Fearmongering or telling it how it is?

About those numbers. They’re obviously very wrong, aren’t they? We all know that the truth hurts but when it is this uncomfortable and painful we simply decide it stops being the truth. There are words to describe and name this kind of decision making.

It might just be me, but I do get the impression that Government’s kindness is firming up. Infringement fines for Covid-19 breaches have gone up heaps and people who want to travel down alert levels now have to show evidence of a very recent negative test. In addition, they’re sharpening the language around mandatory vaccination and this is under “active consideration”. Even if Government doesn’t take it all the way many businesses will take the hint and do the heavy lifting by mandating vaccination for their employees.

Anyway, it takes a lot of guts to put those numbers out and defend them in public. Many a professional reputation of scientists has been burned in the bonfire of public displeasure not to mention savaged by the baying media with their insatiable thirst for blood.

Other scientists and experts have been quick to condemn the numbers without paying much attention to the guiding messages from the model simulations. They should know better and at least choose their words more carefully when commenting in interviews and in public. But nothing is as exhilarating for the ego as getting a mike shoved in your face and a camera pointed at you, and we all live in TV studios nowadays with our kitten- and kids-proof semi-professional Zoom studios and setups.

All models are wrong, but some are useful

George Box

I don’t think it is particularly helpful to single out people, but some of the criticisms of the model simulations by Te Pūnaha Matatini are frankly at the level of arm-chair amateurs with very little understanding of the matter at hand.

At the very beginning of the pandemic last year a medium-sized team of scientific experts went public with their initial modelling, which instantly became famous or infamous, if you prefer.

Left unchecked, the virus would eventually infect 89 percent of New Zealand’s population and kill up to 80,000 people in a worst-case scenario. [my emphasis]

The key point is that NZ Government did not leave things unchecked. They went out hard, repeatedly, when it was necessary and demanded by the circumstances, and I believe New Zealand is record holder in the World Stringency Index tables.

Unfortunately, many still seem to be hung up on those scenarios and because the worst-case scenario never eventuated, anywhere in the World because other countries didn’t leave things unchecked either, they still exhibit the same gut reaction to the results of the most recent model simulations.

Even some other experts seem to be miffed. Some expert reactions can be found the Science Media Centre and others are in mainstream media. One criticism that was rather unhelpful was asserting that the numbers were unrealistically high because the modellers assume that we would “just sit on our hands and do nothing”. Nothing could be farther from the truth, as a quick read of the report will tell you straightaway, but essentially it comes down to same message: if we make certain choices and then do nothing else, which is not going to happen anyway, then numbers of people ending up in hospital with Covid-19 will steeply increase in a large outbreak resulting in overwhelming of capacity of the health system and likely leading to many many deaths.

Short-term views of highly vaccinated countries such as Singapore, Denmark, and Ireland have been used to ‘show’ that the number predictions taken over one year for the whole of NZ are not plausible. These hand waving critics completely ignore many other important factors. In fact, as with other countries such as Israel and Taiwan, a rapid re-think is required when the pandemic is clearly going out of control, again. These cases show that there is no room for simplistic ‘thinking’ and simplistic ‘answers’ AKA kneejerk twitches of a flatulating brain and I believe that our Government knows this very well indeed and it shows.

One of the big unknowns at present is the vaccine effectiveness against the Delta variant.

As the effects of the vaccine on transmission remain uncertain, we consider three levels of vaccine effectiveness: high, central, and low to illustrate a range of possibilities.

This has a profound effect on the results and it should be pointed out that it is mainly the number predictions based on the assumption of central vaccine effectiveness that are mentioned and discussed in the news media. This is not easily influenced or controlled although spacing the two vaccine shots by 6 rather than 3 weeks does give a better immune response on average. There might be other ways that are able to boost overall vaccine effectiveness, e.g., giving a second shot with a different vaccine, but these options have not yet been approved and/or recommended in NZ.

They reiterated an important message again.

Nonetheless, it is not thought to be possible to achieve widespread population immunity to the Delta variant by vaccination alone, which means that moderate public health measures [excluding stay-at-home orders, i.e. Alert Level 3 or 4] will be needed to augment the vaccine programme.

In other words, and in summary:

Nonetheless, the results suggest that a combination of high levels of vaccination within the community, a strong test-trace-isolate-quarantine system (assuming case numbers are kept sufficiently low) and moderate public health measures may be enough to attain population immunity, greatly reducing the need for strong public health measures, such as stay-at-home orders and workplace closures.

It is worth pointing out that the attitudes and sentiments of Kiwis towards Covid-19 are relatively stable, possibly trending upwards into more positive territory, which is possibly due to the recent Delta outbreak, and he overall potential uptake of the 12+ population is estimated to be 85.5% based on the latest survey taken at the end of August.

This provides a good starting point for discussion and public conversation. The numbers per se are not so important, as the authors of the study mention:

Model results are intended as a guide to the relative benefits of different levels of vaccine coverage in the population rather than exact predictions or a detailed roadmap.

Indeed, it is hard to fathom why this elicited such visceral response with many and why people stared themselves blind on the imaginary numbers (not in a mathematical sense) rather than on the key message. People seem to forget that the flu kills many hundreds of Kiwis each season despite an active and pro-active vaccination programme. Maybe because this has been endemic for such a long time it has become more acceptable, unlike deaths caused by small sudden outbreaks of measles or RSV, for example; anything out of the ordinary attracts a disproportional amount of attention, which is often magnified by people with invested and/or political interests. And people like to focus on (the) negatives more than on (the) positives.

Some tough decisions will have to be made in the near future and we’re all in this together, so we can’t honestly shift responsibility and blame (!) to Government-alone nor does vilifying experts help one iota when some of us don’t like what they’re saying. In fact, it undermines the guiding principles and message from science and breeds unhealthy scepticism, cynicism, and distrust of scientists and authorities with the general public, but perhaps that is the (subconscious?) goal all along?

The core plank of our pandemic measures remains vaccination although it is not (yet) the silver bullet and it might never be, as is the case with influenza.

Powered by WPtouch Mobile Suite for WordPress