Time for society to grow a pair. We know who the vulnerable are now: protect them. There is no point on expending resources on absolutely everybody in the country and wait for nil hazard. We’ll all die of old age (or more likely, starvation) first.
It’s time to lift the lockdown. It’s time to get on with our lives.
Kenneth MacKillop
3 years ago
The inexorable and continuous decline of infection rate in just about every region of the world, regardless of public policy and circumstance, after a few weeks of rise after initial detection and commencement of CoVID-19 stat’s collection, goes remarkably unremarked upon.
If we look at the response of the world’s human population to the virus, as a species and from an evolutionary point of view, we should expect a “negative feedback”. It is this that exerts the sustained increase in resistance to infection and viral replication in vivo.
The approximate pure geometric progression of the very early stages can only occur before a significant fraction of the species has been first infected, and this occurs before societies have begun to collect data. It is of theoretical, but not practical, interest.
If species resistance (or immunity) were not to behave this way, with absolute reliability, the species would be wiped out. Negative resistance is required for stability in natural systems, and this applies to species.
In other words, what is the predominant factor working against any significant second wave is human immunology built into our genome(s). We have only limited understanding of our own immunology, and much less of the novel virus yet. But the idea that lockdowns have had anything but a secondary impact is absurd. And they cannot have had any fundamental impact upon the “shape of the curve” (of infections vs. time) at all. That would violate the principles of what keeps the species sustained rather than going extinct.
This is just another virus, and not a very virulent one at that, even if we assume it to have been produced by gain-of-function manipulation in a lab in Wuhan as a chimeric concoction from several different viruses hosted within resident species in nature.
It’s been very much remarked upon, if unreported, in some circles; Prof Levitt pointed this out from Wuhan data; the growth is not strictly exponential but it follows, as it happens, an exponential decline in the exponent, pretty much regardless of public health measures. This produces a Gompretz Curve, and can be seen in every data set.
What this is, is hard to say; some of the ideas that Tom puts out above are likely, but the fact is that there is something natural limiting the spread of the virus everywhere.
I suggest that an immediate second peak is therefore unlikely, and has yet to be seen (Iran’s outbreak is in a different community, as far as I can tell)
The approximate pure geometric progression of the very early stages can only occur before a significant fraction of the species has been first infected,
You meant “exponential increase”, not “geometric progression”. Cheers www pseudoexpertise com
Fraser Bailey
3 years ago
No, there will almost certainly not be a second wave. There does not appear to have been a second wave in Denmark, Austria or any of the other countries that have opened up, or never closed down.
Indeed, for 99% of people there was not even a first wave given that this virus only affects the very old and/or those with various underlying conditions. (And most of those people could have been protected had appropriate measures been taken).
However, there is every chance that there will be a first, second and third wave of redundancies, tax rises, desperate attempts to print and borrow money and all the other economic consequences of the insane and incompetent reaction to C-19.
There hasn’t been a second wave – yet. Can you be so certain that there won’t be a second wave later? The virus hasn’t been eradicated. It’s still around. What scientific evidence is there to show it won’t occur. We only have the data for what is happening now, not the future.
Imperial’s Professor Neil Ferguson told us a couple of weeks ago that “from our crude analysis, it’s plausible that of the order of two-thirds of the people that have died so far might have died in this year anyhow”. Sir David reckons that might be a little high, but says it would be “a reasonable proportion”. Financial Times. From the master himself who predicted 500 000 deaths in the U.K. and 40 000 in Sweden where I have been for the last 3 months. The question is : was it worth it ? How much misery has been created by these lock down ? In 1968 80 000 people died in the U.K. following the wave of Hong Kong flue, 30 000 in France my native country ….’not only was I too young to remember but a lady who was a medical student at the time, could not remember either. News footage show very relaxed French people and not very young either, going about their shopping without a worry in the world….’or if so, they deserve an Oscar.
Loads of people are being made redundant without a pause, some to eager to take the opportunity….’.they had waited for this moment so long. SAS is looking at sacking as many people as they can, at the same time they get wet leased aircraft from outside to do the work. In case of a second wave, very disputed by scientists, people would fools to accept a second lockdown unless they want to be sheep to the slaughter.
With an incubation period of 5 – 10 days even the slightest hint of second wave possibility would be obvious by now………there is nothing. No country in the world is showing any signs whatsoever and some have been “open” for a while. We cannot live the rest of our lives (miserable though they will be for the majority) hidden away because of something harmless to 96% that hasn’t happened yet based on a guess. It’s insane and an indication of how inept the authorites and experts are at handling a relatively mild virus. Hong Kong flu in the 60’s was far worse and they did not stop Woodstock! There was no “Woodstock second wave”.
Robert Parkey
3 years ago
I am a physician practicing in the US. My father and brother are also practicing physicians. We all practice in both inpatient and outpatient settings. We have not seen the “first wave” of COVID19. All deaths in our areas have been in the elderly in assisted living facilities and retirement homes. Our local hospitals have reduced staff (including ICU staff) and are in serious financial stress due to restrictions on typical surgeries and care. We have had a few COVID19 admits, nothing too serious. This disease seems to have a very narrow demographic for significant morbidity. It’s clear to us that it’s a mild disease for the vast majority of people. It seems dose-related, and it seems the disease has moderated over this past month. Our regional data shows our stay-at-home restrictions came after the peak of cases, calling into question the efficacy of the lockdown. The collateral morbidity from cancelling “elective” surgeries and cancer screenings may be significant. We feel it is time to lift all restrictions and instead rely on a concerted education effort for those few that are truly vulnerable, and open our community and economies back up.
