A sober read-but the kind of info you need
Mon Mar 16, 2020 6:32 pm
COVID-19 Why we are right to be scared, and what we can do about it. A thread that I first posted on Twitter, replicated here.
Who the hell am I? I’m a former Army officer who runs a charity these days, and isn’t a scientist.
I’ve an Environmental Sciences BSc sure, but not ‘an expert’ virologist, epidemiologist, or human factors guy. But - I do speak the language, and I am an expert on where the right answers lie.
From 2000 on I trained at Porton Down to specialise in chemical, biological & radiological warfare, deploying in support of UK interests around the world. Christmas 2000 on the Iraq border commanding manned biological detection systems, and things got really busy in 2001.
I started 2001 tracking the virology of F&M in the fields of Cumbria and Devon, but by end of the year I was in Kabul, dealing with some extraordinary challenges, including unsecured Russian Cobalt-60 sources, and Anthrax veterinary vaccine production facilities.
By 03 I was a Major, Chief of Staff to Dep Comd of the Iraq Survey Group. The bloke showing Dr David Kelly around Baghdad days before he returned to face enquiry. I’m not a blind government fanboy. Let's say I learnt the dangers of conflating politics & science the hard way.
I was on the staff at Porton Down, working on a host of projects including planning for military aid to civil authorities, incl pandemics.
So, COVID-19
Scary, isn’t it? I think so too.
There’s also an abundance of information out there, and you’ve questions.
I’ve an answer.
The teams behind the Chief Scientific Advisor are extraordinary.
They are genuinely the world leaders in their fields, and they are ridiculously good at their jobs.
They aren’t googling the answers, or parroting a line that they just heard from a pushy presenter on TV.
The plans for this stuff are incredibly comprehensive, and help a government to act decisively, and at the right time.
So much in response is about timing – and too soon can be more dangerous than too late.
Look at the second (winter) wave of Spanish flu (graph from CDC)
That long game is what they - the experts are considering now.
Pictures of smiling Chinese people removing masks are propaganda, not science. That’s designed to cause an emotional response, and not in your interests
Success of early containment can only be judged in years.
We – in the UK, right now, are doing incredibly well.
We’ll protect our vulnerable best by responding promptly when the time is right, and the people who hold that responsibility deserve our trust and our support.
That takes guts. I know that. Now, more than ever.
Government scientists, advisors and staff also have families, elderly relatives, the immunocompromised.
They aren’t automatons, they feel that weight of responsibility.
Party politics simply doesn’t come into it. It just doesn’t.
So don’t pander to it, or point score.
If your knowledge of the subject of pandemic is such that to understand the history of Spanish Flu you need to google it, then your dissent, because you are scared, has only one place.
Your inner monologue. Keep it to yourself.
Be brave. Read up on the .gov advice.
This is even more important than if you have a following for reasons other than your epidemiological expertise, so, some simple advice:
Shut the f**k up, you are scaring people.
People like Piers might have a voice, but they’d kill us all if we listened to it. Mute them.
Lastly, don’t feel bad about being scared. I’ve been scared, many times, don’t mind admitting it.
Turn off and mute the noise of those who seek personal gain by instilling fear and doubt in others. Those that pander and promote the worst in us. Be Kind.
So, look after each other, particularly those who are less able and more at risk.
Look after yourselves, your own mental as well as your physical health.
Follow the science.
Wash your hands.
Lastly, I post this from a former colleague whose opinion I greatly respect. His observations echo my own:
My views on COVID-19...
I am trained as an epidemiologist and a communicable disease physician. I have also worked in predictive modelling in healthcare and in international health systems development. I am not, however, claiming to be an expert, but I would like to make an few observations...
1... it is unwise to draw parallels from one country to another. Many factors will be different from place to place, population age structure, population density, breadth of healthcare coverage, reliability and breadth of testing facilities, reliability and breadth of contact tracing capability, stage of spread when control measures were first introduced, population mobility, and many other things.
2... epidemic curves are a base case estimate and bear little comparison with real world spread. The more a disease spreads, the less reliable they become and the more complex a situation is, the less predictive they will be.
