Thursday, January 13, 2022

The Madness of Following the Covid Models

By Carl Heneghan and Tom Jefferson - January 13, 2022 at 09:38AM

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Being a purveyor of pessimism is one way to further your career. Predict doom and anything short of doom that happens after that is a blessing, a miracle. And you can be either a saviour or a genius – take your choice.

The UK government has consistently been served with worst-case Covid scenarios from modelling to justify ever more restrictive measures. For much of the pandemic, the government and its advisers have cited projections of cases and deaths, each more terrifying than the last, and a cycle of lockdowns and Eat Out to Help Out-style schemes has followed.

Ministers’ eagerness to understand what might happen next has led to an overreliance on these models. The messaging of fear has provided a rationale for inhumane measures – from solitary confinement to the abandonment of some of the most vulnerable in our society. It has also created unrealistic expectations for what interventions can do to lessen the burden of Covid.

Meanwhile, the negative impacts of such restrictive policies are vast, wide-ranging and should not be underestimated. They will be felt for generations to come, especially by the weakest members of our society.

Finally, however, it seems we have reached the stage where the models are being properly called into question. Despite the models predicting an enormous catastrophe from the Omicron variant, on 21 December 2021, prime minister Boris Johnson said: ‘We don’t think today that there is enough evidence to justify any tougher measures before Christmas.’ Roughly translated, that means we were leaving the doomsday predictions behind. No new restrictions have been announced since then, either, and the prime minister has come as close as possible to saying there won’t be another lockdown.

So why has it taken so long to get to this point, where ministers look at the actual evidence and data? The lack of challenge (until relatively recently at least) to the numbers provided by modellers has certainly not helped.

There is an alternative approach to following the models: to use the evidence and data to monitor events closely and change course as necessary. This means thinking flexibly, acting accordingly and being critical of any assumptions made about the future. These are fundamental principles to those who know anything about clinical practice and dealing with respiratory viruses.

In contrast to the models, studies from England, Scotland and South Africa have pointed to less severe outcomes from the Omicron strain. Cases have risen, but they have not come anywhere near to hitting the one million mark predicted by scientific advisers for the end of December. While the number of patients in hospital with Covid has increased, significantly fewer people require intensive care than in previous waves, and mortality has been far lower, too. And for the first time in the pandemic, questions are being asked as to who is admitted ‘for’ or ‘with’ Covid and who is catching it in hospital – accurate data is vital for informing any future policy restrictions that may have far-reaching consequences.

Thanks to the decision in England to pause and not rush into restrictions, the whole nature of the Covid debate has changed. The politicians have joined the publicans in wanting to keep society open.

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