Covid-19, the magic microbe

Let’s look at WuFlu in computing terms. China has (belatedly) chosen to be like my laptop (Windows 10/Chrome): clogging the system with compulsory protection, spying on every move and constantly interrupting with tailored messages. However, the annoying interference has resulted in a slowing of the rate of new Covid-19 cases to below the UK’s when you adjust for the size of their population, which is 21 times greater than ours.

Now let’s look at the West. Our idea of panic is amassing unfeasible quantities of bog roll and stealing hand sanitisers from hospitals, where if the staff can’t ensure their hygiene we are all in deep doo-doo; hence no doubt the obsession with toilet tissue. (Though behind us at the Lidl checkout a family was stocking up on pasta, handwash – and a stone weight of white sugar. Priorities!)

In contrast to such pathetic prepping, get this: a relation who works in the NHS tells us that a theatre nurse who had just returned from Thailand was asked for a throat swab to check she wasn’t infected – and she refused, forcing the administration to send her home. Operating theatre – patients with open wounds - sterile environment ultra-important – highly trained nurse fully cognizant of implications – my mind is on Planet Boggle.

Or how about Italy’s possible ‘Patient Zero’, who had come from abroad and tested positive for the coronavirus? He was told to self-isolate but ignoring the instruction, continued his work delivering food from a Chinese restaurant until the carabinieri sent him home and closed the business. https://translate.google.com/translate?hl=en&sl=it&u=https://www.adnkronos.com/fatti/cronaca/2020/02/29/coronavirus-positivo-test-viola-quarantena-consegna-cibo-domicilio_JSYcH3sUwZ5TatMYxiUgWM.html&prev=search

Then there’s VICE News’ reporter Julia Lindau, who came back to the USA from northern Italy and tweeted her amazement at walking through JFK’s customs barrier without being asked any health-screening questions. https://twitter.com/julialindau/status/1235714275752267776?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

Is it that viruses aren’t perceived as real? After all, we can’t see them, not even with an optical microscope. We have to take their existence on trust from scientists and medics, like the crazy stuff physicists give out about ‘hexaquarks’ and ‘dark matter’ https://www.space.com/hexaquarks-big-bang-form-universe-dark-matter.html ; and precautions against infection can resemble magic gestures to ward off demons, as e.g. the disinfectant-spraying in this Chinese training exercise (why the outside of the car?) https://observers.france24.com/en/20200228-china-video-police-fishing-net-arrest-coronavirus-covid-fake-news . Perhaps singing Happy Birthday twice while washing one’s hands is a form of incantation.

So, many Americans must have been reassured when the White House told them (or more importantly, the stock markets) that the US had it all under control https://abcnews.go.com/Politics/trump-coronavirus-control-us-problem/story?id=69198905 , only later having to admit to a national shortage of testing kits https://www.bbc.co.uk/news/world-us-canada-51761435 so that the apparent concentration of cases in Washington State was likely a dangerously comforting illusion. https://www.nytimes.com/2020/03/04/us/coronavirus-in-washington-state.html

In the UK, England’s Chief Medical Officer tells us there is now a “very slim to zero” chance of avoiding a worldwide pandemic; accordingly, we are moving from mostly attempting to contain the virus to a “mainly delay” response to slow its spread. https://inews.co.uk/news/health/coronavirus-uk-death-elderly-patient-hospital-spread-2106832 Although fatalities are much more likely among the old and/or those with certain underlying health conditions, the real challenge for the NHS is the possibility of being overwhelmed with critical cases. As an intensive care unit (ICU) doctor explained in the Guardian https://www.theguardian.com/commentisfree/2020/mar/03/icu-doctor-nhs-coronavirus-pandemic-hospitals , thirty (but it could be up to sixty) per cent of the population could become infected, with perhaps one in thirty-five of those needing an ICU bed. The maths of that means over half a million acute cases – when the country has only some 4,000 ICU beds and those are already 90% committed to other needs. Even if the danger has been overestimated by a factor of one thousand, the NHS faces a potentially impossible challenge. Charles Hugh Smith points out that this lack could contribute to a higher death rate among severe cases.  http://charleshughsmith.blogspot.com/2020/03/the-gathering-storm-could-covid-19.html In preparation, our NHS relative tells us, BOC are producing more oxygen bottles, and Army Medical Corps personnel are receiving training in ICU nursing, so somebody up there is still trying to plan responsibly.

Ironically, where at first we feared the spread of Covid-19 from China, now, thanks to major efforts at containment that have not been abandoned as hopeless, the Chinese are worrying instead about the possibility of reimporting the disease from abroad. https://www.aljazeera.com/news/2020/03/china-worries-coronavirus-surge-infected-arrivals-200304062507995.html There will be no casual strolling through airport customs there.

Among the rest of us, the reactions vary from sanguine (‘M.D.’ in Private Eye says ‘We’re all going to die, some much sooner than others’) to the sanguinary ‘Darwinian thinning out of the herd’ (forgetting that the most vulnerable demographic will have bred at least one succeeding generation already.)

Covid-19 has raised a key debating point: who gives a stuff about the old, anyway?

FRIDAY MUSIC: I'm With Her, by JD

More Americana/roots/folk music, this time from a trio of ladies you may not know. Sara Watkins is new to me but Sarah Jarosz and Aoife O'Donovan are familiar faces (and voices) from their appearances on the BBC series Transatlantic Sessions.
https://www.transatlanticsessions.com

Collectively they record as "I'm With Her."
https://en.wikipedia.org/wiki/I%27m_with_Her_(band)

....comment on the first video - "I heard that they had to put them in different rooms in the studio, not because of sound but because if you put so much talent and perfect pitch in one room, the studio spontaneously combusts." .... now ain't that the truth. three very talented musicians as individuals become almost perfect in harmony!

Salisbury poisonings (Skripal case) and Operation Toxic Dagger

Two years after the kerfuffle over the alleged attempted novichok poison assassination by two Russian agents of ex-spy Sergei Skripal and his daughter - a story full of curious anomalies https://www.theblogmire.com/the-salisbury-poisonings-two-years-on-a-riddle-wrapped-in-a-cover-up-inside-a-hoax/ - a detail comes up that could connect the dots in a different way.

