Thursday, 21 January 2021

The NICE formula and the coronavirus

 The National Institute for Health and Care Excellence (NICE) has a formula for determining how much money the public purse can spend on treatments. It is twenty thousand pounds for one additional year of heathy life.

I do not know how much money has been devoted to combating the coronavirus, but it is a massive number. To take just one measure: the government’s response has ensured that the government will add almost four hundred billion pounds to public sector borrowing in this financial year. Another measure is the negative effect on the economy, which is the worst in three hundred years. Whatever the financial cost, it can only be represented in the kind of numbers used by astronomers.

Just as I do not know how much money is being devoted to combating the virus, neither do I know how many additional years of healthy life are being bought by all this money. However, I do know that life expectancy is eighty-one years, and that the average age of a coronavirus related death is almost eighty-two and a half years. The implication of this is that at a population level no years of additional life (healthy or otherwise) are being bought by all that money.

In fact, the situation is, of course, far worse than this because the money being spent on combating the virus is not only not buying additional years of life, it is costing years of healthy life as a result of all the harm caused by this misallocation of resources. Money spent on track and trace, for example, is money that cannot be spent on anything else, including health care.

Just thinking about the government’s response to the coronavirus, even without the detailed numbers, in terms of the NICE formula shows it to be completely irrational, irresponsible and incompetent: that is, if we take the government’s claim to be solely motivated by a concern to save lives.

Our government is at best irrational, irresponsible and incompetent. It could be worse.

Saturday, 9 January 2021

Preventing viral transmission by lockdowns: a lesson from Antarctica

The Antarctic research stations had for many decades shown the value of isolation as a means of preventing the transmission of viral respiratory illnesses. A small group of individuals are isolated until months later there arrives new personnel and supplies. When this happens, the station personnel are susceptible to colds for a period of ten to fourteen days. Then they are untroubled by colds, until the next arrival of new personnel and supplies. This is the usual pattern. However, it has happened that even after months of isolation the group can contract colds. One such outbreak was studied in depth, and the conclusion was the cause was unknown. The study is worth reading https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130424/pdf/jhyg00082-0026.pdf

The obvious way the above study is relevant is in relation to the government’s commitment to the use of non-pharmaceutical interventions to control the virus, specifically its commitment to minimise social contact: stay at home, social distancing, face masks, shut downs, etc.

These interventions can never come anywhere near the complete isolation that occurs in the Antarctic research stations. No matter how draconian the measures a government introduced, there would still be millions of social contacts every day. These contacts would inevitably provide a virus (any virus) with a far more conducive environment for replication and disease causation than an isolated Antarctic research station. In other words we have had many decades of real world experience of the potential of lockdowns to prevent viral transmission, and that experience shows it does not work even in the most strict possible incarnation.

Lockdowns do not and can stop a virus. But the harms of lockdowns are obvious for all to see – which is probably why the government explicitly introduces each iteration of lockdown without any impact assessment. The lockdown policies cannot prevent transmission of the virus, but they certainly can and do kill people.

Sunday, 3 January 2021

Admitted to hospital in the time of the coronavirus

On Wednesday I fell off my bike and I could not get up. An ambulance was called for. I lay on the ice for an hour an a half before the ambulance arrived. I was put on a stretcher and taken to the local hospital. I spent three days and two hours in the hospital. This provided me with the opportunity to make a number of observations of how the responses to the virus have effected hospitals.


Shortly after arrival I had an X-ray. This showed that my hip was broken. An emergency doctor informed me that I needed an operation and would have to be admitted. A little later a young woman turned up and said she needed to take a test. I asked what the test was for. She told me it was a covid test. I said I did not want it. She told me I had to have the test. I said I did not want the test. She repeatedly asserted it had to be done and told me I had no choice. When she eventually realised that I was not going to submit, she stormed off, stating that she would report my refusal. A little later the emergency registrar arrived and told me that the test was mandatory. I told him about health care ethics (specifically the requirement for informed voluntary consent). He responded by talking about the time we a living in. So, I said, I have a broken hip and I can only get an operation if I submit to the test. Yes, he said. So I said that under protest I would submit. He told me that he would note my protest. A little later, a nurse (probably a senior practitioner), turned up. She very gently swabbed a nostril and the inside of my mouth. The result would take the lab a couple of days. I was then admitted to the hospital and transferred from the emergency department to the orthopaedic ward.


