Tag Archives: pandemic

COVID-19. Simple Arithmetic and ‘The Economy First Delusion’. PART 2.


I’d like to think that the most democratic countries have been the best at controlling COVID-19, but this would not be true, although there is no doubt that China did a great job at under reporting the severity of its outbreak, claiming that any suggestion that this was a  problem originating out of China as racist. There was little about the way China reported on its outbreak that would help other countries to prepare.

In the U.K. by 8th April over 60,000 had tested positive for COVID-19, with more than 7,000 deaths as a result of the virus. At the peak of the problem the British Prime Minister Boris Johnson was taken into intensive care, and the good news is that he is showing signs of improvement. It is a little over a couple of months since the first confirmed case in Britain and today alone there have been 938 hospital deaths with 5,492 new cases announced; although there is a claim that infection numbers have increased because more people are now being tested… and a fair response to that would be: testing? Not before time.

This is a very different world from the one where we were wishing our friends a happy 2020 back in January. For many of us, staying at home has so far been voluntary, but last weekend it was sunny and springlike in many parts of the Northern Hemisphere and against official advice quite a numbers of people were out and about with a minority of Brits refusing to conform to anything that felt like an intrusion of personal freedoms. They knew  that if they went out for a wander, nobody was going to shoot them – which is a pity: and I’ll leave that sentence as it is… ambiguous. Unfortunately, some things don’t change – there will always be people who don’t have the discipline to act appropriately, and potentially set back the slowing of COVID-19 infections.

France, has a similar problem: on the 7th of April the lockdown became more severe – the first case in France occurred a little over 10 weeks ago, but by the 7th April the death toll had passed 10,000. That was the figure for Italy almost a week ago and there are claims that the French figures have been distorted, with numbers far higher than official figures. France is now one of the hardest hit European countries. Spain’s death toll has passed 14,000, although both Italy and Spain appear to be at the point where infections are beginning to slow.

But how did South Korea, one of the earliest countries to be hit by the virus, manage the disease so much better than many of the Europe countries, limiting the disease so far, to less than 10,500 infections and 200 deaths. This might well have been aided by experiencing an outbreak of the MERS virus in 2018, but more likely it is down to the way things are organised in South Korea. The country has a very good healthcare infrastructure which isa  plus; and there is a centralised control of decision making and that has been key to getting things done. The country tracked infected citizens in an authorised manner by monitoring locations for cell phones and credit cards. We are told in the west that such a thing would be impossible, unless of course somebody is trying to sell us something, but when done for public health reasons it is an infringement of personal liberties.

Obviously, the South Korean approach would not work everywhere, and in the long term the disease will re-emerge because so few people have so far been infected – you can’t have it all ways; but if anything is to be learnt from this method, it is that a TEST, TRACE and QUARANTINE policy really does work, although many other countries have failed to do this effectively. The best part of the story is that when things started to go badly wrong, South Korea put scientists in charge, and once clear on what needed to be done they acted swiftly, without any kick back from members of the public advocating all the various alternatives to science based decision making. Alternatives to common sense might be absorbed under normal circumstance, but when thousands of people’s lives depend upon governments making reliable decisions on a daily basis, there’s no time for nonsense; and any fool that refuses to make minor short term lifestyle changes to allow others to stay alive, demonstrates about as much discriminatory ability as the virus that the authorities are trying to contain.

COVID-19 is one of the most difficult global problems we have faced in recent time, but this is no longer because people are carrying the disease by flying to new destinations the way they were just a few weeks ago. Now that most commercial flights have been grounded, air quality has improved enormously and there has been a reduction in Carbon emissions. Ironically, as the virus attacks airways in human bodies, airways in the skies have also been depleted, resulting in cleaner air, which makes breathing a healthier experience for all of those who have so far managed to avoid the infection.

In many places in the world, you might think that things can’t get worse, but not if you live in the U.S.A.. It is difficult to find a better example of what dithering can achieve when dealing with a rapidly spreading viral infection; a problem largely ignored during the early stages of the outbreak. In the U.S. there are necessary checks and balances to ensure democracy, but when decisions have to be made at both Federal and State level, results often lack a co-ordinated approach, and during a rapidly moving emergency as is the case with COVID-19, things don’t always go smoothly. Lacking almost any form of control, the virus sensed its freedom and quickly took off. It didn’t have a green card, but moving so fast, easily avoided apprehension. The virus just wasn’t tested and in consequence the U.S. is on the same trajectory for the infection as Italy was a few weeks ago, and will certainly pass it, which to say the least is unfortunate.

The U.S. has experienced a broad range of criticism over its dealings with the pandemic. Florida disease expert Dr. Dena Grayson made the point that the first case of Covid-19 in South Korea occurred on exactly the same day as the first case in the U.S. Jan 20th 2020. While South Korea had its first tests for the disease approved in a week, the U.S. spent most of February wasting time. Countries that have got onto testing early and in high numbers, have been winning the battle because they have a handle on what they are dealing with: knowing who is infected, the rate of infection, and where it is occurring allows the disease to be targeted. Acting without testing is like stumbling around in the dark; worse than that, it is like stumbling around in the dark in the Dark Ages… Getting testing up and running in the U.S. has been slow, and contributed to the spread and general lack of control of the virus in many parts of the country. But more recently President Trump started talking less about the economy and getting people back to work, and more about dealing with the virus, when previously he had down played the problems – hopefully this won’t have come too late to make a difference.

Certainly things are fairly dire with 10,000 deaths by 6th April. On 8th April 8th the daily figure for deaths in New York state alone hit 799, with almost 2,000 Americans across the country dying on a single day…  The same day President Trump swung back to his old approach as he made further comments about opening up the country for business, His advisers said that it was far too soon to loosen up restrictions, and are waiting to see what the President will say next; and it probably isn’t unfair to say that his message on the COVID-19 crisis has become increasingly erratic.

The U.K. like many other places around the world has gone for the personal distancing and isolation for those who are vulnerable or display symptoms, but early on, there was a more relaxed approach. The suggestion was that if enough people were to become infected, ‘herd immunity’ would slow the rate of infection and with less people available to infect, and the infection would drop away; but it soon became clear that with more people getting ill, the health service was likely to become overwhelmed. Britain already had the example if Italy, which was well ahead of other European contries with its stage of infection; and at home intensive care really did mean intensive and often prolonged care, which would become unsustainable as the number of cases increased. It was apparent that some countries had too few respirators and difficult decisions were being made on who lived, and who died. This didn’t go unnoticed by British politicians and there was a sudden change of policy. Maybe there really was an awareness that once an infection rate starts to climb the steep end of an exponential growth curve, ‘things fall apart’ but the decision making might have been more complicated than that, although if they just followed the science it probably didn’t need to be. 