The Off-Guardian https://off-guardian.org/2020/03/04/the-skripal-case-two-years-on/ says that while the two Russian suspects were crashing around seemingly trying hard to draw attention to themselves, there was a major multi-agency military training exercise ongoing, focused on our preparedness for chemical warfare:

• The person who found them was the most senior nurse in the British Army (likely in the area as part of Toxic Dagger, the British Military’s landmark chemical weapons training exercise which began Feb 20th and ran on until March 12th).
• The nurse and her family administer “emergency aid” to the two alleged poisoning victims. Neither she nor anyone else on the scene, nor any of the first responders, ever experience any symptoms of nerve agent poisoning. Neither do any of the other people the Skripal’s came into contact with that day.

Is it possible that the Russians, who had travelled to Salisbury on Russian passports, were tacitly permitted to wander about as observers during the exercise?

Were the Skripals somehow part of the exercise, and of a more complex play?

I prefer spooks and their games to be confined to the covers of John Le Carré books.

(For more on Toxic Dagger, see also https://www.gov.uk/government/news/exercise-toxic-dagger-the-sharp-end-of-chemical-warfare)

Covid-19: Getting A Grip

As cases of Covid-19 approach six figures globally and have passed the half-century in the UK, our government has released its Action Plan https://www.gov.uk/government/publications/coronavirus-action-plan (3 March). Before we look at it, let’s consider some other points.

We’ve been relatively lucky here and in the US. The virus reached us towards the end of the winter flu season and thanks to a reasonably cleanly populace and alert medics ready to jump on new cases and take the more serious to specialist facilities, the situation has the appearance of being so well under control that wiseacres are telling us we’ve been over-reacting https://www.americanthinker.com/articles/2020/03/coronavirus_stay_calm_and_avoid_the_hype.html and pass the port, old boy.

However, we could be in a Phoney War period. It seems that although Covid-19 is fatal to a small percentage, the potential scale of deaths relates more to the number of possible infections and nobody has an immunity. It’s not just a Chinese illness: early on, a Chinese study was released saying that East Asians might be more liable to contract the disease because of a genetic difference in their lung cells; yet as of 4 March 16:27 GMT https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 , in Iran 92/2,922 have died, in Italy 75/2,502 – a death-to-case ratio of three per cent in each case.

This coronavirus has now hit Africa, South America and the Middle East, where health screening and treatment systems are not universally well-developed. A coronavirus simulation exercise conducted a few months before the real outbreak concluded that on average, the world’s nations were only forty per cent prepared to deal with a pandemic https://hub.jhu.edu/2019/11/06/event-201-health-security/?fbclid=IwAR36gEPN_cBanQvewvO19pWHifTMP-aZ5PWea8B2GpjygFe2LVc1YTANuMY . ‘WuFlu’ could go on to brew away among the billions in the southern hemisphere, where autumn is on its way. There is also the Islamic community, for whom pilgrimage to Mecca is one of the Five Pillars of religious duty, incurring a ‘super-spreader’ risk as noted by Shahul H Ebrahim and Ziad A Memish in the Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30466-9/fulltext (27 February). Moreover, there are many other holy sites visited by millions of pilgrims, including internally within Iran, so flight restrictions do not completely solve the problem.

A great global reservoir could be building up, and we shall know what we’re facing when Britain comes again to seasonal flu time. Paradoxically, the fact that for many the illness will be mild, even unnoticed, makes the situation worse because those people will likely go about as normal and stand to infect others. We should use our Phoney War period to plan and rearm.

So we shall. Tony Blair was fond of the phrase ‘joined-up government’, although in practice, joined-up writing looked like a bit of a stretch, except where systemic socio-economic and constitutional vandalism were concerned. Johnson’s first big test has turned out to be, not Brexit but disease. I don’t know whether it’s quite fair to suggest that Etonians generally have a penchant for delegation to ‘little men who do that sort of thing’ but BoJo’s appointee Dominic Cummings has arrived just in time to try out his own theories in respect of the effective management of public affairs, and I assume this ‘Coronavirus: action plan’ document has his fingerprints on it.

The challenge is to strike a balance between showing the government is prepared, and scaring us. It’s not so much a death-puppet that waggles at us, but the prospect of overburdened hospitals and health services, and significant disruption to daily life. 

At present, for every person who dies in hospital (thankfully, nobody in Britain, yet) there are several more in intensive care, plus further numbers within hospitals and even more at home. The team has thought of this (point 2.7) and estimates that at its peak the disease may cause up to a fifth of workers to be absent from duty. This has been repeated in the news media and BoJo has undertaken to allow Statutory Sick Pay to be paid from the first day of illness. https://www.independent.co.uk/news/uk/politics/coronavirus-news-boris-johnson-statutory-sick-pay-self-isolation-a9374696.html

The general treatment strategy (2.9) is fourfold: Self isolation, managing symptoms, support for patients with complications, but most people to manage at home.

The wider strategy (3.7) is to Contain, Delay (to allow time for more clement weather, for research and the development of a vaccine – but paragraph 4.25 notes the need to weigh the ‘social costs’ of implementing actions), Mitigate the consequences, and continue with Research. À propos the last, the document notes (4.32) King’s College London’s work on ‘Emergency Preparedness and Response’ and (4.33) Imperial College’s unit developing Modelling Methodology.

The plan also reminds us of the complexities of devolved government, so HMG is taking that into consideration. Let’s hope that TV interviewers think twice before macho, pen-twiddling ragging of central government ministers about matters for which regional government is responsible https://conservativewoman.co.uk/narky-newman-plumbs-new-depths/ .

A point that is both reassuring and worrying is in (4.8): ‘new powers for medical professionals, public health professionals and the police to allow them to detain and direct individuals in quarantined areas at risk or suspected of having the virus.’ Let us hope the Opposition will keep a beady eye on the potential for abuse of such powers, and insist on periodic reviews and sunset clauses.

