I know this is outside the normal scope of my blog, but given that thousands of people visit this site each month, and that I wish the best for everyone, I want to share my thoughts on what I believe is the truth about the Covid-19 virus, and what should be done by you to protect yourself. It may be that one person reading this doesn’t get infected because they did, and so it will be worthwhile.
I believe that unless radical action is taken, or we get lucky, we all currently have a probability of between 0.1 and 2% of dying in the coming months. Even 0.1% is much higher than it would have been but for the emergence of Covid-19. This statement is based on what we know from China and how national governments are failing to learn from the mistakes of the Chinese Communist Party.
As many on here will know, I have a Ph.D. in medicinal chemistry and I have spent years interpreting clinical data on infectious diseases. My early research focused on developing anti-virals for HIV and Hepatitis, and I have spent much of my subsequent career working in virology or anti-biotics. I also live near the UK’s ground zero for Covid-19…Brighton. My wife works in a busy clinic less than half a mile from where the Brighton super spreader lives. One of my closest friends was on the same flight as the Brighton super spreader from Geneva, so thoughts about this virus have been urgent for me, and these are the conclusions I have drawn, and the actions I believe you…whoever, and wherever you are in the world, need to take to reduce your risk of actual death.
Firstly what we know…the facts:
- Covid-19 is highly infectious. It’s R0, the number of people an infected person infects is at least 2, but maybe as high as 3 or 4. This is more infectious than seasonal flu and without controls will result in the majority of the planet being exposed within a year. On Thursday 13th February a special adviser to the WHO said that 60% of the global population may become infected.
- Covid-19 has a high complication rate, between 10 and 20%. these complications are mostly severe respiratory in nature. With proper healthcare, the majority of cases resolve, but in those that don’t, the patient will die. The current case fatality rates, according to research from Imperial College in London, is between 0.5 and 4%. Seasonal flu is about 0.02-0.05%% by comparison. The time to death from first symptoms can be up to a month, as was the case for Dr Li, a healthy 30 year old, whose warnings could have spared the world from this looming catastrophe if they had been heeded.
- Most importantly is that Covid-19 has an asymptomatic infectious phase of anything from 1 to 14 days, or possibly in rare cases, longer. This means that infecters are completely indistinguishable from non-infecters, and could, theoretically, be anyone you are in contact with.
- China has risked a financial, political and social crisis by locking down many of its major cities in response to what they know about this virus.
- The Chinese data is not reliable.
Crucial things we don’t know:
- The mode of transmission. Droplets definitely, but what about aerosol? We don’t know for sure at this stage. Knowing this will determine exactly how we protect ourselves from this virus…the measures we need to take.
- The actual case fatality rate (CFR). Is it <0.5% or is it 4% or more? Knowing this will determine to what extent we need to act…individually and corporately as a global society.
Until these final two factors are fully characterized, which will take a few more weeks, given what we have observed in China, and what we know, we should act as though it is on the worse end of the spectrum now. Government bodies, like Public Health England (PHE) and CDC, are not doing this at the moment, but you can do things yourself at low personal cost to minimize your own risk.
So back to the data and observations. This is my take on what has happened in China.
They are in shock. The whole society has been completely caught out. While they are being less than honest, the data they have been producing is not technically a lie, but I (and some at the WHO) believe from what we are seeing, that it is just the tip of the iceberg. This is what I believe has happened:
The response to Dr Li’s warnings is the root to all of China’s current problems, and before long, the rest of the world. However, looking at the way that PHE are acting for example, and they know more than the Chinese authorities (CCP) did 2 months ago, our own authorities are no better. While the Wuhan authorities had the opportunity to kill the virus shortly after birth, and didn’t, so our own health authorities and governments, through radical action, could severely reduce the rate of spread, buying us more time, and potentially saving many lives. But like in Wuhan 2 months ago, they aren’t.
Up until about 3 weeks ago the Chinese authorities were able to produce what they thought was reasonably accurate data, but due to one factor, they were caught out – the long asymptomatic infectious phase and the large number of non-serious but infectious cases, and I believe it is fooling our own health authorities today.
Three weeks ago the Chinese thought they were dealing with a virus on the scale of thousands, but due to the silent carriers it was in fact tens of thousands. Then about 2 weeks ago the whole thing exploded in their faces. Suddenly they reached the limit of their PCR (genetic) testing capability. They were seeing thousands of people getting sick, possibly tens of thousands, and maybe thousands dying. I believe they suddenly realized that their testing data was possibly out by a factor of 10 as they had only been capturing symptomatic patients. Looking around, and with no actual idea of numbers, but a realization they were huge, they hit the panic button. They shut down Wuhan first, then the rest of the province and now these lock-downs are extending into places like Shanghai and Beijing.
