The Next Phase of Covid19 – Technology Innovation

Podcast here

It’s becoming clear that a Covid19 vaccine is not going to be the silver bullet as widely advertised. I have been asking for months, why would we expect a vaccine to be 100% effective? Flu and other vaccines are well understood as being less than 100%. On Wednesday Robert Redfield, director of the Centers for Disease Control and Prevention, said during his testimony before a Senate subcommittee that wearing face masks may be more effective at protecting against COVID-19 than a vaccine.  

I note the WHO recommends that successful vaccines should show an estimated risk reduction of at least one-half, with sufficient precision to conclude that the true vaccine efficacy is greater than 30%. This means that the 95% Confidence Interval for the trial result should exclude efficacy less than 30%. This is a minimum baseline. They go on to say a vaccine that has 50% efficacy could appreciably reduce incidence of COVID-19 in vaccinated individuals, and might provide useful herd immunity. Hence, although efficacy far greater than 50% would be better, efficacy of about 50% would represent substantial progress.

We can observe that right across Europe countries are struggling to contain the virus. While deaths and hospitalizations are thankfully lower, due to better treatments and understanding of the condition, case numbers everywhere are once again on an upward, exponential curve. And countries are trying to introduce a complexity of restrictions, often varying by geography to a public that are weary and angry. It looks like a slippery slope with a bad ending to me.

I also note that in the UK Daniel Lawson, senior lecturer in statistical sciences at Bristol University, said there was clear evidence that the surge was being “driven by infection in people aged 17 to 34”. The threat posed by young people failing to distance was spotted early by public health officials, with Preston city council the first to launch a “don’t kill Granny” campaign more than a month ago. However, the message appears not to have got through. Many of the infected young are asymptomatic and are increasingly passing the virus to elderly and vulnerable relatives. Some people have clearly become tired of following the rules. Here in Ireland we can see the same trend, just today I see the median age of cases in the past 14 days is 33 with 20% of cases between the ages of 15 and 24.

Here’s just two stories that summarize the problem. The other day as I walked from the car park in to the village at lunchtime, I could see clearly into the pub back yard. There were some 6 guys, not youngsters, all drinking beer, laughing and joshing. No distancing, no masks. Another guy joins them and they all hi five each other and bunch up close to let the newcomer in. The same day I walked down the road just as the schoolchildren were returning after lunch. There were many hundreds of youngsters, often five abreast, causing other pedestrians to scatter. No sense of social distancing, and not one mask to be seen anywhere. Speaking to a teacher later she said, it’s all nonsense. We enforce social distancing and mask wearing in school, but in the playground or outside the school there’s no compliance at all.

All this makes me ponder on Robert Redfield’s comment on the importance of masks. That they are more important than getting a vaccine, and bearing in mind the limited efficacy of vaccines we will be living with the virus for years. So why don’t we trigger some real innovation in masks and other protective devices. Why doesn’t the BT Young Scientist or a similar organizations hold competitions for innovative ideas in this area. Particularly those that will be attractive to younger people. Why not connect masks to mobile devices to allow dynamic messaging on the front of the mask. Or in-mask microphone allowing hands free speech, or amplification of the voice through the device. Could we see such amplification enabling singing while wearing a mask? Or allowing drinking through a straw. But why stay with the centuries old mask. Consider variants such as wrap around visors with heads up displays, wraparound sound, in-visor (replaceable) air filtering for both viruses and pollution, in-mask or visor language translation. Oh, and also make them comfortable to wear for protracted periods. I could go on.

I have said before, we should never let a crisis go to waste. We should expect high levels of innovation during crisis periods. Clearly there has been and is ongoing massive innovation in the medical and public health spaces. But now we know Covid19 is not going away for probably years, it’s time to innovate in the personal technology space to both protect ourselves but also allow us to live our lives to the full.


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Ireland’s Covid19 Tracker Works – Everyone Needs to Download.

Abstract: Ireland’s Covid19 Tracker is widely regarded as a success in an application space littered with failures. Initial uptake has also surpassed other countries efforts, however in Ireland there has been considerable negative commentary regarding accuracy and privacy. As a result, uptake has been slower than it might have been. This non-technical opinion piece summarises the arguments around the contact tracing app and explains why everyone should be part of this vital national effort now. 

