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COVID-19 illustrates the difficulties society has in dealing with uncertainties and the stresses this creates

COVID-19 illustrates the difficulties society has in dealing with uncertainties and the stresses this creates

No one can say with confidence what our COVID-9 world is going to look like over the next 12 to 24 months. The rules and models of the old world no longer hold.  It is this uncertainty itself that adds great stress, overlaying the fear of specific scenarios.

Times like these can bring out true leaders but also false prophets. Trying to distinguish between them is much easier in retrospect than at the time.

All great leaders instil confidence in the chosen path but there is a fine balance between confidence and false confidence.  The troops do need belief in their leaders, but the leaders also have to be willing to change course in the face of evidence.

There are two quotations from American President and Allied Commander Dwight Eisenhower that I rather like. In fact, there are many of Eisenhower’s sayings that I like, but two seem particularly relevant right now.

Eisenhower once said that “plans are useless, but planning is indispensable.”  I have used that quote to my students many times over the last four decades. It is worth thinking about.

A second Eisenhower quote is that “farming looks mighty easy when your plow is a pencil and you're a thousand miles from the corn field”.   

When Eisenhower enunciated those words in 1956 in Illinois, he was indeed talking about agriculture, but the relevance is universal. It came to mind when I heard TV presenter Mark Richardson opine that he was sure he himself would be a better Prime Minister than the incumbent.

Experts and the media

One of the issues right now is that there are supposed experts on both sides of any COVID-related argument. For example, here in New Zealand we have had epidemiologists arguing both for and against various levels of lockdown and community restrictions. It can be a case of choose your preferred argument and then choose the so-called expert to buttress that argument.

Part of the problem goes back to our population being poorly educated in relation to science. Hence, our media, themselves poorly educated in science, prefer simple statements of certainty. These are then buttressed by a ‘call to authority’ that the message is coming from an ’expert’.

In addition, the popular media thrives on controversy which they themselves delight in stirring up. It is their job to do so.  There can also be an issue of media taking the views of specialists out of context.

This week I was asked by a major media organisation if they could interview me for an article on COVID-19. I turned them down for the simple reason that I did not trust that specific phrases would be kept in context. And I told them so.

One of the reasons why over the last 20 years I have always preferred to do live radio and TV interviews rather than pre-recorded, is that I know with a live interview I cannot blame anyone else but myself if I stuff it up. With a pre-recorded interview, the worry all the time is how a particular phrase will come across as an isolated ‘sound-bite’ of 15 to 30 seconds.

Also, the mainstream media do not usually give their commentators the right to choose the title of an article. In that regard www.interest.co.nz is a welcome exception. In contrast, the mainstream media prefer ‘click-bait’ titles even if they are not always accurate.

However, I also have some sympathy for the media folk who are trying to tease out the real story. Every Government Ministry and every business corporation has its communication team tasked with massaging the flow of information to the public. I think of them as the Propaganda Departments. 

We are all learners

Coming back to COVID-19, if the definition of an expert is someone who knows things with certainty, then there are no experts. Rather, there are specialists in particular areas who can bring their professional knowledge to particular aspects of the issue. But in regard to the big questions of how this virus plays out in particular contexts, we are all very much learners.

In that regard, another quote I like comes from a former colleague and ecologist at University of Queensland. On his door was the statement: “In God we trust; all others must bring data”.

A key problem with COVID-19 is that the data is only starting to emerge. Then there is the question of how it should be interpreted and the extent of any generalisations that can be made from it. But decisions do need to be made.

Despite the lack of data, there are now more than 5000 publications specifically relating to COVID-19 already in the public arena, either as peer-reviewed articles or as preprints awaiting peer review. And then there is the stream of media releases, emanating from the propaganda departments of both Big-Pharma and universities, often with no supporting information available.

I have been trying to peruse both the preprint and peer-reviewed literature on COVID-19, but I defy anyone to keep abreast of it. I scan through the titles, and if something looks particularly interesting then I download the abstract, and then, depending on what the abstract says, I download the full paper.  Inevitably, in so doing I am using my own subjective lens to identify what seems likely to be valid, and how we should interpret those results.