Up until Thursday morning they were still pumping out the PCR numbers, but while these weren’t lies, I believe they are only a sample of the true picture due to limitations in the amount of tests. Then we had the spike yesterday. They added a few days’ worth of clinically diagnosed cases through CT scan and chest X-ray. This has thrown everything out of kilter. Organizations like PHE and the WHO had been blindly trusting the PCR data, but now suddenly they were told the infection rates were higher by a factor of at least 50%. They are still blindly taking this new data at face value, but it is again not accurate. Just like PCR testing has a limited bandwidth, so too does clinical confirmation by CT scan. In the west, your local primary care clinic does not have a CT scan. In most countries it doesn’t even have enough doctors to treat seasonal flu effectively. To perform and interpret one test requires time and the work of highly trained professionals. Moreover, those getting a scan are probably very ill, and only a small sample of those infected have had these scans.
The official numbers, even now, I believe are hopelessly wrong. The Chinese authorities know this but for a number of reasons are not speaking about it. The first reasons are cultural. The Chinese are very proud, and they are desperate to hide the implications of this whole episode – the combination of incompetence and ineffectiveness that lies at the heart of the communist government system (currently being replicated by our own governments).
The second is political. The communist party must been seen as being in control, and it clearly is not. Once the façade of control slips, the belief in the all-powerful nature of the CCP will fade and become challenged, this is what they are most scared of…more than a financial crash.
Thirdly, they are not technically lying. They genuinely don’t know the true extent of the numbers of infections, or the number of deaths, so they are choosing to only report to the rest of the world their official statistics. They aren’t lying, but they are not being completely honest. But their actions, and the reports from citizen reporters do point to the full story.
YOU DO NOT PUT 400 MILLION PEOPLE IN LOCK-DOWN UNLESS YOU HAVE SEEN SOMETHING TERRIFYING.
They may not be able to precisely quantify the nature of TERRIFYING, but they would not take such extreme measures unless they had a very real sense that it was massive and deadly.
In the absence of official information on this, we are left to rely on the YouTube videos that the likes of bureaucrats at PHE etc dismiss as conspiracy theory nonsense as they continue to follow the data produced by the CCP. In these videos you see people saying that crematoria have been working 24/7 burning tens of thousands of bodies. People are going into giant government hospitals, and not receiving any care…they are effectively death camps. Hundreds of millions of people are still forcibly locked inside.
From these observations, I believe it is sensible to conclude that the answers to the key unanswered questions…the way this disease is spread – droplet vs aerosol, and the mortality rates – low vs high, are not particularly reassuring. As a result, until we know these answers for sure, or we get lucky and the spring kills it off, or find effective licensed anti-virals etc, we should do the following.
- Countries should in effect go into external lock-down. This may be too late for some countries as the disease has established a beachhead (in the UK quite literally on a town with a famous beach), but not too late for others. By stopping all but essential international travel, you will massively reduce the rate of spread. I personally have skin in the game. I am due to go to New Zealand later this year, and will go, with a mask, if I am allowed, but I think we shouldn’t be allowed.
- Public Health bodies should be much more urgent in their warnings. The idiot mayor of London Sadiq Khan was reassuring people that it was safe to travel on the tube yesterday. He said he was basing that advice on PHE guidance. That is wrong. At the moment, it may be relatively safe to travel on the tube due to the low incidence of Covid-19 infection in the UK, but because we don’t know how many have it, how easily it is spread and the death rate, and because of the asymptomatic infectious phase, we are unable to quantify just how safe it is to travel on the tube.
- Areas with known cases should go into some kind of proportionate lock down. Pubs and restaurants closed. Shopping times allocated etc. Public transport limited to all but health care and other essential workers.
The advice from authorities should be honest. We don’t know exactly how bad this could be, and until we do, depending on your appetite for risk, you may want to consider severely reducing your person to person interactions, whether it be social, work or on transport. In addition you should be applying rigorous measures to avoid transmission when in public…hand washing, avoid touching others, and surfaces which others may have touched. Schools should be closed very soon, and in places like Brighton…now! Work meetings should be held remotely. Etc etc.
That should be the advice governments are giving until we know things aren’t really that bad.
Given the unknowns, this all makes complete sense. Now if the CFR is nailed down, and it is below 0.5%, we may decide that is a risk that we can live with to avoid economic collapse, because make no mistake, that is why governments are behaving like the mayor of Amity did in Jaws. He kept those beaches open so the tourists would keep coming, and bring their dollars, and get eaten by the monster. Our governments led by Trump, by Boris, by Xi are all precisely the same…as are we to an extent…I would be prepared to take on a small defined increased risk of death to avoid becoming impoverished, however at the moment that risk is not clearly defined, and could be much higher than we are prepared to tolerate. Our governments are taking an undefined risk with our lives to preserve the illusion of economic well-being.
You however, can choose to take you own measures:
Reduce person to person interactions
Take sanitation measures to avoid exposure to infection
Keep healthy to boost your immune system – sleep and eat well.
Or you could do nothing, hope we get lucky and avoid the bullet that has hit China between the eyes.
Please share this post if you feel this is fair analysis of the situation and sensible advise. Thank you for allowing me to side track our great discussions here. Also, if you want to read a great thriller about deadly viruses with asymptomatic infectious phases, then buy the book Deadly Medicine by Orson Wedgwood:
Deadly Medicine US Amazon link