Excellent article. We’re stuffing our economy for something that might be no worse than the 1968 ‘Hong Kong flu’
Mortality in ’68 was circa 80,000 and we shut nothing down.
Andrew Martin
4 years ago
Upon first death in Italy the whole village was mass tested on Feb 20 and found 50% were infected with 45% of those asymptomatic – Prof Crisanti Padua Univ. This supports the “Oxford Univ finding suggesting 20 mill may already be infected in UK with associated very low IFR NB that there is currently no excess mortality. This suggests that lockdown of young population should be released asap with continued protection by isolation of vulnerable population. This will prevent economic disaster.
The veracity of the contagion appears to be the key, so if approximately 50% of the population of U.K. contracted Covid 19 which seems quite plausible, you can then play with the death rate percentage.
Saphié Ashtiany
4 years ago
In the UK and setting aside princes, prime ministers and celebs, we have until recently only tested people in hospital with covid symptoms – so people who are ill and who are reasonably thought to be infected. So why has there been such a low positive rate?
UK has 1 positive in every 3.3 tests – about the highest positive ratio in the world, because we have done so few tests targeted on those who most probably have it. The bad news in there is that many of the people who think they might have had it but were never tested probably didn’t
Peter Mott
4 years ago
Tom’s model may be simple but it is also intelligible. Models with many equations and many parameters and intricate mathematics are not intelligible. I mean no-one can fully grasp them or see in any detail how changing the parameters changes the model.
This is a standard criticism of complex multi-equation models in economics. For example one by the late Wynne Godley in 1999 purportedly showing that EU peripheral; countries would always be at a disadvantage compared to Germany had over 70 equations! How do you criticise that?
That leads to the second issue. because they cannot be properly understood they cannot be criticised either and so we are at a loss to see when they are wrong. In the worst case of this – the climate models – we will have to wait till 2100 before we can assess whether they were right or not.
So Tom in the end defers to complex models by clever people run on big computers (well actually you don’t need a big computer). I prefer simpler models that promise less but whose actual performance can be monitored.
After all the only useful message that has come from the Imperial model is that allowing the epidemic to run would overwhelm the NHS – and this message was only issued when Italian experience showed that the rate of hospitalisation was far greater that had previously been fed into the model.
David Gonzales
4 years ago
From the article: “found 963 cases and just two deaths; an CFR of 0.05%”. Since 2/963 is approximately 0.002, isn’t this supposed to be a CFR of 0.2% (and use ‘a’ instead of ‘an’ while at it)?
I got lost in your maths I think. If for 1% you multiply by 100 then if you use 0.1% shouldn’t you multiply by 10?
Dave Smith
4 years ago
A very good article. I fell ill on the 15th January with what was the worst illness of my life . A virus entered through my left eye I believe. I took to my bed for close on a fortnight and apart from my wife saw nobody. She too fell ill and took longer to recover. The course of the illness was exactly like Covid 19 except that it did not proceed down into my lung other than leaving me a bit short of breath and in a bit of pain when I breathed. The exhaustion was the most I have ever experienced. Recovered by the 4th week but took it easy as I had the feeling that this would recur if I pushed myself. It did not feel like flu at all but something else. I have since found that others had a like illness around the same time. I have this feeling that the virus was here from December and thus earlier in China. It must be extremely infectious and when it reaches a critical mass in any population almost seems to explode. This is why i suppose we are trying to delay the spread. It would seem that random testing of the whole population for antibodies would tell us much.
Simon Bannister
4 years ago
Good article Mr. Chivers, thanks.
Another angle I’ve picked up on, the difference between death with CV19 and death of CV19 i.e. was it the primary or exclusive cause of death and the consequent difference in various counties as to how the death is recorded. Another factor being how vulnerable different people are to it… not just based on age or pre-existing conditions. Seems it does not effect us all in the same way.
Conclusion being, we just don’t know enough about this thing!
Quite how our Government responds therefore is hard to judge, I guess they have to do what they’re doing, assume the worst case for deaths and try and manage the economic impact as best they can whilst protecting the NHS.
samuel.goulding
4 years ago
Thank you for a very well written article. I will add that I like your writing style and its humility whilst also asking the right questions. I appreciate your requesting all of us to go easy on the modellers, they are only human too.
giles.bradshaw
4 years ago
This isn’t quite right. The IFR is the fatality rate for the number of people who have the INFECTION. You can be infected ie a carrier without having the disease.
col
4 years ago
Best balanced article I have read on this – but I’m only saying that because I had thought most of this myself without doing the detailed research and I agree with it. But why, given that we have COBRA scenario planning for situations like this weren’t we more prepared for the process of testing and quarantine and the overall response, in the light of COBRA being there to plan it, has the response been so shambolic?
