Posted 6 May 2020
Today sees a departure in the normal content of my posts. Rather than data and analysis, it is comment and judgement. I have not so far delved into the personalities of the key players in coronavirus, but today I will. I am going to contrast one character who has been a key player (and is making his own headlines this morning) with someone I feel should have been making the font page news instead for a far better outcome. For all of us.
It’s indulgence, it’s conjecture, it’s personal. But maybe my research and posts over the last month have earned me a few minutes of your time for pure indulgence.
Rewind history to the 17 of March 2020. Boris is sat at his desk awaiting a phone call. (This almost certainly is not a true reflection of history but it makes a good narrative). Up until today he has been advocating the soft lockdown approach. He has so far chosen to follow the Sweden model of how to deal with the pandemic. Wash hands, the highest risk stay at home, be sensible but try to carry on.
The phone rings. It’s Dr Neil Ferguson. He and his team at Imperial College have created a model of how COVID-19 could pan-out in the UK and the results are in.
It is Armageddon in a spreadsheet.
“Carry-on as you are and a quarter of a million will die, maybe over half a million”, he and his model suggest. “Take severe lockdown measures right now and the toll will be tens of thousands instead”. Ferguson is persuasive (colleagues and adversaries call him arrogant).
Boris listens: Pubs close, restaurants close, gyms close.
Six days later, on March 23rd, Boris is still listening and takes the biggest step of his political career and the history of the UK changes forever. Lockdown Day 0. The most severe intervention in the lives of UK citizens since the war begins.
But there are dissenting voices. Other academic institutions have their own models. They have their own predictions. It’s too late, Ferguson has won the model war. “Stay at home; Save the NHS; Save lives” became the mantra. If you spoke against that you were irresponsible no matter how academic and researched your thinking. Group-think took over and to question its foundations was heretical. People were dying – how could you be so heartless or stupid to think lockdown was not essential?
No-one really knew just how much ‘up for discussion’, ‘educated-guesswork’, ‘conjecture’ was in that model. Maybe no more so than other models; perhaps, but what was different was the persuasiveness of its creator.
But these other models did not go away. Papers were published deconstructing and finding the flaws in Ferguson’s model. No model is immune to that process; Ferguson’s certainly wasn’t. But Ferguson’s rebuttals to his critics were strong and absolute. They were silenced.
As lockdown continued, others then started using the real data as it became available. The problem was, this real data just did not fit at all well with the Ferguson model. Different lockdowns in different countries and yet some of the key metrics were consistent no matter what the country chose to do. Real data should always trump model data.
Then the Sweden results came in. That again wasn’t a model, that was real people and real lives. The apocalypse as Ferguson’s model would have predicted, did not happen. Rather than the many tens of thousands his model would have predicted for a non-lockdown Sweden, their death toll is still well less than three thousand. Choosing not to go into lockdown did not turn into irresponsible mass-murder.
But you cannot keep a bad model down. Just last week, Ferguson was telling us that if we come out of lockdown too soon, still hundreds of thousands would die.
It is with delicious irony therefore that he falls on his sword today for doing just that.
Let me rewind to 17 March. I want you to conjecture what would have happened if Boris had not picked-up the phone to Ferguson but rather to Dr Aseem Malhotra instead.
Who is Dr Malhotra, you are probably asking? That most people would have to ask the question, is rather telling. He is a cardiologist. A pretty eminent one at that. But one who is considered outspoken because he is a crusader for the metabolic health of the nation and the role poor diet has played in the demise of our well being. Thankfully he is now making some of the headlines for himself, But perhaps this is too little too late.
Imagine on the 17 March the conversation was more like this:
“Prime Minister: The COVID epidemic is far worse for those with obesity, diabetes, hypertension and heart disease. And these are all markers of poor metabolic health. The UK has the highest prevalence of these conditions, and therefore metabolic ill health, than any other European country so the death toll here is likely to be the worst (no model needed there).”
“But, metabolic health can be improved, and improved quickly with appropriate and for most, simple, dietary changes.”
(Don’t worry, I haven’t gone mad. I know I would be very naive to think this could have actually happened, but I can dream).
But If it had, the mantra could have been so very different: “Change your diet; Save the NHS; Save lives. And that would be forever, not just for coronavirus.”
Yes, keep the vulnerable safe (but re-define the vulnerable). Keep washing you hands. Be sensible. But also get a grip and sort out what you eat. Do not let the food and drug industries persuade you that it is OK to eat what you want because you can ‘run it off’ or ‘take a pill’.
Think of the lives saved in the long-run. The many hundreds of thousands over many years who would not die prematurely of heart disease, complications of type II diabetes and obesity. Think of the saved economy and the lives that would save. Think of those whose suffering and ill health in older life could be reduced. And because metabolic illness CAN be reversed so quickly, it could even have saved COVID lives in April 2020, had some one listened.
I can dream.
Thank you for indulging me.