3... In the UK, the actual experts on this sort of thing are known as "Consultants in Communicable Disease Control". In other countries there are different arrangements. While others, such as intensive care specialists, microbiologists, virologist, mathematicians, journalists, acute physicians, behavioural psychologists have a contribution to make, they are not experts on disease spread in the community and should not be regarded (or present themselves) as such
4... Almost everything that I have seen on social media is misleading and inaccurate. Some of it is extremely dangerous. If you want high quality information, you can get it from the health ministry, public health authority or health system of the country you are in. If you don't want to rely solely on government information, look at the official statements from reputable health orientated universities and departments. London School of Hygiene and Tropical Medicine, Johns Hopkins and the TH Chan School of Public Health at Harvard are a good place to start. The World Health Organisation has good information, but it has to work in a range of very different countries and so may not be the most practically useful for a particular country.
5... we are not testing everybody in the world, so we can't reliably measure death rates. A simple totting up of the numbers will be a massive overestimate. In addition to this, the way people are tested varies massively from place to place. A low number of cases could mean not much disease or not enough testing.
6... There are only two meaningful strategies for managing an emerging infection. The first is containment, where you isolate cases and trace and test their contacts. If spread within a community becomes too great, this strategy becomes ineffective. The second strategy is herd immunity. The basis of this is that when a certain proportion of people have become immune to an infection, it can no longer spread and so people who are not immune are protected. This is why we vaccinate children. Part of a herd immunity strategy is to protect people at particular risk of harm until lots of low risk people are immune, so the disease can't spread to the vulnerable. A herd immunity strategy is not about culling the vulnerable, it is about protecting the vulnerable. This is a new infection and we are learning about it and our immune responses over time. Strategies will change and develop as knowledge grows
7... in many outbreaks, more people die (usually of things like heart attacks and strokes) because they can't get access to healthcare than die of the infection itself. It is extremely important to make sure that health services are not overwhelmed so that people can get the help they need.
8... there are three key ways we can protect health services. Firstly we need to ensure that, if we don't need to seek healthcare we stay away. Secondly, we "flatten the curve" to stretch out the number of people getting the infection over a longer time period, so they don't all arrive at hospital at the same time. Finally we need to ensure that we have enough people to staff our health and care services. If people can't get childcare, they may not be able to work, so we must be very cautious about closing schools etc.
9... nothing is simple and every action will have risks of negative consequences that we may not initially be aware of, so if something that is obvious to you is not happening, it doesn't necessarily mean that others are stupid or wicked, it is more likely that you are missing part of the picture...
10... social isolation can do a great deal of harm to people, particularly older people and the more vulnerable. As containment and delay measures increase it will be really important that our friends, families and neighbours are supported. If we all check in on those around us, no one will suffer unnecessarily. Now is a good time to start sharing phone numbers.
11... wash your hands
Who the hell am I? I’m a former Army officer who runs a charity these days, and isn’t a scientist.
I’ve an Environmental Sciences BSc sure, but not ‘an expert’ virologist, epidemiologist, or human factors guy. But - I do speak the language, and I am an expert on where the right answers lie.
From 2000 on I trained at Porton Down to specialise in chemical, biological & radiological warfare, deploying in support of UK interests around the world. Christmas 2000 on the Iraq border commanding manned biological detection systems, and things got really busy in 2001.
I started 2001 tracking the virology of F&M in the fields of Cumbria and Devon, but by end of the year I was in Kabul, dealing with some extraordinary challenges, including unsecured Russian Cobalt-60 sources, and Anthrax veterinary vaccine production facilities.
By 03 I was a Major, Chief of Staff to Dep Comd of the Iraq Survey Group. The bloke showing Dr David Kelly around Baghdad days before he returned to face enquiry. I’m not a blind government fanboy. Let's say I learnt the dangers of conflating politics & science the hard way.
I was on the staff at Porton Down, working on a host of projects including planning for military aid to civil authorities, incl pandemics.
So, COVID-19
Scary, isn’t it? I think so too.
There’s also an abundance of information out there, and you’ve questions.
