Ten Things I Learned from Covid

1. I’m not immune.

It was a shock when I was advised that I should get tested for Covid on Friday, 15 January. It shouldn’t have been. I had been unwell for the previous few days, starting with a headache and developing into general tiredness, cough and loss of appetite. It was also the height of the second wave of infections in the UK. The worst part was the headache, which lasted for eight days and had me searching Google for symptoms of a brain tumour. I had been telling myself that it was just a cold — and I had science on my side. I didn’t have the classic symptoms of infection. I was tested the next morning. It was positive.

By the time I was tested I was over the worst of it and within a few days I was feeling better. My detective daughter worked out how I was infected. A local food shop closed because of an outbreak among staff. Another daughter, a medical professional, told me that I had a “typical infection” when I complained about how I was feeling.

2. Science got it wrong

The headaches started the previous Friday and didn’t stop for eight straight days. I didn’t know then what I know now — that headaches are the most common symptom. At that time, there were three symptoms: fever, cough and loss of taste. I eventually developed one of the symptoms (cough) but for the first four days I only had a headache. Had I known that a persistent headache was the most common symptom (72% of infections) I wouldn’t have went about my business as usual over the weekend and possibly infected people.

The focus on hard surface transmission and hand washing were also misleading. We now know that the virus mostly spreads indoors, in the air, and that ventilation is vital. The food shop was tiny and customers were allowed to wait inside while food was prepared. Everyone wore a mask. We were also told that 80% of infections are asymptomatic. In fact, the majority of infections are symptomatic. In retrospect, the advice about how you get infected, what to look out for if you think you are, and how likely it will be that you’ll “not know” was wrong.

Science was also frustrating. As someone with a personal stake in the matter, I was interested to know if I was immune from reinfection and, if so, for how long. My research threw up a wide range of answers — from 99.99% immune to “not immune at all”. Longevity of immunity was no better, ranging from “a few weeks” to “years”. Even as I write this, there’s no definitive answers for me and my fellow “survivors” (four and a half million of us in the UK). The current best estimate is “strong immunity” (whatever that means) for at least eight months.

3. People can be trusted

People behaved well during the pandemic. The vast majority observed lockdowns and rolled up their sleeves for their vaccinations. Even the British press behaved, generally remaining on-message about the virus. The conspiracy theories haven’t gained much traction and anti-lockdown marches have been sparsely attended. This contrasts with America, where anti-vaxers and vaccine skeptics are more prevalent, perhaps because US media has been less unified in its messaging thanks to the likes of Fox News.

Not that the UK media has been perfect. A study that showed that natural immunity (as a result of infection) lasted for the full duration of the study (five months) became a headline of “Natural immunity lasts up to five months”, which morphed into “natural immunity lasts five months”. Another study that found that the “English variant” was up to 70% more infectious became a headline of “English variant is 70% more infectious and 70% more deadly”. The variant did cause more deaths but only because it caused more infections. The mortality rate didn’t change.

4. We can work from home

I was sitting at my desk in Glasgow at 10am on Monday, 15 March, 2020, when I was told that Microsoft Teams was going to be installed on my PC. I received the update around noon. Two hours later I was told to go home until further notice. I’ve not been back since.

I have the sort of job where you can measure output. My team’s output hasn’t changed. The targets we set pre-pandemic were achieved during the pandemic. Pretty much everything continued as normal — except everything was done differently. Most organisations were plodding along with digital transformation until Covid. The transformation was effectively completed overnight. Bill Gates estimated that the pandemic brought forward remote working by ten years. That’s probably an under-estimation.

Although productivity didn’t change, some things improved. No-one missed the commute. Everyone enjoyed the extra control they had over their lives. Meetings were easier to arrange, better attended and at least as effective as face-to-face meetings. Experienced people, by and large, enjoyed home working. Less experienced people didn’t.

Maybe we shouldn’t have been surprised by the success of remote working. Traditional office work set a low bar.

5. I don’t need stuff

My local shops have been closed for most of the last year. I didn’t miss them. I realised that I have all the shoes, trousers, shirts and pants that I’ll ever need. I missed the local cafes but little else. My needs were met by supermarkets and online shopping. I took advantage of my time at home by clearing out my clutter.

6. People need data skills

If you didn’t know your “dataset” from your “data model” before the pandemic, you do now. Countless news reports began with “The latest modelling shows…”. The public has been bombarded with graphs and charts. The “R number” is common currency. Even Bayes Theorem has made it into the popular press.

I suspect that only a minority of people understand much of this. Here’s a summary of the findings from a study into reinfection rates in people who had previously been infected with Covid.