The paper reminds us that Dad can’t do it all for us, and the advice is worth quoting in full:

4.34 Everyone can help support the UK’s response by:

• following public health authorities’ advice, for example on hand washing

• reducing the impact and spread of misinformation by relying on information from trusted sources, such as that on www.nhs.uk/ , www.nhsinform.scot, www.publichealth.hscni.net , https://gov.wales/coronavirus-covid-19 and www.gov.uk/

• checking and following the latest FCO travel advice when travelling and planning to travel

• ensuring you and your family’s vaccinations are up to date as this will help reduce the pressure on the NHS/HSCNI through reducing vaccine-preventable diseases

• checking on elderly or vulnerable family, friends and neighbours

• using NHS 111 (or NHS 24 in Scotland or NHS Direct Wales) (including online, where possible), pharmacies and GPs responsibly, and go to the hospital only when you really need to. This is further explained on the NHS website - www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergencycare/when-to-go-to-ae/ and http://www.choosewellwales.org.uk/home

• being understanding of the pressures the health and social care systems may be under, and receptive to changes that may be needed to the provision of care to you and your family.

• accepting that the advice for managing COVID-19 for most people will be self-isolation at home and simple over the counter medicines

• checking for new advice as the situation changes.

So far, so good – it feels as though intelligent management is in charge. ‘Keep calm, and carry on.’

Filthy: the treatment of Julian Assange

‘To this day,’ wrote the journalist and humourist Patrick Campbell in 1967 https://www.abebooks.co.uk/9781851453160/Life-Easy-Times-Patrick-Campbell-1851453164/plp , ‘I remain pretty well unmoved by politics... But when something happens today, as it often does, that has the flavour of Berlin, in 1933, I’m very liable to describe it as ‘filthy’. It’s the nearest I can get to making a protest on behalf of humanity.’

The way that Julian Assange has been and is being treated, is filthy. With what anger and shame must we read of the extradition proceedings that make British justice stink like an unburied corpse – see the account Craig Murray, former UK Ambassador to Uzbekistan and himself a whistleblower,  gave last October https://www.craigmurray.org.uk/archives/2019/10/assange-in-court/ :

‘The charge against Julian is very specific; conspiring with Chelsea Manning to publish the Iraq War logs, the Afghanistan war logs and the State Department cables. The charges are nothing to do with Sweden, nothing to do with sex, and nothing to do with the 2016 US election; a simple clarification the mainstream media appears incapable of understanding.’

Even the Swedish authorities wanted to drop the rape allegations, only for the UK’s Crown Prosecution Service to email them with ‘Don’t you dare get cold feet!!!’ (The triple exclamation marks, sic. https://www.theguardian.com/media/2018/feb/11/sweden-tried-to-drop-assange-extradition-in-2013-cps-emails-show )

The Australian Embassy refused to assist their citizen https://www.bbc.co.uk/news/uk-18546082 , so Assange went to the Ecuadorian Embassy, disguised as a courier, and had to stay there on the first floor overlooking Harrods, for seven years, effectively in solitary confinement, while our Government, playing Pussy, waited for him outside his hole, blowing £11 million in police costs in the first three years https://www.dailymail.co.uk/news/article-3131882/Arrogant-Julian-Assange-condemned-refusing-leave-Ecuador-s-embassy-face-justice-rape-allegations-Met-Police-reveal-cost-11million.html .

When Ecuador’s President, the anti-globalist Rafael Correa, ended his third term of office he continued to support the cause of the ‘Maus’ https://en.wikipedia.org/wiki/Maus but last April the new incumbent, Correa’s former deputy Lenín Moreno invited Scotland Yard into his diplomatically immune territory to take Assange by force. Correa tweeted: ‘Moreno is a corrupt man, but what he has done is a crime that humanity will never forget.’ https://www.washingtontimes.com/news/2019/apr/11/rafael-correa-ex-ecuadorian-president-slams-succes/

Some may think I have failed under Godwin’s Law https://en.wikipedia.org/wiki/Godwin%27s_law by drawing a comparison with the totalitarianism of the Thirties and after; but my mother was there at the time, in high school. She loved to read in the school’s library but one day she went in and the shelves were full of big gaps: the socialist and Jewish writers and philosophers had been removed. All the teachers had joined the Party; and her classmates, too, but Opa (our granddad) wouldn’t let her – a gentleman farmer, he considered the movement full of scum. Mum had to fight boys in the playground but being sporty and thickset, won her battles. For the rest of her life she opposed all forms of what she called ‘fanatism.’

The conduct of the proceedings has to be read to be believed – Murray is reporting regularly https://www.craigmurray.org.uk/archives/2020/03/the-armoured-glass-box-is-an-instrument-of-torture/ . They are now taking place in Woolwich Crown Court, almost a granny annexe for the top-security Belmarsh Prison that was designed to hold the country’s most dangerous terrorists. Bearing in mind the fact that Assange attends court in a bulletproof glass cubicle where he finds it hard to follow what is said and cannot communicate freely with his lawyers, the prison management’s behaviour is also scarcely credible https://www.theguardian.com/media/2020/feb/25/julian-assange-handcuffed-stripped-naked-claim-lawyers :

‘Julian Assange was handcuffed 11 times, stripped naked twice and had his case files confiscated after the first day of his extradition hearing, according to his lawyers, who complained of interference in his ability to take part.’

When did you last hear of counsel for the prosecution having to support the defence https://www.craigmurray.org.uk/archives/2020/02/your-man-in-the-public-gallery-assange-hearing-day-2/ in their attempts to persuade the magistrate that ‘it was common practice for magistrates and judges to pass on comments and requests to the prison service where the conduct of the trial was affected, and that jails normally listened to magistrates sympathetically’?

The Guardian is something of a repentant sinner: having made liberal use of Assange’s outfit’s information, they published a crucial password https://www.theguardian.com/media/2011/sep/01/wikileaks-prepares-unredacted-us-cables in their book on Wikileaks that could be used to crack open the encrypted documents that have so embarrassed the United States and some of its allies.

In 2010 the Guardian wanted him to go back to Sweden to face charges (with the risk of being seized and taken to the US) https://www.theguardian.com/commentisfree/2010/dec/19/julian-assange-wikileaks-sex-offences ; they said his fight against authoritarianism was ‘simplistic, hypocritical, as much an authoritarian conspiracy as the United States government is; we should disavow Assange's perspective entirely; the ends do not justify the means’ https://www.theguardian.com/commentisfree/cifamerica/2010/dec/05/wikileaks-julian-assange .

