A hundred and one conspiracy theories

 

Is the novel coronavirus (COV-Sars-2) real? Is it a risk to most people? Are you more likely to be killed in a car accident than die from Covid-19? Or more likely to die in the bath? Was the lockdown a waste of time which cost lives in additional suicides and cancer cases? Should Britain have pursued a ‘herd immunity’ strategy as was the Governments initial plan and modelled themselves on Sweden?

 

Back in March, Sweden’s apparently more relaxed approach appeared to be working. CNBC reported Anders Tegnell, the Public Health Agency epidemiologist in charge of the strategy, as saying:

“Sweden has gone mostly for voluntary measures because that’s how we’re used to working. And we have a long tradition that it works rather well.”

 

Opponents of both the lockdown and mask wearing in the U.K. have seized upon the Swedish approach as evidence that the approach adopted by almost every other country in the World was wrong, if not part of some evil conspiracy to rob them of their freedom.  Sweden’s approach, whilst eschewing a formal lockdown was not quite as laissez faire as its supporters might claim. It relied on responsible social distancing coupled with home working, restrictions on bars and restaurants and the closure of colleges and universities. What seemed to make the policy workable was that the Swedes, unlike the British, have a strong sense of social responsibility.

Fast forward to June 2020. The British Medical Journal had an article by Heba Habib, which claimed that “Sweden’s public was supportive of the strategy 

but is now paying a heavy price.” The Swedish strategy was not one of pretending that the virus does not exist, nor of seeing it as an invented disease by some shadowy organisation as conspiracy theorists would have you believe, but rather was to develop a ‘herd immunity’, the same strategy which the British government were pursuing until they lost their nerve.

 

As Habib notes the early success of the strategy was quickly overtaken by events. “Sweden has the largest number of cases and fatalities in Scandinavia—around 37,000 confirmed cases at the time of writing, compared with its neighbours Denmark, Norway, and Finland which have 12,000, 8,000, and 7,000 cases, respectively. All three neighbouring countries adopted a lockdown approach early in the pandemic, which they are now slowly lifting. All three have since re-opened their borders, but not to Sweden.”

 

Of course since then the numbers have only got worse. As of Tuesday September 8^th Sweden had 85,707 cases, Denmark 18,356, Norway 11,560, and Finland 8,337. Sweden has now recorded 5,836 deaths, a rate closer to the UK’s than any of its Scandinavian neighbours. Herd immunity, it seemed was failing, but this is irrelevant to the anti-lockdown brigade who have no great interest in herd immunity preferring to believe that the virus is an invented disease aimed at preventing them from going to the pub.

 

Essentially, to reach herd immunity requires something above 60% (some experts say as high as 80%, though at least one person has claimed 20% but that is a little fanciful) having acquired immunity. This is done either through a vaccination programme (there is, of course, no vaccine for COVID 19) or by recovering from the virus and developing antibodies which protect you from a further attack. Researchers from Imperial College, London and the University of Oxford have examined data from a number of sources and “the researchers found little evidence for herd immunity and concluded that the decline in cases and deaths was a result of lockdowns, behavioural shifts, social distancing and other interventions.”

 

So contrary to the theory that herd immunity could be reached without a lockdown, there is currently no evidence that anywhere, including Sweden, has achieved herd immunity, and that it is, in fact lockdown measures that have slowed down the spread of cases.

 

There is a fatal flaw in the herd immunity strategy. No, not the lack of a viable vaccine (the latest miracle cure is currently suspended due to a severe adverse reaction in a test subject), but the fact that most people do not want to contract the virus. Indeed, social distancing is designed to prevent herd immunity, so there is a logical flaw at the heart of the World’s approach to the virus. That said, the idea that herd immunity was a viable option was not widely held by scientists who have spent a lifetime studying viruses (one assumes they know slightly more than an oversized boot boy wrapped in a Union Jack). I searched in vain for a reputable expert who was advocating herd immunity as a strategy and could not find a single one. Even Anders Teggers, the Swedish advocate of no-lockdown has taken a less rigid approach as the Swedish model has run into trouble. In an interview with Sverige Radio he conceded:

“If we were to encounter the same disease again, knowing exactly what we know about it today, I think we would settle on doing something in between what Sweden did and what the rest of the world has done.”

An exception is Nobel Laureate Michael Levitt who has received some attention from Covid-deniers impressed by the fact that they appear to have not only an expert on their side, but one with a Nobel prize to his name.  He has claimed that in Britain the government was hoodwinked by epidemiologists whose predictions were wildly inaccurate. Indeed, the team from UCL predicted around 50,000 deaths. The current figure is around 41,614 (worldometers.info), or according to death certificate data, 51,740 (ONS). He has argued that lockdowns have caused more deaths than they saved by increasing suicides and and cancer deaths. 

 

It might also be pointed out that although Professor Levitt is indeed a Nobel prize winner this was for his work as a chemist not for his expertise on virology or epidemiology. Not that this means he is not entitled to an opinion, nor that he cannot be right. However, the fact that he is a Nobel Laureate is used to give his mathematical modelling a credibility it might lack if he was a painter and decorator from Port Talbot who professed a love of numbers.