The concept of contact tracing is new to us all. In the early stages of the Coronavirus pandemic the idea of an app that everyone could use was a silver bullet. A way we could all demonstrate national solidarity in this time of crisis. But reality is inevitably more complex and even in a crisis takes a little more time. Many countries around the world have tried to develop and deliver contact tracing apps with little success and some high-profile failures. In Ireland the HSE launched the Irish COVID Tracker in July, in the face of significant public debate and some negativity triggered by overseas experiences, various public interest groups and a relatively critical media. It was therefore gratifying to see the tech savvy Irish public get behind the launch with some 1.5 million downloads in the first weeks, followed by steady growth thereafter. However, this user base is still way too low. While the world applauds Ireland’s efforts, as way better than almost any other country, we urgently need to extend its reach.

We now understand the contact tracing app is not a silver bullet, rather it’s a vital part of the national contact tracing system. It can speed up and enhance the contact identification process and add critical extra intelligence on the state of the virus to the public health system. But to “control” the virus and allow us all to return to some semblance of normality, we need to more than double the number of users really soon.

There are two areas that have come in for critical comment – accuracy, and privacy, autonomy and security. Let’s start with accuracy because that’s at the core of whether the app is effective.

Accuracy of Close Contact Identification

As discussed, the app is a key part of the much wider contact tracing system. It supports the exposure notification process by exchanging Bluetooth signals with other devices that are detected in range, and registering the “contact” in an anonymous way on the local device if the signal strength is interpreted as a “close contact” and in range for some time period. Early on there were reports that Bluetooth is very imprecise; that signal strength could be highly variable depending on the environment, where the smartphone is placed, whether there are bodies or other physical obstructions between the devices. Buses and trains were also highlighted as particular problem areas because of high levels of metal surfaces.

Various commentators and campaigners have therefore concluded that the app doesn’t work and will never work. They say that there is scant proof that it will work given the proven awkwardness of Bluetooth. That using Bluetooth you can at best obtain a distance resolution of few metres, but you can’t calculate the direction, not even roughly.

The problem is that if the signal strength is misinterpreted it could lead to false positives – contacts that are highly unlikely to cause virus transmission, or false negatives – contacts that might be likely to cause transmission but have not been recorded.

Clearly the requirement for accuracy is very important because false positives might cause individuals to self-isolate unnecessarily, or false negatives might lose opportunities to track the virus spread.

However, the HSE team report that in public health the concept of accuracy is highly variable – that the widely publicised definition of close contact, “closer than 2 metres for 15 minutes” is applied more flexibly with greater weighting on > 15 minutes.  It isn’t necessary therefore to be 100% accurate to chase the virus down and the rules governing the close contact definition can be dynamic and in context with the environment. Whilst the exposure notification app currently uses 2 metres for 15 minutes, the team fully anticipate that the rules will evolve as parameters that can be flexed based on the need to test more or less people; or varied depending on the inferred pattern of contact, such as extended duration without movement etc.

Not surprisingly there is extensive research happening in this area of determining contacts. Scenarios such as on bus or trains are being examined and tested. And many more. We can expect considerable additional sophistication to be incorporated into the close contact algorithms in the very near future.

Research is also taking place in many countries into risk modelling, machine-based learning and sensors to determine the orientation of the devices and the attitude of the Bluetooth antenna. We may also expect to see a range of signal patterns used to derive better results including multiple and two-way signals to allow refinement of results. Also new protocols such as Ultra-wideband that enables precise indoor positioning which then allow dynamic selection of the best protocol to use in a given context. We can also expect new dongles or other devices to emerge very soon which will potentially provide better accuracy, possibly avoiding the need to upgrade smartphones and also offering support to users who may not have smart phones including the elderly and children[i].

At the time of writing the Irish app has been in use for just one month. So, it’s too soon to assess the effectiveness of the app. However early data indicates that at least 416 notifications to close contacts of positive cases have been processed since launch. And the real figure for notifications is probably substantially higher as 20-25 per cent of the 1.5 million people who have downloaded the app have opted out of metrics for personal privacy reasons.

We are all aware of the huge advances being made in the medical world, particularly with vaccines and treatments. What’s perhaps less well known is that the pandemic is also driving huge advances in contact tracing applications and technologies.  Does this mean you should delay a technology adoption because it’s too immature or undergoing great change? Not at all! We have a base level of maturity already and for end users of all ages embracing the core technology immediately is important to keep up with change and being able to quickly adopt new innovations which will in all probability be essential to allow us to live more normal lives.

Privacy, Autonomy and Security

There are also multiple privacy challenges made by media and privacy campaigners. The challenges that potential users may be concerned about include:

The role of Google and Apple in the core code.
The privacy of personal data and IP addresses (personal device location address)
Security against outsider attacks.

