Read on Twitter
This thread looks at UK management of Coronavirus versus a Benchmar of countries.
It uses a standard virological "Time to Double" (DT) to reduce Death/000 noise
The UK sadly has many more deaths than we should vs those countries
I go on to rule in and out causes and ask "How."
It uses a standard virological "Time to Double" (DT) to reduce Death/000 noise
The UK sadly has many more deaths than we should vs those countries
I go on to rule in and out causes and ask "How."
1/41Relative poor UK death rates vs comparable countries have been debated. Unfortunately the Deaths/Thousand metric people cite is noisy for many reasons.
Time to Double (DT) is a cleaner virology metric to avoid miscount
It confirms UK performance is very worrying
2/41SOURCES
I always tell my kids to ask for sources. One they may meet conspiracy theorists fraudsters or bots. Source are their protection. Tell your kids too!
Direct Source is https://ourworldindata.org/coronavirus#confirmed-covid-19-deaths-by-country
Including data from ECDC and WHO.
For my background see pinned
3/41In this thread, I'll explain
1. What the data mean vs simplistic explanation of tweet 1
2. Rule out factors that can't reasonably explain the data
3. Examine the factors remaining, which must explain the UK?
4. Opinion, informed by evidence of HOW we got here.
4/41WHAT THE DATA MEAN
1. DEFINITION
The time to double (DT) is a standard way to look at rate of viral growth. Though you may not have heard of the metric, you probably know of the opposite from TV Series like Chernobyl - the half life?
Half life = decay
DY = grow
5/41For radiation a short half-life usually is good*
In the case of viral growth, a short DT usually is not.
I cannot find exceptions which explain the UK.
*Not forgetting the most dangerous radioactive isotopes have shortest half-lives; because...off-topic.
me
6/41WHAT FACTORS CAN'T EXPLAIN THE DATA
A. Reporting Error
Major undercounting by countries you're comparing with UK or overcounting of UK*.
To eliminate this I removed from the dataset any countries with reports of poor data count or manipulation.
*next
7/41B. Variance in reporting methodology.
A count skew so UK is susceptible to higher or slower rates of growth.
There are scientific complaints* about how the UK is reporting data; none explain this skew.
* methodology would seem to obscure preventable deaths.
8/41Different...
No evidence for these but the record
1. A different virus/strain in the UK
2. UK environment factor
3. UK human/genetic factor
There are many human interventions which could explain better or worse DT. They are the subject of the continuing thread.
9/41Apologies for so many caveats. With controversial data we often
1. reject
2. cast Doubt
3. explain with other factors.
Ruling those out means we can focus on the factors that must be causal. You may know this thanks to Mr Holmes, though it originated in science.
10/413. WHAT FACTORS REMAIN TO EXPLAIN UK?
4. Comparative variances
a) Late diagnosis
b) Late intervention
c) Missed intervention
d) staff shortage
e) suppression compliance
f) treatment regimen
Evidence for UK variance
Factors I missed in comments pls or DM.
12/42An aside.
Help me stop China bias. As a descriptor "China" is about as useful as "Western".
I say this because I have worked with China's scientists. They are as professional as any here. At the start, some corrupt officials did suppress data. But not scientists.
13/41This is the relevant chart from the report. It shows two main things.
i) that death rates rapidly decreased in Wuhan
ii) that death rates started from a lower point outside Wuhan and continued to lower.
The primary driver of both was mass testing. In particular:
14/41a) Mass testing enabled earlier diagnosis and substantially better treatment and outcomes for infected patients.
UK media have missed this point. NHS Staff shortage is important but not the most important reason for testing based on China. TESTING LOWERS DEATHS
15/41b) Mass testing enabled better controls of viral progression across China.
In addition to measures like our lockdown, they were able to earlier or better intervene outside lockdown areas or in advance of new lockdowns.
AND they could confine infection.
16/41That provides the reason why the UK is poor vs EU & Asia in a, b, c. I'll explain.
a). UK lacks the testing scale to (pre&)diagnose infection rates vs better performers. My assumption is this would limit or rule out many medial logistic and triage activities.
17/41b) Most UK interventions - from Schools to Lockdown - came late. Some didn't happen (c) Better testing might have enabled variable sequencing lockdown along with China model - though see point below.
We know lateness + Viral Growth results in more deaths
18/41c) The UK missed airport containment. UKGov argued screening wouldn't STOP the virus.
This is a misstatement of WHO and best practice for 3 reasons.
i. Airport controls were designed to SLOW to give time to NHS to prepare, order PPE etc. & get ready
19/41cii. Screening IS a weak mechanism which is why WHO also recommended testing, passenger information, passenger social pressure to come forward, temperature measurement, interviews and case tracking.
The UK still doesn't have any such airport measures in place
20/41ciii. Prevention of Dispersal.
Crucial for CN, SK, TW & others was NOT fighting the battle on many fronts. All used active airport measures to slow random viral dispersal in the population.
This enabled them to triage, separate and track those with the virus.
21/41No model yet can attribute viral spread or death rate to any single method; however China claims the majority of its success comes from a, b and c. All 3 methods are absent or delayed in the UK.
With a tight airport strategy, the UK should have slowed dispersal
22/41If UK Gov released regional data we'd be able to confirm whether dispersal was randomised in UK as it anecdotally seemed to be.
