In the context of the Covid inquiry, I have had my attention drawn to a paper in the British Medical Journal entitled 'How covid-19 spreads: narratives, counter narratives, and social dramas'. The paper is by Trisha Greenhalgh, professor of primary care health sciences, Mustafa Ozbilgin, professor of organisational behaviour and David Tomlinson, consultant cardiologist and electrophysiologist.
I won't summarise the whole paper. Instead, the discussion stood out. In this they summarised their hypotheses when trying to explain why the story that Covid was spread by droplets (meaning that the hand-washing agenda was encouraged) was promoted so hard when it was clear that it was actually aerosol spread - i.e. through the air, meaning that all that hand washing was a near complete waste of time and money.
They put forward three ideas before reaching what, I am sure, is their over-arching conclusion. Those three ideas were that this bias was, firstly, psychological. Early on it was decided that droplet dissemination caused Covid and it was very hard to dislodge that idea once it was embedded in official thinking, at least without embarrassment to those who had promoted it.
Second, there was scientific elitism. There was a lot of science on droplet spread of disease. Those promoting it did not want to hear alternatives. As the authors noted:
The low status of aerosol science in policy circles was perhaps compounded by the relative youth of this scientific field and the inherent technical difficulties of isolating viable virus from the air (resulting in inconsistent findings in air sampling studies, especially when undertaken by non-experts). The science of indoor air quality (for example, how and when to open windows, what kinds of filters to use) might be (wrongly) viewed as unsophisticated compared with much of modern biomedicine.
So, even though Covid was aerosol spread and the answer to its spread was to control the condition of the air that we breathe, that has not happened, even now.
Third, the bias was practical. Something could be done about droplet spread: there was no preparedness for an aerosol spread virus so nothing could be done. The wrong thing was done instead with a false narrative supporting that wrong action.
Finally, there was the fourth reason that I think trumps all the others without dismissing their significance. I will quote the authors:
Our fourth hypothesis is political. Droplet precautions are, at least to some extent, under the control of individuals and hence resonate with neoliberal discourses about individual freedom, personal responsibility, and restraint of the state (although the “choice” to distance physically, for example, presupposes sufficient space in which to do so). Airborne precautions require a paradigm shift in policy making, with strategic actions from those responsible for public safety; this approach aligns with a more socialist leaning political discourse and requires considerable up-front investment in the built environment whose benefits may take years to accrue. The WHO's tweet emphasises how to protect yourself rather than what to expect of your employer, your child's school, or your government. Relatedly, we hypothesise a role for populism, the modus operandi of which is cherry picking evidence that supports the policy drive and validating anti-science sentiment under the guise of bringing power to people. Populism drew on public desires to return to normalcy and further marginalised aerosol science by depicting its recommended measures as obscure, unaffordable, and an enemy of the public interest.
In other words, people died because of populist politics that denied the need for government action to tackle Covid because that did not fit the populist narrative that individual rather than collective action is always superior.
I hope this evidence is heard at the Covid inquiry.
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Marina Hyde in the Guardian today makes a point that I fear may be overlooked in the coverage of the enquiry and to which a blind eye was turned by the media throughout the crisis.
“For me, the most depressing thing about the revelations at the inquiry this week – and no doubt for many weeks and months to come – is that they are not really revelations. The government was horrendously incompetent, didn’t have a plan, yet still wasted a huge amount of time – and a tragic number of lives – on mad posturing, pointless turf wars or buck-passing and catastrophic infighting. The sad fact is that all of this was said AT THE TIME, and all of it was denied repeatedly by those in charge. And it was denied not just in insidery lobby briefings or to individual journalists – but live on air, to the nation, in those wretched press conferences every night.”
So true
Anyone with half a brain worked that out within the first lockdown. If you kept an open mind and listened to (or more accurately read) the experts they were warning about it. So much so that by May 2020 my dentist had installed a UV filter that kills all viruses and cleans all the air in his consulting room every ten minutes. Bizarrely there was no move to install similar filters in NHS premises or Care Homes. One can only assume that the cost was prohibitive, despite the savings in bed days that most hospitals would realise from extended lengths of stay from cross-infection of influenza and other viruses (covid included).
A similar political scandal was evident over whether natural infection protected against reinfection or transmission of the virus as well as vaccination would (spoiler alert: it is actually better and if you think about it, it would be). The refusal to accept the science and the pushing of vaccination as the only answer, to the point where they threatened to sack NHS staff and indeed did sack care staff was utterly contemptible. Even worse, anyone who tried to challenge the official line with peer reviewed science was targeted as a heretic. Never has it been so apparent that those “in charge” are utterly divorced from reality and will do anything in their power to try and save face. All of them should be removed from their posts and given duties suitable to their talents, like sweeping up and making tea. It is notable that Prof. Whitty would go silent on some topics and indeed became lower and lower in profile as the pandemic progressed while Patrick Vallance and Jonathan Van Tam become more and more prominent before the latter finally and publically transferred into Moderna. Nothing to see here; move along now …
A very interesting perspective. It is worth reflecting on this very specifically for Covid, in the context of Professor David Halpern’s appearance yesterday at the Covid Inquiry. Halpern is an experimental psychologist, who headed the Behavioural Insights Team that applied ‘Nudge Theory’ to the testing of the application of public policy. It is a very professional, well grounded, effective and powerful tool in the application of science to public policy.
