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  • Writer's pictureDr Hugh Willbourn

#10 A realistic fear

A new Director was being shown around a lunatic asylum. A patient standing in the corner of the ward, clapped his hands twice, regularly, every minute. The Director asked him,

“Why are you clapping your hands?”

“It keeps the elephants away,” came the reply.

“But there aren’t any elephants anywhere near here,” said the Director.

“You see! It works!” replied the patient.

You can look forward to seeing this argument ceremoniously wheeled out at the post-lockdown Inquiry.

In the internet age everyone can find guidance and data and studies to support their opinions.

Does lockdown work? Yes, compare Sweden and New Zealand.

Is lockdown pointless? Yes, compare Sweden and the United Kingdom.

Are masks effective? No. Yes. No. Yes. And so on and on.

Whatever your point of view, there is data out there to support it. Does that mean that there is no truth? No. Death is not a matter of opinion and context is meaningful. Thousands of people have died with or of Covid-19 and mortality is very closely correlated with old age and co-morbidities.

The answers to three questions determine our response to the Covid-19 threat.

Q.1 How well do you understand the risk you, and others, face from Covid-19 in the context of all the other risks you run in your daily life?

Many of us are very poor at assessing risk. Even the WHO is not very good.

A large part of the UK population over-estimate the percentage of the population that has died from Covid-19 by a factor of 100.

Most recently the UK Government, and many others, have fallen into a medically unsound confusion between the significance of “testing positive for Covid-19” and “death”. Death is a Bad Thing. Testing positive for the virus is a Good Thing (even though the tests throw up many false positives) for at least three reasons:

1 It is an indicator of increasing herd immunity which is inevitable

2 Most people who test positive are asymptomatic

3 The chances of dying remain very small, and exceedingly small beneath the age of sixty, and once you have had the infection you are almost certainly (although we cannot yet know definitively) protected from getting it again.

Q.2 What level of risk are you willing to tolerate?

Famously Cambridge academics showed that children are more likely to be struck by lightning than to die of Covid-19, and the chance of even the most vulnerable dying from Covid-19 is much, much lower than dying from one of the big four: heart disease, cancer, chronic obstructive pulmonary disease and diabetes.

But people all over the world are very picky about how they are going to die. They are not very keen to stop the behaviour that increases their risk of dying from the big four, (smoking, a sedentary lifestyle, eating ultra-processed food and consuming sugar) but they are extremely eager to avoid the extremely low chance of dying from Covid-19.

This is of course irrational. But people are not rational. They are overwhelmingly driven by emotion.

Q.3 Do you trust other people to look after themselves?

For the majority in the UK the answer is, “No”. People in higher (but still low) risk groups are not trusted to make their own decisions about whether or not to self-isolate. A reader told me of his despair and frustration that his own daughter would not let him sit next to his grand-daughter and told him, “We want to protect you.” The daughter refused to take seriously his explanation that there are no known incidents of children infecting adults.

In the age of mass media we have too little trust in ourselves, and too much trust in our media and our leaders. We fool ourselves if we imagine we are any wiser than our forebears in the 1930s.

The appropriate answers to Question 3 are as follows:

a) Children – No, we should not trust children to look after themselves. It is our job to look after them. However we are failing to do so. We have closed schools, when we should have kept them open. The risks of Covid-19 to, and from, children are infinitesimal.

b) Adults – Yes, we should trust adults to look after themselves. If they wish to self-isolate, they can. They may get it wrong, but so may we. In fact, we have. Our Governments, made up of people who at least technically are adults, have failed to trust other adults to look after themselves and decide how best to protect themselves. They don’t trust us. Not surprisingly more and more people no longer trust them.

c) Vulnerable adults – There are elderly people who are no longer capable of managing their own affairs. Some would have willingly run the small risks of Covid-19, others would not. Their guardians must act as they believe their charges would wish, but they should not have deliberately put them at risk as was done by British (and Swedish and New York) authorities who sent infectious cases into care homes.

The Sars-CoV-2 virus will not disappear. It will join the billions of other viruses which live in humans. We need to find a way to live with it that does not entail lockdowns which Unicef tells us put 6.7 million children at risk of malnutrition and lead to an additional 10,000 child deaths per month.

I used to think it was Ambrose Bierce who defined reason as “the means by which we justify our desires” but I have failed to find the quotation, so perhaps I should attribute it to myself.

Collectively our emotions - our desires and our fears - are very much driving our use of reason. In order to save children’s lives and to restore the society that makes our own lives worth living, all of us, from Prime Ministers to Joe Public, need to ask these three questions repeatedly until we have a better understanding of how Covid-19 fits in amongst all the other risks we run every day.

Eventually a realistic fear of the huge and accelerating loss of life, culture, health and wealth caused by lockdowns, social distancing and dehumanizing masks may supplant our disproportionate fear of Covid-19. We must hope so, because right now too many of us are frightened of the wrong thing.

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Aug 05, 2020

Thank you - a thought provoking rumination. Two things I would say more about : Are masks effective? No, yes etc. The science is actually very clear, it’s just that the wrong terminology has been used. Medical grade masks are not bad at protecting the wearer from infection. Face coverings are from 50-90% effective at stopping the wearer from infecting others. So, to be honest, any of us could have worked that one out but people got distracted by misreporting and opinion. Framing the discussion about wearing face coverings in terms of avoiding a risk to the vulnerable is not about individual liberty. Secondly, about risk. Yes, people often overestimate risk for all the reasons you say (interestingly, the…


Aug 03, 2020

I find that the three questions you pose here link back very neatly to the points you made in CC3 when considering that self employed builders make exceedingly good decision makers; particularly in terms of assessing risk. As it happens my profession brings me in direct contact with many specialist builders working on the renovation of historic buildings. In terms of Q1 those of us who work in genuinely risky and potentially dangerous environments are the first to laugh off the "lesser" risks. In many a site hut or builders van you will find tea mugs that have more fungal growth and viral load than Porton Down - when a falling beam will turn you into ketchup in a second…

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