Dougie Undersub
3 years ago
“We in the media need to be wary of shouting about mistakes and U-turns …” Not much chance of that, Tom, given the media we’re blessed with today.
naillik48
3 years ago
Does it matter so long as the NHS critical care capacity can cope ? The disease isn’t going to disappear ; we have to get out and earn a living and take the risk . The investment bank JP Morgan did a thorough international survey and found no post lockdown lift surge .
Daniel Smallwood
3 years ago
“And we in the media need to be wary of shouting about mistakes and U-turns and instead say: when the facts change, you change your mind.”
And pigs might fly.
Kenneth MacKillop
3 years ago
The only factor which I can imagine would make a second wave possible is seasonality, as for flu and other respiratory viruses. If this proves large enough in magnitude to cause a detectable population-wide resurgence, as it did with Spanish flu, it would not be likely to imply an inversion of rate (i.e. decrease) of continuous increase of herd immunity. It will only be possible for this to occur if the broad population exposure to infection is still small in comparison to the seasonal modulatory effect upon INNATE (as opposed to adaptive) immunity.
This is a good reason for individuals to make sure their vit D hepatic storage is sufficient for adequacy year-round (i.e. throughout the winters), and to supplement orally as required. Very few in temperate climates will not require supplementation.
My guess is that there will be a detectable second-season surge, but that it should not be even close to large enough to threaten hospital resources. If Western governments cannot use the lull of summer months to build up more than adequate response to handle a second season with full discontinuance of lockdown measures this would be more than shameful. The elephant in the room, in terms of human immunological response, is innate immunity. It is very clear that this plays a much larger role for SARS-CoV-2 than for flu. I believe that this is consistent with the fact that flu is a much more virulent type of virus.
The impact of modern urban environmental factors (primarily diet) that are out of evolutionary context (i.e. we are not yet well adapted) is that a substantial minority of the population has heavily degraded innate immune and cellular function. This makes them susceptible to dangerous complications, but it does not make the virus itself fundamentally anything but mild in nature.
A subtle secondary factor may be a relatively more important role for cell-mediated immunity (i.e. T cells) over humoral immunity (i.e. B cells) in the human adaptive response to the novel virus in comparison to flu. This is just a hypotheisis, but there are many clues to suggest it IMO. If correct, there may be a substantial fraction of the population already exposed, with cell-mediated immunity but without antibodies.
What most analysts seem to be ignoring is that which is already in the data reported so far. Theory and modeling MUST be consistent with this before moving on to predict large second-season surges. I do not think it will be possible to meet the requirement of the former with a plausible model that predicts the latter.
From what you’ve said about seasonality, do you predict a significant surge in southern Hemisphere countries like Australia & New Zealand where we are just starting our winter? I live in Australia. We’ve done pretty well here. We don’t have a high death rate from Covid. But will winter change that?
benbow01
3 years ago
Q. Will there be a second Covid wave?
A. Does it matter? The first ‘wave’ was a damp squib so why would anyone imagine a second one will be any more so, or even noticeable, or happen?
By now a large section of the population (Up to 30% some claim) has acquired immunity from prior contact with other coronavirus and from prior contact with this one?
Covid has worked through most of those for whom it will be serious or fatal.
These two facts make it more difficult for the virus to find new victims, which is why its activity curve (in all Countries) show it on the way out, show no ‘second wave’ in Countries which have relaxed lockdown.
The real questions: why is the Government pretending there is a problem other than the one of its own making; why did the dozy, compliant, lazy media let them get away with it in the first place and still?
First of all your comment that “some claim” up to 30% are already infected is just a lazy way to support your argument. There are loads of sensible, reasoned articles out there that would show this comment to be complete rubbish.
“Covid has worked through most of those for whom it will be serious or fatal” – the mind boggles at that statement – did your chrystal ball tell you that, because nothing else could have done.
And, just in case you weren’t in the uk when all this kicked off, I would point out that it was the hysterical MSM, who, as one screeching voice, demanded “lockdown”from the government because every other European country (apart from Sweden) had done so.
Lastly, re “compliant, lazy media” – do me favour, and just watch some of the Downing Street briefings with the likes of Kuenssberg, Peston and Coates asking questions in their nasty, cynical “gotcha’ journalistic way and then tell me you honestly think they’re compliant.
Correct, the Reaper has done his work, and those who qualified for Darwinian selection, have gone. Predominantly this was a cull of the old, knackered and black. Regrettable, but true. Let us not terrify everybody else with hysterical hyperbole about a supposed ‘second wave’. This is not 1918! Let us move on to recovery, if we can.
Dave Smith
3 years ago
YOu are right about the fear of hospitals. I was talking to an old man sitting on his cart when an ambulance pulled up along side. ‘You want to keep well away from those and the death pits of hospitals.’ he said as the crew got out all masked up. Reminds me of my Grandma. Born in a different age she had a real fear of hospitals. Never get out she said. Once you go in. We are gong back there like with so many things.
A MacK
3 years ago
Interesting article. So should we expect a 2nd wave or not?
One thing many folk are realising through this crisis appears to be that natural science is highly equivocal and actual knowledge scant and transitory. It’s about time that happened because it often seems lost on those keen to cultivate a mentality of “white coat superiority”. It seems many epidemiologists (and others on the medical side) would now rather wrap humans in cotton wool and confine them to barracks than allow a reversion to the “old normal” i.e. Normal.
Ms Gupta was probably right: CV19 could be on the way out. The data seem to support hers rather than the axes ground by alternative “guesstimators / commentators”.
As a point of order on the timing of CV19 infection/death in different parts of England: it’s a fact that NHS daily death data show recorded CV19 deaths peaked rapidly on 8th April, or within 3 days of it in every region, and declined thereafter. Deaths had occurred in every region of England by 17th March, well before “Lockdown”. To suggest it wasn’t present elsewhere like it was in London (huge population and density) may appear bold.
