Tag Archives: COVID-19
SA government being taken to court over lockdown
Steenhuisen (leader of the Opposition): “The state of disaster we are currently under, governed by the Disaster Management Act, has zero provision for parliamentary oversight. Which means this secretive NCC answers to no-one. Not even a state of emergency, which is a further step up from a state of disaster, has such sweeping powers with no parliamentary oversight.”
Tracing apps are untested medical interventions , says The Economist
https://www.economist.com/leaders/2020/05/16/dont-rely-on-contact-tracing-apps
The Economist argues that hopes should not be pinned in tracing apps which might not work. Medicine is littered with medical interventions that failed, sometimes harmfully. What is different?
One difference is that this is not a biomedical intervention. However, public health is also littered with ineffective or harmful interventions with dangerous consequences (perhaps the effects of lockdown on mass migration being a case in point). It is interesting that governments should consider giving this potential solution a free pass, so to speak, without testing or an evidence base – perhaps because it hs a technological flavor?
Interview with Power FM: lack of evidence for lockdown and importance of considering things besides COVID deaths @Powerfm987
The report referred to is our Framework for Decisions in a Post-COVID World released a few days ago.
Interview with Newzroom Africa: lack of evidence base for lockdown, need for rational framework for decision-making as outlined in our recent report @Newzroom405 https://vimeo.com/417969046
The report referred to is the A Framework for Decisions in a Post-COVID World – South Africa – Report 1.2, a report we published a few days ago from the Institute for the Future of Knowledge at UJ
BMJ article: Children are not COVID-19 super spreaders: time to go back to school https://adc.bmj.com/content/early/2020/05/05/archdischild-2020-319474 @bmj_latest @DrZweliMkhize @DBE_SA #epitwitter @UNICEF @UNICEF_SA @WHO @WHOAFRO
A very thorough and useful summary of a one-way flow of evidence: children are not super-spreaders, appear not only to suffer less severely but to be infected less commonly (or perhaps more transiently), and this all applies to children with co-morbidities too. The case for opening schools is overwhelming.
This follows a systematic review published in the Lancet in early April, concluding that “Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.”
UJ Panel on the Post-COVID World, Wed 13 May 5.30pm SA time, with Johan Giesecke, Joyce Banda and Sehaam Khan. I’ll be facilitating. Can’t wait! Register for the webinar here: https://universityofjohannesburg.us/4ir/covid-19/ #epitwitter
This is the first in a series of webinars on Shaping the Post-COVID World, organised by the Institute for the Future of Knowledge on the initiative of the Vice Chancellor’s Office at the University of Johannesburg.
You need to register to watch this live, and it will be posted as a recording afterwards. Register here: https://universityofjohannesburg.us/4ir/covid-19/
Historians distinguish two ends to a pandemic: the biological end, consisting in the eradication or control of the disease, and the social end, when people stop fearing the disease and society resumes its normal shape. The “Post-COVID World” may never come from a biological perspective, and some are also saying that it may never come from a social perspective either – that the world will never be the same again. Whatever the case, it is clear that the pandemic that took us by surprise was in fact highly predictable, and indeed predicted by the World Health Organisation, the former President of the United States, and many others. It is, moreover, anything but unprecedented. Sometimes, we cannot predict; but other times, we can, but don’t. Whatever the Post-COVID World is like, our first lesson must be to think more carefully and openly about the future – starting with the Post-COVID World itself.
Our first panelist, Her Excellency Dr Joyce Banda, founded and leads the People’s Party in Malawi. She was President of Malawi 2012-2014. She is an advocate for the rights of women and children, two groups who have been disproportionately affected by the consequences of the COVID-19 pandemic despite being less at risk from the disease itself. Malawi is one of the world’s poorest countries, with over half the population living in poverty and a quarter in extreme poverty (food insecurity and malnutrition), with significant dependence on foreign aid, rendering it vulnerable to global economic downturn. The human consequences of economic downturn will linger in Malawi and elsewhere long after the lockdowns in Europe and America have eased. When the world looks to the future, it must bear these consequences in mind.
Professor Johan Giesecke is an infectious disease epidemiologist, and the scientist masterminding the Swedish response. He has advocated focusing on what comes next – most strikingly, when he asked Australia whether it intended to keep its borders shut for 30 years, in the unlikely event it succeeded in eradicating the virus within them. Contrasting with the “lockdowns” implemented in many countries, the Swedish approach has been to focus on evidence-based (rather than precautionary) interventions to slow the spread of disease, and on protecting vulnerable groups. This is sometimes referred to as a “herd immunity” strategy, which is inaccurate; protecting the vulnerable is the goal, while herd immunity is a by-product of any strategy short of eradication. The Swedish approach stands in contrast to lockdowns pursued in many European countries, and is motivated in part by an eye on the medium and long term future.
