked mess for many...:
- Only those who paid tax on majority self employed earnings in 2019 qualify at all. (One friend who had a bad year and earned under £6k is disqualified because of paying no tax this year.)
- Amount to 80% of average profit over last 3 years.
- Caped at £50k (excludes top 5% of earners).
- Nothing paid until June (back-paid to March). So it stop renters being evicted (after the moratorium ends in 3 months) but doesn't provide any means of sustenance.
- Unclear if it's incompatible with claiming Universal Credit (unemployment support) in the mean time. So not sure if it will ease up the huge burden of online applications, mention above.


• London hospitals described as "facing 'tsunami' of coronavirus cases" [BBC]. Which is certainly as I expect, with Chris Whitty saying it'll be very close in terms of the system coping. But apparently staffing is also being crippled to an unprecedented extent, with 30%-50% off due to self isolating. Unable to know if they can return because there are no tests yet...

The new 4000 bed "Nightingale" hospital being thrown together inside London dockland's 1 mile long ExCel exhibition centre does have an impressive feel, as a project. Although it will need to be up and running within about a week, in order to avoid potentially being a white elephant:

It may certainly help to embody the enormous scale of the national effort to curb the epidemic's impact (necessary due to Gov delay initiating measures). Although the industrial scale might be seen as pretty dehumanising (especially the areas dedicated as mass mortuaries).


• In regular hospitals around the country, all the specialist ICU wards for surgical, cardiac, neurosurgical, etc, patients, are all being turned into Covid-19 units. Meaning that we now need people to not be ill or get treated for any other serious ailments [Twitter]. This is going to be creating a terrible health deficit the longer the acute phase of the crisis continues. Given that NHS was already at (or over) capacity in pretty much every way.


• NHS (111) data is to be thrown over to US firms Amazon, Microsoft and Palantir (founded and overseen by Darth Peter Thiel), plus UK's (untested) Faculty AI [BBC].

Data protection concerns are going to be massively overshadowed in the current milieu. But I think this little detail of the crisis shines a light right into the maw of this Dominic Cummings led administration and his political overhaul philosophy.

After all, he famously co-ordinated with Cambridge Analytica to leverage (stolen) Facebook data for the micro-targeted ad (illegal overspend) that won the Brexit referendum. (Interesting Facebook's not ended up involved...)

So his March 11th meeting, inviting 40 tech firms to Downing Street to help with UK's Coronavirus response [Wired], brings in the same Silicon valley disruption aspiration, for better and worst. Yes, there's much slicker tech competency in many big businesses, which are more agile than Government led IT infrastructure debacles. But there's also murky accountability and unintended consequences galore, with a relinquishment of governance implicit in loosing control of vitally important personal health data.

It remains to be seen if Cummings approach truly values competency above all else, in contrast to the legacy Tory vested interests and old boys networks. But UK is definitely headed towards increasing dependency on the good will and whims of the titans of tech (at best). Speaking of...


• Great new TED interview with Bill Gates [YouTube], who 5 years ago did a talk [YouTube] explicitly about our lack of preparedness for a pandemic of this type, laying out the measures that need be put in place to mitigate it... That were essentially ignored, aside from in his own foundation and some other small scale multi-national organisations:


- He really emphasises the exponential nature of this disease and paramount need for more testing.
- States that allowing a resumption of economic activity and exponential spread would mean 50% of the US infected...
- ... And overwhelming of the health system, which would up case mortality from 1% to 3%-4%. Something I've been very frustrated to see never mentioned in media or discussion!
- But that won't happen, because citizen, and individual states, are not going to go merrily about the shopping and restaurant meals while the pile of bodies stacks up ever higher. Which actually reassures me.
- Yes the economic cost will be huge, but it's unavoidable, given that we missed the opportunity to respond quickly with mass testing, as South Korea did. Much to his frustration. (You can see him grin every time there are questions that would naturally be answered "Trump and co are incompetent morons", choosing careful apolitical responses.)
- Talked about the therapies and procedure tweaks his accelerator has been looking into. That these will help after we ease off the shutdown.
- The need to help out lesser developed countries with economies that can not continue to work from home at all, while distancing. Particularly in the southern hemisphere, which may shortly be hit worst as it transitions into winter (unsure if summer will help us in the north).
- Optimistic overall that we'll get through this and be ready for the next pandemic, having invested in the measures for very rapid response. Much cheaper than the roughly $3 Trillion price tag for the current global disruptions, that he predicted in 2015.



2020-03-28 - You couldn't make this sh*t up!:

• Today our PM Boris Johnson, Health secretary Nick Hancock and chief medical officer Chris Whitty each announced they have confirmed infections (2 tested, the latter just symptoms) and are self isolating [ITV News YouTube]:


This left (startled mole impressionist) Michael Gove leading the press conference, in his official role as "Chancellor of the Duchy of Lancaster", a legacy 'sinecure' cabinet role now used, in his, case for Brexit responsibilities. Incidentally, it's again been confirmed that there will be no delays to the Brexit negotiation time-table, despite the fact they have been impossible for weeks. Clearly they are fully intent on a further disaster of 'no-deal' [Twitter].

