Articles Written By: dr-no

Naturally enough, the UK and devolved governments, and for that matter others who should know better, have attributed the recent declines in daily covid–19 new cases and deaths to the hard lockdown measures put in place in March. This is one of the oldest logical fallacies of them all, the post hoc fallacy. This says that because B followed A, it follows that A caused B. We might just as well say the clocks changed to BST on the 29th March, and soon after that covid started to decline, ergo moving to BST got covid under control. Such divinations are more at home on the ouija board  than in the realm of natural science.

Professor Lockdown, Legover, Pantsdown, call him what you will, may have stepped down as a government adviser (Professor Stepdown), or even been fired (Professor Crackdown) and ordered to keep a low profile (Professor Heads Down), but his pernicious modelling persists (Professor Stayed On), with its tens to hundreds of thousands of deaths (Professor Mow Down) and an overwhelmed NHS (Professor Meltdown), while he himself remains in post on full pay (Professor Drawdown).

One of the unexpected consequences of the lockdown has been the extent to which we Brits have taken its central message — stay home, protect the NHS, save lives — to heart. The behavioural nudge experts got it wrong. Far from people getting lockdown fatigue, quite the opposite has happened. A majority of us have instead internalised the lockdown, as shown in two recent surveys, one covered by Dr No in his last post, and a second, commissioned by The Observer, and published over the weekend. Both consistently show that by and large people are afraid to go out. Stay home has stuck. #stayhome is now #stuckhome. If we are not careful, #stuckhome might just become #diehome.

Putting aside the leery banality of the Nick Robinson interview, the next greatest threat to public service reporting is the sense–of paradigm. Pioneered by the Welsh Windbag known for the time being in this parish as Hoo Wedwards, BBC news anchors no longer ask correspondents in the field, ‘what’s happening?’ Instead, they direct the correspondent to ‘give us your sense of what’s happening, as you see it.’ Intended to make the news sound more direct and personal, the effect is instead one of serial dilution, until there is nothing of substance left, as in a homeopathic remedy.

Happenstance, coincidence and enemy action, the doctrine of three developed by Dr No’s colleague Goldfinger, is as good a guard as any against the risk of over-reacting to chance events. The time to sit up take notice is when something exceptional has happened not once, but three times in a row. The ONS has now reported exceptional rises in the weekly number of all cause deaths in England and Wales for three weeks in a row. It is time to sit up, take notice, and ask, what is going on?

As an appendix to yesterdays post, Dr No is going to do a run through of another reason why high hopes of antibody testing being a game changer will most likely turn out to be false hopes. It is also an introduction or aide-mémoire to the more general question of how do you go about establishing the usefulness of a diagnostic or screening test, using screening for covid-19 antibodies as an example. As always, complex formulae and other numerological devices will be avoided in favour of plain words and simple numbers. You really can do these sums on the back of an envelope.

It is a truth universally acknowledged, that a population assailed by a pandemic, must be in want of a game-changer. More often than not, the game-changer for covid-19 involves antibodies. Antibodies tests will both allow us to know the true community rate of infection, and allow us to manage the safe return to work of those shown to be immune. Knowing the true community rate of infection in turn allows us to assess how close we are to achieving herd immunity, which in turn can be achieved not by letting the virus rip through the community, but by the benign stimulation of antibody production through vaccination. One way or another, a lot of high hopes rest on antibodies. Hope is a good thing in dark times, but like the stewardess in Moonraker who warns Mr Bond that if he goes any higher, her ears will pop, we too should remember that hopes that get too high can also pop. Instead of a speedy deliverance by Apollo from a modern pandemic, we may as time goes by find we have set our scientists a Sisyphean task.     

Even in the bleakest of lockdowns, a Sunday evening dose of The Good Karma Hospital fills the unforgiving hour with sixty minutes’ worth of pure escape. ITV’s Call the Midwife with commercial breaks avoids confinement in an East End convent, and instead sets itself in the bright colours and bustle of an Indian cottage hospital with ideas above its station. There is enough energy in just one episode to keep the lights on in Leeds for a week. All human life is there, from the impish kid to the rheumy old man with signs of Parkinson’s disease. Unafraid of difficult subjects — a recent story line tackled sexually driven acid burns, made all the more poignant by Amanda Redman’s presence, while another took on traditional resistance to vaccination — the characters swing from overflowing, as Clive James would surely have observed, with amused compassion and quizzical adoration, to exchanging smouldering eye work over their surgical masks. Overseeing all is the hospital chief, the splendid Dr Lydia Fonseca, played to perfection by Redman as Sir Lancelot Spratt in drag.

The news event of the week so far, apart from all the other news events of the week so far, is yesterday’s release by ONS of weekly deaths for 2020. For total deaths, weeks 1 to 12 are unremarkable, week 13 showed a none too remarkable rumble in the jungle up-tick, and then it happened in week 14 — the numbers went through the roof. This isn’t an exponential rise, it’s a stratospheric rise, like a rocket taking off for space.

The higher one lies in national life, the more one suffers from the indignities of precautions. When Prince Philip drives his Range Rover over a cliff top at ninety miles per hour, does three full somersaults in the air before landing wheels down in the water, and drives ashore as smooth as James Bond, he nonetheless gets taken to hospital ‘as a precaution’. When the Prime Minister’s covid-19 symptoms failed to settle he was admitted to hospital ‘as a precaution’. Eminent doctors were on hand to speculate as to what tests might be done on the PM, purely as a precaution. Then the PM was admitted to ITU ‘as a precaution’; but happily the tide turned, and Mr Johnson was soon back on the wards. In the last few hours, Mr Johnson has been discharged from hospital, and Dr No wishes him a full recovery which, as his father Mine’s-a-Pint Stan, never one knowingly to keep his mouth shut, has already observed, may take some time.