Geneva, 1 November, 2020

France, Belgium and Germany have last week gone back into lockdown. The UK will do so next week. Today, here, Geneva has announced that the main hospital has been swamped by so many COVID-19 cases in the last 24 hours that emergency measures will apply as of tomorrow; these include temporary closure of all non-essential businesses. A curfew has yet to be imposed. The Swiss borders may soon be closed again. The speed with which the case-numbers have increased in this “second wave” of the COVID-19 pandemic has taken European countries totally by surprise. There is already an active discussion on social media whether governments are to blame for incorrect policies and guidance or whether people are to blame for not doing what their governments have been telling them to do. This cuts both ways in my opinion.

Here are the global cases per day according to the Johns Hopkins COVID-19 information site. Currently, there are half a million cases per day. And rising. This is really serious! Compare now with mid-March when we went into the first lockdown. (It is important to note that the service offered by Johns Hopkins is not the primary source of these data; the site compiles different countries’ reporting of their own COVID-19 statistics.) Below are the daily COVID-19-related deaths. 

Taking a global view of things, these two graphs tell us a great deal about the pandemic and about data collection. First, we are not really living a second wave of this pandemic; we only have that impression because in some countries from around May to September we were able – to a degree – to control the number of cases through social distancing measures. Second, the numbers of daily COVID-19-related deaths have not risen since April. Third, there is a saw-tooth pattern in both graphs due to a seven day cycle; the lowest days are always Sundays.

As for the number of deaths not increasing in proportion to the number of cases, I found a very helpful résumé from 1 September entitled “Coronavirus cases are mounting but deaths remain stable. Why?” by Carl Heneghan and Tom Jefferson from Oxford University. This was published, surprisingly, in The Spectator. The authors propose that a number of factors are at play. Testing has developed in terms of who is tested, when and with what kind of test; as a result, the number of deaths as a proportion of cases could have changed with time. Treatment of serious cases is better and so hospitalised people are less likely to die. Younger people adopt fewer distancing measures and are more likely to become infected but are far less likely to die as a result. The vulnerable people most likely to die as a result of COVID-19 infection are now subject to stricter measures and are therefore less likely to be infected. 

I have found no credible scientific explanation for the weekly cycle and the Sunday dip. It baffles and concerns me. I discussed this via zoom with my friend Nathan in Toronto. He is a statistician. He is the brainiest bloke I know. Meal-time discussions with his teenage sons cover issues like statistical truth and whether mathematics really exist. (I struggle to count how many shots I take in a round of golf!) I drew Nathan’s attention to the COVID-19 weekly cycle. He found it interesting and most amusing. I told him that the lowest day each week for reported cases and deaths was Sunday. This was greeted with unbridled laughter. “This must be some kind of major reporting bias!” I claimed assertively. Tears streamed down his face. “But this is the global COVID-19 statistics” I cried. “Surely, if stats are simply not reported on the day of rest then this is really, really serious!” At this point, Nathan had his head in his hands and emitted a sort of snorting noise. He obviously found my amateurish foray into his world just too much. When he was eventually able to talk, he said “What about Israel?” See what I mean? Very clever! So I dug into the national stats. Despite the sabbath being on Friday in Israel, they too have a Sunday dip. Interesting! So… those countries near the top of the league with a weekly cycle and a Sunday dip: USA, Argentina, Brazil, France, Germany and, earlier in the pandemic, the UK. Spectacularly, Spain has no stats reported on either Saturday or Sunday. No weekly cycle is seen in the stats from India, Russia, Italy, Iran or Colombia. The mystery remains. I hope that Nathan or someone with comparable cerebral capacity (if this were possible) will find time to comment on or even explain this.

What all this comes down to is how science is presented to an ever COVID-19-info hungry public. I am not saying that these statistics or reports are unhelpful or wrong but we should be aware that arriving at real scientific answers to the many questions that this pandemic throws up will involve valid scientific methodologies that in turn require study design, ethical approval, data collection, analysis, review and reporting in an appropriate forum. In other words, time! Just be cautious with respect to what you read and believe as this crisis evolves further – which it will. Be prepared to change your mind.

Nevertheless, I recommend a News Feature from 6 October in Nature by Lynne Peeples. It is a review entitled “Face masks: what the data say.” In brief, face masks do not replace strict social distancing measures; they are an alternative when such measures are not possible. Face masks probably lower the chance of an uninfected person getting the disease and of an infected person spreading the disease. Face masks possibly reduce the chance of serious outcome if a person nevertheless becomes infected by reducing the infective “viral load.” The most effective face masks are those made of two layers of material, are close fitting and are washable. The simple act of people wearing face masks may result in less risky behaviour. 

Credibility is not only important in relation to data and science. Images that accompany COVID-19-related articles in the mainstream media should also be scrutinised with the truth in mind. 

On day 11 of the Lockdown Diary, I had a bit of rant about false images of the coronavirus that are used to colour up news articles; they are computer-generated and bear minimal relation to an actual coronavirus. Last week, the BBC carried a concerning but credible report that the level of antibodies in people previously infected with COVID-19 may fall away rapidly so leaving them once again vulnerable to the disease. This article was covered by yet another starwarsesque image of a coronavirus (purple and fluffy this time) and – a first – surrounded by “Y shaped” antibodies on the attack. This picture does not make the science more accessible or credible. It simply draws the reader in through video game imagery. I’ve pointed out before that TV stations could get actors to deliver the experts’ scientific messages slickly and in a measured, serious voice rather than force us to listen to those umming and uhrring loveable geeks who, incidentally, know what they’re talking about. It’s about the integrity of the message.

