While paying close attention to data, we all initially focused on the sad matter of deaths. I found it remarkable that, in discussing the COVID-19 related deaths, most people I spoke to had no idea of large numbers. Asked approximately how many people a year die in the UK in the ordinary course of events, each a personal tragedy, They usually didn’t know. I had to inform them it is around 620,000, sometimes less if we had a mild winter, sometimes quite a bit higher if we had a severe ’flu season. I mention this number because we know that around 42,000 people have died with or of COVID-19.
While it’s a huge number of people, its ‘only’ 0.06% of the UK population. Its not a coincidence that this is almost the same proportion who have died with or of COVID-19 in each of the heavily infected European countries – for example, Sweden. The annual all-causes mortality of 620,000 amounts to 1,700 per day, lower in summer and higher in winter. That has always been the lot of humans in the temperate zones. So for context, 42,000 is about ~24 days worth of normal mortality. Please know I am not minimising it, just trying to get some perspective on it. Deaths of this magnitude are not uncommon, and can occur in the more severe flu seasons. Flu vaccines help a little, but on only three occasions in the last decade did vaccination reach 50% effectiveness. They’re good, but they’ve never been magic bullets for respiratory viruses. Instead, we have learned to live with such viruses, ranging from numerous common colds all the way to pneumonias which can kill. Medicines and human caring do their best.
So, to this article. Its about the testing we do with something called PCR, an amplification technique, better known to biologists as a research tool used in our labs, when trying to unpick mechanisms of disease. I was frankly astonished to realise they’re sometimes used in population screening for diseases – astonished because it is a very exacting technique, prone to invisible errors and it’s quite a tall order to get reliable information out of it, especially because of the prodigious amounts of amplification involved in attempting to pick up a strand of viral genetic code. The test cannot distinguish between a living virus and a short strand of RNA from a virus which broke into pieces weeks or months ago.
I believe I have identified a serious, really a fatal flaw in the PCR test used in what is called by the UK Government the Pillar 2 screening – that is, testing many people out in their communities. I’m going to go through this with care and in detail because I’m a scientist and dislike where this investigation takes me. I’m not particularly political and my preference is for competent, honest administration over the actual policies chosen. We’re a reasonable lot in UK and not much given to extremes. What I’m particularly reluctant about is that, by following the evidence, I have no choice but to show that the Health Secretary, Matt Hancock, misled the House of Commons and also made misleading statements in a radio interview. Those are serious accusations. I know that. I’m not a ruthless person. But I’m writing this anyway, because what I have uncovered is of monumental importance to the health and wellbeing of all the people living in the nation I have always called home.
Back to the story, and then to the evidence. When the first (and I think, only) wave of COVID-19 hit the UK, I was with almost everyone else in being very afraid. I’m 60 and in reasonable health, but on learning that I had about a 1% additional risk of perishing if I caught the virus, I discovered I was far from ready to go. So, I wasn’t surprised or angry when the first lockdown arrived. It must have been a very difficult thing to decide.
However, before the first three-week period was over, I’d begun to develop an understanding of what was happening. The rate of infection, which has been calculated to have infected well over 100,000 new people every day around the peak, began to fall, and was declining before lockdown. Infection continued to spread out, at an ever-reducing rate and we saw this in the turning point of daily deaths, at a grim press conference each afternoon.
We now know that lockdown made no difference at all to the spread of the virus. We can tell this because the interval between catching the virus and, in those who don’t make it, their death is longer than the interval between lockdown and peak daily deaths. There isn’t any controversy about this fact, easily demonstrated, but I’m aware some people like to pretend it was lockdown that turned the pandemic, perhaps to justify the extraordinary price we have all paid to do it.
That price wasn’t just economic. It involved avoidable deaths from diseases other than COVID-19, as medical services were restricted, in order to focus on the virus. Some say that lockdown, directly and indirectly, killed as many as the virus. I don’t know. Its not something I’ve sought to learn. But I mention because interventions in all our lives should not be made lightly. Its not only inconvenience, but real suffering, loss of livelihoods, friendships, anchors of huge importance to us all, that are severed by such acts. We need to be certain that the prize is worth the price. While it is uncertain it was, even for the first lockdown, I too supported it, because we did not know what we faced, and frankly, almost everyone else did it, except Sweden. I am now resolutely against further interventions in what I have become convinced is a fruitless attempt to ‘control the virus’. We are, in my opinion – shared by others, some of whom are well placed to assess the situation – closer to the end of the pandemic in terms of deaths, than we are to its middle. I believe we should provide the best protection we can for any vulnerable people, and otherwise cautiously get on with our lives. I think we are all going to get a little more Swedish over time.
