I have come across this extraordinary interview by Professor Knut Wittkowski, an epidemiologist who states in powerful form why social distancing will prolong but not eliminate the disease. His insights go a long way toward explaining why recent data has not come close to reaching [initial high death] estimates, and it’s unlikely they will.
Richard Epstein, on the website of the centre-right Hoover Institute
A month after the COVID-19 epidemic peaked in China and SARS-CoV-2 migrated to Europe, then the USA, epidemiological data begin to provide insights into the risks, and effectiveness of intervention strategies such as travel restrictions and social distancing. Respiratory diseases, including the 2003 SARS epidemic, remain about two months in any given population, though peak incidence and lethality can vary. The data suggest at least two strains of the 2020 SARS-CoV-2 virus evolved during migration to Europe. South Korea, Iran, Italy and Italy’s neighbors were hit by the more dangerous “SKII” variant. While the epidemic in Asia is about to end, and in Europe to level off, the more recent epidemic in the younger US population is still increasing, albeit no longer exponentially. Peak level will likely depend on which strain entered the US first. Models that help us understand the epidemic also help us choose prevention strategies. Containment of high-risk groups, like the elderly, and reducing severity by vaccination or early treatment of complications, is the best strategy against a respiratory virus disease. Social distancing or lockdown can be effective over the month following peak incidence of infections, when the exponential increase ends. Earlier containment of low-risk people merely prolongs the time the virus needs to circulate until the incidence is high enough to initiate “herd immunity”. Later containment is not helpful, unless to prevent a rebound if containment started too early.
Abstract of Professor Wittkowski’s recent paper, which prompted the interview.
My post yesterday featured Professor Bhakdi’s open letter to Chancellor Merkel. It also linked to twenty-one other credible authorities questioning the “drastic” measures now being taken in the name of ‘flattening the curve’ of infection through social distancing and lockdown, so that medical capacity is not pushed to breaking point by a flood of cases at the same time.
A comment by bevin pointed out that the initial response of the UK Government had been to downplay the threat, and pursue a ‘herd immunity’ approach quite the opposite of ‘flattening the curve’. Given the context, I took bevin’s wider point to be that any notion of lockdown as establishment conspiracy doesn’t stand up to scrutiny.
I agree, though I’m ahead of myself, having promised yesterday not to stray into speculation: to stick instead to highlighting credible but marginalised voices with legitimate questions. It’s not easy to disprove a conspiracy theory and, as I keep saying, some in any case prove accurate. But for what it’s worth, the truth of bevin’s remark is one of a few things that leave me disinclined to see the official narrative on CV-19 as a grand hoax.
Be that as it may, ‘flattening the curve’ versus ‘herd immunity’ has emerged as a key arena in a struggle of ideas1 somewhat one-sided in the UK (after Boris Johnstone’s U-turn) and across the globe. Clear and critical thinking, always in short supply, gets even scarcer with fear in the mix. But how well founded are our fears? Conversely, are we indifferent to other threats which may pose greater dangers?
Pass. And in any case I’m again ahead of myself. The interview with Professor Wittkowski, cited in my opening quote, took place in New York a week ago on April 1 and 2, though I first found it on OffGuardian yesterday. A little background research threw up this:
Dr. Wittkowski received his PhD in computer science from University of Stuttgart and his ScD (Habilitation) in Medical Biometry from the Eberhard-Karls-University Tuüingen. He worked for 15 years with Klaus Dietz, a leading epidemiologist who coined the term “reproduction number”, on the Epidemiology of HIV before heading for 20 years the Department of Biostatistics, Epidemiology, and Research Design at The Rockefeller University, New York. Dr. Wittkowski is currently the CEO of ASDERA LLC, a company discovering novel treatments for complex diseases from data of genome-wide association studies.
The interview lasts forty-one minutes. (Here’s a transcript of its highlights.) Don’t take my title as evidence of Knut Wittkowski as excitable. He isn’t – I’m embracing my inner tabloid headline writer is all – though he does indeed say, amid many other weighty points, that we should let the children spread the virus.
Like Sucharit Bhakdi, Wittkowski is calm and rational. A scientist first and foremost, the issues he raises are not to be ignored by anyone who takes this pandemic seriously.
