Action needed

How should we respond to the covid-19 epidemic?

To minimise the impact on lives and health, and to minimise the economic effects, we need
  • the best science
  • the best political processes.

The best science

Scientific methods have been developed to give the correct answers to questions that we feel have correct answers. A key attribute is avoidance of errors and correction of any errors that come to light. They can be justified on the basis that
  • they give consistent answers and accurate predictions
  • alternatives do not.

Good science depends on
  • sharing all the evidence, including justifying every contentious statement via a reference to a reliable source
  • forming a fair summary of all the evidence, rather than selecting the evidence that supports a particular conclusion
  • settling disagreements via reference to a comprehensive review article, or the key articles in the field.
  • agreeing a consensus on what it means

Key information


Good sources include the Our World in Data website [1].

Long covid
Symptoms can persist after recovery from the acute illness, which is often termed "long covid" [2][3]

Notes on SARS
SARS (severe acute respiratory syndrome) is caused by the SARS coronavirus, known as SARS CoV. SARS originated in China in 2002. It's thought that a strain of the coronavirus usually only found in small mammals mutated, enabling it to infect humans.

The SARS infection quickly spread from China to other Asian countries. There were also a small number of cases in several other countries, including four in the UK.

The SARS pandemic was eventually brought under control in July 2003, following a policy of isolating people suspected of having the condition and screening all passengers travelling by air from affected countries for signs of the infection. There were around 8,000 reported cases of SARS and 800 deaths.

In 2004 there was another smaller SARS outbreak linked to a medical laboratory in China.

(Notes taken from NHS website [4])

Notes on Ebola
Ebola is not endemic in mankind, but jumps from animals (its usual host) to man and causes outbreaks from time to time.

The number of long term infectious human carriers is either very small or zero.

Outbreaks have so far always been contained and eliminated [5][6].

Individuals
Anthony Costello: Twitter @globalhlthtwit https://twitter.com/globalhlthtwit


The best political processes

Democracy is the system of government that we would choose if given the choice.

We need decisions by politicians to be what is best for the citizens, not what is best for the politicians or their financial backers.

Standards for public life in the UK have been set by the Committee on Standards in Public Life - see here.

There should be a clear plan of action. According to the available evidence, this should be local elimination (with outbreaks from travellers dealt with as they occur); this is based on
  • the success of elimination policies elsewhere e.g. in China, New Zealand and Iceland
  • the similarities with Ebola outbreaks.
Read more

Public discussion
People should be working together to control the outbreak. Working together in science and medicine is the norm, and some key elements are:
  • Be polite
  • Collaborate, don't confront
  • Give sources for information (and check them)
  • Pool all evidence (don't cherry pick)
  • Avoid analyses that haven't been properly scrutinized
  • Weigh up options, pros and cons of each
  • Don't be dogmatic unless the evidence is clear
  • Accept you are fallible - encourage feedback and acknowledge & correct errors.

Political action
We need zero tolerance to departures from good political decision-making.

Marcus Ball has founded "Stop Lying In Politics" a non-partisan, not for profit campaign: https://www.stoplyinginpolitics.org/


References
[1]Our World in Data: Coronavirus Pandemic (COVID-19) (Updated daily) https://ourworldindata.org/coronavirus
[2] Mahase (July 2020) Covid-19: What do we know about “long covid”? https://www.bmj.com/content/370/bmj.m2815.
[3]Coronavirus: 60,000 may have 'long Covid' for more than three months – UK study (Sep 2020) https://www.theguardian.com/society/2020/sep/08/60000-may-have-long-covid-for-more-than-three-months-uk-study
[4]SARS (severe acute respiratory syndrome) https://www.nhs.uk/conditions/sars/
[5]History of Ebola Virus Disease https://www.cdc.gov/vhf/ebola/history/summaries.html
[6]Ebola and Marburg haemorrhagic fevers: outbreaks and case locations https://www.gov.uk/guidance/ebola-and-marburg-haemorrhagic-fevers-outbreaks-and-case-locations
[7]Johns Hopkins Hospital database of cases https://github.com/CSSEGISandData/COVID-19/blob/master/csse_covid_19_data/csse_covid_19_time_series/time_series_covid19_confirmed_global.csv

First published: 5 Jun 2020
Last updated: 29 Oct 2020