Interview With A Socialist Epidemiologist

Recently, Jim Denham, on his Shiraz Socialist blog, carried an interview, by Martin Thomas of the AWL, with Professor George Davey Smith, who is Professor of Clinical Epidemiology at Bristol University. Professor Smith is also a socialist. The interview first appeared in the AWL's paper “Solidarity”. In the interview, he confirms many of the arguments I have put forward since the start of the COVID19 panic. That Jim Denham should carry the interview then is in some ways surprising, because, back in April, he also carried, as a series of guest posts, without qualification, the rants of David Ashcroft, which led me to write my replies to him that appeared on my blog shortly afterwards. 

In the early days of the COVID outbreak, Denham carried the following post setting out the AWL's line. The interesting thing, here, is that the AWL were not following the general drift of the Left, unthinkingly supporting the calls for lockdown. They called for “Make the labour movement fight for public scrutiny and workers’ control!” I was even moved to post a comment to Denham's blog stating, “I am glad to see that you and the AWL are promoting workers control rather than the extension of the state that others are championing. There may just be hope for you yet.” 

The AWL's call for workers' control was reminiscent of when they were a much healthier organisation, back in the late 1970's and early 1980's, when they traded under the name Socialist Organiser, the public face of the International Communist League and subsequently Workers Socialist League. Back then, when nearly all of the Left was calling for a blanket ban on nuclear power, they refused to join in this Sismondist demand, and instead pointed out that nuclear power could be a great boon for the working-class if it was safe, and the way to determine such safety was via workers control of the nuclear power industry. Even during the Miners Strike when there was even greater pressure to support a ban on nuclear power, the organisation stuck to its principles. 

No such luck today. It is a feature of opportunist organisations that they bend to public opinion, particularly the public opinion of the milieu in which they swim. The AWL, today, is most certainly an opportunist organisation that bends to such public opinion, in its chosen milieu, leading to its positions zigging and zagging. The start of the path to that condition was its decision to abandon Marxism, and to adopt the petty-bourgeois socialism of the Third Camp, and its subjective sociological methodology. 

It didn't take long as all of the moral panic surrounding COVID developed for the AWL to drop the emphasis on workers' control, and instead to join in the general clamour for a government imposed lockdown. In March, we see them carry a number of stories about insisting on Workers Control, on how we cannot trust the government, how its necessary to utilise self-help groups, and so on, but by May, all that is gone, and instead, we have the AWL in full statist mode calling on that government we should not trust to implement the lockdown, to take away civil liberties on a grand scale, more harsh than even in wartime, and we see them putting full faith in the capitalist state. In another post on Denham's blog we see them putting forward as the solution to the large scale deaths already apparent in care homes, the idea that this same state should take them into public ownership. 

The demand for workers control in selected workplaces, at certain times, is a valid demand, because in the given conditions, it is something that workers' can organise around, and impose on individual employers, from a position of strength, as a temporary measure, as a condition for providing their labour. It is not a demand that can be raised as a long-term solution, for the reasons Trotsky spells out. No employer, particularly the most powerful employer, i.e. the capitalist state is going to voluntarily agree to real workers control. Raising the demand outside a condition of dual power is just revolutionary phrasemongering. But, that is just what the AWL did. At the same time that the capitalist state, via the NHS, is seeing large numbers of vulnerable people contract COVID after they have gone into hospital for other other conditions, after that same NHS fails to introduce adequate isolation protocols to stop the spread of the virus, after it fails even to provide its workers with adequate PPE, after it wastes huge amounts on a publicity stunt in opening Nightingale Hospitals that remain almost entirely empty for the duration of the crisis, and many hospitals up and down the country see occupancy rates drop to around 40%, at the same time that this same NHS sends elderly people, infected with COVID, back to care homes, where they can infect other residents as well as care staff, the AWL decides as its position that it would like this same capitalist state to take over control also of the care homes!!! Out of a sense of shame, it tags on the demand for “democratic public ownership” whatever that is supposed to mean, as opposed to workers control. 

So, in a way, I am not surprised that having zigged and then zagged, the AWL appear to be engaged in another zig, or are at least preparing the ground for such another change of position. After all, its becoming clear that the lockdown was not just a disaster, but was also ineffective even in its own terms. The global economy has been sent into the worst economic slowdown in 300 years. That has caused the deaths of millions of people around the globe; it has led to half a billion more people being driven into poverty. The long-term consequences of the lockdown will be far more damaging than would COVID even if it had been allowed to run unconstrained, which no one has proposed allowing to happen. But, the lockdowns have not worked, as soon as they are relaxed infection rates increase again, and because the vulnerable 20% are still vulnerable, unless they are isolated, as should have happened from the start, they will face the same prospects of death and serious illness. No herd immunity has been created, and so the virus is able to spread rapidly once more. 

