Coronavirus: buying time

26/03/2020

The daily figures for Covid-19 cases and deaths have been getting later each day but yesterday Public Health England excelled itself. It was well past nine in the evening before they finally appeared and then with the caveat, "these figures do not cover a full 24 hour period".

Nevertheless, the 1,542 increase in the cases was impressive enough, bringing the total to 9,529. But the 463 dead reported – up only ten percent from 422 the previous day – is significantly less than might have been expected.

Conveniently, the lateness of the hour and the fact that they are incomplete have kept the figures out of the headlines, leaving the media all over the place. Some newspapers have Johnson's "volunteer army" for their front pages while some pick on the promised availability of a virus test. Almost all feature Prince Charles as a mild coronavirus sufferer.

But yesterday was also a day when, it seems, there was an intent to inject a note of optimism into the proceedings, with Foot & Mouth modeller Neil Ferguson from Imperial College London telling us that the crisis could be over by Easter. Furthermore, Ferguson is "confident" that the NHS can remain "within capacity" and cope with the surge of cases.

Ferguson is a member of the government's scientific advisory group for emergencies (Sage), and has produced a report suggesting no more than 20,000 people might die from coronavirus. And in his optimism for an early peak for the epidemic, he has the support of deputy chief medical officer Jenny Harries who also believes the worst might be over by Easter.

Strangely, though, even the fanboy gazette is casting doubt on the magical predictions of the modellers, noting the absence of reliable data and urging caution in its interpretation.

It quotes Rosalind Smyth, director and professor of child health, at the Great Ormond Street Institute of Child Health, warning that Britain simply has no idea how many cases it has because of a lack of testing. "On conservative estimates", she says, "the true figure is likely to be five to ten times higher".

These are the sort of issues I was addressing a week ago in my post on "number crunchers", and now, even the Guardian is getting in on the act with a piece headed: "The UK's coronavirus policy may sound scientific. It isn't".

This is a commentary by Nassim Nicholas Taleb is distinguished professor of risk engineering at New York University's Tandon School of Engineering and author of The Black Swan, together with Yaneer Bar-Yam, president of the New England Complex System Institute, and they have some interesting observations to make.

Firstly, the pair rather put the modelling fantasy into perspective, telling us that their work did not use any complicated model with a vast number of variables. It was no more necessary that "someone watching an avalanche heading in their direction calls for complicated statistical models to see if they need to get out of the way".

The trouble I find, though, is that these modellers, with their graphs and charts and the faux certainties offered by complex computer calculations, based on mysterious formulae and algorithms, have a strange allure for hard-pressed politicians in crisis situations, seemingly giving the comfort of certainties that simply do not exist.

Taleb and Bar-Yam actually point out that the error in the UK, in managing this epidemic is on two levels: modelling and policy-making.

Firstly, at the modelling level, they say that the government relied at all stages on epidemiological models that were designed to show us roughly what happens when a preselected set of actions are made, and not what we should make happen, and how.

As such, the modellers use hypotheses/assumptions, which they then feed into models, and use to draw conclusions and make policy recommendations. But the assumptions are untested and lack robustness. They are fine as academic models but, say Taleb and Bar-Yam, "if we base our pandemic response plans on flawed academic models, people die. And they will".

This was the case, they say, with the disastrous "herd immunity" thesis which, in fact, was nothing more than a dressed-up version of a "just do nothing" approach which never had the slightest chance of working – as indeed I pointed out at the time.

But the second, and more grave error, is the policymaking. No 10, we are told, appears to be enamoured with "scientism" – things that have the cosmetic attributes of science but without its rigour, this making it so attractive to politicians (and their advisors) who have a limited grasp of science.

This, say Taleb and Bar-Yam, manifests itself in the nudge group that engages in experimenting with UK citizens or applying methods from behavioural economics that fail to work outside the university – yet patronise citizens as an insult to their ancestral wisdom and risk-perception apparatus.

Social science, they say, is in a "replication crisis", where less than half the results replicate (under exact same conditions), less than a tenth can be taken seriously, and less than a hundredth translate into the real world.

So what is called "evidence-based" methods have a dire track record and are pretty much evidence-free. This scientism also manifests itself in Cummings's love of complexity and complex systems - which he appears to apply incorrectly. And letting a segment of the population die for the sake of the economy is a false dichotomy – aside from the moral repugnance of the idea.

The view of Taleb and Bar-Yam is that, when dealing with deep uncertainty, both governance and precaution require us to hedge for the worst. While risk-taking is a business that is left to individuals, collective safety and systemic risk are the business of the state. Failing that mandate of prudence by gambling with the lives of citizens is a professional wrongdoing that extends beyond academic mistake; it is a violation of the ethics of governing.

The obvious policy left now, they say, is a lockdown, with overactive testing and contact tracing: follow the evidence from China and South Korea rather than thousands of error-prone computer codes. Thus, "we have wasted weeks, and ones that matter with a multiplicative threat".

Yet, for all that, they have said nothing that hasn't already been said on this blog, and elsewhere. There only place where there is no sense of control is No.10, where Johnson continued to wing it, buoyed by extremely dubious modelling from the same team that brought us death and destruction in the Foot & Mouth epidemic.

As yet, though, the Johnson administration doesn't have a plan B, but you have to admire its skills in creating the superb distraction of the "volunteer army", which has the media taking its eye off the ball. But, with both Italy and now Spain, leading the way in emergency treatment (pictured), indicating our direction of travel, this can surely only be short-lived.

One gets a sense though that, deep down, Johnson still thinks this is a problem that will go away of its own accord, and that all he needs to do is hold his nerve until the crisis abates. And if that is the case, the likes of Neil Ferguson are playing to his weakness, bolstering his fantasies.

For the moment also, this is buying time, as is the promise of home testing kits, which may or may not be available in the near future. But while, as I recently warned, you can't bullshit a virus, fudging the figures will only give you so much respite before reality comes crowding in.

And, as Pete illustrates, there are complications to this epidemic that go way beyond Johnson's limited competence to deal with. Having failed even to grasp the domestic dimensions, his dire tenure as foreign secretary make it unlikely that he will be able to deal with the broader international issues.

However, if it was buying time that Johnson was after, it looks as if he has partially succeeded. An astute politician, though, buys time to seek solutions. Johnson seems just to be deferring the crisis in the hope that it will go away. It won't.