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What’s the point of contact tracing? Compared to continual lockdown or the virus spreading, even an imperfect tracking system might be the least bad of all options

If you can't trust the British Government to organise a hugely complicated IT project, who can you? Photo by GLYN KIRK/AFP via Getty Images

If you can't trust the British Government to organise a hugely complicated IT project, who can you? Photo by GLYN KIRK/AFP via Getty Images


June 16, 2020   6 mins

Lockdown isn’t over. Nowhere near.  You can’t go and sit in a pub; hardly any children are back at school; and there are still severe restrictions on who you can meet and when. Most people are still complying with those rules.

But we do need to start coming out of it soon, or the cure will become worse than the disease. So we need a way of returning to a sort of normality, and allowing the economy to restart, while avoiding that second wave. 

“Test, trace and isolate” — finding infected people, tracking down the people they’ve been in contact with, and getting them all to isolate for a period — is the most promising avenue, and the government says that it has put in place a “world-beating” system. But their handling of the testing regime — full of self-congratulatory bluster and statistical malfeasance — has not instilled confidence; and while the first tranche of results from the system have been reasonably promising, it has been slow to be developed at all, so it is already fighting uphill. So: can it work?

Well, one interesting paper just published by researchers at University College London looks at the impact contact tracing will have on the economy relative to lockdown. I spoke to one of the authors, the policy researcher David Manheim, to find out whether test and trace could indeed work for the UK. 

Some caveats: modelling is inherently uncertain. Manheim says that the model is robust — the headline outcomes remain broadly consistent even if the assumptions and inputs are tweaked — but it’s just one paper, and so far not peer-reviewed. As the situation develops we can compare its scenarios with reality.

It is worth noting how bad the two extreme situations, “doing nothing” and “staying locked down”, are. The most widely used estimate for the infection fatality rate (IFR) of Covid-19 is about 1%, and that’s what the paper uses. (UnHerd has spoken to various people who think it’s lower than that, and I perhaps over-optimistically predicted a few weeks ago that it would be below that level, but that seems to be the standard estimate.)

So here’s the background situation. If we come out of lockdown entirely, without any attempt at tracing and isolation, the paper estimates that between 60% and 80% of the country would end up infected, and between about 250,000 and 550,000 people would die. People will correctly point out the average age of death is over 80, but nonetheless it is a brutal toll.

On the other hand, if we try to reduce spread by only using lockdown, with no testing or tracing, then “we are likely to need lockdown for three of every four months (or four of every six months)” until the development and availability of a vaccine or highly effective drug treatments. That represents an extraordinary hit to the economy — in the worst case, around £1.2 trillion GDP lost by May 2022, when their models ended. To put that in context, the UK’s GDP in 2019 was about £2.2 trillion. We are talking about roughly a quarter of the entire UK economy being mothballed, with all the knock-on effects to health, wellbeing and happiness that entails.

What you need is some sort of way of targeting your interventions. “Think of it as a continuum,” he says. “How good is our ability to figure out if someone has Covid? If we have no ability, then it’s ‘shut everything down’. If we have some ability, then you can isolate people purely based on symptoms. That reduces spread significantly, but isn’t enough on its own.”

“If you add testing, it gets better, because testing has a lower false negative rate than symptoms, and it catches it little earlier. But tracing catches it much earlier: you isolate everyone who was in contact with this person for two weeks.”

What testing and contact tracing allows is for people to go about their lives in some fairly normal way, and for something like a fully functioning economy to get underway. But the question is whether the scale of the system needed to do that is 1) plausible and 2) available at a cost worth paying. If it would cost a trillion pounds to put one in place, then it wouldn’t really achieve anything over remaining in intermittent lockdown.

“What we model in the paper is: how many tracers would you need?” says Manheim. It’s not a small job: the paper assumes that it would take almost exactly a full week’s work (37 hours) for one contact tracer to follow up all the contacts of a single infected person, including interviews with the subject and their contacts, arranging testing, and doing follow-up monitoring calls. 

Still, the basic result, he says, is that when case counts are relatively low, it is possible to identify and track enough of them to keep the rate of transmission down, at a cost that is relatively manageable. But “when there are too many cases, the costs of tracing are completely out of hand”, he says. If you have millions of cases, then you need many millions of tracers, and it becomes implausible.

Eventually it becomes cheaper simply to test literally everybody once a week — which ends up being about 10 million people a day — and requiring people who get positive tests to self-isolate. And even that is cheaper and more manageable than the costs of lockdown — the paper estimates it would cost about £36 billion over the next two years to do that many tests, a fraction of the £700 billion hit to GDP (and the smaller but still huge hit to the public finances) that we would otherwise be facing.

