Matt Ridley's Blog, page 7
November 23, 2020
The second wave peaked before lockdown began
There is now little doubt that the second wave of the virus crested before the lockdown began on Thursday. On Friday the Government announced that the number of new positive tests over the previous seven days was 156,742, or 2,006 fewer than in the previous seven days: the first time this autumn the weekly number had not gone up.
The same day the Office for National Statistics published its estimate, based on sampling the population, that the number of cases per day was 45,700, slightly down on the previous week, saying “incidence appears to have stabilised at around 50,000 new infections per day”.
A third source confirms the peak: the ZOE survey of King’s College London, using the Covid Symptom Study app, which estimated 42,049 new daily cases compared with 43,569 a week before. ZOE’s Professor Tim Spector noted on Friday that “while these population changes will take a while to work through, we believe they are a positive sign that we have passed the peak of this second wave”. He estimates R to be 1 for the UK as a whole, as does Alastair Grant of the University of East Anglia.
The ONS finds that case numbers are falling in the North west (they have been falling in Liverpool for nearly three weeks), and flat or rising more slowly than before in the rest of the country. The areas with strict regional lockdowns before the national lockdown are doing best.
The highest percentage of positive tests is among 17-24 year olds, but this is now the group seeing the fastest fall. The disease is rarely dangerous in the young and long-term complications are also rare. The big worry has always been the spread of the virus from the young to the elderly. That clearly has happened to some extent but it is not speeding up. In those over 70 the infection rate is still rising, but more slowly than it was in early October.
So statistics confirm what anecdote suggests: a significant autumn epidemic caused by the return of children to school and students to university, especially in northern cities, now flattening. This contrasts with the first wave, where 20 per cent of infections happened in hospitals and 45 per cent of deaths in care homes.
The number of people admitted to hospital with Covid has also started to slow. The Prime Minister says that a still rising number of deaths justifies lockdown. But the number of new cases tends to be two weeks ahead of hospitalisations and four weeks ahead of deaths, meaning that the peak in deaths should come at about the time the lockdown is due to end in early December. It will be wrong to credit lockdown for a fall in deaths until mid December.
The Government’s dashboard says the latest daily death rate, averaged over seven days (and defined as deaths within 28 days of a positive test) is 355. This is bad, but lower than expected by the four models used last Saturday to alarm us into lockdown, especially the now notorious Cambridge University/Public Health England model, which expected around 1,000 deaths a day by now, on course for a peak of 4,000 deaths a day. That forecast had twice been updated, producing much lower numbers, a fact omitted from the Downing Street briefing.
The first wave of infections also peaked before lockdown began, resulting in a peak of deaths on April 8. Voluntary social distancing had already begun to take effect. Now it is probably the regional, tiered restrictions that made the difference, although it cannot be ruled out that the wave is just running out of steam. This would happen if the virus relatively quickly depletes the population of superspreaders, people who for social or biological reasons are more likely to catch and pass on the virus.
The Government’s “reasonable worst case scenario”, still unpublished, seems to have bizarrely assumed no increase in cases until mid November, so it’s no wonder we are worse off than that. Like most respiratory viruses, Covid likes colder weather and prefers to spread indoors: it broke out in chilly abattoirs during the summer. An autumn second wave was probably inevitable, especially given the start of school and university terms. Locking down young people in March may have made it worse by ensuring there was a bigger population of susceptibles.
In 1889-90 a new respiratory virus with similar symptoms to Covid killed a million people, mainly the elderly and disproportionately men, as it spread around the world from Russia. Genetic evidence suggests it may have been a coronavirus, the one now known as OC43.
It too faded in summer but came back for a second wave in the autumn. It then largely ceased killing people, but it never went away: it is still with us as one of the causes of the common cold.
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Temper your excitement about the Covid vaccine
Ever since Giacomo Pylarini, a physician working in the Ottoman Empire, sent a report to the Royal Society in 1701 that Turkish women believed pus from a smallpox survivor could induce immunity in a healthy person – and was dismissed as a dangerous quack – inoculation has been as much an art as a science. But it has proven to be the greatest life-saver of all time, eliminating smallpox and suppressing many other diseases. In Pylarini’s prescient words, it is 'an operation invented not by persons conversant in philosophy or skilled in physic, but by a vulgar, illiterate people; an operation in the highest degree beneficial to the human race.'
It looks like a vaccine is probably going to work against Covid. That was never guaranteed: it’s been decades since scientists started seeking a vaccine for malaria and HIV, with no luck so far, and flu vaccines only last for a limited time before the virus mutates. But the announcement last week that the German firm BioNTech’s vaccine, developed in partnership with Pfizer, seems to prevent Covid infection is encouraging news. Kudos to Kate Bingham for spotting it early.
Temper your excitement though. The sample size is small, the safety of the vaccine not yet proven, its effectiveness in the elderly uncertain, the duration of immunity unknown and it needs to be stored at -70C, which requires some pretty James Bond style logistics. Then there’s the challenge of immunising 67 million people in a short space of time.
The reason the vaccine prefers such a cold temperature is that it’s made of a fatty bubble containing messenger RNA, an unstable compound, never before used to make a vaccine. This is a critter whose purpose was first spotted, legend has it, at a seminar on Good Friday in 1961. The talk was being held in a private room in King's College, Cambridge, because the laboratories were closed for the holiday. The speaker was the French resistance hero and molecular biologist Francois Jacob who was describing an experiment.
The host of the seminar, Sydney Brenner, suddenly let out a 'yelp'. The scientists had got stuck with a wrong idea about how genes told cells what proteins to make. Jacob’s experiment broke the logjam, Brenner saw: genes must produce short-lived, working-copy read-outs of their messages that go out and get translated into protein by special little machines.