In other major news from recent days, President Recep Tayyib Erdogan of Turkey is outraged by insults levelled against him in France. Above, I expressed surprise that The Spectator should carry a serious article about COVID-19 mortality. The link here is that, in 2016, The Spectator, astonishingly, ran a competition for who could write the most offensive poem about President Erdogan and obviously published the winner’s entry. The thing is that the winner was none other than the former editor of same rag, former Mayor of London, Member of Parliament for Uxbridge and South Ruislip, former Foreign Secretary, current Prime Minister of the United Kingdom and COVID-19 survivor, the Right Blondable, Boris Johnson. Quite the diplomat! I will leave you with his victorious limerick. I know…. I said be cautious about what you believe but this one is true.

Geneva, 25 October, 2020

In the Lockdown Diary on 11 May I said “today will be the last post of the Diary… at least for the time being!” It was clear that the end of the lockdown did not equate with the end of the pandemic. Even then, experts’ long-term predictions included living with “a series of stop-start measures.” That’s where we are now with many countries currently reporting case numbers higher than when we went into lockdown in mid-March.

I came across this graph the other day. Note the little blip in the 14th century resulting from 200 million deaths from the Black Death in Europe. (Given the difficulties we have today establishing the number of COVID-19 cases and deaths one wonders……) Whatever, us humans have done pretty well. The boom in total carbon mass of our species would have been impossible if we had simply continued as hunter-gatherers. According to one bioboffin I heard on the radio, we can only have achieved this population boom through burning fossil carbon. In other words, we have effectively utilised carbon from the ground to power agriculture, industry and transport and, over a few thousand years, enabled ourselves to produce and move increasing amounts of edible carbon to the extent that there are so many of us we have taken over most of the planet. This has required and further nourished the potential for our outsized brains to innovate. We have come up with the likes of the Haber-Bosch process (whereby atmospheric nitrogen can be converted into fertiliser) and so can now feed billions more people. Of course, the great human story also tells of combating disease, developing the means to live in security and learning that it’s better to trade with our neighbours than to fight them (that took us some time to figure out!) Wowzers! A biological view of homo sapiens’ existence is pretty amazing. But can we really just carry on like this? If we insist on living in increasingly big cities, enjoying mass gatherings and gadding around the globe in aluminium tubes with wings, is it any surprise that a highly transmissible little single-stranded RNA respiratory virus could run us into the ground? 

Our governments are juggling the statistics and desperately struggling with that big trade-off between suppressing the transmission of the virus and maintaining their nations’ social and economic well-being. Little surprise then that COVID-19 dominates the news. Opinions, statements, policies and practices have ranged from impressive to ineffective to laughable to knee-tremblingly pathetic to downright outrageous. It is all too awful. There’s only one thing I can do to avoid the screaming ab-dabs or curling up on the sofa in the foetal position with thumb in mouth……. Welcome to the first of the COVID Chronicles.

Inevitably and not unreasonably, the fickle needle of a global media on COVID overload swings again and again towards one man, Donald Trump. Furthermore, a bitterly contested US election draws nigh. One main issue of course…. the (mis)management of the COVID pandemic. And just when you thought the political circus over there resembled a pie-throwing class at clown school, the Commander in Cheat conflobulates the whole blabberpshere by having the misfortune – or political cunning – to report that he tested positive for the disease. His extraordinarily rapid recovery – celebrated by him tearing off his mask in public – only proved that he is a man of steel constitution and a natural leader in the fight against all things evil and Chinese. We will know in a matter of days whether this sniffle gains him more than a vote or two. I fear it will. 

We’re familiar with images of hungry-for-visibility political wannabees standing in the background when the President makes an important statement. But why would a senior doctor drag his colleagues out of hospital – still in scrubs and unrecognisable anyway in masks – to back him up when he gives waiting journalists some inconsistent snippets of medical non-news about Mr Trump’s condition? Does having what look like medi-thugs on hand add veracity to your message? Ducked if I know!

Masks have crashed into every aspect of our lives. They make for ubiquitous litter and are now a major source of pollution of our waterways. To wear or not to wear has become a massive political issue. Wearing has become an emblem of the responsible COVID-aware citizen. Not wearing has become a statement of a personal philosophy that says “I don’t care!” or “Don’t mess with me!” Commercial flights have been grounded because one passenger refuses to wear a mask. The need for hand washing, that central pillar of public health, that was repeated and repeated at the beginning of the pandemic barely gets a mention now. 

Ironic photos aside, I hate the whole mask thing. (I comply though.) Above all, I want to see strangers faces when I deal with them; and I want to shake their hands. And I hate my regular pocket-tangle of those elastic ear-loops, door keys and glasses. To lift our socially distanced spirits, my wife and I decided to go out for a fine dining experience here in town. True, the food was fantastic….. But monkfish carpaccio with a lime and almond oil drizzle followed by venison dauphinoise just don’t get the taste buds fizzing as they oughta when served by people in masks and, worse, rubber gloves; forensic examiners come to mind at just the wrong moment. I guess I have to accept that this is all part of the “new normal.” 

We have been able to play golf since the lockdown. There are of course, strict social distancing measures in place around the club house. At the stellar level, the main professional golf tours in the US and Europe seem to be particularly well organised with regular COVID-19 testing of players, their caddies and tournament officials all of whom move in a bubble from one tournament venue to another. There are no spectators on the courses but the TV coverage is exceptional. All golfers keenly await Tiger Woods’s upcoming defence of his US Masters title at the re-scheduled iconic event in Augusta, Georgia. Personally, I’d like to see Rory McIlroy claim this title. The friendly rivalry of these two stars goes back a few years. 

Hoping you are all well and as happy as possible under whatever COVID measures you are obliged to suffer. Part 2 of the COVID Chronicles will be published next week.