Well, as William Randolph Hearst said, ‘News is something somebody doesn't want printed; all else is advertising.’ https://www.goodreads.com/quotes/77244-news-is-something-somebody-doesn-t-want-printed-all-else-is The Guardian’s staff have finally realised comment is not free: that if they support what is beginning to seem like a show trial of a fellow journalist, the cats may come for them too, one day. So their line is now, ‘Don’t do it.’ https://www.theguardian.com/commentisfree/2019/nov/20/the-guardian-view-on-extraditing-julian-assange-dont-do-it

Assange does not have to be Simon-pure for us to support him (the terms ‘journalist’ and ‘ascetic’ are rarely found together). In fact, it’s not him alone we are or should be championing: it is justice, the unbiased independence of the judiciary – independence even against a powerful foreign ally - and our blood-bought, centuries-old culture of freedom. Welcome back, prodigal sons of the Manchester Guardian: we shall fatten the calf for you.

USA: Central bank intervention reinflates stock markets

'On Monday, all three major stock indices skyrocketed higher on news that global central banks would aggressively lower interest rates in response to the economic damage from the coronavirus pandemic. The benchmark Dow Jones Industrials were up more than 5% or 1,293 points, the biggest point gain in history.'
https://www.unz.com/mwhitney/dead-cat-bounce-central-bank-easing-sends-stocks-into-the-stratosphere/

Covid-19: keep calm and make a plan

While some of the Press produce shouty headlines for fun and profit and others affect armchair insouciance, the truth lies somewhere in between: no, it’s not going to kill us all; no, it’s not just flu; no, it’s not going away.

This week’s Spectator adopts the postprandially relaxed position. Martin Vander Weyer reassures us https://www.spectator.co.uk/2020/02/coronavirus-is-a-chance-to-buy-cheaper-but-it-comes-with-a-health-warning/ that the recent stockmarket reverses (btw, in percentage terms nothing remotely like the Dow’s one-day drop in 1987 https://edition.cnn.com/2013/05/31/us/dow-jones-industrial-average-fast-facts/index.html ) may offer buying opportunities, particularly in pharma firms seeking a vaccine for Covid-19, though (chuckle) investors should ‘wash hands and don a face mask’ before placing their bets. Well yes, I think the frail, twisted state of the world’s financial system is currently much more of a real and present danger to shareholders and pensioners; but we’ll come back to vaccines in a moment.

The Speccie’s Ross Clark https://www.spectator.co.uk/2020/02/the-most-dangerous-thing-about-coronavirus-is-the-hysteria/ also seeks to allay our ‘hysteria’ about coronavirus, but his downplaying doesn’t quite work for me. Like so many, he makes the comparison with influenza in the winter of 2017-18, quoting the Office for National Statistics’ figure of 50,000 fatalities, but must have missed the British Medical Journal’s comment (referencing Public Health England’s study): ‘the ONS seem to have exaggerated the risk to the public by in the region of 150 times.’ https://www.bmj.com/content/361/bmj.k2795/rr-6 . The fatality rate from seasonal flu is something like one in a thousand; The Guardian (28 February) says Covid-19 is ‘ten times more deadly.’ https://www.theguardian.com/world/2020/feb/28/coronavirus-truth-myths-flu-covid-19-face-masks . Clark tells us that SARS (9.6% fatalities https://www.businessinsider.com/china-wuhan-coronavirus-compared-to-sars-2020-1?r=US&IR=T ) and H5N1 (60% death rate https://www.who.int/influenza/human_animal_interface/avian_influenza/h5n1_research/faqs/en/ ) ‘hardly justify’ being called epidemics, let alone pandemics; and ‘If China had not taken such dramatic steps to stop the [Covid-19] disease, we wouldn’t be half as worried.’ Au contraire, the Chinese should have acted earlier and faster and they are certainly not overreacting now; the dropped match that might have been doused quickly at the start has become a blaze requiring all available appliances.

Covid-19 is much less fatal than SARS, but has a similarly high level of transmission from person to person. The threshold contagion rate for an epidemic is R1, i.e. on average each person passes the disease on to one more; MERS https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov) and the highly deadly H5N1 https://www.cdc.gov/flu/avianflu/h5n1-people.htm were below this rate, but SARS was in the region of R2-R3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558759/ and Covid-19 is now thought to be similarly infective https://www.theatlantic.com/science/archive/2020/01/how-fast-and-far-will-new-coronavirus-spread/605632/ , though earlier estimated at R4 https://www.medrxiv.org/content/10.1101/2020.01.27.20018952v1.

What makes the latest coronavirus more dangerous is that it seems to have a longer incubation period https://www.health.harvard.edu/blog/as-coronavirus-spreads-many-questions-and-some-answers-2020022719004#q2 than SARS’ 2-7 days https://www.cdc.gov/sars/about/faq.html , so there is a greater chance that it will slip through basic screening measures at airports etc. It also vastly expands the network of possible contacts before and after a case of infection, so containment becomes exponentially more difficult. The UK’s twentieth case, appearing in Surrey on Friday, is the first to have occurred here through secondary or tertiary transmission but given a prolonged pre-symptom period the trail can easily go cold. https://news.sky.com/story/first-case-of-coronavirus-confirmed-in-wales-and-two-more-in-england-11945201

Paradoxically, a quick and deadly disease is less of a threat, since it can be spotted early and eliminates its host fast before it can find many new ones; Covid-19 may go on to claim lots more victims overall because it kills a small percentage of a much larger number. Interviewed by The Atlantic magazine, Harvard epidemiology professor Marc Lipsitch opines, ‘I think the likely outcome is that it will ultimately not be containable,’ so rather than an epidemic or pandemic it will be endemic: a new regular seasonal illness like colds and flu, but one for which – as with other coronaviruses - there may be no long-lasting immunity, and which is more fatal than flu. https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000

In the same Atlantic article, the CEO of the Coalition for Epidemic Preparedness points out that even though a vaccine may be developed by Spring or summer this year, testing for safety and effectiveness may mean it is not publicly available until 12 – 18 months from now.