They soon retired to Francis Crick’s house for a party. It was, said Jacob, 'a very British evening with the cream of Cambridge, an abundance of pretty girls, various kinds of drink, and pop music. Sydney and I, however, were much too busy and excited to take an active part in the festivities…A euphoric Sydney covered entire pages with calculations and diagrams. Sometimes Francis would stick his head in for a moment to explain what we had to do.'
When a virus infects you, its genes are transcribed into messenger RNAs by your own cell machinery, and these are then translated into the proteins that build more viruses. Eventually your immune system wakes up to what is happening and suffocates those proteins. So if you can inject specific messengers to be translated into copies of just part of the virus’s 'spike' protein, you will alert the immune system without causing disease. That’s what Ozlem Tureci and Ugur Sahin, the founders of BioNTech, did. It worked in the lab.
They approached Pfizer, whose chief executive Albert Bourla decided to take a punt on the project with the firm’s own cash, refusing government grants. Back in September, he explained why: 'I wanted to liberate our scientists from any bureaucracy. When you get money from someone that always comes with strings. They want to see how we are going to progress, what types of moves you are going to do. They want reports. I didn’t want to have any of that.' Seems to have worked.
To get results from phase 3 clinical trials for a vaccine this fast is unprecedented and suggests the messenger approach may be the future for vaccines. It is inherently safer than using attenuated or inactivated viruses as vaccines, which worked for polio but not before one of the manufacturers, Cutter Laboratories, in 1955 paralysed more than 200 people with polio through an inadequately inactivated virus. Later polio viruses were contaminated with a virus called SV40 that luckily proved harmless. That kind of thing no longer happens but side effects do. Trials of other covid vaccines have been paused to investigate adverse reactions, including this week the Chinese company Sinovac’s inactivated coronavac vaccine in Brazil.
The Oxford-Astrazeneca team uses a harmless virus into which a coronavirus gene has been inserted. Results from that vaccine’s trials are expected soon. Imperial College is using a DNA version of the messenger method.
There are eleven vaccines in phase 3 trials. The chances that some of them are both safe and effective must be fairly high. But everything about vaccine development is uncertain. Will the vehicle deliver the vaccine to the right place? Will you get an immune response? Will it be strong and long-lasting? Will there be side effects? Will the virus mutate too fast? We don’t know the answers yet.
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Ten reasons why Boris’s green agenda is just plain wrong
Our fearless leader has descended from the mountain with a 10-commandment plan for a green industrial revolution. At a cost of £12 billion, he will have all Britons driving electric cars powered by North Sea wind turbines and giving up their gas boilers to heat their homes with ground-source heat pumps. He will invent zero-emission planes and ships. This vast enterprise will create 250,000 jobs. I am a loyal supporter of the prime minister, but this Ed Miliband policy makes no sense any way you look at it. Here are 10 reasons why.
First, if it’s jobs we are after then spending £48,000 per job is a lot. Cheaper, as Lord Lawson put it, to create the same employment erecting a statue of Boris in every town. Anyway, it’s backwards: it’s not jobs in the generating of energy that count but jobs that use it. Providing cheap, reliable energy enables the private sector to create jobs for free as far as the taxpayer is concerned.
Second, he misreads how innovation works, a topic on which I’ve just written a book. Innovation will create marvellous, unexpected things in the next 10 years. But if you could summon up innovations to order in any sector you want, such as electric planes and cheap ways of making hydrogen, just by spending money, then the promises of my childhood would have come true: routine space travel, personal jetpacks and flying cars. Instead, we flew in 747s for more than 50 years.
Third, he is hugely underestimating the cost. The wind industry claims that its cost is coming down. But the accounts of wind energy companies show that both capital and operating expenditures of offshore wind farms continue to rise, as Gordon Hughes of Edinburgh University and John Aldersey-Williams of Aberdeen Busines School have found. Wind firms sign contracts to deliver cheap electricity, but the penalties for walking away from those contracts, demanding higher prices from a desperate grid in the future, are minimal and their investors know it. Britain already has among the highest electricity prices for business in Europe because of the £10 billion a year that electricity-bill payers spend on subsidising the rich capitalists who own wind farms; raising them further will kill a lot more than 250,000 jobs.
Fourth, these policies will not significantly reduce the nation’s emissions, let alone the world’s. It takes a lot more emissions to make an electric car than a petrol one because of the battery. This is usually made in China. If the battery lasts for 100,000 miles – which is optimistic – and the electricity with which it is recharged is made partly with gas, then there is only a small saving in emissions over the lifetime of the car, according to Gautam Kalghatgi of Oxford University.
Fifth, the plan will make the electricity supply less reliable. Already this autumn there have been power-cut near misses and there was a bad blackout in 2019. Costly diesel generators came to our rescue, but keeping the grid stable is getting harder, and in both Australia and California, blackouts have become more common because of reliance on renewables. Smart meters that drain your electric car’s battery to help keep other people’s lights on may help. But if you think that will be popular, Boris, good luck, and wait till the lights go out or the cost of heating your home goes through the roof.
Sixth, Mr Johnson is depending on impractical technologies. Ground-source heat pumps can work, though they deliver low-grade heat and can’t cope on a freezing night. Air source heat pumps have not proved so far to be nearly as efficient as promised. They need electricity, make a noise and take up outside space that is not there in a terrace of houses. Forcing us to use compact fluorescent light bulbs, when LEDs were coming, proved a costly mistake.
Seventh, hydrogen is not an energy source; it first has to be made, using energy, then stored and transported. Making it from natural gas is expensive and generates emissions, but making it with electricity is vastly more expensive. Its minuscule molecules can slip through almost any kind of hole, so the natural gas pipe network is not suitable. Leaks will happen at hydrogen fuelling stations, as one did in Norway in June last year, resulting in a massive explosion.