 

A search of the web reveals what appears to be scientific evidence supporting the view that the lockdown has caused more deaths than it has saved. But, this evidence, on closer examination turns out to be less conclusive than its advocates like to believe. For example, in June psychiatrist Leo Sher published an article in ‘QJM: an international journal of medicine’ in which he proposed that Covid 19 would lead to an increase in suicide rates. Looking at a range of sources he speculated that:

“Social isolation, anxiety, fear of contagion, uncertainty, chronic stress and economic difficulties may lead to the development or exacerbation of stress-related disorders and suicidality in vulnerable populations including individuals with pre-existing psychiatric disorders, low-resilient persons, individuals who reside in high COVID-19 prevalence areas and people who have a family member or a friend who has died of COVID-19.”

 

The key words here are “may lead”, and of course he may prove to be right. But this was translated by anti-lockdown activists as evidence of a 200% increase in suicides due to lockdown. The latest suicide figures for England however for Quarter 2, which is the period of the lockdown show a decline in the rate of suicide to its lowest level since 2001 a rate 0f 6.9 per 100k compared to the lowest ever Q2 rate of 8.7 in 2007.

 

Similarly, a paper in The Lancet by Maringe et al., predicted that there would be an increase in cancer deaths due to the suspension of screening programmes. Their findings make sobering reading:

“..we estimate a 7·9–9·6% increase in the number of deaths due to breast cancer up to year 5 after diagnosis, corresponding to .. 329–358 additional deaths. For colorectal cancer, we estimate ..1534–1592 additional deaths; for lung cancer..1343–1401 additional deaths, a 4·8–5·3% increase; and for oesophageal cancer..336–348 additional deaths, 5·8–6·0% increase up to 5 years after diagnosis.”

 

The key words here are “we estimate”. This is not actual deaths, but estimates based on a range of factors which may or may not turn out to be accurate. I am not saying that these “experts” are wrong, they may well turn out to be correct. Of note though is that they were not advocating a retreat from lockdown but rather:

“..the urgent need for policy interventions to mitigate the predicted additional cancer deaths resulting from delays in diagnosis.”

 

In these cases, professionals with a vested interest in their specialisms are suggesting that as the lockdown proceeded it was necessary to take account of the wider implications for healthcare. They were not intending to provide ammunition for a group of people who refuse to wear masks who suddenly, and against type, have developed a concern for the health of  people who may be worse off than themselves.

 

In addition to these scientific papers Covid-deniers have found support for at least one of their theories in the weekly published death statistics produced by the Office for National Statistics. These provide death statistics according to death certificate classification in addition to a 5-year average. It is this average which has provided the source for some wild speculation. 

 

For week 35 (28^th August) the total number of deaths is recorded as 9,032. The 5-year average is 8,241. The number of Covid deaths is 101, and the number of deaths attributed to pneumonia/flu is 795. This makes it look as one Twitter user claimed that there are 8 times more people dying from flu and pneumonia than from Covid. It is also the case that the excess deaths (the actual deaths minus the 5-year average) is 791. In which case, so it is said, rather than reimposing lockdown measures it is time to abandon them completely. 

 

The first thing to say about these figures is that their interpretation is not as easy as the average social media user might think. For starters deaths from pneumonia/flu are not actually deaths from flu or pneumonia at all, but instances where these are mentioned on the death certificate. As the stats note:

“Note: Deaths could possibly be counted in both causes presented. If a death had an underlying respiratory cause and a mention of COVID-19 then it would appear in both counts.”

So, at least one of the figures could be double counted. My own Father died last December after living with dementia for four years, but it was pneumonia which eventually killed him.

 

More importantly the 5-year average is being treated as a reliable indicator of what the number of deaths ‘should be’ in any week. But it does not take much thinking about this to realise that there is no particular reason why deaths should follow a pattern set by an average. The number of deaths in week 35 have ranged in that 5 year period from 7,865 to 9,036. That higher figure is remarkably close to the figure recorded for 2020. Indeed, since lockdown was introduced, excluding Covid deaths there have been 14 weeks where the number of deaths is below the 5-year average, compared to 10 where it has been higher. This pattern would be the similar with or without Covid.  In most weeks the death figures are well within a range that might be expected.  So, any speculation about an excess figure based on the average is just that – speculation.

 

The danger is that public discourse becomes so dominated by a small minority highjacking the genuine concerns of ordinary people that these kinds of papers and statistics become abused to promote an anti-health agenda. This is clearly not what the authors intended. Incidentally, the statistics for cancer deaths are released about two years behind so we won’t know whether there is an increase in deaths due to the lockdown until at least 2022.

 

Most considered opinion on the spread of viruses suggests that the only way to stop the spread of a virus which goes from person to person is to limit contact between people. Of course, the death rate might have come down anyway. But, nobody knows that anymore than I know whether cancer deaths will rise due to the lockdown. It is plausible that the environmental affects of the lockdown (a lowering of workplace stress, a reduction in traffic pollution) could actually cause cancer rates to fall during the lockdown. But, we will never know for certain.