That also tallies with the official ONS death statistics which show “peak deaths” were reported in Weeks 15 and 16 (which tallies well with the NHS data 8/4/20 peak due to lag in reporting etc.) and the numbers declined very dramatically since then. Since then, to Week 22 now, the numbers have dramatically declined.
A confounding variable is that testing levels have increased dramatically of late, which means that number of confirmed cases in any area is not as reliable an indicator unless corrected for numbers of tests. Also of course, the testing has been selectively targeted rather than blindly across the board. Deaths are, unfortunately, the best stats.
Of course it’s possible that lockdown contributed to that decline in “CV19 Deaths” since Week 15/6 (and hence gains may be reversed as “Normal” resumes), but open minded scientists should also see it is possible that lockdown would not have changed much and “peak deaths” around 8 March may have reflected the lagged ravages of a virus that had passed through most of the population already…
Like many things scientific, we may only have a really good idea once the data are in for the year. Whether or not it comes back, we will see soon enough.
Kenneth MacKillop
3 years ago
The misuse of the word “science” has enabled a massive amount of non-scientific narrative. It is much too general and meaningless a term. I suggest the word “experiment” be considered instead. Changing one variable applies to a controlled experiment.
“Science” is also substituted for data and information inappropriately. The quality of data and experiments both vary widely, and much or most have negative value. Designing high-quality experiments and gathering high-accuracy data are very, very difficult.
Data and experiments are only two aspects and tools of science, and by no means the only ones. Both, in the absence of theory, are likely to be misused.
The way “science” is used by many in government and media strongly suggests they really have no idea what the word means. It has been reduced to signalling jargon.
Kenneth MacKillop
3 years ago
For some reason, although not in this article, the month of September seems to be almost always predicted as the beginning of a “second wave”. This seems disingenuous and implausible to me.
November or December are more characteristic for a first seasonal wave of flu. That should be the default assumption, and these months are also well in advance of detection and lockdown in Wuhan.
September does, of course, mark the typical opening of schools. SARS-CoV-2 is absolutely remarkable in that children appear to be incapable of transmission.
The fans of lockdown (and these are a sickly feature of society IMO) seem desperate to sustain panic in the general populace, and what better and more widespread way to do this than to target parents?
As usual, many who use the word “science” (and I am not including the author or this article) in a cryptic, misleading, and virtue-signaling manner, are ignoring and contradicting what limited knowledge has been so far acquired in order to perpetuate their own interests and narrative. Hopefully common sense will prevail over these miscreants.
Russ Littler
3 years ago
Of course there will be a second wave, and it will break out on the 1st of October, amid a flurry of media hype and scare stories promising Armageddon to the whole nation (to coincide with the US Election, of course). Any excuse to let the democrats and deepstate get their fraudulent postal voting system in place. Can’t have all those Trump supporters turning out at polling stations.
Adrian Smith
3 years ago
Just had my 52nd birthday celebration BBQ in my English garden with another household making the total number of people 8 (within Welsh and Scottish Rules). Oh dear will this affect R? No of course not. It is not about the rules, but how sensibly people apply them (rules are for the obedience of fools and guidance of the wise). Having a load of people reasonably well spaced on the beach near Durdle Door, all then crunched up together so an air ambulance can land to sort out 3 idiots tomb-stoning was not really thought about in the rules was it?
Ultimately the release from lockdown is not some sort of great science experiment, nor is it about simple rules, nor is it about death figures and how the MSM and govt spin them. It is about people managing personal risk whilst being socially responsible. When the glib messages get ditched and a serious conversation happens about those issues, then maybe we might just get somewhere,
Surely when we want to learn from other countries the richest source of useful data is Sweden. It seems that using or even referring to Swedish data is like making use of Nazi human experimentation data.
r j
3 years ago
Infective illness is cyclical and further wave of infection with SARS-2 is possible. It is unrealistic to presume or portray every human, regardless of concomitant factors, as vulnerable to SARS-2 in every circumstance. We do not live in a Victorian fog of ignorance and individual resistance to infection (viral or otherwise) is not “mystical” but a combination of well known factors such as dose, exposure time, natural responses to infection, concomitant illness etc. Importantly viral particles themselves are not static entities and mutation means, not that they continue unabated to decimate the human population but their adverse impact is modified and in almost every case attenuated. Many to the point of them being detectable but to all normal circumstances, and for most healthy people, invisible aspects of the complex environment we live in. A bit like the insect parts that are evident in every foodstuff depending only on how hard you look. Instilling fear among an average population of mystic and unavoidable waves of death by comments made or taken out of context is truly unhelpful and unjustifiable. What’s required is more understanding of basics and a less blinkered academic comment that fails to take into account the bigger picture. A lot of this pandemics impact will undoubtedly be due to the unique and complex global governmental responses that have altered and impacted affected populations. Unravelling it will not be possible just as calling for altering matters one variable at a time in some bizzare playtime experiment is frankly absurd. It’s too important an issue for such a simplistic approach more fitting to schooldays.
Michael de Podesta
3 years ago
Tom Chivers:
Thank you for your clearly reasoned article. Please allow me to add one note about average R and fluctuations. For people who do not live alone, it is very hard to not spread the virus to at least one other person. So for one hundred people, many people will inevitably spread it to at least one other person. So we are relying on ‘heroes’ to stick to the rules and transmit the virus to nobody else. But as you point out, fluctuations upwards can grow very large – whereas fluctuations downwards are bounded at zero. So it is quite easy for the average R to grow above unity.