Eighth, this industrial revolution is anything but green. To generate all our electricity from wind in the North Sea, taking into account the increased demand for electricity for heat pumps, electric cars and hydrogen manufacture, would require a wall of turbines 20 miles wide stretching from Thanet to John O’Groats, says Andrew Montford of the Global Warming Policy Foundation. The effect on migratory birds would be terrible.
Ninth, nobody is following Britain’s example. China has announced that its use of fossil fuels will not even peak till 2030. China has more coal-fired power now under development than the entire coal power capacity of the United States. It will use coal to make the turbines and cars and batteries we use, laughing all the way to the bank. The world still generates 93% of its energy from CO2-emitting combustion (coal, oil, gas and wood) and just 1.4% from wind and solar.
Tenth, while climate change is a real issue and must be tackled, Extinction Rebellion is simply wrong about the urgency. If it’s extinction they worry about, let’s tackle invasive alien species, responsible for most extinctions. By contrast, there is no confirmed extinction of a species due to climate change. Nor has global warming resulted in more or fiercer storms or droughts. The extremists’ claims otherwise simply ignore the scientific evidence. Emissions have so far increased crop yields and made all ecosystems greener.
Yes, we need to address the issue, but we would be better off funding research to bring down the cost of carbon capture, nuclear power and fusion. Nuclear is the one form of carbon-free energy that can generate reliable power from a tiny footprint of land. The reason nuclear electricity costs so much today is because we have made innovation in nuclear design all but impossible by devising a byzantine regulatory process of immense cost. Let’s reform that. Small, modular molten-salt reactors are an innovation within reach, unlike electric planes.
My fear is that we will carry out Boris’s promised 10-point plan, cripple our economy, ruin our seascapes and landscapes, and then half way through the 2030s along will come cheap, small, safe fusion reactors. The offshore wind industry, by then so stuffed with subsidies they can afford to lobby politicians and journalists even more than they do to today, will suck their teeth and say: “no, no, no – ignore the fusion crowd. We’re on the brink of solving the reliability issue, and don’t worry, the cost will come down eventually. Promise!”
Boris, this is not the way to the promised land, especially when the government is borrowing £300 billion because of covid. High-cost electricity will prevent the United Kingdom making a success of Brexit. It will bankrupt us in the short run, make us less competitive in the long run and not cut emissions much anyway.
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My new book How Innovation Works is available now in the US, Canada, and UK.
Was Covid beginning to peak before the second lockdown?
'I don’t think that word means what you think it means,’ says the Spaniard Inigo Montoya in the film The Princess Bride, when Vizzini keeps saying it is ‘inconceivable’ that the Dread Pirate Roberts is still on their tail. I muttered those words to myself during a parliamentary debate just before the start of the latest lockdown, when the minister twice said that the wave of infections was increasing ‘exponentially’.
Far from increasing, let alone exponentially, the data showed that the wave was faltering if not cresting already. The lockdown came in on a Thursday. The very next day data from three reliable sources – the Office for National Statistics, the government and the Covid Symptom Study – showed slight falls of the number of positive cases or some levelling off. The fall was steep in some places such as Liverpool. The cynic in me wondered whether the haste with which the government had rushed to bring in the national lockdown, at the urging of its questionably sage advisors, was so that lockdown could be credited with the fall that was coming.
Ah, said the government at the time, but hospital admissions are still increasing and so are deaths. Well, sure. Hospital admissions lag cases by two weeks, and deaths lag admissions by two weeks. We now have two more weeks of data and the evidence looks clear. The faltering of the wave in late October and early November was not just a pause but a peak. Hospital admissions appear to have peaked on 11 November and began to fall, implying a peak of infections in late October, well before lockdown began. Even deaths seem to have now stabilised, unexpectedly, with the seven-day average also steady since 11 November.
The same thing happened in April, when in retrospect it became clear that infections peaked before lockdown began, with deaths peaking around 8 April – too soon to credit the lockdown.
What explains the peak, then, if not lockdown? In some places, such as London, the virus may be struggling to find susceptible people. Some are already immune after the first wave, others have a degree of cross immunity from common colds. Above all the superspreaders – the people the virus really relies on – have been depleted by previous infection because they were the first to catch it. We know that about 80 per cent of cases are spread by between 10 and 20 per cent of people.
But it may also be because voluntary measures work. People did change their behaviour again in October, as the warnings ratcheted up. It really is not necessary to order people about: much better to ask them. Not only does it work, but it gets buy-in. Ordering stops people thinking and starts making them rebellious.
Take me. I don’t want to catch this virus. I am in my sixties and more at risk than some. I can work from home. Therefore, given the choice, I will be cautious, at least as much as I am being now. But the moment the government says to me ‘you are free to do as you please’, I will have to think through what I therefore plan to do. Do I start socialising yet? Travelling? Probably not. At the moment, I just don’t have that conversation with myself. Instead I try to get my head around the rules that say what is and is not permissible, as set out by the prison guards, and try to suppress my instinctive desire to start digging a tunnel beneath a wooden horse.
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November 2, 2020
Six reasons the new lockdown is a deadly mistake
I was in favour of a national lockdown in the spring. I am not now, for six main reasons.
Covid is not a very dangerous disease for most people. The death rate is probably around 0.2 per cent of those infected, and most who die are elderly and suffering from other medical conditions. The mortality of those in hospital with Covid has almost halved for the over 80s since the start of the epidemic as treatment has improved.
Lockdowns are lethal. They cause more deaths from cancer, heart disease and suicide as well as job losses, bankruptcies, social disintegration and mental illness especially among the young, who are at least risk from the virus. In April sunshine, many people and firms could cope for a short period – once. Today, in November rain, the pain will be far worse. I will be all right, living in a rural area and able to work online, but what of those who started restaurants or live alone in small flats?
There is overwhelming support in the scientific community for national lockdown, say scientists, but the scientific community and the civil service are on secure public-sector salaries and think in top-down ways.