The virus was a little slower getting to some parts of the world; and this was the case for Nigeria, where preparations were being made long before it arrived; especially in Lagos, which has around 20 million inhabitants, and is the most populated city in Africa.

In the capital city, one in three households live in poverty which makes dealing with any contagious disease difficult. This is true for any country that has large numbers of people living in close proximity to one another with poor sanitation, problems with clean water, and otherwise difficult conditions. In such places COVID-19 could prove devastating as local infrastructures prove inadequate when dealing with such a virulent disease. There is also a high probability that such locations could become reservoirs for COVID-19, with outbreaks continuing for years into the future.

We learn from every viral infection that has gone before. In 2009, a new flu virus emerged and was given the name (H1N1)pdm09, it would became a pandemic. This flu variation showed up in a form quite different from the H1N1 virus that had been circulating previously, but despite the differences older people appeared to have some immunity to it, perhaps because of previous exposure to the H1N1 virus earlier in their lives, and the disease would primarily infect younger people who had not had the same exposure to the H1N1 virus. Retrospectively, we can see trends with most viral diseases, but when a new one crops up, or returns in a slightly different form, it can be difficult to predict outcomes. One of the options is to closely watch a disease in its early stages, and extrapolate the numbers that the course of infection throws up and act accordingly.

Flattening the Curve.

With infections of COVID-19 doubling every three days both in the U.K. and elsewhere it became clear that if the virus was allowed to run its course without resistance it would overwhelm health services and make dealing with the virus impossible. The solution was to flatten the curve. i.e. to spread the number of infections over a longer period of time to avoid losing control. The policy required people to wash their hands, keep a distance from one other, and for the most vulnerable and the infected to self-isolate for several weeks, thus starving off opportunities for the infection to reach a new hosts. In Figure 1 an individual works away to flatten the curve. Above the red line, high numbers of infections will overwhelm the health service in a short period of time and put hard pressed health workers at greater risk of infection.

If the number of infections can be spread, keeping the curve below the red line as in Figure 2, the load will be reduced and make dealing with  the disease more manageable.

 On 20/3/20 bars and restaurants were closed in Britain encouraging people to keep their distance from one another – stay at home was the message. But around the world not everybody was listening to government advice. On the other side of the world large numbers of people were out and about in close proximity, enjoying themselves on Bondi beach. Perhaps embarrassed by the publicity, the New South Wales authoritie -, within a few hours of the story emerging – closed beach access. Then came the news that the day after tighter restrictions  in the U.K., people had responded by going out in Bank Holiday numbers to beaches all around Britain, with Brighton, Bridlington and Skegness especially busy. People were also travelling from heavily populated areas to remote locations such as the Highlands of Scotland in an attempt to escape the virus, potentially bringing the disease with them. Initially the message wasn’t getting through – clearly some people  weren’t taking the crisis seriously and valuable days were lost while government went about trying to provide a clearer message on why in the short term a lifestyle change was necessary.  By the beginning of April a sunny weekend became irresistible for some, and ‘the rules’ might need to be more rigorously enforced in future, especially at Easter, when the continued efforts of the majority could so easily be compromised.

The way beaches around the World should look where COVID-19 is a problem and people are obeying the rules. On the positive side, wildlife has more opportunities with fewer people on the move.

Maybe there’s a simple way to explain why we all have to modify our behaviours to combat COVID-19, because when simple arithmetic begins to look like maths, nobody wants to know, although in the U.S. it’s math, which makes it even more singularly dull. So, consider a hypothetical viral disease similar to  COVID-19: the number of people infected by the disease doubles every three and a half days and it is most infective during the first week after entering a new host, where it gets busy shedding rapidly to optimise the chances of entering other hosts. Under these circumstances a person infected by the disease will infect two other people over the course of a week, and those two people will each infect two others during the second week, and so on as the disease progresses. 

For no better reason than vulnerable people in Britain have been advised to isolate themselves for three months, let’s run the course of the disease over the same period and assume a vulnerable person comes out of isolation on week 13. If I was superstitious I’d describe this as the unlucky week, especially if the vulnerable person was to meet up with a ‘couldn’t care less infected individual running in a direct line of transmission from the original source.

Here’s how it goes: Harry is a bit of a twit and doesn’t like following rules; against government advice he’ll take his chances of getting infected. Harry is out and about and he doesn’t care: on the beach one day, in the park another, and drinking with friends in social gatherings. He has the virus in his system but shows no symptoms – the surprise is he infects only two people during his first week of carrying the disease and that’s how things start.

Over the course of twelve weeks Harry’s indifferent behaviour sets off a a progression of infections for which he is the only source; the infection of other individuals progresses week by week starting from the initial 2 infections in the first week, which creates 4 infections the second week, and so on. 4 becomes 8, 8 becomes 16 then 32, 64, 128, 256, 512, 1024, 2048, 4096, and by the unlucky 13th week, Harry has been responsible for 8,192 infections. Fortunately, the death rate is only at 1% of those infected – I have been generous because The World Heath Organisation gives a figure of 3.4% for COVID-19, but I’m thinking it might not be that high because there must be a lot of people infected who are not aware, due to a general lack of testing in so many places; and there must be a good numbers of people walking around who never get to a hospital. So, with the theoretical disease Harry has killed only 80 people and that’s well above what most serial killers will manage. Infact you’d probably have to go to war to kill that many people and get away with it. If it was as high as 3.4% Harry would be responsible for the deaths of 272 people

What if you were as irresponsible as Harry but you infected 3 people in a week rather than two, and things went on at that rate, tripling up rather than doubling up – a transmission rate that by some estimates would be low for Covid-19. The series would run: 3, 6, 12, 24, 48, 96, 288, 864, 2,592, 7776, 23,328, 69,984, 209,952 and if things went on another week, that would push the figure up to nearly half a million. With a death rate of  1% over just the 13 weeks there would be over 2000 people dead. What if  4 people were infected each week?… Perhaps it does make sense to avoid other people for a while… 

I will admit to a hole in this model. There will be people not going out in an effort to avoid Harry and other people like him, and so the more people who are behaving responsibly the less contacts Harry will make, but nevertheless amongst Harry’s friends, it isn’t too difficult to infect 2 people over the course of a week. Nevertheless, people distancing themselves from others will starve the disease and the number of people catching the virus will drop significantly. This is the reason models come in for so much criticism, they appear to be all over the place, with the predictive number of infections varying from a few thousand to hundreds of thousands, this not because the model is wrong, but because figures can change dramatically when small changes are made early in the progression of the disease. If we don’t get our behaviours right, the number of infections possible are sobering and demonstrates that simply doing the right thing can make a huge difference; and my figures might be regarded as low – to keep things simple I’ve only considered the number of new infections at the end of the 13 week period and not added in all the previous infections as the process moved along ( i.e. the overall total infection number). The same is also the case for the number of deaths.

There are only dummies in shopping malls now.

