A global archive of independent reviews of everything happening from the beginning of the millennium
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9 February 2021
On this day one would have to ask the Labour front bench whether it would seriously have encouraged anyone to spend time in Scotland last summer who did not have to, knowing the record on care home casualties there, and whether the SNP is intending to place in quarantine hotels Labour front bench members who might live in the London Borough of Lambeth arriving in Scotland in advance of the elections? (The South African variant has been detected in that borough).
10 February 2021
On 31 August 2020 a coronavirus data comparison website gave the following data. The towns and cities are not given as the accuracy of the data cannot be vouched for:
A Californian coastal town; population 14,000, 65 cases, no deaths
A Scottish coastal city; population 184,000, 396 cases, no deaths
A Belgian industrial city; population 77,000, 85 cases, no deaths
An English coastal town; population 175,000, 118 cases, no deaths
A French Mediterranean coastal city; population 75,000, 6 cases, no deaths
These 5 locations were the only ones I was monitoring.
That there were no deaths at all shows the great benefits that summer can offer to adults and children alike.
What these data do not support is the Scottish government's contention that disease importation in the summer is to blame.
The South African variant is not known to be more deadly than other variants and quarantine hotels being used in the United Kingdom to address it is a disproportionate measure which will discourage the population travelling to safe places in the summer.
The Labour Party and the Scottish National Party are wrong to call for the quarantining of all arrivals in Britain.
28 April 2021
Dr Andrew Miller, Australian Medical Association WA President, is reported as accusing authorities on ABC Radio of being 'grossly negligent' and breaching the human rights of 'innocent people' who are infected with Covid-19 in hotel quarantine 'because of denial of airborne problems'.
The politics of Australia can look after themselves but parties calling for anything other than the removal of hotel quarantine in Britain are also politically negligent and not worthy of a vote in upcoming elections as they do not provide supporting medical data or figures as to the number of hotel premises available that can guarantee the absence of aerosol transmission through ductwork.
Hotels unable to do so should not be accepting the elevated quarantine charges imposed.
This bespeaks failure to seek engineering advice and to match availability of premises to the likely number of people passing through ports from countries of concern.
These parties cannot plan or do much independent thought so irresponsibly advocate an eventually chaotic situation.
Home quarantine with daily verification telephone calls is a better and less costly proposition.
Willie Walsh of IATA has rightly described the charges made for PCR tests in Britain associated with travel (up to £150 each) as a scam. These tests are provided free by public authorities in many countries and the reagent, of which there is now no shortage, is known to cost 12 pence per test.
Realistically, a vaccination green pass with a QR code on it that can be worn on a lapel, or similar, should be all that is necessary for international arrivals that have been fully vaccinated or a single PCR test on day 2 for those who have not been.
If a pre-travel PCR is required by the travel undertaking or the destination country this should be left to the transport undertaking to verify.
14 May 2021
42,000 out of the 127,000 deaths due to Covid-19 in Britain have been in care homes.
The biggest line of accountability in an enquiry will not hang on political timing but on why institutional settings were handled so badly despite or because of the over-profusion of guidance to them.
Quarantine hotels are dangerous institutional settings not properly thought through and deaths and spread of disease because of them need to be avoided.
Border control is a big red herring in a vaccinated society which - except for children where they may be ethical issues attached to their vaccination - the U.K. will be sometime in July 2021.
The case for a single PCR test on day 2 after entry to the country can be made out as it allows genetic profiles of any disease to be made but anything else approaches enforced toll-keeping and cannot be justified on medical or economic grounds.
From mid-summer U.K. Border Force will be overwhelmed verifying superfluous box-ticking at entry ports, subjecting travellers to indoor queues.
mRNA vaccines, and one hopes the others as well, appear to be capable at preventing severe disease due to any of the known Covid-19 variants following second dose so much so it draws into question whether future booster shots should be admnistered at all given the spinoff of any side effects.
So following vaccination of the society, concern about which known variant is present from time to time should not be made disproportionate as it is at present.
Data from Israel should be instructive as it is approaching the position of being a society comprehensively vaccinated with mRNA vaccine.
In the event of a variant increasing in incidence in a local area the following action could be taken without delay:
Ask non-vaccinated people to stay away from workplaces, paying them to do so if necessary.
Close local schools until the outbreak has passed as children have not been vaccinated.