The first lockdown may not have achieved as much as claimed. The death rate peaked on April 8, just 16 days after lockdown began, implying that voluntary social distancing had already worked: deaths lag infection by four weeks on average. Infectivity is highly uneven so depleting the superspreaders, who tend to get infected earlier, slows the spread. Sweden and Norway are seeing much smaller second waves because they did not lock down so harshly, and no, it’s not because they live in huts in the forest or never hug each other: Sweden is a slightly more urbanised society than Britain.
There is an alternative strategy: protect the vulnerable. In the first wave, because of insufficient protective equipment and testing, health workers carried the virus between care homes and between hospital beds. As the entrepreneur Hugh Osmond points out: “Protecting all hospital and care home patients means protecting around 550,000 people in 12,500 known locations. This could prevent 75 per cent of all Covid fatalities. As opposed to trying to stop infections in 67 million people by shutting down society, with untold consequences.”
As Lord Sumption has argued, democracy itself is at risk. The Government has given itself powers to rule by decree, under a Health Protection Act intended for restricting the movements of infected people, not healthy people. Police forces have the power to issue on-the-spot fines of up to an unprecedented £10,000.
Finally, the second wave shows signs of slowing. In Nottingham, Liverpool and Newcastle the surge of infections that came with students has already peaked. “While cases are still rising across the UK, we want to reassure people that cases have not spiralled out of control, as has been recently reported from other surveys,” says Professor Tim Spector of King’s College London, curator of the widely respected ZOE survey.
A four-week lockdown now will hurt Britain more than the virus and achieve little so it would not be the last.
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October 18, 2020
Students who catch COVID may be saving lives
It is counterintuitive but the current spread of Covid may on balance be the least worst thing that could happen now. In the absence of a vaccine, and with no real prospect of eradicating the disease, the virus spreading among younger people, mostly without hitting the vulnerable, is creating immunity that will eventually slow the epidemic. The second wave is real, but it is not like the first. It would be a mistake to tackle it with compulsory lockdowns (even if called ‘circuit breakers’), whether national or local. The cure would be worse than the disease.
If you cannot extinguish an epidemic at the start, the best strategy is for the healthy to get infected first. Lockdowns ensure that the vulnerable and the healthy both get infected with similar probability. School closures, concluded a recent paper in the British Medical Journal, can paradoxically lead to more deaths by prioritising the protection of the least vulnerable.
In July the World Health Organisation said full lockdowns could be ‘the only option’ to prevent resurgence. But last week Dr David Nabarro, a WHO special envoy for Covid-19, told Andrew Neil on Spectator TV that ‘We in the WHO do not advocate lockdowns as the primary means of control of this virus… We really do appeal to all world leaders: stop using lockdown as your primary control method.’
Back in March when the pandemic first poleaxed the country, I argued in these pages that ‘there are no good outcomes from here. Many people will die prematurely. Many will lose their jobs. Many businesses will go under. Many people will suffer bereavement, loneliness and despair, even if they dodge the virus.’ That is still true. There is no course that involves zero suffering. It’s a question of minimising it.
This time, unlike in the spring, the virus has been mostly spreading among students. Places where more than 25 per cent of the population are university students have seven times the positive test rate of the rest of the country. Among students the infection is mostly asymptomatic or mild. As of last week, 70,000 students in the United States had tested positive with just three hospitalisations (one released) and no deaths.
By contrast, the effect of lockdowns on the mental health of young people is huge. Psychologists report that anxiety and depression have sky-rocketed, especially among the young, so that the highest mental impact is being felt among those least likely to die. It’s not Covid that is causing this, but lockdown and recession.
As Professor Karol Sikora puts it: ‘It’s clear that mass testing at universities has uncovered a huge amount of positive results that are largely behind some of the higher numbers. These are already on the way down in some areas. It’s not unreasonable to question whether this has been properly taken into account.’
Consider my home city of Newcastle. Roughly 50,000 students moved into Newcastle last month. On 3 October Northumbria University announced that there were 770 positive tests among its students, and just 78 of those showed any symptoms at all: that’s 90 per cent showing none. In the seven days up to 5 October, the Evening Chronicle reports, there were 609 positive tests (I refuse to call them cases) in the city centre, Shieldfield and Heaton Park — areas where students live. In Scotswood, a short distance away and where few students also live, there were 16.
It is the ability of this virus to be spread by those not showing symptoms, yet also sometimes to kill, that makes it so hard to control and so dangerous. Back in March the disease was spreading mostly within hospitals and care homes, among highly vulnerable people and their carers. Policy was based on the false assumption that most people would show symptoms, so carers could go from home to home without testing. That was a big mistake, as the medically trained entrepreneur Hugh Osmond kept telling me at the time: many fatal cases of Covid were caught after going into hospital for something else.
Locking down the whole country, schools, pubs, offices and all, did little to prevent that tragedy: health workers were not locked down. But it prevented the growth of natural immunity that happens to some extent with most viruses and thus probably made a second wave inevitable.
At the time I thought it was nonetheless necessary because of the dangerous nature of the virus. As I wrote here in March: ‘The government is now effectively admitting that even if drastic curfews lead to successive waves of the disease, that may be the least worst outcome. It is still a daunting prospect. Successive waves mean successive curfews and successive body blows to the economy. If we clamp down hard now and the infection rate drops, then we might be able, slowly and cautiously, to restart the economy in the summer but have to clamp down again when the virus resurges. Each time we do this, it will be more painful.’
Yet Sweden shows that the second wave could have been largely avoided. At the end of March, on the very weekend Derbyshire police tried to shame solitary hikers in the Peak District back indoors with drones and snide tweets, the Guardian described how ‘Malmo’s café terraces do a brisk trade. On the beach and surrounding parkland at Sibbarp there were picnics and barbecues this weekend; the adjoining skate park and playground were rammed.’ The New York Times called Sweden a ‘pariah state’. The Sun headline read: ‘Sweden’s refusal to enter coronavirus lockdown leaving schools and pubs open “will lead to catastrophe”, doctors warn.’
