Tuesday 31 March 2020

Kinglake's 19 days in Cairo in 1835, at the worst point of the plague

I loved Eothen when I was, I bitterly regret to say, an idle undergraduate reading anything that was not on my syllabus. I am now rereading Alexander Kinglake's account of surviving the plague in Cairo, attended, if my memory serves me, by a man who had been Byron's servant. 

I thought it was one of the books that one 'had to read', though anything but a chore, but like most of those books my life experience has taught me that nobody else has. Dr Johnson said, talking of Greek and Latin authors, that it is remarkable how little literature there is in the world. Nowadays that's true too of English classics.

Kinglake's nineteen days in Cairo must have been at the high point of the plague, when the death rate rose from 400 to 1,200 a day. He ignored the advice he was given that touching someone with the infection meant catching it. All the people he had anything to do with in the city, including his banker, his doctor and even his magician, died of the plague in those nineteen days. When he did develop a fever he was the very epitome of sang-froid, a French expression for an English thing. He hid the food he had no appetite to eat from his servants and, in the end, a cup of tea made him feel better.
"When first I arrived at Cairo the funerals that daily passed under my windows were many, but still there were frequent and long intervals without a single howl. Every day, however (except one, when I fancied that I observed a diminution of funerals), these intervals became less frequent and shorter, and at last, the passing of the howlers from morn till noon was almost incessant. I believe that about one-half of the whole people was carried off by this visitation. The Orientals, however, have more quiet fortitude than Europeans under afflictions of this sort, and they never allow the plague to interfere with their religious usages. I rode one day round the great burial-ground. The tombs are strewed over a great expanse, among the vast mountains of rubbish (the accumulations of many centuries) which surround the city. The ground, unlike the Turkish “cities of the dead,” which are made so beautiful by their dark cypresses, has nothing to sweeten melancholy, nothing to mitigate the odiousness of death. Carnivorous beasts and birds possess the place by night, and now in the fair morning it was all alive with fresh comers—alive with dead. Yet at this very time, when the plague was raging so furiously, and on this very ground, which resounded so mournfully with the howls of arriving funerals, preparations were going on for the religious festival called the Kourban Bairam. Tents were pitched, and swings hung for the amusement of children—a ghastly holiday; but the Mahometans take a pride, and a just pride, in following their ancient customs undisturbed by the shadow of death.

Coronavirus Tuesday 31 March 2020

To use the most popular opening conversational gambit these days, I am no epidemiologist. I  just try to make sense of the news. I do however mightily distrust the media for good reasons.

32,137 out of the 685,623 people in the world who had tested positive for Covid-19 by Sunday had died - meaning 4.7% - but this death rate is meaningless. Half of people in Iceland who are test-positive have no symptoms and most of the rest have mild cold-like symptoms. This does not tell us much either, except that Iceland tests a lot of people and the virus came to Iceland more recently than to, say, Italy.

What is noticeable and hopeful is evidence that the virus is already surprisingly widespread in many countries and that most cases are not detected because the infected people have few or no symptoms.

Measures to prevent deaths sometimes cause deaths. In a German nursing home for people with advanced dementia, 15 test-positive people died, but not necessarily from the virus. Some of these people may have died as a result of the changes to their routine: isolation, no physical contact, staff wearing masks.

I quote from an interesting article today in the Financial Times:

Mike Ryan, executive director of the World Health Organization’s health emergencies programme, has outlined four factors that might contribute to the differing mortality rates: who becomes infected, what stage the epidemic has reached in a country, how much testing a country is doing, and how well different healthcare systems are coping. But there are other sources of doubt too, including how many coronavirus victims would have died of other causes if no pandemic had occurred. In a typical year, about 56m people die around the world — an average of about 153,000 per day. 

Researchers at the University of Hong Kong have estimated that, in Wuhan, where the pandemic began, the likely death rate was 1.4 per cent — much lower than the previous estimate of 4.5 per cent, which was calculated using official statistics on the region’s cases and deaths. In the UK, where the government has been criticised for a slow initial response, only the most serious cases are being tested. In total 1,231 people have died out of 19,758 confirmed cases, giving a death rate of 6.2 per cent. Rosalind Smyth, professor of child health at UCL, said official UK coronavirus data was “so misleading that it should not be used”. Using conservative estimates, the true number of people infected “is likely to be 5-10 times higher”, she said.  

But different countries are also reporting cases and deaths in different ways: in Italy, Covid-19 is listed as the cause of death even if a patient was already ill and died from a combination of illnesses. “Only 12 per cent of death certificates have shown a direct causality from coronavirus,” said the scientific adviser to Italy’s minister of health last week. Spain’s national government simply lists how many people with confirmed cases of coronavirus have died and provides no extra information on any other medical conditions. 

...In the UK, about 150,000 people die every year between January and March. To date, the vast majority of those who have died from Covid-19 in Britain have been aged 70 or older or had serious pre-existing health conditions. What is not clear is how many of those deaths would have occurred anyway if the patients had not contracted Covid-19. Speaking at a parliamentary hearing last week, Professor Neil Ferguson, director of the MRC Centre for Global Infectious Disease Analysis at Imperial College London, said it was not yet clear how many “excess deaths” caused by coronavirus there would be in the UK. However, he said the proportion of Covid-19 victims who would have died anyway could be “as many as half or two-thirds”. 

Italy does not distinguish between people who die with and people who die of the Coronavirus but there is evidence that many deaths of people with or of the virus are not being reported as such at all. This is very worrying.

I quote Ambrose Evans-Pritchard in The Daily Telegraph. He is pessimistic and alarmist about everything but has strong arguments to alarm us.

We have a ‘real time’ laboratory before our eyes. What is happening at the Italian coal face is not remotely consistent with claims being made by some that the death rate from Covid-19 is akin to seasonal winter flu at around 0.1pc.

