Prof Spector: We have a vaccine that looks like it may work, which means that if that one doesn’t others properly will. I think it’s dangerous to think that this will be actually working for us in the spring. We don’t know how long they last. We don’t know if it works in all people, all kinds of caveats. And we will have to carry around minus 80 freezers with us.

And the other worry, I think, is that they might just use that carrot to keep us locked down for the next three months.

Unherd: Hello, and welcome. You’re watching LockdownTV from UnHerd. So we get numbers all the time about what the state of the virus is, how many infections, how many cases. And one of the streams of data is now coming from an app, which is known as the “Zoe app”.

And here to tell us about it is its founder, Professor Tim Spector. Hi, Tim.

Prof Spector: Hello there.

Unherd: So, tell us how it works. Basically, you’ve got tens of thousands, or even hundreds of thousands of people signed up to giving their symptoms on a daily basis into your app. And you get a collective picture from that.

Prof Spector: Well, we’ve got more than a few thousand actually. So we’ve got 4.3 million people who’ve downloaded the app. And we have over a million people who log on every day, and tell us how they’re feeling. And generally, most people would just say:

“Okay, I’m fine.”

And skip to the next day. If you say I’m not feeling fine, then you have a list of 25 symptoms that may, or may not, be Covid, which people record. And then based on that response, if they’d be well for a week, or so, and they suddenly turn ill, we send them an invite to have a swab test. And those people then can get invited to be swapped. And then we see if how many of those are positive.

And that allows us to build up a picture across the country of the rates of change. And whether it’s going up, or down, in which regions are particularly involved. Much faster than any of the other methods around. So we are getting our results pretty much in real time.

Unherd: So whose data is it then? Is this a government programme? I mean, who pays for it? Who owns it?

Prof Spector: It’s a good question. For the first six months, really, it was Zoe, that were funding it. Plus we got some money from the citizen scientists who were using the app. So we started their fundraising campaign who said:

“Well, the government’s not funding this. No one’s funding it. We think it’s very useful.”

And so actual users, about 70,000 contributed as well. And then in the summer, finally, after a bit of pressure, the government did agree to start funding it. And the Department of Health now fund it. Although they have been providing these free swap tests, since about May.

Unherd: In a sense, it was quite a beautiful thing for it not to be funded by the government, because it enables you to validate and check the numbers that were getting passed from the government. I mean, do you feel you’re still as free as ever to do that?

Prof Spector: In terms of the data we are very free. I’m slightly less free to say exactly what I want [chuckling] on social media. But that’s fair enough, because, you know, it is a partnership.

But one of the conditions of the contract was that they wouldn’t limit the data we showed, or they wouldn’t stop any publications, or anything else.

So I think we managed to keep our integrity, if you like, to be the source of information that people were looking for, that they could see as independent. And we could have commentaries around the data.

Unherd: And presumably you can criticise them, still? There’s not in the contract that you’re not allowed to criticise the government?

Prof Spector: No. Correct.

Unherd: Good! Good! Because one of my kind of first questions was going to be about the data that you published last week, or over the course of the last 10 days, which seems to indicate pretty conclusively that total numbers of infections were already coming down last week, before Lockdown Two started. Tell us about that.

Prof Spector: Yes, that’s broadly the conclusion that we reached. Certainly nationally, it looked like the levels have peaked at the end of October. And when you took the worst affected regions, like Northwest, or northeast of England, and Scotland, they already started to fall.

This was contrasted with those in the south, where it wasn’t clear exactly what was going on, they were on a plateau, or slightly rising.

So definitely, if our data would be used to decide whether to go into a lockdown, or not, I think people would have reached a very different conclusion.

Unherd: Does that make you think that it was the wrong conclusion? And that we should have seen how things went with the tiered approach before going into a national lockdown?

Prof Spector: Yeah, my personal opinion is that the tiered approach was working. That even in the worst places, it was already on the way down, before we came out of the tiered approach. And if, you know, the government had held it’s nerve, which was what they wanted to do in the first place. Before they got these other reports, then we’d be pretty much the same situation, but without a national lockdown. So, we would be seeing the fall in cases. And interestingly, even in the tier one areas, we’re now seeing a fall off in cases.

So this is again, this has to be before the effects of lockdown happened.

So there’s both a natural phase of the virus, it comes in waves anyway, and affects people and then suddenly runs out of susceptible people to infect. And there’s also the effects of restrictions. And both of these things were in play across the country. So yes.

But it turns out that you know, that ours is not the only source of data. And I think the government advisors took one of the other surveys. There’s three surveys in all. And they took the one from Imperial, the React Study, at face value. Which suddenly showed this huge increase in cases. That was about a week before, about the third week of October, which we weren’t seeing, and the ONS, that’s the government official survey, was also not showing.