It did not. Sweden, a slightly more urbanised society than Britain, suffered almost as high a death rate in the first wave — it likewise failed to protect care homes — but is seeing almost no second wave. More to the point, its economy is in much better shape and therefore so are people’s lives. It ran a budget surplus in August and its economy is forecast to shrink 3.3 per cent this year compared with 5.8 per cent for the UK. Had we protected hospitals and care homes while keeping schools and pubs open, the chances are we too would be much better off.
Or look at London, where just 34 people died of Covid in the first week of October, compared with more than 1,000 a week in early April. There isn’t much of a second wave there, despite — or because of — demonstrations and crowded tube trains during the summer. This is probably because London’s first wave was already well advanced when lockdown started. Given widespread immune responses to the four kinds of corona-caused common colds, and the skewed pattern of viral infection, whereby a few super-spreaders cause most of the new cases, it looks increasingly as if the virus is already finding it harder to spread in the capital this time round.
The alternative to lockdown is not ‘letting the virus rip’, as Boris Johnson puts it. The Great Barrington Declaration, signed by over 20,000 doctors and medical scientists (but disgracefully censored by Google’s search engine), calls for focused protection: help the elderly and vulnerable stay at home, but let the young and invulnerable go out and achieve immunity for us all, while earning a living. The extraordinary truth is that a student catching Covid might be saving Granny’s life rather than threatening it.
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October 15, 2020
A New Approach to Covid-19
Letter from 12 Conservative peers to The Times:
Sir, It is now clear that a policy of lockdown failed to bring the virus under control while having crippling economic and social side effects. Sweden has achieved a lower death rate from Covid-19 than the UK, with far less economic and social damage, despite being a slightly more urbanised society. If lockdown were a treatment undergoing a clinical trial, the trial would be halted because of the side effects. We suggest the government try a new approach, more in keeping with the Conservative philosophy of individual responsibility. Anyone who wishes to be locked down, whether because they are vulnerable or for other reasons, should be supported in doing so safely. Anyone who wishes to resume normal life, and take the risk of catching the virus, should be free to do so. The choice would be ours.
Lord Ridley; Lord Cavendish of Furness; Lord Dobbs; Lord Hamilton of Epsom; Lord Howard of Rising; Lord Lamont of Lerwick; Lord Lilley; Lord Mancroft; Baroness Meyer; Baroness Noakes; Lord Robathan; Lord Shinkwin; House of Lords
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October 11, 2020
What the Pandemic Has Taught Us About Science
My article for the Wall Street Journal:
The Covid-19 pandemic has stretched the bond between the public and the scientific profession as never before. Scientists have been revealed to be neither omniscient demigods whose opinions automatically outweigh all political disagreement, nor unscrupulous fraudsters pursuing a political agenda under a cloak of impartiality. Somewhere between the two lies the truth: Science is a flawed and all too human affair, but it can generate timeless truths, and reliable practical guidance, in a way that other approaches cannot.
In a lecture at Cornell University in 1964, the physicist Richard Feynman defined the scientific method. First, you guess, he said, to a ripple of laughter. Then you compute the consequences of your guess. Then you compare those consequences with the evidence from observations or experiments. “If [your guess] disagrees with experiment, it’s wrong. In that simple statement is the key to science. It does not make a difference how beautiful the guess is, how smart you are, who made the guess or what his name is…it’s wrong.”
So when people started falling ill last winter with a respiratory illness, some scientists guessed that a novel coronavirus was responsible. The evidence proved them right. Some guessed it had come from an animal sold in the Wuhan wildlife market. The evidence proved them wrong. Some guessed vaccines could be developed that would prevent infection. The jury is still out.
Seeing science as a game of guess-and-test clarifies what has been happening these past months. Science is not about pronouncing with certainty on the known facts of the world; it is about exploring the unknown by testing guesses, some of which prove wrong.
Bad practice can corrupt all stages of the process. Some scientists fall so in love with their guesses that they fail to test them against evidence. They just compute the consequences and stop there. Mathematical models are elaborate, formal guesses, and there has been a disturbing tendency in recent years to describe their output with words like data, result or outcome. They are nothing of the sort.
An epidemiological model developed last March at Imperial College London was treated by politicians as hard evidence that without lockdowns, the pandemic could kill 2.2 million Americans, 510,000 Britons and 96,000 Swedes. The Swedes tested the model against the real world and found it wanting: They decided to forgo a lockdown, and fewer than 6,000 have died there.
In general, science is much better at telling you about the past and the present than the future. As Philip Tetlock of the University of Pennsylvania and others have shown, forecasting economic, meteorological or epidemiological events more than a short time ahead continues to prove frustratingly hard, and experts are sometimes worse at it than amateurs, because they overemphasize their pet causal theories.
A second mistake is to gather flawed data. On May 22, the respected medical journals the Lancet and the New England Journal of Medicine published a study based on the medical records of 96,000 patients from 671 hospitals around the world that appeared to disprove the guess that the drug hydroxychloroquine could cure Covid-19. The study caused the World Health Organization to halt trials of the drug.
It then emerged, however, that the database came from Surgisphere, a small company with little track record, few employees and no independent scientific board. When challenged, Surgisphere failed to produce the raw data. The papers were retracted with abject apologies from the journals. Nor has hydroxychloroquine since been proven to work. Uncertainty about it persists.
