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Thaddeus Michaels: My criticisms of Ferguson

This is an article by Thaddeus Michaels (not his real name), who is a data scientist.

Neil Ferguson’s critics see him as a doom-monger, whose death forecasts have far exceeded reality.

His defenders tend to counter with two points. First, that his models made the best of the available data at the time. Second, that regardless of the accuracy of the models, they broadly had the desired effect of spurring the government into action.

The first point has been picked over relentlessly over the past few months, but the second point tends to go unchallenged. Does it hold up? Here are some obvious problems with it:

1. Doctors must prioritise treatments for individual patients

If we tell a doctor that Patient X has a 7% chance of dying from Covid-19 in the next 3 months, and only a 2% chance of dying of cancer, which disease will be that doctor’s priority? Overly pessimistic projections of Covid-19 fatality undermine treatment for other conditions.

The big flaw in the ‘better safe than sorry’ position on Covid-19 is that it completely ignores emerging evidence that people are dying of other conditions: cancer, mental illness, addiction, and many others that benefit from early intervention and regular medical attention.

Getting the probabilities right matters, and errors in either direction can be damaging to health outcomes. Of course we have to accept that with a novel disease outbreak, these probabilities will be ranges with wide confidence intervals. Nobody is expecting epidemic modellers to get things exactly right, but that uncertainty must be communicated well to non-specialists.

2. Healthcare policymakers must prioritise who is treated

The big fear at the start of the Covid-19 epidemic was that UK hospitals (and specifically ICUs) would be overwhelmed. This drove policymakers to find ways of keeping people out of hospital (‘Protect the NHS’).

Some of the measures intended to ‘Protect the NHS’ were sensible and well-evidenced: encouraging hand washing, building additional capacity, sourcing emergency PPE supplies for medics, and so on. Hard to argue with any of that, despite flaws in the implementation.

Other measures, though, were underpinned by Ferguson’s idea that the NHS would almost certainly overshoot capacity, and that therefore the government would have to prioritise which patients merited the most urgent treatment.

The very high projected numbers of healthy working-age individuals hospitalised by Covid-19 forced the government to look for ways of protecting capacity for those groups.

Did this consequently lead to the catastrophic policy of sending elderly Covid-19 infected patients back to care homes? We cannot be sure at the moment, but the anecdotal information from doctors assigned to care homes is that many patients who could have been saved have been left to die as a result of this policy, whilst also infecting other care home residents and care workers.

And yet the Nightingale hospitals were empty! What logical explanation is there for this besides the overly pessimistic modelling forcing policymakers to make a deadly trade-off?

3. The public and media reaction is informed by ‘the science’

It is widely claimed that lockdown or no lockdown, behaviour would have changed and the economy would have suffered because of the self-organising public reaction to Covid-19.

But why did the public react the way they did? Was it the news out of China and Italy? Was it because they had direct experience of the disease ravaging through their local communities? Or was it because the media faithfully reported Ferguson’s projections that over half a million people might die in the UK alone?

We will never know exactly why – and there is unlikely to be a single explanation – but clearly the public react to the information they’re given by experts. Indeed, this kind of feedback loop is one of the biggest challenges with modelling human behaviour at the macro level.

There is now emerging evidence that people are delaying seeking treatment for very urgent medical conditions such as strokes and heart attacks. This is what happens when you convince people that they are more at risk from potentially catching a virus with a <1% fatality rate than currently experiencing a catastrophic heart failure.

So we have to conclude: pessimistic projections can take lives.

 

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23 thoughts on “Thaddeus Michaels: My criticisms of Ferguson

  1. If the reports allegedly based on the models (as far as I know they haven’t been published) drove the government to take action, so what?
    Was it the right action? Driving the wrong action is never helpful!

  2. Like with the boy crying “Wolf”, dealing with future events may be compromised by this fiasco, the dreadful number of care home deaths which have resulted from believing and following models. So the next major danger to public health might be underplayed.
    Models can be useful, but basing major policy decisions on just one, without background information and corroboration from other sources, is appalling.
    After the world has calmed down, there might be grounds for a corporate manslaughter charge against some advisors and politicians for the unnecessary deaths their panic has caused.

  3. It becomes ever clearer, I believe, that C-19 will be little different to a bad flu in terms of death rates. It presents differently, spreads quicker, and thankfully seems to spare the very young. (13 deaths under 20, with 10 of those with underlying problems), Tragic but sadly 500,000 die in England each year – or perhaps the government will lock us down to avoid deaths from any cause. Boris is going to reduce obesity as a start.