Models are projections based on assumptions

In relation to the models of what is likely to happen, I always focus on the underlying assumptions. Often these are not explicit. In regard to models, another quote that I have used many times over the years with both students and also in my own research projects, comes from famous British econometrician George Box. He said that “all models are wrong but some models are useful”.  What he was saying was that models can provide insights as to how systems work, and what are the crucial parameters, but they don’t predict the future.

To understand something of models, one has to understand the language of mathematics, including calculus and differential equations. Scientists soon learn that use of equations and statistical methods can be a pre-requisite of publication in good journals, but it is amazing how many papers get through peer review with incorrect equations and incorrect use of statistics. It also means that very few non specialists can understand those papers because they don’t understand the language of mathematics.

The evidence is murky

From the evidence I can find, there is absolutely nothing that is proven at this time in terms of a successful treatment for COVID-19. There are a number of treatments that I am following closely and that can be described as ‘promising’, but even that term can be open to misinterpretation.  

There is great confusion in the public arena together with debate amongst scientists as to the overall levels of community infection. Some overseas studies are indicative of a considerable number of asymptomatic infections, but scratch beneath the surface of those studies and lots of necessary caveats can be identified.

Often, the messages about possible community levels of infection get confused between asymptomatic cases (no symptoms ever) and pre-symptomatic cases (yet to show symptoms). Also, some of the studies that talk about a high proportion of asymptomatic infections show no understanding of what are called antibody specificity levels (false positives) which have to be taken into account.  

Serology (antibody tests) can be highly informative in understanding how a pandemic is evolving, and I would like to see New Zealand getting involved with a lot more vigour than currently.  But antibody tests need to be interpreted by people who understand the nuances of both sensitivity and specificity, together with how they apply in specific situations.

Using Mycoplasma bovis as an example, the New Zealand eradication program would have long-failed if it were not for antibody testing, despite lots of false positive and false negatives that occur. If there had been ongoing reliance on just swab (PCR) testing, then failure would have been certain. As the program evolved and with increasing experience, much more weight has been placed on antibody testing as a key diagnostic tool. However, whether that program will succeed is still unknown.

All developed countries have a program

Across the world, there are no developed countries that I can find that do not have an active program to reduce the transmission of COVID-19. There are some that were very slow to get started such as Brazil and they are now paying the consequences.  There are others such as Sweden which have no lockdown, but which do have social distancing programs that include only seated customers at bars, the self-isolation of older people, and the cancellation of both concerts and mass sporting events. Indeed, the Swedish strategy is very similar to what New Zealand will have under Level 2.

One of the concerns for New Zealand is that the Swedish death rate on a per capita basis is now 75 times that of New Zealand. Adjusted for New Zealand’s population, the equivalent number of deaths in New Zealand would now be over 1500 with many more to come. Sweden had hoped that infections would decline as population immunity built up, but there is no convincing evidence so far that this is occurring. I see a lot more problems ahead for Sweden.

In most parts of the developed world apart from New Zealand, Australia and much of North-East Asia, there is no prospect of eliminating COVID-19 in the short or medium term unless and until a vaccine is developed. They left it too late.

There is also now a broad consensus that in most of the world we have only seen the prelude. In musical terms, the more substantial fugue is still to come. There is also a developing belief that the future waves will be multiple.

In New Zealand we are so lucky that through the combination of our isolation, the late arrival of the virus, and a lockdown that came in just the nick of time, that new cases are now very low. Hopefully, we will not squander the position we have reached. 

Treading the fine line

One of the key issues is that there is a very fine line between a transmission rate below ‘1’, where each person on average infects less than one other person and with this leading to virus levels declining, and a contrasting level a little above ‘1’, such that disease levels builds again. This is one of the issues that all European countries now have to be very concerned about.