I’ve an answer.
The teams behind the Chief Scientific Advisor are extraordinary.
They are genuinely the world leaders in their fields, and they are ridiculously good at their jobs.
They aren’t googling the answers, or parroting a line that they just heard from a pushy presenter on TV.
The plans for this stuff are incredibly comprehensive, and help a government to act decisively, and at the right time.
So much in response is about timing – and too soon can be more dangerous than too late.
Look at the second (winter) wave of Spanish flu (graph from CDC)
That long game is what they - the experts are considering now.
Pictures of smiling Chinese people removing masks are propaganda, not science. That’s designed to cause an emotional response, and not in your interests
Success of early containment can only be judged in years.
We – in the UK, right now, are doing incredibly well.
We’ll protect our vulnerable best by responding promptly when the time is right, and the people who hold that responsibility deserve our trust and our support.
That takes guts. I know that. Now, more than ever.
Government scientists, advisors and staff also have families, elderly relatives, the immunocompromised.
They aren’t automatons, they feel that weight of responsibility.
Party politics simply doesn’t come into it. It just doesn’t.
So don’t pander to it, or point score.
If your knowledge of the subject of pandemic is such that to understand the history of Spanish Flu you need to google it, then your dissent, because you are scared, has only one place.
Your inner monologue. Keep it to yourself.
Be brave. Read up on the .gov advice.
This is even more important than if you have a following for reasons other than your epidemiological expertise, so, some simple advice:
Shut the f**k up, you are scaring people.
People like Piers might have a voice, but they’d kill us all if we listened to it. Mute them.
Lastly, don’t feel bad about being scared. I’ve been scared, many times, don’t mind admitting it.
Turn off and mute the noise of those who seek personal gain by instilling fear and doubt in others. Those that pander and promote the worst in us. Be Kind.
So, look after each other, particularly those who are less able and more at risk.
Look after yourselves, your own mental as well as your physical health.
Follow the science.
Wash your hands.
Lastly, I post this from a former colleague whose opinion I greatly respect. His observations echo my own:
My views on COVID-19...
I am trained as an epidemiologist and a communicable disease physician. I have also worked in predictive modelling in healthcare and in international health systems development. I am not, however, claiming to be an expert, but I would like to make an few observations...
1... it is unwise to draw parallels from one country to another. Many factors will be different from place to place, population age structure, population density, breadth of healthcare coverage, reliability and breadth of testing facilities, reliability and breadth of contact tracing capability, stage of spread when control measures were first introduced, population mobility, and many other things.
2... epidemic curves are a base case estimate and bear little comparison with real world spread. The more a disease spreads, the less reliable they become and the more complex a situation is, the less predictive they will be.
3... In the UK, the actual experts on this sort of thing are known as "Consultants in Communicable Disease Control". In other countries there are different arrangements. While others, such as intensive care specialists, microbiologists, virologist, mathematicians, journalists, acute physicians, behavioural psychologists have a contribution to make, they are not experts on disease spread in the community and should not be regarded (or present themselves) as such
4... Almost everything that I have seen on social media is misleading and inaccurate. Some of it is extremely dangerous. If you want high quality information, you can get it from the health ministry, public health authority or health system of the country you are in. If you don't want to rely solely on government information, look at the official statements from reputable health orientated universities and departments. London School of Hygiene and Tropical Medicine, Johns Hopkins and the TH Chan School of Public Health at Harvard are a good place to start. The World Health Organisation has good information, but it has to work in a range of very different countries and so may not be the most practically useful for a particular country.
5... we are not testing everybody in the world, so we can't reliably measure death rates. A simple totting up of the numbers will be a massive overestimate. In addition to this, the way people are tested varies massively from place to place. A low number of cases could mean not much disease or not enough testing.