In the UK there are still over 100,000 actively ill people, so it is practically certain that some of these ill people will seed new and growing outbreaks. It is like trying to put out a wildfire – even after the main fire is contained – as long as even a single ember remains, the possibility of the fire re-starting remains. I think we may have to live with situation for quite some time.
Once a virus gets into your population, you’ve lost control of it. End of discussion. We should have shut our borders, rather than locking down the entire population. Too late for that now, so all we can do is protect our vulnerable while the rest of us get on with life. There is no other way.
If we “shut our borders” we’d starve. The UK hasn’t been self-sufficient in food since the 18th century
Adrian Smith
3 years ago
WRT the South West. The economy there is reliant on tourism. As soon as it is worth going there because things are open, people will head there as going abroad is not a realistic option. Infection will spread there. The death rate is highest in over 60s (over 91% of deaths in England iaw NHS England data). The South West has a higher proportion of older people. If they do not shield themselves, they are going to be hit badly, that is inevitable. What is needed is a proper explanation of risk so people can make their own sensible decisions based on their own circumstances.
There can be no doubt that the virus is both ageist and sexist. However, I have my doubts over whether the virus is racist (the implication of what was announced today), as I believe when all the factors are properly isolated, the differences between people of different races will be minimal. I have grave concerns about do-gooding ideas that we should treat people of different colour differently for their own good. There does not seem to be any clamour to protect men, who very clearly are more affected (about 2/3 of deaths are in men, despite there being more older women because female life expectancy has been greater than male life expectancy for decades). How about we make it mandatory for BAME to wear face masks outside their own house – seems like a good idea? Perhaps we should make Jews wear yellow stars too. Hmm perhaps not, but that just an exaggeration of the downsides of treating people differently just because of their race.
T J Putnam
3 years ago
Good overview Glad to see that the variability of case transmission is coming more into view. Close analysis of early clusters indicated that >80% of cases came from <20% of infected, indicating that shutting down superspreader contexts and individuals should be the focus of future controls. The extent and duration of cross immunity with the widespread beta corona cold viruses needs further study. Kinsella et al included these in their second wave modelling (Science, 22 May) and they could affect both the magnitude and timing of subsequent waves. Important to remember that coronavirus cold immunities are known to be of about 10 months duration, so collective inter-corona immunities if significant now, will also fall significantly later this year.
Although if it’s a matter of superspreaders it’s good news; they will catch it early and then cease spreading, and are unlikely to catch it again. This reduces % required for herd immunity.
Isn’t the point about superspreaders not that they are especially virulent, but that they are normally virulent but are in a place and acting in a manner that quickly spreads the virus to other people nearby? There may be an element of the former, but the latter seems more likely, as Tom’s article suggested.
Neil John
3 years ago
Most probably, and most likely imported via a ‘safe’ nation from a hotspot elsewhere in the world, or direct by dingy…
Jean Redpath
3 years ago
What will happen in countries like Australia and New Zealand, who haven’t even had a first wave?
Satya Kanwarova
3 years ago
The vast majority of countries have not even experienced a first wave, and the disease is already declining in them. In fact this wave has been confined to a handful of countries in Europe, NY State and possibly Brazil. So surely the question to ask first is why is it that these countries got a first wave.
C Arros
3 years ago
Sadly, another article saying nothing and stoking the already existing irrational fear…
You quote Dr. Lewis “The measures have been coming one after the other or at the same time, so it will be very difficult to unpick the effect of any one measure”. In principal it seems something one could agree with.
But wait, wasn’t that exactly what happened with the introduction of the lockdown measures, leaving us now in this uncomfortable situation of not knowing which measures have really had an impact?
And then you mention as well the Spanish flu without putting it really in context (incidentally it is reported as having come in 3, not only 2 waves, source https://www.ncbi.nlm.nih.go… ). If we wanted to use the Spanish flu as a reminder of how dangerous pandemics can be and to justify the (not so) swift (over-)reaction in the present crisis, we should have recognized now for some time already that fortunately nothing similar is befalling us on this occasion and we should have stopped the fearmongering. It is not to belittle the tragic cost of lives in the coronacrisis, but we are a far cry from the death toll of the 1918 flu ranging in estimates from 20 to 100 million people worldwide with a global population being about a third of the one of today. Furthermore it was particularly deadly for young adults between 20 to 40 years of age, as such a trait uncommon for influenza outbreaks, but not having been seen in the present pandemic either.
So yes, let us conclude that when facts become clearer, we should change our minds, stop fearmongering and resume our lives.
James Watson
3 years ago
Great article! A fourth potential reason could be a seasonal effect. (something you see for many respiratory infections)
Michael Yeadon
3 years ago
I think of the explanations offered, the only one which is consistent with the totality of the data is the emergence of sufficient levels of population immunity that the disease pretty much dies out as a massed risk. There won’t be a ‘second spike’ in areas of lower pop immunity either, because contact density is too low to attain critical (infected) mass to get runaway infection.
Michael Dawson
3 years ago
To my mind the track and trace issue has been viewed from the wrong perspective.
Getting a system in place that will work very effectively going forward – trying to find people who may be infected before they show symptoms or start infecting others – will be very hard. The UK has obvious cultural differences compared with South Korea, for example, and the spread of the virus is much greater. Technology is unproven.
I’d focus on using track and trace to find out how the disease has already spread, which should greatly help in focusing restrictions on key risks – for example, as Tom mentioned, if superspreaders are key, avoiding situations where one person can simultaneously infect tens more would be a top priority. Or does the data suggest parents of school age children are more or less vulnerable than non-parents with otherwise the same characteristics? The government has a huge database of people who have been confirmed positive. Pick a large enough sample at random and start finding out how they caught the disease and whether they have passed it on. This should have been done from the start, but I have seen nothing to suggest that the government has been doing this. Please correct me if I’m wrong. (I am not saying this with the great benefit of hindsight: I’ve made the same point here and elsewhere for weeks now.)