In Germany, the evidence suggests that their transmission rate declined to about 0.7, but that it may have already increased again to at least 0.9 and may even be heading beyond there above the critical level of ‘1’. Lags in the system between behaviours and confirmation of infection mean that key confirmatory information arrives too late for good decisions.

In the United States, the overall transmission rate is now declining but this is only because of the dominating effect of New York, and, to a lesser extent, cities such as Detroit and New Orleans. In two thirds of American states the number of cases is still exponentiating.

Accordingly, unless there is a strong seasonal effect with summer coming on, then big trouble still looms in many parts of the USA as restrictions are removed.  Unfortunately, the evidence from Brazil, Mexico, Ecuador, Singapore and an increasing number of other countries is that this virus does tolerate summer and even tropical conditions.  The key issue is social distancing rather than climate.

There are also lessons to be learnt from across the Tasman where the Cedar Meats cluster in Victoria has exploded in the last few days from just two cases on 27 April to 75 cases as at 9 May.  It has now spread from the meat company itself to at least one hospital, one care home, and one school. Under LEVEL 2, a similar outbreak in New Zealand could be traumatic.

There is also a tendency in some quarters in NZ to believe that an ongoing low level of infection is acceptable. What is apparently not understood by these people is that a low level of infection does not stay that way without a lot of heavy stamping just like we were doing in LEVEL 4.

There has now been enough testing in New Zealand that we can be confident that community transmission is not widespread. However, there could still be pockets of transmission, particularly among groups of young people who are the most likely ones to have very mild or even zero symptoms.

As for any moves to establishing a cross-Tasman bubble, each time the bubble expands there is increasing risk that we are exposing ourselves to new hidden embers. We would need to see zero new cases on both sides of the Tasman for at least a month before we could be confident that the embers had died out.

The science of uncertainty and the art of probability

Coming back to my chosen title for this article, it comes from a German medical friend of mine with whom I shared some adventures in the Andes of South America many years ago. In a recent communication he quoted from the famous 19th century Canadian physician and medical professor William Osler, who described medicine as “a science of uncertainty and an art of probability”. My medical friend and I both think that still applies very much today in relation to COVID-19.

Another apt quote from Osler was that he once said to his students: “Gentlemen, I have a confession to make; half or what we have taught you is in error, and furthermore we cannot tell you which half it is.

In relation to what we currently think we know about COVID-19, it may well be that more than half is in error. So, we do indeed need to keep learning, and acknowledge that there are no all-knowing experts. There are no certainties. As we look around the world, the importance of the precautionary principle seems evident.


*Keith Woodford was Professor of Farm Management and Agribusiness at Lincoln University for 15 years through to 2015, and retains an honorary position as Professor of Agrifood Systems. He is now Principal Consultant at AgriFood Systems Ltd. One of his interests is the epidemiology of both animal and human diseases. He can be contacted at kbwoodford@gmail.com. Keith’s previous COVID-19 articles are available here.

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59 Comments

18
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A good read and as good a summary of the situation as any. Thx.
The best bit?
"There is also a tendency in some quarters in NZ to believe that an ongoing low level of infection is acceptable. What is apparently not understood by these people is that a low level of infection does not stay that way without a lot of heavy stamping just like we were doing in LEVEL 4."

Just in case anyone was wondering about the broader associations and background of much of the alt-right links that are being shared regularly in these comments these days...there is a battle of narratives going on, there always is, and far be it from me to tell anyone what to believe, however, it's important to look at both sides and make your own mind up.

"The Unz Review, a website that promotes anti-semitism, Holocaust denial, conspiracy theories, and white supremacist material.[1][2][3] In addition to Unz's own writings, the site has hosted pieces by white supremacist Jared Taylor, among others.[4]

https://en.wikipedia.org/wiki/Ron_Unz

Not knowing anything about the links above, this comment makes me think that these days most people try to discredit people as opposed to their ideas. Hitler had many horrible ideas but the autobahn and animal conservation weren’t bad. I would love to see more debate on what’s said rather than who’s said it.