    I think if you deduct the deaths caused by the NHS strategy to push old folks back to home and care homes (thought to be 10 to 15,000), many with C-19, that they spread through their cohort, the number of deaths would be close to the 28,000 flu deaths of 5 years ago. (2014/15).

    Will we trash our economy and lock everyone down again when the next big flu season comes along? Will the MSM chant the death numbers every day? Will Boris or understudy be doing a daily brief? I guess nobody will notice (like 2014/15) just as long as we call it Flu and us old folk die quietly and slowly enough to not inconvenience the NHS.

  4. Ed P. You mention “the dreadful number of care home deaths which have resulted from believing and following models.”

    I’m not sure that the current figures show deaths in UK care homes to be proportionally worse than in other countries. These numbers, for C-19 deaths in care homes as a proportion of the total, are from Guido Fawkes but I’ve briefly scanned the source ( European Centre for Disease Prevention and Control) and they seem to be correct:

    Spain 66%, Norway 61% (including out of hospital settings), Belgium 51%, Sweden 50%, France 50%, Germany 37%,UK 21%.

    Obviously if you turn these proportions into numbers of people, the UK has had more deaths in care homes than, say, Germany or Norway but, as the proportion is smaller, there’s no reason to particularly criticise UK care home treatment. Criticism might be of the overall numbers rather than singling out care homes.

  5. The panic meant many elderly patients were sent out of hospitals, back to their homes or care homes, without knowing if they were carrying the infection. Unsurprisingly, many were and so infected others in their close communities. It’s this callous attitude to the vulnerable which I despise.

  6. Fascinating, thank you for sharing.

    These two links are worth reading: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingcovid19inthecaresectorenglandandwales/deathsoccurringupto1may2020andregisteredupto9may2020provisional

    https://www.health.org.uk/news-and-comment/charts-and-infographics/deaths-from-any-cause-in-care-homes-have-increased

    My interpretation is that a bit more analysis is needed to be sure of these comparisons, since deaths in care homes can mean two different things (deaths of care home residents in any setting, or deaths of care home residents in a care home).

    It’s also very unclear in care homes what the residents are actually dying of. A patient with dementia, lung cancer, and a recently acquired Covid-19 infection is a guessing game for a doctor, so national policies will affect how the statistics appear.

  7. Follow the science they cry…..when it suits them
    The entire situation of re-opening schools is being driven by fear and panic not the science

  8. TM,
    You ask what explanation might there be for the Nightingale “hospitals” remaining empty. I’d think that as one of the usual complaints about the NHS is shortage of staff under normal conditions, there were never going to be enough people to staff these places, if things had got worse, so they were only ever a conjuring trick, an illusion. Or maybe I should say, a delusion.
    You also ask why the public panicked and acted as they did. I think a massive amount of the hysteria was initiated by the method of reporting employed by the media. Headlines in the rags like “Killer virus” and “Deadly bug”, along with pictures of empty shelves in supermarkets and trolleys overflowing with toilet rolls were hardly conducive to keeping the peace.
    I feel the hysterical panic evidenced by a vast swathe of the voters in turn got the government into a tizz and, lo and behold, we were away!

  9. Governor Cuomo of New York insisted on expelling infectious COVID-19 victims from the hospitals into the care homes. I gather that Quebec Province had a similar policy, and no doubt there are other places too.

    So what needs explanation is why many different governments pursued the policy.

  10. It would be deeply cynical to suppose the expected reduction in pension and care payments was behind the disregard and culling of the elderly.
    I couldn’t possibly think that…

  11. Not sure about this sentence:- “…Ferguson’s idea that the NHS would almost certainly overshoot capacity, and that therefore the government would have to prioritise…”

    Surely he was worried that the NHS provision would UNDERSHOOT that which was required?

  12. Spurring the government into action sounds more like the justification of a campaign group. I thought SAGE et al were providers of impartial science advice. If they think it is a win to push the government into action it may betray their real mindset as campaigners.
    On a related theme, some of you may have seen the Youtube interview that Unherd conducted with Michael Levitt. At the end he was asked how his collegues had reacted to his contrarian position. Levitt said he had received hostility because many of them wanted a lockdown and revealing the truth may compromise that aim. Now hold on a minute. Acedmics are supposed to be the impartial seekers of the truth, but here are a group of academics wanting to suppress the truth because it didn’t fit with their political aim of a lockdown.
    It makes me wonder what other science gets suppressed because it doesn’t support the narrative.