Luckily, the UK is not in that situation. Despite the somewhat doom-and-gloomy atmosphere, case counts are down somewhere a bit more manageable. The paper includes several scenarios which loosen and re-impose lockdown on given “triggers” — when the number of daily cases goes above 40,000, it is reimposed, and when they fall below 10,000 it is relaxed. The daily number of lab-confirmed cases in the UK, as of Sunday 14 June, was 1,514; that’s probably a low number because the weekend interferes with data collection, but data from the KCL/Zoe Covid-tracker app suggests that there are fewer than 5,000 daily new cases at the moment. So we are in the “manageable with contact tracing” zone.

But is the testing and contact tracing system we actually have fit for purpose? The British government has been making very loud noises about meeting the targets it set itself, of 100,000 tests by the end of April and 200,000 by the end of May. But those numbers were largely nonsense: the 100,000 tests included tests put in the post but not carried out, and multiple tests being carried out on the same person; the 200,000 included those but also included antibody tests, which are good and important things but entirely different. (And both also referred to “capacity”, rather than actual tests carried out.) Radio 4’s magnificent More or Less team have been digging away at this dispiriting little bit of governmental misinformation for weeks. Sadly, the virus does not seem to be reading the Department for Health and Social Care’s press releases.

The actual, real number of individual people being tested is about 50,000 a day. That’s not negligible, but in the paper’s best-case scenario (which still involves many thousands more people dying than have already), we will need to test at least 75,000 people now, and about 300,000 people a day over the winter. That’s assuming that we have enough contact tracers in place – if I’m reading the paper right, somewhere around 80,000 “public health community officers”, ie recruits, and a smaller number of more senior people to manage them – to contact all the contacts of each person with a positive test result. 

The system doesn’t have to be perfect. The paper assumes that 64% of the contacts are traced within a day, and then self-isolate; but there’s no guarantee they will do so; in Israel, where Manheim lives, there are legal sanctions — people who leave their home when expected to isolate are texted a warning and can be given a ticket or arrested — but that may not be feasible here. 

And, Manheim points out, we shouldn’t throw up our hands and say that the British Government’s difficulties with testing and tracing now mean that the whole enterprise is doomed: we can improve it. “The sooner we find out what does and doesn’t work, the better. You’re not going to have a perfect system on day one.” There have been reports of the contact tracers saying that they have signed up and not been given any work, which sounds bad, but “that’s like any new for-profit company building a new thing. The public sector isn’t going to magically do any better. The question isn’t whether it’s doing well on day one, but whether it’s doing OK on day 30, and doing well enough on day 60.”

That said, the Government has not covered itself in glory. “One big bottom line thing that I think is important is that this study should never have been needed,” says Manheim. “We’ve known we needed test-and-trace for a long time.”  They wrote it with the intention of showing policymakers what may and may not work. It may be, he says, that in two months we learn that the Governments’ systems that they already have in place could be scaled up fast, and will do the job. But even if they aren’t, it’s better to start now than to leave it. 

“What they absolutely can’t do, and is a danger in the interim, is print out giant ‘mission accomplished’ banners and declare they’ve got everything done.” It’s not easy for politicians to tell the population that we’re going to have a tough time for the next two years; you don’t get rewarded for that. So it’s easier, in the short term, to declare victory.

But in the end, the numbers of deaths and hospitalisations will be the yardstick of success, and they’re very hard to explain away. The temptation to soft-pedal, to pay lip service to test-and-trace but actually just quietly let lockdown dissolve, will be great, but then we could end up in the worst of all worlds — a huge economic hit due to the pointless 12 weeks of lockdown, and vast numbers of dead all the same.

 


Tom Chivers is a science writer. His second book, How to Read Numbers, is out now.

TomChivers

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Nick Whitehouse
Nick Whitehouse
4 years ago

I feel sorry for the Government at present, they are always attacked by the MSM for supposed failings, but never given any credit.
There were obviously plans for a flu like epidemic – remember how quickly the Nightingale hospitals were built? How the NHS was mobilised to empty the hospitals for people ill with flu?

At the time, bearing mind that Spanish Flu killed 200,000 people and the 1968 Hong Kong flu killed 80,000, it appeared a very good approach.

Unfortunately for the Government, this is a different flu virus, that attacks the old and already ill, in a novel way. It is only with hindsight that we now know that the virus attacks the old in a new way and thus the emphasis has had to change. To pretend that we should have isolated the old at once is to ignore the knowledge gained from previous epidemic that it was younger people who worst infected.