 

What we do know is that wherever the lockdown has been lifted the number of cases has started to rise. Right now we are in the midst of mini-epidemics fuelled by foreign travel and school returns which have seen local lockdowns imposed in Bolton, Birmingham and Caerphilly. But this assumes that we know what a case is. Again, there is plenty of misinformation being circulated on the web, but according to the American Centre for Disease Control:

“A case definition is a set of standard criteria for classifying whether a person has a particular disease, syndrome, or other health condition.”

 

There are some standard uses of cases allowing for cross comparison, but there is no single definition of a case. Which means that attempts by anti-Covid campaigners to argue that a case only refers to somebody hospitalised as per standard epidemiological practice is pure bunkum. The definition of a confirmed case, as defined by the World Health Organisation is:

“A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.”

Nobody is simply counting anybody who self reports as a case. To be a case you need to have tested positive and that positive test must be confirmed by a laboratory.

The attempt by anti-Covid groups to suggest that both the number of cases and the death rates are lower than published (in reality they are likely to be higher) is part of a campaign to present Covid 19 as of little consequence. An anti-lockdown conspiracist told me that I was more likely to die in a road accident than from Covid. Not so. The latest figures for road accident deaths in England are from 2019 and total 1,870 (according to the RAC). I have also been told that deaths from Covid are less likely than being hit by lightning (hardly, there was only one death from a lightning strike in the U.K. last year), or that I was more likely to die in the bath (unlikely as I only have a shower, but whilst there are no statistics for drowning in the bath, official stats reveal that 321 people drowned in the U.K. last year). An oft repeated claim is that more people die from flu. That is not true. There were 1,692 deaths from flu in England last year, but like Covid 19, flu is a contagious disease, which is more than can be said for drowning, crashing your car, being hit by lightning, or even cancer or suicide.

 

As an aside I was in hospital during February and March and whilst there a patient on my ward was diagnosed with flu. I suddenly found myself on an isolation ward and all visitors had to wear masks as did I. But here is the point. I was not happy being in a ward with a person with flu, but I was not terrified that I would die if I caught it. I just worried that my operation would be held up whilst I recovered. I can tell you however that had that man had Covid 19 symptoms I would have been extremely worried because as contagious as flu might be I know that it is unlikely it will kill me (I usually get flu symptoms about once a year), I am not so confident that I would survive Covid 19. I also know that for some people Covid 19 has long term health affects, I am not aware that is the case with flu.

 

The majority of the population in the U.K. support the lockdown measures as can be seen in a number of opinion polls carried out since it began.

The truth is that those who are campaigning against lockdown measures, social distancing and mask wearing have no great interest in either Covid 19 or freedom.  Those opposing the lockdown tend to be right wingers who are using some public disquiet over the handling of the pandemic to recruit people to their perverted ideologies. Whilst they happily quote statistics, some real some imagined, few of them have the intellectual skills necessary to understand the papers on which they are based. An article in the journal ‘Personality and Individual Differences’ based on a survey of 640 individuals found a positive correlation between believing conspiracy theories related to Covid 19 and low educational attainment. It is this demographic who were most likely to vote for Brexit, and also most likely to support the Conservatives in the last General Election. People attracted to the right tend to be less empathetic and less accepting of change, and very often come from deprived backgrounds where they have been subjected to abuse. Of course, there are those amongst the Covid deniers who are perfectly capable of understanding statistics and are choosing to use them for their own ends. Sometimes those ends are overtly political (and not always right-wing), but sometimes just an irritation that a Worldwide pandemic has interfered with what they considered ‘normal life’.

 

What we now have is a perfect storm. Politicians in government, clearly way out of their depth, sending at best mixed and at worst muddled messages. A body politic in the U.K. and USA which has shifted right wards, and a pandemic that has as its best form of defence restrictions on personal liberty. We should remember that for all the noise made by the conspiracy theorists they remain a minority. But rather than making the mistake that the People’s Vote campaign made and calling our opponents thick and uncouth, we should recognise that if confronted with evidence the less committed can be shifted away from the right. The vacuum has been left by established parties (particularly the Labour Party in the U.K.) in thrall to the right-wing dominated media and terrified to speak out lest they lose the support of voters who never supported them in the first place.

 

Sars-Covid-2 is real. It is potentially lethal. It is most definitely not a plot to enslave people. Those arguing such are claiming for the lockdown precisely what they would like to do. The internet and social media have given them a platform greater than they could previously have dreamed of, but the numbers are relatively small. My greatest scorn is not for Covid deniers, per se, but for academics such as Michael Levitt who for some reason known only to their own inflated ego have chosen to use their status to promote theories (and that is all they are, theories) which have the result of undermining public health measures.

 

The left in democracies have always seen education as a key to their role. In this current crisis, with national figures and the media gleefully repeating conspiracy theories as if they are fact we have an even greater imperative to try to help our fellow citizens see through the fog. Covid 19 cannot be defeated politically or by an act of will. It is a health issue that requires a public health approach. Hygiene and safe distancing are what we all can do whilst those with the skill work on developing a vaccine. Stay safe.

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