Is lockdown right? Bioethics, global health and COVID-19. Talk I’m giving for PhilHEAD workshop https://philhead.org/events/ 17 Oct, 3pm SA/EU

Excited to be giving these thoughts their first outing, in what I hope will be my considered philosophical paper on the thoughts I’ve been having during 2020. The event is open and you can join here: https://bit.ly/3lnxPci

Interview – why lockdowns didn’t work in South Africa – Radio 702 https://omny.fm/shows/early-breakfast-with-abongile-nzelenzele/why-lockdown-didnt-work

https://omny.fm/shows/early-breakfast-with-abongile-nzelenzele/why-lockdown-didnt-work

Commenting on a recent piece in The Conversation, related to a paper published in Global Epidemiology recently, indicating no obvious effect of lockdown over and above mitigation in South Africa.

Paper just out in Global Epidemiology: COVID-19 in South Africa https://doi.org/10.1016/j.gloepi.2020.100034 #epitwitter @CGDev @besmart

https://www.sciencedirect.com/science/article/pii/S2590113320300183

With Herkulaas Combrink and Benjamin Smart.

Part of a project at the Institute for the Future of Knowledge funded by the Center for Global Development. The project looks at the indirect health effects of lockdown in multiple countries.

Lots of people in Africa have already been infected with SARS-Cov-2. Good news, if frustrating for those of us predicting this since March https://www.sciencemag.org/news/2020/08/pandemic-appears-have-spared-africa-so-far-scientists-are-struggling-explain-why

https://www.sciencemag.org/news/2020/08/pandemic-appears-have-spared-africa-so-far-scientists-are-struggling-explain-why

Lockdown was never right for Africa. Half the population is 19 or under, highlighted in this report; and known prior to COVID, of course. On the cost side of the balance sheet, other risks are massively dominant over that posed by COVID-19. Living conditions mean that suppression was never achievable in any case. Costs of lockdown were obviously going to be horrific, because recession means starvation in contexts of poverty. What a mess for those countries that did lock down. And those that didn’t seem to be doing fine, COVID-wise: e.g. Malawi, whose supreme court prevented the government from locking down.

Aside from all that, it’s clear that there’s a great deal of uncertainty about why some places get hit so much harder than others by COVID-19. Sweden is held up as being hit hard, and blamed; but that ignores the fact that many other European countries that did lock down were hit a lot harder. Why? I favour the following theory: we don’t know.

Epistemic humility in all matters relating to medicine is always appropriate.

I think Sweden handled this pandemic better than any other country. Here’s Anders Tegnell explaining the Swedish stance, again: https://unherd.com/2020/07/swedens-anders-tegnell-judge-me-in-a-year/

If I guess the time, and get it right, do I know the time? No, says common sense, and nearly all theoretical and formal epistemology. If I guess that it will rain tomorrow, am I any better off? Presumably not. Yet we assess predictions almost entirely by whether they are right.

I do think Swedish predictive work was broadly accurate, compared to, for example, the models produced by Imperial College London. But more importantly, I think their stance was rational. They did what was right given the evidence. That isn’t the same as being right in the sense of landing on the truth. But there’s nothing either epistemically or morally significant about the latter. The former, however, is both. Sweden behaved more reasonably than any other country, or perhaps at least as reasonably as the most reasonable, given that there was room for reasonable disagreement.

The stance on Sweden is another version of the intellectual intolerance of the age. And it ignores the evidence. Sweden has done well: not perfectly, but no country has, that I can think of. Whether it comes out tops long-term is up in the air. But there is good reason to think it will – at least as good as the reasons to think it won’t.

eNCA TV interview – COVID-19 in South Africa, readiness (lack of), lockdown making zero difference, and the need to ask people what will work for them https://www.youtube.com/watch?v=No67yxuNrzU @mediauj #epitwitter @enca

ENCA interview – COVID progress in SA, comments on readiness and regulations

Soon I’ll have an opinion piece out arguing several of these points. In particular, regulation is just the wrong idea in the first place: people need to be consulted. And that’s not a watery option, it’s the way to get effective solutions that are context-specific.

Lancet letter: ‘Lockdown is not egalitarian: the costs fall on the global poor.’ #epitwitter

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31422-7/fulltext

We wrote this letter a couple of months ago in response to an editorial in the Lancet suggesting that opposing lockdowns was neoliberal. I continue to be surprised by how the world hasn’t noticed that, in fact, extreme measures to combat COVID-19 shift the burden from the wealthy to the poor, who suffer more from the measures than from the disease. It’s a disease that primarily affects the old, and thus primarily the wealthy. This is true even if people who are of the same age fare worse if they are lower down the socioeconomic scale. That is unsurprising, extremely so; what is surprising, and what outweighs that effect massively, is that this disease is so much more dangerous for demographics that are dominated by the wealthy of the world. I still feel that has not been grasped in the global north. So, I’m very pleased to have this letter out. Maybe it will change the perspective just a little towards a more global one.

Western Cape COVID-19 levels higher than rest of SA. Is it because they defy lockdown there? Probably not, says phone data

https://www.ecologi.st/post/covid/ Evidence from phone data that W Cape adherence to lockdown has been quite strict thus lack of adherence is less likely to be the cause of the spike there. Thanks to Monomiat Ebrahim for the share.

Wondering if this means it is more likely to be:

1. A demographic feature such as age

2. A latitude feature – around the equator, COVID-19 has generally been less prevalent

3. A climate feature

4. High concentrations of “starters” leading to a critical mass for an epidemic

…add your pet hypothesis here!

From Judea Pearl’s blog: report of a webinar: “Artificial Intelligence and COVID-19: A wake-up call” #epitwitter @TheBJPS

Check the entry on Pearl’s blog which includes a write-up provided by the organisers

Video of the event is available too