Perspectives on the Pandemic | Professor Knut Wittkowski | Episode 2 – Bing video
- In this regard I recommend J.G Farrell’s splendid Siege of Krishnapur, set in a town on the Indian Plain during the Uprising of 1857. To pass the time, the besieged English sahibs hold an Oxford style debate – exquisitely surreal given that participants and audience face death by hunger, disease or the vengeance of the mutineer sepoys – on the cause of cholera. Farrell based it on contemporaneous exchanges in the Lancet, and pits medical orthodoxy (a complacent but likeable old sawbones) on the disease as arising from airborne ‘vapours’, against the newfangled nonsense (espoused by a younger man, a rationalist and idealist both) of its being caused by foul water. I have another story about how cholera was shown to be waterborne, but this is the more relevant here.
Bevin’s observation is of relevance here.
The UK, the USA and many other Western Governments initially adopted an approach of let it rip. Either by default through inaction or deliberate bravado to maintain economic business as usual.
With no preperation – and reports do exist that at least US intelligence agencies were sounding alarm bells about he Chinese outbreak at least in November 2019 if not sooner- in terms of testing and protective equipment this approach has complicated and exacerbated the situation on the ground by, in many cases, not properly collecting data necessary to:
1. Know realistically where we are in terms of the actual true spread at any moment in time.
2. Make rational decisions.
Elderly patients are being sent back into care homes some of which are witnessing high levels of mortality which do not just impact on the residents but also the staff and their families.
Other at risk groups, not all of them elderly by any measure, are either being asked to sign DNR forms in advance or in some reports having them signed for them.
These are not part of the official figures and as a result there is no way of knowing the true figures at least in the UK and probably elsewhere as Governments try to manage perceptions designed to downplay the fact that the initial approach was inadequate and negligent.
As a result it seems reasonable to observe there is every likelihood that in a number of instances particular countries are merely guessing where they are in the cycle.
Adoption of the kind of measures proposed here should have occurred straight away. However, having screwed up the the initial response the only feasible practical option was to manage the cock up by instigating measures to slow down the impact on under resourced health systems to prevent them from being overwhelmed. Hence hiding some of the impact by sending people back to care homes so they don’t appear on the headline tally’s.
As the good Prof. observed the horse had already bolted.
Not that there are not also valid questions and issues around the arguments and analysis put forward here.
As with all such argument and analysis it is couched in terms which involve caveats. A “peak level will depend on” here and a “vaccination is he best strategy” there.
All good sound arguments for basing policy decisions on – in an ideal situation in which all the variables are adequately known and vaccinations exist.
Which unfortunately is not the case. We cannot know how many cases exist when we have insufficient testing kits and an ineffective testing system along with doctored data. When we are not collecting the data in order to make an informed decision.
Neither do we have a vaccine. Which may at best be eighteen months away.
The matter is further complicated by insufficient consideration of factors not taken into account. Like the fact that viruses mutate. By the time the herd has been culled sufficiently to acquire immunity the virus has mutated and we go around the merry-go-round again.
A major flaw which Baldrick would no doubt be proud of.
As I type I’ve just been alerted to a report that some fifty patients in South Korea who recovered from the virus and got the all clear have got it again. At this stage it remains to be seen whether it is the same virus or a rapidly mutated variant.
Consequently, I’m reminded of the well known military observation that no plan ever survives its first contact with enemy.
In an ideal situation where we have sufficient information and a vaccine the approach set out here is sound. Unfortunately, apart from all the other real life outside the closed laboratory issues mentioned (and no doubt a number of others), we don’t know enough about the ability of this virus to mutate, nor that timeline.
In such scenarios we have to adapt to what actually exists, a lot of which will be based on far from ideal information and laboratory conditions.
Agreed Dave. But when we don’t know, should we be changing the status quo to the extent we’re passively consenting to? Especially when change comes at high cost, and entails even higher risks – though I’m again ahead of myself – on so many fronts?
I’m only asking.
All reasonable points Phil.