Anyone can set up a website or blog to discuss their views on white supremacy or whatever conspiracy theory they are wedded to. David Icke has been doing it for decades. No one has silenced him, his books are still published, he is as prevalent as he ever was. Facebook and other social media platforms are private businesses who set their own terms and conditions. They ban content all the time. Funny how when its child murder and pornography, no one whines about freedom of speech and liberty infringement, but when its some alt-right, conspiritard or antivaxxer.... oh how they whine about the tragedy and injustice of it all!!! The very fact that Audaxes can link and share Unz is proof that he isn't silenced, he just isn't free to use social media platforms that deem him against their rules.

I think you missed my gist. Is what they were saying wrong? That is what I’m getting at and your playing the man not the ball again in that comment. Horrible people can be right occasionally but we won’t know unless we look at the idea and not just discount it because of the person. That goes both ways as well, for those so inclined - just because Jacinda says it doesn’t mean it’s automatically wrong.

I read part of the 1st link. It was junk so gave up. Clearly the blog-owner is obsessed by conspiracies. So that would include plenty of alt right however as far as I read he was describing Covid-19 as an american plot and the Chinese being the intended victims. It was hardly Trump loving MAGA.
This site does have its share of left-wing orientated conspiracies so there is some balance. Maybe more right than left which is not surprising since it is mainly about economics, investment and property. But both voices are heard.

Great article Keith. You have been well ahead of the curve on this from day 1. It's always great to read your well informed and well reasoned articles.

I thought this paragraph should be read by a few commenters on interest, who repeatedly claim the death rate is tiny due to 'asymptomatic' carriers.

Often, the messages about possible community levels of infection get confused between asymptomatic cases (no symptoms ever) and pre-symptomatic cases (yet to show symptoms). Also, some of the studies that talk about a high proportion of asymptomatic infections show no understanding of what are called antibody specificity levels (false positives) which have to be taken into account.

14
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Keith,
thank you, a well written and excellent overview.

15
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wow what a pleasant surprise on a sunday afternoon -- bloody good journalism ~

great read thank you -- particularly the importance of the relationship between low numbers and L4 restrictions - hugely important that people understand how impossible acting at L2 and keeping cases to say 25-30 a day really is

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'Government propaganda teams massaging the flow of information'. We have now regressed to the government point blank refusing to engage with the media except on its terms, arrogantly declaring 'because we can, given our popularity'. Minister Parker goes trumpian, bypassing journalists and using social media instead to advance his ideas.

10
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South Korea thought they had it right...as of today they now know they got it wrong, one person is all it takes to kick start a new wave, their one person visited 5 different bars in one night and generated a storm of new cases which will take quite some time to track and isolate. Hence they are now back in lockdown
Lets not do it wrong here in NZ

It is very difficult when a person decides to be stupid. This man with clear symptoms decided to visit the crowded night clubs and escort.
Same thing can happen anywhere in the world. That person single-handily infected 100 people so far.
NZ should keep restrictions on the bars, night club, and escort service, in addition to introducing curfew.
Last thing we want to see is a 22 year old spreading Covid to his family, relatives and coworkers, then we would have locked down for nothing.

