Richard North, 02/06/2020  

In an interesting intervention, Prof. Hugh Pennington writes in the Telegraph that there is no evidence to suggest a coronavirus "second wave" is coming. He's right. There isn't any evidence.

For quite a while now, it's been pretty obvious that there wasn't even a first wave, or "peak" or "spike", or whatever  you want to call it. The single epidemic curve was simply an artefact for the ignorant to get excited over.

In reality, there were simply multiple outbreaks bubbling up, each with a fraction of the case-rate recorded and some of the deaths. The summation over time gave a curve which approximated what a single outbreak curve might have looked like, had there been one.

But the data collection system is so flawed, and the recording so degraded, that the curve conveyed no useful epidemiological information. In a very real sense, it actually obscured what was going on. Yet still, politicians and pundits alike blather about an "outbreak" and a "pandemic" as if it was a single entity, warning portentously about a "second wave".

At least Pennington puts the "second wave" canard to bed. He considers that the evidence supporting the notion of a second wave or peak of Covid-19 infections in the UK that would swamp the NHS "is very weak".

People, he says, are taking the idea of a devastating second wave almost entirely from looking at the profile of the 1918 Spanish flu pandemic. The first wave occurred in June and July and the second in October and November. The first was mild and the second was lethal.

Although it has yet to be explained why the infections occurred in waves and why the virus faded away after the first and then returned, the fact is that the profile of Covid-19 has been different.

Far more than we have ever experienced with flu, this disease has most commonly occurred in clusters. Says Pennington, in New Zealand (which may well have eradicated the virus), 41 percent of cases occurred in 16 clusters of 13 or more cases in each. And, sadly, in the UK the virus has taken an enormous toll on residents of care homes, many of which have had multiple cases.

He doesn't say it, but somebody must. A number of clusters – unknown in the secretive environment of the NHS - have occurred in hospitals. Given the information from Sage and our own observations, the epidemic profile has most likely morphed, making this largely an institutional disease.

Of course, if we had a halfway decent epidemiological system, we would be getting the information back from the ground and we wouldn't need to guess. But with this half-arsed, top-down system devised by Hancock and his PHE "experts", most of the key information which we need is either not collected or goes missing. What is left is largely unusable for epidemiological purposes.

For Pennington though, he is confident enough to assert that, if we get the easing of lockdown wrong, we are "far more likely" to get "a continuation of infections, many in the form of localised outbreaks, but not waves or peaks".

Needless to say, that would not stop the painfully inadequate pundits, who have acquired all the skills of born-again epidemiologists, again misreading the cumulative curve and coming to false conclusions.

But there is also an agenda here. There is no way Hancock or his minions are going to admit that Covid-19 has become a disease of institutions – meaning that his beloved NHS hospitals are a major part of the problem. Presenting cumulative figures hides that problem – but it also makes sure it is never properly addressed.

At the very heart of the problem, though, Pennington asserts, are the "defeatist flu models". They "still lurk behind current Covid-19 predictions", he says, adding that the idea that the virus will persist for ages "is a flu concept".

These predictions should be put to one side, he says, "Like Sars, and unlike flu, the virus is eradicable. If China and New Zealand are striving to be free of it, we should be, too".

For that to happen, though, requires a level of understanding that is not manifest in the Department of Health, or in the ranks of Public Health England. But it would also need political courage to admit that, after all, Covid-19 is controllable.

Even our cadre of thick journalists might then eventually ask why we failed to take measures to control it from the outset. At the moment, as a collective, they still haven't understood that the model was one of planned retreat, based on the 2011 pandemic flu plan which stated, "it will not be possible to halt the spread of a new pandemic influenza virus, and it would be a waste of public health resources and capacity to attempt to do so".

As it stands, these precious darlings are still bogged down in the idea that shortage of resources prevented an effective response, their limited brains failing to grasp the concept that we didn't have the resources to fight this disease because we never intended to fight it.

Just as an army that doesn't intend to fight doesn't stockpile expensive weapons or recruit and train soldiers, a health system which is not planning on suppressing a pandemic when it arrives on these shores isn't going to support expensive systems that it has no intention of using.

The point that stems from this is that, had Blair's government in 2005 not made a wrong turn, and had not every successive government perpetuated the original error in not planning for a SARS-like disease, and making the resource available, the lockdown could have been avoided or kept very much shorter.

As much to the point, had data collection been properly localised, we would have immediately seen the cluster profile. Local or regional lockdowns – as are being mooted at the moment – could have been the norm. There would have been no need for a national lockdown. In truth, there never was a need, but we didn't have enough of the right sort of information to make that case.

However, there is no getting past the resource issue. As Edward Spalton for the Campaign for an Independent Britain asks, "Could pre-Seventies localism have halted the spread of COVID-19?". The question, of course, is rhetorical.

We have enough information to know that old-school "shoe-leather" epidemiology would have stopped this epidemic in its tracks. As Spalton points out, money is not the only requisite.

The Indian state of Kerala, he writes, has a population about half of the UK’s and its gross domestic product (GDP) per head is only £2,200, compared with £33,100 in the UK. Yet Kerala has done amazingly well under its vigorous Minister of Health, a lady called K K Shailaja.

The reason why is precisely because old-school techniques were used. While the fatuous Hancock has been dazzled by computer models, and misled by his advisors, Shailaja went back to basics and adopted the time-honoured policy of test, trace, isolate and support.

Even now that Hancock is talking the talk, nothing he says can be believed. His "world class" test and trace system is a shambles. It was supposed to be ready last week but now Downing Street admits that it will take a "period of time" before it is fully operational.

Even if it ever gets to that state, however, it will never be fully effective. The fundamental structure is flawed. Without the flaws being recognised and addressed, the requisite improvements can never be made. As the system fails, all they will do is apply layers of sticking plaster to it, in an attempt to make it work. Sooner or later, it will get so top-heavy that it will topple.

Without government intervention though, the epidemic quite obviously is waning – but the price we have paid is far too high and unnecessarily so. And, in the face of continued government incompetence, we can expect Covid-19 to grumble on in the background, in a series of local outbreaks, just as Pennington suggests.

The majority of those, however, will be in institutions such as NHS hospitals, which are not equipped to control infection and will continue to act as reservoirs of infection, keeping the epidemic going. Community-originated infection will remain relatively rare.

Perhaps if we renamed Covid-19, we might get some action. If it was called "government stupidity", I cannot see ministers lasting long if, each day, they have to stand before the nation and tells us how many people have died from that cause. That is what is happening though – all they have to do is admit it.

Also published on Turbulent Times.

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