Apple and Google took the initiative to develop the Exposure Notification System (ENS) framework and specification and to incorporate it into their operating systems. In normal times we might expect that such an important framework would be managed by a standards organization. However, anyone familiar with standards development will be aware that standards processes are rarely completed rapidly because of the necessary cross industry consultation and participation. In fact, many standards emerge based on successful early efforts typically by major technology companies. In this case the framework has emerged in just a few months. We can already see Google is committed to transparency of the ENS code[ii] and upgrade contents.  We can expect this Google Apple API will become the industry standard in due course. In addition, in April, the EU started the process of assessing the proposed system for compatibility with privacy and data protection laws, including GDPR. Also, in April, the UK’s Information Commissioner’s Office, published an opinion stating that the systems are aligned with the principles of data protection as mandated by the GDPR.

There has been considerable adverse comment on data protection, specifically in the Google ecosystem. It has been reported widely that because the Google ENS framework uses Google Play Services that are part of the operating system, that personal data is automatically transferred to Google Servers. However, critics should be aware that while this is not a new problem – on Android devices it has been in place for many years that Google shares personal user data[iii] together with fine-grained data on the apps running on the phone, Google is very clear there is no personal data sharing. The reason the ENS module ships in Google Play services is because it’s an updatable layer on Google Android devices, thereby enabling the ENS to be available on all devices quickly. Asked about personal data protection in contact tracing Google commented, “In keeping with our privacy commitments for the Exposure Notification API, Apple and Google do not receive information about the end user, location data, or information about any other devices the user has been in proximity of”.

In April the Electronic Frontier Foundation[iv] reported concerns the protocol was vulnerable to “linkage attacks”, where third parties may be able to turn contact information into tracking information for users who have disclosed their COVID-19 status. This tracking information could be used to track individuals’ movements, or to establish replay attacks to simulate coronavirus outbreaks, although in the latter case the purpose of this other than simply mindless vandalism is unclear. It seems this threat is certainly not unique to the Covid19 tracker application and, given the significant effort involved to effect, seems to be low risk.

Some Conclusions

It’s important that we understand the context in which the Contact Tracing app is being delivered. We are in the middle a global crisis, which will probably persist for another year.  Our primary aim is to shift the balance away from “responding and reacting” to the virus to “controlling” it. If we can control the virus it is possible that we can recover some semblance of economic and social stability as soon as possible. Speed is of the essence.

The HSE has delivered the contact tracing app using Agile methods that “deliver useful functionality early, and continuously evolve on the basis of practical experience”. The entire contact tracing system and the underlying technology is therefore evolving at great speed to meet this urgent need to control the virus. But the app together with the national contact tracing system will only deliver the control over the virus if a significant proportion of the population download and use the system. From the foregoing it is clear the accuracy and privacy concerns are over-stated or out of date because the functionality is moving so fast. Any issues over accuracy will be resolved very rapidly. There will be glitches and unforeseen events. This is inevitable and there will be issues that need to be resolved. But this app is mission critical to the national contact tracing effort and part of that picture is a comprehensive user base. There is no reason for delaying download and usage. The system is effective and secure in its current state and will only improve. There is good accuracy, privacy, security and governance right now and the more citizens that use the app, the sooner we achieve greater control over our lives.

David Sprott, August 2020

Bio: For 50 years David Sprott was at the forefront of application development technology. As researcher, author, consultant and educator, he advised government agencies and commercial enterprises worldwide, and led industry efforts in the areas of software componentization, service specification and automation. He is now retired, living in Cork and provides voluntary tech support to non-profit

[i] Coronavirus: Why Singapore turned to wearable contact-tracing tech

[ii] Google Code Transparency

Open sourced EN implementation code

Documented the (narrow) EN telemetry design

Added note in EN documentation on general Android platform telemetry

Published release notes for each EN version

Risks and mitigations for the EN protocol.

[iii] Google Shared user data – IP address, international mobile equipment identity (IMEA), hardware serial number, SIM serial number, handset phone number and user email address

[iv] Apple and Google’s COVID-19 Exposure Notification API: Questions and Answers

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Education in the Covid19 World – Problem or Opportunity

Many important innovations have occurred in times of crisis. Natural disasters, pandemics or wars have all triggered and or accelerated huge change. The 1918 Spanish Flu pandemic led to a wave of public health efforts, a huge focus in epidemiology and the creation of the World Health Organization (WHO). The second world war saw an amazing amount of innovation including radar, code breaking, nuclear fission and women participating strongly in the workplace. During times of stability the impetus for change is clearly lower. In times of crisis we can observe huge change can happen extraordinarily rapidly.