But this is the problem with lockdown. It already was for nothing except buying a little time, or can kicking if you are less generous. It buys time it does not eradicate the infection. At least not if you follow the logic of the paper that we used as justification for entering lockdown.
The Imperial college paper is not very good science but it's the science we used to get here. In the paper it clearly states that if you leave lockdown, the virus flairs up again. So you have to go back into lockdown to control it. Then it dies down a bit, you leave, it flairs up ad infinitum until you either get herd immunity or a vaccine.
A vaccine is a wild gamble. Vaccines are not easy. The fastest vaccine was the mumps vaccine and it took about 4 years. Typically they take about 10 years. We don't have a vaccine for AIDS and there has been a colossal amount of research and money thrown at that.
Herd immunity is something that has protected us for a long time, it is a not a model or a theory, it is what happens all the time and it is proven. But we have decided not to go down the herd immunity path.
So that leaves us with going in and out of various levels of lockdown for years until we develop immunity or there is a miracle vaccine. In the end we will have the same outbreak and the same level of death just spread over a longer time and with a huge amount f damage wrought on society.
Once we enter level 2 there will be flair ups. There is a wide range of estimates on how much more prevalent covid is in the population than we think from the cases / deaths reported. But the minimum seems to be 10 times (with estimates going to 50 times or even more in the Santa Clara study). If we look at our figures, nearly 1500 cases means that there are likely some 15 000 cases. That would be supported by the fact that there is a lot of asymptomatic spread and that even if you show symptoms they are often very mild, not at the level where a person would go to a doctor, hospital or testing station especially with all the messaging about inundating the health system as well as the air of fear our government has encouraged.
Where are those cases? Who is tracing them?
It seems likely that it will flair up. If so will the government accept that lockdown is pointless especially for a relatively benign disease that affects a very specific group of people? Or will the "not early and not hard enough" narrative take hold.
Einstein said "insanity is doing the same thing over and over and expecting a different result". Unfortunately Jacinda only seems to accept advice from epidemiologists and puts way too much faith in models. Maybe historians might be able to give her some more useful context.

by keithwoodford | 11th May 20, 6:01pm
0
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wee willy winkie
I came across a paper about 10 days ago - from China but published in one of the leading internatonal journals (I do not recall which one, will have to go searching) which reported that some of the variants have much more binding power to human cells than others. I am very open to the possibilty that some countries will have got lucky in regard to the dominant variants. In the UK, they have lost at least 90 hospital workers and and at least the same number of care home workers. These are workers who have died, not just got sick. Lots ot think about.
Keith

we will never know what they outcome would have been if we didn't do this...maybe 'just a few old people" as many on here often quote,but who knows the outcome if it became rampant through lower socio economic areas like Sth Auckland with large amounts of people with compromised health and underlying conditions,who make up much of our health system,either as patients or as the hospital cleaners,orderlies etc.

18
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New Zealand, we're told, has an advantage. We are an isolated island. We can control who we let in.

The problem is our economy also relies on this maxim. There is little value add. Many retailers put more time into campaigning for GST to be added to consumer imports than developing their own online offerings and shipping options. Ticket clipping is rife. The same goods through the same chains in NZ are many hundreds or even thousands more than the same store offers in Australia. We have the internet. We can see the prices. This isn't the 1970s.

Now those same retailers are utterly dependent on their online models. The courier network, which was average at best before (international parcels take less time to get here than they take to get from the airport to Penrose), can't cope. Basic staples are not immune - export prices have driven local prices for the not-export-quality food products through the roof. The less said about housing, the better.

We have a land of milk and honey where no one can afford the land, the milk, or the honey. Now we are stuck with each other, totally reliant on the best of our produce going overseas to make us money, and a retail model within massively inflated prices relative to our pathetically low earnings. The Australian parent bank of my local bank offers interest rates a full percent lower than the local board rate.

Covid19 isn't the problem. New Zealand is the problem. We just can't hide from it anymore. We can't print our way out of this.

(also great Sunday evening read, fantastic article).

Well said!

I fail to understand why we are still getting cases from known cases. Surely known cases should be tightly isolated. There has been less than 500 for well over a month, so not that hard to do.
The entire country is living in fear and under major restrictions and it shouldn't be so. We have had the lockdown, identified all the cases, and know there is no community transmission. The message should be positive and we should be in the clear.
Opening the border will be something entirely different.

We're still flying people home - presumably these are people testing positive while quarantined.

If the links to overseas travel are people inside the same bubble who are just asymptomatically reinfecting each other as they quarantine, then things will unravel at level 2 really fast.

