The Home Secretary, when questioned on the BBC Andrew Marr show announced on Sunday 28 June
‘there is going to be a Leicester lockdown?’ ‘So, there will be support going into Leicester … with local flare-ups, it’s right that we have a local solution’
But looking at the public data from coronavirus.data.gov on Covid infections, Leicester does not have a significant problem:
It is only when you look at the Public Health England surveillance report, you notice something awry.
Why the dispartity? This comes from the difference in how tests are reported. Coronavirus.data.gov only reveals so-called ‘Pillar 1’ tests (those in the NHS), wheres the PHE maps include both Pillar 1 and Pillar 2, the latter being conducted under the auspices of NHS Test and Trace and other commercial partners.
Data from Pillar 2 tests is only just getting through to Directors of Public Health. And the number of people tested is still not disclosed (the number of people tested is still ‘unavailable’).
Public Health England only report publicly the level of outbreaks at the Upper Tier Local Authority level (mostly county councils, unless there are large cities such as Leicester where the are unitary authorities).
So, how do we know that there isn’t an outbreak in our local area? Basically, we don’t. But the PHE surveillance report is the best we have for now. Also worth examining the cluster of outbreaks around Manchester (which may be outbreaks in schools or hospitals)
What appears to be unusual about the Leicester outbreak is that it does not appear to have been traced back to care homes, hospitals, or schools. It appears to be community transmission, and is the first real test of the Government’s policy of preventing a resurgence of COVID-19
The news that UK business secretary Alok Sharma has been tested for Covid-19 highlighted the issue of survivorship bias, that is the systematic overestimation of performance and underestimation of risk by ignoring non-survivors.
In the early stages of the epidemic, the risk perception of politicians broadly matched that of the general population. However, if the proportion of decision makes that have been infected by the virus and survived exceeds that of the population, the executive’s risk appetite could surpass that of the people they represent.
Politicians need to ensure that they make decisions in such a way that suvivorship bias does not affect their judgment.
Dr Duncan Robertson
School of Business and Economics, Loughborough University
Our paper in Journal of Simulation ‘How simulation modelling can help reduce the impact of COVID-19‘ setting out how simulation modelling can help in the fight against COVID-19 and subsequent epidemics and pandemics. Click here to access the paper.
Modelling has been used extensively by all national governments and the World Health Organisation in deciding on the best strategies to pursue in mitigating the effects of COVID-19. Principally these have been epidemiological models aimed at understanding the spread of the disease and the impacts of different interventions. But a global pandemic generates a large number of problems and questions, not just those related to disease transmission, and each requires a different model to find the best solution. In this article we identify challenges resulting from the COVID-19 pandemic and discuss how simulation modelling could help to support decision-makers in making the most informed decisions. Modellers should see the article as a call to arms and decision-makers as a guide to what support is available from the simulation community.
In 1959, Charles Lindblom wrote The Science of “Muddling Through”, advocating an incremental approach to public policy and management. “Muddling through” does not work for pandemics. The science of pandemics is dominated by epidemiology, not behavioral science. The delay between policy decisions (or indecisions) and the resultant high UK death rate needs tracing back from the prime minister and his advisers to Cobra, the chief scientific adviser, and the Scientific Advisory Group for Emergencies. However, this is one form of contact tracing that can be delayed until the inevitable public inquiry.
Dr Duncan Robertson Fellow in Management Studies, St Catherine’s College, University of Oxford, UK
The real problem with Coronavirus Covid-19 is that when the health service becomes overloaded, the death rate goes up significantly. So, it is imperative that we keep the number of cases at any one time below or as near as possible to NHS capacity.
The Government’s model relies on shifting the peak. I am not clear that we are doing this fast enough. We are an outlier compared to other countries in our social distancing policy response.
There is a tension between epidemiologists – those who study how diseases spread (a very established science started around the time of the Spanish Flu 100 years ago), and behavioural scientists who study how people behave and react.
Epidemiologists have models validated against past pandemics. Behavioral scientists do not.
There are economic and social costs of social distancing. But if you delay social distancing too much, there are potentially very real human costs in increased mortality. Doctors will need to make very difficult moral decisions on who to treat and who not to treat.
I do not understand why, if the intention is to create herd immunity, why we are not isolating our vulnerable population, especially those in care homes.
Behavioral insights are great when you are trying to get people to pay their tax bills on time. And if people don’t, it doesn’t really matter. With a pandemic, if you get the timing wrong, more people die unnecessarily. Then you look back from your computer and say, yes, we got that behavioral model wrong while doctors and nurses on the front line are exposed to extra cases that could put their own lives at risk.
Here’s a video to show what we should be trying to do: