Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Thank you everyone who is reading and reposting. Everything I write is public domain so please share. I am keeping this and future posts to about 4 pages of text. I provide sources as well as commentary. Red text indicates figures or information will change, probably rapidly. Bold text indicates a key point.

Introduction

The first blog was published on 4th March. I have issued one every Wednesday since. Last night, as I walked from my office to the back door of the house, I nearly kicked a hedgehog. I have not seen one in our garden for years. I wish I had its ability to curl into a ball and wait for troubles to pass. Unfortunately, we cannot, so read on.

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Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Thank you to everyone reading and reposting this. Everything I write is public domain so please share. I am keeping this, and future posts to about 4 pages of text. I provide sources as well as commentary. Red text indicates figures or information will change, probably rapidly. Bold text indicates a key point.

Introduction

Covid-19 was officially declared a pandemic by the Director General of the WHO on 11th March.¹ This is largely a formality and does not change the response. The need for clear information and guidance remains paramount. A week ago, the British Government appeared to be going its own way, essentially arguing for building up herd immunity. On 6th March Prime Minister Johnson held a lengthy press conference changing advice, based on newly released science.² This will be addressed below.

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Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

A week ago, I posted my first blog (or communique) on Covid-19. I was taken aback to learn that, by Monday, there had been over 14,000 visits to the article. Thank you. I find it humbling and greatly appreciate your engagement. Everything I write is public domain so please feel free to share this blog.

Red text indicates figures or information will change, probably rapidly. Bold text indicates a key point.

So, a week on, what has changed, what do we need to know and what do we need to do? I am going to keep this, and future posts to 4 pages of text. I continue to provide sources as well as commentary.

The consensus is, there is a need for clear information and guidance, which will evolve with the epidemic. The recent article by Anderson et. al. gives an excellent summary of what is known about Covid-19. It is a must read.¹ We should adapt. For example, if the first presenting symptom is fever, people need to self-isolate immediately, not wait for a cough or shortness of breath. It may not be Covid-19, but this is the appropriate, effective early response, and will prevent onward transmission.

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Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal http://www.alan-whiteside.com

4th March 2020

Introduction

I am expected to know something about epidemics and pandemics,¹ and their causes and consequences. Many friends and colleagues have been asking me about Covid-19.

Here is a quick ‘fact sheet’ as of 4 March – what we know, what we don’t know, and what we need to know. I include hot links. Please feel free to send it on.

Red text indicates the figures or information will change, and probably rapidly.

Bold text indicates a key point.

Obvious public sources of information are:

• the World Health Organisation (WHO);
• government websites, for example Public Health England, but be aware that government websites may have biases;
• academic institutions such as Johns Hopkins University;
• and NGOs and AID Agencies.

There is no shortage of information, but it needs sorting and sifting. There is a great deal of uncertainty about the trajectory of the epidemic, and how and when it will resolve.

Predicting the course and consequences of epidemic disease is not new. It has been addressed in the science and intelligence communities and in literature. The emergence of AIDS in the 1980s gave rise to a concern about the security implications of disease. One result was the US National Intelligence Council’s National Intelligence Estimate on the Global Infectious Disease Threat, January 2000. It noted the surge in HIV/AIDS, TB, malaria, hepatitis, with HIV/AIDS and TB expected to be the major cause of death in developing countries by 2020. It stated: “Acute lower respiratory infections—including pneumonia and influenza—as well as diarrheal diseases and measles, appear to have peaked at high incidence levels”². In the UK the Foresight project³ looked specifically at infectious disease and produced a multi-volume report in 2006⁴. These and subsequent government work are prescient. The works of fiction detailing such events range from Albert Camus’ 1947 book The Plague to South African thriller writer Deon Meyer’s 2016 Fever.

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