....The mayors of Bergamo and Brescia - two Covid-19 hotspots - say the reported deaths in their cities are a small fraction of the true numbers. An epidemiological portrait is easy to construct. You compare deaths since January with seasonal averages over recent years. Corriere Della Sera has done exactly that.

The small town of Nembro has 11,600 inhabitants. Typically it would have 35 deaths over the first quarter. This year it had already had 158 deaths by March 24. Yet the official data counts just 31 Covid-19 mortalities. The implication is that the real pandemic death rate has been four times higher.

The same method showed that deaths were 6.1 times normal in Cernusco and Pesaro, and 10.4 times higher in the city of Bergamo. This is partly because Covid-19 care is crowding out treatment for other diseases. But that changes nothing in practical terms. It is all part of the same drama.
Ambrose Evans-Pritchard suspects that the Government’s original strategy of herd immunity wasted weeks when was happening in Wuhan and Lombardy was ignored and that Boris Johnson 'overruled bad counsel in the nick of time'. I am told by insiders that the reverse is true, that the Scientific Advisory Group for Emergencies (SAGE) wanted a lockdown earlier and were overruled by Boris.

It is too soon to guess at what the social and political consequences of the epidemic will be. Will it mean more globalism and more movement of people or more emphasis on the local?  More respect for experts and the state or less? Fortress Europe or Europe as an immigrant society like the USA?

The virus could symbolise the dangers of globalisation and interconnectedness or it could make young people see the value of both.

David Aaronovtch, archglobalist and neocon, advocate of the invasion of Iraq and ardent critic of Brexit, thinks the latter is certain.

After COVID-19 there will not be some snapping back to ancient virtues of faith, flag and family. Those who imagine that the young, freed from a psychological and social austerity imposed upon them for the sake mostly of their elders, are going to decide to live for ever in such a condition are fooling themselves.

Inevitably NGOs are arguing that conditions in migrant camps make them dangerous breeding grounds for the epidemic but in fact COVID-19 is not a deadly plague slaughtering wholescale like the bubonic plague. It kills overwhelmingly the old and infirm. The migrants in camps or being expelled by Turkey, are mostly in their 20s. To allow them to settle in Europe because of the virus is to give up on a European external border. That in turn means giving up on keeping Europe European.

In the case of Syrian migrants, they can be sent back to Syria in return for some pay off for the Syrian government but very few refugees now are Syrian and those mostly Syrians who have been in Turkey long before the war. Almost all are economic migrants seeking a better life. European states - unfortunately - really must resile from the 1967 Protocol to the Geneva Convention on Refugees obliging them to take in refugees from outside Europe. Turkey has never signed this protocol, by the way.

Monday 30 March 2020

"Coronavirus Threatens European Unity"

The problem with the EU is that it cannot be democratic because there is no European demos. Marx has bedevilled intellectuals from his day to ours with the idea that class is real and nationality is not, but as history has shown time and again (not least when the USSR broke up into 15 countries) nationality and ethnicity are real and drive history, whereas class is (to use a phrase coined by Marxist John Berger) a social construct.

The EU is an artificial construction too. 

Marxists and extreme leftists disagree of course. Here is the view of an Englishman who says he is no longer exactly a Marxist but who does not want to be English or believe there is any English national identity or demos. 

Now we see that the lack of a European demos does not just make democracy impossible at a European level but solidarity (in French revolutionary terms, fraternity) too. How much better the Hapsburgs managed things. Their empire had a monarch, a central government, armed forces and Catholicism and conservatism to give the country purpose, rather than modern liberalism.

I thought EXACTLY the same as the estimable Lilico. 

This essentially is what worries me about what the media reports. They seem to ignore the fact that very large numbers of people over 65 or 70 die everyday anyway, and at times of a nasty new virus the number shoots up a long way.

This may be why Italy and Spain are in grave trouble. In Sweden there are (I was shocked to learn) almost no families in which three generations live together and virtually no mothers who stay at home with their children. Sweden has no lockdown and so far 110 deaths.

Coronavirus in Romania: Monday 30 March

Raed Arafat said last night that in Romania there were 1,815 known Coronavirus cases, 52 patients were in intensive care and 43 people have died.

1,213 people are in quarantine and 162,374 are in self-isolation.

When the number of cases reaches 2000, as it will today, Romania goes up to level 4 of the lockdown.

Since movement restrictions were enforced, on March 25, almost 33,500 people have been fined, with fines totaling RON 46 million (EUR 9.5 million).

I adore long walks and had hoped to enjoy lots of them in deserted streets, but then they brought in the restrictions on movement. 
I left the house only to walk short distances at the weekend, intimidated because the old town in Bucharest, where I live, is full of policemen and women, enjoying the sunshine, chatting and not minding me. I'd love a long walk along the Dimbovita or Calea Victoriei. 

A sporty friend told me she went for a 8 km (5 mile) walk yesterday without any trouble.
Adevarul has a couple of stories of people with declarations written out and in order getting fined. One wanted to go into the centre of Timisoara from somewhere on the edge of town to a bakery that baked bread she liked. Although I too am a gourmand, I think they probably got her bang to rights.

Saturday 28 March 2020

Coronavirus Saturday 28 March

People should isolate themselves and if possible stay at home and work from home. In three weeks we shall have much more information about the Coronavirus. It is much better to be safe than sorry. 

However, there are a lot of interesting scraps of information already that I am trying to make sense of. One of my main reasons for blogging is to clarify my mind.

The most concerning news at the moment is from Italy but what is happening there and why?

In Italy 969 died yesterday with (not necessarily of) the Coronavirus.  Normally, on average, 1750 people die in Italy per day. 

The latest figures from Bergamo show that total mortality there almost quadrupled in March 2020, from 200 to 300 people per month to around 900 people. It is unclear what proportion of this was due to Covid19.

In total, 9,134 people in Italy have now died with Covid-19. Around one in seven are under the age of 70.

A number of people have said that the high number of deaths in Lombardy is a crisis caused by lack of facilities for geriatric care. The ageing population does not help. 

