Covid

Which experts?

by reestheskin on 16/06/2021

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The following is from Pulse, a magazine that is aimed at GPs. My point is not so much about the specifics but a more general point.

Headache, runny nose and sore throat top three symptoms of Delta variant, says researcher – Pulse Today

Professor Spector said cases were rising exponentially and people who have only had one vaccine dose should not be complacent.

The UK really does now have a problem and we’ll probably be seeing, in a week, 20,000 cases and by 21st June well in excess of that number,’ he said. ‘Most of these infections are occurring in unvaccinated people. We’re only seeing slight increases in the vaccinated group and most of those in the single vaccinated group,’ he said.

He goes on to say:

Covid is also acting differently now. Its more like a bad cold in this younger population and people don’t realise that and it hasn’t come across in any of the government information.This means that people might think they’ve got some sort of seasonal cold and they still go out to parties and might spread around to six other people and we think this is fuelling a lot of the problem.

He added:

The number one symptom is headache, followed by runny nose, sore throat and fever. Not the old classic symptoms. We don’t see loss of smell in the top ten any more, this variant seems to be working slightly differently.

He advised people:

who were feeling unwell to stay at home for a few days, use lateral flow tests with a confirmation PCR test if they get a positive result.

Now comes the boilerplate Orwellian response from the Department of Health and Social Care

[A] spokesperson said: ‘Everyone in England, regardless of whether they are showing symptoms, can now access rapid testing twice a week for free, in line with clinical guidance.

Experts keep the symptoms of Covid-19 under constant review and anyone experiencing the key symptoms – a high temperature, a new continuous cough, or a loss or change to sense of smell or taste – should get a PCR test as soon as possible and immediately self-isolate along with their household.’ [emphasis added]

Two points:

  1. The spokesperson, as usual, is not named nor are the credentials of this person available. How are we to assess their competence or reliability? At least you can look Prof Spector up and check out his work.
  2. Following on from the first point, which experts are we talking about? Most expertise, we know, is not within the Dept of Health. One of the most interesting features of the pandemic has been the recognition that the government nor the state (including the Dept of Health) have a monopoly on knowledge. Of course, we know they will seek to conceal and dissemble for political reasons. But the fact remains that many people now appreciate that knowledge is diffused more widely within society. David King and his alternative SAGE group have played an important role — beyond just Covid.

Contagion: the sequel.

by reestheskin on 12/08/2020

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On September 1, I’m scheduled to teach 170 students in a windowless room. After 12 sessions of 3 hours in the sealed room with 170 people, 50 of them will then disperse back to their 20+ native countries for the holidays. If the producers of Contagion decide on a sequel, I have an idea for their opening scene.

Post Corona: Higher Ed, Part Deux | No Mercy / No Malice

Competence, and the lack of it.

by reestheskin on 11/08/2020

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Someone in your family has fallen ill with a respiratory infection that has already killed large numbers. Your small house means that you do not have enough room to quarantine them. Your have little money, and the hospitals are full. You contact the local public health authority.

Not to worry, you are told: A crew will be by shortly to set up a sturdy, well-ventilated, portable, tiny house in your yard. Once installed, your family member will be free to convalesce in comfort. You can deliver home-cooked meals to their door and communicate through open windows — and a trained nurse will be by for regular examinations. And no, there will be no charge for the house.

A fascinating story by Naomi Klein in the Intercept. Seemingly from a time when government knew what government was for.

This is not a dispatch from some future functional United States, one with a government capable of caring for its people in the midst of spiraling economic carnage and a public health emergency. It’s a dispatch from this country’s past, a time eight decades ago when it similarly found itself in the two-fisted grip of an even deeper economic crisis (the Great Depression), and a surging contagious respiratory illness (tuberculosis).

How Not to Lose the Covid-19 Lockdown Generation

It is less easy to forgive ourselves

by reestheskin on 17/07/2020

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Henry Miller died a few months before I started medical school in Newcastle in 1976. At the time of his death he was VC of the university having been Dean of Medicine and Professor of Neurology. By today’s standards he was a larger than life figure. I like reading what he said about medical education, although with hindsight I think he was wrong about many if not most things. But there was a freshness and sense of spirited independence of mind in his writing that we not longer see in those who run our universities (with some notable exceptions such as Louise Richardson). In the time of COVID we should remember the costs of conformity and patronage.