People forget the fuss over ventilators, why haven’t the Government bought enough? Now it appears that ventilation is not generally a good treatment for Covid 19 and new orders have been cancelled.

Or to put it more simply, this is a new disease and only when the scientist understand it better can the Government have a clear pathway to containing it. Until that time arrives the future is all guesswork and I do not take much notice of modelling as it is guesswork as well.

Lucy Smex
Lucy Smex
4 years ago

How the NHS was mobilised to empty the hospitals for people ill with flu?

It was that hasty emptying of hospitals of everyone they could, without checking if they had the virus, is what caused the outbreak in so many care homes, i.e. those most vulnerable and at risk.
The same thing happened in a number of US states, all Democrat-run unless someone can give proof otherwise, resulting in a high percentage of deaths in those states coming from nursing and retirement homes.
I would suggest that this NHS policy is no better than government-mandated homicide. It’s not something I would be congratulating them on. I would suggest that they’ve actually managed to kill more than they’ve saved.

John Church
John Church
4 years ago

Your view is flawed because you have overestimated the mortality rate. We knew the mortality a long time ago when we had the Diamond Princess data and the initial statistics of the %’s that were dying in Italian hospitals. It is age dependent so we can query the usefulness of an average, but your average is too high. When you take into account the whole population, the IFR is below 0.5% (for the UK – much lower in countries with younger populations). When you take into account the fact that 95% of cases have serious other problems, the lethality as applied to a healthy population is less than 0.025%. And of course not everyone will catch this. Given the fact that there must be a significant cohort of the population that are naturally resistant (based on the fact that exponential growth always stops before 20% infection rates), then we know it will only spread to a maximum of 50% of the population before it dies away. So the chance of dying from this for your average healthy person in the land is somewhere around 0.01%.

Now with that view, why is ‘doing nothing’ a problem ?

Paul Wright
Paul Wright
4 years ago
Reply to  John Church

London’s IFR is about 0.4 % (from serology, see previous discussion here) (edit: fixed to say serology rather than just looking at PFR as a bound). Using the Diamond Princess data gets you an estimate of about 0.5 % IFR for China. So while 1% is high, about half of that is plausible, and still gets you a lot more deaths than we’ve seen already in the case where it goes through the population unmolested.

Given the fact that there must be a significant cohort of the population that are naturally resistant (based on the fact that exponential growth always stops before 20% infection rates), then we know it will only spread to a maximum of 50% of the population before it dies away.

The number of infected peaks when you have herd immunity for the current R. Are you arguing that the measures, both voluntary and mandatory, that have been put in have no effect? How do you distinguish that from natural resistance to get your 50% estimate?

naillik48
naillik48
4 years ago

Oh dear , modelling assumptions…
60% to 80 % infection ? I F R 1% …?
The Carnival Princess cruise ship , which was an almost perfect environment for asymptomatic spreading , had an infection rate of around 20% and an infection fatality rate of around 0.04.
These are the sort of numbers suggested by Prof Gupta and her Oxford University team.

Paul Wright
Paul Wright
4 years ago
Reply to  naillik48

The Diamond Princess had 14 deaths and about 700 confirmed cases, giving an IFR of 2%. The population was old, extrapolating Diamond Princess to China gets you about 0.5 % IFR there (see https://www.eurosurveillanc… )

Prof Gupta’s claims are wildly implausible, her 0.05 % IFR implies that more people have had the virus in the UK than actually live here. 20 days ago on May 28th, we had about 38000 deaths. A UK population of 68 milllon and an IFR of 0.05% gives you 34000 deaths if everyone gets it, which serology (and common sense) says they haven’t.

Michael Yeadon
Michael Yeadon
4 years ago
Reply to  Paul Wright

I didn’t take Gupta as claiming an IFR of 0.05%. She pointed out early on however that the observed mortality statistics could fit a wide range of numbers infected & IFR.
One extreme, such as the IFR in this article, is an unlikely to be correct as is the sub-0.1% which sparked criticism of Gupta.
Empirically, I think it’s more likely that U.K. has come close to infection of all susceptible people. An IFR of 0.2%, essentially the CDC estimate, and 42,000 deaths (maybe it’s more; Aldi we’ve not yet finished & could easily see 5000 more before stopping) imply 21,000,000 infections. Based on the above, we could easily reach 22,5million infections. Some observational studies do suggest that 1/3rd isn’t far below the susceptible fraction of the population.
Seen in this admittedly optimistic light, the U.K. piece of the pandemic is ending & cannot return on scale. I like this interpretation because it provides a logical solution to the question “what has caused R to move continuously lower, despite measures moving closer & closer to normality. Obviously it’s emerging herd immunity (which takes many forms & is not invalidated by finding a low prevalence of anti covid19 antibodies.
The most compelling piece of evidence that population resistance has already developed is that there has been no impact of the lifting & breaking of restrictions in recent weeks.