My trip (on a stretcher) through the hospital revealed a scene very like the Emergency Department. This was not a bustling hospital. There were very few patients, the staff were anything but busy and whole sections were clearly not in use. In contrast, the Orthopaedic Ward appeared fairly normal with not too many empty beds. I was allocated a bed in a bay (room) for four beds, one of which was already occupied. The occupant was a ninety year old, who had fallen at home and broken his hip. The other beds were vacant.


The next day another patient was wheeled into the bay. He had fallen on ice (coincidentally very close to where I had fallen off my bike at almost the same time - he had attended as on out-patient the previous day). He had apparently torn tendons around his knee and needed an operation. 


Later that day the surgeon in charge of orthopaedic surgery visited the ward. He was very satirical about the covid 19 safety protocols, making much of how he donned and changed plastic aprons for each patient. When he spoke to me, he was very matter of fact and simply explained the options and asked which I preferred. I chose to have the break repaired by a plate and screws. And later that afternoon I was wheeled over to the operating theatre.


I was placed at eye level, strapped down and given a local anaesthetic. The surgical team consisted of at least fifteen people, although, as I could subsequently tell, at least a couple of them were there for training purposes. This team clearly had a high level of esprit de corps. There was little actual task focused talk and a substantial amount of repartee and banter. This helped to reduce my stress level. a little. Before they started the operation, I was asked if I would like some music to listen to. I asked for Carmina Burana, and received a blank look. So, I asked if they had Fleetwood Mac. They did and so I got to listen Stevie Nicks et al whilst they conducted the operation, which really helped with the stress.


After the operation, which had taken just over an hour or so, I was wheeled into the Recovery Room. There was one other patient, and I could see there were stations for a dozen patients. Other than for the purpose of complying with standard procedures, I could not see why I had been taken to the Recovery Room and I was only there for a few minutes before I was again being wheeled across the semi-deserted landscape that the hospital presented.


Back on the ward, I now had my first experience of hospital food. It was terrible. I ate it, not because I recognised it as food or out of hunger, but because I was seriously dehydrated, and one cannot rehydrate just by drinking water. I do not put down the awfulness of the food to the coronavirus responses, but the responses had got rid of all the means that patients had previously had of getting their own food - visits from relatives, bearing food from home or those charitable tea rooms that hospitals used to have.


There were many other things that were missing from a modern hospital. There were no televisions, news-stands, areas for patients to socialise, etc. And these absences were all clearly coronavirus responses.


In the morning I was briefly visited by occupational therapists. This started with surreal moment of amusement (for me, not the therapists). I was told they wanted to ask me for some personal information, so would I like the curtains around my bed to be closed. I pointed out that the curtains did not prevent the transmission of sound and invited them to ask away. They wanted to know about my home circumstances. I gave them the information and told them I wanted to go home. I asked for some crutches. They gave me a Zimmer frame, and promptly disappeared.


I practised walking around the ward. This resulted in the staff quickly offering me some less revealing clothing - they had cut off my clothes after the X-ray had revealed the broken hip and had only supplied me with theatre gown.


The next morning the therapists reappeared, this time with crutches. They expressed doubt about my ability to be able to get up and down stairs, which I would have to at home. I suggested we put it to the test. So, I was given the crutches and some instructions on how to use them, and invited walk up and down the ward, which I did. We then went off the ward to the nearest staircase and I used the crutches to ascend and descend. As these tasks were satisfactorily performed, I was told I could be discharged. This took several hours, due to booking an ambulance slot, completing the paperwork, and getting the drugs I would need from the pharmacy.


A big take away for me from this visit was that the staff were all compliant with the covid safety procedures that the hospital had put in place. But there were obvious differences in the level of enthusiasm for those procedures.


Just before I was discharged, the patient who had been admitted for the torn tendons was about to leave the hospital. It had started to snow and he was worrying that his sister-in-law, who was coming to collect him might have an accident in her car. I asked him why he hadn't opted to be taken home by ambulance in the first place. He told me that they (meaning the hospital) are overwhelmed. I obviously looked surprised because he immediately referred to a BBC story that he had viewed on his phone. The story showed a line of ambulances outside a hospital, which "proved" the NHS was overwhelmed.


"You have been in this hospital for days, and you been all over. You have seen parts are closed down. You seen there are hardly any patients. You have seen the staff are not even busy," I said.


