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of 14 15 march bold emphasis added by me i think the new understanding on the weekend of 14 and 15 march was that we were much further ahead in the pandemic than we realised and the numbers that came in that week showed that there were many more cases it was far more widespread and was accelerating faster than anyone had expected we got information on 13 march which unambiguously showed that the pandemic was far more widespread and far bigger and moving faster than we had anticipated the advice given on 18 march was a consequence of our concerns about the rapid doubling time and number of infections a major reason sage did not advise earlier and more extensive interventions for example on 10 march rather than 16 march was that we were unaware of how widely seeded the virus was in the uk and how short the doubling time had become i am asked if the models underestimated the spread of the virus early in the pandemic i think that they did at least in terms of speed until shortly before the four day period of 13 to 16 march which i discuss above this was a function of poor and time delayed data and a consequent under estimation of the virus doubling time the conclusions that we are inescapably being asked to draw from these multiple statements is that a sage was underestimating the growth rate of the pandemic prior to the weekend of 14 15 march but corrected their error at that time and b the correction of this error was critical in changing their advice from a measured program of mitigation to a much more urgent suppression of the pandemic vallance s evidence to the house of commons science and technology committee july 2020 this mirrors the testimony vallance gave previously to the house of commons science and technology committee in july 2020 when the sage sub group on modelling spi m saw that the doubling time had gone down to three days which was in the middle of march that was when the advice sage issued was that the remainder of the measures should be introduced as soon as possible the advice changed because the doubling rate of the epidemic was seen to be down to three days instead of six or seven days we did not explicitly say how many weeks we were behind italy as a reason to change it was the doubling time and the realisation that on the basis of the data we were further ahead in the epidemic than had been thought by the modelling groups up until that time sage minutes of mid march and other contemporaneous evidence however contrary to these claims the minutes of the sage meeting on the 16th march very clearly stated uk cases may be doubling in number every 5 6 days and later that day vallance personally repeated the 5 day doubling figure live on tv the epidemic you d expect to double every 5 days or so two days later the minutes of the sage meeting on the 18th march again stated assuming a doubling time of around 5 7 days continues to be reasonable but this is before any of the measures brought in have had an effect these measures are likely to slow the doubling time even if there is still an exponential curve the first time 3 day doubling was hinted at in any official documentation appears to be the spi m o meeting on the 20th march nowcasting and forecasting of the current situation in the uk suggests that the doubling time of cases accruing in icu is short ranging from 3 to 5 days and this was finally endorsed in the sage minutes of the 23rd march the doubling time for icu patients is estimated to be 3 4 days it looks like sir patrick may have confused the weekends of 14 15 march with 21 22 march for example the spi m meeting he referred to above as taking place prior to sage s change of heart in the middle of march is actually documented as having taken place on the 20th march i hope you will be able to contact him to ask him about these discrepancies at the very least the documentary evidence proves that sage was still underestimating the growth rate of the pandemic right through their meetings of the 16th and 18th march only finally correcting their error on the 23rd but perhaps a more worrying implication here is that sir patrick s recollection of sage s approach towards mitigation and lockdown at this time is also in error in fact the minutes of the meetings of the 16th and 18th appear entirely supportive of the govt actions at that time which were to continue with the gradual extension of the measured program of mostly voluntary measures on the 16th sage cannot be certain that the measures being considered by hmg will be sufficient to push demand for critical care below nhs capacity but they may get very close under the rwc scenario while sage s view remains that school closures constitutes one of the less effective single measure to reduce the epidemic peak it may nevertheless become necessary to introduce school closures in order to push demand for critical care below nhs capacity however school closures could increase the risks of transmission at smaller gatherings and for more vulnerable groups as well as impacting on key workers including nhs staff as such it was agreed that further analysis and modelling of potential school closures was required demand supply and effects on spread and on the 18th sage advises that the measures already announced should have a significant effect provided compliance rates are good and in line with the assumptions additional measures will be needed if compliance rates are low they even argued that the measures implemented on the 18th including the new school closures were probably adequate to fully suppress the pandemic sage reviewed available evidence and modelling on the potential impact of school closures the evidence indicates that school closures combined with other measures could help to bring the r0 number below 1 although there is uncertainty summary the claims that the govt was responsible for a week of delay at this time and that sage was arguing for much more immediate and stringent action is not supported by a reasonable reading of the evidence indeed sage had no reason to be doing this since they still believed contrary to vallance s testimony above that the pandemic was doubling at a rate no more rapidly than 5 days at worst and furthermore as they explicitly stated on the 18th was probably being significantly slowed beyond this figure by existing policies already introduced at that time all of the quotations i have given above are directly copied from official documentation available on the govt s own web site other than that taken from the youtube video of the pm statement and press conference of the 16th march which is my own transcription please contact me if you require any help in validating the provenance or accuracy any of this evidence regards james annan jdannan blueskiesresearch org uk posted by james annan at tuesday november 28 2023 2 comments email this blogthis share to x share to facebook share to pinterest labels covid 19 saturday november 25 2023 vallance vs vallance vs sage why does doubling time matter one thing that all the protagonists myself included agree on is that sage s estimate of doubling time in mid march was of critical importance vallance testified forcefully to this effect in 2020 when the sage sub group on modelling spi m saw that the doubling time had gone down to three days which was in the middle of march that was when the advice sage issued was that the remainder of the measures should be introduced as soon as possible and then confirmed in this exchange