The recent brisk treatment of Professor Allyson Pollock on twitter by fellow medics reminds us of how polarised views about covid–19 have become. Pollock’s chief point, that a positive PCR test for covid RNA doesn’t on its own prove infectiousness is perfectly reasonable, and Dr No agrees. Finding a broken fragment of a needle in a haystack doesn’t mean you can conclude the haystack is a working sewing machine. Yet an army of contrarians queued up, expressing views ranging from astonishment that she ‘would be willing to risk lives like this’ (argumentum ad homicide), and admonition ‘we have been screening pre-op cases for six months – it’s the accepted standard of care…the position of all four surgical colleges is clear’ (argumentum ad authority and populum), through incredulity ‘the whole thread is wrongheaded’ (argumentum ad bonehead) to imploration ‘loved your book but you are absolutely supporting some nonsense here’ (absolutely argumentum ad incredulum). There was, in short, argumentum ad nauseam, but what was conspicuous by its absence was even a single reference to any evidence that a bald positive covid PCR test confirms infectiousness.

This means, to put it bluntly, that all the arguments ranged against Pollock are opinions. It also means that Pollock’s point is also an opinion, but that is inevitable: you can’t prove a negative, so we might say it is partly her best assessment of the current (inadequate) evidence, but also more importantly a conclusion of unimpeachable logic (broken needles don’t prove haystacks are sewing machines). What about the other side? A quick look at the ‘position of all four surgical colleges’ reveals a dated (March to early June) guidance document with prose turgid enough to make the toes curl that relies on dodgy data, including the infamous sick old patients undergoing major operations are more likely to die paper. Nothing particularly substantial there, and nor is there anywhere else. So how is it that a normally level headed sensible body of professional opinion can become so polemic?

The answer, Dr No suggests, lies in popular delusions and the madness of crowds. This of course is a marginally truncated phrase — done merely to keep the post title to  length — taken from Charles Mackay’s Extraordinary Popular Delusions and the Madness of Crowds, an early study of crowd psychology first published in 1841. Among other events, Mackay analysed Tulip Mania, the Dutch 1630s speculative bubble centred on the newly introduced tulip, and described a sequence of events, since challenged, it has to be said, but that doesn’t impair the general observations, that came together to create the bubble. Could the covid–19 pandemic, and more importantly, the global response to it, be a similar phenomenon, just transplanted from the botanico-financial world to the pandemico-medical world?

The similarities in the processes and steps are striking. First, there is the introduction of something new, tulips and a novel virus, that catches the attention of all members of society. Both Tulip Mania and the covid–19 pandemic are driven by consuming passions, very different in appeal, it is true — the accumulation of wealth, and the avoidance of death — but still nonetheless all consuming passions. And crucially, both are driven, because perhaps this is the key thing, by dodgy numbers. This unholy trinity, of something new, that inflates passion, and is imperfectly described by uncertain numbers, is common to both Tulip Mania, and indeed other financial manias, and the global response to covid–19. The consequences are catastrophic: speculation, about wealth/deaths, becomes rife; absurd investment in futures contracts (for bulbs, vaccines, test and trace, Moonshots) follow; and the bubble grows absurdly and uncontrollably.

Which is where we are now, in the violent grip of covid mania. It is this mania, fuelled by dodgy numbers falling on the fertile ground of inflamed passions, that drives establishment science, the merchants of doom, the milk curdlers, the bed wetters and of course the army of Pollock’s critics. The conflation of an all consuming end, of wealth or death, with swirling numbers, is as matches are to petrol, and the results are equally as dangerous. In the ever-growing tension of the covid bubble, the sick elderly who would hitherto have been allowed a gentle humane end of nature taking its course are drawn instead into the maelstrom of covid mania: all lives, but especially covid lives, must be saved, whatever the cost; and this too then feeds the mania, by inflating the numbers. Yesteryear’s quiet natural death becomes today’s covid death, added to the over-whelming ever rising oh-my-God tide of numbers, and the bubble, already obscene, grows ever larger. And yet those caught in the bubble remain blind to the fact that the vast majority of alleged covid deaths are deaths with covid in the sick elderly who were likely to die soon — within years rather than decades — and yet these normal course of events deaths get sucked into the covid maelstrom, further fuelling the mania.          

Tulip Mania is history, part of the history of the folly of mankind, but the same cannot yet be said for covid mania. The bubble is still growing, but one day it will end. What happens on that still to come day depends very much on what we do from now on up to the day when the covid bubble ends. We can feed the mania, grow the tension, and pump up the numbers — recall, it is numbers that are the engines of these manias — by doing ever more absurd numbers of tests. We can carry on the absurdity of describing deaths with covid as deaths from covid. We can carry on the devilish cycles of draconian distancing controls, that themselves feed the economic tension of the bubble, and the bigger the economic tension of the bubble when it bursts, the more dreadful will be the consequences. We can, in short, build a bubble so large that when it does finally burst it takes with it all that we hold dear.

Or we can calm down. There is much talk these days of the rather bizarre notion of circuit breaker lockdowns — bizarre in the sense that covid the disease is somehow some sort of circuit — it isn’t, it’s a train that goes from A to B, C or D, from infection, to recovery, long covid or death. What if instead we apply a circuit breaker to something that is more a circuit, the swirling looping ever-rising cycle of ever more tests? Perhaps the most sensible way to ease covid mania is to put the brakes on ever more tests, tests that are in themselves all too often quite uninterpretable. That way we can take the tension out of the bubble, and allow it to deflate gradually, and controllably. Such an end, Dr No suggests, is infinitely preferable to the alternative of letting rip with popular delusions and the madness of crowds.