Step up real time PCR testing in institutional settings like big workplaces.
Encourage and support self-isolation for mild disease as it is likely in time to be the main manifestation of the disease in a vaccinated society.
19 May 2021
Even if the B.1.617.2 variant has exponential growth in some clusters, chances are that the hospitalisation rate will stay linear due to the already high percentage of those who were most at risk having been vaccinated twice in Britain.
Both the variants first identified in South Africa and Brazil have failed to gain purchase in Britain. The Brazil variant has also failed to gain purchase in the U.S. although, too, it initially created a few clusters.
The manner of classifying countries due to case rates for the purposes of travel is always going to differ between the EU, the U.S. and the U.K.
The traffic light system in the EU last year created all kinds of problems for safe free movement within it because of the artificially low threshold of 25 cases per 100,000 population.
Now we have the additional benefit of vaccinations. So EU countries should not worry unduly about Britain's traffic light system. EU case rates have not come down as fast as predicted but in three weeks time it is likely many more EU countries will be moved into the green classification.
Given the acceleration of vaccination, important metrics are hospitalisations (which were officially described today as being 'flat'), and the age groups these occur for, but these may not have been properly accounted for in algorithms anywhere.
Hospitalisations are very low in Britain currently and the flow of fully vaccinated persons between countries is unlikely to risk this.
2 July 2021
Researchers, what is the age profile of the Indian population?
India is the country where the B.1.617.2 variant, now known as the Delta variant, was first identified.
In the U.K., using data from a sample of the population, the Delta variant has been estimated to be 60% more transmissible than the Alpha variant.
If the Indian population is heavily skewed towards younger people it is not entirely surprising that a variant that is more transmissible has emerged or established itself rapidly there.
Younger people will be more likely to throw off the disease quickly and so the disease is likely to need to spread more quickly.
In the U.K. it has also been stated that the Delta variant could be twice as likely as the Alpha variant to cause serious disease.
More information is needed on in whom (and who is taken as the control group for the comparison) - in a broad cross-section, in vaccinated people, in unvaccinated people, in younger people, in older people?
It can now be confirmed that the increase in infections has been exponential and the increase in hospitalisations approximately linear.
One might usually take it as likely that a more transmissible variant was less likely to cause serious disease but one hypothesis put forward is that Delta creates higher viral loads in the upper respiratory tract.
It is not necessarily surprising that Delta has become the overwhelmingly dominant strain currently in the U.K. because those that have no vaccine protection - from either one dose or two - are predominantly young, so possibly echoing an Indian age profile.
It is not necessarily certain that Delta would become rapidly dominant in an older society with still relatively low vaccination rates, such as Japan.
25 July 2021
You should always consider the conditions a variant emerged in.
India is not a cold country and Delta is not relying on winter being present to establish its dominance in Europe and North America.
So far it looks quite like a disease of the summer and the young but that may change with time and we really do need a lot more information about how it impacted different age groups in India, if that information is available, which it may not prove to be.
As for Beta, with its lower transmissibility, and origins in the southern hemisphere summer, it looks unlikely to break through into the temperate world with, so far, Alpha for competition in winter and Delta in summer.
Conditions may even be as potent a line of defence as vaccines.
Much of Europe was vaccinated against influenza in late 2020 but the Covid-19 prevention measures meant that conditions were inimical to it there. You cannot prevent it travelling, you cannot be subsumed into miasmic fear of it mutating and evading vaccines but it does seem that elementary social distancing, imposed or voluntary, worked wonders.
CORONAVIRUS IN 2021
Reviewed by ANDRE BEAUMONT
Democracy is the best system of governance we have. The United States is right to promote it as a system globally.
Representative democracy has serious challenges to its construction, however.
The characteristics of democracy must be maintained, even if citizens do not necessarily wish to be represented except on narrow ranges of issues of their individual choosing, because they, too, where they already have democracy, overwhelmingly want it.
In the United Kingdom the Queen in Parliament is sovereign and Members of Parliament represent constituencies but they do not necessarily represent citizens. Members of the House of Lords are part of democracy but they do not represent citizens.
Two of the strongest characteristics of democracy are freedom of speech and freedom of citizens to enter and leave their own nation unhindered (except in wartime). Remove either and the commonly arguable advantages of democracies over autocracies become much slighter.
From public reports on radio and private anecdotal evidence, coronavirus was present in America, Scotland, Ireland and England at the end of January 2020.