Yes, and why did government allow Spanish football supporters en mass into Liverpool when such was not the case in most of Europe? We don’t need to model this to know that is the reason that Liverpool is having greater rate of increase than Manchester. Or was it modelled before it was allowed as an experiment to judge what proportion of Spanish were infectious?
Louise Lowry
4 years ago
Surely among the unknown variables discussed the total number of Covid 19 deaths in a county, which will checked for verification in several months time, compared with its total population, and the rate of increase or decrease in the deaths/day are figures that need to be explained & reflect on the state of its health system & the ‘scientists’ that the government was prepared to take advice from. In UK & USA the desire to let it rip through the population & so gain ‘herd immunity’ has been disastrous for the economy they wished to protect. Of course the death toll will be mainly of older people & /or those with underlying health conditions, which it seems was thought to be a price well worth paying: they would die soon anyway as a respected UK statistician on BBC ‘s ‘ More or less ‘ said unchallenged in the programme before last. Cummings has been reported as saying pensioners will die & of course they will. Just how many die in each country will be judged globally in months & years to come
alberto.menoni
4 years ago
My preferred metric: Deaths / 1 million population, but you only know the final number when the epidemic/pandemic is over (5.7 globally on April 01, 2020, 14:40 GMT, and counting)
Am I right in thinking Covid19 has only recently been officially adopted as a principle cause of death . Before that happened people could have died with it but not because of it ( because it wasn’t listed as a notifiable cause)
David Radford
4 years ago
Why has no-one suggested large scale random surveys using the same methodology as opinion polls. By asking if each respondent has no symptoms, has symptoms or has recovered from symptoms we get results that can be repeated say weekly to give trends and provide breakdowns by region etc. This is just one aspect covered in an outstanding article. I have been trying to get this considered for weeks with no result. As unherd has an ex YouGov exec maybe you can help!
Ray Hall
4 years ago
Mr Chivers , don’ t know if you will read my comment which is 3 days after your article , but here goes….. The German news “100 Sekunden” says that a thousand strong sample of the population in Munich will soon be tested for antibodies in respect of the corona virus. Perhaps that will give an idea of the true prevalence of the spread of the virus. The newscast did not say which test was to be used , nor when the results will be available . According to a different item in the same newscast , the Robert Koch Institute says the disease is slowing due to Social Distancing and due to the restriction on going out . Don’t know if this helps . …..
Jit Kach
4 years ago
Isn’t is the case that the models are dynamic rather then static given the inputs put in it. The early information from china was that the disease was mainly effecting the older population, over 70s, with a mortality rate of around 11%. This must have been the original input in the UK team strategy. The inputs from Italy and now here in UK is that the age range of the severe COVID-19 patients is younger then anticipated in a model and if this input is added to the model then the model will say something else then the strategy the team started with.
Andrew Smith
4 years ago
Imperial are using code that is 13 years old and no one else has seen it?
That sounds a lot like the climate alarmists approach to models. Come to think about it, this article is interesting for pointing up all the problems of definition, data reliability and modelling. The climate alarmists seemed to have no such difficulty when modelling the eath’s atmosphere and oceans and using data from multiple measuring devices and types from several millenia ago to the present day. They claim to have been able to reliably tell us what the climate will be in a hundred years time down to tenths of a degree.
Adrian Smith
4 years ago
“All models are wrong, some models are useful in certain specific circumstances” is the starting phrase of any half decent modelling course. Our gov’t seems to think its approach to modelling is world leading. I suspect they are wrong about that, But given the daily repeated claim that they are following the science (not just the model, but mainly the model) to do the right thing at the right time, undermining that assertion would do far more harm to decision making (what little we have actually seen, other than deciding it is too early to decide) and more importantly public confidence in the decisions that are made. Maintaining public confidence in and therefore broad compliance with what is eventually decided is going to be even more important as we try to find our way out of this maze..
Another thing to factor in is how accurate are the tests? Many different tests looking for different aspects of the virus are being used around the world. I understand WHO is still evaluating a large number which have been submitted for evaluation – proper evaluation takes time. I would suggest that a lot of the early testing was done using tests of dubious accuracy. With the push to achieve more testing in UK, has the standard for accuracy been relaxed? The much hoped for and publicised antibody test does not seem to have made the grade and it has all gone deathly quiet on that front. Though I understand some limited random surveillance testing has occurred.
It need to be remembered that there are lots of Coronaviruses in circulation all the time. The term describes the shape – it looks like a crown in 2D. Are many of the virus tests detecting specifically CV 19, or are many of them also detecting some or all of the many other Coronaviruses as well? Will there be a similar problem with antibodies?
