Caught between the Great Back Pedal and the Determined Double Down
Caught between the Great Back Pedal and the Determined Double Down
The “Winter of Death” foretold by President Joe Biden has fortunately not materialised. Similarly, Prime Minister Boris Johnson’s warnings of the new “emergency in our battle with the new variant” and that a “tidal wave” of Omicron could be “so big that cancellations and disruptions, like the loss of cancer appointments, would be even greater next year” now seem over-stated.
SPI-M, a group of scientists which reports to the UK government’s SAGE (Scientific Advisory Group for Emergencies), warned that, based on their modelling, hospitalisations could peak between 3,000 and 10,000 a day and deaths at between 600 and 6,000 a day in January. That is now obviously unlikely.
Has yet another wave of worst case scenario modelling proven to be a case of the boy crying wolf?
As the threat of Omicron recedes, it’s interesting to observe different reactions from government, scientists and media. We are caught in a liminal time of back pedalling and doubling down.
On a separate matter, but also contextual to back pedalling, there is currently widespread and righteous condemnation about Downing Street parties. I'm more interested in the fact that they felt safe to be at a party. The attendees did not stay at home to help save lives and protect the NHS. They did not act like they had it, or seem worried that a cup of coffee would cost lives, etcetera. Why weren’t they terrified?
Were government officials wilfully reckless, or did they actually possess a reasonable understanding of their risk, while conveying an entirely different sense of risk to the population? I suggest the latter, since they had the best available data. After all, we know that they knew that we knew we weren’t all at equal risk. Exhibit A in the thesis of my book A State of Fear is the set of SPI-B minutes, dated 22nd March 2020:
“A substantial number of people still do not feel sufficiently personally threatened; it could be that they are reassured by the low death rate in their demographic group… The perceived level of personal threat needs to be increased among those who are complacent, using hard-hitting emotional messaging.”
In an evolving pandemic, some information has changed, but some has not. In different countries, governments, public health bodies and media are pedalling back towards information they always had. Others double down.
I wondered if we could co-create a list of 2022 Back Pedals and Double Downs together? Please use the comments section and I will update this article to create a compendium.
Back Pedalling
1. Covid deaths occurred mainly in people who are already unwell.
Rochelle Walensky, the Director of the Centers for Disease Control and Prevention in the United States, said on CNN in January 2022 that 75% of Covid deaths had at least four morbidities and “were unwell to begin with”.
This is not new news, but the reminder is welcome because health professionals and government officials have sought, at times, to make us all feel equally at risk. Various articles and studies have shown that old age, as well as deprivation, the male sex, overweight and obese, diabetes, hypertensive disorders and other conditions are associated with severe illness and death from Covid.
2. PCR tests can be positive for up to 12 weeks.
"What we do know is that the PCR test after infection can be positive for up to 12 weeks, so that is not going to be helpful. You're not going to be transmitting during all of that period of time,” CDC director Walensky told NBC in January 2022.
The PCR test was never an accurate measure of infectiousness. Again, this is not news. False positives are possible when people test for a second time too soon, as the test can find fragments of virus from a former infection. Yet the PCR test was used to determine ‘current’ diagnosis, creating stress and anxiety, and led to self-isolation, disrupting business, employment, education, healthcare and our personal lives, sometimes after infectiousness had passed.
3. Self-isolation has been reduced to five days in some instances in the US, and from 10 to seven days in the UK.
"We know that the most amount of transmission occurs in those one to two days before you develop symptoms (to) those two to three days after you develop symptoms," Walensky said. "And if you map that out, those five days account for somewhere between 85% to 90% of all transmission that occurs.”
Long self-isolation has disrupted everything from NHS care to education to earning a living. Acknowledging the likely period of maximum transmission is long overdue.
4. T cells from common colds can protect against coronavirus infection.
A new study about T cells has been published in Nature. Dr Rhia Kundu, one of the authors, from Imperial's National Heart & Lung Institute, said:
"Being exposed to the SARS-CoV-2 virus doesn't always result in infection, and we've been keen to understand why. "We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.”
Memory T cells are known for their ability to affect the clinical severity and susceptibility to future infection. They also affect the threshold needed for herd immunity. Original Covid modelling from Imperial College did not assume existing immunity to Covid. By the time I wrote my book, A State of Fear, six studies (that I knew of) had shown T-cell reactivity from previous coronaviruses in 20% to 50% of people with no known exposure to Covid.
Why was this news buried for so long?