The last time when a border sealing strategy, as used later in New Zealand, could have worked for Britain would have been around the time of the last week of January 2020. It might have offered the chance of isolating existing infection in Britain but it probably would not have worked as it had not been located by tracing and it would only have bought time as thousands of hauliers have to come into Britain every week with the minimum of impediment, including from Italy which seemed overwhelmed by the virus.
On the day Britain left the EU I attended a talk by a former nominee to be Italian prime minister. It was all about the Italian economy and Brexit was not mentioned. I agreed with his analysis but my primary concern was to keep well clear of all other attendees and not breathe the exhalations of others, eschewing usual readiness to exchange ideas in person.
Any virus elimination strategy attempted for Britain in 2021 will fail as it will across Europe as children cannot be vaccinated and children are a reservoir, possibly the primary reservoir, of asymptomatic disease.
That the summer months of 2020 left the overwhelming majority of adults healthy over much of Europe, with many resort towns doubling in population and still having no Covid-19 deaths, further suggests that survival of the virus was in asymptomatic children.
Mortality, in Britain, however, could be brought down to below that expected for flu if children could eventually be vaccinated.
Countries that go for rapid suppression rather than border sealing are likely to be positioning themselves better in the world medium term. So Norway, South Korea and Vietnam are better examples now, if not in the beginning, for Europe and the Americas than New Zealand and Australia.
Australian citizens are waiting up to 18 months to return and that challenges the basis of the democracy. Nation states have been taking themselves far too seriously this century and their flakiness (and of any blocks they form and imagined secessions) is greater in Europe, historically home to different arrangements.
The most probable means for the world to be rid of Covid-19 is for it to mutate into evolutionary dead ends. Presumably that is the case with bird flus. So we must have some fear of mutations but not totally fear them.
The other observation that needs to be made at this point is that when people congregate in institutional settings - overcrowded offices, care homes, hospitals, densely populated schools, quarantine facilities, some university buildings and so on - the virus really takes off as people share the same air for a long time. Some African countries are known to have escaped the worst of the virus but there again they may have few of these institutions or do part of their schooling outdoors.
One possibility is that if health authorities across Europe had issued a call to families at the beginning to take their relatives out of care homes if they could possibly tend to them safely elsewhere the death toll in these would have been much less and the assumption that the state knows best necessarily challenged. Those that wishfully insist the state acts like South Korea and Taiwan are not cognisant that the warehousing of people in institutions is less there. The state is also managerially challenged in the four nations of the United Kingdom and the private companies it outsources to are not up to it.
It is possible to be over-influenced by past experience. Travel quarantine has been applied to visible diseases but only rarely to respiratory diseases. The pandemic response in Britain made some assumptions that it would be like flu; it is different in many respects. I may be over-influenced by the precautions you have to take to avoid Legionnaire's Disease; it spreads by aerosol, it has a reservoir, it likes institutions and air conditioning is not your friend. Ebola has been marginalised, smallpox eliminated and human papilloma virus rolled back by a herd immunity strategy but we would be wrong to assume that a theory that worked in another context will work again.
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26 March 2021
One hypothesis I started to develop in February 2020 when discussing whether students would return to Cambridge the following term was that the virus might prefer to attack people with older cells in their bodies or that it might have a propensity to reproduce slightly differently in people with much younger cells.
The second part of the hypothesis might be worth revisiting.
Europe is now afflicted with the B.117 variant, first uncovered in Kent. The reported percentage for France is 76.3% of new daily cases. It is also sweeping Germany and Poland amongst other countries.
What is clear is that the variant did not come from England to infect so many nations. It would appear to have mutated spontaneously in more that one country. (Britain does half the world's genetic sequencing of Covid-19 so it always had a good chance of identifying a variant early).
Leaving schools open in a pandemic is a political decision. It is not feasible to have them shut all year round.
It is possible, however, that the B.117 mutation has emerged where schools have remained open for full terms, the virus having changed its make up to spread more rapidly between people who are not badly affected by it.
The B.117 mutation emerged in Britain at the tail end of a full term. It is sweeping France after schools have been left open for a prolonged period. It is disappearing from Britain after a long school closure, a vaccination programme that reduces population susceptibility and in a continuing and prolonged lockdown.
This does not establish a causal link.