I B
3 years ago
“we’re trying to make a country that works for its citizens”. You don’t seriously believe this do you? It’s time to get the human capital exploited again, nothing more than that. The capitalists are losing surplus value – this must stop, even if some of the human capital is lost. It’s all replaceable anyway.
Time for society to grow a pair. We know who the vulnerable are now: protect them. There is no point on expending resources on absolutely everybody in the country and wait for nil hazard. We’ll all die of old age (or more likely, starvation) first.
It’s time to lift the lockdown. It’s time to get on with our lives.
The inexorable and continuous decline of infection rate in just about every region of the world, regardless of public policy and circumstance, after a few weeks of rise after initial detection and commencement of CoVID-19 stat’s collection, goes remarkably unremarked upon.
If we look at the response of the world’s human population to the virus, as a species and from an evolutionary point of view, we should expect a “negative feedback”. It is this that exerts the sustained increase in resistance to infection and viral replication in vivo.
The approximate pure geometric progression of the very early stages can only occur before a significant fraction of the species has been first infected, and this occurs before societies have begun to collect data. It is of theoretical, but not practical, interest.
If species resistance (or immunity) were not to behave this way, with absolute reliability, the species would be wiped out. Negative resistance is required for stability in natural systems, and this applies to species.
In other words, what is the predominant factor working against any significant second wave is human immunology built into our genome(s). We have only limited understanding of our own immunology, and much less of the novel virus yet. But the idea that lockdowns have had anything but a secondary impact is absurd. And they cannot have had any fundamental impact upon the “shape of the curve” (of infections vs. time) at all. That would violate the principles of what keeps the species sustained rather than going extinct.
This is just another virus, and not a very virulent one at that, even if we assume it to have been produced by gain-of-function manipulation in a lab in Wuhan as a chimeric concoction from several different viruses hosted within resident species in nature.
Thank you for an intelligent, informed, well-written comment.
It’s been very much remarked upon, if unreported, in some circles; Prof Levitt pointed this out from Wuhan data; the growth is not strictly exponential but it follows, as it happens, an exponential decline in the exponent, pretty much regardless of public health measures. This produces a Gompretz Curve, and can be seen in every data set.
What this is, is hard to say; some of the ideas that Tom puts out above are likely, but the fact is that there is something natural limiting the spread of the virus everywhere.
I suggest that an immediate second peak is therefore unlikely, and has yet to be seen (Iran’s outbreak is in a different community, as far as I can tell)
You meant “exponential increase”, not “geometric progression”. Cheers www pseudoexpertise com
No, there will almost certainly not be a second wave. There does not appear to have been a second wave in Denmark, Austria or any of the other countries that have opened up, or never closed down.
Indeed, for 99% of people there was not even a first wave given that this virus only affects the very old and/or those with various underlying conditions. (And most of those people could have been protected had appropriate measures been taken).
However, there is every chance that there will be a first, second and third wave of redundancies, tax rises, desperate attempts to print and borrow money and all the other economic consequences of the insane and incompetent reaction to C-19.
Hear, hear. I’ve been shouting this from the beginning.
There hasn’t been a second wave – yet. Can you be so certain that there won’t be a second wave later? The virus hasn’t been eradicated. It’s still around. What scientific evidence is there to show it won’t occur. We only have the data for what is happening now, not the future.
Imperial’s Professor Neil Ferguson told us a couple of weeks ago that “from our crude analysis, it’s plausible that of the order of two-thirds of the people that have died so far might have died in this year anyhow”. Sir David reckons that might be a little high, but says it would be “a reasonable proportion”.
Financial Times.
From the master himself who predicted 500 000 deaths in the U.K. and 40 000 in Sweden where I have been for the last 3 months.
The question is : was it worth it ? How much misery has been created by these lock down ?
In 1968 80 000 people died in the U.K. following the wave of Hong Kong flue, 30 000 in France my native country ….’not only was I too young to remember but a lady who was a medical student at the time, could not remember either.
News footage show very relaxed French people and not very young either, going about their shopping without a worry in the world….’or if so, they deserve an Oscar.
Loads of people are being made redundant without a pause, some to eager to take the opportunity….’.they had waited for this moment so long.
SAS is looking at sacking as many people as they can, at the same time they get wet leased aircraft from outside to do the work.
In case of a second wave, very disputed by scientists, people would fools to accept a second lockdown unless they want to be sheep to the slaughter.
With an incubation period of 5 – 10 days even the slightest hint of second wave possibility would be obvious by now………there is nothing. No country in the world is showing any signs whatsoever and some have been “open” for a while. We cannot live the rest of our lives (miserable though they will be for the majority) hidden away because of something harmless to 96% that hasn’t happened yet based on a guess. It’s insane and an indication of how inept the authorites and experts are at handling a relatively mild virus. Hong Kong flu in the 60’s was far worse and they did not stop Woodstock! There was no “Woodstock second wave”.
I am a physician practicing in the US. My father and brother are also practicing physicians. We all practice in both inpatient and outpatient settings. We have not seen the “first wave” of COVID19. All deaths in our areas have been in the elderly in assisted living facilities and retirement homes. Our local hospitals have reduced staff (including ICU staff) and are in serious financial stress due to restrictions on typical surgeries and care. We have had a few COVID19 admits, nothing too serious. This disease seems to have a very narrow demographic for significant morbidity. It’s clear to us that it’s a mild disease for the vast majority of people. It seems dose-related, and it seems the disease has moderated over this past month. Our regional data shows our stay-at-home restrictions came after the peak of cases, calling into question the efficacy of the lockdown. The collateral morbidity from cancelling “elective” surgeries and cancer screenings may be significant. We feel it is time to lift all restrictions and instead rely on a concerted education effort for those few that are truly vulnerable, and open our community and economies back up.
