select search filters
briefings
roundups & rapid reactions
before the headlines
Fiona fox's blog
Experts from a variety of disciplines have written joint open letters to the government questioning their response to the COVID-19 outbreak.
Prof Richard Tedder, Visiting Professor in Medical Virology, Imperial College London, said:
“I think on balance the most potent societal response has to be effective social distancing, we saw this work against the odds in Sierra Leone with Ebola and we’ve seen what happens if you don’t have social distancing, for example look at the price that China has paid and Italy is currently paying. The biggest difficulty I see is that the mathematical models are necessarily always speculative and uncertain and yet politicians have to base judgements on them. This makes things very challenging and I agree with those asking to see the modelling data being relied upon by the scientific advisers to Government. For example what happens if we close schools: what degree of changes in social mixing occur in the community as a result? And will the influx of children out of school, bringing their parents back from work, make the rate of transmission greater or less for the country as a whole? These are critical questions and it would be good for the scientific community to see what actual data the current answers from Government are based on?
“I think the point made by the immunologists is absolutely correct. I would also ask are the virological opinions in all of this? We know very little about how the body in the long term handles Covid 19 virus. What we learnt from Ebola was that there are sanctuary positions in the human body from where the immune system cannot remove the virus and that about somewhere around 1/3 of persons recovered from Ebola disease will have spontaneous reactivations and presumably shedding of infectious virus by males in semen potentially re-seeding the outbreak. Could that also be the case with Covid-19? In fact the question should be do we know this concept of sanctuary sites is not the case for this “new to humans” infection? These are scientific questions that we need answers to. And the problem is that until we know more about the reality of the concept of herd immunity this may be a fallacious concept as the immunologists say in their letter. Is the death toll and damage to China, in establishing what appears to be sufficient herd immunity to lead to extinguishing transmissions, a price we should, or need to, pay in the UK? ”
Prof David Spiegelhalter, Chair, Winton Centre for Risk and Evidence Communication, University of Cambridge, said:
“I think that the idea of ‘herd immunity’ will be seen to be a red herring, as it is never mentioned as a short-term goal in the published strategies, and Patrick Valance only mentioned it in relation to the longer term, if the virus returns annually. It’s unfortunate he did not immediately add that this was not a short-term goal.”
Dr Gail Carson, Director of Network Development at ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium), and Consultant in Infectious Diseases, University of Oxford, said:
“During an outbreak the situation and decisions can change quickly. The UK government has explained further about what they meant around herd immunity and that they will share the data behind the decisions of last week. Trust takes time to build and is all to easily broken. The people who are leading this politically and scientifically will be doing their best with little sleep, under stress and in the middle of the fluid situation of COVID19. But we are not starting from scratch, there are many people involved in the response who have been working on pandemic preparedness related issues for years. As I said to some last week, any outbreak will show cracks in systems – political, society, health and the economy. It is for all of us to bind all of the above together. That does not mean not to speak up if you do not understand or disagree, do but then, we have to move on – together.”
Prof Rowland Kao, Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, said:
“Its clear that the recent decision on a ‘softer’ approach to controls, was based on a very tricky balancing act of minimising economic disruption (in an already weak economy that in Brexit is negotiating an excruciatingly difficult transition already) and trying to get through this pandemic crisis with minimal impact on human life. Any policy requires buy-in from the public. Irrespective of the merits of the original choice, lack of buy-in can have severe consequences. Trust is a crucial issue, and if trust is lost, the result can be a haphazard implementation of what was intended. The call for transparency is therefore extremely welcome.”
Prof Martin Hibberd, Professor of Emerging Infectious Disease, London School of Hygiene & Tropical Medicine, said:
“My feeling is that the Government policy is taking a more forward planning approach than many and planning for the next 9 months. This policy means that a peak of cases can be delayed and flattened, perhaps to last over the summer, when the NHS will be more prepared. With the worry that the disease could become more prevalent during the winter, as seasonal Influenza does, this strategy would give some herd immunity during these critical winter months. By pacing the social distancing, the hope is that they can be prolonged over these 9 months. With more intense social distancing targeted at people who are likely to suffer more from the disease, this approach overall is hoped to save the maximum number of lives over this 9 months period. The worry with intense ‘lock-down’ approaches is that they may not be sustainable over this 9 month period.
“Once embarked on this course of action the number of infected people will rise quickly and it will not be possible to change our minds later, as it will be impossible to quarantine these large numbers of people, except at home.
“While scientifically sound, this approach does not take into account the potential for scientific breakthroughs that might occur during this period.
“An alternative approach would be to try to contain the outbreak as much as possible, with the hope that a therapy might become available. Containment can be done using the lock-down approach, which has been shown to work in China. This may suffer from sustainability. Alternatively (and my preferred approach) would be a mixture of extensive case finding through large scale testing and intensive contact tracing, together with targeted social distancing, as successfully used in Singapore. While difficult, these approaches try to protect people for long enough for therapies to be developed that could then be used to treat COVID-19 cases. While a vaccine may take more than a year, a therapy may potentially be available in 6 months if we are lucky and a current drug can be re-purposed against COVID-19.
“It would be good for the UK government to give more evidence on the approach they have taken and its assumptions and evidence, so we can all work together to implement it.”
Prof Sheila Bird, Formerly Programme Leader, MRC Biostatistics Unit, University of Cambridge, said:
“Too little of the UK’s key data on coronavirus are reported publicly in a manner that allows other professionals to appraise them appropriately. For example, we lack information on the age-distribution of successive cohorts of UK’s COVID-19 cases (by sample-date, not confirmation-date).
“And the accumulated test-results for samples taken on or before 13 March 2020 should, within a week, be cross-tabulated by their sample-week and route-into-testing jointly so that public and professional understanding of how matters stood before the important shift to hospital-based testing was announced on 12 March 2020.
“While the switch to focus testing capacity on hospitalized patients is both pragmatic and highly sensible, the switch should be marked by an immediate change in how UK’s test-results are reported. Reporting needs to identify separately the number of hospital-based tests: numbers tested negative; numbers tested positive. Also, but a week in arrears, these hospital-based tests should have their results reported by sample-week and age-group jointly.
“Modelling work is assessed by a peer-group (SPI-M for Modelling) but clarity about the membership of both SPI-M and UK’s Scientific Advisory Group in Emergencies (SAGE) for Coronavirus would be generally reassuring.”
*
1. From the society for immunology
https://www.immunology.org/news/bsi-open-letter-government-sars-cov-2-outbreak-response
2. Main one being cited in media as signed by over 200 scientists.
http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on_coronavirus_measures.pdf
3. From behavioural scientists
https://sites.google.com/view/covidopenletter/home
4. From global health expert and epidemiologists
All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19
Declared interests
None requested