We could get bogged down with many other aspects of the disease, but for our purposes, all we essentially need to know is the rate of infection, which to some degree depends on how infective the virus is and how we might reduce its spread by our good behaviours. It would obviously be useful to know exactly who is infected and what percentage of the infected are dying, but beyond knowing how many people are behaving irresponsibly, most of the figures are out there, and it’s up to our governments to assess them and implement effective policies to reduce the number of infections and deaths as effectively as possible. We essentially are just the fuel in the equation – numbers on the graph – and need to stay off of the page if we possibly can.

A Canada Day past: it comes around on 1st July, but this year maybe it won’t look like this.

Test, test, test has been the mantra of the World Heath Organisation, and some  governments have been hopelessly ineffective at doing so (Ontario has the highest number of cases of COVID-19 and the lowest testing rates of all the Provinces in Canada…. Is that a coincidence?). In so many countries, as individuals, we need to stay out of circulation for a while – it’s the very least we can do for medical staff who’s lives we put at risk when failing to do so. Staying indoors for most of the day is inconvenient, but it’s better than being dead or causing the death of others.

Saving the Economy Versus Slowing the Disease – Let’s Look at It Another Way.

There’s a pilot with a dilemma. He has taken a small party of people to do business in a remote area of jungle and has to fly them home in a light aircraft. The plane takes off with everybody on board, but pretty soon the aircraft’s engine begins to misfire and the pilot wonders if he should perhaps land on one of the occasional small airstrips still available below and fix the engine; but he knows the businessmen need to get back, and so he flies on. Suddenly the engine begins to misfire very badly and the pilot reconsiders what he should do because the airfields are beginning to thin out now; but he thinks first and foremost of the businessmen knowing he must get them back to their busy lives of doing business and he flies on. But, he hasn’t flown much further when he begins to notice that there are now fewer airfields below just as the engine suddenly catches fire and begins to fail. By great good fortune the pilot sees one last airfield up ahead… he knows exactly what he must do…… he flies on.

For those entrusted with saving the economy it should be apparent that when dealing with an exponentially growing threat, the best policy is to fight that threat as early as possible, never underestimating the power that could be unleashed if you don’t, because when that happens, the price can be very high.

And maybe it’s worth remembering that money isn’t real, it’s value depends on whatever we convince ourselves it’s worth, whereas death isn’t negotiable. It might be that we have to adjust our economies to line up with the natural circumstances we are all living through, instead of allowing the majority to suffer when the loan sharks decide that it’s payback time. Once through the pandemic  we might be forced to live in ways that are less damaging to the environment, even though history demonstrates that major disasters do not in the long term halt our Carbon emissions; and there is no guarantee that the future will demonstrate that we have learnt anything useful from the problems we are now facing.

I appreciate the hardship caused to people who have been prohibited from working, but in part this situation is the fault of the many governments that have let things ride, hoping they could get away with it. They pushed their luck and they failed.

In fairness, COVID-19 is new to us and nobody can be absolutely sure at which point we might have done better as we were passed through it; but the figures should have provided at least an inkling, and at times it seems as if many minds have been busy elsewhere.

We haven’t been dealing with some abstract existentialist threat: just like the world’s airlines, this has been a grounded event  – an exponentially growing  disaster with nothing hidden from view. If only more politicians had recognised the danger signs earlier than they have, because many of the answers were sitting there quietly in the arithmetic – just waiting to be discovered.

COVID-19. Simple Arithmetic and the ‘Economy First’ Delusion.

Although most of us now have some idea of how to behave in the face of the COVID-19 pandemic, few of us understand how ‘the thing’ really operates, but we can still glean information from the freely available daily figures. Unfortunately, there are also a lot of politicians who don’t understand the virus very well either, despite having access to expert advice and a lot more information. One wonders if perhaps they had spoken more regularly to immunologist rather than economist, whether things would be different now, standing as we are on the  pandemic side of the infection – somewhere quite different from that ‘nothing to worry about’ place that many of us were sleepwalking through all those days ago… way back in February!

Facing the lack of political direction some countries are experiencing, it is no bad thing to take an analytical approach rather than just adopting an opinion. Opinions can be interesting, but everything makes more sense when approached from an evidence based perspective.

Are some of our leaders indulging in blue sky thinking, or is it all just a bit fluffy.

There have been three ways to go with the COVID-19 pandemic and the approach has varied from country to country.

1: Herd Immunity: Let people get infected and when a large percentage of the population has developed immunity the disease will drop away.

Several countries started out with this approach but abandoned it when rates of infection began to rise and put health services in danger of being overwhelmed. Sweden has held on to one version, but it’s less a ‘herd immunity’ policy, than a watered down version of self distancing, with children still at school, small businesses operating, and no travel restrictions. It might have worked out because Sweden has a low population, but there could be other reasons – perhaps even the cool Scandinavian approach to greeting one another has played its part; but as infections begin to rise, there is pressure building for a more rigorous approach to dealing with the virus.

2. Personal distancing, isolation of the most vulnerable, and in extreme cases a total lock down: people will still get the disease, but the infection rate will slow enough to allow medical services to cope. Britain started with 1. found it difficult to hold infection rates to manageable levels and switched to 2.

3. The South Korean and Taiwanese approach has been to combine technology with contact tracing, and use and aggressive strategy to  limit the number of infections – this works well where people can be relied upon to follow instructions, but it doesn’t work everywhere. The danger is that the population will not get a high percentage immunity and the disease will returns from outside at a later date.

Only time will tell which approach gives the best results, but there is an indication that, in the end, all will lead to a similar outcome: rates of infection will vary, and the results come at different times.  As yet, nobody knows what will happen, and there’s always a chance the disease could just run out of steam and disappear entirely, but as yet, shows no signs of doing so.  

Things we should know when thinking ourselves through the COVID-19 pandemic.

It is helpful to know what is sometimes termed ‘the percentages’ to get a better understanding of how an infection runs.  Although it doesn’t apply to all contagious diseases, a basic plan of fifths is a model applicable to many, and appears to work for COVID-19. The general rule for those infected is that four fifths will show trivial symptoms but still be contagious; one fifth will show more severe symptoms and one fifth of those with more severe symptoms will be in a serious life threatening situation.

Viral load doesn’t have so much arithmetic about it, but it is relevant, especially to medical workers. With other infective disease, it has been noticed that the first person in a family to contract a contagious disease will sometimes show less severe symptoms than others members of the family who later become infected. The suggestion is that the level of a virus contracted can increase the severity of an infection. If this story proves to be more than just anecdotal, it might explain why health workers are at such great risk, especially when intubating patients (inserting and removing a tube into the trachea to aid breathing). At such times they are subjected to high levels of the virus. This merits a mention because so many health workers have been poorly provisioned with adequate protective clothing which is entirely unacceptable, considering how long some authorities have had to prepare.