“We in the media need to be wary of shouting about mistakes and U-turns …”
Not much chance of that, Tom, given the media we’re blessed with today.
Does it matter so long as the NHS critical care capacity can cope ? The disease isn’t going to disappear ; we have to get out and earn a living and take the risk .
The investment bank JP Morgan did a thorough international survey and found no post lockdown lift surge .
“And we in the media need to be wary of shouting about mistakes and U-turns and instead say: when the facts change, you change your mind.”
And pigs might fly.
The only factor which I can imagine would make a second wave possible is seasonality, as for flu and other respiratory viruses. If this proves large enough in magnitude to cause a detectable population-wide resurgence, as it did with Spanish flu, it would not be likely to imply an inversion of rate (i.e. decrease) of continuous increase of herd immunity.
It will only be possible for this to occur if the broad population exposure to infection is still small in comparison to the seasonal modulatory effect upon INNATE (as opposed to adaptive) immunity.
This is a good reason for individuals to make sure their vit D hepatic storage is sufficient for adequacy year-round (i.e. throughout the winters), and to supplement orally as required. Very few in temperate climates will not require supplementation.
My guess is that there will be a detectable second-season surge, but that it should not be even close to large enough to threaten hospital resources. If Western governments cannot use the lull of summer months to build up more than adequate response to handle a second season with full discontinuance of lockdown measures this would be more than shameful.
The elephant in the room, in terms of human immunological response, is innate immunity. It is very clear that this plays a much larger role for SARS-CoV-2 than for flu. I believe that this is consistent with the fact that flu is a much more virulent type of virus.
The impact of modern urban environmental factors (primarily diet) that are out of evolutionary context (i.e. we are not yet well adapted) is that a substantial minority of the population has heavily degraded innate immune and cellular function. This makes them susceptible to dangerous complications, but it does not make the virus itself fundamentally anything but mild in nature.
A subtle secondary factor may be a relatively more important role for cell-mediated immunity (i.e. T cells) over humoral immunity (i.e. B cells) in the human adaptive response to the novel virus in comparison to flu. This is just a hypotheisis, but there are many clues to suggest it IMO. If correct, there may be a substantial fraction of the population already exposed, with cell-mediated immunity but without antibodies.
What most analysts seem to be ignoring is that which is already in the data reported so far. Theory and modeling MUST be consistent with this before moving on to predict large second-season surges. I do not think it will be possible to meet the requirement of the former with a plausible model that predicts the latter.
From what you’ve said about seasonality, do you predict a significant surge in southern Hemisphere countries like Australia & New Zealand where we are just starting our winter? I live in Australia. We’ve done pretty well here. We don’t have a high death rate from Covid. But will winter change that?
Q. Will there be a second Covid wave?
A. Does it matter? The first ‘wave’ was a damp squib so why would anyone imagine a second one will be any more so, or even noticeable, or happen?
By now a large section of the population (Up to 30% some claim) has acquired immunity from prior contact with other coronavirus and from prior contact with this one?
Covid has worked through most of those for whom it will be serious or fatal.
These two facts make it more difficult for the virus to find new victims, which is why its activity curve (in all Countries) show it on the way out, show no ‘second wave’ in Countries which have relaxed lockdown.
The real questions: why is the Government pretending there is a problem other than the one of its own making; why did the dozy, compliant, lazy media let them get away with it in the first place and still?
Have you just landed from another planet?
First of all your comment that “some claim” up to 30% are already infected is just a lazy way to support your argument. There are loads of sensible, reasoned articles out there that would show this comment to be complete rubbish.
“Covid has worked through most of those for whom it will be serious or fatal” – the mind boggles at that statement – did your chrystal ball tell you that, because nothing else could have done.
And, just in case you weren’t in the uk when all this kicked off, I would point out that it was the hysterical MSM, who, as one screeching voice, demanded “lockdown”from the government because every other European country (apart from Sweden) had done so.
Lastly, re “compliant, lazy media” – do me favour, and just watch some of the Downing Street briefings with the likes of Kuenssberg, Peston and Coates asking questions in their nasty, cynical “gotcha’ journalistic way and then tell me you honestly think they’re compliant.
Correct, the Reaper has done his work, and those who qualified for Darwinian selection, have gone. Predominantly this was a cull of the old, knackered and black. Regrettable, but true.
Let us not terrify everybody else with hysterical hyperbole about a supposed ‘second wave’. This is not 1918! Let us move on to recovery, if we can.
YOu are right about the fear of hospitals. I was talking to an old man sitting on his cart when an ambulance pulled up along side.
‘You want to keep well away from those and the death pits of hospitals.’ he said as the crew got out all masked up.
Reminds me of my Grandma. Born in a different age she had a real fear of hospitals. Never get out she said. Once you go in.
We are gong back there like with so many things.
Interesting article. So should we expect a 2nd wave or not?
One thing many folk are realising through this crisis appears to be that natural science is highly equivocal and actual knowledge scant and transitory. It’s about time that happened because it often seems lost on those keen to cultivate a mentality of “white coat superiority”. It seems many epidemiologists (and others on the medical side) would now rather wrap humans in cotton wool and confine them to barracks than allow a reversion to the “old normal” i.e. Normal.
Ms Gupta was probably right: CV19 could be on the way out. The data seem to support hers rather than the axes ground by alternative “guesstimators / commentators”.