A third problem is that data can be trustworthy but inadequate. Evidence-based medicine teaches doctors to fully trust only science based on the gold standard of randomized controlled trials. But there have been no randomized controlled trials on the wearing of masks to prevent the spread of respiratory diseases (though one is now under way in Denmark). In the West, unlike in Asia, there were months of disagreement this year about the value of masks, culminating in the somewhat desperate argument of mask foes that people might behave too complacently when wearing them. The scientific consensus is that the evidence is good enough and the inconvenience small enough that we need not wait for absolute certainty before advising people to wear masks.
This is an inverted form of the so-called precautionary principle, which holds that uncertainty about possible hazards is a strong reason to limit or ban new technologies. But the principle cuts both ways. If a course of action is known to be safe and cheap and might help to prevent or cure diseases—like wearing a face mask or taking vitamin D supplements, in the case of Covid-19—then uncertainty is no excuse for not trying it.
A fourth mistake is to gather data that are compatible with your guess but to ignore data that contest it. This is known as confirmation bias. You should test the proposition that all swans are white by looking for black ones, not by finding more white ones. Yet scientists “believe” in their guesses, so they often accumulate evidence compatible with them but discount as aberrations evidence that would falsify them—saying, for example, that black swans in Australia don’t count.
Advocates of competing theories are apt to see the same data in different ways. Last January, Chinese scientists published a genome sequence known as RaTG13 from the virus most closely related to the one that causes Covid-19, isolated from a horseshoe bat in 2013. But there are questions surrounding the data. When the sequence was published, the researchers made no reference to the previous name given to the sample or to the outbreak of illness in 2012 that led to the investigation of the mine where the bat lived. It emerged only in July that the sample had been sequenced in 2017-2018 instead of post-Covid, as originally claimed.
These anomalies have led some scientists, including Dr. Li-Meng Yan, who recently left the University of Hong Kong School of Public Health and is a strong critic of the Chinese government, to claim that the bat virus genome sequence was fabricated to distract attention from the truth that the SARS-CoV-2 virus was actually manufactured from other viruses in a laboratory. These scientists continue to seek evidence, such as a lack of expected bacterial DNA in the supposedly fecal sample, that casts doubt on the official story.
By contrast, Dr. Kristian Andersen of Scripps Research in California has looked at the same confused announcements and stated that he does not “believe that any type of laboratory-based scenario is plausible.” Having checked the raw data, he has “no concerns about the overall quality of [the genome of] RaTG13.”
Given that Dr. Andersen’s standing in the scientific world is higher than Dr. Yan’s, much of the media treats Dr. Yan as a crank or conspiracy theorist. Even many of those who think a laboratory leak of the virus causing Covid-19 is possible or likely do not go so far as to claim that a bat virus sequence was fabricated as a distraction. But it is likely that all sides in this debate are succumbing to confirmation bias to some extent, seeking evidence that is compatible with their preferred theory and discounting contradictory evidence.
Dr. Andersen, for instance, has argued that although the virus causing Covid-19 has a “high affinity” for human cell receptors, “computational analyses predict that the interaction is not ideal” and is different from that of SARS, which is “strong evidence that SARS-CoV-2 is not the product of purposeful manipulation.” Yet, even if he is right, many of those who agree the virus is natural would not see this evidence as a slam dunk.
As this example illustrates, one of the hardest questions a science commentator faces is when to take a heretic seriously. It’s tempting for established scientists to use arguments from authority to dismiss reasonable challenges, but not every maverick is a new Galileo. As the astronomer Carl Sagan once put it, “Too much openness and you accept every notion, idea and hypothesis—which is tantamount to knowing nothing. Too much skepticism—especially rejection of new ideas before they are adequately tested—and you’re not only unpleasantly grumpy, but also closed to the advance of science.” In other words, as some wit once put it, don’t be so open-minded that your brains fall out.
Peer review is supposed to be the device that guides us away from unreliable heretics. A scientific result is only reliable when reputable scholars have given it their approval. Dr. Yan’s report has not been peer reviewed. But in recent years, peer review’s reputation has been tarnished by a series of scandals. The Surgisphere study was peer reviewed, as was the study by Dr. Andrew Wakefield, hero of the anti-vaccine movement, claiming that the MMR vaccine (for measles, mumps and rubella) caused autism. Investigations show that peer review is often perfunctory rather than thorough; often exploited by chums to help each other; and frequently used by gatekeepers to exclude and extinguish legitimate minority scientific opinions in a field.
Herbert Ayres, an expert in operations research, summarized the problem well several decades ago: “As a referee of a paper that threatens to disrupt his life, [a professor] is in a conflict-of-interest position, pure and simple. Unless we’re convinced that he, we, and all our friends who referee have integrity in the upper fifth percentile of those who have so far qualified for sainthood, it is beyond naive to believe that censorship does not occur.” Rosalyn Yalow, winner of the Nobel Prize in medicine, was fond of displaying the letter she received in 1955 from the Journal of Clinical Investigation noting that the reviewers were “particularly emphatic in rejecting” her paper.
The health of science depends on tolerating, even encouraging, at least some disagreement. In practice, science is prevented from turning into religion not by asking scientists to challenge their own theories but by getting them to challenge each other, sometimes with gusto. Where science becomes political, as in climate change and Covid-19, this diversity of opinion is sometimes extinguished in the pursuit of a consensus to present to a politician or a press conference, and to deny the oxygen of publicity to cranks. This year has driven home as never before the message that there is no such thing as “the science”; there are different scientific views on how to suppress the virus.
Anthony Fauci, the chief scientific adviser in the U.S., was adamant in the spring that a lockdown was necessary and continues to defend the policy. His equivalent in Sweden, Anders Tegnell, by contrast, had insisted that his country would not impose a formal lockdown and would keep borders, schools, restaurants and fitness centers open while encouraging voluntary social distancing. At first, Dr. Tegnell’s experiment looked foolish as Sweden’s case load increased. Now, with cases low and the Swedish economy in much better health than other countries, he looks wise. Both are good scientists looking at similar evidence, but they came to different conclusions.