At most a few hundred cases of the South African and Brazilian variants have been detected in Britain and have not resulted in serious disease outcomes. The dominance of B.117 in terms of transmission may also be limiting their ability to replicate.
The reported combined incidence of these two variants for France is 4.7%. Given this must represent many more cases than cumulatively have occured in Britain, one must question whether the variants were actually imported to continental Europe or also spontaneously mutated there.
The data recently supplied by Astra Zeneca about its trials in America suggests its vaccine is 100% effective at preventing hospitalisation and death even in respect of these two variants.
By mid-April Britain is likely to have vaccinated the 99% of its population most at risk of disease - or at least offered vaccination to it in a country where the take up rate is very high amongst those offered vaccination.
Allowing for margins of errors in all statistics and should the Pfizer vaccine, the other vaccine in use in Britain so far, have similar effectiveness in preventing hospitalisation and death from the two variants, there is no cause for Britain to excessively fear the two variants or maintain a hotel quarantine system beyond 17 May 2021.
Reinfection is possible from the Brazil variant (if it is not suppressed first in a population by B.117) but it would appear it cannot cause hospitalisation or death in those vaccinated. It may escape those antibodies that prevent its entry into the body but not those primed by vaccines to combat or kill it, nor escape T-cells.
The risk, therefore, mainly subsists to the unvaccinated, but all variants have not been demonstrated to produce significantly different outcomes in hospitalisations or deaths from one another. These are now falling significantly following much reduced transmission in Britain.
In global terms, the Oxford team remains essential in modifying the Astra Zeneca vaccine to counter emerging variants and in developing vaccine that can be used for children.
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5 April 2021
In an imperial age Britain made rules for the world but the world has tired of that and sent it on its way.
It was fun going to Lord's cricket ground knowing that in this spot the rules for cricket were administered and anything else was not cricket but that was eventually Packer-ed off to where it belongs.
What is holding Britain back now in the 21st century and will continue to do so is its propensity to continually be making rules for its own citizens as a substitute. The state, and the corporations too, can continually be making rules that eventually overwhelm and confuse in their profusion but they do not substitute for reality.
What makes Britain stand out are its relations with the whole world and these are under great pressure. In every sector they are the icing on the cake that stops it being just vanilla sponge.
Looking to the state to set all kinds of rules and give permission simply will not work. It is not able to do things, just set rules that annoy citizens.
We are fortunate that a team not essentially dominated by the civil service agreed vaccine contracts and that local NHS operations have so effectively rolled out vaccination but these are not classic actions of the central state. Despite the personable nature of spokespeople we should not swallow the shamanism that has surrounded public health policy for so long.
Dare one say it, given the poor performance up to March 2021, but the U.S. is becoming the example of how a Covid-19 infected, large society should react. Rapid vaccination - even faster than Britain - mask wearing and social distancing are at the heart of federal messaging but ultimately the individual states and citizens are not much controlled centrally.
What the state will do most is modify worn out economic policies that hinder advance.
Continental proximity to the Brazilian variant does not mean it can be kept out but neither does it mean it will gain purchase in a vaccinated society or one with widely differing social and geographical conditions.
In Europe the big spikes in infection are very likely to have tailed off to levels now found in Britain within 6 weeks, especially if vaccination programmes are accelerated and new central dictats that confuse are limited.
Then by 17 May 2021 most of this continent may be clear of high incidence and ready for international exchange.
Do the maths properly and it will be apparent that if a quarter of the population has been vaccinated the main sources of remaining risk will be schools, as pupils remain unvaccinated, and densely used workplaces, in that order.
25 August 2021
As we approach the return to school in England we also approach, as in 2020, the biggest risk factor for the escalation of Covid-19 incidence.
In the summer term 2020 a return to school was aborted and it took Covid-19 incidence down to its lowest level since the commencement of the pandemic.
In January 2021 the return to school was cancelled on the first day and headed off an even more horrific expression of the Alpha variant than took place amongst a largely unvaccinated population.
Why Britain should have to rely on school closures to save the bacon is related to complex factors.
One surely is that the British ethos of health has made clients out of the population. People are taught to believe the NHS will look after them from cradle to grave, that their health is its responsibility and it will get them out of jam, and that they must wait for it to give them instructions. None of this is true and has never been more demonstrated than by the pandemic.