Taken together this would provide an invaluable illumination of the mistakes that were made.
I agree that the cult of ‘hyper-individualisation’ acts like a smokescreen and puts too much onus on individuals allowing poor governments to get away with murder.
Interestingly enough, the markets knew better as anyone who wanted to buy a face mask found out and demand was high as was cost, suggesting that many people decided that Covid was in the air and not on the hands.
I still wear a mask in certain social situations and get dismayed looks and scowls all of the time.
I’d like to read their full report.
The link is in the post and it is open access
My dentist installed a sizeable air pump that completely changed the air in the room between each patient. He didn’t do that for no reason. I also read recently that some trials with HEPA air filters in schools substantially reduced absenteeism from covid, coughs, colds etc. But the trials were very limited due to “lack of money”.
The evidence that HEPA filters work is overwhelming
But the also increase educational attainment too as children breathing in clean air concentrate better
Several weeks ago I noticed in our school stock room unused HEPA air scrubbers and monitors. I took a monitor and recorded high levels of CO2 in the 6th form classrooms and common room. I asked for, and got, two of them. The difference in air quality is noticeable, the CO2 levels lower, and presumably some effect on the virus.
Like the computers, we never got enough for students or classrooms, 80 cheap laptops we could’ve got at one third of the price, and 10 HEPA scrubbers. There’s 10 rooms in the Maths block alone.
Government attitude was always f off and die.
Greenhalgh is part of the Independent Sage group – who have been almost the only regular consistent public analysts during the covid era – and are still doing it, and still showing that ‘let them get it’, and ‘you’re on your own’ is still the ‘policy’.
I just wish the Inquiry would have at least one session which can show that a lot of this disfunctional / malevolent govt action / inaction is still going on, as is the pandemic.
People are getting infected multiple times – which can lead to more illness – neurological, cardiovascualr, and others . But many people still feel its good to ‘get it’. The murderous ‘herd immuinty’ ideas – continue to flourish – govt saying nothing and having no policy encourages such notions to spread – just like the virus.
The ‘populist’ narrative seems to include supporting the killing of thousands of Gazan civilians, as well as culling the old in this country, and govt ministers now calling for the sacking of individual academics for saying the wrong thing.
Trisha Greenhalgh was an important, scientifically and medically qualified voice during Covid along with people like Devi Sridhar and Rachel Clarke. Ignored or dismissed by the government. Following the science was one of that government’s biggest lies. I hope we hear from more of those people.
Johnson’s government, and their predecessors who ran down the NHS – I’m looking at you J Hunt – are guilty of something close to culpable homicide. They made decisions knowing that they would cause increased deaths notably amongst the elderly. As has been pointed out, about 4 times as many died, as civilians died in the Second World War. What chance of a civil case given the evidence we are hearing…
High, I would say….
It’s a small gesture I know but I have written to Hunt as my MP, as politely as I could manage, to point out how he is personally accountable, and the fatal consequences of his decisions. Both as health secretary before Covid degrading NHS capacity and capabilities, and as Chancellor now.
I am sure you will get an evasive reply.
Devi Sridhar in the Guardian today:
https://www.theguardian.com/commentisfree/2023/nov/03/scientific-advisers-covid-inquiry-chris-whitty-scientists?utm_term=6545271abaf7de38f04c1229e7663c1b&utm_campaign=BestOfGuardianOpinionUK&utm_source=esp&utm_medium=Email&CMP=opinionuk_email
Correct
And negligent, in my opinion
And we are still getting false information. This morning on the Today programme professor Spiegelhalter, Cambridge University statistician, claimed that despite the Scottish Government’s apparent competence Scotland had a worse outcome than England. Excess deaths 2020-22, the only definite measure of the pandemic’s effects were 10% higher in England than in Scotland. The UK coronavirus tracker shows an 8.4% higher deaths from Coronavirus in England. At least let’s be honest.
Spiegelhalter, along with several other compromised scientists has never really questioned govt policy
The FT, ‘Did Scotland’s cautious coronavirus approach yield results’ (14th February, 2022) reported that: “From the beginning of the pandemic in early 2020 to January 28 2022, there were 2,668 deaths per million people in England where coronavirus was mentioned on the death certificate compared with 2,315 in Scotland” (ft.com, using ONS, NHS, PHS sourced data). The FT report also noted that from the perspective of public impact, using YouGoc/Imperial College London sources, the Scottish government’s approach had a greater impact on the public’s behaviour (higher mask wearing for longer etc.: remember that Covid is principally an aerosol borne disease).