All around the world the teaching profession and its administrators are searching for solutions that allow teaching in a world where Covid19 is an ever-present threat. In most cases the attention is on social distance which brings intractable problems of classroom and class size. Remote teaching is also seen as problematic because not all pupils have adequate network access to support modern technology-based teaching. What we are not hearing is how dealing with the Covid19 situation might represent an opportunity to address some of the really important issues that the education profession will need to address over the coming decades. If we are searching for solutions on how to return to the status quo, it’s likely to involve very difficult and very expensive solutions. So why not start from a different place and consider how should we be educating young people for tomorrow’s world?

In tomorrow’s world individuals will need to be prepared to take responsibility for lifelong learning. And as life expectancy increases facts are less important than high levels of adaptability supporting excellence in thinking, researching and communicating skills. Also, sooner than we think, machines will undertake up to 80% of today’s jobs. The routine and or knowledge intensive activities that can be automated. But machines will never take over our human capabilities so we should be educating young people in essentially human skills such as systems analysis, data analysis, statistical analysis, policy development, governance practices, education, as well as all the humanities and arts that will never be automated. Further we should be educating young people to work individually and in teams, to collaborate on problem solving and solution delivery.

We actually have a model for this form of education in the essential principles of the Montessori Method, which teaches child centered education with children of different ages working independently and collaboratively on projects with teachers, that encourage these behaviors and work with all of the children on an individual as well as collective or team basis. This model does not require set class sizes. Rather it is ideal for numerous bubbles or teams of differing sizes. This model can leverage multiple teachers with different skills that are needed across the bubbles.

But let’s go further and consider why we organize classes around subjects. If we use a project-based approach to learning, then each project and team might need several teachers involved at different times. Consider a project where five children are working on developing their own environmental model – this might involve teaching support for english, science, economics, maths, geography, business  and conceivably history (for comparisons).  Of course, we know there are concerns about needing lots of additional teachers if class sizes are smaller; but if teaching is more consultative this makes it easier – simply allowing children to take the lead in requesting support. And of course, the support could easily be remote. The remote support could also facilitate the involvement of retired teachers on a voluntary basis. And why wouldn’t we also consider involving subject matter experts who volunteer their support. This would be an amazing way of giving young people insight into the real world.

Similarly, we could consider organizing projects in which teams collaborate with children from other countries, developing language skills. So using the example of the personal environmental model, to develop country comparisons. We could also envisage that a school might set up pairing arrangements with a similar school in a developing country, allowing children to become familiar with a whole range of situations.  And if project work becomes the norm, why not encourage more work experience from an earlier age to allow children to undertake a whole range of activity with guidance and support from teachers and other subject matter experts.

We hear that there are real limitations on broadband availability, particularly in rural areas that would prevent this form of remote/onsite model. In business as a matter of good practice, we solve and optimize the mainstream processes and work on exceptions which generally are multivarious  and require diverse solutions. And are also hopefully transient. In many geographies it’s likely over 80% of students would be able to participate remotely. Maybe with assistance with technology equipment. The other 20% might need to travel to a hub or friendly neighbour, but over time then exceptions would diminish as broadband coverage is extended.  

The Covid19 threat may be with us for a considerable period. If we look on this as a problem, we will solve it some way that will always be incredibly expensive yet suboptimal. We might expect that the teaching profession and unions will be hugely protective of their current practices. But change is coming and starting down a new path is perhaps easier in a time of crisis. If we manage the current crisis as an opportunity, we will put ourselves on a path to addressing core issues that need to be solved. And in the process, we will recognize children are at the heart of our future and we will have shown them we trust them to take responsibility as citizens of the future.  

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New Models for the Post Covid19 World

There’s great talk in the media about how after Covid19 nothing will be the same – that we will have the opportunity to rethink our world. This is of course absolute nonsense. The commercial rush to return to normality is already in progress. Airlines are running 40% of their normal schedule and encouraging everyone to go on overseas holidays as soon as possible. Tourism related businesses are eagerly awaiting the rush of tourists to hospitality businesses, pubs and restaurants etc. Cruise ships are announcing new schedules! I admit in the past I would never have stepped foot on a cruise ship even if you paid me, but now . . . give me a word stronger than never!

There’s an interesting model going the rounds – the Doughnut Economic Model. This is an interesting idea – providing a template for a new economic model that rejects the idea of GDP as the basis for financial planning and introduces ideas of a model that melds climate actions and social justice.  Evidently the city of Amsterdam is piloting the ideas. The problem with models of this sort are that they are impossible to implement. Idealistic concepts never survive the light of day in the real world in which vested interests, politics and powerful players have the real say in most countries.

It occurs to me that a working model needs to be practical, implementable and saleable to ordinary people. Forget the fancy diagrams, show me the benefits to me and my family or my business.