And so that would that made a big difference. Because suddenly they said, well, the R value is way over two. And all the experts say the hospitals would be overrun. And they’d be, you know, and then unrelated to that this other model came in saying that there’d be 8,000 deaths a day.

Unherd: So, it was four 4,000 deaths a day, wasn’t it, at the peak?

Prof Spector: Four, that is right.

Unherd: So this really matters, doesn’t it? I mean, it’s so important! Because we’ve now taken this huge step of once again, basically shutting down the country and businesses.

How can it be, do you think that the picture we got last Tuesday, or Monday, whenever the presentation was, where it really felt very graves.

And you know, there was a slide showing lots of different models, which was presuming, you know, to show that they were taking advice from lots of different groups. But all of them showed a terrifying surge to come. And meanwhile, you’ve got data on the ground, that’s even at that stage, I guess, was already showing a slowing? How do you explain that huge gap?

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Prof Spector: It’s difficult to explain. I think what they were really showing, and looking at have was really the worst case scenario. And if you combine the modelling that was coming out of IM [?] with the Imperial survey that looks at people every two, or three weeks, and put them together, you come up with this worst case scenario of everything being overrun.

And what they didn’t do, I think, was offer the alternate views, or perhaps the views of other modellers, and the views of other surveys, to try and balance it. And, I don’t know what went on in Sage, or all these meetings to come up with those conclusions. But I think probably the government wasn’t left with much choice, given that they weren’t presented with a “Plan B2”. They really had to just say:

“Okay, well, the experts who got maybe burnt the first time round and got the modelling wrong by saying that we had plenty of time to deal with it in March, and then ended up with no time to deal with it. Perhaps we’re veering on the side of caution this time and said, okay, we can’t afford to get it wrong, we’ll cover this.”

But this is just speculation.

Unherd: I think that’s quite possibly right. But I think beyond speculation, it seems we can say for certain is that if there is a tilt, it tends to be on the side of caution, you know.

And that’s been something we’ve been kind of pushing back on while trying to be responsible, but pushing back on. Because, it seems like there’s no political penalty for being overly cautious. Whilst there is a penalty for being seen to be lax, or under cautious.

So, all these governments are kind of driving in one direction. You, as an epidemiologist, what’s your view on that? Do you think they’ve got the kind of risk calculation wrong in a more bigger picture sense?

Prof Spector: Yes. Because both the government and the media, it must be said, are not putting things in context. They’re not equating the loss in GDP, to loss of life and longevity. They’re not adding up the numbers of cancer and heart attack victims that are causing a lot. The number of suicides and depressions.

And so, no one’s there saying, as soon as you mentioned a lockdown, you know, there’s someone’s actually worked out the real cost there. So, the argument is, it’s there in the background. But it’s not really up front. And everyone has been, in a way, programmed by most of the traditional press, to be looking at number of confirmed cases, and number of deaths. And there’s no context there at all! They just see a death count.

And don’t realise that in most November’s, December’s, 50,000 people die each month. And so these numbers are actually trivial compared to the expected rate. We don’t see any balance in that.

So, as an epidemiologist, and there are a number of people who think like myself, we should be taking a much broader view of this. And that there should have been a balanced view where the Prime Minister could have said:

“Well, you know, this is what’s happening. But if I do this, these other people will die. And there’s a probability that this model is wrong. There’s no doubt with lockdown, these people will die.”

It could have been a different scenario.

But I think comes back to your major point that politicians, and actually scientists, only seem to get punished when they underestimate risk, and you know, their jobs are threatened. And that’s generally true across all society. We are very risk averse, without ever thinking of the consequences of these restrictions on all of our lives.

Unherd: Just to go back a little bit into something you said earlier. Which is that you were observing and all the different regions, a natural slowing down, and in some cases already coming down from the peak before this Lockdown Two. And that you mentioned that you thought it was to do with a depletion of susceptible population.

This is a highly controversial area, as you will know, because people are constantly fighting about the nature of immunity and whether the official estimates under count the number of people who are really immune, and all of that. What’s your view on that? Is your view that those curves were coming down, because there is larger degrees of immunity in the population by then, and it sort of began to slow down naturally? What’s your take?

Prof Spector: Well, we know from other epidemics, that these things naturally occur. You know, infections don’t just carry on going up. They do come in waves. And we see this with colds, we see this with flu. And basically, they sort of run out of steam when it’s either infected enough people. And there’s no one new to go to, or the people that are new to go to have an immunity to the virus. And that’s an essential part of most viral epidemics. So this wave thing is what we see.

Now, why it may take over more slowly in some areas. And what’s interesting is to look at is,I’ve been following London, for example. Now, London never really took off in a big way as other places did in the second wave. It did in the first wave. And, you know, our estimates are that, you know, probably a quarter of Londoners were immune to the virus. And that could be an underestimate.