With any serious viral infection one of the most important considerations is to understand what exponential growth really means: it is a progression of numbers that double up over a period of time; this sounds easy to understand, but few people fully comprehend the consequences of this form of increasingly rapid growth. If a disease is increasing exponentially, it is possible to recognise the end game by reading the figures correctly in the early stages: essentially it is a question of identify what you are dealing by understanding the numbers. I have outlined the details of this in a previous article: ‘Take a Picture – Save the Planet. UP, UP AND AWAY. From Ebola to Exponential and Beyond.’ and all I need to say here is, that whenever you see an exponential curve and have some kind of negative relationship with it in its later stages, then ‘Be afraid. Be very afraid’… This sounds extreme, but many of the problem issues we currently face, especially those relating to the environment involve dealing with exponential growth, because when you get to the steep end of the curve things can get critical. 

Go back a few generations and consider the affects on our world of such activities as burning coal, oil use and rapidly increasing human population  –  they all looked very different when our ancestors were standing lower on the curve, well before the steep climb that typifies exponential. Back then many might have rejected ominous predictions about the future based upon the way things were looking, but somebody reading the figures correctly could have accurately predicted the problems that we are now facing. The same might be said for COVID-19, as the spread of the disease has been growing exponentially, but when the virus started out, it didn’t sit on the lower slopes for very long, but immunologist were still able to predict from a very early stage where things were heading, while many a less well informed individual, didn’t anticipate any problems.

A few quick sketches of graphs demonstrating exponential growth. The shape is a give away, they all look very similar.

One of the graphs above, shows the U.S. death rate from COVID-19 through March 2020, and another, the release of C02 into the atmosphere between 1800 to 2020: both look exactly the same but they have nothing in common, other than being examples of exponential growth. With the CO2 graph I’ve ignored figures prior to 1800, to make the similarity clearer, but we shouldn’t make a habit of ignoring data, because cherry picking is a frequent misuse of statistical analysis to re-enforce selective points of view. Here it has been done only to demonstrate the shape of a curve with no intention to deceive.

Because COVID-19 kicked off with a vengeance from absolutely nothing and there is consequently no gentle rise of the lower slope of the curve for the U.S. Covid 19 figures,  I have added  ‘A STANDARD EXPONENTIAL’ curve which is often called the hockey stick curve. This indicates a calmer foothills slope, where the signs of exponential growth can still be read and what lies ahead is easily predictable. The question is whether the problem gets  picked up and recognised as the get out of jail card it can sometimes be.

 Sadly, by the time of writing (around 5th April), deaths in Britain caused by COVID-19 began to show a progression that looks exactly like most other exponential growth curves. Go back to the 22nd March when the figures were far lower and you might not predict what was to come. Unless they were reading the numbers, and might have been surprised by the steep rise to follow. 30th March: 180/ 31st:38/ 1st April: 563/ 2nd: 569/ 4th: 708/ 5th: 621. The way things have run elsewhere that have shown similar infection rates, the likelihood is that infections and deaths will slow over the next week or so, the numbers are about to plateau but exactly when will to some degree depend on public behaviour. If people continue to stay at home and bring down infection numbers it will certainly make a longterm difference – longterm being only a couple of weeks now as we live through the new reality of virus time.

Any of us can get daily figures on this disease for almost anywhere in the world; the death rate in particular is difficult to misrepresent – although when people die outside of hospital they are not always recorded as a COVID-19 case. Certainly in the U.K. there hasn’t been widespread testing of the general population, and without that it is difficult to assess who is infected; and it skews the percentages in relation to the number of people dying (the death rate is what it is, but the infection rate is probably higher than reported); and this general lack of essential knowledge about the disease is disconcerting.

Nevertheless, predictions for the rate of COVID-19 infections have been easy to make by simply interpreting the day to day figures we do have, as any error in the records will remain constant and make it possible to extrapolate the graphs appropriately. Sadly, many elected officials ignored the finer details of the growth rate and were slow to take action, and this had an affect on the infection rate at a later stage of the disease. Either, they didn’t understand the horrors that an exponential curve represents, or they were wishful thinkers, hoping for better outcomes.

Even the most optimistic amongst us must at some stage face reality: with infection numbers doubling every three to four days it should have been obvious that infection rates would get out of hand unless there was a rapid response: which might include social distancing, self isolation, some form of treatment or a vaccine, although the latter two options are presently unavailable. It is difficult not to feel that in both the U.K. and to a greater extent the U.S., authorities were slow to recognise the exponential nature of the disease, even when they had a clear model of what was likely to occur by observing countries like Italy that were already going through a later stage of the infection. The U.S. had at least a two week jump on some of the countries in Europe, but whatever the case, many countries did not prepare adequately .

There are many examples of exponential growth that are important to us, in particular those relating to the environment, there wouldn’t be a problem if space and resources were unlimited; certainly we run our economies as if this were the case, ignoring the absolute reality that we are living in a finite world. Now we are troubled by the steep ends of so many exponential curves, with doubling times arriving so quickly and numbers so massive, the likelihood that if we can continue the way we are drastic changes with be forced upon us, and some are already suggesting that the COVID-19 pandemic is a sombre reminder of how vulnerable we are. 

We are still part of nature, but our technologies ensure that presently many of the rules that apply to other species do not apply so fully to us.

In the natural world biological systems often run in cycles with a complex web of feed back mechanisms to limit any one thing from throwing the system out of balance. Since the development of our various technologies, humans have to varying degrees been living outside of the general rules imposed by natural systems; but we can’t control everything – there are chinks in the armour of our existence and it won’t be the last time we come under attack from a micro-organisms such as COVID-19. Viruses are reasserting nature’s influence and we’re learning lessons from a simple parasitic organism we cannot see, that is benefiting enormously from our close social interactions and high population numbers, and with deadly consequences.

Immunologists have been waiting for the inevitable, and now it has arrived we should be taking advice from those who saw it coming. This we are told is a hundred year event, but immunologists know better – our lifestyles are very different from the way they were a hundred years ago. Our population, relentless consumption, and ability to travel almost anywhere in the World have combined to make us vulnerable, and if a novel virus had hands we’d be playing right into them. It should be no surprise that we are battling a pandemic; with this perhaps an indicator of the kind of wars we will be fighting in the future.

The last pandemic occurred in 1918, it was caused by a bird related H1N1 virus incorrectly named Spanish flu – and it was never cured, never seen – there were no electron-microscopes back then. This was like no flu ever experienced. In a worst case scenario, a person might feel unwell at breakfast and be dead before their evening meal, but despite its virulent nature the disease eventually burnt itself out, having infected some 500 million people, and caused some 50 million deaths. Every viral infection has its own signature: this one carried off the most youthful and healthy wherever they gathered together, with young men fighting together during the 1st World War especially vulnerable; but this terrible toll on humanity was soon to pass from collective memory. When I was a child, remembering Two World Wars was an oppressive part of life in Britain, but there was never any mention of the virulent and deadly influenza that killed many more people than had died in the First and Second World Wars put together. From an American perspective it killed more U.S. citizens than all of the wars fought by the United States through the entire 20th Century and yet we have chosen to ignore it. 