Northern Italy also has the worst air quality in Europe, which has led to an increased number of respiratory diseases and deaths in the past.

Two professors of medicine at Stanford, Dr. Eran Bendavid and Dr. Jay Bhattacharya, say that the lethality of Covid19 is overestimated by several orders of magnitude and probably even in Italy is only at 0.01% to 0.06% and thus below that of influenza. The reason for this overestimate is the greatly underestimated number of people already infected (without symptoms).

Friday 27 March 2020

How infectious is the Coronavirus?

Thousands of foreigners were evacuated from Wuhan city in late January and February and quarantined for 14 days. Back home in their various countries, 0.6% tested positive, so the virus is not very infectious and yet it is, because it gallops fast across the globe. How is this paradox possible?

The British Chief Officer told us a while back that mass gatherings are not dangerous - the disease is spread between people who live or work together. Now we mustn't leave the house unless really necessary - this change of policy in the UK is based on a report from Imperial College, London which is contradicted by another one from Oxford. Neither report is very convincing


For those who remember William Boot's telegrams in Scoop:


Biden is clearly becoming senile

This clip from the Jimmy Dore Show shows that Joe Biden is clearly in the early stages of senility. By the way, CNN describes the Jimmy Dore Show as "a far-left YouTube channel", so Jimmy Dore's mockery comes from the left not the right.

Does every country have the Coronavirus outbreak it deserves?

Every country has the government it deserves, according to Joseph de Maistre. No-one deserves to contract a virus and yet every rich country has the Coronavirus outbreak it deserves. 

The Japanese prefer to make the nation and the economy the first priority rather than the individual, life in Tokyo carries on much as normal but they are very efficient at treating pneumonia. Remarkably few Japanese, 47, are reported to have died of the virus.

The British are laid back and then panic. 

The French, according to an article in Asia Times by Pepe Escobar, corruptly prevented the sale of the antimalarial drug which is said to cure the covid-19 virus and then the stocks were stolen. 

The Americans are fighting a culture war over the virus, as they do over everything.

Italians might say that they did not deserve to have Chinese tourists bring the virus to their shores in a cruise ship, but cruises are a fact of life. On the other hand, the left-wing Italian government did waste time warning against anti-Chinese racism, rather than getting down to the job of looking after its people. 

I was astonished to read last night that

“British Deputy Chief Medical Officer Jenny Harries has told the BBC that ‘overall we are looking at a scenario of over a six month period but not necessarily with a lock down of this level going on throughout that time’.”

On Facebook a friend posted a BBC story that ‘a Scottish diplomat’ has died after getting coronavirus. The BBC should of course have said a British diplomat, but let that pass. What I found very strange is that in Italy recently only two people had died under the age of 60 and both were 59 with ‘serious health conditions’. The average age of people in Italy dying of the coronavirus was 79.5. But several much younger British people have died from the virus including a previously healthy woman of 21 and a boy of 18. Why?

Back on the 29th of February, which seems another age (though it was two months after Brexit) Ross Clark in The Spectator said,

"If you have just cancelled your trip to Venice and ordered your £19.99 surgical face mask from Amazon, how about this for a terrifying vision: by the time we get to April, 50,000 Britons will have succumbed to a combination of infectious disease and adverse weather. Frightened? If you are, don’t worry: you survived. It was two years ago. In 2017-18 the Office for National Statistics recorded 50,100 ‘excess winter deaths’. The explanation, according to the ONS, was probably ‘the predominant strain of flu, the effectiveness of the influenza vaccine, and below average winter temperatures’."

The British government's new lockdown is being compared, favourably or unfavourably, with the previous policy of herd immunity, which is still being pursued in Sweden, the Netherlands, Mexico and Brazil, where people go blithely to restaurants and bars. We shall see how those countries fare.

You will scarcely be surprised that right-wing populist President Bolsonaro of Brazil is bitterly attacked in the English language media for this policy, while progressive Sweden is not criticised at all.

South Korea which seems to have overcome the virus, did not have a lockdown but did have a lot of testing and a lot of spontaneous self—isolation.

Dr. Dan Yamin, an Israeli who has developed models for predicting the spread of infectious diseases and helped curb the Ebola epidemic, has said,

“But there is one country we can learn from: South Korea. South Korea has been coping with corona for a long time, more than most Western countries, and they lead in the number of tests per capita. Therefore, the official mortality rate there is 0.9 percent. But even in South Korea, not all the infected were tested – most have very mild symptoms. 

“The actual number of people who are sick with the virus in South Korea is at least double what’s being reported, so the chance of dying is at least twice as low, standing at about 0.45 percent – very far from the World Health Organization’s [global mortality] figure of 3.4 percent. And that’s already a reason for cautious optimism.”
In Japan the approach that has been tried involves ignoring the virus in order not to damage the economy. Trains and buses are full of people. CT scans are provided for early detection of pneumonia. Expert treatment of pneumonia is provided, the elderly are vaccinated against it and Covid-19 numbers are suppressed by losing them in unpublished pneumonia statistics. Japan has recorded a mere 49 deaths from the virus although how many have died who knows?

The Japanese Medical Association has said that there were 290 cases of doctors deciding patients need to be tested for the virus but healthcare centres refuse to administer the tests. Because few tests are carried out in Japan it is really impossible to know what the fatality rate there is but in South Korea very extensive testing was done, nearly 4000 tests per million people were carried out and the mortality among those infected was only 0.6%. I imagine in developed countries the mortality rate will be something like this or maybe half as much – higher figures reflect paucity of tests.

Japan has the advantage that social distancing is a cultural norm. People rarely kiss or shake hands. Wearing masks for health reasons is also part of their culture – as it will be from now on in Europe - and they are an extremely clean people.

And what of Romania? Romania has a severe lockdown, more severe than the one in England. 1,029 confirmed coronavirus (Covid-19) cases had been reported yesterday, exactly a month after the first one, and the number of new cases in the last 24 hours was 123, down for the second day in a row.

