Taming the fearsome – Confounding and Confusing

I have partially borrowed the title from a book titled ‘Taming the unknown’, a wonderful book on the history of algebra, the unknown referring to the missing ‘X’. Just as algebra tames the unknown through several concepts, methods and techniques, whole branches of medicine and public health are trying to tame this complex phenomenon called Covid-19, but indications so far are that the virus is a fierce customer.

In the two years since it made its unwelcome entry and spread, Covid-19 has been a perplexing phenomenon, troubling both scientists/experts and the lay public. There are three strands of thinking that I am going to address here. the set of substantive issues about the virus –transmission, mutations, vaccines, immunity and so on; the role of the mass media; the set of issues centered around data – its specific definition here, methods of capture and storage, the levels of granularity and their linkages, size of data and its consequences, correlation & causality, to mention the most important.

Embarrassment of riches

I have not seen in my life time such a large number of reports, studies, surveys by governments, research institutions – independent and affiliated – on one subject, all at one and the same time. Yet, there is not enough detailed information on how and what information was gathered and many contradict one another. In the early stages when panic was at its most intense and widespread, there were ‘studies’ that ‘showed’ how long the virus ‘lingered’ on various kinds of surfaces, leading to a spate of claims by many businesses about how their product protects 99% from virus! This was subsequently shown to be completely baseless. I have already written on this.

Dr Subramanian Swaminathan, Director, Infectious diseases, Gleneagles Global Health City, Chennai, while speaking to ET on Sunday (January 9) predicted that “the Omicron wave will be huge in India. We may see 15-20 lakh cases per day over the next two weeks”. It is now two weeks since and, although cases are rising, I have not come across such numbers. There has been no follow-up story, which is mandatory in a continuing subject. Of course, advocates can always attribute this to underreporting or delays in reporting.

Some studies said that the virus could ‘travel’ up to 2 km; now comes a report saying that the virus lingers within a short distance and for 5 minutes! The Guardian reports on a new study (not yet peer reviewed) by University of Bristol’s Aerosol Research Centre which focuses on how the relative humidity of the surrounding air affects the speed with which the virus dries out, losing its ability to infect human cells (https://www.theguardian.com/world/2022/jan/11/covid-loses-90-of-ability-to-infect-within-five-minutes-in-air-study). Professor Jonathan Reid, director of the University of Bristol’s Aerosol Research Centre and the study’s lead author, says that, “People have been focused on poorly ventilated spaces and thinking about airborne transmission over metres or across a room. I’m not saying that doesn’t happen, but I think still the greatest risk of exposure is when you’re close to someone. When you move further away, not only is the aerosol diluted down, there’s also less infectious virus because the virus has lost infectivity [as a result of time].”

Fine, but I find one particular fact difficult to deal with: daily commute in densely populated cities. Mumbai’s suburban trains and BEST buses are packed with people every day. Going by the Bristol study, daily commuters in densely populated cities are at risk the most, alongside the public health professionals. Lakhs of people travel in Mumbai alone everyday but the numbers of the affected and the dead isn’t high relative to the number of people travelling. Everyday. To me this is a logical question but the media hasn’t asked anyone.

In the same Guardian story, Dr Stephen Griffin, associate professor of virology at the University of Leeds, considers ventilation important because “Aerosols will fill up indoor spaces rapidly in the absence of proper ventilation, so assuming the infected individual remains within the room, the levels of virus will be replenished.” And “the temperature of the air made no difference to viral infectivity, contradicting the widely held belief that viral transmission is lower at high temperatures”.

Herd immunity

Let us look at herd immunity. Dr Sunetra Gupta, Professor of Theoretical Epidemiology, Department of Zoology, Oxford University, is insistent we will reach safety state only with achieving herd immunity and it is naïve to expect vaccines to check the spread of the virus and its mutations (https://timesofindia.indiatimes.com/home/sunday-times/all-that-matters/our-ability-to-block-covid-infections-even-with-vaccines-is-short-lived-dr-sunetra-gupta/articleshow/88228611.cms). She says: “The pandemic could end because of the vaccines if we took care to make sure that those who need it got it. But the main reason that it is going to end is that many of us have been naturally infected and have natural immunity which gets topped up again. In India, I am hopeful that herd immunity was acquired during the second big wave. That will be continually topped up and will keep the majority protected because the more people immune in the population, lower the risk of infection”.

However, according to Eric Feigi Ding, a US-based epidemiologist and a Senior Fellow at the Federation of American Scientists, “People should not be saying that. It is irresponsible” (ET on Saturday, page 5, January 15, 2021). Observing that many people have been wrong on this before he says: “people had said earlier that there was herd immunity in India in February 2021. And then Delta came”. Again, I haven’t seen any discussion of why it is irresponsible to speak of herd immunity. Merely quoting two people even if they are experts doesn’t help. Consider the decision to impose night curfew. Dr Soumya Swaminathan, Chief Scientist, WHO, has gone on record to say that there is no evidence to support that night curfew has any impact on containing the spread of the virus. I haven’t read any article asking the government about this.

Or consider the view expressed a couple of weeks ago that the booster needed to be different from the vaccine administered and now comes the exact opposite – that the booster can be the same as the vaccine! According to Eric Feigi Ding, a mix and match will be better but goes on to add “but I think the same vaccine three times is not that bad” (ET on Saturday, page 5, January 15, 2021). Is it any wonder people are wondering what to do?

In (almost) every subject, there are deep differences dividing each community of experts, and the lay public is not even aware of such differences, but the virus is a subject that touches all of us in our everyday lives. The media thus has a more than normally important responsibility but it is a tough task and I will now turn my attention to that. And then to questions of data.

Takeaways

The subject of virus is characterized by deep differences of views

Diametrically opposite views by experts have troubled ordinary people

Accusations of irresponsibility made against some experts

Who should guide public policy becomes a contentious issue