Alan Whiteside, Alec Hogg: Making sense of Covid-19 data. MUST LISTEN!

Professor Alan Whiteside is an applied academic who is a specialist in development economics. In particular, he has made his mark in contributing to global understanding on the spread and containment of HIV/Aids. He has dozens of books, book chapters and journal articles under his belt. Prof Whiteside is probably one of the best-placed public health policy experts to speak to for an understanding of the Covid-19 pandemic that is sweeping the globe and shutting down economies as it spreads. In this podcast with Alec Hogg, BizNews founder and editor-in-chief, Whiteside explains how various countries manipulate the statistics for political advantage. He also sets out why a lockdown now can help contain this deadly disease when you look at the graphs and statistics. – Jackie Cameron.Professor Alan Whiteside joins us from the UK, a well-known South African. Alan, before we go into the topic of our conversation today, your connection with South Africa goes back many years?.___STEADY_PAYWALL___.Yes indeed, I grew up in Swaziland and was educated at a school there. I then went to the United Kingdom to avoid military service, because I wasn't prepared to kill for apartheid. I returned to South Africa in 1983 to join the University of Natal..Quite a bit of crossing of swords over the whole HIV/Aids saga here?.Absolutely, it was one of the most demoralising episodes in our lives as scientists. We thought we were talking common sense and it turned out that people weren't listening and they had other agendas..As a scientist you must be seeing what's happening with Covid-19 with a combination of a fascination and horror. Where are we now in the disaster?.I think the answer has to be as with so many things, there isn't one size fits everyone. If we look at the epidemic around the world, what we see is that in China, Japan, South Korea there are signs that it's under control and in some countries at unacceptably high levels. It's absolutely fascinating that the Japanese numbers are climbing now that we know that they aren't going to have the Olympics which says something about the politics of data. The first cluster is in Asia, but that seems to be controlled. The second one is in Europe where it is absolutely out of control. We're watching the numbers climb to an unbelievable level, 74,386 today according to the Johns Hopkins website in Italy. The third major area is North America and the US now have 70,000 infections and those continue to climb at the same rate. What is really interesting though is the lower levels of infection across Africa and South America which may be a combination of factors from climate to air links..I pulled the numbers out from yesterday to today and the overnight growth is 48% in the US. That's extraordinary. We understand that in the early stages of this pandemic a rate of about 30%, which is where South Africa is tracking at the moment, is normal. Why would the United States be so much higher at this point?.It's quite simply a lack of leadership..People are not getting the leadership at the national level that they need. We say the federal level that they need, which leaves the local state level people trying desperately to take care of this crisis. You've got to have a united government to deal with it. That is what we didn't have in the UK until quite recently. .I was talking yesterday with David Shapiro whose daughter lives in New York City and what was quite strange is that although this is the epicentre of the United States pandemic they still allow people to leave the city and go off to other parts of the country which sounds really strange..Yes it does. Deborah Bricks who is the one lady who stands behind Donald Trump at these briefings and has looked increasingly stressed over the past few weeks and as I understood it, was also puzzled over this decision. We need to go into complete lockdown, which is what we have in the UK. You're allowed to go out to walk, exercise or run, otherwise you must stay at home..South Africa started last night. Do you think that's the solution? .Again, I don't think it's a case of one size fits all. What you have in the UK and in rich countries, where people can stock up with food where they're not living cheek by bowl, you could move to this lockdown. That's common sense. I'm not certain how it works in poorer countries. We've got a huge social experiment. Is it a public health solution? Is it a socially possible solution? I really don't know..You mentioned the data is political. If you would elaborate on how data can be political?.The first way you can make data political is not to test because if you're not testing you can't report cases. There has been a suggestion that the amount of testing in China has gone down quite considerably so their caseload has stayed pretty constant at just under 82,000. On the other hand maybe that's a good thing because it does give the Chinese people a sense that the state has it under control. The Japanese data is fine because I think they were desperately trying to keep their numbers down for the Olympic Games, which they thought they were still going to hold. African data is more a factor of the lack of testing kits and the inability than the lack of an epidemic. It may be the lack of an epidemic, but we can't know that because we've got no idea what the testing kits are looking like..Having said that there's something I must just explain very quickly, what we have at the moment is test kits that pick up people who are infected. In other words the virus is active in their bodies. What we don't have and we're desperate for is test kits which will tell us if anybody has had the virus because in theory those people should have immunity. In theory they don't need to go through the same processes as people who haven't had the virus and scientists know this is the gold standard that we're desperate to see. Scientists are scurrying to get us kits that will tell if you've had the virus..Is there any progress on that front?.Absolutely, I would say we'll have them out in the next month perhaps even sooner..The rational part about it is that