Unfortunately UKGov will not release regional data to confirm this either way.
The reasons for that at this stage are wholly unclear.
23/41d) staff shortages have been covered at length in UK media and will cause deaths. No more to discuss.
e) Supression Compliance.
Google data shows UK compares to benchmark. For this thread I've ruled out this factor (until more analysis) https://www.google.com/covid19/mobility/
24/41f) I've found no evidence to suggest that NHS provides treatment options that are substandard vs other countries, with 2 exceptions.
i. Diagnostic limitations due to lack of testing
ii. Ventilator availability.
As per thread no data on the severity
25/41 In Summary. 5 factors (1 ruled out) explain UK relative performance in DT
a) Late diagnosis
b) Late intervention
c) Missed intervention
d) staff shortage
f) treatment regimen
Based on China a, b and c are (were) most critical
No data source to compare d&f
26/41 Theories follow, first 3 immediate steps:
1. Understand that testing is even more important - directly saves lives, enables triage
2. Read then follow best practices from WHO
3. Political faux promises and statements must end today. Testing inflation kills
27/41 4. THEORY AND OPINION OF HOW WE GOT HERE, AND WHAT MUST CHANGE
Same factor approach, with fewer data sources. I propose these as theories to rule out (journalists jump in). All conspiracies that have no evidence have been excluded from the list
28/41 4.1 What happened?
a) NERVTAG advice
b) Herd Immunity delay/focus
c) Non-science developed in UKGov
d) UK Gov Science oversight
e) Cultural reluctance to listen to external experts
f) Political avoidance of the EU beyond what Brexit needed
Missing? comments pls
29/41 4.1a) NERVTAG World-Class Scientists supporting UKGov in risk & mitigation of viruses like #covid19 type.
I reviewed all minutes for last year. Their advice was impeccable, no odd science suggested.
RULED OUT
https://app.box.com/s/3lkcbxepqixkg4mv640dpvvg978ixjtf
30/41 4.1b) HERD IMMUNITY (HI)
Regardless of Science validity, the question is the likelihood that HI resulted in delays or distractions for other strategies.
Where do we attribute?
i. no Containment
ii. 1st test orders 16/2
iii. Ventilator request 11/3
31/41 4.1b) cont
iii. PPE order delay (evidence of dates missing)
iv. School delay
v. Lockdown delay
These delays or lack of preparation are public record, so if we don't allocate to HI distraction, what do we conclude? Only explanations are conspiracy, no evidence
32/41 4.1c) Non Science Fiction
Many UKGov statements were invalid novel #coronavirus: 60% HI rate, immunity, vaccine and ""slowly role through""
Likely a competing theory distracted. More here https://twitter.com/atatimelikethis/status/1241091002871545863?s=20
33/41 4.1d) Science Oversight
Parliament can oversee Government strategy, but no good mechanism exists to review or validate scientific conclusions beyond official advisors who can no longer be viewed as impartial since they were frequently the source of science fiction.
34/41 4.1e) Cultural Reluctance?
I've been unable to find any UKGov intervention that was on time compared to other countries' best practice, and have found many that were not implemented in the UK. CSO statements (eg. J Hunt interview - death in youth) were uninformed
35/41 4.1e) continued
""Logic dictates""
i. unaware of other best practices
ii. not interested
iii. rejected vs alternative approach
iv. mismanaged/communicated
NERVTAG minutes rule out (i), the other 3 are concerning since UKGov still hasn't acted on some - airports
36/41 4.f) EU Collaboration
Regardless of Brexit, nothing prevented collaboration with EU on purchasing, viral research, and importantly best practice sharing.
We actively removed angles of cooperation and lied about purchases (ventilators).
Bizarre? Lives at stake
37/41 Summary then, the 5 reasons were caused - HOW?
Both attached in pics
b. Delay/Distraction due to competing Herd Immunity
c. Invalid science allowed
d. No science validity controls
e. Poor best practice use
f. Ideological EU attitude
Reminder - cannot rule OUT
38/41 Summary cont.
However, absent other factors, one or more is the cause.
These are sufficient to raise concerns about UKGOV making cogent decisions. Therefore I'm going to remind you of the end of section 3.
Even if UKGov cannot, we MUST
to save lives.
39/41 Post Script 1
Reference to delayed UKGov decisions can be found in my pinned tweets here
https://twitter.com/atatimelikethis/status/1243224650626273280?s=20
Poor Press oversight is here https://twitter.com/atatimelikethis/status/1241765538419875840?s=20
40/41 Postscript 2
I'm concerned that the hints from UKGov and Vallance around Exit Strategy are again not in line with Best Practice. That is detailed here. https://twitter.com/atatimelikethis/status/1246305021421027329?s=20
41/41 Postscript 3 - Group Dynamics
I have no direct evidence of the Group Think to enable Science Fiction. But there is good academic work on it, detailed here. https://twitter.com/atatimelikethis/status/1245367418467336193?s=20
18/41 One final comment.
looks at effects if HI continued. 500K-1m extra deaths. We were lucky, but this crisis may go on for another year, and then the next time.
Our system of government is out of control, it must change before more die. https://twitter.com/atatimelikethis/status/1242083584590196739?s=20