Having proved a guess right, scientists must then repeat the experiment. Here too there are problems. A replication crisis has shocked psychology and medicine in recent years, with many scientific conclusions proving impossible to replicate because they were rushed into print with “publication bias” in favor of marginally and accidentally significant results. As the psychologist Stuart Ritchie of Kings College London argues in his new book, “Science Fictions: Exposing Fraud, Bias, Negligence and Hype in Science,” unreliable and even fraudulent papers are now known to lie behind some influential theories.
For example, “priming”—the phenomenon by which people can be induced to behave differently by suggestive words or stimuli—was until recently thought to be a firmly established fact, but studies consistently fail to replicate it. In the famous 1971 Stanford prison experiment, taught to generations of psychology students, role-playing volunteers supposedly chose to behave sadistically toward “prisoners.” Tapes have revealed that the “guards” were actually instructed to behave that way. A widely believed study, subject of a hugely popular TED talk, showing that “power posing” gives you a hormonal boost, cannot be replicated. And a much-publicized discovery that ocean acidification alters fish behavior turned out to be bunk.
Prof. Ritchie argues that the way scientists are funded, published and promoted is corrupting: “Peer review is far from the guarantee of reliability it is cracked up to be, while the system of publication that’s supposed to be a crucial strength of science has become its Achilles heel.” He says that we have “ended up with a scientific system that doesn’t just overlook our human foibles but amplifies them.”
At times, people with great expertise have been humiliated during this pandemic by the way the virus has defied their predictions. Feynman also said: “Science is the belief in the ignorance of experts.” But a theoretical physicist can afford such a view; it is not much comfort to an ordinary person trying to stay safe during the pandemic or a politician looking for advice on how to prevent the spread of the virus. Organized science is indeed able to distill sufficient expertise out of debate in such a way as to solve practical problems. It does so imperfectly, and with wrong turns, but it still does so.
How should the public begin to make sense of the flurry of sometimes contradictory scientific views generated by the Covid-19 crisis? There is no shortcut. The only way to be absolutely sure that one scientific pronouncement is reliable and another is not is to examine the evidence yourself. Relying on the reputation of the scientist, or the reporter reporting it, is the way that many of us go, and is better than nothing, but it is not infallible. If in doubt, do your homework.
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October 1, 2020
Correcting Britain's Vitamin D deficiency could save thousands of lives
My article with MP David Davis, for the Telegraph:
As we face six tough months of curfews, isolation and economic misery, with vaccines a distant hope, testing struggling to control the virus, and the hospitalisation rate once again rising, it’s surely time to try anything reasonable to slow the pandemic down. There is one chemical that is known to be safe, known to be needed by many people anyway, known to have a clinically proven track record of helping people fight off respiratory diseases, and is so cheap no big firm is pushing it: vitamin D. It is not a silver bullet, but growing evidence suggests that it might help prevent Covid turning serious in some people.
In May, arguments on the link between Vitamin D deficiency and its association with poor Covid outcomes started to gather pace. That month, the Health Secretary’s attention was drawn to two studies showing a strong association between the incidence and severity of Covid-19 with vitamin D deficiencies in the patients. Vadim Backman of Northwestern University, one of the authors of one of those studies, said about healthy levels of vitamin D that “Our analysis shows that it might be as high as cutting the mortality rate in half.”
When asked to look at the evidence, Matt Hancock perfectly reasonably handed the question to Public Health England to answer. They attempted to analyse the statistical data and came up unconvinced. The problem is that a correlation is not a proof of cause and effect, and a correlation (albeit a very strong one) is all that we had at that point. Or almost all that we had.
The gold standard of medical research is the randomised controlled trial. Back in May, we had no such test for vitamin D and Covid-19. Now we do. The world’s first randomised control trial on vitamin D and Covid has just been published. The results are clear-cut. The trial, which took place in Spain at the Reina Sofía University Hospital, involved 76 patients suffering from Covid-19. Fifty of those patients were given vitamin D. The remaining 26 were not. Half of those not given Vitamin D became so sick that they needed to be put on intensive care. By comparison, only one person who was given Vitamin D requiring ICU admission.
Put another way, the use of Vitamin D reduced a patient’s risk of needing intensive care 25-fold. Two patients who did not receive Vitamin D died. And while the sample is too small to conclude that Vitamin D abolishes the risk of death in Covid patients, it is nonetheless an astonishing result, and corresponds with Prof Backman’s assertion that correcting vitamin deficiency might cut mortality by half. The Government should now act on this latest evidence.
Vitamin D cannot be obtained from a normal diet, but is synthesised by summer sunshine. It is unusual among vitamins in being deficient in much of the British population especially towards the end of winter and especially among at-risk groups such as the elderly, obese, and black and minority ethnic groups.
Vitamins are useless as medications in people who already have sufficient of them; they only work in those who are deficient. So this is not a call to boost a vitamin that is already present in sufficient quantity in most people. Britain has a national policy already of wanting to redress the widespread winter deficiency of vitamin D.
We have two possible courses of action. The first, as we called for back in May, is for people to up their intake of Vitamin D through supplements. The NHS providing free Vitamin D supplements to at risk groups is the easiest and most straightforward option. Vitamin D supplementation is cheap – it costs less than a penny a pill – and readily available. If you allocated this to the identified comorbidity risk group it would cost £45 million: to these, plus to every ethnic minority citizen, about £200 million, to every obese person somewhat more. These costs are trivial rounding errors by comparison with the costs of lockdown.
The second option would be to do what the Nordics do and fortify food with vitamin D, including bread, flour and milk. The ideal approach would be to undertake both options at the same time, along with a public health education campaign.