It would be naive to express surprise at the equanimity with which successive governments have regarded the deteriorating hospital service, since it is in the nature of governments to ignore inconvenient situations until they become scandalous enough to excite powerful public pressure. Nor, perhaps, should one expect patients to be more demanding: their uncomplaining stoicism springs from ignorance and fear rather than fortitude; they are mostly grateful for what they receive and do not know how far it falls short of what is possible. It is less easy to forgive ourselves…..Indeed election as president of a college, a vice chancellor, or a member of the University Grants committee usually spells an inevitable preoccupation with the politically practicable, and insidious identification with central authority, and a change of role from informed critic to uncomfortable apologist.

Originally published in the Lancet, 1966,2, 647-54. (This version from ‘Remembering Henry’, edited by Stephen Lock and Heather Windle).

No just in time here

by reestheskin on 16/07/2020

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“I hope the lesson will really be that we can’t afford as a society to create the fire brigade once the house is on fire. We need that fire brigade ready all the time hoping that it never has to be deployed.”

Peter Piot 1

No just in time here. It’s in the statistical tails that dragons lurk and reputations are shattered. Chimes with a quote from Stewart Brand that I posted a short while back.

Education is intellectual infrastructure. So is science. They have very high yield, but delayed payback. Hasty societies that can’t span those delays will lose out over time to societies that can. On the other hand, cultures too hidebound to allow education to advance at infrastructural pace also lose out.

  1. (Virologist Peter Piot,  co-discoverer of  Ebola and who worked on treating and preventing HIV, talking about getting COVID-19 on his institution’s podcast. (London School of Hygiene & Tropical Medicine podcast )

Peter Piot in the Guardian

As with HIV, “an epidemic reveals the fault lines in society. The big one this epidemic has revealed is how we treat the elderly. We often park them in pre-mortuary type institutions and give a bit of money and hope it is OK”.

Make masks compulsory in public in UK, says virus expert | Coronavirus outbreak | The Guardian

When the tide goes out you see who is not wearing bathing costumes…

Space, SWAG, 2CVs, and viruses

by reestheskin on 19/05/2020

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Terrific post in the Monday Note from Jean-Louis Gassée. He writes:

This week’s note was sparked by a conversation with a learned engineer friend. He cut through my lamentation that our country lacks the will to send astronauts to the Moon again. ‘It’s not about will, it’s about our changed estimate for the cost of human lives!’.

Jean-Louis then expands on this with details of the various space flight-related accidents, before moving on — as befits a Frenchman— to the legendary 2CV, and the change in safety trade-offs between then and now in car design. Then there is the matter of covid-19, and the calculus advanced societies took the in the not so distant past.

Worth a read in full, and not just for the new acronym (to me, anyway) SWAG (scientific wild-ass guess).

Dumb techies and their acolytes

by reestheskin on 15/05/2020

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There is lots about covid-19 that I do not understand — the biology and all that. But the NHS and government’s responses are something else. I find it hard not to assume that every statement has an ulterior motive: they are, it seems, strangers to the truth. Here is Bruce Schneier (the security guru as the Economist once called him).

Crypto-Gram: May 15, 2020 – Schneier on Security

“My problem with contact tracing apps is that they have absolutely no value,” Bruce Schneier, a privacy expert and fellow at the Berkman Klein Center for Internet & Society at Harvard University, told BuzzFeed News. “I’m not even talking about the privacy concerns, I mean the efficacy. Does anybody think this will do something useful? … This is just something governments want to do for the hell of it. To me, it’s just techies doing techie things because they don’t know what else to do.”

He writes:

I haven’t blogged about this because I thought it was obvious. But from the tweets and emails I have received, it seems not.

It has nothing to do with privacy concerns. The idea that contact tracing can be done with an app, and not human health professionals is just plain dumb.

Testing, testing and more testing, please.

What money can’t buy

by reestheskin on 13/05/2020

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But, as R.H. Tawney once observed, shifts to collective provision are only realised after demonstrations that ‘high individual incomes will not purchase the mass of mankind immunity from cholera, typhus and ignorance’: many elements of the coming future ought to be favourable to the left, though only if they are shaped politically, and if blame – always elusive in the UK’s diffuse system of responsibility – is correctly apportioned.

James Butler · Follow the Science · LRB 4 April 2020