I suggest that what’s needed is a Transformational Model that is focused tightly on policies that underpin implementation and governance. Take a look at the following list:

– Employee Reps on Company Boards with majority power over director and management remuneration.

-Citizen’s Assemblies that (don’t just provide ideas but) have approval over legislative programme.

-Citizen’s Reps that provide governance over platform providers (Google, Facebook, Twitter etc)

-Mandatory contracts of Employment that eliminate gig economy.

-4 day week.

-Basic Living Wage.

-Unemployed people of all ages do mandatory community work (or Youth Corp, Civil Defense etc)

-Climate Metrics for companies determine their corporation tax rate.

-Climate Metrics for home owners determines their property tax rate.

-Measured outcomes of twinning of businesses or towns with developing world determines tax liability.

-Civil servants have mandatory job rotation with private sector.

-And so on . . . . .

You get the idea. This is just a starter for 10.

In the same way that turkeys never vote for Christmas, politicians would NEVER implement many policies like these. But if the populace saw here policies that would enable real change they would potentially become vote winners and have profound change over how the basic economic model works.   

Reference – Doughnut Economic Model

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How Ireland Can Return to Post Covid19 Normality

Listening to Michael McGrath (FF Finance) this morning he was asked whether his party, if in government, would make face masks mandatory in enclosed spaces such as transport and shops. His answer was interesting. He said that his thinking is that if the key influencers including medical experts, government and media got behind the idea, then just as the public has overwhelmingly supported and complied with the Covid19 restrictions, mask wearing would quickly become the norm.

McGrath made the point that, there will always be a small number of people that simply cannot wear masks for a variety of reasons including their age or specific medical conditions. And we should avoid stigmatising individuals. In this short conversation McGrath summarised the differences and opportunity for Ireland – that without talking about green jerseys as a nation we have proven we can collectively act in the national interest. There will always be a small minority who don’t, but the experience of the past two months is that the overwhelming majority can act in the national interest.

It is perhaps easy to look at New Zealand and observe that they do the same. An island state with similar size of population they have, through national unity of purpose, effectively killed the virus and are on a course to establish a bubble comprising New Zealand and Australia. Unfortunately, Ireland can never copy New Zealand. Our island has a porous international border and will never be able to close that, or establish a virtual bubble with the North because they are governed by a different national entity.  There is also a very high level of dependency upon international tourism and trade and keeping borders open is going to be an economic necessity.

The answer for the Republic of Ireland to achieve something like normality is almost certainly to establish an effective automated contact tracing system. If the tracing system is working well and is downloaded and used by a high proportion of the population, any outbreak of the virus would be rapidly identified and managed. Ireland has made some good decisions in this area, choosing to implement the Apple/Google API which is a distributed architecture that protects individual privacy. Unfortunately, there are various actors who are already briefing against the app, even though they clearly don’t understand the architecture. I note today that Iceland, another small country like us, who have moved rapidly to implement an app, report they only have 40% of the population using the app and have pretty much discounted it as a potential game changer. For Ireland, because of our open borders, the app must be the game changer. It is the only way that we will achieve anything like normality in the next few months and through 2021 as we wait for a possible vaccine.

Returning to Michael McGrath’s comments, we need to see the use of the app in a similar way to the use of masks in enclosed public spaces. We need to see at least 80% uptake not just of the app but also in individuals self-isolating when they have been in close proximity to a confirmed case for 15 minutes. This will require a concerted effort by the key influencers to explain why this is another area where we need a huge effort and compliance by the entire population. Perhaps we should start by explaining that the contact tracing app is actually just one key component in our virus suppression system. The system is so much more than the technology, it’s the buy-in of the entire population in the process that starts when an individual believes and reports that they have symptoms through to managing the isolation of their contacts and the prevention of outbreaks.

This will need, just like over the last two months, everyone to put their shoulders to the wheel. But the prize is a return to normality.  

Posted in Coronavirus, Covid19, Digital Transformation, lockdown, Pandemic | 2 Comments

Medical Advice on Lockdown

Most governments, perhaps excluding the USA, have been at pains to emphasize their adherence to medical advice. Who can blame the politicos for wanting to avoid taking the blame for thousands of deaths and a destroyed economy! But my personal experience is that “unquestioning adherence to medical advice” is a slippery slope on which we should take great care.