The lockdown was supposed to buy time to build up resources, to prevent hospitals being overrun, but hospitals, other than in one or two cases, never were  overrun. On the contrary, hospital occupancy rates fell to as low as 40%! The Nightingale hospital in London's Excel centre treated just over 50 people! No doubt faith was placed on a vaccine being developed so as to produce herd immunity artificially. It looks like a vaccine may be available next year, but already its been found that the COVID19 virus has developed a new strain, so that one person infected with the previous strain, and who developed antibodies, has been infected again, though they are asymptomatic. That means that any vaccine may be useless, because, as with the flu vaccine, unless you are vaccinated against the strain of virus that infects you, will not have the antibodies required to provide immunity. Again, this shows why it was necessary to have allowed herd immunity to develop as quickly as possible so as to try to prevent the virus being at large for a prolonged period during which it could mutate. 

So, with the strategy they had zagged towards now falling apart, as unemployment rises rapidly, its not surprising that the AWL, are preparing the ground for another zig away from it, so as to avoid being tarred with blame for its consequences. So let's have a look at what Professor Smith says, compared to what I have said, and also look at what the AWL had to say in the interview. 

Highlighting this point, but also the point I have made from the start that COVID19 is not something unprecedented, Professor Smith says, 

“An important thing that’s becoming clear is that this is very likely going to become the fifth endemic coronavirus. There are four seasonal coronaviruses (sCoVs) that cause symptoms of the common cold and occasionally more serious illness, and might even bring forward deaths among the elderly. 

That the four previous coronaviruses are endemic doesn’t mean that they are prevalent all the time. They tend to arrive seasonally. Levels of infection go up and down. There are levels of immunity and cross-immunity [immunity from one particular sCoV that provides some protection against another], so infection rates from any particular one can remain low for several years, until increasing again.” 

He sets out why it is likely to become endemic, pointing, as I have also done from the start, that even the information from China, from the start, showed that 80% of those infected are asymptomatic or suffer only very mild symptoms. 

“One of the first scientific papers on this virus, coming out of China at the end of February, showed that 80% of infections were not being picked up as cases, being asymptomatic or being accompanied by mild common symptoms that would not reach medical attention. With that level of asymptomatic transmission it is extremely difficult to eliminate a virus.” 

The next question from Martin Thomas is phrased in a way that I found hilarious. He says, 

“There has been talk of ‘shielding’ old and frail people through the pandemic until they are protected by chains of infection in the wider population becoming short and rare.” 

Well I don't know exactly who else but me has talked about “shielding” the 20% at risk, but there you go. But, it was the last part of the sentence that I had to laugh at. What this convoluted chain of words means can be stated in just three words “protected by herd immunity”. But, clearly Martin dare not speak its name, because the morons seized upon the optics of the term “herd immunity” from the beginning as an easy weapon with which to beat Johnson and Cummings. The truth is that herd immunity is a perfectly well established scientific term for the process by which members of a population acquire immunity either through natural infection or via vaccination, so that they can no longer be infected, meaning that a virus cannot find hosts to infect, and so cannot spread, thereby, dying out. But, the morons lay waste, like a retreating army engaged in a strategy of scorched earth. They are unconcerned by what damage their strategy might cause in the longer-term, just so long as they can score short-term political victories over their opponents. So, the perfectly rational strategy of “herd immunity” was demonised, and all sorts of weird explanations of it, such as Social Darwinism, were flung into the pot. 

What, Martin's long winded phraseology demonstrates is precisely the opportunism referred to earlier. He cannot bring himself to use the term “herd immunity”, because he knows what the connotations surrounding it have become. A principled socialist would take the morons on, and confront them and their crude methods. They would use the term herd immunity boldly so as to confront the moronic attempts to demonise the term, and thereby to prevent rational discussion around it. 

But, again, the response to the question is illuminating. Professor Smith, again confirms a point I have made from the beginning. He says, 

“One of the things we know about the virus is that it is extremely selective as regards the people who become sickest, with age being the strongest influence by far. The average age of deaths is over 80. In the early days in Britain there was extreme anxiety about personal risk across all age groups.” 

In other words, exactly as I have said from the start, 80% of the population are not at serious risk from this virus, despite the narrative that has been conveyed by the media. Only 20% of the population are at serious risk of death or serious illness, and, of these, by far the greatest factor is age, with more than half those dying being aged over 80, and 92% of all those dying being aged over 60. Of the rest, 7% are people with underlying medical conditions, such as obesity, respiratory conditions, diabetes etc. But, not only did the media spread a message of moral panic that everyone was at equal risk, they also hyped the possibility that huge numbers of people were going to die, using from early on the figures of half a million UK deaths that the Imperial Study had suggested would be a worst case scenario, but which there was very little chance of ever occurring. 

“Figures were reported as if they were definite — such as the oft-repeated prediction there would be 510,000 deaths from Covid — when there was (and remains) considerable uncertainty.” 

