Articles Written By: dr-no

There has been much fuss over the question of whether covid–19 is a truly exceptional event that justifies the draconian restrictive measures imposed by decree that our governments have freely, even wantonly, applied, or whether it is just another seasonal flu like illness. Dr No, readers of this blog will know, is inclined to the latter view. One way of attempting to get closer to a definitive answer to this question is to compare the Spring 2020 covid spike in deaths with previous spikes, and see how it measures up. There are problems, though, in doing this: not only has the population grown in size (so pro rata, all other things being equal, we expect more deaths), but it has also changed in age structure (more older people, so again we expect more deaths). And if that wasn’t enough, underlying health and medicine’s capabilities have also changed — hopefully for the better — over time, so we might expect less deaths.

Bad mental picture of the week so far is an image of Boris Johnson in a Santa Claus outfit stuck upside down in a fireplace chimney chortling ’tis the season to be jolly careful. In the recurring nightmare Dr No endured last night, all attempts to light a fire under the bastard ended in failure, and Dr No drifted off into fitful sleep only to wake again with a fresh box of Bryant and May’s in his hand, for the whole ghastly cycle to repeat itself. If the nightmare comes back tonight, Dr No will be up on the roof with a vat of boiling oil. Simple, but effective.

There’s not much to be said yet about the Pfizer vaccine study itself. It’s still early days, the case numbers are small, and there is still more than enough oppatoonity as they say Stateside left for it to fall over. But hidden within the interim results released last week is a rather interesting accidental study, which does bear having something said about it. Though not set up as such — and normally this would be a serious objection — the study is, in its placebo arm, as near as can be to a prospective covid–19 incidence study. Healthy patients have been enrolled, and assiduously followed up for months, to see, among other things, whether they develop covid–19. That is exactly what a prospective incidence study does. What does the study so far tell us about covid–19 incidence, and how does the study’s incidence compare with other estimates? Might we at last get a better idea of real incidence, and so a better idea of whether we are over or under reacting to the pandemic?

Only in Liverpool could it be done. Announced with a fanfare fit for a king, Liverpool has become the first city in the UK to organise mass covid super-spreader events, all in the name of public health. All covid symptom free Liverpudlians are being urged to gather at multiple sites across the city over the coming days in a pilot study to assess whether residents of the city famous for its identikit citizens really are thick enough to congregate in groups of a hundred or more to facilitate rapid covid spread across the community. Speaking to the BBC, Matt Ashton, the city’s Director of Public Health said, “This is a fantastic locally led national opportunity to get hundreds of uninfected people to mingle with infectious but asymptomatic super-spreaders, and spread covid far and wide, using rapid lateral flow infection. It’s not for nothing we say in Liverpool, you’ll never walk alone!”

Dr No wrote this post (starting at paragraph 2) yesterday — and what a difference a day makes in covid. Overnight, news has broken of catastrophic worst case scenario predictions from the government’s pandemic modelling group SPI-M for the coming winter, with [enter your own choice of a large number here] deaths possible unless radical measures are taken immediately. Headlines vary in their degree of certainty, but the general message is that Boris Johnson is set to announce a national four week lockdown on Monday. Dr No takes a dim view of these hysterical worst case scenario predictions, viewing them as nothing more than Ferguson Reloaded. Though not yet fully in the public domain, some un-referenced blurry details have emerged, along with a completely unintelligible ‘surge capacity is burnt through’ Cabinet Office ‘timeline’ chart of hospital overload based on the SPI-M modelling, which once again suggest yet more modelling on steroids. Despite the appearance of these dire predictions this morning, Dr No continues to believe the NHS is not at risk of imploding by what the Cabinet Office calls ‘Xmas week’, and so publishes the post now as it was written yesterday.        

One of the most exciting and at the same time frightening developments of recent years has been our ability to collect and analyse vast amounts of data. Something of the sort has always been possible, but it was only with the arrival of cheap personal computers that ologies like epidemiology have been able to move from pencilled clustered tally marks ‘ ‘ analysed with back of the envelop chi-squared tests via the hidden 1s and 0s of computers to massive data sets probed in ways quite unfathomable even only a few decades ago. Back in 1982, the year Dr No qualified, no one had heard of logistic regression or data modelling. Google’s Ngram Viewer — itself a wonderful example of data collection and analysis — shows that both logistic regression and data modelling took off in the mid nineteen eighties. Add the discrete citizen surveillance device more commonly known as the smart phone, and the explosion in social media use, which have together enabled  the collection of personal data on a huge scale, and we now find ourselves living in a world where data is everything, and everything is data; a world in which once unique individuals have become transformed into numbers, to be probed, analysed and described at will, not as individuals, but as data.