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5 March 2020

Wash Your Hands

Tag(s): Foreign Affairs, Politics & Economics, Current Affairs
The threat of Coronavirus Novel Covid-19 is no doubt real and the advice of the Government and Public Health Authorities to take precautions and wash our hands more frequently than normal is sensible. But though I claim no expertise in microbiology I do have some understanding of statistics and think we should keep a sense of proportion. The risk of losing this may be greater to society at large than the risk of the virus itself.

In a normal year between 290,000 and 600,000 people in the world die from respiratory diseases linked to the seasonal influenza virus, known colloquially as flu.[i] Most years this seasonal virus mutates to some extent which means that the vaccines developed to help prevent it also need to be revised. In the UK the average rate of death is a small fraction of the world’s figure at just about 600, though in exceptional years this can rise to over 10,000. In 2013, it exceeded 13,000 and since that time NHS England has campaigned particularly to the elderly, to get into the regular practice of an annual vaccination.

Many more people suffer from flu but the rate of mortality is low, usually about 1% to 2%. Covid-19 is a new strain of Coronavirus but at present the rate of mortality is still judged to be low at about 1%. By contrast the mortality rate of the Ebola virus is up to 90%.  This means that the vast majority of sufferers from Covid-19, at least 98% and maybe more, will have an unpleasant illness but with no long term effects except that they will now be immune to the disease in future. The majority of deaths occur in the elderly and other high risk groups.

Compared with the annual rate of death from flu of hundreds of thousands worldwide to date just over 3,000 are reported to have died from Covid-19, mostly in China , where the flu first appeared. Why do the media over react in the way that they are doing? Well, they always do. Between 2002 and 2004 there were two SARS outbreaks again starting in China. The British media whipped themselves up into a frenzy as if this was a biblical plague. In the event only four people in the UK became infected and none of them died.

But the impact on the NHS and other care providers was catastrophic. The NHS is overstretched as we all know. I have demonstrated on these pages several times that it always will be by definition. If you design a service to be free at the point of use then since you cannot control demand you can only limit supply by rationing which means waiting lists and queues.  So by heaping a whole load of extra pressure on the NHS other regular patients will suffer. Operations will be delayed. Queues will get longer. And the media and the opposition will complain about that even though they created the problem.

Coming back to statistics, I have often thought that no one should be allowed to serve in senior roles in public life whether as MPs or civil servants, or for that matter newspaper and news programme editors, unless they have taken a serious course in statistics and have demonstrated a reasonable level of numeracy. This week in the London Evening Standard[ii], the editorial, possibly penned by the editor, former Chancellor of the Exchequer George ‘Gideon’ Osborne, concludes:

“Health experts suggest that in the worst case between 60-80% of the population could become infected at some point in the course of the outbreak. Some other countries have, unfortunately, reached that point already.”

This is arrant nonsense and has no basis in reality. It is designed to frighten and put pressure on our politicians to do the impossible and therefore damage the fabric of society. If we really believed this we would have to close just about everything; schools, public transport, offices, factories, restaurants and pubs etc etc. To date fewer than 100,000 cases have been identified worldwide. It is not easy to identify in the first stages, indeed probably impossible. So, of course, there are more people infected than that but not this huge number claimed by Osborne or his stooge.

The reference to “worst case” leaves me cold. I have often been in business situations, where some smart alec might ask, “So, what’s the worst case scenario?” For some this seems a legitimate line of enquiry when examining a range of potential outcomes. But it isn’t because the worst case scenario is all out nuclear war, or that a meteor from outer space knocks the Earth sideways and says goodbye to humanity just as its forerunner did to the dinosaurs.  What matters is probability and that brings us back to statistics.

This week the newspapers reported the government plan with its consideration of different outcomes and deliberately misinterpreted it. They described some of the gloomier range of possibilities as a prediction. The government is trying to ensure that it is prepared if a genuine pandemic ensues with widespread infection and therefore there will be a need for special measures. Clearly the virus is spreading. Clearly it has reached and is reaching more and more countries. But if we overreact to unlikely possibilities then far more harm could and will result.

The fact that this again comes from China is no surprise. The sporadic examples of racist outrage are unacceptable but it is not racist to say that the Chinese have an unfortunate track record with SARS, Swine flu, Bird flu and now Covid-19, all in this brief century. On my business trips to China, fortunately some time ago, I am afraid I observed poor standards of personal hygiene, unlike Japan or Singapore where they are very high. In China I was obliged to sit at a restaurant table with my hosts who all ate from the same large bowl serving themselves with the same chopsticks that they used to eat the food.

But the fact that China is much more engaged in global supply chains today has another impact on the public condition. I don’t think that trade wars are any answer and our best chance of combating this virus is through collaboration, sharing information, research and most of all, helping less prepared nations to deal with the threat. I was delighted to see that the UK was one of three European nations to offer help to Iran, which seems particularly badly hit, and that the World Bank has announced a $12 billion package to help developing nations with much less prepared medical infrastructure, and again the UK will be a major contributor to that.

So, all of us should wash our hands often and well, but the media, social media and opposition politicians should not wash their hands of making a difficult situation far worse. 

 [1] World Health Organization  
 [1]  “Government sets out its pandemic battle plan”. Evening Standard 3rd March, 2010

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