"But its on the news!" he interjected.


"So, you see an image of ambulances outside a hospital and a reporter claiming that the image shows the NHS is overwhelmed and you prefer to believe that to the evidence for your own senses?"


"Well, no," he said.


"So what was the reason for not getting an ambulance in the first place?"


"What I said. They are over..." And then he shook his head. Cognitive dissonance is hard to see from the inside.

Sunday, 6 December 2020

Coronavirus equivocation

The language of the coronavirus narrative is the language of equivocation. Its official narrators have adopted the policy of using a word to mean both what it denotes and what it does not, switching back and forth between the two in order to deceive. No matter how much the policies have changed, equivocation has remained the constant watchword of the propagandists. This misuse of language can be seen in the exploitation of every key term.

The term Covid deaths has been represented as though it means that the deaths were caused by the virus. Yet, the term has been used to refer to anyone who died and was with diagnosed with or presumed to have had the virus. These deaths could be from any cause. They might be caused by the virus or a heart attack or pneumonia or being run over by a bus. As long as the person either had or was presumed to have had the virus, the death has been counted as a Covid death.

When the government and the corporate media found in the summer that the number of deaths that could be attributed to the virus were so vanishingly few they stopped reporting them and resorted to the number of cases. A case is an individual who is ill and has been diagnosed and is in receipt of medical treatment, and that is how the term has been represented. However, what was being referred to in the daily reporting of all these so called cases was in fact positive results from the coronavirus tests. Yet, many of the people whose tests were positive were asymptomatic; they were not ill and they had not be diagnosed and they were not in receipt of medical attention. They were not cases.

Another example of this knowing misuse of the language has been the use of the word data. The government's most senior scientific advisor told the nation during a press briefing immediately prior to a parliamentary vote on the second lockdown: "The modelling, that's the data we are looking at." Patrick Vallance cannot but know that the outcomes of computer models are not data. Data are facts, things that have happened. He obviously knows this. Yet, he (and other expert advisers and government ministers and so called journalists) pretends that such mathematical projections are facts.

Last week the Medical and Health products Regulatory Agency announced that it had approved a vaccine. This was just another misuse of the language. A vaccine confers immunity from the disease on the vaccinated individual. Yet the developers of the product approved by the agency only claim that it will reduce the severity of symptoms. They do not claim that it confers immunity. Nevertheless, the coronavirus propagandists hail the approval as a historic moment and demand that everyone should be vaccinated in order to achieve herd immunity. The claim being that the "vaccine" is a public health measure and it is a moral duty to be vaccinated in order to protect others. Yet a vaccine is not a public health measure. It is a clinical treatment. The vaccinated individual is immune from the disease regardless of how many other people are vaccinated. The unvaccinated present no threat to the vaccinated as they have immunity. But of course in this case that is not true because the so called vaccine is not a vaccine as it does not confer immunity.

Throughout the pandemic the carriers of the narrative that the coronavirus is a deadly disease have deliberately misused the language in order to deceive. They have misused the language to consistently exaggerate the level of threat that the virus poses. This misuse of the language has lead directly and inevitably to the absurd situation where the government is intent on "vaccinating" the whole population with a "vaccine" that will not provide anyone with immunity from the disease in the name of protecting everyone from the disease.

If government ministers are being rational on the coronavirus issue (and there certainly is room for doubt), it would appear that the purpose of the so called vaccine is to dial down the fear that they generated and thus enable them to remove the restrictions that have caused such massive harm. If that is the case, a placebo labelled as a vaccine would be a better option as at least that would do no harm and would be considerably cheaper.


Sunday, 29 November 2020

To protect the NHS

Average age of coronavirus related death is 82.4.

Life expectancy is 81.

The virus is having zero effect on mortality.


In order to deal with this the government have decided to spend hundreds of billions (which they do not have). These are hundreds of billions that cannot be spent on other things, including health care to save lives.


In order to deal with the virus the government have hollowed out democracy. They cancelled elections. They turned parliament into a pretend parliament. They passed the Coronavirus Act 2020, which at Part 2 Section 90 gave the government the power to rule by ministerial fiat.


In order to deal with the virus the government have taken away our rights and liberties. We are now expected to be grateful if the government allows us to meet a few friends and relatives for a few days over Christmas. The violation of our rights and liberties is driving suicides, mental health problems, domestic violence and child abuse and neglect.