The differences, in international terms, were not large but it must also be remembered that Scotland was tackling Covid from within the UK. It could not ignore UK Government policy, nor was it entirely independent of UK Government policy; although the Scottish Conservatives like to attack the Scottish Government using arguments that effectively presume that Scotland is indeed already independent; and particularly hysterically, as a ‘dead cat’ strategy to divert attention from the implosion of the Conservative Government and Party caused by the Covid inquiry revelations, the cost of living crisis, and the generally sordid nature of Conservative political culture.
Thanks
One of the statements that Helen McNamara made yesterday was that it took 7 months to get a hand sanitiser near the door between the two main offices in Downing Street. I thought at the time that it wasn’t necessary anyway as covid was spread by aerosol. Hand sanitisers were to replace handwashing where water wasn’t available.
But it was claimed that hand sanitisation was essential – entirely falsely
That is the whole point of the article I refer to
Stevens is lying when he says about staff having had covid being given easier duties.
When I was on a covid ward in September 2021 there were staff there doing double shifts who had had covid in the first phase and were still suffering from the effects of it.
On a covid ward!
They had long covid but still had to come into work as they could not afford not to.
Stevens, lie?
No reply needed.
Japan’s national broadcaster, NHK, very early in the pandemic (March 2020?) broadcast special programmes that among other things highlighted the issue of potential aerosol spread. I watched them on the NHK World site at the time, and they were far more use that the tripe available on British airwaves. The risk of aerosol spread was taken seriously from a very early stage by scientists and medics in Japan, which was one reason for the widespread mask-wearing there. Whenever I heard their British counterparts on the airwaves, however, the message was always ‘we’re not sure how much good masks do’, ‘we’re not sure how important airborne transmission is’, etc. But if you’re not sure, shouldn’t the precautionary principle kick in? I haven’t read the entire article you summarise, but its conclusions seem very convincing to me (but then, I’ve been listening to Independent Sage throughout). The approach in east Asia – where there had been previous experience of SARS etc – was very different (and as far as I can see far more effective) than in the UK, but never seemed to be taken seriously by British scientists. Their attitudes and pronouncements suggested they thought they had nothing to learn.
The Japanese and South Korean populations started wearing masks before their governments said anything about it. In Hong Kong at the start of the pandemic it was illegal to wear a face mask — a law passed during the protests there. However the HK government quickly changed the regulations presumably because it would have been impractical to arrest everyone who was wearing one.
The thrust of your post, Richard, was not just about the aerosol transmision issue but mainly about the inadequate responses being, in part, driven by populist politics. This has been revealed as the fundamental truth by Hugo Keith’s forensic handling of part of Dominic Cummings’ concluding statements on the first afternoon of his evidence.
So far, I have not seen anyone comment on it. It ran thus…..
Keith; “So, you helped to put into power and sustain someone who was in your view, and I emphasise this was your view – the inquiry’s reached no view, somebody who was unfit to meet the extraordinarily difficult demands of the pandemic?”
Cummings: “Correct.”
Keith: “Are you sorry?”
Cummings: “No. Because you have to er… Politics is about choices and the choice that we had in summer 2019 was… Do we allow the situation… this whole situation of constitutional crisis to continue, melt down and possibly see Jeremy Corbyn as PM and a second referendum on Brexit, which we thought would be catastrophic for the country eh, for democracy, for the fate of democracy, or to roll the dice on Boris and to try and control them and build a team around him who could control him?… um… And we didn’t take that choice lightly. We considered in summer ’19 staying out of it…um… but we thought that the combination of second referendum and Corbyn was so bad that we should roll the dice.”
See the You Tube video from 5.26.21on.
Now, unless the “we” is a reference to both of Cummings’ egos…. just who exactly was that “we” who made that “choice… in summer 2019…. to roll the dice on Boris” – and did so precisely, apparently in the name of that “we’s” conception of democracy, in order to prevent a second referendum on Brexit? The context of Cummings’ pre-Downing Street career path, working for Vote Leave, through which he had been taken by Keith earlier, make it abundantly clear that the “we” in this testimony means the people behind that campaign.
There it is. Explicit and in the open. Johnson, the incompetent PM unsuited to handle the pandemic, was the direct product of the Brexit Vote Leave leadership – and no doubt their backers- for the sole purpose of saving Brexit from the danger of a fresh democratic vote.
So… populist politics did indeed give us the disastrous handling of the pandemic.
Thank you
An interesting commentary on Cummings’s evasion of responsibility here: https://yorkshirebylines.co.uk/news/brexit/cummings-tells-covid-19-inquiry-the-brexit-blob-to-blame-for-lockdowns/
“or to roll the dice on Boris and to try and control them and build a team around him who could control him?…”
In the USA, the Republican party did the EXACT same thing with Donald Trump to stop Hillary Clinton (who actually got more individual votes) and FAILED. Now the Republican party is a PRISONER to the 30% MAGAt crowd.
If I were a UK citizen, I would vote Labour simply to get rid of the conservatives (especially the David Frost, Baron Frost person who seems to be pulling strings behind the scenes)
[…] By Richard Murphy, part-time Professor of Accounting Practice at Sheffield University Management School, director of the Corporate Accountability Network, member of Finance for the Future LLP, and director of Tax Research LLP. Originally published at Tax Research […]