A novel disease like COVID-19 can start from a single infection, and because the new host (in this case, us) has no developed resistance, the infection rate can increase exponentially. How much slower the rate of growth would be if the virus reproduced over the same time period as we do – say 25 years per generation. If we had that kind of time we’d undoubtedly defeat such a disease in its early stages, but viruses work on a different schedule: they have places to be and a natural ability to get there shockingly fast – so we need to move fast to.

Nobody is wandering through European cities now, and without people they have become shadows of their former selves.

Once Inside the human body, infective viruses are usually in a rush to double their numbers by dividing, and this leads to our next point of arithmetic interest – infection rates, which are measures of how frequently the virus can be successfully transmitted to other individuals. With COVID-19  infections double up every three or four days, in the U.K.. It took 13 days to go from 1 death to 100. 10 days to go from 100 to 1,000. There are only 5 numbers here; usually far too few to come to a conclusion about anything, but these numbers tell us an awful lot. I could complicate the issue by claiming that after another 4 days COVID-19 had infected another 1,000 people… but that’s predictable… so I won’t bother.

The RValue

 is the Basic Reproduction Number (or Ratio). Such numbers  are usually based on models and often quite specific in their use. We might think of the Ro Number as a general measure of infection, but that’s not quite right; the Ro number cannot for example be modified by vaccines, and is mostly used as a way to ascertain if a disease is developing in a population. If the Ro value is less than 1, the disease will not be spreading because it is in decline, but above 1 the infection will be growing, and the larger the Ro value, the more difficult the disease will be to control. There are other factors when considering how fast a disease can spread, the numbers of people in a population that are vulnerable, there are many factors, but none of them stop an Ro value from being a useful indication of how an infection is spreading.

If we see an Ro figure of 2 then it is rather like watching cell division in a petri dish i.e the growth is doubling up in an exponential manner and after less than a dozen doubling ups the numbers begin to get quite large and the disease may become difficult to control. Whether or not a disease becomes a problem depends on many things, the most obvious being how a disease is spread and how frequently that occurs. Ebola had an Ro of 2 and I’ve considered this disease in a previous article. The Ro for Covid-19 has been given during its history as having values that range from 2 to 3, sometimes 4 and quite a lot in between. All we need to know is that the higher the value the bigger the problem and that ascertaining an Ro number early on is important when estimating a diseases progress.

Dispelling the ‘Don’t Worry It’s Just Like Flu’ Myth.

Unfortunately early in the outbreak Donald Trump compared coronavirus with flu, but this was misleading. In the U.S. between 5 and 20% of people can expect to get flu during the course of a year, 200,000 will become seriously ill, and up to 20,000 will die.

The death rate of seasonal flu we know is typically around 0.1%. but during the early stages of the infection in mainland China the death rate for COVID-19 was estimated at anything between 0.4 to 2.9%; and as the virus could infect between 50 to 80% of a population very quickly, and there was no vaccine or cure, the situation was potentially very serious.

On 24th March a worried Governor Andrew Cuomo said that it was coming across the U.S. like a bullet train as  N.Y. cases topped 25,000 with 200 deaths  – he didn’t use the term exponential growth, but did say the rate of infection  was doubling every 3 days. New York was Ill prepared for the onslaught and the Governor was understandably worried. You don’t need to be an epidemiologist to know the difference between seasonal flu and COVID-19, the former doesn’t put your health service into total breakdown but COVID-19 can do so in a matter of days, particularly when the infection rate is climbing the steep part of that exponential curve – and you don’t have to dither very long before experienceing the full force of the disease.

It’s a Matter of Life or Death:

This has been a time when Governments needed to interpret available information, make decisions and then act very quickly, but they haven’t always done so. Computer simulations have been of great importance in the process, but many indicators of the path that should be taken have been ignored. In the U.K. ex-government minister Phillip Lee has spoken about a computer simulation of a pandemic undertaken a few years ago in order to inform government strategy, utilising an outbreak of a virus similar to SARS. One of the results of the exercise was that it indicated, even when there were both treatments and a vaccine available, there would not be enough ventilators for the predicted number of patients. The obvious question is: why the government didn’t react to this important information? Most likely there was a belief that the chances of a SARS like pandemic was low, but when COVID-19 kicked off, why wasn’t there a more rapid reaction to the emergency? Certainly it has been shameful that very basic supplies of protective masks, goggles and clothing have been in short supply and very limited testing even of medical staff for the virus. This to most people is unacceptable; health workers on the front line need more than just a round of applause. Having witnessed the outbreak in Italy, and even earlier when the virus became a problem in China, there was time to react, but preparations for the spread of the virus were unacceptably slow.

Spring is in the northern hemisphere, and many feel they are missing on it.

In Britain there was further criticism because testing is essential for monitoring the spread of the disease and it has failed to do this adequately, even when the disease was running up the steep end of the exponential curve. Some countries have been more efficient in their dealings with the threat. Germany for example was setting up testing labs fairly early on, but Britain did not react as quickly, and put all their efforts into a single dedicated lab – this to ensure standardisation of testing, in preference to using university and other laboratories around the country that had volunteered help. The government project then had problems accessing chemical reagents required for their tests because these weren’t purchased early enough. In consequence the system hasn’t been moving fast enough to deal with even the most basic number of tests – they soon might though, as help has now been accepted from some of those other labs, but it could all be coming rather too late.

Both of these stories came out on the same day that Britain reported 563 deaths from Covid-19. It was April 1st All Fools Day – unfortunately the virus moved with great speed, but of course governments are not usually so good at doing that and the result almost certainly will be be a greater loss of life. A thoughtful person might be wondering how we will look back on this predictable situation that got very much out of hand. Maybe it just hasn’t been a fair fight – the virus has been efficient and has moved very fast, while governments in general… Well, perhaps not so much.

Now is not the time to draw too many conclusions, but at some stage, after we’ve worked out exit strategies from the present pandemic (and that’s a whole other story in itself), there will have to be questions asked. The next time a pandemic occurs, which if nothing much changes is a certainty, we must be better prepared for the fight. We owe that much at the very least to all of those who have so far lost their battle with this deadly enemy.

Next: COVID-19. Simple Arithmetic and the ‘Economy First’ Delusion. PART 2.

A Brief History and Natural History of Coronavirus and its journey to Pandemic.

Is the Coronavirus emergency a dry run for how climate change will be dealt with in the not too distant future? If that is the case there is cause for concern.