In recent weeks, though, it cannot have escaped anyone’s attention that there has been a drum beat which feels for all the world like a prelude to yet more fruitless and damaging restrictions. Think back to mid-summer. We were newly out of lockdown and despite concerns for crowded beaches, large demonstrations, opening of shops and pubs, the main item on the news in relation to COVID-19 was the reassuring and relentless fall in daily deaths. I noticed that, as compared to the slopes of the declining death tolls in many nearby countries, that our slope was too flat. I even mentioned to scientist friends that inferred the presence of some fixed signal that was being mixed up with genuine COVID-19 deaths. Imagine how gratifying it was when the definition of a COVID-19 death was changed to line up with that in other countries and in a heartbeat our declining death toll line became matched with that elsewhere. I was sure it would: what we have experienced and witnessed is a terrible kind of equilibrium. A virus that kills few, then leaves survivors who are almost certainly immune – a virus to which perhaps 30-50% were already immune because it has relatives and some of us have already encountered them – accounts for the whole terrible but also fascinating biological process. There was a very interesting piece in the BMJ in recent days that offers potential support for this contention.
Now we have learned some of the unusual characteristics of the new virus, better treatments (anti-inflammatory steroids, anti-coagulants and in particular, oxygen masks and not ventilators in the main) the ‘case fatality rate’ even for the most hard-hit individuals is far lower now than it was six months ago.
As there is no foundational, medical or scientific literature which tells us to expect a ‘second wave’, I began to pay more attention to the phrase as it appeared on TV, radio and print media – all on the same day – and has been relentlessly repeated ever since.
I was interviewed recently by Julia Hartley-Brewer on her talkRADIO show and on that occasion I called on the Government to disclose to us the evidence upon which they were relying to predict this second wave. Surely they have some evidence? I don’t think they do. I searched and am very qualified to do so, drawing on academic friends, and we were all surprised to find that there is nothing at all. The last two novel coronaviruses, Sars (2003) and MERS (2012), were of one wave each. Even the WW1 flu ‘waves’ were almost certainly a series of single waves involving more than one virus. I believe any second wave talk is pure speculation. Or perhaps it is in a model somewhere, disconnected from the world of evidence to me? It would be reasonable to expect some limited ‘resurgence’ of a virus given we don’t mix like cordial in a glass of water, but in a more lumpy, human fashion. You’re most in contact with family, friends and workmates and they are the people with whom you generally exchange colds.
A long period of imposed restrictions, in addition to those of our ordinary lives did prevent the final few percent of virus mixing with the population. With the movements of holidays, new jobs, visiting distant relatives, starting new terms at universities and schools, that final mixing is under way. It should not be a terrifying process. It happens with every new virus, flu included. It’s just that we’ve never before in our history chased it around the countryside with a technique more suited to the biology lab than to a supermarket car park.
A very long prelude, but necessary. Part of the ‘project fear’ that is rather too obvious, involving second waves, has been the daily count of ‘cases’. Its important to understand that, according to the infectious disease specialists I’ve spoken to, the word ‘case’ has to mean more than merely the presence of some foreign organism. It must present signs (things medics notice) and symptoms (things you notice). And in most so-called cases, those testing positive had no signs or symptoms of illness at all. There was much talk of asymptomatic spreading, and as a biologist this surprised me. In almost every case, a person is symptomatic because they have a high viral load and either it is attacking their body or their immune system is fighting it, generally a mix. I don’t doubt there have been some cases of asymptomatic transmission, but I’m confident it is not important.
That all said, Government decided to call a person a ‘case’ if their swab sample was positive for viral RNA, which is what is measured in PCR. A person’s sample can be positive if they have the virus, and so it should. They can also be positive if they’ve had the virus some weeks or months ago and recovered. It’s faintly possible that high loads of related, but different coronaviruses, which can cause some of the common colds we get, might also react in the PCR test, though it’s unclear to me if it does.
But there’s a final setting in which a person can be positive and that’s a random process. This may have multiple causes, such as the amplification technique not being perfect and so amplifying the ‘bait’ sequences placed in with the sample, with the aim of marrying up with related SARS-CoV-2 viral RNA. There will be many other contributions to such positives. These are what are called false positives.
Think of any diagnostic test a doctor might use on you. The ideal diagnostic test correctly confirms all who have the disease and never wrongly indicates that healthy people have the disease. There is no such test. All tests have some degree of weakness in generating false positives. The important thing is to know how often this happens, and this is called the false positive rate. If 1 in 100 disease-free samples are wrongly coming up positive, the disease is not present, we call that a 1% false positive rate. The actual or operational false positive rate differs, sometimes substantially, under different settings, technical operators, detection methods and equipment. I’m focusing solely on the false positive rate in Pillar 2, because most people do not have the virus (recently around 1 in 1000 people and earlier in summer it was around 1 in 2000 people). It is when the amount of disease, its so-called prevalence, is low that any amount of a false positive rate can be a major problem. This problem can be so severe that unless changes are made, the test is hopelessly unsuitable to the job asked of it. In this case, the test in Pillar 2 was and remains charged with the job of identifying people with the virus, yet as I will show, it is unable to do so.
Because of the high false positive rate and the low prevalence, almost every positive test, a so-called case, identified by Pillar 2 since May of this year has been a FALSE POSITIVE. Not just a few percent. Not a quarter or even a half of the positives are FALSE, but around 90% of them. Put simply, the number of people Mr Hancock sombrely tells us about is an overestimate by a factor of about ten-fold. Earlier in the summer, it was an overestimate by about 20-fold.