Paul Wright
Paul Wright
4 years ago
Reply to  Michael Yeadon

I didn’t take Gupta as claiming an IFR of 0.05%

also you:

an infection rate of around 20% and an infection fatality rate of around 0.04.
These are the sort of numbers suggested by Prof Gupta and her Oxford University team.

So which is it?

She pointed out early on however that the observed mortality statistics could fit a wide range of numbers infected & IFR.

She plumped for 0.05 % in Freddy Sayers’ interview with her for this very site, unfortunately, as well as backing away from the original paper’s claim that serology testing was urgently needed to resolve the issue by saying maybe there’s a whole bunch of infections which won’t show up in serology testing. At this point, it’s starting to look like epicycles. Why not just admit that the Earth goes around the Sun?

Some observational studies do suggest that 1/3rd isn’t far below the susceptible fraction of the population.

Got a reference?

R is pretty close to 1 right now, so I’m not sure why you think it has been continuously lowering. Again, I need to see a reference for that. I’m not sure what is going on with the lack of an uptick despite restrictions being eased, I admit. Seasonality? Indoor work in air-conditioned open-plan offices being a primary way to spread it and most offices still working from home?

Michael Yeadon
Michael Yeadon
4 years ago
Reply to  Paul Wright

I am sceptical that R is known. Last time I attempted to get to the data from which a media quoted value was derived, I couldn’t find any.
The fact that the proportion of the population currently infected has been falling quickly (halving in ten days based on quoted values on BBC news) indicates that R is well below 1. Do you agree? If not, please explain how R can be close to 1, yet at the same time, the % infected fall quickly.
Serology sadly doesn’t give us binary information (have had the virus vs not had the. Virus).

olivps
olivps
4 years ago

I think people are still tied on the original numbers of IFR and Ferguson like models. For a test and track system to be feasible (real useful and not a fudge history) you need to know what you want to achieve. If it is reducing hospitalisation, they are already reducing without implementation of any system anywhere in the world. If it is to reduce deaths you need to find who is the susceptible population; I dare to say based on the current trends that the majority of those who were susceptible to die have already died. They will be additional deaths but the numbers would be so low that they will not be of epidemiological relevance per se; they will not be adding too much Excess deaths than currently estimated annually under the “respiratory infections” group of deaths. I believe that this is dust for the eyes of the commoner to confound a shambolic handle of all this subject. And adding up cost to other inefficient things like the famous Nightingdale’s.

tony.mooney
tony.mooney
4 years ago

Tom

Every single study out there of the actual data so far, starting with the Diamond Princess all the way to a variety of Scientific, evidence based studies from every geography has the IFR well below 1%. So your ‘..but that seems to be the standard estimate’ is very misleading. The data we now have demonstrates that the virus, thank goodness, is patently not the zombie apocalypse that many modelled/estimated it would be yet still many media commentators
over emphasise the risks to the general population, double down on ‘the only answer is Lockdown’ and any dissenting evidence is ignored (or aggressively attacked without counter factual data) even if it comes from the most reputable sources. Feels, worryingly, like GroupThink and censorship of open debate. I must confess, I just don’t understand the agenda and purpose of those that promote this. I, for one, have been thankful for UnHerd, which has been an oasis of common sense and sanity and bi partisan in talking to many brave scientists, medical experts and statisticians who at least have data and evidence to back their views. Unlike majority of mainstream media.

Michael Yeadon
Michael Yeadon
4 years ago

I’m sorry, but the author is using an IFR that no well informed person would. There have been several dozen independent estimates of IFR from around the world, using different methodologies & the median value, which the US CDC uses, is around 0.26%. So divide potential fatalities by 4.
Also, the max % susceptible to infection is not known definitively, but is considered more likely to sit between 1/3rd & 2/3rd. Even the post WW1 ‘flu infected no more than 1/3rd of the population.
If you combine IFR of 0.25% & use 33% as susceptible fraction, then after 42K deaths, then we have already had 3/4 of all the infections we could have (16.8million individuals infected out of a max of 22million).
It’s not surprising that the virus is “dying out”: on my calculation, it must have become very much less likely that an infected person interacts with another, susceptible person.
It’s impossible to get a ‘second wave’. Too low a density of susceptible people remain.
I’m therefore of the view that we’ve reached the point where removing all restrictions is the less harmful strategy.