In order to deal with the virus the government have virtually shutdown the health service so as to protect the NHS. Thus, cancers have gone untreated and undiagnosed. Heart disease has been neglected, etc, etc. People are being denied health care to save the NHS.


In order to further protect the NHS the government moved older people out of hospitals to free up space for COVID 19. These people were put in lockdown within care homes, denied access to relatives and health care, and they died: in tens of thousands.


In order to further protect the NHS the government have decimated the economy. They have shutdown whole sectors of the economy, repeatedly, ensuring millions of people will be rendered unemployed: millions who will not be able to contribute to the economy, the economy that is needed to pay for the NHS.


The professed motivation of the government – to protect the NHS in order to Save Lives – is either a lie or government ministers are suffering from madness. Certainly, the government’s policies judged by the professed motivation are irrational, irresponsible and incompetent. The government’s responses to the virus are, entirely predictably, doing far more harm than the virus ever could.

Wednesday, 25 November 2020

Coronavirus propaganda is beyond satire

On Monday Boris Johnson told the House of Commons that the mass testing in Liverpool had caused a dramatic reduction in “infections”. This was obviously the government line, rather than just some off the cuff assertion, as can be seen by the fact that other government ministers are making the same assertion.


It now looks like the government thinks that its propaganda narrative is so firmly entrenched that it is no longer even necessary for its assertions to have even a scintilla of plausibility. The paraphernalia of the coronavirus have mutated into magical talismans. Tests magically remove the virus from infected individuals.


From this perspective, whatever happens proves the government’s coronavirus narrative. If the numbers (deaths, hospitalisations, cases, the R number, whatever) go down, it proves that the lockdowns, social distancing, face masks and the rest are working; if the numbers go up, it proves the need for more draconian measures/enforcement. Assertion and confirmation bias are “the science” of the coronavirus responses.


In this context, no dissent can be tolerated. All dissent is not just self evidently wrong; the dissenters are construed as not just ignorant and misinformed, but as immoral and dangerous. From the point of view of the lockdownistas, those who disagree are an existential threat. This leaves no room for evidenced and reasoned argument. One does not politely argue with the enemy to discover the truth; one defeats the enemy, by whatever means are necessary. This is why pointing out the lack of scientific evidence for social distancing or face mask wearing is so ineffective: it is not about science. The science is now nothing more than a rhetorical device. This is why pointing to the harm caused by lockdowns is so ineffective: it is not about saving lives. It is about defeating the virus.


The lockdownistas are believers, and, like believers of any belief system, they will use all the cognitive biases to which we are so prone to defend their belief that defeating the virus is more important than anything else and therefore any sacrifice is worth it. This was blatantly illustrated on Monday when Boris Johnson’s link to the House failed and Matt Hancock rose to his feet. He, with apparent sincerity, assured the House that he/the government had assessed all the risks and the only way to protect the people was by focusing on the virus.

Friday, 6 November 2020

Coronavirus responses: an examination of the government's motivation

The first lockdown in response to the coronavirus was announced on 23 March 2020. Prime Minister, Boris Johnson, told the country that the measures were necessary to save lives. This has remained the government's rationale for all the constantly changing measures ever since. However, there is much about the government's policies and the justifications used to support them that draws into question the claimed motivation. This is especially marked in respect to the constantly reiterated claim that the policies are the result of "the science". Indeed, the gap between the claims to be basing policy on scientific evidence and the quality of the presented justifications is so wide as to demand serious scepticism.

At the Daily Coronavirus Update on 10 April 2020, Matt Hancock, the Secretary of Health, stated that the government had not made any attempt to assess how many people would die as a result of the government's lockdown measures. This was an admission (given the claim to be concerned to save lives) that the government had adopted an irrational, irresponsible and incompetent approach to policy-making on the coronavirus issue. If the government's concern was to save lives, and it was acting as a rational policy-maker, it would have weighed the risks and costs against the potential benefits before adopting any policy measure. The fact that the government had made no attempt to assess how many people (let alone a quality life years assessment) would die as a result of its measures completely undermines its claim to have been motivated by a concern to save lives.

