One of the things that has intrigued Dr No with increasing trigue during the covid pandemic has been the mechanics of how a state becomes at first authoritarian, and then totalitarian. He is not after some waffling account of putative prose impenetrable by man on ethno-hegemonic constructs pertaining to a pandemic dialectric, but rather a sort of physical mechanics, an e = mc2, or rather t = mc2, where, for instance, t = totalitarianism, m = the mob and c = something that is squared to get the answer. What he is particularly interested in is the tipping point, the point at which the gradient on the slippery slope becomes sufficient for gravity to take over, and nudges are no longer required; or, in quantum terms, the point at which we are sucked unwittingly through a putative quantum key hole all too penetrable by man into Schrödinger’s covid cage, where Geiger’s dissident counter crackles over a vial of totalitarian poison.
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?
This last week, another rapid covid–19 test hit the fan. The story is becoming boringly familiar. A company announces a new covid–19 test, and puts a high gloss on the test’s performance. Ministers respond by placing large orders. Later, it turns out the company has been polishing a turd, as real world studies show the test’s performance is, err, crap, and ministers find that instead of getting more bang for their buck, they have got more crap for their cash. Such are the rewards for ministers who admire their reflections on the faces of polished turds. What made this particular turd/fan disintegration situation more notable than some is the suggestion, made by the BMJ and denied by the DHSC, that the government had known all along it was buying a polished turd, but deliberately suppressed the information, because it would get in the way of procurement.
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 first came across Stanley Milgram’s now infamous but fascinating obedience to authority experiments as a disobedient undergraduate keen to understand why so many of his fellow students seemed willing to toe the line to authority, even when authority had got things wrong. The Great Secret, it turned out, was for authority to dress things up as being for the greater good, add some cuckoo science, and ideally put the public facing authoritarians in uniform. Faced with this diabolic trident, ‘normal’ — Dr No uses quotes because one of the criticism’s of Milgram’s work was that his sample was small and in no way representative — Americans would, despite most showing evident anguish, and even great distress, and occasionally infantile giggling, administer what they believed to be dangerous electric shocks to fellow citizens, because they wanted to do the right thing.
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.
How do Western democracies become authoritarian, and then totalitarian states? For an answer, we need look no further than Germany in the 1930s. The Germans are a fine people, advanced in their scientific and artistic achievements, with strings of world class composers, philosophers, writers and others to their credit. Einstein, Handel, Marx, Robert Koch and Herman Hesse were all born in Germany. Wikipedia lists well over a thousand individuals on its notable Germans page. It is difficult to conceive of a more civilised country, and yet, smarting in the ignominity of defeat in the Great War, it managed the most diabolical convulsion into at first an authoritarian police state, and then in short order one of the most foul evil regimes that has ever besmirched the face of the earth.
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.