Meanwhile, we can begin to analyse and quantify the risk factors of Covid-19, based on cases identified so far. Worldometer https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ combines information from two authoritative sources to estimate the likelihood of dying if infected, according to age, sex and pre-existing medical conditions. The initial indications are:

1.  Below age 50, the risk of death is 0.4% or less; after that, it goes from 1.3% to above 10% at age 80

2. Men are significantly more vulnerable than women, BUT most cases so far are Chinese and in China, men are much more likely to be smokers (as this study confirms https://jech.bmj.com/content/71/2/154 )

3. In descending order, the following conditions significantly increase mortality risk: cardiovascular disease; diabetes; chronic respiratory disease; hypertension; cancer.

On the basis of the above, we can begin thinking about public and individual strategies to cope with the challenge of Covid-19.

First, timing: we need a plan to get through the next 18 months to two years, by which time a vaccine may become available. During this time, we all need to be extra-cautious, not only to evade the virus personally but to avoid spreading it to others. Perhaps all public places – e.g. schools, shops, offices, places of worship and mass entertainment – should have wall-mounted hand sanitisers as is standard in hospital wards. We need to wash hands frequently. Masks, says the government’s advice to transport workers https://www.gov.uk/government/publications/covid-19-guidance-for-staff-in-the-transport-sector/covid-19-guidance-for-staff-in-the-transport-sector , ‘do not provide protection from respiratory viruses [but should] be worn by symptomatic passengers to reduce the risk of transmitting the infection to other people.’ One reader suggested shopping off-peak if possible; others may have more ideas to offer.

Then, focus: the elderly and infirm are clearly much more at risk. Maybe the NHS Secretary could authorise doctors and pharmacies to allow the old and weak to stockpile essential medicines so that if there is a local outbreak they can self-isolate in order to avoid contracting the disease; and their carers and visitors need to be much more scrupulous in hygiene precautions (think of sheltered accommodation and nursing homes.) There may need to be safer arrangements for them to access GP and hospital services. Those who still work may be permitted to do more at home. Health advice and initiatives may increase their stress on reducing smoking, excess body weight (dieting can beat diabetes in some cases), blood pressure etc. How about preparing varied food packs and menus to make it simpler for the vulnerable to have adequate and appropriate nutrition to endure a viral siege? (We need a new Lord Woolton and Marguerite Patten!)

Any more ideas?

FRIDAY MUSIC: Mandolin Orange, by JD

Mandolin Orange is an Americana/folk duo based out of Chapel Hill, North Carolina. The group was formed in 2009 in Chapel Hill, North Carolina and consists of the group's songwriter Andrew Marlin (vocals, mandolin, guitar, banjo) and Emily Frantz (vocals, violin, guitar).

"Mandolin Orange’s music radiates a mysterious warmth —their songs feel like whispered secrets, one hand cupped to your ear. The North Carolina duo have built a steady and growing fanbase with this kind of intimacy, and on Tides of A Teardrop, due out February 1, it is more potent than ever. By all accounts, it is the duo’s fullest, richest, and most personal effort. You can hear the air between them—the taut space of shared understanding, as palpable as a magnetic field, that makes their music sound like two halves of an endlessly completing thought. Singer-songwriter Andrew Marlin and multi-instrumentalist Emily Frantz have honed this lamp glow intimacy for years."
http://www.mandolinorange.com

There was a comment beneath one of their videos which compared them to Gram Parsons and Emmylou Harris and that is high praise indeed: Listen to Parsons/Harris singing 'Love Hurts' to understand why.













... Tim O'Brien's was the first version of Pretty Maid that I heard and its origin is 17th century and has changed over the years, as ancient folk songs often do -
https://terreceltiche.altervista.org/fair-maid-in-the-garden-the-ballad-of-john-riley/

Covid-19: die another day

The following is a riposte to some commenters at The Conservative Woman, where a version of yesterday's post was published: https://conservativewoman.co.uk/prepare-for-the-worst-coronavirus-could-kill-hundreds-of-thousands-here/

Covid-19 a scare story? Pace a number of commenters on the last piece: no. You will recall that Professor Ferguson was quoted as saying the risk of infection in the UK could be 60% and the fatality rate 1%, meaning (given the size of our population) a possible 400,000 victims.

That is simply logic. If the coronavirus spreads easily and nobody does anything, many people will catch it. The point is to change our behaviour to reduce the risk. Some of those changes can be a matter of individual choice, some collective.

The wrong collective action may result in worse outcomes. The ‘Diamond Princess’ cruise ship had some 3,700 souls on board when ten passengers were diagnosed with the illness https://www.theguardian.com/world/2020/feb/21/brits-coronavirus-diamond-princess-cruise-ship-to-fly-home . In quarantine, the number of cases has risen to 691 (as of 26 Feb 12:25 GMT https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 ). That is about 18 per cent of passengers and crew, not the 60 per cent that the Professor speculated; on the other hand, these were frightened people keeping in their quarters, trying very hard not to be the next patients. Sadly, the ship’s ventilation system could have helped spread the virus https://metro.co.uk/2020/02/13/coronavirus-cruise-spread-room-room-air-conditioning-12236176/ , in a way similar to Legionnaire’s Disease https://www.nhs.uk/conditions/legionnaires-disease/ .

Of those infected, only four (less than one per cent) have died so far; but the passengers on a luxury sea voyage will be well-nourished, well-cared-for people, and the seriously ill were taken to Japanese hospitals, presumably among the best in the world. Globally (but so far, overwhelmingly in China), 3.4 per cent of cases have resulted in death, 37 percent have recovered and 59 per cent are still fighting the illness; so it is too early to say what the true ratios will finally turn out to be.

However, let’s say for the sake of argument everybody decides to ignore all risks and precautions and the Professor’s estimate is exactly correct. Result: 0.6 per cent of the UK population dies; but by the same token, that means 99.4 per cent will not die of Covid-19 (though many may suffer a period of unpleasant illness.)

What we need is neither panic nor blasé complacency; we need perspective. In 2017 the UK population was (officially) 65.6 million https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/ukpopulation2017 , and 607,172 people died from all causes https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/2017 – less than one in a hundred. In fact, the average person’s risk of dying in the next twelve months stays below one per cent until they hit their late fifties http://www.bandolier.org.uk/booth/Risk/dyingage.html . You have to be in your mid-eighties before the chance of meeting the Grim Reaper gets higher than ten per cent – good odds!