As with most other options there’s no way of knowing in advance and, to at least a certain extent, the initial choice, however it came about, of openly* attempting business as usual which has allowed the virus to spread in populations has let the genie out of the bottle.
What we do now about the virus can be found from various sources such as this from the Conversation:
The most relevant points being:
“COVID-19 is caused by a coronavirus called SARS-CoV-2.”
…..”most of the damage in COVID-19, the illness caused by the new coronavirus, is caused by the immune system carrying out a scorched earth defense to stop the virus from spreading. Millions of cells from the immune system invade the infected lung tissue and cause massive amounts of damage in the process of cleaning out the virus and any infected cells.
Each COVID-19 lesion ranges from the size of a grape to the size of a grapefruit. The challenge for health care workers treating patients is to support the body and keep the blood oxygenated while the lung is repairing itself.”
” SARS-CoV-2 is more severe than seasonal influenza in part because it has many more ways to stop cells from calling out to the immune system for help.”
Consequently the name of the game has been to lessen as much as possible the impact on under resourced and poorly equipped health and social service systems.
Which raises practical questions for not just hospital and CCB capacity but also how you isolate all vulnerable groups and their families with a social care system which in some places are non existent and others cut to the bone ? Vulnerable groups which include anyone of any age with a range of health issues from cancer, asthma, transplanted organ, pregnant and so on?
Given the lack of system capacity to deal with the initial cock up to preserve BAU there are a group of relevant questions to be posed to be the PTB in respect not just of the initial stance (which Bevin succinctly outlined) but also the dogma underlying the policy which produced those systems.
But no one will be holding their breath the way the British State closes ranks.
At the other extreme the approach taken in Ecuador poses its own equally valid set of questions:
I’m really not invested in any fixed position on this. I hear a lot of shouting from all sides and some of it sounds hyperbolic to the point of religious. It’s slowly dawned on me, with a little help from friends of varied stripe, you included, that I need as far as this is ever possible to shed a priori assumptions. To look at what the science is saying. Since scientists appear divided on this, my purpose narrows further: to highlight questions raised by credible scientists, even and especially if they are being sidelined by media I already know to be ignorant and/or untrustworthy.
That Conversation piece is clearly written but not, I fear, by a relevant expert. Moreover, he offers no evidence – which is fine for a community health informational but not for this inquiry – so I have no way of evaluating the truth or otherwise of this claim:
I doubt he made that up in his armchair last night but, without contextual/comparative data as requested by Prof Bhakdi, it is hard to know what to make of it and I’d prefer he avoided emotive metaphors like ‘scorched earth’ when you can guarantee that’s the one phrase his readers will carry away with them! The author, Benjamine Neumann, is a professor of biology. We are speaking primarily about epidemiology, and that troubles me. Especially in light of this further claim:
What Bhakdi and Wittkowski, a microbiologist and an epidemiologist, both with decades of field leadership under their belt, say is that we have no evidential support for such a claim. That doesn’t make it wrong of course but … well, we’re in danger of going round in circles!
I really am just asking questions. Some of which may well be answered in the coming weeks.
‘most of the damage in COVID-19, the illness caused by the new coronavirus, is caused by the immune system carrying out a scorched earth defense to stop the virus from spreading. Millions of cells from the immune system invade the infected lung tissue and cause massive amounts of damage in the process of cleaning out the virus and any infected cells.’
‘SARS-CoV-2 is more severe than seasonal influenza in part because it has many more ways to stop cells from calling out to the immune system for help.’
Aren’t these two statements contradictory?
On the face of it, yes. Maybe Professor Neumann has answers in light of the underlying science. We can’t tell either way but now you mention it, it does weaken the piece even – in fact especially – in what I called a “community health informational”. Prima facie paradoxes often turn out on deeper inquiry to be nothing of the kind, but that’s no excuse for leaving them as litter for us lay folk to trip over in popularised forms!
That’s what comes of trying to take up less space by only supplying short snippets. Apologies.
The relevant quote comes with a link here referencing a further literature review link from 2014
( https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-480 ) which suggests the average patient spreads the flu virus to 1.3 others.
Unfortunately, this primary link provides only limited link citation references to scientific (biological and epidemiological) papers in respect of the data provided in order to cross reference properly.
