News from Wales

Baroness Hallett and team on vacation

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From the Welsh leg of the Hallett Inquiry

HART member Dr Roland Salmon, retired Consultant Epidemiologist and former Director of the Communicable Disease Surveillance Centre (Wales), was interviewed on 1st March at the UK Covid-19 Public Inquiry, Welsh module. See video, from 1 hour 38 minutes in, or read the transcript here

We were pleased to see that the KC for this session in Wales was polite and behaved much more correctly than the appallingly rude treatment meted out to Carl Heneghan by Andrew O’Connor. Mr Tom Poole allowed Roland time to explain why he was concerned about the whole concept and potential societal harms of lockdowns and the rationale for so-called ‘focussed protection’. Roland made some very good points about herd immunity and disagreed strongly with the suggestion that this was a very risky strategy. He remarked on Chris Whitty writing in the BMJ “and I frankly thought it was bizarre, because your jumping-off point — and the examples he used in the British Medical Journal were the Ebola virus and the human immunodeficiency virus, HIV. Now, of course your jumping-off point for any consideration of your strategy is the biology of the virus that you’re dealing with, and those viruses are so fundamentally different in their properties that, yes, of course you wouldn’t adopt a herd immunity strategy for them, but my point is that the underlying virology of the coronavirus is such that that becomes a reasonable option and, in my view, one that — about which you could have made relatively optimistic predictions from a fairly early date.”

If you are feeling keen, you can also watch the witness before him, Dr Chris Williams, a consultant epidemiologist in Public Health Wales. Depressingly, he said à propos of facemasks, “On face coverings I can recall arguing verbally (in TAG) in favour of their use, even in the absence of evidence, as I knew that there was evidence from SARS-CoV-1 that surgical face coverings had a protective effect in hospitals and also that they were likely empirically to be effective; and that a measure with low effectiveness deployed very widely can have a significant effect.”  But, like Roland Salmon, he also expressed significant concerns about school closures and the adverse impacts this would have on not only the students, but also on their working parents. He was asked to comment on a briefing paper from TAC (the Technical Advisory Cell – I thought cells were usually small terrorist networks when not used in their usual biological sense!). This contained the infamous Imperial modelling graph, unless you are colour blind which the KC pointed out would render it totally uninterpretable. If you believe that modelling was the way to go, which I have to say, we don’t, it looks as if the famous ‘flatten the sombrero’ call is best represented by the red line. This involves case isolation (which surely is what we always would advocate = stay at home if you’re not well!), plus isolating household contacts (à la bubonic plague) plus social distancing for over 65s (≈ focussed protection). Whereas the grey dotted line involving school and college closures and whole population social distancing (≈ a euphemism for lockdowns) seems to give a peak bed occupancy higher than orange CI (Case Isolation only) line.  The only difference is that this model (PC_CI_HQ_SD) puts the peak into July rather than May for the CI model, not exactly a strong rationale for the lockdowns, which as Mark Drakeford has now admitted were a massive “failed experiment”. See more in Pick of the Week.

Figure 1. Hospital bed-occupancy modelling for England by ‘No intervention’ compared with combinations of five possible interventions 

Of course, even the ‘No intervention’ model was based on the assumption that the whole population were susceptible and any epidemic would therefore sweep through the whole population over the space of twelve weeks (identical modelling which Imperial gave for the Swine flu outbreak in 2009 which turned out to be completely wrong). Roland Salmon during cross examination was asked to explain why he thought that modellers ‘dominated the agenda’. He replied, “one of the things which you will find with any group of scientists in the room is that there will be a number of opinions, or at least two or three opinions. They have to be synthesised in some way. And then of course along come the mathematical modellers with some very neat numerical constructions, and there’s always a little bit of a tendency to heave a sigh of relief and to follow the way that that guides. And in many ways that can be very helpful, but you do have to detach yourself a little bit from that and ask: well, how do these models, in my own qualitative assessment, relate to the infectious disease problem as I see it? And I didn’t get a sense of that happening.” 

His last sentence seems to sum it all up.

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