17 people have died. Most were over 65 and already had chronic diseases, according to the authorities. 

Romanians always live in an atmosphere of fear. Now if it is not fear of the virus then it's fear of the police. The streets and shops have been empty for a couple of weeks. The police yesterday were everywhere and more than 5,600 people were fined yesterday for leaving the house without having a good reason. The total value of the fines is over one and a half million euros. We're talking serious money.

Different political tailors cut the cloth of the coronavirus to suit their political purposes. The American left complains loudly about racism. The Old Trumpites see in Chinese viruses examples of the perils of globalisation and ain’t that the sorry truth? Other right wingers see the lockdown as an example of over-mighty state interfering with civil liberties because of misinformation. That might well be true too.  Endless numbers of people somehow try to link Brexit with the coronavirus or attempt in a way that is very transparent to make this Donald Trump's Hurricane Katrina.

Donald Trump I said the virus was only flu. His hunch was right that the mortality rate from the virus be less 1%. Donald Trump II instituted travel bans and a lockdown. Donald Trump III might decide to the economy had to be prioritised above the virus. If so, this could be lethal for his chances of re-election - or it could be the right call. Nobody knows. We are flying blind, people.

Thursday 26 March 2020

Don’t Make Trump Worse

I have no time for people who use the Coronavirus crisis to score partisan points about Boris or the Donald or anybody else. Criticisms of the Chinese Communist Party are something else. 

The American media obsess about fact checking but are intolerably unreliable and politically biassed, consumed with an obsessive hatred for the President. The story of the poor people who died after swallowing fish tank cleaning fluid was a low point. Very low as the media have been, this was yet lower.

I link to a good article in the National Review on this subject by Kyle Smith, headed

Don’t Make Trump Worse

"...The president is not us, but for now he is tied up with us. We want him to succeed, do we not? Is it not obvious that, even if you despise everything the man has ever said and done and want his presidency to end so spectacularly it’ll make the Hindenburg look like a Duraflame log, it would be good for us if he got us through these next few months with the least conceivable damage to life, health, and wealth?

We know that the president is unusually thin-skinned and capricious, that he is keenly and perhaps unhealthily focused on what the media are saying about him at any given nanosecond, that he has a short temper and a quick fuse. He goes through cabinet secretaries like a newborn goes through diapers. And pointing out his errors is the legitimate business of CNN, NBC, ABC, MSNBC, the Washington Post, etc. But the way the media are trying to gin up a feud between Trump and Dr. Anthony Fauci is disgraceful and disgusting.

Folks, and by “folks” I mean you absolute freaking Muppets, are you trying to get Fauci fired? Do we really want to start over with a new specialist in infectious diseases in the White House? Would you be happy if Omarosa were Trump’s chief adviser on epidemiology? Would you be more secure if Jared were the last man standing during the medical briefings?

The incandescently moronic jibber-jabber (I won’t call it “reporting”) about the bizarre case of the Arizona woman whose husband died after taking fish-tank cleaner he and she incorrectly supposed to be the drug Trump touted in the White House is the kind of barnyard waste product that shouldn’t even make it to national news reports, and ordinarily wouldn’t, except that the media seem to be getting a near-erotic thrill out of any scrap of information they think might set off Trump. The dead Arizona man didn’t take chloroquine. He took chloroquine phosphate, in a massive dose. Please run the tape for me where Trump said, “Everybody take a spoonful of fish-tank cleaner to save your lives.” “The difference between the fish tank cleaning additive that the couple took and the drug used to treat malaria is the way they are formulated,” dryly noted CBS News. Oh, you don’t say? Because I was going to put rubbing alcohol in my martini tonight. Or is rubbing alcohol differently formulated than gin?..."

Tuesday 24 March 2020

Where we are now

Italian coronavirus cases are likely to be ‘10 times higher than reported’, the head of the Italian Civil Protection Agency Angelo Borrelli told La Repubblica. This would bring the estimated number of coronavirus cases in Italy is closer to 640,000 rather than the confirmed number of 63,927 of which 6,077 have died. A mortality rate of less than 1% is very much more credible than almost 10%. Fortunately the death and infection rate has recently slowed, no doubt because people do not go outdoors.

Romania is in a state of emergency and the President decreed today that as of tomorrow we have something like the 'lockdown' Boris imposed last night on the UK. 

A canny and experienced British nurse I know told me a week ago that she thought we would be over the worst of this in two weeks. I never thought that likely. In London the Chancellor of the Duchy of Lancaster (minister without portfolio) Michael Gove told Sky News this morning that ‘in three weeks’ time we’ll be able to say whether or not the path we’ve followed needs intensification’.

In an interesting article in Haarretz by Professor Ran Balicer, Founding Director of the Clalit Research Institute, which researches non-communicable diseases, said this about the prospects for

"If we can halt the rate of multiplying deaths within three weeks, we can start a gradual exit from the closure, until we reach the new status quo. We won’t return to the routine of two months ago, but life will return slowly but surely under a new routine. And who knows – maybe the summer will bring a significant easing of the disease, and we will join the countries that succeeded in avoiding disaster."

Monday 23 March 2020

Lies, damned lies and statistics

All figures for mortality rates and for numbers infected with the virus are suspect. All dead and dying people in Italy are tested for the virus although they are usually dying of something else, whereas in Germany dead and dying people are not routinely tested for the virus. This is much of the reason that Germany has far fewer cases of the virus than Italy.

According to Professor Walter Ricciardi, scientific adviser to the Italian health minister, 'only 12% of death certificates have shown a direct causality from coronavirus.' Yet, he says, 'all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.'

Researchers at Imperial College London predicted between 250,000 and 500,000 deaths in the UK from Covid-19, but the authors of the study have conceded that many of these deaths are part of the normal annual mortality rate, which in the UK is 600,000 people per year. Many would have died anyway.