This includes reference (but no direct link) to data from China on Covid-19 that the average person with Covid-19 spreads it to 2 to 2.5 people. Along with reference, again to the Chinese data that 20% of Covid-19 patients require hospitalisation – about 10 times more than with flu.
Although it does provide a link to a Lancet paper dated March 28 2020 – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext to substantiate the claim that the average stay in hospital from Covid-19 is 11 days whereas with flu it is five to six days – unfortunately no citation link.
I’ll try and chase this up after the Easter break.
The apparent contradiction seems to be as a result of two slightly different things being conflated.
As far as I understand/interpret the article Covid-19 is a NEW variant of a coronovirus SARS-CoV-2.
It is the Covid-19 variant which causes the immune system to produce cells to deal with the infected lung tissue.
SARS-CoV-2 on the other hand contains features which prevent cells from calling out to the immune system for help.
Hope this helps.
I have stated to many that while we have the lockdown I can stay relatively safe. As a person who is at high risk, I know that once the lockdown is lifted I have little chance of remaining safe and will inevitably catch the virus, in whatever mutated form it presents itself and die. The NHS will not be able to keep me alive. It is also likely I will lose one of my brothers and several of my neighbours. That is not a pleasant reality for me, but it is one I must accept.
Had the herd immunity approach been adopted, many thousands more would be dead(and not just the elderly or health compromised).
The pro eugenics crews would be very satisfied at the death toll of so many people like myself, my brother and neighbours, being the useless creatures we are, and likely pleased to be rid of us. However, as Dave points out, the virus has already mutated once in a very short span of time, and much like the “flu” variants, does not usually afford anyone lasting immunity.
For now, we recognize that too little, too late is what we have and the main reason the NHS would have been overwhelmed is because it was so poorly financed. It’s all rather moot, at least as far as the virus is concerned. It’s here and possibly will be for many years to come. One might consider my own thinking on the matter – living long enough to see one last summer through – slightly selfish, that would be the sentient being in me rather than the herd animal that knows no different, but I can only hope that the lockdown lasts for months as opposed to weeks.
That said, my parents would have the “flu” jab every year and within ten days come down with flu, whilst I refused to have the so-called vaccination and never caught the flu, not from them nor anyone else.
I don’t think anyone really knows what the right choices are and I wouldn’t wish to make the decision for so many lives which might be lost no matter which way you jump.
The various opinions I have read from intelligent experts all seem to have equal merit but without all the facts available and proven, I’m not sure the right choices are available to everyone, nor who should make those choices.
The only other point I would make is that too often “herd immunity” is a myth. It is for bovine TB, Cape Hunting Dog rabies and Saiga antelope disease and it isn’t working out too well for the Tasmanian Devil and their cancer. Relying on something that is at best limited to a few instances of pathogen immunity is not really a very clever answer, it’s more like a wing and a prayer option.
Stay safe and best wishes.
Stay safe yourself Susan. And no, you’re not allowed to die. You are needed!.
I’m less certain than you, either way, but on this we are as one:
In fact, until a week or two ago this (and neoliberalism’s inadequacy in general to deal with pandemic) was what I was most focused on. I’ve come rather slowly and rather late to the possibility that, whether or not this is a hoax (and I’m pretty confident it isn’t) the global impact of the strategies in place will lead to millions of deaths. Recessions kill, and in huge numbers, but they do so in ways that seldom make the headlines.
If the virus breaks free of it’s constraints and it is being constrained. the number of people sick will be monumental and of course the vast majority will be the workforce. The death toll will look like a lottery ticket reference number and the country, without it’s workforce will provide an unintended lockdown. the result of lifting the lockdown will mean that the global spread will see more mutations which will continue apace in wave after wave of infection. The whole point of herd immunity is that the victims who survive build their own resistance to a contagion – small comfort to the dead (who are cold in the grave)and their relatives who did not pull through.
The other side of the coin is that BoJo’s U turn was probably primarily about not saving the NHS but saving the private sector health care in readiness for a TPA with the US, because, in fact, he has secured a future for the private health sector. Unlike some people, I don’t believe in the veracity of this “Save the NHS” slogan. It just isn’t in the interests of the Tories or even the right wing opposition.