As a point of order on the timing of CV19 infection/death in different parts of England: it’s a fact that NHS daily death data show recorded CV19 deaths peaked rapidly on 8th April, or within 3 days of it in every region, and declined thereafter. Deaths had occurred in every region of England by 17th March, well before “Lockdown”. To suggest it wasn’t present elsewhere like it was in London (huge population and density) may appear bold.
That also tallies with the official ONS death statistics which show “peak deaths” were reported in Weeks 15 and 16 (which tallies well with the NHS data 8/4/20 peak due to lag in reporting etc.) and the numbers declined very dramatically since then. Since then, to Week 22 now, the numbers have dramatically declined.
A confounding variable is that testing levels have increased dramatically of late, which means that number of confirmed cases in any area is not as reliable an indicator unless corrected for numbers of tests. Also of course, the testing has been selectively targeted rather than blindly across the board. Deaths are, unfortunately, the best stats.
Of course it’s possible that lockdown contributed to that decline in “CV19 Deaths” since Week 15/6 (and hence gains may be reversed as “Normal” resumes), but open minded scientists should also see it is possible that lockdown would not have changed much and “peak deaths” around 8 March may have reflected the lagged ravages of a virus that had passed through most of the population already…
Like many things scientific, we may only have a really good idea once the data are in for the year. Whether or not it comes back, we will see soon enough.
The misuse of the word “science” has enabled a massive amount of non-scientific narrative. It is much too general and meaningless a term. I suggest the word “experiment” be considered instead. Changing one variable applies to a controlled experiment.
“Science” is also substituted for data and information inappropriately. The quality of data and experiments both vary widely, and much or most have negative value. Designing high-quality experiments and gathering high-accuracy data are very, very difficult.
Data and experiments are only two aspects and tools of science, and by no means the only ones. Both, in the absence of theory, are likely to be misused.
The way “science” is used by many in government and media strongly suggests they really have no idea what the word means. It has been reduced to signalling jargon.
For some reason, although not in this article, the month of September seems to be almost always predicted as the beginning of a “second wave”. This seems disingenuous and implausible to me.
November or December are more characteristic for a first seasonal wave of flu. That should be the default assumption, and these months are also well in advance of detection and lockdown in Wuhan.
September does, of course, mark the typical opening of schools. SARS-CoV-2 is absolutely remarkable in that children appear to be incapable of transmission.
The fans of lockdown (and these are a sickly feature of society IMO) seem desperate to sustain panic in the general populace, and what better and more widespread way to do this than to target parents?
As usual, many who use the word “science” (and I am not including the author or this article) in a cryptic, misleading, and virtue-signaling manner, are ignoring and contradicting what limited knowledge has been so far acquired in order to perpetuate their own interests and narrative. Hopefully common sense will prevail over these miscreants.
Of course there will be a second wave, and it will break out on the 1st of October, amid a flurry of media hype and scare stories promising Armageddon to the whole nation (to coincide with the US Election, of course). Any excuse to let the democrats and deepstate get their fraudulent postal voting system in place. Can’t have all those Trump supporters turning out at polling stations.
Just had my 52nd birthday celebration BBQ in my English garden with another household making the total number of people 8 (within Welsh and Scottish Rules). Oh dear will this affect R? No of course not. It is not about the rules, but how sensibly people apply them (rules are for the obedience of fools and guidance of the wise). Having a load of people reasonably well spaced on the beach near Durdle Door, all then crunched up together so an air ambulance can land to sort out 3 idiots tomb-stoning was not really thought about in the rules was it?
Ultimately the release from lockdown is not some sort of great science experiment, nor is it about simple rules, nor is it about death figures and how the MSM and govt spin them. It is about people managing personal risk whilst being socially responsible. When the glib messages get ditched and a serious conversation happens about those issues, then maybe we might just get somewhere,
Surely when we want to learn from other countries the richest source of useful data is Sweden. It seems that using or even referring to Swedish data is like making use of Nazi human experimentation data.
Infective illness is cyclical and further wave of infection with SARS-2 is possible. It is unrealistic to presume or portray every human, regardless of concomitant factors, as vulnerable to SARS-2 in every circumstance. We do not live in a Victorian fog of ignorance and individual resistance to infection (viral or otherwise) is not “mystical” but a combination of well known factors such as dose, exposure time, natural responses to infection, concomitant illness etc. Importantly viral particles themselves are not static entities and mutation means, not that they continue unabated to decimate the human population but their adverse impact is modified and in almost every case attenuated. Many to the point of them being detectable but to all normal circumstances, and for most healthy people, invisible aspects of the complex environment we live in. A bit like the insect parts that are evident in every foodstuff depending only on how hard you look. Instilling fear among an average population of mystic and unavoidable waves of death by comments made or taken out of context is truly unhelpful and unjustifiable. What’s required is more understanding of basics and a less blinkered academic comment that fails to take into account the bigger picture. A lot of this pandemics impact will undoubtedly be due to the unique and complex global governmental responses that have altered and impacted affected populations. Unravelling it will not be possible just as calling for altering matters one variable at a time in some bizzare playtime experiment is frankly absurd. It’s too important an issue for such a simplistic approach more fitting to schooldays.
Tom Chivers:
Thank you for your clearly reasoned article. Please allow me to add one note about average R and fluctuations. For people who do not live alone, it is very hard to not spread the virus to at least one other person. So for one hundred people, many people will inevitably spread it to at least one other person. So we are relying on ‘heroes’ to stick to the rules and transmit the virus to nobody else. But as you point out, fluctuations upwards can grow very large – whereas fluctuations downwards are bounded at zero. So it is quite easy for the average R to grow above unity.
In the UK there are still over 100,000 actively ill people, so it is practically certain that some of these ill people will seed new and growing outbreaks. It is like trying to put out a wildfire – even after the main fire is contained – as long as even a single ember remains, the possibility of the fire re-starting remains. I think we may have to live with situation for quite some time.