with a committee member sir patrick vallance knowledge of the three day doubling rate became evident during the week before q1080 ed this number has changed from the previous time i posted about this graham stringer did it immediately affect the recommendations on what to do sir patrick vallance it absolutely affected the recommendations on what to do which was that the remaining measures should be implemented as soon as possible i think that was the advice given and again sir patrick vallance the advice changed because the doubling rate of the epidemic was seen to be down to three days instead of six or seven days we did not explicitly say how many weeks we were behind italy as a reason to change it was the doubling time and the realisation that on the basis of the data we were further ahead in the epidemic than had been thought by the modelling groups up until that time but why does the doubling time matter so much and is the difference between 3 days and 5 day really important the point of this post is to answer these questions i ll start by repeating a couple of plots i first made way back in april 2020 when it was just dawning on me what a colossal cock up sage had made of it these graphs are generated by a simple seir model that i ve shown to reasonably replicate more sophisticated ones in the below the blue calibrated line uses data up to 14 march to estimate doubling time which comes out at 3 days the red uncalibrated line uses parameters from ferguson s march 16 paper which has a doubling time of 5 days so one obvious point is that the blue curve does a much better job of predicting what was going to happen ie the magenta x which were not used to calibrate either model but that s not the point of this particular post rather it s just that the predictions for 3d vs 5d doubling are radically different here is the longer term view now without the logarithmic scaling on the axis note the we are here point is mid march when the red and blue curves are visually indistinguishable there are several reasons why the doubling time matters firstly the estimate of current pandemic size is based on historic data edmunds specifically talks of a 12 day delay from infection to illness to testing to finally test data reporting so 100 cases reported today means 100 infections 12 days ago and that s 4 doublings at 3d doubling meaning 1 600 cases now if the doubling time was only 5d then the 12 day delay is just over 2 doublings and we wouldn t be at 1 600 cases for another 8 days 4 doublings is 20 days so that means 12 just past and another 8 in the future so one immediate consequence of a change in perceived doubling time is that we ve lost just over a week in terms of pandemic progression these calculations all ignore the proportion of infections that are undetected which can reasonably assume to be roughly constant and thus not affect the argument secondly the 3d doubling means the pandemic comes much sooner and thirdly reaches a much higher peak as shown in the 2nd graph above what was expected some time over the summer is now happening next month and it s going to be a lot worse than expected getting on for twice as many cases per day at peak finally the more rapid doubling implies a higher r0 number and this makes it harder to control with r0 2 4 ferguson s 16 march number a reduction of contacts to 40 of normal would control the virus because 2 4 x 0 4 0 96 which is less than 1 whereas a 3d doubling implies a rather higher r0 let s say 3 2 this then requires much stiffer action because 3 2 x 0 4 1 28 which is still greater than 1 a reduction to 30 of previous contact levels to get the r number below 1 3 2 x 0 3 0 96 as before is obviously much tougher to achieve especially given that family members essential work etc mean we can t really isolate perfectly quibbling over the exact value of r0 to use doesn t invalidate the general point that a higher r0 is harder to control so changing the estimate of doubling time from 5d to 3d would be a real oh shit moment for anyone involved in pandemic planning it means a we ve instantaneously lost 8 days of lead time b the pandemic peak is going to be coming a month sooner than expected c the peak is going to be almost twice as big as expected and d the control measures we were hoping to use are much less likely to be adequate any plan predicated on a 5d doubling time would immediately have to be revisited in the most extreme and urgent manner i hope i have convinced my reader that whatever plans were in place in early march under the assumption of a 5 day doubling the new understanding that the doubling time was instead 3d would cause an abrupt and substantial change of perspective this from a scientific perspective is inevitable and obvious posted by james annan at saturday november 25 2023 3 comments email this blogthis share to x share to facebook share to pinterest labels covid 19 thursday november 23 2023 vallance vs vallance vs sage introduction ok i m going to do a bit of analysis of vallance s evidence to the uk covid 19 inquiry focussing specifically on the events of the mid march 2020 period up to the imposition of the first lockdown on 23rd march on monday 20th nov 2023 he was interviewed by the inquiry and also provided some written testimony this is broadly speaking a more detailed version of the testimony he provided back in july 2020 to the house of commons science and technology committee which i blogged about at the time but appears significantly inconsistent with the documentary evidence provided by the minutes of sage meetings and other records of that period if you already agree with me that vallance misled the s tc with his testimony in 2020 then you might not find this very interesting but i think i might as well go over it again as there s a lot more testimony to consider including other participants in sage i ll break it up into sections in order to make it digestible and also to avoid me going round in ever decreasing circles to start with let s consider some background concepts posted by james annan at thursday november 23 2023 0 comments email this blogthis share to x share to facebook share to pinterest labels covid 19 tuesday november 21 2023 uk covid 19 inquiry module 2 the currently ongoing module 2 describes its aims thusly this module will look at and make recommendations upon the uk s core political and administrative decision making in relation to the covid 19 pandemic between early january 2020 until february 2022 when the remaining covid restrictions were lifted it will pay particular scrutiny to the decisions taken by the prime minister and the cabinet as advised by the civil service senior political scientific and medical advisers and relevant cabinet sub committees between early january and late march 2020 when the first national lockdown was imposed i m particularly interested in this period as it s the time that the expert scientific analysis and advice from sage was so woefully inadequate i ve blogged about this at length but just to recap the scientists were mistakenly thinking that the doubling time of the pandemic was about 5 6 days various numbers appear in the sage minutes and that we shouldn t take too stringent measures as there was a genuine risk that by doing so we d put the pandemic off to the following winter when it would add to the normal seasonal pressures on the nhs they were quite anxious that we should get through it over the summer of 2020 instead vallance misled ...
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