  13. Im am of the opinion that it is NHS policy to get the elderly (bed blockers) out of hospital as soon as they are considered medically fit. They tried this with my elderly mother when she had been in hospital for a couple of weeks after a fall and a urine infection. The infection had gone so it was policy to send her home. I pointed out that she was incapable of walking which they had overlooked. So it is and still is NHS policy

  14. Martin S: “Academics are supposed to be the impartial seekers of the truth, but here are a group of academics wanting to suppress the truth because it didn’t fit with their political aim of a lockdown.”

    All this was foreseen. It is worth reading President Eisenhower’s 1961 “Farewell Address” — famous because he introduced the term “Military-Industrial Complex”. Immediately after warning about the MIC, President Eisenhower (who had been President of Columbia University after WWII) warned about the baleful influence of (politically influenced) government funding on science and scientists.

    What we have all seen with the Global Warming Scam is that scientists are human beings first, and only occasionally pursuers of the truth. As human beings, most scientists are greatly affected by peer pressure and are highly responsive to funding incentives from the political entities.

    In the US National Labs, this is referred to as the “Revenge of the C Students”. The really smart A students get hired by the National Labs to do cutting-edge research. The marginal C students go to work for the Federal Government in Washington DC, where they influence which projects the A students will get funding to pursue.

  15. Academics as “impartial seekers after truth” was probably never true, from the founder of the original Academy onward. Levitt’s position is interesting. He seems to have been in much the same position as the contrarians leading up to the Great Financial Crash, a small number of people who thought that the data showed that a crash must come who were overwhelmed by people who knew better. Perhaps a future monarch will ask, in an inversion of the Queen’s question about GFC: “Why did nobody see it wasn’t coming?”

    While Levitt shared the financial contrarians’ position of being an outsider (it’s not his field of science) his situation was more difficult in that he had very little time, messy data and confounding factors against his interpretation. Most importantly, AFAIK, Levitt didn’t propose a mechanism for the decline of covid. He could quite legitimately say that it was up to specialists to do so, but that wouldn’t be persuasive. Very few politicians would be prepared to oppose the herd armed with such flimsy weapons.

    The financial contrarians could at least make themselves feel better by betting against the crowd; Levitt may have to console himself only with having been right.

  16. There is an interesting term; ‘Single Function Thinkers’. This I believe describes people like Ferguson well. Science is full of people like this and they serve very useful roles.

    The mistake is to take their advise as being the single point of data from which to make a decision. The thing that has saved Ferguson in the past has been no one has taken him seriously after FMD.

    Perhaps the really interesting question is what has created the environment that his voice was so prominent across the world?

  17. “Follow ‘the science'” – ah, but which science?

    There was a time when most scientists (or “natural philosophers” as they were called) investigated nature out of sheer curiosity (with perhaps an additional hope of discovering useful things).

    But they were self-supporting – gentlemen of independent means, or paid and equipped by enlightened rulers and institutions. (Isaac Newton was a fellow of Trinity College Cambridge for many years, and the college placed absolutely no requirements or restrictions on what he did with his time. He never had to apply for a grant).

    Today, almost all scientists work for corporations or governments (universities have either become corporations or work for them). Thus “he who pays the piper calls the tune”.

    I came across this “Dilbert” cartoon from 2016 which puts the matter very clearly.

    http://assets.amuniversal.com/7f343ac0870a01332a13005056a9545d

  18. “All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out”.

    – I. F. Stone

  19. I was under the impression that Ferguson’s pandemic modelling has continued to be taken seriously after FMD.

  20. My criticism would be that both science advisors like Ferguson and the politicians using them to authorise policy are scientifically-illiterate. They treat science as infallible oracle or singular authority, so reducing diverse opinion and uncertainty to knowledge as unchallengeable dogma. But to be ‘scientific’, knowledge must always be subject to scepticism, falsification and thus progress. Truly scientific advisors would only do their work as part of a team in perpetual disagreement, to prevent science being reduced to faith. Science as dogma also drives the insane zero emissions policy on CO2, precisely because sceptical opinion has been excluded or smeared into silence. Science is belief in the ignorance of experts, said Richard Feynman. Precisely! Anyone wanting to know more about how science as dogma is building an irrational culture of fear may enjoy my piece on medium.com: “How (not) to become a climate crisis fear-monger”.

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