Interview Sunetra Gupta: Covid-19 is on the way out The author of the Oxford model defends her view that the virus has passed through the UK's population BY Freddie Sayers Freddie Sayers is the Executive Editor of UnHerd. He was previously Editor-in-Chief of YouGov, and founder of PoliticsHome. May 21, 2020 freddiesayers May 21, 2020 Filed under: CoronavirusCOVID-19herd immunity Share: It’s the biggest question in the world right now: is Covid-19 a deadly disease that only a small fraction of our populations have so far been exposed to? Or is it a much milder pandemic that a large percentage of people have already encountered and is already on its way out? If Professor Neil Ferguson of Imperial College is the figurehead for the first opinion, then Sunetra Gupta, Professor of Theoretical Epidemiology at the University of Oxford, is the representative of the second. Her group at Oxford produced a rival model to Ferguson’s back in March which speculated that as much as 50% of the population may already have been infected and the true Infection Fatality Rate may be as low as 0.1%. Since then, we have seen various antibody studies around the world indicating a disappointingly small percentage of seroprevalence — the percentage of the population has the anti-Covid-19 antibody. It was starting to seem like Ferguson’s view was the one closer to the truth. But, in her first major interview since the Oxford study was published in March, Professor Gupta is only more convinced that her original opinion was correct. As she sees it, the antibody studies, although useful, do not indicate the true level of exposure or level of immunity. First, many of the antibody tests are “extremely unreliable” and rely on hard-to-achieve representative groups. But more important, many people who have been exposed to the virus will have other kinds of immunity that don’t show up on antibody tests — either for genetic reasons or the result of pre-existing immunities to related coronaviruses such as the common cold. The implications of this are profound – it means that when we hear results from antibody tests (such as a forthcoming official UK Government study) the percentage who test positive for antibodies is not necessarily equal to the percentage who have immunity or resistance to the virus. The true number could be much higher. Observing the very similar patterns of the epidemic across countries around the world has convinced Professor Gupta that it is this hidden immunity, more than lockdowns or government interventions, that offers the best explanation of the Covid-19 progression: “In almost every context we’ve seen the epidemic grow, turn around and die away — almost like clockwork. Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour which is highly consistent with the SIR model. To me that suggests that much of the driving force here was due to the build-up of immunity. I think that’s a more parsimonious explanation than one which requires in every country for lockdown (or various degrees of lockdown, including no lockdown) to have had the same effect.” Asked what her updated estimate for the Infection Fatality Rate is, Professor Gupta says, “I think that the epidemic has largely come and is on its way out in this country so I think it would be definitely less than 1 in 1000 and probably closer to 1 in 10,000.” That would be somewhere between 0.1% and 0.01%. Professor Gupta also remains openly critical of the Government lockdown policy: “The Government’s defence is that this [the Imperial College model] was a plausible worst case scenario. I agree it was a plausible — or at least a possible — worst case scenario. The question is, should we act on a possible worst case scenario, given the costs of lockdown? It seems to me that given that the costs of lockdown are mounting, that case is becoming more and more fragile.” She recommends “a more rapid exit from lockdown based more on certain heuristics, like who is dying and what is happening to the death rates”. She does not believe that the R rate is a useful tool in making decisions about government policies, as an R rate is “principally dependent on how many people are immune” and we don’t have that information. She believes that deaths are the only reliable measure, and that the number of cases should not even be presented as it is so reliant on the amount of testing being done. She explains the flare-ups in places like New York, where the IFR seems to have been higher than 0.1%, through a combination of circumstances leading to unusually bad outbreaks, including the infection load and the layout of the population: “When you have pockets of vulnerable people it might rip through those pockets in a way that it wouldn’t if the vulnerable people were more scattered within the general population.” She believes that longer-term lockdown-style social distancing makes us more vulnerable, not less vulnerable, to infectious diseases, because it keeps people unprotected from pathogens: “Remaining in a state of lockdown is extremely dangerous from the point of view of the vulnerability of the entire population to new pathogens. Effectively we used to live in a state approximating lockdown 100 years ago, and that was what created the conditions for the Spanish Flu to come in and kill 50m people.” Commenting on the Government response to the virus, she suggests it erred on the side of over-reaction not under-reaction: “I think there’s a chance we might have done better by doing nothing at all, or at least by doing something different, which would have been to pay attention to protecting the vulnerable, to have thought