Why all the fuss then? you may ask. The issue is avoidability: the Office for National Statistics https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/2017 estimates that almost a quarter of those 2017 deaths – i.e. over 140,000 fatalities – could have been avoided, either by ‘timely and effective healthcare’ or ‘public health interventions’ (and there are three big things we can do personally to improve our chances of a long life https://web.archive.org/web/20121122110650/http://www.hsph.harvard.edu/news/press-releases/2009-releases/smoking-high-blood-pressure-overweight-preventable-causes-death-us.html .) A laissez-faire approach to Covid-19 could add up to 400,000 unnecessary deaths to the total – quadrupling the toll.

We can’t leave everything to our chronically inept government. Apart from anything else, we have to think what we would do if, say, some lockdown was imposed and shop shelves were cleared in panic buying, as has happened in Italy https://www.dailymail.co.uk/news/article-8045987/Shoppers-fight-food-supermarket-Italys-red-zone.html – our worst enemy could be other people’s behaviour. It’s no good waiting till then: as the ancient Greek saying goes, there is no borrowing a sword in time of war.

Not only are there practical things we can do to protect ourselves, we have a good idea who is most at risk so we can give them extra help. For example, we can ensure that an elderly or infirm relative has enough goods in the house not to have to go out if the virus has come nearby; and that visitors, carers and medical staff are firmly reminded to check who they’ve been in contact with recently and to sanitise their hands frequently. Alternatively, if you’re impatient for Granny’s worldly goods, take her out for a bus ride daily at schools chucking-out time; or a cruise.

We all have to go sometime, but if we plan the right course of action it is likely we will die another day, not today; that should provide us with a quantum of solace.

Covid-19: be prepared

Things are moving fast in this outbreak. On February 22 I said there were five cases of Covid-19 in Iran, two of whom had died; now (25 Feb 16:50 GMT) the Johns Hopkins tracker https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

 records 95 cases and sixteen deaths. In Italy, seven have died (none, a few days ago) out of 283 cases so far; the government has imposed travel restrictions on a dozen northern cities.

Why should the UK (13 cases, no deaths to date) escape the scourge? Or rather, how?

We are only two months into the crisis and aside from frantic research to find a vaccine (that may take a very long time), teams are trying to estimate the likely spread of the disease. The standard model uses an analysis known as ‘SEIR’: what proportion of the population is Susceptible to catching it, how many of those will be Exposed to it, how many Infected, how many will Recover.

There are only two of those categories that are amenable to intervention: giving prompt, good medical treatment (but as we have seen, even high-quality hospitals cannot always save the elderly and infirm); and better still, preventing contagion. As to the latter, a Hungarian study published on February 19 https://www.mdpi.com/2077-0383/9/2/571 looks at how the  international spread of Covid-19 could be limited, and concludes that countries with less frequent connections to China should focus on entry screening or travel restrictions, whereas those (like the UK) that have a high level of such connections should focus on further measures to control infection after arrival.

The bad news from that paper (see Figure 4, right hand graph)  is that for us, even if numbers of visitors from China are halved and the rate of exposure to others once they are here is cut significantly, the probability of a major outbreak in the UK rises above 50 per cent as total cases in China (outside Hubei province) exceed 600,000. The authors’ graph implies that we are more at risk even than Germany, France and Italy.

In a world that is economically interconnected, the authorities are conflicted, trying to balance safety precautions with the need to keep the trading show on the road. We saw the World Health Organisation first argue against travel restrictions https://www.abc.net.au/news/2020-02-05/who-coronavirus-update-china-travel/11930752 and then warn us that the virus was a ‘serious and imminent threat’ https://www.euronews.com/2020/02/10/coronavirus-outbreak-uk-declares-virus-serious-and-imminent-threat-to-public-health ; now it is telling us that the epidemic has peaked in China https://www.dailymail.co.uk/health/article-8039517/Coronavirus-epidemic-PEAKED-China-says-World-Health-Organisation.html  , despite the culture of secrecy there that means we might not know the whole truth.

In the UK, the government attempts a similar compromise: its advice to transport workers https://www.gov.uk/government/publications/covid-19-guidance-for-staff-in-the-transport-sector/covid-19-guidance-for-staff-in-the-transport-sector assures them that they ‘are not considered to be at a heightened risk of contracting coronavirus as a result of their work’ and that ‘staff are not recommended to wear respiratory masks. They do not provide protection from respiratory viruses.’ Passengers arriving via direct flights from specified areas will be given ‘health announcements [… and] a general declaration 60 minutes before landing on any passenger health issues or suspected cases’; and so on. The latest advice for arrivals from northern Italy is that they should self-isolate  https://www.bbc.co.uk/news/uk-51625733 .

The British approach may seem too soft-handed, but the alternative strategy of grasping the nettle tightly could be doomed. Although Wuhan, the epicentre of the outbreak, was officially locked down on January 23, this Twitter user https://twitter.com/jenniferatntd/status/1231374535250841600 says cellphone data shows that nearly 140,000 people escaped the city in the first two weeks of February alone. MedPage Today says https://www.medpagetoday.com/infectiousdisease/publichealth/85027 that it is possible for the illness to be transmitted by carriers who show no symptoms themselves; they describe a case of a young Chinese woman who inadvertently infected five members of her family. A report from Imperial College, London https://www.imperial.ac.uk/news/195564/two-thirds-covid-19-cases-exported-from-mainland/ says that two-thirds of Covid-19 cases that have left China may have gone undetected. In Europe, others may also choose to break quarantines, like that set on northern Italian towns https://www.dw.com/en/coronavirus-life-around-italys-quarantined-red-zone/a-52513830 - for example, just across the border in Hohenturn, Austria, a brothel services hundreds of visiting Italians every weekend https://kaernten.orf.at/stories/3036029/ (htp: ‘Raedwald’ https://raedwald.blogspot.com/2020/02/covid-19-living-with-threat.html ) and, it seems, Austrian law does not permit the State to impose Italian-type cordons sanitaires. New Scientist magazine says that battle may already be lost https://www.newscientist.com/article/2234967-covid-19-our-chance-to-contain-the-coronavirus-may-already-be-over/ .

