We know everything – and nothing – about Covid

We know everything – and nothing – about Covid, by Matt Ridley.

Germany’s strange achievement of a consistently low case fatality rate seems baffling — until you think through where most early cases were found: in hospitals. By doing a lot more testing, countries like Germany might have partly kept the virus from spreading within the healthcare system. Germany, Japan and Hong Kong had different and more effective protocols in place from day one to prevent the virus spreading within care homes and hospitals.

The horrible truth is that it now looks like in many of the early cases, the disease was probably caught in hospitals and doctors’ surgeries. That is where the virus kept returning, in the lungs of sick people, and that is where the next person often caught it, including plenty of healthcare workers. …

The evidence from both Wuhan and Italy suggests that it was in healthcare settings, among the elderly and frail, that the epidemic was first amplified. But the Chinese authorities were then careful to quarantine those who tested positive in special facilities, keeping them away from the hospitals, and this may have been crucial. In Britain, the data shows that the vast majority of people in hospital with Covid-19 at every stage have been ‘inpatients newly diagnosed’; relatively few were ‘confirmed at the time of admission’. The assumption has been that most of the first group had been admitted on an earlier day with Covid symptoms. But maybe a lot of them had come to hospital with something else and then got the virus. …

Oops — the health system caused many COVID cases. But look on the bright side: contagiousness was initially overestimated, and severe lockdowns are probably not warranted:

If Covid-19 is at least partly a ‘nosocomial’ (hospital-acquired) disease, then the pandemic might burn itself out quicker than expected. …

If it is right, it drives a coach and horses through the assumptions of the Imperial College model, on which policy decisions were hung. The famous ‘R’ (R0 at the start), or reproductive rate of the virus, could have been very high in hospitals and care homes, and much lower in the community. It makes no sense to talk of a single number for the whole of society. The simplistic Imperial College model, which spread around the world like a virus, should be buried. It is data, not modelling, that we need now….

Dr Muge Cevik of St Andrews University … concluded … ‘Casual, short interactions are not the main driver… Epidemic intensity is strongly shaped by crowding.’ …

Emerging data on children:

Children do not transmit the virus much if at all. A recent review by paediatricians could not find a single case of a child passing the disease on and said the evidence ‘consistently demonstrates reduced infection and infectivity of children in the transmission chain’.

One boy who caught it while skiing failed to give it to 170 contacts, but he also had both flu and a cold, which he donated to two siblings. Children appear to have ACE2 receptors, the cellular lock that the coronavirus picks, in their noses but not their lungs.

This makes models based on flu, a disease that hits the young hard, misleading. The more the coronavirus has to use younger people to get around, the weaker its chances of surviving.

Vitamin D emerges as significant, again:

Summer sunlight should slow it further, both by killing the virus directly and by boosting vitamin D levels. Vitamin D protects against colds and flu, and especially at the end of winter is often deficient in obese, dark-skinned or elderly people, all of whom have proved more susceptible to Covid-19. In a study in Indonesia, Covid-19 cases with deficient vitamin D were an enormous 19 times more likely to die from the disease than people with adequate levels.

The US and UK find themselves after a month or more of lockdowns in a dire situation. They did not reduce new cases, because they “forgot” to close their borders and institute quarantine. They merely flattened the curve. The countries that are crushing the curve — eliminating it on their territory — have quarantines and border control.

So, now what for the US and UK? Unfortunately they are where they are. Even now closing the borders would obviously be the first priority, but the media/left/swamp are preventing even discussion of that. Time to ease up, but how much?

It won’t be straightforward and there will be setbacks, but testing, followed by track and trace, is plainly now the way out. …

The problem is not now people disobeying the rules, but being terrified to give up the extreme safety of lockdown and relaxed about staying at home on taxpayer-subsidised wages. In the light of what we know, it is vital that the government now switches from urging us to stay at home to urging us to return to as much of normal life as possible.

Be in no doubt that the strangulation that is asphyxiating the economy will have to be gradually lifted long before we know the full epidemiology of the virus. Perilous though the path is, we cannot wait for the fog to lift before we start down the mountain.