I do not know, because I am not a virologist, if the biggest problem is the number of deaths taking place this year or the fact that the deaths are happening at the same time, depriving many dangerously ill people of beds.

Death in Lombardy

Last week 400 people died in Bergamo and 12 neighbouring towns, which is the place in the world worst afflicted by Coronavirus. 400 deaths is four times the number in the same week the previous year, according to the mayor’s office.

A fourfold increase in the mortality rate since last year is a hard and very alarming fact.

Of those 400 only 91 had tested positive for the virus. What does this mean? That only 91 had the virus, of whom most had other conditions too? Or that many of the others had the virus but hadn't been tested? The history does not relate but the latter sounds more likely to me.

If few tests are being carried out in Lombardy this would explain the very high mortality rate (expressed as the number of people who died with the virus divided by the number of people in whom the virus was detected.)

Sunday 22 March 2020

An Israeli doctor on Covid-19

'And do you know what’s most absurd? That in the final analysis Trump was right. Not that the coronavirus is just plain flu – it absolutely isn’t – but as he put it: ‘This is just my hunch – way under 1 percent’ [will die]. We must be cautious, of course, but at the moment a high probability is emerging that the risks are far lower than what the World Health Organization presented. Under two assumptions – that the health system doesn’t collapse and that life continues as usual – we are not likely to see more than 13,500 victims of the coronavirus in Israel.' (About 45,000 people die in Israel in a normal year, which would make for a rise of approximately one-third.)

Quotations for Sunday morning

“I quote others only in order the better to express myself.” Montaigne

“To be left alone is the most precious thing one can ask of the modern world.” Anthony Burgess, Homage To Qwert Yuiop

“I've spent my entire life playing it safe.. just to avoid being exactly where I am right now.” This Is Where I Leave You (2014) 

“He allowed himself to be swayed by his conviction that human beings are not born once and for all on the day their mothers give birth to them, but that life obliges them over and over again to give birth to themselves.” Gabriel García Márquez, Love in the Time of Cholera

"The salutary effect of surviving a heart-attack: One felt that nothing mattered beyond kindness, good manners and humour." Hugh Montgomery-Massingberd

Saturday 21 March 2020

Boris did not take Chief Medical Officer's advice about lockdown

Modelling by researchers at the Universities of Exeter, Bristol and Warwick has showed that, without any measures to limit it, the Coronavirus epidemic would have peaked in late June or early July. It is reassuring to know this but social distancing will delay the peak for a very long time, unless the epidemic is suppressed by the emergency measures or defeated by drugs that are discovered in the months to come.

Researchers at the London School of Hygiene and Tropical Medicine (LSHTM) estimate that up to 23 million people in the UK may have the virus without symptoms. The Daily Telegraph said the scientists feared that the number might be that hig but they should rejoice if it is so, because people who have had the virus but don't know it will not get it again, at least for some time. This is the herd immunity that the British Chief Medical Officer spoke about at the first Corona virus press conference, standing beside Boris, although the immunity is not necessarily permanent and anyway viruses mutate quickly

Talking of that first press conference, I was told today by a very good source that before that first conference the Chief Medical Officer had advised the Government to adopt the drastic measures that Boris. 

Boris overruled him because, understandably, of the terrible damage they would do to the British economy. That, gentle reader, IS  a scoop. You read it here first.

Good news about the virus outbreak

A combination of zithromax and chloroquine has been shown in a clinical setting safely, effectively and rapidly to clear the coronavirus infection from patients.

These drugs have been prescribed for decades. However, Dr Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases and chief adviser to the White House on the coronavirus, said yesterday that more trials are needed.

Why can't clinical *trials* determine optimal dosage while the drugs are used by doctors today?

In fact, that is what is starting to happen, even though Dr. Fauci in yesterday's press conference created the erroneous impression that this cure cannot be given to the public for however long it takes for clinical trials to conclude. 

More good news. Oxford Economics predicts that the world economy will jump back once this is over - after all consumption and business have been suppressed for medical not economic reasons. 

This is very persuasive, though we do not know how soon the virus will stop being very dangerous and we can expect it to come back, perhaps every year or perhaps whenever the isolation measures are relaxed.

More good news. A test to discover if a person has had Covid-19 (and therefore be significantly more immune) is expected to become available imminently.

Antiracism and the coronavirus

Dr. Giorgio Palù, Professor of Virology and Microbiology at the University of Padua, says that decisions on travel restrictions and border controls were taken too late because of politically correct fears.

The attempts to minimise potential "racism" and "stigmatisation" in response to the corona virus were an initiative of the World Health Organization (WHO), which was then adopted by the left-wing Italian left.

In February, the mayor of Florence went a step further and launched a campaign urging Italians to hug a Chinese in the street to "stop the hatred".

Friday 20 March 2020

Books on the plague to read on your Kindle while self-isolating

What books are there to read on the plague? A surprisingly long list. 

Defoe's Journal of the Plague Year. 

Camus's The Plague. 

The Masque of the Red Death by Poe. 

The Decameron, which my father told me was naughty but which seemed disappointingly proper to me as a child. 

Love in the Time of Cholera by Marques, which I liked but never finished in hospital 30 years ago, in a country that no longer exists. 

Death in Venice. 

Old St Paul's. Available for free on Kindle. In my early adolescence I decided that it looked creaky and melodramatic and was no longer a book one 'had' to read, but I think it will be fun now.

Pepys's and Evelyn's diaries cover the Great Plague of London in 1665 and the Great Fire the next year. I found Evelyn much less fun than Pepys. 

I recommend much more Kinglake's account of the plague in Cairo, where he found himself surrounded by dead and dying Cairenes.

The Roses of Eyam, about the Great Plague of 1665 in a Derbyshire village, was the most moving TV programme I ever watched (today it would be called a film). It reduced my mother, sister and me to floods of tears. My father refused indignantly to watch it. It's on YouTube.