about protecting the vulnerable 30 or 40 years ago when we started cutting hospital beds. The roots of this go a long, long way back.” And she believes it is a “strong possibility” that if we return to full normal tomorrow — pubs, nightclubs, festivals — we would be fine, but accepts that is hard to prove with the current evidence: “So what do we do? I think we weigh that strong possibility against the costs of lockdown. I think it is very dangerous to talk about lockdown without recognising the enormous costs that it has on other vulnerable sectors in the population.” On the politics of the question, Professor Gupta is clear that she believes that lockdowns are an affront to progressive values: “So I know there is a sort of libertarian argument for the release of lockdown, and I think it is unfortunate that those of us who feel we should think differently about lockdown have had our voices added to that libertarian harangue. But the truth is that lockdown is a luxury, and it’s a luxury that the middle classes are enjoying and higher income countries are enjoying at the expense of the poor, the vulnerable and less developed countries. It’s a very serious crisis.” Join the discussion I think we were heading for a no lockdown position where the measures in place on 16th March were seen as enough. Along came Neil Ferguson ((again!) look at foot and mouth, swine flu, mad cow disease etc) and spooked the decision makers into a political lockdown. Motivation for epidemiologists to overstate risks from a virus: government funding will increase with perceived threat of virus; big pharma will finance research of new vaccine; media spotlight for scientists predicting the worst; (and for those with hard left politics) a desire to bring capitalism down. The most disgraceful aspect of the Niall Ferguson episode was that he was not interviewed on TV to justify his behaviour. Instead of either explaining why he considered himself immune from the virus or admitting that he had been lying all along, he was allowed to slink back off to his research grants. I have some sympathy for the politicians. They decided to put the decision in the hands of ‘the science’ and then found that there are many versions of ‘the science’. Don’t you have to look at excess deaths over the, say, January – June time frame to get an idea of the deaths FROM as opposed to WITH covid. Two other interesting observations: 1. Sweden had more deaths in April 1993 and April 2000 than in April 2020. I don’t remember a lockdown/social distancing talk then? People just got on with their normal lives, no media panic etc(2 bad influenza A years). 2. 800m people in Asia Pacific(excl China). Almost hardly any deaths. This is where pandemics start. Japan with 130m people and the oldest population in the world, 700 deaths. Less than UK in a bad afternoon. No lock down, restaurants open etc. Japan has a really bad flu season(probably with other viruses) in 2019 like most countries in Asia pac. Is it possible that this region has got some form of immunity? Professor Gupta’s theory is inconsistent with observed data. Captive populations such as the crew of the french aircraft carrier Charles de Gaulle showed high rates of infection when the virus was able to spread unchecked – 45% in that case. Serology surveillance survey results announced by the UK Health Secretary today show 17% seroprevalence in London and 5% elsewhere – the same test in the same survey. Thus even if the cross-immunity which Professor Gupta imagines exists does exist, the UK population outside London is vulnerable to 2.4x as much infection (and death) as it has already seen. This is hardly a virus “on its way out”. Stockholm/Sweden data shows the same phenomenon. There is also the issue that this survey shows equal seroprevalence across all age ranges and for healthcare and non-healthcare workers alike. What is this strange non-susceptibility property that does not vary either with age or regular exposure to infectious pathogens? Is there any clinical evidence of it? One would think that by now with all the practical studies being done around the world that someone would have noticed this. A further example of Gupta’s theory’s clash with observable reality is the large scale serology survey just reported in Spain, with seroprevalence rates given for 50 different states. Seroprevalence correlates with death rates. There is no sign of an antibody “signal” disappearing over time in the states affected earliest. I am very worried that politics took control over lock down decisions. Why else would Dominic Cummings want to be present on SAGE meetings? The history of Cummings and his methods (clever but not wise) are that of playing to the gallery, seeking the route that appeals to the many for the purpose of retaining power. The more I look at the lock down arguments the more i find them wanting. I am not an epidemiologist but i can read and understand data. No logic, no principal, no plan – especially one to get out of it. While we are focused on the path of the disease in our own first world countries Sunetra Gupta is looking, I think, at a wider picture. The virus passes through, it hits one continent after another. And then, having killed whom it will kill, it moves away… and, in the end dies out. Exceptional plagues, such as the bubonic and waste born things like cholera return and persist. But this is not usual. Even the Spanish Flu made no more than two and a half visits. We can argue stats and percentages for ever but Gupta’s evaluation is most likely to be proven correct. Clearly the answer remains somewhere in the middle ground. I