In Ireland all the over 70s are locked down in what is referred to as cocooning. Basically you stay home. Period. You don’t do out except to your garden. Your groceries and medications and other essentials must be delivered. My wife and I are early/mid seventies. Prior to the lockdown we were pretty fit, walking regularly with a pretty full diary of activities. But we accepted the guidance and stayed home. Like many, we anticipated the lockdown by a couple of weeks and therefore we have been “at home” for nearly eight weeks. Hasn’t been a problem; our neighbours have been great helping with the shopping; pharmacies have delivered medicine. And while in the early days it was hard to get grocery deliveries because of the demand, recently the Tescos supermarket has opened up lots of delivery slots for over 65s, so we are sorted. And we have kept ourselves pretty busy with voluntary work that can be done remotely, online classes, gardening, patchwork quilting (not me) art, reading etc.

Before the lockdown we were both walking very regularly. Up to two hours a few times a week. And I would often go out in the early morning and do a 40 minute local loop. However when the lockdown happened the walking stopped; I continued my Ashtanga Yoga, which is actually heavy stuff, but not the same level of cardio vascular exercise as say walking.

Last weekend the lockdown was eased – we were allowed to take short local walks, so I started walking. The first time out I did 40 minutes easy. Felt really good. The next day I did the same and my legs were killing me. Strangely the pain wasn’t the normal muscular pain; sharp stabbing pains in the back and then front of the leg. In the evening when I go home I had occasion to get up suddenly from a sofa. And I felt really dizzy, which for me is very unusual. Blood pressure 100/65! Which is low. Sounds like circulation issues! So I took a day off walking. Over the next few days I gingerly recommenced walking. By the end of the week I am doing between 30 and 60 minutes a day. I will extend gently and figure it will take a complete month to get back to my previous level of fitness.

 I now have a healthy scepticism regarding medical advice. I really felt I wanted to comply with the restrictions because it’s so easy for every individual to reinvent the advice for their own situation. And that’s the road to hell for the country. But in future I’m more inclined to put my own health first and then figure out how I remain in compliance at least in spirit if not to the letter.

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Personal Responsibility in the Next Phase of the Covid19 Pandemic

It’s time we got used to this

There has rightly been huge emphasis placed upon individual Irish citizens responsibility in overcoming the Covid19 threat. The consistent message has been, reduce the number of infections by total compliance with the social distancing, cocooning, hand washing, etc. And following an obviously very high level of compliance it appears there is growing optimism that we can keep the peak infections to a manageable level and perhaps start to relax the restrictions after Easter. But we all know that if we do that too quickly, the number of infections will probably come roaring back? So is there anything more “we” can do?
Many of us will have observed that it is normal for Asian citizens to wear face masks. We see Chinese and Japanese tourists wearing masks on our streets, and we notice because it’s not something that we ourselves do. And if we have given it a thought, we would conclude they do have massive pollution issues in large cities such as Beijing and Tokyo. Now ask yourself the question, why is it that China, Japan, South Korea and Singapore seem to have managed the Coronavirus better than the West? Of course, there are multiple reasons, particularly comprehensive testing and contact tracing. But an additional reason may be the ubiquitous wearing of masks just may have played a significant part.
There are lots of conflicting opinions on using Face Masks. The medical experts say only medical people should use them. And understandably they are most concerned about the supply shortage and the need to prioritize the front-line workers in hospitals, nursing homes, test centres etc. One of American’s top health officials, battling a catastrophic shortage of masks for healthcare workers, has very recently tweeted for people to “STOP BUYING MASKS! So, no contest there.
But it does seem clear that all types of masks protect healthcare workers from high levels of viral pathogens to some extent. From the lowly paper mask to ultra-high filtration N95 masks designed to stop aerosols, decades of studies show masks stop healthcare workers from getting infected in hospitals and prevent sick people from spreading disease to others. Even home-made masks, although not as effective as surgical products, but most experts say they are better than nothing when it comes to preventing the spread of coronavirus. At the very least they will contain the wearer’s sneeze or drips that form the lethal spray infecting others.
George Gao, director-general of the Chinese Center for Disease Control and Prevention (CDC) was part of a team that did the first isolation and sequencing of SARS-CoV-2, the virus that causes COVID-19. Gao later earned a Ph.D. in biochemistry at the University of Oxford and did postdocs there and at Harvard University, specializing in immunology and virology. Very recently the Science Journal asked Gao, “What mistakes are other countries making?“ He replied, “The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.”
It would seem to be an obvious next step, as we start to lift some of the extreme restrictions, to strongly advise or even mandate the wearing of face masks. This won’t be easy. It’s not currently socially acceptable, there are clearly worldwide supply issues with consequent price issues also. However, there’s little doubt that the Irish public would, after a period of such extreme social isolation, be prepared to change their habits of a lifetime. Clearly supply and price issues must be solved and this would offer immediate commercial opportunity for firms struggling with the enforced commercial shutdown as well as a place for simply DIY and cottage industry solutions.
There is no reason why this strategy should not be introduced immediately. People are currently going to essential workplaces and going shopping for food and essentials. This will be a profound social change that may need to be in place for 12 months or more until a vaccine becomes available. It would be a key action that would mitigate the severity of a second and even subsequent infection peaks.
The widespread adoption of face masks would be a highly personal and positive demonstration of individuals taking further responsibility upon themselves to ensure we manage our way out of the pandemic.