This article has 4 comments

  1. Tish Farrell Reply

    Yes, for godsakes stop the tests. I’m sure I read some time ago that the Chinese simply stopped testing (and drat, I don’t have the reference). My fear is the ‘soaring’ ‘positive’ results may well be used to justify mass vaccination under emergency terms (administered without licence or liability as the Gov. vaccine consultation document implies could happen). It’s the perfect self-fulfilling sales tool.

    Actually another thing the public doesn’t know is whether the PCR tests used in the UK have been fully approved or if, as in the US they are being used under emergency terms and do not have FDA approval. https://diagnostics.roche.com/global/en/products/params/cobas-sars-cov-2-test.html

  2. Mike S Reply

    Thank you Dr, you have hit the nail right on the head. I’ve been fascinated for years by Mackay’s work and always felt it applied to Covidism. The mania can certainly be identified by the illogic that a Covid death is somehow vastly more significant than a death by any other means and that no cost is too great to prevent even one.

    We see the same illogic here in the US where the only black lives that seem to matter are the ones killed by white policemen (on video), no matter what the circumstances.

    Do you think that the idea that these lives are more significant is a manipulation by those exploiting the manias, or is it simply a natural conclusion for everyone who has fallen into the mania’s grip?

  3. dearieme Reply

    The public, and many politicians (and many doctors?) don’t have much quantitative sense of risk. So here’s my suggestion for a two-step explanation of the risk of Covid-19 in Britain (or England, or where you will).

    Step the first: state the age at which Covid becomes deadlier than the flu of an ordinarily bad flu season. Thus tell everyone that, unless they are already invalids, they are at less risk from C19 than flu until the age of 60 (or whatever the age turns out to be).

    It’s true that this measure has to use the rather rough numbers for death by C19, but if they can be replaced by the rather better excess deaths, by all means do so. Also note that the phrase “unless they are already invalids” could well be deleted if (as I suspect) those poor souls are also particularly vulnerable to flu too.

    OK: so now we have one number that even the innumerate can understand: your risk from Covid is less than that from the flu if you are under (say) 60. So much for relative risk: now for absolute risk.

    Step the second: state the number of deaths by C19 so far for those non-invalids under (same guess) 60. Again, even the innumerate would understand – I hope – that if only (wild guess) eight hundred well people under 60 have died of C19 in six months, then it ain’t the Black Death.

    Indeed, our PM might add, it is less deadly than … list some things e.g. less deadly than motorcycling, less deadly than smoking cigarettes, less deadly than mountaineering, less deadly than males under 25 driving cars, less deadly than … Remember to base those comparisons on per thousand who do such-and-such, e.g. motorcycling, mountaineering, …

    And that’s it. You only have to get two numbers into people’s heads – the crossover age, and the number of deaths to non-invalids below the crossover age. No stuff about means, standard deviations, skewness, kurtosis, mad bats, pangolins, China, Mr Trump, Dr Fauci, Professor Ferguson, the Chief M.O., the Chief Scientist, the Sage committee, Nicola bloody Sturgeon, and all the other sorry crew. ….

  4. dr-no Reply

    Tish – as I mentioned before, I have not been able to find out which PCR tests are used in the UK. That said, that Roche link (note you have to click through various intermediate pages/screens – go for the health professionals version) is very interesting. The tests are clearly intended for diagnostic not screening use (“The cobas® SARS-CoV-2 Test provides reliable and high-quality results for clinical decision-making for the improved management of COVID-19 patients” and “clinical correlation with patient history and other diagnostic information is necessary to determine patient infection status”). They also say the test is a qualitative (so not a quantitative) test.

    Dr No hasn’t yet posted on mass vaccination, partly because as a UK doctor he prefers to think it inconceivable that UK doctors would condone forced (mandatory) vaccination. But it is an area very much under review eg the forcing could come from coercive controls (health passports, restriction of liberties etc if not vaccinated) ie measures introduced by government, so people ‘volunteer’ for vaccination – but the problem is, coerced consent isn’t consent…

    Mike – I tend not to be a conspiracy theorist, so I incline more to the view that the various XXX lives matter (with their rather non-inclusive implications that others don’t…) movements happen as a (herd) response to circumstances, rather than a result of some group’s deliberate attempt to bring them about. That said it all falls on very fertile ground, given the modern ‘I identify as’ fetish, and then there is the role of the media…

    dearieme – agree, judging risk is generally poor, for all sorts of unfortunate reasons, many documented in the literature. I can also confirm a lot of doctors are somewhat less able to judge risk than one would hope in a profession where an understanding of risk is pretty central to what we do. To many doctors still use relative risks when they should be using absolute risks or NNTs/NNHs etc, and too few have a proper grasp of, and have available at their fingertips, things like PPVs (eg for say PSA and other tests on the Great Prostate Train Crash Journey, so a lot of men end up on the Prostate Express not really appreciate all the risks).

    Also agree that expressing risk by using comparators is simple but effective, and provides context. And of course fully agree with avoiding obf*ckstrating terminology (and people) at all costs!

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