if people are cleared to go back to work they can start getting the economy going again..That would be fantastic, people will be able to start getting back to normal lives. At the moment we're on tenterhooks, will I get it, won't I get it unless I've had it. And if you take just the global figures we have 472,109 today according to Johns Hopkins of whom 114,000 have recovered. Now those people are able to make a contribution to the society in which the rest of us cannot because we don't know our status..Those antibody tests, are they likely to get to South Africa anytime soon?.There will be a rollout to get them out as far as possible. One thing about South Africa is we really understand testing. This would be like the HIV test where you are positive or negative, you've had Covid-19 or you haven't had it. We have the ability, infrastructure and the knowledge to be able to roll it out if we can get them to the country..Alan you did mention John Hopkins University and that they are putting out these numbers. I watch it every day as well. How come they've become the global source for the reporting?.That's a very good question. I think the answer is because they were the first there. Secondly because they are a model of simplicity, you pull up the dashboard and you can see exactly what's going on. You can focus on the United States and you can see what's going on by state. It's an easy site to use, well done to Johns Hopkins. They've done a brilliant job. There are others, but they don't give that level of information that I want at a glance..Where are they pulling their data from?.This is where we run into one of the problems with data, people reporting to them. Which is why China has consistently stuck at just under 82,000 and why Djibouti has 11, Haiti has 8, eSwatini 4 cases at the moment. You are relying on reports coming from the public health authorities in those countries. If they don't report you haven't got the data. Academics like myself need to be saying, you're not reporting data..Presumably there's enough there for us to be able to make decisions? South Africa has gone with the lockdown, first of all 21 days. Is that the right term?.Well the option is always to extend this and that 21 days is what Boris Johnson has placed on the United Kingdom. I think it's probably enough, we are going to see curves flattening but perhaps not the global, but country curves will start to flatten. 21 days is a good start, it is going to be difficult for you, for me and for everyone there..You say it might be enough scientifically, why does this actually destroy the virus in that period?.It's a little bit more complicated than that. If we have a 21 day lockdown and nobody goes and gets re-infected then what we're going to see is that the epidemic will splatter to a halt because we need to understand a few other little epidemiological things. The key is the R number which is how many people will be infected from an individual case. If I'm infected and I infect two other people, the epidemic will carry on, if I infect four other people it will carry on faster. If I can cut it down so that I don't infect anybody else, the numbers will start to decline quite rapidly and we think that the number of days involved in this is quite small..If you extrapolate from where we are today and if the Chinese are telling us the truth, in other words that political data that you mentioned we take that question out of it. How much longer might a country like South Africa be visited with this pandemic?.There's good news and bad news I'm afraid. The good news side we've got some really amazing actions going with the lockdown, that should make a difference provided people do strictures. The bad news is that we think that it is possible that this is a winter disease, that as it heats up in the north we will have a less favourable atmosphere for the virus to survive. That would mean that as we see with flus it may become a Southern epidemic as you move into your autumn and winter. Having said that of course forewarned is forearmed, so maybe we can prevent that from happening. Your question is how long, the answer to that one has to be I don't know. .The mortality rate, we know that in South Korea it's down to 0.6% in Italy it's a multiple of that. The United States is also starting to climb in that area. What is the best guess at the moment for this number?.What we have to understand is that it is a guess, not the answer you're looking for, it's between 1% and 5%. It will depend on the levels of treatment that people get; it will depend on how they were infected. The Chinese doctor who died so early in the epidemic was a young, fit healthy man before he started working on the epidemic. I suspect he was exposed multiple times and that's why his immune system eventually just couldn't take it. There's also the question of where the virus lodges in your body. If it's in the upper respiratory tract you get your sore throat. If it's in your lower respiratory tract you're going to end up with pneumonia. It's going to depend on the ages of people. No one is immune to this virus but you're more likely to get seriously ill if you're older particularly if you have co-morbidities. That means that you're old and you're living with other diseases. So hypertension, diabetes, cancer and so on and, of course, all smokers, please stop smoking..We've had warnings about coronaviruses before with SARS and with MERS, the Middle East Respiratory Syndrome. Presumably this isn't going to be the last one from a scientific perspective that will infect mankind?.That's correct. We are living in a world where we are so close to nature but not in a good way. This is somebody cutting down trees with the bats and the other creatures have their livelihoods and eating these creatures. So I believe we will see more events like this. It's called a zoonotics event when a disease jumps from one species to another. Of course the zoonotics which we never talk about is where we human beings are infecting animals, which does happen of course.

Alan Whiteside, Alec Hogg: Making sense of Covid-19 data. MUST LISTEN!

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