Best wishes
Michael
Once a virus gets into your population, you’ve lost control of it. End of discussion. We should have shut our borders, rather than locking down the entire population. Too late for that now, so all we can do is protect our vulnerable while the rest of us get on with life. There is no other way.
If we “shut our borders” we’d starve. The UK hasn’t been self-sufficient in food since the 18th century
WRT the South West. The economy there is reliant on tourism. As soon as it is worth going there because things are open, people will head there as going abroad is not a realistic option. Infection will spread there. The death rate is highest in over 60s (over 91% of deaths in England iaw NHS England data). The South West has a higher proportion of older people. If they do not shield themselves, they are going to be hit badly, that is inevitable. What is needed is a proper explanation of risk so people can make their own sensible decisions based on their own circumstances.
There can be no doubt that the virus is both ageist and sexist. However, I have my doubts over whether the virus is racist (the implication of what was announced today), as I believe when all the factors are properly isolated, the differences between people of different races will be minimal. I have grave concerns about do-gooding ideas that we should treat people of different colour differently for their own good. There does not seem to be any clamour to protect men, who very clearly are more affected (about 2/3 of deaths are in men, despite there being more older women because female life expectancy has been greater than male life expectancy for decades). How about we make it mandatory for BAME to wear face masks outside their own house – seems like a good idea? Perhaps we should make Jews wear yellow stars too. Hmm perhaps not, but that just an exaggeration of the downsides of treating people differently just because of their race.
Good overview Glad to see that the variability of case transmission is coming more into view. Close analysis of early clusters indicated that >80% of cases came from <20% of infected, indicating that shutting down superspreader contexts and individuals should be the focus of future controls.
The extent and duration of cross immunity with the widespread beta corona cold viruses needs further study. Kinsella et al included these in their second wave modelling (Science, 22 May) and they could affect both the magnitude and timing of subsequent waves. Important to remember that coronavirus cold immunities are known to be of about 10 months duration, so collective inter-corona immunities if significant now, will also fall significantly later this year.
Although if it’s a matter of superspreaders it’s good news; they will catch it early and then cease spreading, and are unlikely to catch it again. This reduces % required for herd immunity.
Isn’t the point about superspreaders not that they are especially virulent, but that they are normally virulent but are in a place and acting in a manner that quickly spreads the virus to other people nearby? There may be an element of the former, but the latter seems more likely, as Tom’s article suggested.
Most probably, and most likely imported via a ‘safe’ nation from a hotspot elsewhere in the world, or direct by dingy…
What will happen in countries like Australia and New Zealand, who haven’t even had a first wave?
The vast majority of countries have not even experienced a first wave, and the disease is already declining in them. In fact this wave has been confined to a handful of countries in Europe, NY State and possibly Brazil. So surely the question to ask first is why is it that these countries got a first wave.
Sadly, another article saying nothing and stoking the already existing irrational fear…
You quote Dr. Lewis “The measures have been coming one after the other or at the same time, so it will be very difficult to unpick the effect of any one measure”. In principal it seems something one could agree with.
But wait, wasn’t that exactly what happened with the introduction of the lockdown measures, leaving us now in this uncomfortable situation of not knowing which measures have really had an impact?
And then you mention as well the Spanish flu without putting it really in context (incidentally it is reported as having come in 3, not only 2 waves, source https://www.ncbi.nlm.nih.go… ). If we wanted to use the Spanish flu as a reminder of how dangerous pandemics can be and to justify the (not so) swift (over-)reaction in the present crisis, we should have recognized now for some time already that fortunately nothing similar is befalling us on this occasion and we should have stopped the fearmongering. It is not to belittle the tragic cost of lives in the coronacrisis, but we are a far cry from the death toll of the 1918 flu ranging in estimates from 20 to 100 million people worldwide with a global population being about a third of the one of today. Furthermore it was particularly deadly for young adults between 20 to 40 years of age, as such a trait uncommon for influenza outbreaks, but not having been seen in the present pandemic either.
So yes, let us conclude that when facts become clearer, we should change our minds, stop fearmongering and resume our lives.
Great article!
A fourth potential reason could be a seasonal effect. (something you see for many respiratory infections)
I think of the explanations offered, the only one which is consistent with the totality of the data is the emergence of sufficient levels of population immunity that the disease pretty much dies out as a massed risk. There won’t be a ‘second spike’ in areas of lower pop immunity either, because contact density is too low to attain critical (infected) mass to get runaway infection.
To my mind the track and trace issue has been viewed from the wrong perspective.
Getting a system in place that will work very effectively going forward – trying to find people who may be infected before they show symptoms or start infecting others – will be very hard. The UK has obvious cultural differences compared with South Korea, for example, and the spread of the virus is much greater. Technology is unproven.
I’d focus on using track and trace to find out how the disease has already spread, which should greatly help in focusing restrictions on key risks – for example, as Tom mentioned, if superspreaders are key, avoiding situations where one person can simultaneously infect tens more would be a top priority. Or does the data suggest parents of school age children are more or less vulnerable than non-parents with otherwise the same characteristics? The government has a huge database of people who have been confirmed positive. Pick a large enough sample at random and start finding out how they caught the disease and whether they have passed it on. This should have been done from the start, but I have seen nothing to suggest that the government has been doing this. Please correct me if I’m wrong. (I am not saying this with the great benefit of hindsight: I’ve made the same point here and elsewhere for weeks now.)
“we’re trying to make a country that works for its citizens”.
You don’t seriously believe this do you? It’s time to get the human capital exploited again, nothing more than that. The capitalists are losing surplus value – this must stop, even if some of the human capital is lost. It’s all replaceable anyway.