5. Hospitalisation with Covid versus from Covid is finally being discussed.
Chris Hopson, CEO of NHS Providers, has been honest and nuanced on Twitter and in the media about differentiating hospitalisation data. Until recently, Covid hospitalisations were presented as one brute misleading number throughout the pandemic. In the US and the UK the media are - finally! - asking for breakdowns. I was asking these questions of the NHS in January 2021 and hit brick walls.
6. Vaccine effectiveness
I don’t like to comment much on vaccine efficacy or safety, but I will park these two comments from the CEO of Pfizer as an example of changing information or back pedalling.
7. Dr Steve James at Kings College Hospital challenged Sajid Javid about the vaccine mandate for NHS workers. He claimed that the science was not there to justify mandates and asked him to reconsider.
It seemed a little strange to me that the news clip began with Javid asking, “What do you think of the new rule to require vaccination of all NHS staff?”, even if he thought he had a rapturous audience of vaccinated NHS staff before him. Was any part of this encounter staged? If so, perhaps that is a sign that the mandate will be withdrawn.
(I am speculating and might be completely wrong, there might have been nothing engineered about this meeting and the question.)
8. Free lateral flow tests may face the axe as part of the UK government’s strategy for living with Covid. But as recently as November 2021 the government was committed to free rapid tests for all.
On one hand, stopping free LFTs could be a step towards recovery from the pandemic and unravelling the fear messaging. Asymptomatic mass testing is not helpful for recapturing a normal attitude to health as well as creating disastrous pingdemics. I strongly suspect that Operation Nudging Us Back to Normal is underway.
On the other hand, let’s hope there is not a parallel with other European countries which have increased the roll out of vaccine passports alongside reducing free testing, or removing that option from the passport, in order to drive vaccination rates. (I’m afraid I have become cynical.) Vaccine passports ‘benefit’ from serious investment and support from well-placed advocates as well as some of the public. And let’s be honest, pharmaceutical and software companies would probably like to see vaccine passports rolled out further.
I think this is both a back pedal and a double down.
Double downs
1. The UK government has produced an Evidence Summary for masks in schools, which found “inconclusive” evidence of the benefit of mask wearing in stopping covid transmission. It also reported that 94% of headteachers felt face to face coverings made communication more difficult, while 80% of children felt they were less able to communicate and 50% of children found learning difficult. However, the report highlighted a survey by the Unison trade union, which found 71% of members said face coverings in secondary school lessons were an important safety measure.
Masks were intended to be ‘signals’ and the evidence for them was always weak and limited. This is now obvious to all, but the unions and government have doubled down.
What would you add to these lists? Please add your suggestions in the comments!
And please subscribe to support my substack!
Talking about back-pedalling today with Mike Graham on talkRADIO:
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00086-7/fulltext
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/908434/Disparities_in_the_risk_and_outcomes_of_COVID_August_2020_update.pdf
https://www.kingsfund.org.uk/publications/deaths-covid-19
“We know that the most amount of transmission occurs in those one to two days before you develop symptoms (to) those two to three days after you develop symptoms," Walensky said. "And if you map that out, those five days account for somewhere between 85% to 90% of all transmission that occurs.”
If asymptomatic transmission (AT) is epidemiologically relevant, I’m proposing per Walensky’s remarks to be seeing 40% of transmission that we’re pretty sure about occurred from individuals without symptoms.
To what extent does the literature support that?
It’s an important point. I’ve argued that AT is not only epidemiologically irrelevant, but that decision makers knew perfectly well that’s this was true.
Fauci said exactly this with his “Never in the history of respiratory viral epidemics has transmission been driven by people without symptoms...” speech.
WHO’s Kerkhouve said the same, with her “We've been looking at transmission from those without symptoms & to be honest, we’re not finding it, it’s very, very rare”. She later was reported to have “walked back” her remarks. She didn’t, though. Instead she said “our models tell us AT is important” (circular argument).
re point 7 this crossed my mind too. A way out perhaps, or at least a gateway to a conversation based on "new" information?
I think I may have mentioned this to you on Twitter but Facebook "fact-checked" that BMJ article on T Cells in September 2020 - my Facebook memories are full of "This post is no longer available"
Nicola Sturgeon has back-pedalled today too - lifting restrictions on large outdoor events.
Then she doubled-down on vaccine passports - second dose > 4 months and you're unvaccinated again.
I also noticed the use of the word "protections" rather than "restrictions" - no doubt some will thank her for this!!