I asked on a forum I belong to on Facebook for suggestions and received these. They included a book we all mean to read but few do, Manzoni's The Betrothed, The Last Man by Mrs. Shelley, which I hope is less dull than Frankenstein, and The Painted Veil by Somerset Maugham, which I am sure is more fun than Mrs. Shelley.

The other titles were unknown to me and form a long list.

Pale Horse, Pale Rider by Katherine Anne Porter

Plague Maker - Tim Downs

Company of Liars - Karen Maitland

Doomsday Book by Connie Willis

Fever by Deon Meyer – ‘best book of the last 100 years’ said the man who recommended it.

I Am Legend by Richard Matheson

Y: The Last Man by Brian K Vaughan

Don Lawson Pale Horse, Pale Rider by Katherine Anne Porter

Shirley Jackson  The Lottery

Blindness, by Jose Saramago

L'Œuvre au noir, Marguerite Yourcenar

Year of Wonders by Geraldine Brooks and The Dress Lodger by Sheri Holman.
Lucretius, the plague of Athens in De rerum natura.
Year of Wonders

Stephen King's The Stand – he’s pulp fiction, isn’t he?
Jose Saramago, Blindness.

Diane Gardner Premo Station Eleven by Emily St John Mandel.

Hesse, Narcissus and Goldmund

The Corner that Held Them, by Sylvia Townsend Warner.

Zone One by Colson Whitehead

The Great Believers, by Rebecca Makkai

The Holy Bible, Exodus 11-12 KJV. Exodus 7-12 RSV.

Virus update 20th March 2020

Romanians face up to 15 years in prison if they know they have the disease, break the quarantine rules and someone gets infected and dies as a result of their actions.
Anyone failing to respect quarantine rules faces up to three years in prison and up to five if his actions leads to the infection of someone else.

Around 3,800 people have been placed in quarantine in Romania, because of returning from high-risk places or being in contact with a confirmed or suspected coronavirus patient.

Things are starting to return "not to normal but a new normal" in China, according to an article in yesterday's Daily Telegraph.

Donald Trump said finding that the malaria drug hydroxychloroquine cures the virus was a "tremendous breakthrough" and said it would be available almost immediately to fight coronavirus. But the FDA contradicted him.

Other drugs are said to be effective too. The Australians have found one, as I blogged previously.

Ambrose Evans-Pritchard, international business editor of the Daily Telegraph, writes that the EU has failed badly once more.

America has mobilized for total economic war. The Trump treasury, the Pelosi Congress, and the Federal Reserve have come together with formidable force.

Washington was slow to act. Covid-19 denialism wasted three vital weeks. But the US is now moving with the sort of determination shown after Pearl Harbour. It is an impressive beast when roused, even if it cannot alone stop markets repricing the frightening reality of an economic sudden stop for the whole planet.

It is Europe that now looks bitterly divided and incapable of meaningful action, the world’s weakest link, and rapidly becoming the greatest danger for the international financial system.

Bel Mooney put a very good post on Facebook.
"I just made a comment on somebody's timeline which I will share here. It is so depressing to read carping about Boris Johnson all over the place and the opinion that naturally Corbyn would be better. So this is what I put - and I'm not inviting discussion, just telling you what I think. Which is pretty straightforward.

"I have no doubt Corbyn would stumble along, out of his depth but doing his best - just as BJ is. And so would Keir Starmer. Which politician of any stripe has the magic bullet to see off a deadly virus, a collapsing economy, a people in need, food panics, and the rest? The people who are still carping along tribal political lines have already stripped the shelves of their brains - not only of intelligence but of decency and fellow-feeling too.'"

I agree with her. Same goes for the USA but, at the risk of being political myself, I do think it should be remembered by everyone that Joe Biden and Ursula v d Leyen condemned Trump for his ban on people coming to the EU from Schengen.

What absolutely disgusts me are the people tweeting that the Tories are happy for the poor to die. People who think like that are very contemptible. And I usually never feel contempt. Not even for David Aaronovitch or the Liberal Democrats. 

“All of man's problems come from his inability to sit quietly alone in a room.”

“All of man's problems come from his inability to sit quietly alone in a room.” Pascal

"Solitude is the school of genius." Gibbon

I have self isolated for years and I love it. Some friends who, unlike me, are married with children tell me the same thing. 

Thursday 19 March 2020

British Chief Scientific Advisor thinks there might be a 'death rate of one fatality for every 1,000 cases'

The British Government's Chief Scientific Advisor, Sir Patrick Vallance answered questions from the House of Commons'  Health and Social Care Select Committee on Tuesday afternoon. The Committee chairman Jeremy Hunt asked him whether the expected death rate was one fatality for every 1,000 cases, which would mean that there is "potentially 55,000 cases".

Sir Patrick replied: 

"We've tried to get a handle on that in SAGE (the scientific advisory group for emergencies) and if you put all the modelling information together, that's a reasonable ballpark way of looking at it. It's not more accurate than that."

Let's hope the mortality rate is 1 in 1,000, the same rate as for flu. Disregard numbers of coronavirus cases reported in different countries, because they largely reflect how many people in a country were tested. This is why rich or important people, like the new Romanian Prime Minister, are announcing that they have the virus. They undergo tests. Figures for deaths are very much much accurate.

Wednesday 18 March 2020

C. S. Lewis on how to face atomic war

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“The first action to be taken is to pull ourselves together. If we are going to be destroyed by an atomic bomb, let that bomb, when it comes, find us doing sensible and human things - praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts -- not huddled together like frightened sheep and thinking about bombs. [Bombs] may break our bodies (a microbe can do that), but they need not dominate our minds.”

C. S. Lewis (acknowlegements Madalina Dobraca)

Lockdown might last a year or even more

An unusually empty Piccadilly Circus in central London
Piccadilly Circus

Immediately after Boris Johnson, on scientific advice, had gone from being laid-back and British about the killer virus to ordering everyone who could do so to keep away from everyone else, Professor Neil Fergusson, England's leading epidemiologist, explained the reasons to a press conference of science journalists. He told them that he hoped for only 20,000 coronavirus deaths in the UK, rather than a possible 260,000. He said that, were no measures taken at all, between 400,000 and 550,000 people would die.

