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?