Monday 16 March 2020

nature's test (the herd immunity) (A Work of Poetic Journalism on COVID-19)

(Picture credit: dukehealth.org)


every now and again
in it's Gaian form of self-regulation,
the Earth throws us a curveball,

the present one being in the form of
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),
the cause of the COVID-19 disease,
more popularly known as the coronavirus,
the result of which is the ongoing global pandemic.

this is
nature's test,

and
presently
in the United Kingdom,
we are failing.

it is a near-inevitability
that at some point
we will come into
contact
with the virus.

i work
two different jobs,
both of which involve dealing with
members of the public.

(you wouldn't think
there was a virus
doing the rounds:

"Are you not entertained?")

I am someone who faces
the fair possibility of exposure,

and have resigned myself
to the knowledge of
that potential outcome,

but what I object to is

our government bodies' lackadaisical approach.

Schools are due to close in Northern Ireland for at least 16 weeks,
but not with immediate effect,

and

the elderly are recommended by the UK government to
self-isolate for up to four months.

There's a clear correlation between
those estimated timeframes.

Northern Ireland's First Minister Arlene Foster,
ever the one to cover her back,
as evidenced with the recent RHI Inquiry,
wiping away the tracks
should something come back to bite,
says she she is
"taking my advice from the Northern Ireland Chief Medical Officer,"
so there's someone to
pass the buck onto
should push come to shove.

Her colleague Peter Weir,
the Education Minister for Northern Ireland,
argued that such a decision would be
"counter-productive from a public health point of view,"
despite the pleas of the Archbishop Eamon Martin.

For the present,
they,
like Robin Swann, Health Minster for Northern Ireland,
who spoke after a meeting with
UK Health Minister Matt Hancock
and
NI Chief Medical Officer Michael McBride,
will
"continue to be led by the science."

Not that they particularly cared about the science before,
cherry-picking their usage of it
if and when as it pleases them
to take that stance,
adopt that attitude,
policy,
especially where the
Petition of Concern is, well,
concerned.

Foster's words about aiming to
"flatten the peak of the virus' impact,"
startlingly echo those of
the UK's Chief Scientific Advisor, Sir Patrick Vallance,

(the same "Sir Patrick"
UK Prime Minister Boris Johnson repeatedly referred to in his
speech last Thursday),

when speaking on Radio Four's Today programme on Friday:

"Our aim is to try and reduce the peak,
broaden the peak,
not suppress it completely;
also, because the vast majority of people get a mild illness,
to build up some kind of
herd immunity
so more people are immune to this disease
and
we reduce this transmission."

Although the UK Health Minister Matt Hancock has argued otherwise,
that this is not the official state policy,
the fact is that this looks like
damage control for a potentially risky strategy
and that
the cat has indeed been let out of the bag.

The figure that has been bounced around is

60%.

60%
is the number that has come out
in relation to reports emerging that
ministers wanted as many as
60% of the population to contract the disease
in a bid to prevent it spreading further
among the more vulnerable of our population.

The aim appears to be
to prevent a second wave
of the disease coming round
next winter.

Although,
as usual,
our leaders in Northern Ireland
are disagreeing with each other,
Stormont will fall in line
somewhere between Parliament and the Dáil.

Arlene Foster,
in an instance of politico doublespeak,
within the same statement
emphasised the swift action of the Executive, being there
"right at the start of this process...
to act quickly and proportionately to public health,"
but also the need to take the time to make a decision,
"next week we will be revisiting some of the other issues but
it's important that we do everything in a timely fashion.

Deputy First Minister for Northern Ireland, Michelle O'Neill,
has aired concerns about this, but
in a classic Sinn Fein move,
says one thing publicly and does another behind the scenes.
Although admitting the situation is
"under review," that
Northern Ireland should
"err on the side of caution" and that
"now is the time for action,"
she is part of the joint decisions
between OFM, DFM and the various other departments,
which they insist are based upon scientific evidence.

For all intents and purposes,
the official stance remains unopposed.

It follow then that,
with caution being thrown to the wind
and our province's historical predisposition towards ignorance,
that Northern Ireland is following the
precedent set out across the rest of the United Kingdom.

All of a sudden,
in light of what has been presented,
the Prime Minister's words that
"many more families are going to lose loved ones before their time,"
which could be praised for their cadence and honesty,
take on a far more sobering tone.

As repeatedly emphasised by the World Health Organisation,
a swift all-encompassing, cross-departmental governmental action in tackling an outbreak
has proven to be the most effective measure of approach.

Geographically speaking,
as an island we have an advantage over the mainland,

but still the point remains that
over here we're taking an altogether different outlook,
one which could lead to a very dangerous and costly situation.

Anthony Costello, paediatrician and former WHO director,
said that the UK government was
out of kilter
in looking to
herd immunity as the answer.

Quoting WHO Director-General Dr. Tedro Adhanom Ghebreyesus,
he said,
"The idea that countries should shift from
containment to mitigation
is wrong and dangerous."

(A brief disclaimer must be mentioned before I delve into this section.
With all the misinformation going round,
the last thing I want to do is become
a scaremonger.
However,
I will proceed,

choosing to use the following figures
so as to emphasise the seriousness of the situation.)

Let's pose the hypothetical situation that
the United Kingdom achieves
herd immunity.
60% of the population would need to
get ill or immune,
but it could need
as much as 70% or more
in order to achieve that status.

(at this stage,
I decided to take a walk with the dog.
truthfully,
i was shaken by the
numbers and statistics
I had worked out.)

In the scenario figuring in
60% of the UK's population,
which sits presently at 66.44 million people,
39.864 million people, approximately 40 million people,
would have to become
ill, infected or recover
in order to achieve
herd immunity.