6... There are only two meaningful strategies for managing an emerging infection. The first is containment, where you isolate cases and trace and test their contacts. If spread within a community becomes too great, this strategy becomes ineffective. The second strategy is herd immunity. The basis of this is that when a certain proportion of people have become immune to an infection, it can no longer spread and so people who are not immune are protected. This is why we vaccinate children. Part of a herd immunity strategy is to protect people at particular risk of harm until lots of low risk people are immune, so the disease can't spread to the vulnerable. A herd immunity strategy is not about culling the vulnerable, it is about protecting the vulnerable. This is a new infection and we are learning about it and our immune responses over time. Strategies will change and develop as knowledge grows
7... in many outbreaks, more people die (usually of things like heart attacks and strokes) because they can't get access to healthcare than die of the infection itself. It is extremely important to make sure that health services are not overwhelmed so that people can get the help they need.
8... there are three key ways we can protect health services. Firstly we need to ensure that, if we don't need to seek healthcare we stay away. Secondly, we "flatten the curve" to stretch out the number of people getting the infection over a longer time period, so they don't all arrive at hospital at the same time. Finally we need to ensure that we have enough people to staff our health and care services. If people can't get childcare, they may not be able to work, so we must be very cautious about closing schools etc.
9... nothing is simple and every action will have risks of negative consequences that we may not initially be aware of, so if something that is obvious to you is not happening, it doesn't necessarily mean that others are stupid or wicked, it is more likely that you are missing part of the picture...
10... social isolation can do a great deal of harm to people, particularly older people and the more vulnerable. As containment and delay measures increase it will be really important that our friends, families and neighbours are supported. If we all check in on those around us, no one will suffer unnecessarily. Now is a good time to start sharing phone numbers.
11... wash your hands
Re: A sober read-but the kind of info you need
Mon Mar 16, 2020 6:59 pm
Read this on Twitter and very interesting.
I'll be honest and admit when this whole thing started being reported I didn't think much of it and thought it would be nowhere near as bad as it was being reported.
But the fact is that it's even worse than was initially being reported.
Many many others thought the same as I did and even publicised these views, including some on here, but sadly they are not prepared to admit they were wrong.
I hope everyone on here stays safe - friend or foe.
I'll be honest and admit when this whole thing started being reported I didn't think much of it and thought it would be nowhere near as bad as it was being reported.
But the fact is that it's even worse than was initially being reported.
Many many others thought the same as I did and even publicised these views, including some on here, but sadly they are not prepared to admit they were wrong.
I hope everyone on here stays safe - friend or foe.
Re: A sober read-but the kind of info you need
Mon Mar 16, 2020 10:33 pm
I spent some time at Porton Down when serving. These guys belong to a different planet but I left the place comforted by the fact they were on our side. There are so many of us slagging off Boris because we are not all house bound yet. Surely we should have at least shut our borders by now. Well I would imagine Boris would be getting his advice from these guys and if they say we don't need to close our borders well that is good enough for me.
Yes it is a concern but is it as bad as we have been told? If it was these guys would have advised by now.
Yes it is a concern but is it as bad as we have been told? If it was these guys would have advised by now.
Re: A sober read-but the kind of info you need
Mon Mar 16, 2020 11:53 pm
To be honest, this makes sense to me. I can't understand a complete lockdown unless you close your borders and completely stop the incoming of any people from the outside which in this modern age of planes ships etc is practically impossible. It will only take one person with the virus to restart the whole process. Surely, unless there is a miracle vaccine soon, the virus has to take its course, just hopefully at a controlled rate where we are able to help the most vulnerable. I just wonder whether Boris will have the strength to carry it through with the pressure he is obviously under.
Re: A sober read-but the kind of info you need
Tue Mar 17, 2020 12:55 am
worcester_ccfc wrote:Read this on Twitter and very interesting.
I'll be honest and admit when this whole thing started being reported I didn't think much of it and thought it would be nowhere near as bad as it was being reported.
But the fact is that it's even worse than was initially being reported.
Many many others thought the same as I did and even publicised these views, including some on here, but sadly they are not prepared to admit they were wrong.
I hope everyone on here stays safe - friend or foe.