China eventually broke up infected bubbles and pit people into individual quarantine using hotel rooms for that reason. They could have ended up waiting months to snuff out the virus in large family groups. Faster and safer by far for the people in those bubbles to more actively manage those cases.

here is a statistic for you
50% of all new cases reported today came as new arrivals into the country

So we really can’t afford to open the borders for tourists or students?

Who is still flying in and out of NZ?
This seems to be kept under cover.
Last week there was the story of a NZer caught doing a drug run NZ to USA to NZ!

Caleb, excluding new imported cases of returning Kiwis etc, cases linked to known cases have continued to grow because lock downs reduce the R0 but not to zero. The tricky thing about SARS-CoV-2 is that it is *highly* contagious and has varied incubation rates (some have been weeks but the average is under 2 weeks), varied symptomology (some asymptomatic) and then human error (people not hand washing) stupidity and lack of compliance.

Cross-posted from the Top 5 yesterday - a useful reminder from Matt Ridley (who, in 2010, in the Rational Optimist, mused that a world-wide flu-variant could yet upset the Optimism of the title...) that we know 'everything and nothing' about the WuHuFlu, that models are useless, and that a large dose of humility all around would be appropriate. Plus, as he notes, "Be in no doubt that the strangulation that is asphyxiating the economy will have to be gradually lifted long before we know the full epidemiology of the virus. Perilous though the path is, we cannot wait for the fog to lift before we start down the mountain."

Says the man who presided over the Northern Rock disaster ?

Indeed.

Consider the sauce

That's a curious point to make, David. All that the Northern rock debacle proves is that Matt Ridley is probably a poor company director but he could still be (and probably is) an excellent scientist (or science writer). Isaac Newton lost £20,000 (around $5 million in today's money) in the South Sea Bubble but, as far as I know, he is still held in some regard as a scientist.

COVID-19 is a science of uncertainty and an art of probability

Like Bitcoin?

13
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Ok open border to students that may bring 1 billion per year as well as CV19 or keep them out because we just spent 20 Billion plus and destroyed many peoples businesses to get on top if this virus.
You would have to be crazy to let students back in my view as they will be very high risk to the control of CV19 for such a small contribution to our overall economy.

Reopening the boarders may well be an election issue.....

I see no reason to myself given the cost of level 4

22
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If this was the only NZ written article I had read these past 5 weeks I would conclude that our journalism is alive and well...

Pity you're not at the 1pm sitcoms Keith - it would be really interesting to hear your insightful line of thinking turned into challenging questions directed at JA & AB - not because they're performing badly themselves but because the quality and usefulness of question time is consistently ruined by poor journalists.

^^ this, so much this.

'In God we trust; all others must bring data' W. E. Deming isn't it?

"We've arranged a global civilization in which most crucial elements profoundly depend on science and technology. We have also arranged things so that almost no one understands science and technology." - Carl Sagan

12
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Great article Keith. Thank you.

I think it is also necessary to be realistic and acknowledge the chasm between what is ideal and what is possible. Lockdown fatigue is real. A predictable and observable psychological phenomenon. Overdoing restrictions where they are not absolutely needed could be unleashing a whole host of other, possibly more intractable and ugly problems, than a small outbreak or new cluster of the virus. There is lockdown fatigue in countries that have shocking death rates, so expecting a NZ population to follow extreme restrictions much longer, when the human tragedy is so comparably minor is a big ask.

I was a strong advocate of the early, strict lockdown. As I saw it, NZ was wholly unprepared for a pandemic. The health service was/is not in great shape, headed to winter, there were nowhere near enough ventilators or ICU beds for the kind of infection rates being seen elsewhere and with a new lethal novel virus, buying time is always a good strategy. However, there are only 123 identified active cases in NZ today, many maybe all of which are recently imported cases or known link to a previous cases. We have massively upskilled in testing, quarantining and contact tracing and I think the balance of risk is moving towards continued lockdowns causing more harm than good. Obviously, NZ's success will be predicated on the strength of the track and trace system and the ability to monitor the quarantine of incoming cases but what I am seeing now is people not following any restrictions at all, let alone level 2. That is a symptom of lockdown fatigue and of virus complacency, which I think could be much more dangerous at this stage.