Andrew Crisp
Andrew Crisp
4 years ago

Is it still not understood?! There is no more danger in C.19 than the annual flu, according to the stats, so why bother with all this control, testing and restrictions. We wouldn’t do it in a “normal” flu outbreak. Is it necessary to state the obvious; people die at the end of life, any flu will hasten it, this is normal.

This is a government control operation, involving the army (77th Brigade, on-line surveillance), the intelligence service, behavioral psychologists (in SAGE) and the police, for what? All this, for an epidemic that is similar to flu, but has been made devastatingly worse by the measures taken against it. Measures, which are the opposite of what should have been done; isolate the infected, get fresh air and sunlight, boost the immune system, protect the elderly and infirm.

OK. so the government panicked, but that is no reason to continue this farce and endanger more lives by lack of standard hospital treatment for those that have ACTUAL, treatable diseases. Mandatory mask-wearing continues the falsity of “threat”, causes untold psychological harm and actual physical harm (it is not healthy to continually re-breathe one’s own breath). People need to start petitioning their MPs to get their civil rights back, now.

Dennis Wheeler
Dennis Wheeler
4 years ago
Reply to  Andrew Crisp

Indeed, but facts don’t matter to the mass media and politicians pushing the Narrative of a new Black Death, for which we all need to be very afraid – and compliant with totalitarian government social and economic controls – from now until…well, when isn’t quite clear…

Until they tell us a vaccine is here? Even though over half of all doctors and nurses don’t even get the annual flu vaccine because they know it is only about 50% effective and mostly pointless? More likely until Trump loses – then the media will announce the world is largely Covid free on November 4 (race relations will be declared to have magically improved on that date as well).

Bruce Wallace
Bruce Wallace
4 years ago

“So here’s the background situation. If we come out of lockdown entirely, without any attempt at tracing and isolation, the paper estimates that between 60% and 80% of the country would end up infected, and between about 250,000 and 500,000 people would die. People will correctly point out the average age of death is over 80, but nonetheless it is a brutal toll.”

This isn’t a serious estimation of doing nothing. It assumes two unknowns. Firstly that the IFR is 1%. There have been numerous estimates of the IFR that are as low as 0.1%. The Centre for Disease Control in the US estimated it to be 0.26%. So assuming 1% is just that…an assumption and precisely that used by Imperial College to project 250,000 to 500,000 deaths without ANY intervention. It’s bullshit.

The second assumption is that 60-80% would be infected? This belies the fact there may be a large chunk of the population who have various levels of immunity without having had to develop anti-bodies through infection.

There is no consensus on these spurious projections. I’ll put this article down as just more covid noise.

Tim Gardener
Tim Gardener
4 years ago

The paper by UCL makes the assumption that the IFR is 1% and then creates a first scenario which results in a prediction of 600,000 deaths. Not much subtlety there. But the numbers are ludicrous and the modelling is deeply flawed.

We know that the IFR is very significantly age dependent. This excellent paper from Berkeley looks at the Italian excess mortality numbers and gives a strong evidence based estimate for age dependent IFR. “How deadly is COVID-19? A rigorous analysis of excess mortality and age-dependent fatality rates in Italy” https://www.medrxiv.org/con

Unless you factor age into the IFR you come up with ludicrous estimates. I am genuinely surprised that these models are allowed out in public. I am surprised that these UCL academics have any credibility or reputation left.

Tom – you are usually much more able to spot the errors in this type of publication!

Bill Gaffney
Bill Gaffney
4 years ago

Models are all a farce. You want to be traced? Why don’t you just put a bell around your neck like a good sheep? Better yet, have a chip inserted. You live like a sheep you will be a sheep..and easy to be led.

Nick Rogers
Nick Rogers
4 years ago

Tom, I’ve enjoyed many of your articles looking at the statistics around Covid 19 but in your last two you have fallen victim to the “let’s take some guesses, multiply them by some other guesses and then claim we have found the answer.” I also think you have begun to talk to Captain Hindsight. Shame.