 Coronaviruses are a group of viruses variously associated with crossing from mammals to humans, which cause novel and often serious diseases when they do so. In general appearance they look as if somebody has taken a potato and stuck golf tees into the surface… a potato too small to eat, and golf tees too tiny for a cart jockey to ‘go chasing whitey’.

On December 31st 2019 China reported several cases of an unusual from of pneumonia in Wuhan, a port city in Hubei province. Some of those infected worked in a local fish market, which was quickly shut down. The virus responsible was a member of the coronavirus family, a new variation on a very basic plan: imperceptible to the naked eye, this tiny organism crossed over from a wild creature to a human being – it wasn’t the first time this has happened and it won’t be the last. The original host is still in question, but thought to have been a bat, although the virus may have passed through an intermediary, perhaps a pangolin, which is odd because pangolins are a critically endangered species.

There are four species of Asian Pangolin all endangered; and poachers are now targeting African species to fulfil demand.

The Chinese have an insatiable desire for pangolin scales, with the creature’s meat a delicacy. Years ago a Chinese friend joked that if it moved, the Chinese will eat it, which sounded racist even back in 1985, but I couldn’t help myself and said, ‘Just like the French.”  We both laughed, but not as loudly as the Belgian standing next to us. We were beneath the shade of a big old tree in Central Africa, with there was nobody around to get offended on somebody else’s behalf. I was trying to buy the python my Chinese friend was fattening up in a sack under his house – he said it would make good soup, but I’m fond of snakes and was doing my best to keep the creature alive. The reptile had grown large and my friend had decided to present it to me just before I flew out on a light aircraft – with a pilot who was extremely concerned, but he needn’t have worried, the reptile escaped without my help. Had I taken the creature on board I might have claimed this the inspiration for ‘Snakes on a Plane’, but there was no chance of that now we’d escaped a potential disaster… It was quite the reverse from how things are today with the recently emerged coronavirus getting on a planes and proving itself infinitely more deadly than any reptile, travelling as it would in the respiratory systems of passengers, almost unnoticed – apart from a few raised temperatures and irritating coughs. This enterprising virus would get to almost any location that a human might decide to travel, and do so very quickly. Persistent and infectious this mutant coronavirus would make any snake related disaster imaginable seem like a minor inconvenience.

The new infection would soon to be taken seriously enough to be given its own name, COVID-19, officially known as ‘Severe Acute Respiratory Syndrome Coronavirus 2‘, or SARS-CoV-2 because it is related to the first SARS virus – an outbreak of which occurred in 2003. Initial reports suggested that it had originated from a cobra, but snakes are not closely related to our species making them an unlikely source for a human variant; far more likely that it came from a mammal.

In late February 2020 a research group demonstrated that a coronavirus found in frozen cell samples taken from illegally trafficked pangolins in China shared between 85.5% to 92.4% D.N.A. with the coronavirus that was infecting humans. Another research project came up with a slightly tighter match at around 90%; and yet another study discovered a coronavirus in a bat that shared 96%  of its DNA with the human COVID-19 form; but despite a basic awareness of the numerous animal species that carry closely related coronaviruses, nobody knows the precise route the variant took to enter a human host.

When a coronavirus crossed over to become Severe Acute  Respiratory Syndrome (SARS CoV) in 2002-2003, it produced a severe form of pneumonia which probably originated from a live animal market in Guangdong – the bat population from which the syndrome was thought to originate was however only about 1 kilometre from the nearest village and the virus also  remains viable for a time in bat droppings and with transmission to other mammals the route  it took to enter a human host is still open to question. Nevertheless it rapidly became a problem because humans do not have any developed resistance to new infections that arise from mutated forms that suddenly adopt us as a host.

The SARS virus was found to be present in Rhinolophus bats, the Asian palm civet and a variety of other small mammals – and because of its association with the virus the civet was soon to become persecuted. But wild animals carrying viruses that might cross over to us are not really to blame, especially when they are captured and brought into primitive markets where basic standards of hygiene are a low priority. Here a variety of creatures are brought together in high numbers in cages stacked one upon another bringing together animals, both wild and domestic, that would not usually meet, making it a high probability that COVID-19 originated under these circumstances. China hopes that other nations will not play the blame game, but if novel viral infections are proven to originate from such animal markets and these continue to operate, attitudes to how global trade and travel is conducted must significantly change.

SARS is closely related to COVID-19, but it was contained and died out before a vaccine could be developed. Iin 2012 another Coronavirus showed up in humans – Middle East respiratory syndrome (MERS-CoV) which once again was thought to be transmitted by bats. Scientists compared the virus surface spikes of MERS-CoV to a related bat coronavirus HKU4 which cannot mediate entry into a human, but only two mutations (on the MERS-CoV spike) were required to enable it to do so, thus enabling the virus to enter a human cell.

The coronavirus that recently crossed over to a human most likely came from a horseshoe bat; and it was an Asian fruit bat that transmitted the Nipah virus to humans in Malaysia in 1998. In Central Africa Ebola virus probably crossed over from a fruit bat before reaching epidemic proportions in 2014, and at least 300 strains of coronavirus are now known to be circulating in bats.

Why Bats?

The reason relates directly to the evolution of flight in the order of mammals (Chiroptera). A flying bat has a metabolic rate two and a half to three times the requirements of an active non-flying mammal of similar size. Essentially, flight should be detrimental to a bat’s health – the oxidative stress of a high metabolic rate inducing the release of free radicals which damage DNA. To overcome the toxicity, bats have evolved mechanisms to minimise the problem and also repair damaged DNA; in the process the gene variants involved provide protection by boosting the immune system, allowing bats to carry viruses without serious consequences, which makes them ideal hosts for coronaviruses to inhabit.

The next question is how does coronavirus get into a human in the first place – what is the physics and chemistry of the process: certainly the spiky surface of the organism is an important part of the story. The virus must firstly get into the respiratory tract of a human, once there it has to enter a cell and this is achieved when the oily layer coating a spike manages to combine with the membrane on a cells surface. If fusion occurs the virus may then enter the cell and mutations of the proteins contained on the spike’s surface are important factors in transmissibility – if everything falls into place the coronavirus will infect its new host. 

Knowing this to be a basic mechanism of transmission, the advice we have been given to inhibit the infection now running through the human populations makes sense: washing our hands properly with soap and water along with the use of alcohol wipes and sprays helps reduce COVID-19’s progress by disrupting the oily protein layer on the spikes of the virus and greatly reduces the chances of the organism entering a human respiratory system cell, and in a best case scenario will dissolve the virus membrane rendering it inactive.

Viruses are too small to see with the naked eye – there are no optical pictures. The ones we do see are either computer generated images or scanning electron microscope pictures. However as real viruses are smaller than the shortest wavelength of light they do not have any colour. Certainly scanning electron microscope picture are in black and white, but to make them more interesting they are often given a variety of tinted colours: this is not science, so maybe we should call it art.