The change in strategy had been necessitated by new data. Whereas the new social-distancing measures had been temporary, now they would need to continue until a vaccine or treatment was found, which could take a year or more. 

New data has caused this change but, in any case, the British Government's Chief Medical Officer, whose modest but authoritative manner at press confidences is universally admired, had been giving the government and country culpably bad advice. 

He, you recall, said that large numbers, even a majority of the British population would be infected and this would provide the population with herd immunity, meaning the virus would not come back each year.

Saloni Dattani, a PhD student in psychiatric genetics at King's College London, writes this in Unherd:

Finally, there is a lack of evidence that lasting herd immunity to COVID-19 was possible in humans when acquired by infection, and that recovered cases would be prevented from reinfection. “Typically coronaviruses don’t make long-lasting antibody responses,” tweeted Brian Ferguson, an immunologist at Cambridge University, adding, “if this is a deliberate approach it’s not scientifically based and irresponsible.”

The Government’s chief medical advisor claimed that part of the reason he believed cases in China had declined was because 20% of the Wuhan population had been infected by the virus and had acquired herd immunity and because a large proportion of cases were asymptomatic. 

But as mentioned previously, evidence from researchers at the London School of Hygiene & Tropical Medicine estimated that 94.8% of the Wuhan population were still susceptible to infection at the end of January (i.e. had not been infected by the virus) and that “there was evidence that the majority of cases were symptomatic.” Daniel Falush, a statistical geneticist at the University of Bath, tweeted that these claims were contradictory, adding that “unfortunately, tragically, this error is driving UK policy right now.”

...The evidence was not conflicted, it was clear: the Government’s strategy of delaying the peak and inducing herd immunity was unscientific, unfeasible and dangerous. It is hugely unfortunate that the Government delayed aggressive social distancing measures, which will have already caused avoidable deaths and suffering, but it is encouraging that they quickly reconsidered many of their initial plans — for the damage must be mitigated swiftly. Countries around the world considering the British strategy should seriously reconsider. Containment is possible. Containment is necessary. Containment must be the goal.

Tuesday 17 March 2020

Oh let us never, never doubt what nobody is sure about

A wide range of opinions are confidently proffered on the virus, its provenance and its effects on economics and politics. That is without the exotic absurdity of the preposterous, crackpot theories that the virus is germ warfare developed by the CIA, the Chinese or (inevitably) Mossad. 

Israeli virologist Professor Jihad Bishara said on television that everyone should to calm down.
“I’ve been in this business for 30 years. I’ve been through MERS, SARS, Ebola, the first Gulf war and the second, and I don’t recall anything like this. There’s unnecessary, exaggerated panic. We have to calm people down.

“People are thinking that there’s a kind of virus, it’s in the air, it’s going to attack every one of us, and whoever is attacked is going to die.

“That’s not the way it is at all. It’s not in the air. Not everyone [who is infected] dies; most of them will get better and won’t even know they were sick, or will have a bit of mucus.

This is good to hear. So is this news item from Australia.

"University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au today they have seen two drugs used to treat other conditions can wipe out the virus in test tubes.

"He said one of the medications, given to some of the first people to test positive for COVID-19 in Australia, had already resulted in "disappearance of the virus" and complete recovery from the infection."

"One of the two medications is a HIV drug, which has been superseded by "newer generation" HIV drugs, and the other is an anti-malaria drug called chloroquine which is rarely used and "kept on the shelf now" due to resistance to malaria."
The Americans and Israelis are working on vaccines and hope to have them ready soon, but who knows when or whether they will be be found?

My hope was that warm weather would clear the virus away till the autumn, as it does flu, but there is bad news in a scientific paper from Harvard University, that argues that the virus won't go away when the warm weather comes. Let us hope the paper is wrong.

Why the huge discrepancies in reported mortality rates? The WHO mortality rate of 3% for Wuhan some weeks ago was obviously very wrong because it ignored the many people infected who were not reported. The real mortality rate seems to be one percent or less. Donald Trump's hunch was right.. 

In Italy I have read of mortality rates of 7% or 5% and different explanations are given for why they are so high, like an ageing population and pollution. Poor testing seems a much more likely explanation to me. 

The British Chief Scientific Adviser Sir Patrick Vallance today said he had no way of knowing but thought a mortality rate of 0.1% is his ball park estimate of how many will die in the UK. That is the mortality rate for normal flu.

A very heretical view was expressed a week or so ago by Wolfgang Wodarg, a German doctor and former SDP MP. He did not think more people were dying than die of flu in other years. He argued that the Coronavirus was a statistical anomaly due to over testing using the PCR test, but this does not explain why Italian hospitals are overwhelmed.

He makes what seem like good points about discrepancies in testing between countries but his conclusions seem to have been overtaken by events. His website has been blacklisted by Wikipedia.

58,000 people died of new flu strains in the UK two years ago, without anyone noticing. It would be good if as few as that died this time. The British Government's central estimate of total deaths from the virus and flu this year is 100,000 but let us hope it is less than 60,000, which would vindicate Dr Wodarg, though the death toll of 58,000 was an outlier.  But for now his words seem dangerously complacent.

Allison Pearson in the Daily Telegraph today makes a very good point about the usual numbers who die each year of flu.

"Normal influenza kills an average of 17,000 in England every year. That makes it sound like we’re over-reacting to this beastly Chinese interloper until you realise that those 17,000 people are already having to share just over 4,000 adult critical care beds. Quarantine will not be totally effective, but at least it will slow the rate of transmission, giving the health system more time to manage the load."

Romanian deputies vote one by one in special room to support new government

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The emergency parliamentary session to vote on the new government took place in a disinfected room. MPs wore surgical masks and disposable gloves and entered one by one to cast their votes. The vote to support Ludovic Orban's government was carried overwhelmingly, supported by most of the opposition, despite the same government having lost a vote of confidence last month.