Fraser Bailey
Fraser Bailey
4 years ago

i don’t suppose there is any point to it, just as there is little point to any activity undertaken by the state. That’s why I call it the scamdemic. Anyway, I’m sick of C-19. When is Apple bringing out C-20? If Steve Jobs was still around we’d be on C-24 by now.

marionhusband
marionhusband
4 years ago

I receive emails from unherd everyday and very often I ignore them because of articles like this. As many commentators below write, with more skill and knowledge than the author of this ridiculous piece, nothing further should be done regarding this virus – the government needs to apologise for the horrible, horrible mistakes it has made and insist everyone goes back to work and school, no masks, no anti-social distancing, nothing. Also, No one in their right mind is going to download this app, unless they want more time off work on the tax payers’ buck (so, maybe some will then – teachers, maybe….?) This article reads as though this cold virus is a true threat to healthy people under or even over the age of 80. It isn’t. A vast percentage of all deaths are of people over the age of eighty who were already ill and would most likely have died of any virus or bacterial infection within this year. For goodness sake, whoever wrote this should get a grip. Idiotic fear-mongering.

Michael Yeadon
Michael Yeadon
4 years ago
Reply to  marionhusband

I agree. In case you’ve not yet seen it, there is compelling evidence that the bulk of those who’ve died would in any case have died soon.
If you go to http://www.EuroMOMO.eu, scroll down to Z-scores, deselect all countries then select France, and be prepared to be stunned by what you see.

Kenneth MacKillop
Kenneth MacKillop
4 years ago

Once a truly infected individual can test positive for endogenous viral replication, he likely will have been infected for 6 or 7 days with this virus. How useful can contact tracing be, especially at a massive level never before even thought of, much less performed successfully.

To catch this infection within a day of adequate incubation time for a positive test result would require that everyone be tested once daily.

Is anyone really thinking about this with even a small degree of care? It is ridiculous.

It would be more sensible to pay attention to comments like the one from Dr. Alberto Zangrillo, the head of Milan’s San Raffaele Hospital, that viral load is now “infinitesimal” in cases seen in-hospital in Milan compared to those from one or two months ago.

This is almost certainly reflective of developing herd immunological resistance to the virus, and hugely significant. It means that people infected now in Milan are hugely less likely to develop serious complications. This is the way things work in the real world. And humoral immunity is only part of the picture. Cell-mediated immunity (to SARS-2) is a very important component that is starting to be analyzed by a few researchers. And antibodies themselves are not very effective (i.e. not “neutralizing”) without robust T-cell response, so even for a vaccine to be effective will involve the cell-mediated part of adaptive immunity — this is known, basic immunology.

Protecting the very aged and most vulnerable (i.e. those with serious comorbidities) is the only justifiable role for government, and they have almost all been massive failures at this worldwide, paying nothing but lip service. The vast majority of the population should ideally carry on in a normal manner, getting infected by the virus quickly and building up herd immunity. I know whereof I speak — I have been infected first in respiratory system (which was so trivial I did not know it was CoVID-19 at the time) and a few months later in gut (exclusively — I tested negative with throat swab). I have a severe case of a genetic condition known as CVID — I myself cannot manufacture antibodies for almost any virus or bacterium. My B cells are almost completely nonfunctional. But I have now developed cell-mediated (i.e. T-cells) immunity in the only two outwardly facing tissues. T-cell immunity is tissue-specific, and so I did not have cell-mediated immunity in gut until infected in that organ directly. And I am close to 62 years of age. But healthy at the cellular and overall physiological level.

Most of us should get our vit D status up to snuff (if it is not already), and get healthy in general, and not worry about infection — rather, get it over with. Make use of what nature has already endowed us with.

Dr Leah Remeika-Dugan
Dr Leah Remeika-Dugan
4 years ago

I agree with you 100%

Glad you are feeling better.

Good Wishes

Derek M
Derek M
4 years ago

This piece lost it’s way when it admitted the inherent problem with modelling but then blithely claimed as a fact a death toll of half a million based on nothing at all. ” the cure will become worse than the disease”, it already has. We’ve given ourselves a massive self inflicted wound based on hysteria.

lodewijk.paardenkooper299
lodewijk.paardenkooper299
4 years ago

I would recommnend contacting Willem Engel, at mail@weltschmerz.nl
He has given the scientific explanation for the ridiculousness of lockdowns, the useless R figure and the real herd immunity. The Dutch community that are not lackeys of political power are convinced he has very good and scientific points

Dennis Wheeler
Dennis Wheeler
4 years ago

What’s the point of contact tracing?: Totalitarian social control.

My state has been advertising these CovidStasi jobs (for which they’ve approved a 4 page long sheet of outside vendors as contractors in an astonishingly short period of time – I’m sure a look at these “private” vendors funding and ownership would show massive conflicts of interest with government officials). And don’t think it will stop with Covid. After all, once these new CovidStasi agents are on the payrolls the state won’t want to put them back out of work, so they’ll find new “public health risks” they supposedly need to monitor people for from now unitl the end of time.