One small silver lining is that people took the instruction to turn up for their double jabs but the willingness to swallow the outdated ethos swiftly diminishes, rightly, below 25 years of age. This is a new generation that calculates the odds for itself. More important, therefore, that the odds are rationally explained and not reduced to diversionary incentives like being permitted to go to nightclubs if vaccinated.
We are in a different situation from August 2020, when no one was vaccinated, and the odds are different.
Some can take voluntary risk to re-enter society because they are double vaccinated and have low probability of getting serious disease.
Some have to take involuntary risk to re-enter society because they are not vaccinated, insufficiently vaccinated or their life requires it. These are predominantly young - children, students, young members of the workforce.
They mostly also have a low probability of getting serious disease but a much higher probability of getting some disease. They might, say, have a one in four chance of getting the disease before the end of the year.
Another group is vaccinated but still do not like the odds because they have other risk factors that do not lend themselves to oversimplification.
What happens to schools is a political judgement, what happens in workplaces about employers yielding to commonsense and university students are adults and should be treated as such.
What we should not do is take refuge in blaming travel or insufficiency of testing for Covid-19 incidence.
International travellers this quarter have almost all been double vaccinated, except children, and obliged to take a minimum of two PCR tests. They are probably the least likely to have disease or to possess the capability to pass it on as double vaccinated people have a lower capability. The best air transport business cluster in Europe currently trails much of Europe and needs to be fully opened up along with the Channel Tunnel.
Likewise, even a parliamentary investigation concluded that test and trace had little impact on the pandemic. Testing is a diversion from taking responsibility for both the authorities and individuals.
The risk areas from September are clear. In order - schools, workplaces, closed or semi-closed institutions .... with outdoor hospitality and all retail well down the line.
The remedies are clear - vaccination, taking responsibility, social distancing, masks, ventilation regimes and closing schools in that order.
A giant ethical problem with vaccinating children is that historically no one properly asks children's views or even their permission. It is not for the NHS, schools or even parents to decide. If it safe for children over 12 to have the vaccine then it should be their decision should it be offered to them.
As so many can now take voluntary risk, closing retail and lockdowns should not be necessary.
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29 November 2021
It has to be accepted that hotel quarantine has failed on its own terms in both Australia and the United Kingdom. It is just that we are not told how; no-one likes to publicise failure.
When a new global variant of concern emerges, as has been the case with Omicron in the last few days, the time flight bans are effective are in the first few days or weeks when cases in a big country are in single figures to hundreds. In February 2020 I favoured a three week flight ban from four countries before the British government accepted that the original virus was in the wild in its own territory.
Then, as now, the financial markets were and are indicating that the virus is in the wild globally. There are always people in the know and that leaks to the markets.
However, once the number of cases pass 1000 in a large country there is no further point in flight bans and, more importantly, strict quarantines are bound to fail. It will then be time to switch to domestic only measures or an approximation to them. There is already a non-travel related case in Scotland.
The anti-Covid measures protests that have turned violent in Europe are a big warning.
We need measures to get us through the next six weeks but thereafter a proper assessment of Omicron will have been arrived at.
Covid passes and similar may be attractive to people with controlling tendencies but they risk substituting box ticking for reality just as focussing on travel rather than implementing domestic measures was a widespread form of escapism from reality in the early months of 2021 in the U.K.
In 2022 those countries with Covid pass regimes should start dismantling them. Their populations will be reaching the maximum level of people who have voluntarily agreed to vaccination.
Civil disorder is best avoided. People need to get to their families in periods of disease. It would be better for admittance to services to be allowed by taking people's word that they have been vaccinated rather than engage in box ticking exercises that create artificial classes of citizens.
Doing so will create peer pressure on outliers. Accepting that someone saying that they have had three vaccinations, or the vaccination and the disease, is fairly likely to be telling the truth is better than just scanning a document. The person wielding the document might be feeling dreadful but the document lets them through and the personnel doing the scanning are at risk.
As societies pass 70%, 75% or 80% full vaccination rates they need to reassess depending on their population age profile. Living with continuous mutation of the virus is necessary.
If drugs that take down the disease in the early stages can be made available at vaccination drug prices then mass use of them through general practitioners should be instituted. Mass use will yield a proper return on drug development costs. Used this way in combination with vaccination, mortality rates could be made comparable to those from flu. The hospital system deserves such a refocussing if Covid-19 remains endemic.