Excellent article. We’re stuffing our economy for something that might be no worse than the 1968 ‘Hong Kong flu’
Mortality in ’68 was circa 80,000 and we shut nothing down.
Upon first death in Italy the whole village was mass tested on Feb 20 and found 50% were infected with 45% of those asymptomatic – Prof Crisanti Padua Univ. This supports the “Oxford Univ finding suggesting 20 mill may already be infected in UK with associated very low IFR NB that there is currently no excess mortality. This suggests that lockdown of young population should be released asap with continued protection by isolation of vulnerable population. This will prevent economic disaster.
The veracity of the contagion appears to be the key, so if approximately 50% of the population of U.K. contracted Covid 19 which seems quite plausible, you can then play with the death rate percentage.
In the UK and setting aside princes, prime ministers and celebs, we have until recently only tested people in hospital with covid symptoms – so people who are ill and who are reasonably thought to be infected. So why has there been such a low positive rate?
That is a very good question!
UK has 1 positive in every 3.3 tests – about the highest positive ratio in the world, because we have done so few tests targeted on those who most probably have it. The bad news in there is that many of the people who think they might have had it but were never tested probably didn’t
Tom’s model may be simple but it is also intelligible. Models with many equations and many parameters and intricate mathematics are not intelligible. I mean no-one can fully grasp them or see in any detail how changing the parameters changes the model.
This is a standard criticism of complex multi-equation models in economics. For example one by the late Wynne Godley in 1999 purportedly showing that EU peripheral; countries would always be at a disadvantage compared to Germany had over 70 equations! How do you criticise that?
That leads to the second issue. because they cannot be properly understood they cannot be criticised either and so we are at a loss to see when they are wrong. In the worst case of this – the climate models – we will have to wait till 2100 before we can assess whether they were right or not.
So Tom in the end defers to complex models by clever people run on big computers (well actually you don’t need a big computer). I prefer simpler models that promise less but whose actual performance can be monitored.
After all the only useful message that has come from the Imperial model is that allowing the epidemic to run would overwhelm the NHS – and this message was only issued when Italian experience showed that the rate of hospitalisation was far greater that had previously been fed into the model.
From the article: “found 963 cases and just two deaths; an CFR of 0.05%”. Since 2/963 is approximately 0.002, isn’t this supposed to be a CFR of 0.2% (and use ‘a’ instead of ‘an’ while at it)?
b****r! Yes, you’re right – the CEBM used the 0.2% to extrapolate an IFR, not CFR, of 0.05%. My mistake – hopefully should be fixed in a little bit.
Thanks for pointing out! Whoops.
However Tom the IFR is the fatality rate for infections NOT disease. Not all infections result in disease. That’s an important distinction.
I got lost in your maths I think.
If for 1% you multiply by 100 then if you use 0.1% shouldn’t you multiply by 10?
A very good article. I fell ill on the 15th January with what was the worst illness of my life . A virus entered through my left eye I believe. I took to my bed for close on a fortnight and apart from my wife saw nobody. She too fell ill and took longer to recover. The course of the illness was exactly like Covid 19 except that it did not proceed down into my lung other than leaving me a bit short of breath and in a bit of pain when I breathed. The exhaustion was the most I have ever experienced. Recovered by the 4th week but took it easy as I had the feeling that this would recur if I pushed myself.
It did not feel like flu at all but something else. I have since found that others had a like illness around the same time.
I have this feeling that the virus was here from December and thus earlier in China. It must be extremely infectious and when it reaches a critical mass in any population almost seems to explode. This is why i suppose we are trying to delay the spread.
It would seem that random testing of the whole population for antibodies would tell us much.
Good article Mr. Chivers, thanks.
Another angle I’ve picked up on, the difference between death with CV19 and death of CV19 i.e. was it the primary or exclusive cause of death and the consequent difference in various counties as to how the death is recorded. Another factor being how vulnerable different people are to it… not just based on age or pre-existing conditions. Seems it does not effect us all in the same way.
Conclusion being, we just don’t know enough about this thing!
Quite how our Government responds therefore is hard to judge, I guess they have to do what they’re doing, assume the worst case for deaths and try and manage the economic impact as best they can whilst protecting the NHS.
Thank you for a very well written article. I will add that I like your writing style and its humility whilst also asking the right questions. I appreciate your requesting all of us to go easy on the modellers, they are only human too.
This isn’t quite right. The IFR is the fatality rate for the number of people who have the INFECTION. You can be infected ie a carrier without having the disease.