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We Are Living a Sci-Fi or Horror Movie!

Today, Friday was beautiful, and we walked a favourite path along the cliffs and then down to the beach east of Crosshaven overlooking the heads of Cork Harbour. A nearly clear sky, about 7 degrees with a stiff breeze off the Atlantic.

Surprisingly we saw only a few fellow walkers. As we walked along this idyllic route in near perfect conditions our mood was subtly different to normal. We were alert to other walkers and apart from the usual greetings, we and the other parties we met were treating each other with the greatest caution, ensuring maximum space between us and mostly keeping greetings to the minimum. The usual craic was missing.

It dawned on us that we were starring in a Sci-Fi movie. On the surface everything around us was entirely normal. But we are acutely aware that there is a lethal, unseen danger lurking. We have seen and heard the reports from Italy where hospitals are literally overwhelmed with critical cases and deaths. Apparently, the onset is very like a normal flu; dry cough, sore throat, fever, aching, tiredness and headache. Most people recover in a few days, but a significant minority develop critical breathing difficulties. One in five cases that need intensive care die – horribly, without their relatives at their side; and are cremated without ceremony. Over 4000 have died in Italy in just four weeks. And the pace is accelerating.

In our movie, there’s no hero scientist, engineer or everyman, who finds the solution and saves millions of lives. Instead we are all encouraged to be heroes – stopping the spread of the virus by socially distancing. And if we all do it, we will all be heroes. Predictably there’s always a few langers, (Cork slang for stupid or contemptible people), but thankfully we observe most people being incredibly careful. But we are told by the scientists that it will be two to three weeks before we can expect to see significant positive trends.

The Coronavirus is only one type of threat. We also have monsters, parodies of actual human beings that have manifest themselves as our leaders. And in these roles they spread fear, uncertainty and doubt. The President of the United States who initially denied Coronavirus was a problem in the USA, now actually “cuts” the budget of the Centre for Disease Control and Prevention (CDC) and the Infection Diseases Rapid Response Reserve Fund, spreads falsehoods about the existence of vaccines and attacks journalists who ask difficult questions. He has no empathy with suffering, his only interest is feeding his own narcissism and getting re-elected.  

In the United Kingdom the Prime Minister Boris Johnson brings his maverick attitude to the battle with the inanimate virus. He adopts a strategy based on establishing “herd immunity” which is in complete conflict with the guidance given by the World Health Organization (WHO). The herd immunity is based on unproven science and we understand may generate extraordinary levels of infection and unsustainable demand upon the National Health Service (NHS). This morning I receive a link to a clearly authoritative report from a doctor friend in the UK. It makes distressing reading. Also this morning the Irish Times includes a report titled, Boris Johnson is gambling with the health of his citizens. It includes the extraordinary comment, “The folly of the British approach was spelled out on Monday in a report by Neil Ferguson’s team of epidemiological modellers at Imperial College London. It said that if Britain did not introduce tougher measures aimed at suppressing the virus, the epidemic could kill up to a quarter of a million people.”

We can only pray for our friends and families in the USA and the UK. And if some countries situations spiral out of control, it will prolong the recovery of the entire world and increase the overall negative impact.

Many years ago in my teens I was a great fan of John Wyndham, author of post-apocalyptic landscapes such as the The Kraken Wakes or The Chrysalids. Wyndham painted the picture of coexistent normality and deadly abnormality. Somewhat later I devoured all of Michael Crichton’s works that are very relevant to our world today, such as Prey and State of Fear.  Even more relevant are Crichton’s Jurassic theme novels that blend the Sci-Fi and Horror genres. None of these books ended happily. And as we know we have an even bigger existential crisis around the corner called Climate Change. It hasn’t gone away you know!

It seems we are fated to live through scenarios that Sci-Fi and horror books and movies have envisioned. We have come to understand that the truth is usually stranger than fiction, and it seems that these monsters have not recognized the awful truth that their words may cost many, many lives.  

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Edvard Munch The Scream 1893

In 2015 Bill Gates gave a TED talk. He predicted the current pandemic. He said, “. . . If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse. In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned. . . . “
So Bill Gates and presumably others have predicted this moment for a while. But here’s the thing – in 1918 the Spanish flu infected 500 million people around the world, or about 27% of the world population of between 1.8 and 1.9 billion. The death toll was estimated to have been anywhere from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest epidemics in human history. It is unlikely that the Coronavirus will be near that level, but we should be planning for many more virus’ and sooner rather than later we will get the big one.