Anyone taking these CovidStasi jobs should be socially ostracized, tarred & feathered, and banned from polite society. If I were starving, I’d consider it more noble and honorable to steal than to take one of these state Covid spy jobs.

I hope these new CovidStasi units are using The Lives of Others in their in their recruiting materials (truth in advertising to let people know what they are signing-up to be):

https://www.google.com/sear

Russ Littler
Russ Littler
4 years ago

Well, for a guy who is supposedly a “science” writer, there certainly wasn’t much evidence of any scientific facts in that article. It was pure drivel.

David Bell
David Bell
4 years ago

The real problem with track and trace is asymptomatic cases. The true number of cases and therefore the spread of the disease is hidden by asymptomatic cases. There is still a massive question mark over asymptomatic spreading of Covid 19.

What we need is a system that protects the vulnerable, that means older people and people with certain underlying heath conditions. Everyone else, especially school children, need to get back to normal. Track and trace should only be used when Covid 19 spreads beyond the core at risk group.

Michael Yeadon
Michael Yeadon
4 years ago
Reply to  David Bell

Regarding the high prevalence of asymptomatic cases, please allow me to point out something really important: it has the effect of REDUCING the infection fatality ratio and this also INCREASES the number of people who’ve already been infected.
Please see my newer post. If the IFR is 0.1%, only 1 in 1000 infections die. Crucially, 42,000 deaths means 42million infections. This is 2/3rd of the population. A commonly held view is that the maximum susceptible fraction of the population is 2/3rd.
I think these are estimates that are close to the truth. The result tallies with what we’re seeing: a fading away of infections & deaths, day by day.
No further precautions are needed, nor is track & trace, masks or a vaccine.

Mike Hughes
Mike Hughes
4 years ago
Reply to  Michael Yeadon

Since there is evidence from November 2019 that the virus was in the UK then it is likely that herd immunity was reached well before the lockdown. By the middle of April it was clear that intervention was unnecessary. As for vaccines our immune system runs rings around any vaccine and certainly don’t need any dodgy, untested treatment where Bill Gates might be involved.

fretters00
fretters00
4 years ago
Reply to  David Bell

I totally agree that those at low risk should have returned to normal (months ago, as soon as we were last 9th April and numbers were declining). But is it so huge a question mark over asymptomatic carriers? Logic alone can tell you that a disease spread by droplets will be much less likely to spread by people who don’t cough. The WHO has reported that there is good global data on it and studies so far have consistently shown asymptomatic transmission to be “very rare”. It’s true that more studies will help to verify whether that can fairly be extrapolated globally, but contrary to press headlines the WHO have not retracted evidence of asymptomatic transmission being rare, but instead rather cryptically added that “some modellers are using 40% as a figure”. Modellers could use 100% as a figure if they wanted, it doesn’t mean there’s any scientific or evidential basis for doing so.

Fraser Bailey
Fraser Bailey
4 years ago
Reply to  David Bell

I lost my sense of humour for a few days back in March. Does that count as ‘asymptomatic’?

Bill Gaffney
Bill Gaffney
4 years ago
Reply to  Fraser Bailey

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David Bell
David Bell
4 years ago
Reply to  Fraser Bailey

one never knows!

Derek M
Derek M
4 years ago

Nice to see it’s not just me who had doubts about this https://lockdownsceptics.or

Kenneth MacKillop
Kenneth MacKillop
4 years ago

Almost unbelievable that anyone is still talking about 1 in 100 IFR still. That is probably something like what it was for Spanish flu — a tremendously more virulent virus. Evidence is pretty substantial that it is likely to be 1 in 1000 or so.
And large-scale PCR testing? It has never been done before. Almost inconceivable that any government could use this as anything but a massive boondoggle. If extremely shrewdly and narrowly targeted — i.e. used in a novel and well planned way, I could conceive it to be of limited use.

But PCR testing of a (primarily) respiratory virus infection/epidemic is nearly useless for clinical purposes, for epidemiological purposes, for contact tracing purposes, or any other purposes. This is an out-of-control global pandemic — the horse is out of the barn. Too late for useful application of PCR testing.

Academics love this type of thing — it provides them with work and income. They are the last people who should be asked for an opinion.