Best balanced article I have read on this – but I’m only saying that because I had thought most of this myself without doing the detailed research and I agree with it. But why, given that we have COBRA scenario planning for situations like this weren’t we more prepared for the process of testing and quarantine and the overall response, in the light of COBRA being there to plan it, has the response been so shambolic?
Yes, and why did government allow Spanish football supporters en mass into Liverpool when such was not the case in most of Europe?
We don’t need to model this to know that is the reason that Liverpool is having greater rate of increase than Manchester. Or was it modelled before it was allowed as an experiment to judge what proportion of Spanish were infectious?
Surely among the unknown variables discussed the total number of Covid 19 deaths in a county, which will checked for verification in several months time, compared with its total population, and the rate of increase or decrease in the deaths/day are figures that need to be explained & reflect on the state of its health system & the ‘scientists’ that the government was prepared to take advice from. In UK & USA the desire to let it rip through the population & so gain ‘herd immunity’ has been disastrous for the economy they wished to protect. Of course the death toll will be mainly of older people & /or those with underlying health conditions, which it seems was thought to be a price well worth paying: they would die soon anyway as a respected UK statistician on BBC ‘s ‘ More or less ‘ said unchallenged in the programme before last. Cummings has been reported as saying pensioners will die & of course they will. Just how many die in each country will be judged globally in months & years to come
My preferred metric: Deaths / 1 million population, but you only know the final number when the epidemic/pandemic is over (5.7 globally on April 01, 2020, 14:40 GMT, and counting)
Which source are you using
Am I right in thinking Covid19 has only recently been officially adopted as a principle cause of death . Before that happened people could have died with it but not because of it ( because it wasn’t listed as a notifiable cause)
Why has no-one suggested large scale random surveys using the same methodology as opinion polls. By asking if each respondent has no symptoms, has symptoms or has recovered from symptoms we get results that can be repeated say weekly to give trends and provide breakdowns by region etc.
This is just one aspect covered in an outstanding article. I have been trying to get this considered for weeks with no result.
As unherd has an ex YouGov exec maybe you can help!
Mr Chivers , don’ t know if you will read my comment which is 3 days after your article , but here goes…..
The German news “100 Sekunden” says that a thousand strong sample of the population in Munich will soon be tested for antibodies in respect of the corona virus. Perhaps that will give an idea of the true prevalence of the spread of the virus. The newscast did not say which test was to be used , nor when the results will be available . According to a different item in the same newscast , the Robert Koch Institute says the disease is slowing due to Social Distancing and due to the restriction on going out .
Don’t know if this helps . …..
Isn’t is the case that the models are dynamic rather then static given the inputs put in it.
The early information from china was that the disease was mainly effecting the older population, over 70s, with a mortality rate of around 11%. This must have been the original input in the UK team strategy.
The inputs from Italy and now here in UK is that the age range of the severe COVID-19 patients is younger then anticipated in a model and if this input is added to the model then the model will say something else then the strategy the team started with.
Imperial are using code that is 13 years old and no one else has seen it?
That sounds a lot like the climate alarmists approach to models. Come to think about it, this article is interesting for pointing up all the problems of definition, data reliability and modelling. The climate alarmists seemed to have no such difficulty when modelling the eath’s atmosphere and oceans and using data from multiple measuring devices and types from several millenia ago to the present day. They claim to have been able to reliably tell us what the climate will be in a hundred years time down to tenths of a degree.
“All models are wrong, some models are useful in certain specific circumstances” is the starting phrase of any half decent modelling course. Our gov’t seems to think its approach to modelling is world leading. I suspect they are wrong about that, But given the daily repeated claim that they are following the science (not just the model, but mainly the model) to do the right thing at the right time, undermining that assertion would do far more harm to decision making (what little we have actually seen, other than deciding it is too early to decide) and more importantly public confidence in the decisions that are made. Maintaining public confidence in and therefore broad compliance with what is eventually decided is going to be even more important as we try to find our way out of this maze..
Another thing to factor in is how accurate are the tests? Many different tests looking for different aspects of the virus are being used around the world. I understand WHO is still evaluating a large number which have been submitted for evaluation – proper evaluation takes time. I would suggest that a lot of the early testing was done using tests of dubious accuracy. With the push to achieve more testing in UK, has the standard for accuracy been relaxed? The much hoped for and publicised antibody test does not seem to have made the grade and it has all gone deathly quiet on that front. Though I understand some limited random surveillance testing has occurred.
It need to be remembered that there are lots of Coronaviruses in circulation all the time. The term describes the shape – it looks like a crown in 2D. Are many of the virus tests detecting specifically CV 19, or are many of them also detecting some or all of the many other Coronaviruses as well? Will there be a similar problem with antibodies?