Applying the
mean mortality rate
as estimated by the World Health Organisation of
3.4%
to the sum of 39.864 million,
you reach the figure of

1.355376 million.

That is the
potential number of deaths
in the United Kingdom
in a possible scenario
which would see COVID-19
spiral out of control,

and
that is perhaps
not even the worst case scenario.

(The formula by which I came to this conclusion is taking the population number (PN), multiplying it by 0.6 (60%) of population infected (PI), dividing that sum by 100 and further multiplying it by 3.4, the mean mortality rate (MMR) of 3.4%.

Thus, in basic mathematical terms: 66.44x0.6÷100x3.4=1.355376.)

Apply the same formula to
Northern Ireland,
37168.8,

and to
our neighbours
in the Republic of Ireland,
98532,

who,
as a bordering country
we also run the risk of contaminating.

Now,
obviously these scenarios are not taking into account
the effective quarantine measures which
would no doubt be implemented to
target and control the flow of the disease
before it reaches that stage,

and
there are also many variables involved,
such as the morality rate,
which fluctuates on the basis of
the age and outstanding health conditions of the individuals involved,

but
when it comes to viruses
you are playing with fire,
and
it is wise
not to stoke the flame,
but to
smother it and choke it out.

I do not believe it will reach this stage,
but as evidenced above,
even a small fraction, proportion
of the figures stated,
is a disaster.

Another day has passed and
we have seen a spike of
no less than 330 newly-confirmed cases of
coronavirus.

As stated by the WHO themselves,
it is
"very early to make any conclusive statements
about what the overall mortality rate will be,"

but
it is still
a concern
nevertheless.

Martin Hibberd, Professor of Emerging Infectious Diseases,
department of Pathogen Molecular Biology at the
London School of Hygiene and Tropical Medicine,
said,
"I do worry that
making plans that assume such
a large proportion of the population
will be infected (and hopefully recovered and immune)
may not be the very best that we can do."

This statement becomes
more prescient
when one thinks of
the possibility of
genetic mutation,
COVID-19 changing it's make-up into
something altogether more powerful.

As indicated in the microbiology research article
'On the origin and continuing evolution of SARS-CoV-2,'
using a sample of 103 available SARS-CoV-2 genomes,
the scientists involved identified not one but two major types of the virus,
the minor S-type (~30%) and the major L-type (~70%).

Although the L-type evolved from the ancient S-type,
it is the L-type which transmits or replicates faster in human populations,
accumulating more mutations that the ancestral S-type,
and thus the L-type might be more aggressive due to
potentially higher transmission and/or replication rate.

So, from this evidence we can see already that
two strains of SARS-CoV-2 exist.
Although more prevalent in humans,
it is unclear whether the L-type evolved from the S-type
in humans or the intermediate animal hosts,
or whether the L-type is more virulent than the S-type.

What this shows is that,
although at an early stage to be making
any definitive conclusion,
there is the potentiality for the virus to evolve,
and the possible emergence of
yet another more virulent strain
emphasises the need for further
immediate and comprehensive studies into the subject.

I understand the logic
of
the government's approach,
especially as regards
an already emburdened National Health Service,
the financial implications on the state,
encouraging people to self-isolate
and wanting to get this over and done with
so we can move on to tackle other issues such as
Brexit.

However,
this strange choice of inaction
is also, paradoxically, a quick fix-it strategy,
a rope-a-dope snare of a trap
that is the equivalent of leaving the floodgates open,
letting the terrorist into your city to catch a thief,
instead of an offensive force of active suppression,

and one that
I feel
could cost the lives
of many people.

We still do not even know
the true extent
of
the virus' prevalence,
existence.

In order to perform
a complex operation on the abdomen,
you do not use a machete to
carve out someone's gallbladder,
wrap them up in Sellotape
and hope for the best.
You perform laparoscopy, comprehensive keyhole surgery,
with careful precision, and
stitch them up appropriately.

Although
I don't envy
the Prime Minister
his position,
unfortunately his attitude appears to be
that the cost of human life
is a necessary sacrifice
that he is willing to make
in the pursuit of his strategy
towards the ultimate goal,

endgame.

The great question is
how many
potentially
tens of thousands of individuals
could be affected
before the government decides to
do something about it?

"Europe has now become the epicentre of the pandemic..."
Again, a quote from
Dr. Tedros Adhanom Ghebreyesus.

Italy, France and Spain
are now on lockdown,
even the United States have
extended a blanket travel ban
from Europe to the US,

and yet
Britain plods on,
business as usual.

In the year when Britain is supposed to be
celebrating in reassuming her autonomy,
this could turn into a calamity,
a potential catastrophe.

Already
I can feel the weight
on my back and shoulders,
knowing what could happen.

Every day that passes by
gives the disease time.
It is like having
an open door into your house,
and the guest is more than willing
to accept the invitation of
we, the welcoming hosts.

I am not a scientist,
a mathematician,
a professor
or a statistician,

nor can I claim to be
an expert on these matters
in any way, shape or form,

but
what I am
is a

citizen,

a citizen
who cannot argue
with the evidence
before his very eyes,

and
as a citizen,

I urge,
and cannot emphasise enough,
in the strongest possible terms,
for

swift, immediate action

on the part of our governments
and
our Prime Minster,

not tomorrow,
not the day after tomorrow,
not next week,
not in a fortnight,
not in a month,

but

now,

right now.

Signed, Callum J. McCready, March 16, 2020

(As I typed this out, the number of reported cases in the United Kingdom jumped up again. According gov.uk, "the risk to the UK has been raised to high.")

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