The government has a clear motive in wanting to present COVID19 as something exceptional. It has closed down the economy causing the worst economic slowdown in 300 years; it has led to large numbers of deaths amongst people who were deprived of medical treatment as resources were diverted to COVID19; it has closed down schools causing millions of children to lose most of a year's education, and causing chaos in their exams, and as a consequence future potential earnings and employment capacity. If you are going to do all those things, you had better have had a rock solid reason for having done so. But, as professor Smith sets out, there is nothing particularly exceptional about COVID19, even compared to bad years for the flu. 

“Seasonal influenzas have on occasion led to more deaths than Covid in younger age groups, and even with the four previous endemic coronaviruses there have been outbreaks associated with deaths in care homes. Boris Johnson and others have conveyed that this is the worst health crisis of anyone’s lifetime; but the 1968 flu epidemic (let alone the 1951 or 1957 outbreaks) was more deadly if you make allowance for the fact that life expectancy has increased greatly since then and there are many more frail 90-year olds today.” 

Indeed, Professor Smith says, the fact that last year was a relatively good year for flu deaths, could mean that more elderly people survived, only to then be targets for COVID itself. And, again this points to the idiocy of the strategy that was adopted, which failed to take account of the fact that the virus is highly age specific in its targets, and so required that it was primarily the old that needed to be isolated from it. To have done that in care homes you would have thought would have been obvious and relatively easy to achieve. But, nowhere seems to have done so, including Sweden, which explains why, although it did enable herd immunity to develop amongst its general population, and appears, thereby, to have stopped the further spread of the virus, it suffered, early on, a large number of deaths of old people, primarily in its large, concentrated care home sector. 

“The tragedy with the care homes in Britain was that by 23 March it was well known how age-selective the virus is. The shielding of institutions where a large proportion of people are susceptible should have been done properly. Indeed, the predictors of which care homes have done badly are the obvious ones: casualised staff, inadequate PPE, and so on. 

Germany has done better, and one factor there is that care homes are better in Germany, and a higher proportion of people at any particular age are living in them. In the USA, one of the reason why the Bronx has done terribly is that on the East Coast of the USA, if you want a cheap care home, the Bronx is the place to look.” 

Its interesting to note that Professor Smith does not come to the crude statist conclusion that the AWL previously put forward that its all about the capitalist state having ownership and control of the care homes, but simply is a question of the quality of the homes. In fact, if we look back at the outbreaks of MRSA and C-Diff in Britain that also killed significant numbers of people, who were infected with them after going into hospital, that was limited almost entirely to NHS hospitals. There were no cases in private hospitals. 

And the same is true, here. 

“Hospital-acquired infection has also been important. People have died who acquired their infection with the virus in hospital.” 

Professor Smith also confirms the point I made early on that given the high levels of infections, its unlikely that a strategy of test and trace can work, even setting aside the governments' incompetence in implementing such strategies, because its impossible to trace people fast enough. 

“Testing, tracing, and isolation is very difficult to make complete when we have such a high level of asymptomatic infection.” 

According to the government, and various groups, infections have probably only occurred in around 5% of the population, other surveys show infection rates around 15% amongst certain groups. However, the existing tests for anti-bodies do not appear reliable, and it assumes that you have tested the right sample of people. With such a high level of asymptomatic infection, its highly likely that more people have been infected than those samples indicate. There is also the fact of other forms of immunity besides the existence of antibodies, such as cell mediated immunity. The tests for current infections are next to useless, because they do not show who has immunity, and nor do they show, who might be infected an hour after having been tested. 

“We don’t know, but the general consensus is that in Britain, for example, the proportion who have responded to an infection is likely to be higher than the 5% estimated from antibody tests. Other aspects of immunity — known as cell-mediated immunity — can provide some protection in the absence of detectable antibodies. In the largest serology study in the world, in Spain, individuals who had clearly been infected did not have detectable antibodies at a later date. The crucial question is the extent to which there may be varying levels of susceptibility due to pre-existing sCoVs and prior SARS-CoV-2 exposure.” 

Professor Smith also sets out why the decision to close schools was wrong. 

“The Independent SAGE proposal of a “zero Covid” aim is, in my view, unrealistic. On 14 July David King, the chair of Independent SAGE, said: “I don’t believe schools should be reopened until we’re reached zero Covid”. This completely fails to recognise the huge and lasting adverse consequences of interrupted education, especially for the poorest in society. 

The Independent SAGE model is New Zealand. But that’s two remote islands where you could have literally no one arriving on a plane for a while. And even there the long-term sustainability of “zero Covid” is not certain... 

Camilla Stoltenberg, the director of the National Public Health Institute in Norway, says that the decision to shut the schools there was probably wrong. Studies have consistently shown that children, as well as being much less likely to suffer badly, appear not to transmit the virus as much as adults. Given all the bad consequences of a long period with schools closed, I don’t think the schools should have been shut in Britain. But once they’re shut you can’t easily undo that.” 

If this interview conducted by the AWL, and replicated by Jim Denham on his blog is an indication of the AWL again changing its position that, at least, is a positive sign. That it arrived at it only after several zigs and zags is not.