One of the reasons I joined up here, after being a long time reader, was to congratulate you for your scientific approach, so different to the many ideology and conspiracy theory driven commenters on here. Well done.

Back to level 2 on 18 May?
I really hope they put this ‘Level 2.5’ nonsense to bed tomorrow...

I hate the term "2.5" but I would be in favour of level 2 on the 18th with the exception of regional travel and vulnerable groups.
I think it would be prudent to restrict travel in and out of places where there are existing live cases whilst in level 2 for a few more weeks and maintain stricter measures and additional protections for at risk people at communities.

If some new cases/clusters randomly pop up, then we need to rethink, but on the data we have, the sooner we get to level 2 the better. Not because I think the virus is not still a risk, but *because* the virus is a risk. No strategy will work if its citizens have burnt out and become complacent. The circumstances always change, history shows us that, but human behaviour does not.

Absolutely, GN. Government needs the consent of the Governed, and that's ebbing away as we type.......There's not nearly enough recognition of behavioural economics in this whole schemozzle, and as you sagely point out, human nature is baked in and won't change.

Can someone please pass this article onto Mike Hosking et el - this is not a linear issue as is well put here. Dealing with massive exponential spread potential with this virus leaves no room for error. Theres no neogtiation with this virus and to have expended so much to get to where we are now we must hold the line to keep ahead and on top of it. The alternative route is far more horrendous than the long road back we already face with a healthy population.

Don't feed the troll. Attention is oxygen to them.

You're assuming Mike Hosking's can read.

I think he only reads his own press in front of the mirror...

Sweden is doing very well when compared against the model that locked down the US and the UK - and no doubt influenced NZ. Sweden may have got some things wrong but at least will have an economy out the other side.
"Last week, the UK’s R number was estimated at 0.8 (± 0.2 points), a figure described as an achievement of lockdown. But Sweden’s reading is 0.85, with a smaller error margin of ±0.02pts.

This raises an interesting question: might voluntary lockdowns work just as well?

...An Uppsala team, feeding Imperial’s parameters into its own study, agreed. The modelling envisaged Sweden paying a heavy price for its rejection of lockdown, with 40,000 Covid deaths by 1 May and almost 100,000 by June.
The latest figure for Sweden is 2,680 deaths, with daily deaths peaking a fortnight ago. The virus, it turns out, has been spreading at a fraction of the speed suggested. So Imperial College’s modelling – the same modelling used to inform the UK response – was wrong, by an order of magnitude."
https://www.spectator.co.uk/article/sweden-tames-its-r-number-without-lo...

Apples and oranges.
Sweden's population is actually following the restrictions. They are well known for being solitary people who often live in small groups 2-3.
UK is a whole different kettle of fish.
Not to mention Swedens death toll hasn't gone down like they had hoped. It continues daily.

Why do you keep oversimplifying the issue Profile? Lockdowns were NOT an either/or strategy. Lockdowns were about buying time, increasing healthcare and testing capacity, which has now been done because if/when healthcare facilities are overwhelmed the death rate of both the virus and all other preventable deaths would have increased to the scale of a potential human tragedy. STOP MISREPRESENTING THE ISSUE.

The fact that all governments are currently loosening restrictions and putting R0 goals in place proves that I am right and that you are twisting things to suit your narrative. Governments were never going to be able to keep populations locked in until there was a vaccine and that was patently never the plan. It was about buying time to prepare. Once everyone had prepared, once testing capacity was increased, once a clearer picture was apparent, restrictions have been rapidly reduced.

What's more, governments have clearly assessed the level of infection and likely hospital admission rate they can manage without risking the aforementioned human tragedy, which is why governments are stipulating a data based approach to the infection rate. I.E if the infection rate is increasing to what would overwhelm heath services again, restrictions will increase. They are clearly planning to increase and decrease restrictions according to their capacity to manage the pandemic.