How bad could it get? On 12 February Professor Neil Ferguson told Radio 4’s Today programme https://www.theguardian.com/world/2020/feb/13/coronavirus-medical-chief-says-uk-hopes-to-delay-any-outbreak-until-summer that if the disease got out of control in the UK, potentially 60 per cent of the population could be infected and if the fatality rate is one per cent the toll could run into hundreds of thousands. The latter may well be an under-estimate; outside mainland China it’s over 1.5 per cent (42 deaths out of 2,690 cases, and many of those still sick have yet to recover) and on the Chinese mainland it’s about 3.5 per cent (2,705 deaths from 77,660 cases.)

As with flu generally, old people with underlying health problems are most at risk, but that does not mean the rest of us can be sanguine. Imagine a country where 60 percent of teachers, medical and emergency staff, port workers, passenger transport staff, delivery drivers etc are off sick, even if only on a rolling basis of infection (and possibly even re-infection) over months. The disruption to the economy could be far greater – and far closer to home - than temporary swoons on the stockmarkets https://www.washingtonexaminer.com/news/stock-markets-around-the-world-slide-as-coronavirus-outbreak-becomes-potential-pandemic?utm_source=breaking_push&utm_medium=app&utm_campaign=push_notifications . The modern system of just-in-time resupply could become too-late, please-wait.

Hope for the best, but prepare for the worst: prudent citizens may have to do more than just wash their hands.

ART: Interference Paints, by JD

A few more paintings:

Looking for something in the untidiness of my cupboards I found something else, as often happens, which diverted me and now I have forgotten what I was looking for in the first place!

But that something else was a few tubes and jars of 'interference' paints, paints which give a tint to a colour depending on the source of the light.

So I decided to play around with them and see what effects could be achieved. These are all acrylic paintings on 2" x 2" canvas. The half dozen here are the result.

The first canvas, top left, was covered completely with interference gold and then the scene was painted over loosely with bright normal colours and the underpainting shows through in places. Below is an enlarged portion of it; not sure if it can be seen clearly in the image. It shows partially in the tree and on the shore line next to the figures.

A few more with varying success. The dervish is painted with interference copper effect and I think it shows more clearly than the others (I'm not entirely satisfied with the figure so I'll have another try some time.)

The sky behind the line of trees is painted with a fluorescent blue over a yellow background and is very striking in reality, not sure about in the screen image. The ground around the trees is purple mixed with yellow. I might change the shadows at a later date (or not.)

The third image is one of several similar which I did before Christmas, the others given to friends as Xmas presents!

I think I have done about two dozen of these minis over the past two weeks but when I was in Poundland the other day I couldn't see any more. Perhaps they no longer sell them and in fact their art materials are now sparse compared to last year. Perhaps I should 'upgrade' - painting teacher No3 told me ages ago I should be painting 'big' pictures. She is right but I would need a bigger house! I shall continue painting, whatever the size, because...... well, because I can't and do not want to stop. As noted previously, when I am 100 I might be getting the hang of it!

Covid-19 outside mainland China: update

... while passing on the disease, of course:
https://www.theargus.co.uk/news/18242077.thirty-brighton-doctors-coronavirus-isolation-says-clinician/

According to the Johns Hopkins tracker the total number of confirmed cases now approaches 78,000 of which over 600 are outside the Chinese mainland. https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 . Of the latter, only 12 have died so far.

However, it is clear that the virus is lethal to more than East Asians. Two days ago, a couple of Iranians succumbed; and it seems they had not travelled outside their country. They died in Qom (90 miles from the capital, Tehran), and two other patients have been diagnosed there since, plus one in Arak (who happens to be a doctor from Qom), bringing the total cases to five. https://www.channelnewsasia.com/news/world/iran-qom-coronavirus-covid19-religious-gatherings-cases-12455638

Qom is a magnet for pilgrims, so there is some question as to whether piety may outweigh prudence. 20 million visitors (both domestic and foreign) come annually because it is not only a holy city but ‘the largest centre for Shiʿa scholarship in the world’. https://en.wikipedia.org/wiki/Qom Conversely, millions of Shi’ite pilgrims travel from Iran to Iraq each year to see the holy cities of Najaf and Karbala; Iraq has now taken the precautions of suspending flights to Iran and closing their mutual border https://www.timesofisrael.com/iraq-closes-border-with-iran-over-coronavirus-fears/ but we shall see how effective and sustained these measures will be.

And today we hear of a fatality in Italy (see below).

Here is the toll to date, in sequence, for the world outside mainland China:

(1) 02 February: a 44-year-old Chinese tourist from Wuhan, Hubei province died in hospital in Manila, the Philippines; he was ‘thought to have had other pre-existing health conditions.’ https://www.bbc.co.uk/news/world-asia-51345855

(2) 04 February: a 39-year-old Hong Kong man dies there of heart failure, having been diagnosed on 31 January with the virus. He is said to have had a ‘long-term illness.’ https://agbrief.com/headline/coronavirus-live-updates-2020/

(3) 13 February: a woman in her eighties died in a Japanese hospital where she had been kept since February 1; her son-in law is a taxi driver and has also been confirmed infected. https://www.theguardian.com/world/2020/feb/13/japan-reports-first-coronavirus-death-as-44-more-cases-confirmed-aboard-cruise-ship

(4) 15 February: an 80-year-old Chinese tourist from Hubei province died in Paris, France after weeks in hospital. https://www.nytimes.com/2020/02/15/world/europe/france-coronarivus-death.html

(5) 15 February: a 61-year-old male taxi driver from central Taiwan died in hospital there from Covid-19-related pneumonia and sepsis; he had a history of Hepatitis B and diabetes. Many of his fares had come from China, Macau and Hong Kong. 

https://www.hongkongfp.com/2020/02/17/coronavirus-taiwan-records-first-death-govt-expands-testing-measures/

(6, 7) 19 February: two Iranian citizens died in Qom, northern Iran; both were elderly and with underlying health conditions. They ‘were not known to have left Iran’ but as said above, Qom is a major religious destination for pilgrims and scholars. https://www.dw.com/en/coronavirus-first-deaths-reported-in-middle-east/a-52436966

