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This week on Investment Uncut, show hosts Dan Mikulskis and Mary Spencer catch up with Dr Jonathan Pearson-Stuttard on his epidemiologist perspective of the current pandemic.

Key takeaways:

• Mythbusting – how should we be reading the figures?
• The daily announced cases isn’t the true picture
• Focus on the ONS case numbers (9 days lagging) which gives a truer picture of the true number of cases – usually 2x the daily announced cases

What’s misunderstood?

• Short-termism about the discussion when it comes to timeframes. April things will be better, closer to normal. Plan beyond next few months and look from here to April
• Lockdown is what we did in March, not what was happening before November
• Compromises not working – eg closing pubs early doesn’t help transmission much, and also hurts economically. Middle ground options not the way to go

 Evidence:

• Myth of being “led by science” – some of the best scientists in world just did not know
• Dr Jonathan's key references
• Comprehensive comparison of excess deaths from the first wave across 21 countries published in Nature Medicine

Findings:

• Deaths 23% higher than normal overall , some countries (NZ) no increase from baseline. England and Wales 38% higher.
• Why? No one single reason but identified 3 contributors
  1. Existing health of public (obesity, diabetes, dense cities, older populations)
  2. Public health structures (resilience, capacity, functioning test and trace)
  3. Policy response (good test and trace did well throughout, early lockdowns did better, culture and communication: coherent message)

What does 2nd wave look like?

• Projection of reasonable worst case scenario of 100km excess deaths. Treatment pathways better, society behaviour different. So looking likely 2nd wave will be much worse. Capacity of health service already lower
• Risk of dying of Covid-19 was exactly parallel to broader risk of dying – ie increasing with age
• Evidence of indirect impact on population – eg women dying at home with dementia increased by 75%
• All cause excess deaths are the measure to look at to capture indirect.
• Group deaths:
  1. Direct from Covid-19
  2. Indirect because chronic disease not able to be cared for in some way
  3. From wider impact on social and economic environment
• Protecting deaths from any cause rely on one service: The NHS. The rationale of protect NHS is right, as impacts care across all conditions.

Is the only solution a vaccine?

• Broadly, yes. Naturally acquired immunity might not last long at all (Imperial study)
• General hope there will be vaccines early next year for vulnerable, roll out from Easter onward. More coming down the line, first ones won’t be the most effective. No vaccines will be perfect but will help us get there
• Vaccine taskforce piece here

One thing to takeaway

• Virus shows how vulnerable we are, but also showed the best of the public private partnerships, what it has shown is an opportunity to stop and re-think: is health our most untapped opportunity?

Most under appreciated thing about health?

• Health itself is an asset. A health index can help us value the stock of health. If we come out of the pandemic valuing health better we’ll be in a good place

Recommendations

• Science in action series on the BBC World Service
• Excess deaths from the first wave of Covid-19: Lessons and Implications
• Declining antibody prevalence Imperial study
• Lancet piece from the chair of the UK Vaccine taskforce
• Dr Jonathan's book pre-order on Amazon: Whose Health is it Anyway?

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