This early indication that the government was not acting as a rational policy-maker has been followed by many others. This can be seen particularly clearly in respect of the claim to be "following the science".  Government ministers and senior scientific advisors have repeatedly made claims that they cannot but know to be false. One illustration of this is the claim that the two metre social distancing rule is based on the scientific evidence. When Professor Yvonne Doyle of Public Health England was asked by the House of Commons Select Committee on Science and Technology for the evidence on 22 May 2020, her reply was a succinct: "The precautionary principle," which, as hardly needs stating, is neither science nor evidence. It is nothing more than wishful thinking, at best.

There are many more illustrations of this claim to scientific evidence that evaporate under even the most cursory examination. For example, Boris Johnson told the House of Commons that the government had scientific evidence for the ten o'clock rule. When pressed for the evidence, he resorted to what can only be characterised as a Just So Story. He said that the longer people socialise and the more they drink alcohol, the less able they are to observe social distancing. This social distancing being the rule that was adopted as a precaution, rather than as a result of scientific evidence, piling pseudoscience upon pseudoscience.

Every time advisors and ministers have claimed that the policies have been based on scientific evidence, they have been telling us things that they cannot but know are false. There is no scientific evidence for the various rules. Indeed, some of the rules are absurd on their face. The face masks required when standing in a hospitality venue, but not required when seated in the same venue looks like nothing so much as comedy. Yet, we have been told repeatedly that the science demands we follow the rule.

The same strictures apply to the presentation of what the government has dubbed the data. The outcomes of computer models have been presented to the public as data. Indeed, Patrick Vallance, the government's most senior scientific advisor, at a press briefing shortly before the introduction of the lockdown version two, said: "The modelling, that's the data we are looking at." Yet it is simply not credible that Vallance does not know that the outcomes of computer models are not data; that data are facts, things that have happened; and that the outcomes of computer models are nothing more than the mathematically inevitable results of the starting assumptions. But of course he does know. When he was questioned this week by the Select Committee on Science and Technology immediately prior to the vote in parliament to authorise the second version of lockdown, he at first referred to the computer model outcomes as predictions, but under questioning amended this to projections, and then to scenarios, and then resorted to: what will happen if we don't adopt the lockdown measures (ie, back to predictions). The notion that someone of his education does not know that predictions, projections, and scenarios are all very different defies credulity. When someone resorts to such linguistic tricks, scepticism is the only rational position to take.

The government has even gone so far as to invent facts. In an attempt to justify to parliament the need for the second lockdown, Boris Johnson told the House that seventy percent of all transmission of the virus was asymptomatic. He made no attempt to offer any evidence to support the claim, but simply resorted to the rhetorical flourish: "as you all know." Yet the notion that anyone knows this to be the case is fantastical. The World Health Organisation acknowledged that asymptomatic transmission is "very rare" and indeed were unable to identify even one definitely confirmed case of asymptomatic transmission.

In fact, the government has introduced a set of public health measures in response to the coronavirus that were until this year expressly recommended against for respiratory viral infectious diseases. Lockdowns, face masks for the general public, track and trace: these were all considered to be ineffective and indeed counter-productive measures until this year. And it isn't that the scientific evidence has changed. This can be seen in the World Health Organisation's change of position on face masks. The World Health Organisation reversed its advice on 8 June 2020 on the basis of political lobbying, as even the BBC reported. Unfortunately, the BBC did not report who did the lobbying.

Whilst the government has relied on the rhetoric of science for its public health measures in response to the virus, it has relied on actual science in order to elicit compliance with those measures. A sub-committee of the Scientific Advisory Group for Emergencies made up of behavioural scientists at an early stage advised the government on how to elicit compliance. A major plank of that advice was to promote fear. It also advised the government to propagandise in terms of altruism and to exploit the power of social disproval and shaming. These techniques have been employed extensively by both the state and its allies, especially in the corporate media, subjecting the population to a veritable campaign of terror. 

This list of discrepancies between the government's professed motivation - to be following the science to save lives - and its actual practice could be substantially extended, but I think the point has been made. I do not know what the government's motive(s) is, but it is clear that they routinely say things that they must know to be false; that they claim to have scientific evidence when they clearly do not; that they have engaged in a campaign to terrorise the population; that they have pretended that the outcomes of computer models are data; that they have invented facts; that they have done precisely what was expressly recommended against by all health authorities in the event of a respiratory viral infection; that they have introduced these measures without any attempt to assess the harm that they will cause, including the number of deaths, which makes a mockery of the claim to be motivated by a concern to save lives.