The new PM and most of his cabinet did not attend the parliamentary vote, because they are in self-quarantine, after a senator of their party, the National Liberal Party, was found to be infected with coronavirus.

In the midst of the great coronavirus scare of 2020

In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 cases of influenza-like illness (ILI) cases occurred in Italy. 9% of Italians caught ILI. There were more than 68,000 deaths attributable to flu epidemics. In other words, the average number of deaths from ILU over those four years was 17,000. This was roughly the same figure as in the UK.

The proportion of people infected with the new strain of coronavirus who die ('the mortality rate') entirely depends on how many cases were detected, which in turn depends on how many were tested. Most people who catch it have no symptoms at all. Others think they have a cold or mild flu, so are not reported or tested.

In previous years various types of coronavirus existed but no tests were made for them and no figures kept, so no comparisons can be made.

I don't know whether this suggests that there is less to worry about than people think but I certainly hope so. Still it's probably a good idea for Romania to close her borders.

I read somewhere that the overall death rate in Italy recently has not been higher than in other years, but I have absolutely no idea if this is true. That is what to look at, but certainly a lot of people are dying suddenly in Italy - eight priests in Bergamo alone!

I note the ridicule of Donald Trump by clever people when he banned people from most of the EU entering the USA. Joe Biden said it was reactionary and pointless. So did Justin Trudeau's government two days before he did the same thing. Macron also turned on a coin yesterday.

I still hope it all turns out to be an exaggerated scare like bird flu and swine flu, which killed lots of people but which were not nearly as bad as people predicted. If it does WHO needs to be reformed.

I do not have an opinion on how bad this crisis will be or how long it will last, beyond hoping and suspecting it will be less bad than people imagine. Experts, whom everyone prefers these days to politicians or bishops, and with reason, say different things. Remember the Hollywood maxim: nobody knows anything.

Still discretion is the better part of valour. As Leonardo de Vinci said, cowardice preserves life just as courage endangers it.

Saturday 14 March 2020

Very hopeful news from the Orient

From the South China Morning Post, March 8.
"The Guangzhou team based their study on every novel coronavirus case confirmed around the world between January 20 and February 4, including in more than 400 Chinese cities and regions. These were then modelled against official meteorological data for January from across China and the capital cities of each country affected.
"The analysis indicated that case numbers rose in line with average temperatures up to a peak of 8.72 degrees Celsius and then declined."

(Acknowledgements, Mark Patton.)

Denmark, Czechia, Slovakia and Poland self-isolate - should Romania do so?

Danish borders will close at 12 noon today and air, ferry and train transport will be completely or partially halted to prevent the spread of coronavirus.

The Danish Prime Minister (42, female, Social Democrat, Donald Trump called her nasty for not wanting to sell him Greenland) said that until April 13 all foreigners with no good reason to enter Denmark will be turned away at the border. That includes all tourists. Danish citizens will always be able to enter.

The armed forces will be present at the border to back up immigration officials.

The measure comes after 801 people in Denmark have been found infected with coronavirus. Twenty-three of them are in hospital, four of them in intensive care, two of them are in critical condition.

However, the actual number of infected people is higher, as the National Board of Health no longer encourages people to call the doctor unless their symptoms are serious.

The Polish Prime Minister (51, male, a crunchy conservative, strongly opposes abortion and immigration from the Maghreb) said his government will do the same and go further. 

Restaurants, bars, casinos and some shops will be closed. 

At midnight tonight local time, Poland will suspend international flights and international railway connections. 

Poles returning to their country will undergo a two week quarantine. 

Slovakia is closing the country’s international airports and stopping all international bus and train travel. Czechia will bar all foreigners except for those with Czech residence permits starting on Monday.

Spain is ordering people not to leave home except to buy food and pharmaceutical products, go to and from work and to and from hospitals. Italy did this last week. 

Israel has forbidden entry for a long time to everyone coming from a host of countries where the virus exists and so far has 126 people infected out of a population of nine million.

Should Romania do likewise? Yes, as a short-term precaution for a couple of months, though I very much hope and I think that by the early summer things will be looking much better and the virus will turn out, like flu, to be a winter illness. 

Romania may well do so any day, which is why yesterday I reluctantly cancelled my trip to London to see Sir Tom Stoppard's hit play and meet friends in an eerily deserted West End.

The Polish and Danish policies are the exact opposite of the British Chief Medical Officer's view that widespread infection is inevitable and in some ways desirable, because it creates 'herd immunity' and will deter the virus from returning in future years. 

There are very many big differences between Britain and Romania. One is that Britain has a first class health service. Romania has a very unsatisfactory health service indeed, to put it mildly, and British hospitals might well be overwhelmed. Everything possible has to be done to contain the numbers admitted to Romanian hospitals. 

The biggest problem for Romania is the 1.3 million Romanians who are or were living in Italy, by far the largest immigrant community in Italy. Many are or will be out of work and have nowhere to go but home. Most would normally spend Easter (which is much bigger thn Christmas here) in Romania.

Over 40000 people who left or passed through Italy have entered Romania since February 23. The Romanian government has asked them to stay put and stopped direct flights but they are driving back or flying via third countries.

If I sound like I am panicking about the virus, I am not. I hope and suspect that it will spread much less widely than is feared, but it still makes very good sense to take stern precautions, looking at what is happening in Italy. I hope this will be yet another quasi-eschatological scare like mad cow disease, avian flu and swine flu. 

How many died from swine flu in the epidemic of 2009?

They now think maybe 203,000 people worldwide, which is ten times more than was thought at the time, but only half as many as an estimate by researchers in 2012. Yet I recall no panic. In fact I scarcely recall swine flu at all and do not remember reading about it much at the time. People thought it reduced world GDP by 1%. They feared it might trigger a recession, but it didn't.