certainly believe that the virus entered UK during the Christmas / New Year period and that we had deaths way earlier than the “first death”. It was a time of year when people were dying of flu and pneumonia; CV 19 is not all that different in how it presents and many had coughs and fevers anyway and we were not really testing for it as we had so little capacity I don’t believe the R0 was ever as high as Ferguson assumed (3-4). It therefore spread much more slowly than Gupta assumes. IFR is also not as high as Ferguson assumed – he was 0.9-1%, but clearly it is not as low as Gupta believes. There are people who were tested positive who have no detectable antibodies. We don’t know how many and can only speculate about possible reasons why. Antibody tests are unreliable, though our government now claims the test it has very recently licensed and is buying to issue free at point of delivery, does not give false positives – by definition it gives false negatives. It has been obvious to me for ages that London had developed a fairly high immunity rate as there is no way Londoners were practising better social distancing than other areas of the country. Other hard hit densely populated cities will also have decent rates of immunity. The fears about using public transport in these cities are therefore exaggerated. I think the debate about whether we should have locked down in the first place is largely pointless and is actually becoming more of a distraction than a help. We can’t change what has happened. The important thing is to do the right thing going forwards. My view remains that we need to be lifting lockdown much more rapidly and getting the working age back to work (and why shouldn’t they enjoy a beer in a beer garden or socially distanced bar when they finish?) and kids back to school – they are not at any real risk. We should shield the most vulnerable, whilst remembering most elderly still have the capacity to make their own decisions on quality vs quantity of their own lives. Above all we need to replace irrational fear, which really is not based on the reality of personal risk, with common sense whilst being socially responsible to minimise relatively easily avoidable infections. I agree with what Prof Gupta says about death figures being the only really reliable source of data for analysis of what was happening to infection rates 2-3 weeks earlier, but that is all they should be used for. Not for MSM to delight when a new set of higher figures come out because more has been included and they can use them to tell us how bad it is and scare people more. Deaths are a sad but inevitable part of life. The excess deaths we are seeing now, about 30% of which are not directly linked to CV19 (either of or with), will largely be reversed later this year and over the next couple of years, as so many of them have just been brought forward by between a few months to a couple of years, we really cannot sacrifice the quality of life of so many for however long it takes to rebuild our economy any further, due to an obsession with a few graphs. Percentage of the population. Say there are around 8 milllion people in NYC and about 15000 deaths (search “nyc coronavirus statistics” on Google), that’s 0.19% of the population. But we know that not everyone in NYC has been infected, so the IFR must be more than that to get that number of deaths. Stockholm city mortality rate is also well above 0.1% and still going up. The same is happening in Belgium and same happened in Lombardy, Italy. . She is talking nonsense and desperately defending her paper. Well what about New York City, with 0.2% dead, and Stockholm getting there soon? To view all comments and stay up to date, become a registered user. It's simple, quick and free. Sign me up
I think we were heading for a no lockdown position where the measures in place on 16th March were seen as enough. Along came Neil Ferguson ((again!) look at foot and mouth, swine flu, mad cow disease etc) and spooked the decision makers into a political lockdown.
Motivation for epidemiologists to overstate risks from a virus: government funding will increase with perceived threat of virus; big pharma will finance research of new vaccine; media spotlight for scientists predicting the worst; (and for those with hard left politics) a desire to bring capitalism down. The most disgraceful aspect of the Niall Ferguson episode was that he was not interviewed on TV to justify his behaviour. Instead of either explaining why he considered himself immune from the virus or admitting that he had been lying all along, he was allowed to slink back off to his research grants. I have some sympathy for the politicians. They decided to put the decision in the hands of ‘the science’ and then found that there are many versions of ‘the science’.
Don’t you have to look at excess deaths over the, say, January – June time frame to get an idea of the deaths FROM as opposed to WITH covid. Two other interesting observations: 1. Sweden had more deaths in April 1993 and April 2000 than in April 2020. I don’t remember a lockdown/social distancing talk then? People just got on with their normal lives, no media panic etc(2 bad influenza A years). 2. 800m people in Asia Pacific(excl China). Almost hardly any deaths. This is where pandemics start. Japan with 130m people and the oldest population in the world, 700 deaths. Less than UK in a bad afternoon. No lock down, restaurants open etc. Japan has a really bad flu season(probably with other viruses) in 2019 like most countries in Asia pac. Is it possible that this region has got some form of immunity?