Barron’s magazine published a pile of almost meaningless nationwide CoVID-19 stat’s this past week, illustrating the problem of nearly total lack of understanding of what data are useful and what are not for epidemiology. But I was glad to see that only two nations (Sweden and USA where I live) are on a linear ramp upward in accumulation of exposure to the SARS-2 virus (although this is misleading, because in the northeast we are more like Europe, far along on the downslope, and elsewhere exposure is just getting started). All of the other nations shown (including UK) have almost halted exposure rate. This is really betting big on a successful vaccine at best. And the economic damage that will have been done by the time any vaccine(s) can be adequately tested will be mindboggling. In the worst case there may be no successful vaccine, or many years before this becomes available. In other words, the first tries (which are purely theoretical about a novel virus very poorly understood at the molecular/immunological level as yet) may fail, yielding increase in understanding but requiring 2nd and maybe 3rd attempts before success. Such efforts as vaccine development can be intrinsically iterative projects, as are most scientific and engineering efforts in the real world.

Meanwhile, it was expected and it is hilarious (to me) that Beijing is being locked down. No country will be successful with a lockdown strategy indefinitely, and this virus is fundamentally a weak pathogen. Xi Jinping and the CCP have now trapped themselves, having lied about the figures and pretended that the virus can be contained with lockdowns. And the Western world has (mostly) aped the CCP as if they know what they are doing. The CCP has a reason to lie and defraud and spew propaganda. The West does not, except for its leaderlessness.

Dave Tagge
Dave Tagge
4 years ago

As others point out, it is seeming less and less likely that we’ll see the combination of 1% IFR *and* 60% to 80% of the population becoming infected. I point out the combination of the two because there seems to be a subset of the population that calls into question the exact definition of “infected”. If someone tests positive on a PCR, has no symptoms, and then doesn’t show antibodies on a serology test, has that person been “infected” or not?

There’s a combination of factors. I’m not going to post the dozen links needed to look at all of these, but the information from reputable sources (including studies and pre-prints) is readily out there for anyone who wants to try to find it.

– Unknown number of people who are asymptomatic or have very mild symptoms, increasing the denominator.

– Indications that some significant part of populations is not susceptible to infection. Study of cross-reactivity of T-cells makes the point that perhaps 50% of people fall in this category. This percent could differ across countries and regions. Dr. Muge Cevik of the University of St. Andrews has a pinned tweet pointing out many studies that show a less than 20% infections rate among household members of confirmed cases, which also points to well less than 100% of the population being susceptible. It could help explain Japan’s experience of a very low rate of COVID-19 deaths even with limited testing and no hard lockdown. It could also help explain why deaths and hospitalizations in Sweden have been much lower than projected by epidemiological models.

– Indications of people who test positive on PCR tests (sometimes more than once) but have few if any symptoms and don’t test positive for antibodies on serology tests. That indicates that even serology tests understate the number of people who have been “infected”. It also indicates a subset of cases where it’s debatable whether people were truly “infected” or not.

– We see spread slowing dramatically – or failing to reignite after shutdowns end – in populations where serology tests show antibodies in far less than 60% to 80% of the population.

Put it all together, and it seems to take a somewhat narrow definition of “infection” – meaning showing antibodies on a serology test – to arrive at a 1% IFR across a population. (And some studies arrive at lower than 1% even with serology tests.) Perhaps there’s a broader definition of “infection” encompassing people who fight off the virus very quickly due to T-cell response, but that would lower the IFR even though it would also increase the prevalence.

hari singh virk
hari singh virk
4 years ago

Maybe in addition to track and test we could be more proactive?

Why can’t we have fast tracked anonymous random group testing of say groups of 10 or 20, using simple raffle tickets. Different communities around the country could be tested much faster each day? Say at tube or train stations, supermarkets, shops. If a positive is then found in the group, then test again to identify who it was. Then test in their places of contact.

fretters00
fretters00
4 years ago

Why are people so willing to accept models based on an IFR almost ten times over that implied by the best data? Predicting for a worst case scenario fails to take account of the lives lost by putting in place lockdown measures. Currently these extend to tens of thousands already in the UK alone, with with estimates over a million in the US as a result of unemployment alone.

Tripod
Tripod
4 years ago

“a huge economic hit due to the pointless 12 weeks of lockdown, and vast numbers of dead all the same.”

I’m afraid it will be so. Lockdown to “flatten the curve” prolongs the economic pain while doing little to reduce the area under the curve, although I am pleased to see the news of a steroid treatment getting good results.

connieperkins9999
connieperkins9999
4 years ago

I thought we had moved past the assumption of a 1% IFR and 80% infected – this is a frustrating read.