Gates went on to say “ . . . The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up to large numbers. . . . So they are absolutely ready to go. . . . the kinds of things we need to deal with an epidemic. . . . First, we need strong health systems in poor countries. That’s where mothers can give birth safely, kids can get all their vaccines. But, also where we’ll see the outbreak very early on. We need a medical reserve corps: lots of people who’ve got the training and background who are ready to go, with the expertise. And then we need to pair those medical people with the military. taking advantage of the military’s ability to move fast, do logistics and secure areas. We need to do simulations, germ games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn’t go so well. So far the score is germs: 1, people: 0. Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.”

We need to cop on that Coronavirus isn’t the BIG one. It’s simply a DRILL. Given the awful process we are all going through, we could be forgiven for thinking this was a real, existential disaster. But it’s not. There are vast numbers of much more deadly pathogens out there, and mankind is actually making the likelihood of further pandemics much more likely. The real lesson we have to learn is how to prevent the big one.

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2020 – The Year the Climate Crisis Heats Up

M and I attended a brilliant session with (ex Irish President) Mary Robinson a couple of weeks ago; and we were very inspired by her advice to start climate action at home. She urged us all to work bottom up because the politicians and big business will only move when they see the demand is really there.

But for ages we have all been saying, “what can we ourselves do as a sensible response to the climate crisis?” And for many of us it’s very hard; we are highly dependent upon government policy actions to give us grants for house renovation or electric cars or charging points. And also, highly dependent upon big businesses that control the cars we drive, the fuel that’s available for transport, home heating and electricity to name just a few. So, when we watch the disaster that was COP 25 and learn that the fossil fuel industry plus the USA, Russia and Brazilian governments effectively killed any agreement, who can blame us for being cynical and despondent.

So I was very interested to come across Ted Countdown. An initiative by Future Stewards (a coalition of partners working together) to build a regenerative future – where we meet the needs of all, within the means of the planet and Ted. Countdown is a collaboration in which literally everyone to play a part in counting the world’s emissions down to zero. The intent is not to be something brand new, but to amplify and cross-fertilize the extraordinary work that has already been done by so many. Powerful solutions have already been proposed by more than 50 authorities on climate issues. The website provides information and opportunities for people around the globe to join the effort.

A team led by Future Stewards and TED will select the best proposals and turn them into talks. Partner organizations, including YouTube, C40, Global Covenant of Mayors, Climate Reality Project, Climate Leadership Initiative, Global Citizen, and Project Drawdown. Individuals are also lending their voices, among them climate scientists Johan Rockström with the Stockholm Resilience Centre in Sweden; Hoesung Lee, Chair of the IPCC and Endowed Chair Professor at Korea University Graduate School of Energy and Environment; and Katharine Hayhoe, an atmospheric scientist and director of the Climate Science Center at Texas Tech University. Others include Pierce Brosnan, Don Cheadle, Leonardo DiCaprio, Ava DuVernay, Davis Guggenheim, Jimmy Kimmel, Julia Louis-Dreyfus, Norman and Lyn Lear, Rooney Mara, Joaquin Phoenix, Mark Ruffalo, and Meg Ryan.

Among the leaders who convened to announce Countdown were: Chris Anderson, Head of TED; Christiana Figueres, previously Executive Secretary of the United Nations Framework Convention on Climate Change during the Paris negotiations; António Guterres, Secretary-General of the United Nations; Tshering Tobgay, former Prime Minister of Bhutan; Al Gore, former Vice President and environmental activist; Jessica Walsh of &Walsh, who created the campaign visuals; actor and environmental activist Mark Ruffalo; Ted Halstead, Chairman and CEO of the Climate Leadership Council; and Yuval Noah Harari, historian, philosopher and author of Sapiens.

These will be delivered at a Countdown summit in Bergen, in front of a hand-picked audience capable of turning those ideas into action. The proposals and their accompanying commitments for action will be shared with the world on 10/10/20 with an opportunity for global companies, cities and individuals to participate. For the cities portion, C40 and the Global Covenant of Mayors have joined as official partners, and for the first time local TEDx organizers – operating 4,000 events annually – will activate to bring Countdown to their communities. Beyond cities and TEDx, companies around the world are invited to join this initiative and engage with employees on how to best play a part.

Take a look at the Ted Video. Note the whole thing is worth an hour of your time, but the Q & A at the end is very powerful. I came away thinking this just might work.

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