Professor Gupta’s theory is inconsistent with observed data. Captive populations such as the crew of the french aircraft carrier Charles de Gaulle showed high rates of infection when the virus was able to spread unchecked – 45% in that case. Serology surveillance survey results announced by the UK Health Secretary today show 17% seroprevalence in London and 5% elsewhere – the same test in the same survey. Thus even if the cross-immunity which Professor Gupta imagines exists does exist, the UK population outside London is vulnerable to 2.4x as much infection (and death) as it has already seen. This is hardly a virus “on its way out”. Stockholm/Sweden data shows the same phenomenon. There is also the issue that this survey shows equal seroprevalence across all age ranges and for healthcare and non-healthcare workers alike. What is this strange non-susceptibility property that does not vary either with age or regular exposure to infectious pathogens? Is there any clinical evidence of it? One would think that by now with all the practical studies being done around the world that someone would have noticed this. A further example of Gupta’s theory’s clash with observable reality is the large scale serology survey just reported in Spain, with seroprevalence rates given for 50 different states. Seroprevalence correlates with death rates. There is no sign of an antibody “signal” disappearing over time in the states affected earliest.
I am very worried that politics took control over lock down decisions. Why else would Dominic Cummings want to be present on SAGE meetings? The history of Cummings and his methods (clever but not wise) are that of playing to the gallery, seeking the route that appeals to the many for the purpose of retaining power. The more I look at the lock down arguments the more i find them wanting. I am not an epidemiologist but i can read and understand data. No logic, no principal, no plan – especially one to get out of it.
While we are focused on the path of the disease in our own first world countries Sunetra Gupta is looking, I think, at a wider picture. The virus passes through, it hits one continent after another. And then, having killed whom it will kill, it moves away… and, in the end dies out. Exceptional plagues, such as the bubonic and waste born things like cholera return and persist. But this is not usual. Even the Spanish Flu made no more than two and a half visits. We can argue stats and percentages for ever but Gupta’s evaluation is most likely to be proven correct.
Clearly the answer remains somewhere in the middle ground. I certainly believe that the virus entered UK during the Christmas / New Year period and that we had deaths way earlier than the “first death”. It was a time of year when people were dying of flu and pneumonia; CV 19 is not all that different in how it presents and many had coughs and fevers anyway and we were not really testing for it as we had so little capacity I don’t believe the R0 was ever as high as Ferguson assumed (3-4). It therefore spread much more slowly than Gupta assumes. IFR is also not as high as Ferguson assumed – he was 0.9-1%, but clearly it is not as low as Gupta believes. There are people who were tested positive who have no detectable antibodies. We don’t know how many and can only speculate about possible reasons why. Antibody tests are unreliable, though our government now claims the test it has very recently licensed and is buying to issue free at point of delivery, does not give false positives – by definition it gives false negatives. It has been obvious to me for ages that London had developed a fairly high immunity rate as there is no way Londoners were practising better social distancing than other areas of the country. Other hard hit densely populated cities will also have decent rates of immunity. The fears about using public transport in these cities are therefore exaggerated. I think the debate about whether we should have locked down in the first place is largely pointless and is actually becoming more of a distraction than a help. We can’t change what has happened. The important thing is to do the right thing going forwards. My view remains that we need to be lifting lockdown much more rapidly and getting the working age back to work (and why shouldn’t they enjoy a beer in a beer garden or socially distanced bar when they finish?) and kids back to school – they are not at any real risk. We should shield the most vulnerable, whilst remembering most elderly still have the capacity to make their own decisions on quality vs quantity of their own lives. Above all we need to replace irrational fear, which really is not based on the reality of personal risk, with common sense whilst being socially responsible to minimise relatively easily avoidable infections. I agree with what Prof Gupta says about death figures being the only really reliable source of data for analysis of what was happening to infection rates 2-3 weeks earlier, but that is all they should be used for. Not for MSM to delight when a new set of higher figures come out because more has been included and they can use them to tell us how bad it is and scare people more. Deaths are a sad but inevitable part of life. The excess deaths we are seeing now, about 30% of which are not directly linked to CV19 (either of or with), will largely be reversed later this year and over the next couple of years, as so many of them have just been brought forward by between a few months to a couple of years, we really cannot sacrifice the quality of life of so many for however long it takes to rebuild our economy any further, due to an obsession with a few graphs.
Percentage of the population. Say there are around 8 milllion people in NYC and about 15000 deaths (search “nyc coronavirus statistics” on Google), that’s 0.19% of the population. But we know that not everyone in NYC has been infected, so the IFR must be more than that to get that number of deaths.
Stockholm city mortality rate is also well above 0.1% and still going up. The same is happening in Belgium and same happened in Lombardy, Italy. . She is talking nonsense and desperately defending her paper.