Findings: During the first surge (ie, before June, 2020), 533 381 people were tested, of whom 11 727 (2·20%) were PCR positive, and 525 339 were eligible for follow-up in the second surge, of whom 11 068 (2·11%) had tested positive during the first surge. Among eligible PCR-positive individuals from the first surge of the epidemic, 72 (0·65% [95% CI 0·51–0·82]) tested positive again during the second surge compared with 16 819 (3·27% [3·22–3·32]) of 514 271 who tested negative during the first surge (adjusted RR 0·195 [95% CI 0·155–0·246]). Protection against repeat infection was 80·5% (95% CI 75·4–84·5).

Good luck trying to make sense of that. Journalists didn’t, or couldn’t, help. Misleading headlines were as likely to be the result of poor data literacy as sensation-seeking. “R numbers”, “variants”, “mutants”, “double mutants” and “immune escape” were liberally employed by the media, often in terrifying combinations.

You might wonder why this matters. Why not leave statistics to the statisticians? It matters because passively accepting information makes you anxious. For example, the media has said a lot about “immune escape”, meaning new variants that render vaccines ineffective. But the immunological evidence indicates that that is unlikely. This virus, unlike the flu, has limited potential to mutate. The expert consensus is that it will take a year or two, at worst, for a new vaccine-resistant strain to emerge. Or it might never happen. But “Vaccines are fine” doesn’t sell newspapers.

It also matters because not understanding statistics takes away choice. What if I told you that people who have been infected don’t need two vaccinations? What if I told you that their immune response after one vaccination was six times higher than the immune response of uninfected people after two vaccinations? Would you still get two vaccinations? Maybe. Maybe not.

7. Covid can make you famous

Who had heard of Dr John Campbell before the pandemic? Or mild-mannered Dr Moran? Or, even, Professor Tim Spector? Thanks to the pandemic, “Dr John” has become a household name for almost one million YouTube subscribers. His daily Covid updates cover global infections and vaccinations, vaccine efficacy, side-effects of the vaccine, new variants — all explained in an easy-to-understand, matter-of-fact, school-teacher manner.

The pandemic has propelled lots of practitioners and academics into the limelight. The media had little choice. The usual talking heads simply couldn’t cope with the complexities. It didn’t matter that the academics weren’t slick talkers with nice hair. We needed experts.

8. Vaccines, not lockdowns, are the answer

Lockdowns work. They work whether Covid is scarce or Covid is everywhere. When Covid is scarce, lockdowns permit countries to pursue a “zero Covid” strategy, which is what countries like Australia and New Zealand did. When Covid is everywhere, lockdowns constrain the increase in infections, which is what countries like the UK and the US did. Some countries did both. China used lockdowns to contain infections then used lockdowns, together with track and trace, to eliminate them.

Covid is a “novel” virus because it’s new, which means that the human immune system doesn’t recognise it. At the start of the pandemic, there were 7.5 billion humans ripe for infection. The only way to stop a new virus is for people to develop immunity, which can be done in one of two ways: immunity through infection or immunity through vaccination. Four and a half million Britons now have immunity due to prior infection. Another 36 million have immunity through vaccination.

Lockdowns buy us time. Vaccines set us free. It’s ironic that the countries that handled the pandemic the worst in the early stages (US and UK) will be among the first to put it behind them and those that handled it well (Australia and New Zealand) may be the last.

9. Science got it right

The pandemic was a tragedy for many but a triumph for science. The development and deployment of vaccines was unparalleled. Vaccines were developed at break-neck speed. Almost two billion vaccinations have now been administered. If the 1917 Flu Pandemic had been the 1917 Covid Pandemic, it would have decimated humanity.

The pandemic saw the first real-world use of mRNA vaccines on humans, a technology that holds immense promise for lots of health conditions including cancer. Statisticians and data scientists were able to create accurate models to predict infection patterns so that politicians were able to take preventative action. The pandemic showed what humanity can do when we put our minds to it.

10. Things probably won’t change

Big changes follow big events, and the pandemic was a big event. Revolutions threatened the established order after World War One. The National Health Service was conceived from World War Two. So you might expect significant change after the pandemic. I don’t. I suspect that as the pandemic disappears into the rear view mirror, so will our good intentions.

It’s not that people don’t want change. When the pandemic struck we didn’t run to accountants, lawyers and hedge fund managers for help. We ran to nurses, doctors, teachers, scientists, researchers and statisticians. While bankers scuttled off to their second homes in the Dordogne for the duration, those people were left to pick up the pieces. The pandemic brought into focus the common humanity of people. It won’t last. Too many people have too much interest in the status quo.

Not everything will return to normal. Remote working (for some) is here to stay. There’ll be less travelling to business meetings. Maybe education will be more flexible. I’m struggling to think of anything else. Historical events give us an opportunity to re-evaluate our values. What’s important? Who’s important? What needs to change? Serious questions. I’m not expecting serious answers.