The 'shock' infections news comes 3 weeks after Johnson bragged about shaking hands with everyone in a ward treating coronavirus patients [Twitter]. Although these new cases seem most likely to stem from contact with junior health minister, Nadine Dorries, who showed symptoms 2 weeks ago, on the same day as an event with the PM, and who also probably infected her 82 year old mother [BBC].🤦


• As the Government's information campaign finally seems to have been put into gear, CMO Chris Whitty's haunted visage appeared on our TVs, and [Twitter]. Presumably recorded before symptoms showed:


• New wording on the daily Government testing and mortality announcements seems to imply that certain Covid-19 deaths are not being counted [Twitter]. E.g. those dying outside of hospital or unconfirmed by testing.

It's a very serious issue if we are under-reporting! I did feel suspicious that the gradient of the UK's cumulative death toll log curve was slowly flattening off for no good reason. Although it seems to have straighten back up close to an alarming 2 day doubling for the last couple days [Twitter]. The change in testing provision (to hospital only) appears to have made this obvious discontinuity around the 21st March, when plotting confirmed cases curve like so [Twitter]:


• The US epidemic graph sailed past China's curve at an alarming tangent(!), as it took the unenviable top position in number of confirmed infected [Twitter]:

• The US coronavirus $500Bn bailout package is lambasted for giving average people measly amounts while containing a corporate 'slush fund' for the mega-rich to further extend their wealth inequality. e.g. AOC [Twitter].

• Indeed, US wealth and health inequity highlighted as it's revelled that the first US teenager to die was refused treatment for lack of insurance [Gizmodo].

• The EPA (environmental protection agency) has used the crisis to drop enforcement against corporations, indefinitely [Twitter].

• Trump appears to be choosing to oppose the protective social shut-down measures in the US, as a political tactic to win the election, according to this [NY Times] opinion piece. Gambling that division will distract from his ineptitude thus far, while pushing the blame for economic pain on the local state governors who ultimately have control over such measures. Of course he'll be taking any credit for success too.

So, certainly the immediate reactions provoked are not going to improving the future directly...


• After ripping into the UK Gov, on BBC Question Time, for their inexplicable failure to act on at all on Covid-19 for the whole of February, despite clear warning in January [Twitter video], Chief editor of Britain's most prestigious medical journal, the Lancet, used his platform to publish a scathing written followup [Lancet]. Using quotes from NHS staff to spell out that London no longer has a functioning western health system, as the major peak of seriously ill is about to roll over us.


• It seems like the number of self employed excluded by the UK Chancellor's new scheme is probably closer to 25%, than his stated 5% [Twitter].

This [FT] article quotes a few of those failed, for various reasons. The huge problem is many people just have zero income for *at least* the 5 weeks it would usually take for Universal Credit to pay out, but can't even log on to get registered for that.

In the mean time, foodbanks are depleting due to unavailability of tinned goods in supermarkets, shops and older volunteers social distancing, etc, and no explicit gov support. This Guardian "Anywhere but Westminster" [YouTube] video gives a good insight. Personally, I feel like people are going to starve en-mass. I'd expect (food) riots in certain parts before too long, given protests are implicitly illegal right now...



• Digestive symptoms may commonly start before the typical ones. 18.6% of confirmed Covid-19 cases had diarrhoea in [this study], verses the typically stated incidence of ~3%. (Also, 40% had loss of appetite and 2% vomiting.)

Digestive symptoms are associated with more viral activity detected in the gut & stool, plus longer and more severe illness. In this study [Lancet] 31% of cases with pneumonia (i.e. severe) had diarrhoea, too. So, I'm wondering a couple of things:

(1) There seemed to be hints that infection of the gut could account for return of illness after apparent recovery. Patients may have tested negative from upper respiratory swabs (PCR test), but the infection re-surged from affected gut cells (my hypothesis).

(2) Is gut-first infection caused by ingestion of the virus? I.e. the oral-faecal route, already acknowledged. Is that e.g from food that's been coughed on, or contaminated with faecal particles, or direct from shared toilet facilities?

(3) Could oral Vit-C (in mega doses) be especially useful for cases starting via digestive upset...?

I first heard of the possibility of the potential importance (and substantial under-reporting) of digestive symptoms via Chris Kresser linking to this [CBS] article. Then found links to more papers in this [NY Times] opinion piece, with a woman lamenting accidentally spreading infection to many friends due to her atypical symptoms (and poor official advice).



2020-03-29 - Ongoing updates in this new post...

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