Finally, there is the question of how frequently mutations occur: coronavirus has a proof reading enzyme which stops too many mistakes from being made during reproduction, reducing the number of mutations of the relevant protein on the surface of the spike. Because mutations are less frequent it has been difficult for scientists to follow the course of the infection, because it is changes in the virus’s make up that provides markers to indicate where the infection has come from. Not being able to ascertain the route has to some degree hindered attempts to contain the infection; but there is also an up side – unlike flu this viruses does not change regularly which at least makes it predictable and important in the development of a treatment. 

Covid-19 is thought to have started in a similar manner to SARS, but in this case originating in a wet market in Hubei province and once established in a human host the new viral disease would soon begin its rapid journey around the world. The first recorded case from China was on the 17th November 2019, and by the 11th March 2020, 122,000 cases had been recorded in 121 different countries. The clever thing about viral infections is that they don’t stay in one place for very long, and unless dealt with in the emergent stage, will sometimes become unstoppable. 

If when the disease emerged China had clamped down, the virus might have been contained, but the initial decisions were taken at a local level, and it wasn’t until decisions were made further up the chain of command that the disease was dealt with effectively. With a virus spreading exponentially a day missed can result in thousands of infections. Unfortunately, before the government clampdown in the region where the outbreak started, people were moving off to visit family and friends on their Chinese New Year holidays and initially there were no movement or quarantine restrictions – it was a bad start. For a month very little was done to curtail the disease, and by the time more stringent measures were in place, it was far too late, the disease had taken off and  moving elsewhere – the problem no longer containable.

In fairness to China, after a poor start, the country has shown an unrelenting commitment to eradicate the virus, and with impressive results. Back in February it was a different story. On 12th. Hubei reported nearly 15,000 cases of infection, with 242 deaths in a single day – figures were being reassessed, officials were being sacked. On 13th there were 5,000 more cases and another 116 people had died. It was disturbing, and by 18th the total number of infections in Hubei totalled 61,682, with the death toll reaching 1,921.

At this stage it was difficult to image that things were going to get better, but a month later on 18th March 2020 it was announce that homeland infections in China had been reduced to zero, which is astonishing given the virulence of COVID-19. If the official figures given for the outbreak were considered on the low side, then this only serves to make the present situation all the more impressive. With restrictions becoming less strict in Hubei, the world now waits to see if the virus will make a comeback, and if it does, how it will be dealt with.

 As the cradle of the disease China presented an early example of how the disease might progress and South Korea which I mention later, wasn’t far behind and it was important for other countries to watch and learn from these early dealings with the disease.

For some inexplicable reason, many Europe countries and the United States dithered. China and South Korea were far away – maybe it wouldn’t be such a big problem. In the U.S. in particular it was business as usual no matter the warning signs, few preparations were made for what was about to happen and valuable time was wasted. 

On 31st Jan 2020. two Chinese tourists tested positive for COVID-19 in Rome; a week later an Italian man returning from Wuhan in China was taken into hospital and became the third case in Italy. Then things took off. The Lombardy region was hit particularly hard and pretty soon growth in the disease would reach an exponential growth rate. Soon there were too many cases for hospitals to deal with; intensive care units were overwhelmed, and the only products being manufactured were coffins.

To list the figures for the next 19 days isn’t necessary. It is a distressing story, a novel disease would produce something more terrible than a work of fiction and by 19th March 2020 Italy surpassed China with 3,400 deaths from Covid-19, with 40,000 recorded cases, 5,322 of them on this one day. The outbreak in Italy put the frighteners on the rest of Europe, and pretty soon things began to look bad in France, German, Britain and especially in Spain.

For a time, the streets of Italy were deserted with people confined to their homes. To see such a thing is unusual because in spring and summer Italians are very social – often out of doors; but for obvious reasons I was never there and this picture is a bit of a cheat…

Almost a week before the COVID-19 was declared a ‘Global Heath Emergency’ a group of news correspondents in the U.K. complacently suggested that the situation was mostly under control, which begs the question: how much do these people really know, or more to the point – how much of what they think they know is wishful thinking? Wherever we are in the world we know these people – they are the same ones that told us Donald Trump was unelectable and Brexit would never happen. People who find it easy to run off at the mouth despite being incapable of critical analysis – they are prepared to offer their thoughts on just about anything without due consideration for their ignorance; in this case, an immunological problem about which they knew absolutely nothing.

Then there are the politicians who’s priorities it seems has been to keep world economies stable, making this a priority over the health of the people who elected them into office. Of course, it would be naive to suggest that economies are not enormously consequential to us all, but the truth about what we are all likely to experience should not be coming in a poor third to financial gain and political self interest. It is of course necessary to reduce the likelihood of panic, but underplaying the science, which so clearly indicates that COVID-19 will most likely become a pandemic requiring a rapid and appropriately reaction is unforgivable. (Obviously, things have moved along since I wrote this. So has there been an appropriate reaction. In many places around the World the answer has to be no).

I guess if politicians aren’t going to take the virus seriously, it’s O.K. for me to represent bagpipe style virus in my grandfather’s tartan.

 Clearly the smooth running of our economies is important, but like wars, less important to most individuals than staying alive. If politicians can’t grasp the magnitude of the situation and the disease’s potential because they are incapable of understanding the science and the basic maths that goes along with it, they should listen more closely to what their scientific advisors tell them, even when this is based on models of likely outcomes, as data based decision making is much better than simply guessing, or those other favourites – ‘being hopeful’ and ‘maybe we’ll get lucky’.

There was a point in the disease when many believed that this was just another bout of the flu, so why bother with it? –  nature was just clearing out her old sock drawer, but thinking that way was a mistake. The disease is more infectious than flu, moving faster and increasing exponentially over a very short period of time  – in some cases doubling every three days – and without a vaccine it could, if unchecked, create total chaos as health services become overwhelmed with patients they will not be able to treat, and with large numbers dying unnecessarily. In many countries there has been inadequate testing for the virus, in consequence knowing exactly how many people are carrying the disease is impossible to estimate because some people show no symptoms. We will of course be aware of the number of people infected in hospitals and the numbers dying because such things are hard to miss; but increasingly it isn’t just the old and vulnerable who are in danger, as younger people are now dying from the infection; and who can say for certain that the virus won’t suddenly mutate and start taking out healthy young economists, the same way it is taking out health workers. 

The situation in the USA was sketchy from very early on. On February 26th President Trump was at first dismissive – ‘there were a low number of cases, the people who were ill were getting better and in a couple of days the numbers would be down to zero’. Then on the 28th he said – about those working on the virus – that ‘they’d done an incredible job, and like a miracle it would disappear’. On March 6th he clarified that, ‘anybody who needed a test would get a test and the tests were beautiful’… and they may well have been, but they certainly weren’t available to everybody who needed one.