Professor Sehaam Khan is a microbiologist and Dean of Health Sciences at the University of Johannesburg. Under lockdown, South African universities have moved to online delivery of teaching. Opinions differ as to how successful this is proving, and how sustainable it may be. Not all students are able to access online resources, and not all subjects are amenable to online teaching. Disciplines requiring hands-on training, including some medical disciplines and laboratory sciences, are heavily impacted by lockdown. Much more than schools, universities mix generations, and while evidence suggests that schools can be reopened without much risk, there is little evidence about universities. The sector will need to think ahead, bringing together health expertise with a deep understanding nature of the university and its and societal role, in order to emerge strong from the chaos.
A Framework for Decisions in a Post-COVID World: an aid to policy-makers in South Africa. A report of the Institute for the Future of Knowledge at the University of Johannesburg
A Framework for Decisions in a Post-COVID World – South Africa – Report 1.2
Executive Summary
The document identifies six fundamental policy priorities which, together, constitute a framework for making all-things-considered policy decisions. These decisions must respond to immediate needs for action, but must also be taken with a view to the future (the post-COVID world). The policy decisions that frame them are not created by this pandemic: they existed before it, will persist beyond it, and constitute the reason that we care about COVID-19 and its consequences.
Available evidence suggests that South Africa’s lockdown lacks a strong evidence base, especially when compared to moderate scenarios rather than complete inaction. A one-page analysis (two-pages in the case of health) is provided for each of the following priorities.
- Health
- Food security and nutrition
- Education
- Economy and unemployment
- Vulnerable groups
- Governance and enforcement
A decision tool is offered for scoring these components to represent the impact of lockdown or other measure on that policy priority, and weighting them to represent the relative accordance afforded to e.g. health, the economy, and so on. This approach is customizable: items may be altered, added and subtracted from the list of policy priorities.
While the report writers offer their own recommendations based on the rationale encapsulated in their one-page summaries, in the end these are of secondary importance. This document is meant to support rather than prescribe to policy-makers, by enabling a decision process that makes implicit assumptions and value-judgements clear.
Our primary recommendation is that this framework be adopted, adapted and used by policy-makers for both making decisions and communicating the rationale for decisions, especially (i) decisions to allow and prohibit particular behaviours at different lockdown levels and (ii) decisions to move from one level to another.
Read the report | Access the decision tool
Note on versions: 1.0, 1.1, 1.2 etc denote minor corrections and updates, e.g. spelling, references, etc. Versions can be used interchangeably for all intents and purposes. Substantive new editions are marked by an increment from 1.1, 1.2 etc to 2.0, 2.1, etc.
A reminder of what Imperial said: with a world on max lockdown, we would still expect about 900,000 deaths around now. Give or take. More or less. Etc. #epitwitter I fear this may be epidemiology’s version of the 2008 financial crisis…
The table below shows 250 days after first infection. Yes yes infection didn’t all start on 1 Jan but this model would only be ballpark correct if the infection started globally 6 weeks ago.
It’s easy to be wise in hindsight – except that quite a few people were saying this sort of thing, at every step of the way. I predict that in future this – the model, the politics, all of it – will become a classic study in how science policy should not be made. In the meantime, as we climb down from the heights of our panic, it’s just so fascinating to witness ideas that start off as dangerous – like “maybe we shouldn’t be locking down” – gradually become more common, and to feel the tug in oneself of trying to decide who to trust.
The usual disclaimer: I’m not saying the virus isn’t dangerous, that lives don’t matter, that we should do nothing… just that we haven’t reacted well.
Great piece from @JonathanJFuller ‘What’s Missing in Pandemic Models: Philosophy is needed to put the science of COVID-19 in perspective.’ In @NautilusMag #epitwitter
http://nautil.us/issue/84/outbreak/whats-missing-in-pandemic-models
Jonathan Fuller writes: “In the COVID-19 pandemic, numerous models are being used to predict the future. But as helpful as they are, they cannot make sense of themselves. They rely on epidemiologists and other modelers to interpret them. Trouble is, making predictions in a pandemic is also a philosophical exercise. We need to think about hypothetical worlds, causation, evidence, and the relationship between models and reality.”