There are so many angles I could come at this subject from, I scarcely know where to begin.
ie. This virus does discriminate, it attacks the elderly and the vulnerable more readily than those who have money for a selective diet, a comfortable roof over their heads and the means by which they can choose or have options. That in itself endangers health compromised, homeless, hungry and those in care.
ie. This virus occurred at a time when the US is in a trade war with China and the first country to be hit was of course – China. A coincidence – quite possibly – or did the planners just shoot themselves in the foot?
ie. How many of the esteemed epidemiologists etc. believe that the global population – (China is a country of over a billion, the ME and Africa, several billion, India, with it’s dreadful lack of available healthcare and many of the aforesaid with questionable sanitary conditions but lots of resources), should be culled for the sake of saving the “superior” peoples in the rest of the world. Many western thinkers have this worldview whereby other countries which they deem less civilised are the reason their own civilisation is worthier of entitlement and manage to judge them by their own short sited standards. This is something which you wrote about some time ago regarding Syria. When should logic be the only consideration in solving a problem and more importantly, whose logic?
Countries around the world are robbing the poorest in order to supply the richest and all those many “aspiring middle classes”. I don’t consider myself a socialist but Marx was right on the basic observations. I am not a “class” of people but if I were to describe myself it would be as working class. Only if people aspire to being something better with regard to status does class become a distinction. This virus should create a level playing field, but it won’t. The “middle class” will expand before it finally contracts always at the expense of others. If enough people die because of this virus, my “betters” will find a way
to exploit others – again.
I know I’m rambling but I cannot find a solution that fits morally and logically and I have no-one to crack heads with – hence the reply I’m posting.
On other related matters, Israel is pretty much stealing(now there’s a change)medical supplies destined for other countries and no-one makes a fuss.
The Army General has relieved Bolsonaro because the parliament thinks he’s lost the plot with regard to Covid 19.
Trump is remaining adamant about continuing the murder of Iranian and Venezuelan citizens with sanctions and he’s kicked Crozier?(the commander of the aircraft carrier with Covid 19 among it’s crew who wanted to dock in a safe port to isolate his men), while his
men pay tribute to him for actually caring what happens to them some US idiot(OK, there are a lot of idiots in the US) in uniform is telling people a cotton bandana will perform well as a mask and protect them!
Keep writing your thoughts and challenging me with the hope you will keep me sane.
All the best.
Maybe, but though I dislike the currently fashionable term, ‘fear porn’, I can’t help but feel our emotions are being played here. WDYT about what Professor Wittkowski has to say on herd immunity?
Yes, and this is acknowledged by Prof K in the first minute or two of the interview.
Thanks Susan. I will of course, though tbh I’m trying – not very successfuly I admit – to set them aside in this, my second post dedicated to giving a wider hearing to valid science I sense is being sidelined.
PS on the other stuff I agree in large part – except I do call myself a socialist …
short sighted – whoopsie! I tried to spell beleagred and found I couldn’t oh dearie me.
As long as we get the gist, we steel city scribblers are tolerant of typos and spelling errors. Bigger fish to fry …
“my second post dedicated to giving a wider hearing to valid science I sense is being sidelined.”
Which post – I’ve read your posts and don’t know which one you mean.
This post is the second. The first is Professor Bhakdi’s open letter to Angela Merkel in Questions, just questions.
rough scanned this socialist action article today, will look into it, but it sounds right and is probably just as applicable in the UK.
I’ve scanned it too, Susan. I’m sympathetic to what it is doing – pointing out, as good socialists should, how rotten capitalism is proving in its response to pandemic. I’ve been doing the same myself. In fact I’ve written far more posts on that aspect than I have on the current question: how reliable is the evidence on which social distancing and lockdown are based?
I’ll be getting back to my day job of capital-bashing soon enough but, until then, pieces like this from Socialist Action shed no light. Rather, we must look to the science. Or for current purposes, to credible scientists raising important questions but being ignored. That combination – credibility + marginalisation in a context of vast political import – should ring alarm bells for any critical thinker.