Rather oddly, on the 20th February when things started to look problematic the President put Vice-President Mike Pence in charge – an individual who thinks Darwin was wrong – a clear indication that this is a man not well versed in science. The President could have appointed an expert medical advisor such as Dr Anthony Fauci The director of the National Institute of Allergy and Infectious Diseases; a man already on the task force, but he had spoken out on the lack of preparedness of the administration to deal with the outbreak. A comment made when President Trump closed US airports indicated that the president ‘had shut the chicken coop door after the horse had bolted’ – an interesting mixed metaphor, implying that the President had missed his opportunity to react appropriately. Soon after the President gave himself a perfect 10 out of 10 for his dealings with the coronavirus emergency. A U.S. medical expert quickly responded that 10 out of 100 was nearer the mark.

On a more personal note the air travel announcement came a couple of hours after I’d seen my wife off from Vancouver airport to attend her mother’s funeral in the U.K. she had booked to travel via the USA before the virus went global, and her return flight was cancelled; she then had trouble booking a flight back to Canada. Everything was suddenly moving too quickly for most of us to keep up with. U.S. airports had already been closed to travellers from Europe (understandably so because on that very same day Italy had 250 deaths in 24 hours). Now US air travel was being closed to Britain where the death rate still remained low, but nevertheless doubled on the 14th March. There were then 1,100 confirmed cases of infection in the U.K. but the real figure was estimated to be nearer 10 times that figure. Without testing the general population, it was impossible to say and by 26th March no testing outside of hospitals  was still the official policy – probably because there simply aren’t enough kits to facilitate doing so.

South Korea is one of a few exceptions to the general trend, and were able to provide reliable figures fairly early on because they were testing thousands of people. By 11th March the USA had tested 11,000 people,  while South Korea was testing 10,000 a day for free, with some reports suggesting this figure was nearer 20,000 a day. Five days later it was reported that South Korea had tested some 250,000 people while the USA had managed only 20,000 in total; which is ironic because on the same day The World Health Organisation (WHO) said, ‘You can’t fight a fire blindfolded. Test, test, test’. The clear implication, being that it is impossible to judge the scope of the problem until you know how many people are infected, and when you have done as many tests as possible, it makes sense to identify all contacts from two days prior to the infected persons first signs of illness and test those people as well. However, the increasing number of infections in many countries was by this time, likely to have passed the point where this could be done successfully; certainly this was the case for the U.S.A. because so few had been tested under a public health service that was poorly funded making the number of infected people difficult to ascertain. 

The USA had opted to produce its own testing kits, but there simply weren’t enough of them, and many didn’t work very well. It was as if the U.S. wasn’t serious about dealing with the problem. President Trump seemed preoccupied with protecting the economy and appeared to be saying almost anything to divert attention from the problems that a potential pandemic might have on the money markets, and so the country didn’t react when it should have done. Stock exchange values began to tumble and realising the U.S. was not going to escape fiscal pain the President surprised everybody with a U-turn and on 13th March declared a national emergency.

In Britain as of 25th of March people were not being tested unless they were in hospital, and neither were the medical staff who were treating them (although by the 27th there were promises to do so, as health workers were quite reasonably, showing concern). But those who though they had the virus were still being told to go home and self isolate and were unable to get tested by a doctor. To say Britain has been ill prepared for this emergency is an understatement. On 26th March Mayor Giorgio Gori of Bergamo in the Lombardy region of Italy said that Britain had got it wrong – with infection rate two weeks behind Italy, it had been too slow to react which might cost many lives.

In the USA critics considered the administrations reaction to COVID-19 to be all over the place and the markets continued to be volatile. It was Jo Biden (the most likely candidate to stand against President Trump in the Presidential election of November 2020) who on 12th March steadied the ship, with a speech that probably should have been made by the president; and you have to wonder if the electorate will remember the disorganised  nature of the current administration’s handling of this national emergency when it comes to November… if the election still happens. On 26th March President Trump was still hopeful of getting people back to work – a couple of days previously he had suggested that could be by Easter, but set against the news on 26th March, that the USA had 83,000 confirmed cases of COVID-19, overtaking all other countries to become the epicentre of the pandemic, getting back to work seemed the least of its problems. By the 28th New York was pleading with the government to get started on making respirators as they needed them urgently. The president thought that such provisions were better coming from private industry, but N.Y. needed them urgently…and I wonder how many political turning points you can have as this will to come back to haunt the president if there are people dying through lack of respirators.

The country had plenty of time to consider the seriousness of the developing situation, but still appeared woefully ill prepared. Looking beyond COVID-19, we might ask whether many of  our leaders will persist with exactly the same approach to global climate change, and continue with the usual resistance to scientific evidence, inhibiting our ability to react appropriately, and we find ourselves in yet another dire situation of a different making.

The only positive thing to come from the pandemic is a slowing of industrial productivity, leading to a rapid reduction in carbon and other emissions with the consequence that many of us are experiencing much cleaner air. Aerial views of major cities worldwide demonstrate that pollutants have largely disappeared from areas that a few months ago were experiencing serious air quality problems – with some of this the result of a recent reduction in air travel. However, the global pandemic is co-incidental to our climate problems, and probably isn’t the most appropriate way to reduce Carbon emissions.

COVID-19 has demonstrated clearly, that we might be incapable of reacting quickly any big problems that occur on a global scale; as by the time we do, they are out of our control. Just as with climate change,  we are too often simply hoping for the best, while our leaders react too slowly to scientific evidence available, in deference to short term economic gain; and if that continues, such actions will not save our economies, but inevitably lead us to a far more precarious future.

I am aware the COVID-19 pandemic has caused suffering in a great many countries and I regret that I have not been able to follow all of them; certainly I should have given more attention to Spain where the virus has taken hold. As I finish writing on 27th March, although the infection rate in Spain has slowed, the number of deaths today totalled 769. Unfortunately the country did not lock down quickly enough and testing for the virus was not adequate.

Around the world the COVID-19 story is changing by the hour, with India now coming into the story: this country has the second highest population in the world – and with  people living in close proximity to one another, self distancing is difficult to achieve. Dealing with the virus under such circumstances is a monumental task; nevertheless on 24th March Prime Minister Narendra Modi put the country on lockdown for 21 days in an effort to get to grips with the virus at a relatively early stage when infection rates might still be manageable. It remains to be seen whether India can succeed where other countries have failed. Whatever the case, the World must now act together in solidarity because for the first time in living memory, we are all in this together. On the evening of 28th March Prime Minister Boris Johnson who the previous evening had tested positive for the virus (as was the case for his Health Secretary and Chief Medical Officer), announced a lockdown in Britain; and critics of policies that had previously seemed too vague for many Britains to follow were saying, ‘better late than never’.