Well said, Ned
One of the biggest problems is the pandemic spread of misinformation by media and other mischief-makers
I read one article today where some guy reckons to is all down to 5G and Huwawei, whilst another reckons it is a Chinese conspiracy (pointing at their sudden decrease in its spread) to boost their own economy as others go into steep recession
It's a virus...and like all other virus', it has to be dealt with in a structured manner and without panic
Re: A sober read-but the kind of info you need
Tue Mar 17, 2020 9:44 am
Some sense on here and good advice, thanks for posting.
Re: A sober read-but the kind of info you need
Tue Mar 17, 2020 10:57 am
i read upto the bullet points and i'm not trying to be a dick, but i didnt understand hardly any of it, is he saying its not that bad, so stop acting like it is ?
Re: A sober read-but the kind of info you need
Tue Mar 17, 2020 7:45 pm
bluebird04 wrote:i read upto the bullet points and i'm not trying to be a dick, but i didnt understand hardly any of it, is he saying its not that bad, so stop acting like it is ?
I’m with you there mate.
Re: A sober read-but the kind of info you need
Wed Mar 18, 2020 11:20 am
From someone who has been assigned to the covid ward at the Heath they told me earlier today - the problems will start when they close the schools, About 40% of nurses have kids in school - without childcare they cant work.
So if schools do close - they need to provide a space for kids to go - if they need somewhere to go. Im sure there are activities schools can put on for kids. Plus it means their parents can work in the hospitals etc.
I wont go into the lack of resources at most levels. There isnt a health service in the world that could be prepared for this - but at least we are buying time by recognising this.
The other thing I really wish would happen - is that people / politicians stop cheap political point scoring. No one could have predicted this 6 months ago and no one would sign off the spend on something that may or may not happen. It is akin to war footing which means we all look out for each other, we call out dickhead behaviour when we see it and hopefully shame people into acting responsibly.
And lastly - keep on spending and using local business wherever possible. Buy from the local butcher, baker and in my case I'll go an buy a crate of real ale from the micro brewery - as I'll be drinking the stuff at home from now on.
So if schools do close - they need to provide a space for kids to go - if they need somewhere to go. Im sure there are activities schools can put on for kids. Plus it means their parents can work in the hospitals etc.
I wont go into the lack of resources at most levels. There isnt a health service in the world that could be prepared for this - but at least we are buying time by recognising this.
The other thing I really wish would happen - is that people / politicians stop cheap political point scoring. No one could have predicted this 6 months ago and no one would sign off the spend on something that may or may not happen. It is akin to war footing which means we all look out for each other, we call out dickhead behaviour when we see it and hopefully shame people into acting responsibly.
And lastly - keep on spending and using local business wherever possible. Buy from the local butcher, baker and in my case I'll go an buy a crate of real ale from the micro brewery - as I'll be drinking the stuff at home from now on.
Re: A sober read-but the kind of info you need
Wed Mar 18, 2020 12:07 pm
Well said. It is about time people got a grip of themselves. All this hysteria. No government could prepare for this and no hospital service in the world could cope. There seem to be more experts in virus transmission and treatment, plus economic experts than there are actual people seriously suffering from the flu, if you listen to the media reports.
Re: A sober read-but the kind of info you need
Wed Mar 18, 2020 1:07 pm
ReesWestonSuperMare wrote:From someone who has been assigned to the covid ward at the Heath they told me earlier today - the problems will start when they close the schools, About 40% of nurses have kids in school - without childcare they cant work.
So if schools do close - they need to provide a space for kids to go - if they need somewhere to go. Im sure there are activities schools can put on for kids. Plus it means their parents can work in the hospitals etc.
I wont go into the lack of resources at most levels. There isnt a health service in the world that could be prepared for this - but at least we are buying time by recognising this.
The other thing I really wish would happen - is that people / politicians stop cheap political point scoring. No one could have predicted this 6 months ago and no one would sign off the spend on something that may or may not happen. It is akin to war footing which means we all look out for each other, we call out dickhead behaviour when we see it and hopefully shame people into acting responsibly.
And lastly - keep on spending and using local business wherever possible. Buy from the local butcher, baker and in my case I'll go an buy a crate of real ale from the micro brewery - as I'll be drinking the stuff at home from now on.
Good post, cheers for the insight