Great article Keith.Good to read a non partisan,scientific & factual piece.
Agree whole heartidly on the MSM click bait headlines & people like Mike Hoskings,editing to suit and only talking to people that fit his narrative(which appears to be a deep seated hatred of this government).
Like another response above,it would be good to have you asking questions at 1pm...intelligent questions would undoubtedly get better answers from Ms Ardern & Mr Bloomfield who get vilified by many in here,but with many of the banal & stupid quedtions asked by our journalists,its hard to answer some of those questions without rolling your eyes,no wonder they said don't bother to the ministers.

Best comment I've read from facebook over the weekend is: Why should be assume that an economic depression will leave the healthcare system standing"?

Letting some people die. That is an art in medicine.
And a science.
1997 publicly debated withholding of health spend on a 63 year old got this comment from the media:
"the hospitals (and courts) handed out a death sentence ".
Rationing decisions are in most all decisions made each day on the contact floor, more or less.
The health sector is a business. And it cannot afford to"save" everyone.
And Covid response is mostly a rationing decision. What can we afford?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115722/
BMJ. 1999 May 15; 318(7194): 1346–1348.
Rationing health care in New Zealand

Totally great article Keith. Stay on.

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Thanks Keith. Always worth a read & I always learn something as I'm not a scientist. I'm politically right of centre but realise that a change of govt every-so-often is a necessity. It's a shame that we have the students in charge at the moment, but there's nothing standing out anywhere else just now, so it is what it is. Would have liked to see good quarantine working in early March but it's still not working in early May, so that's a fail. And I enjoy the posts on this site very much, with both sides playing the game which is exactly how I like it. And I wish everyone well in level 2.

The real issue that fails to get discussed is what cohort of society is actually dying from this virus (versus any normal flu) and what is their normal life expectancy in any case. And then what cost as a society are we willing to pay in order to protect the most vulnerable, to give them their normal life expectancy (and quality of life) and are there better ways of doing that without wrecking everyone elses' livelihoods. Stopping this flu is going to be impossible without killing the economy, so compromises and acceptable losses (we all die in the end) need to be made unfortunately. Tough, 'callous' decisions but ones that with transparent data need to be made.

Keith, NZ seems to have experienced a less virulent form of the virus, if the infection rates of the middle aged and otherwise healthy are any indication. The USA seems to have many deaths of policemen, servicemen (and women) who one imagines would have been required to pass routine health checks, which would rule out underlying conditions. Yet all of our deaths have been in the older, more compromised demographic. Out of our nearly 1500 cases, very few seem to be progressing to the hospitalisation stage let alone ICU. Could this be a contributor to our lucky let off?

wee willy winkie
I came across a paper about 10 days ago - from China but published in one of the leading internatonal journals (I do not recall which one, will have to go searching) which reported that some of the variants have much more binding power to human cells than others. I am very open to the possibilty that some countries will have got lucky in regard to the dominant variants. In the UK, they have lost at least 90 hospital workers and and at least the same number of care home workers. These are workers who have died, not just got sick. Lots ot think about.
Keith

"In God we trust; all others must bring data" brilliant. And another insightful article, thanks Keith. Good luck to all of us.

Good article again Keith. I have been a member/reader of interest.co.nz for over 8 years and about a week ago I became a financial member.

Everyone, if we want journalism like this, we need to pay for it.

I think that this is an excellent article and one I will keep. But it has one flaw. It does not give sufficient weight to the the significant and long-term issues arising from mass unemployment-these are; economic of course, but encompass both physical and mental health up to and sadly, including suicide.
There are many studies which show these effects all too clearly. I will quote very briefly from one; Unemployment and suicide. Evidence for a causal association?
Conclusions: Being unemployed was associated with a twofold to threefold increased relative risk of death by suicide, compared with being employed".
Under a precautionary approach, the benefits can be seen immediately in having few additional deaths, while the many negative issues arising from long-term unemployment only appear gradually.

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