We have good reason to think vitamin D supplementation will help reduce mortality from Covid-19 and we know it can reduce the incidence and severity of the other acute respiratory illnesses. With hospitals already facing pressures from influenza during the winter months, any way of reducing this strain should be taken up. This will no doubt save thousands of lives in any second wave. There is now no reason not to act.
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September 13, 2020
Pleasures of sex and berries
Our ancestors have spent a few hundred years in cities at most. Before that, they spent a million years or more on what was essentially a perpetual camping trip, most of it in Africa. Little wonder then that people are more easily scared of snakes than cars, of deep water than speed, of spiders than guns. We are, to a significant extent, adapted to the environment we evolved in, rather than the one most of us now inhabit.
This mismatch explains quite a lot about our modern problems, and Adam Hart, an entomologist and broadcaster, has set out to see just how far, and how convincingly, mismatch can explain things like allergies, obesity, and our addiction to drugs, social media and even fake news. His book is especially valuable because it does not fall for simplistic “just-so” stories without checking the actual evidence first.
In the case of obesity, for example, the mismatch theory goes that our ancestors would have gorged on sugary fruit and fatty grubs whenever we got the chance, because a famine was just around the corner. Now there’s no famine but perpetual abundance, this tendency makes us fat and diabetic. This is known as the thrifty gene hypothesis and it makes superficial sense.
But Hart finds it wanting. With the exception of Samoans, who put on weight especially easily but do not become diabetic easily probably because of very long, very hungry canoe journeys in which the fat survived and the lean did not, most of the evidence points away from thrifty genes once examined in detail. For instance, only nine of 115 genes associated with obesity show evidence of selection and five of those have been selected to promote lean bodies.
Rather, Hart argues, what makes us put on fat today is that we no longer get chased by sabre-toothed tigers and the like. When we ceased to become regular prey, which was quite a while ago, the disadvantage of being tubby disappeared. So our genes “drifted” into allowing us to put on too much weight once confronted with easily available and affordable carb-rich diets.
The steady increase in auto-immune disease, allergy and dietary intolerance may be best explained by an impoverishment in the range and abundance of bacteria that inhabit our guts. We have become so relentlessly hygienic that we no longer get the bugs in our system that the body expects, and this causes an immune over-reaction.
Here I feel Hart sells his own thesis short. This “hygiene hypothesis” never fully made sense for me until I read An Epidemic of Absence, by Moises Velasquez-Manoff. That book solved my problem, which was puzzlement as to why the immune system should overreact if underused. It’s not as if it gets bored. Velasquez-Manoff’s sources pointed out that a parasite quickly evolves the ability to dampen the immune reaction of its host. That starts an evolutionary arms race, in which the host evolves an overreactive immune system. Take away the parasite and the thing overreacts against grass pollen.
Sure enough, there is abundant evidence that removing worms from (for example) Ethiopian villages is followed by the appearance of hay fever, asthma and the like for the first time. Experiments with mice have found that infecting them with worms reduces allergies, inflammatory bowel disease and even diabetes and multiple-sclerosis-like conditions. Treating people with worms has also been shown to work against these diseases, though it’s hardly a good bargain since worm infections are no fun. Hart mentions worms only in passing, focusing mainly on bacteria, but there is little doubt that many of our modern conditions derive from the extinction of both parasites and friendly creatures within us.
In an ingenious chapter, Hart argues that our problem with social media stems from the fact that we are designed to have a social network of about 150 people, not thousands. This number, named after the evolutionary biologist Robin Dunbar, derives from a neat correlation between brain size and group size in primates and fits surprisingly neatly with the number of people in an old-fashioned address book, or the size of a company before it becomes too unwieldy to manage. Today we have real and virtual social networks that far exceed this number, and we are not well placed to cope.
Here is another intriguing mismatch. Why do we like alcohol so much that we get addicted to it? Neatly, there are genetic clues. A mutant version of a gene called ADH4 arose around 10 million years ago in the ancestors of African great apes, making us 40 times as good at digesting ethanol. Getting tipsy was a small price to pay for the calories. It probably gave significant advantage to foraging on fallen, rotting fruit.
Along with other drugs which stimulate the brain system that is triggered by orgasm, argues Hart, “the modern environment is one of great temptation and a wealth of new and potent opportunities to highjack a brain that evolved to enjoy, and reward, the pleasures of sex and ripe berries.”
Perhaps the most original of Hart’s arguments is the one where he explains fake news. We have a deeply-evolved tendency to take things on trust. “There is a very thin line between the trust necessary for everyday life and the gullibility or credulity that can lead us towards believing fake news.” We put a halo on our heroes, either as a neurological side effect of the tendency to fall in love with high-status mates, or as a by-product of having followed leaders into battle against enemy tribes for millions of years. Us-and-them tribal loyalty, a deeply-ingrained human tendency, then does the rest, leaving us polarised into groups with unshakeable beliefs in “facts” that are sometimes unshakeably wrong.
My favourite example of this tendency is the experiment that Hans Rosling, the now sadly dead author of Factfulness, did with more than 1,000 people. He simply asked them, “Has the percentage of the world population that lives in extreme poverty (a) halved, (b) doubled, or (c) stayed the same in the past 20 years?” Only 5 per cent got the right answer that it had halved; 65 per cent thought it had doubled. Rosling pointed out that if he wrote the three answers on three bananas and threw them to a chimpanzee, it would pick up the right answer 33 per cent of the time, doing six times as well as human beings at answering a question about human society.
It is this mismatch, between our tendency to believe persuasive people and our exposure to charlatans with global megaphones, that explains the worst aspect of the modern world: the headlong rush into cults, whether of Trump, Muhammad, Marx, Corbyn, Ayn Rand or Foucault. (That’s my list, not Hart’s, by the way.) This book is therefore a good place to start to understand almost everything about the twenty-first century, from obesity to Donald Trump, by recognising that we are still apes.
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