(8) 19 February: a second Hong Kong victim dies there – a 70-year-old man with ‘underlying illnesses.’ He had previously visited mainland China on 22 January via the island’s border checkpoint at Lok Ma Chau. https://www.hongkongfp.com/2020/02/19/breaking-70-year-old-dies-bringing-hong-kong-coronavirus-death-toll-two/

(9) 19 February: a 63-year-old local man died in a hospital in South Korea and was diagnosed posthumously with the virus. Many new cases have been registered in the South Korean city of Daegu, where a South Korean woman is thought to have infected the congregation of a Christian sect; she is said to be in her early 60s and with no recent record of overseas travel. https://www.scmp.com/week-asia/health-environment/article/3050517/coronavirus-how-diamond-princess-cruise-ship-became

(10, 11) 20 February: two Japanese citizens died in a hospital in Japan, having been taken off the ‘Diamond Princess’ cruise ship (quarantined near Yokohama) the previous week. ‘Both were in their 80s with underlying health conditions.’ https://www.bbc.co.uk/news/world-asia-51568496 The infection may have been spread by a Hong Kong resident who had briefly visited the Chinese mainland prior to boarding the ship at Yokohama on 20 January https://www.scmp.com/week-asia/health-environment/article/3050517/coronavirus-how-diamond-princess-cruise-ship-became ; he disembarked at Hong Kong on January 25, reporting to a hospital on the island, where he was diagnosed with coronavirus. The ship’s itinerary from 1 December 2019 on is here: http://crew-center.com/diamond-princess-itinerary - the latest cruise was to have been 29 days long, starting in Singapore. https://www.scmp.com/week-asia/health-environment/article/3050517/coronavirus-how-diamond-princess-cruise-ship-became

(12) 22 February: a 78-year-old man died in Padua, Italy. The first arrival of the virus in the country is traced to China: ‘The "index case" - or patient zero - was reported to be a 38-year-old man from Codogno who is believed to have caught the virus from a friend who had returned from China in January.’ https://news.sky.com/story/italy-reports-first-coronavirus-death-as-infections-worldwide-pass-77-000-11940004

The pattern of lethality is similar to that for ‘ordinary’ flu: Covid-19 hits the old and infirm disproportionately. That said, we also see how easily it seems to spread, and (thanks to modern communications and mass travel) how far – not only across the Far East but the Middle East, Australasia, Europe, North America, India, Egypt… So far, nothing reported from sub-Saharan Africa, or central and southern American states; but we are hardly three months into this outbreak and not all countries may as quick to diagnose cases correctly.

There is no room for complacency, as Charles Hugh Smith explains. http://charleshughsmith.blogspot.com/2020/02/covid-19-pandemic-complacent-are.html

FRIDAY MUSIC: Caroline Shaw, by JD

Earlier this year on BBC 4 Stewart Copeland host a three part series called Adventures in Music; https://www.bbc.co.uk/programmes/m000db8m

These were three exceptionally good documentaries in that they didn't follow the usual formula but asked the question - "How does music work? What exactly is this thing that brings us together, moves us and binds us, communicates stories like no other art form, and which seemingly has transcendental powers?"

Among the various people Copeland spoke to in his search for the 'magic ingredient' was the American composer Caroline shaw. Perhaps a bit too unorthodox for most tastes but I thought her music was excellent!

It was also good to see a couple of very hostile commenters beneath her videos make fools of themselves by declaring their own musical qualifications and pedigree; their professional jealousy in other words!
https://en.wikipedia.org/wiki/Caroline_Shaw

"How do you capture the tragic, beautiful loneliness of existence, and the complete, ecstatic joy of existence?" asks Caroline Shaw. Shaw was awarded the Pulitzer Prize for music in 2013, making her the youngest ever recipient of the award. She explains in this video that music helps her tackle some of life's loftiest questions."

This just in...

https://www.bbc.co.uk/news/av/uk-politics-51560780/abbott-language-plan-is-dog-whistle-politics

Are we off-air now?

-          Yes.

‘Cause you know what I said was all bollox, don’t you?

-          Sorry?

That stuff about ability to speak English being dog-whistle politics.

-          Yes, but surely Labour is in favour of immigration?

That was just an angle, you know the game we’re playing and you love it. Actually this points system is the best news I’ve heard since I was a kid.

-          Amazing! Why?

Think, for goodness’ sake. What’s going to happen when we can’t bring in loads of poor people to do essential services like elderly care?

-          There’ll be a shortage and old people won’t be looked after.

There’ll be a shortage and care workers’ pay will have to go up, at last. And then there’ll be a recruitment drive, more employment.

-          But healthcare costs will go up, won’t they?

And about time. Our country has been exploiting the labouring classes for far too long. Besides, yes, there might be more taxes to raise, but there’ll be more people earning enough to pay taxes too. And they’ll spend more, and create more profits and employment elsewhere.

-          Excuse me for saying it, but that sounds like right-wing economic thinking.

Right economic thinking, you mean. Why do you think Jeremy and I have always wanted us out of the EU?

-          But that wasn’t Labour policy, was it? You’ve opposed Brexit before and after the Referendum and the last General Election.

I’m surprised you don’t know the difference between policy and strategy. You know we’ve had to ride two horses in the Party, same as the Tories. Half our voters haven’t a clue, they’re teddy-huggers who really do think money grows on trees.

-          Wow, you’re a secret Tory!

Let’s get this straight. You vote Labour, don’t you?

-          Well, at the BBC we maintain impartial-

Just say yes, it’s quicker.

-          Erm…

And what do you think you’re voting for us for? You get, what, a six-figure salary? The person who lifts your poor old nan out of her bed doesn’t get a fifth of your pay, while the heaviest thing you lift is a sticky bun in the BBC canteen.

-         - Tahini wrap, actually…

Never mind. Workers take care of your olds, dead cheap, so you can go clubbing and stick happy sherbet up your nose. Is that your idea of socialism?

-          Blimey, if you’re going to be like that I’m voting Tory next time.

So am I, if we can’t change our strategy, ‘cause obviously it’s failed in the North. Meanwhile, let’s stay together for the sake of the viewers, darling, shall we? Let’s do a bit more on racism next time, okay?