Once you start getting that population, if you think of the people who are actually exposing themselves in London, not isolating, not shielding. These people still going to work, still going out, were going to restaurants. It’s highly likely that perhaps 50% of those had some immunity, in my view.

And so that’s why the virus was harder to take hold of that group. And you know, the peak never really got very high, and it would go down earlier.

Unherd: Does that mean that, …

Prof Spector: My view is that there is this immunity for at least six months, which would have protected some of these populations, because those very people who are immune, more of them were in that group, than in the ones shielding.

Unherd: So I mean, is it going too far to say that the data you have in all these different regions, including London, which showed that slowing off and tapering before the big new interventions, I mean, is that proof of some kind of herd immunity effect? At least for those people who were out and about. Or could there be other explanations for it?

Prof Spector: In epidemiology, there’s always other explanations, unfortunately. This is observational data. And so, you’d have to repeat this sort of experiment many times before you were sure what was going on. So, we can say this is the most likely explanation, or it’s one of the explanations.

Obviously, you know, you compare London and you compare the northwest of the country, there are big differences. So people will argue, well, it’s colder in Manchester, or people are breaking the rules more in Manchester than London, or more people were working at home in London. You know, there’s all kinds of micro arguments to do that.

But my personal view is, I was very surprised why we didn’t have more problems in London, given the size and density of the population, and the sheer numbers of people using public transport, etc. It didn’t make sense, unless you believe in some form of prior immunity from the first wave, in that setting.

Unherd: So why do you think that it has become so controversial? It’s extraordinary, the degree to which, you know, any mention of it, and immediately you’re grouped with the kind of “denying camp”, which is “anti science”, and all the rest of it. Whilst surely, you can believe that it’s a serious disease, you can believe that we should be taking it seriously, and still think that immunity is an obvious and visible, and you might now say, provable, effect!

Prof Spector: I think it pretty much comes back the Government’s view on messaging. Thinking that if people who had it in the first wave, felt they were immune, they would go crazy. And not obey lockdown, and spread, you know, disobedience around the country. So I think, that’s my personal view. All these views are personal, [smiling] rather than anything due to my university, or Zoe.

So I think there was this general pressure to not talk about immunity, because people might take more risks, etc.

And, I guess also the personal level, if you went and said, that I believe, I think, immunity last six months. Someone at five months, goes and gets Covid and dies. There’s this sort of feeling that you’ll be responsible for these deaths. Again, it comes back to this argument about risk.

Unherd: Possibly it’s part of why the conversation has got so kind of poisonous, really, because you’ve had this combination of political and government concerns, such as not being caught out and not being irresponsible, with an atmosphere of science and lots of data and sharing information. Whilst clearly not all the information is being shared. And it’s being given a tilt when it is shared. And that’s what’s driving a lot of people to kind of throw the whole thing out!

It really feels like they’ve made it a lot worse for themselves. Would you agree with that?

Prof Spector: I think that’s right. I think they’ve staked their point out very early on, saying:

“We don’t discuss immunity, because that’s going to make people behave badly. We’re not going to discuss compliance, because that also might show that things aren’t effective. We’re not going to discuss more than three symptoms. Because people don’t understand that.”

And you may remember, there was only two symptoms until the Zoe app really uncovered the importance of loss of taste and smell.

Other countries have much broader ideas and do share it more.

So very early on, we’ve had these rules, because of the centralization of the approach, which is different in other countries that have had much more regional ones, where they’ve allowed different health authorities to work out things differently. We’ve had this very much top down approach and clear decision making. The Comms Teams, you know, deciding what can be said and what can not be said. And also increasing relatively the level of fear, so that people are complying with the rules. And obviously, that’s being seen as a important for public health, that people do obey the rules. Don’t go crazy.

But at the same time, for many people, this fear element is stopping them going to their local hospital. And they’re going to die at home, because of it. And with this centralised approach, it’s very hard to change that main dogma.

Unherd: The big news yesterday was the vaccine trial. Clearly, there’s now a hope, … Someone was on the radio saying that we might be back to normal in the spring. Boris Johnson gave a press conference, this is the new kind of narrative, I suppose, which is that it’s worth persisting with these draconian lockdowns and everything, because the end is now in sight. Vaccine is around the corner. What’s your view on that plan?

Prof Spector: I think it’s great to have some optimism. So, we have “a vaccine” that looks like it may work, which means that if that one doesn’t, others probably will.

I think it’s dangerous to think that this will be actually working for us in the spring. We don’t know how they last. We don’t know if it works in old people. All kinds of caveats. And we will have to carry around minus 80 freezers with us!

And the other worry, I think, is that they might just use that carrot to keep us locked down for the next three months, without really any great rationale, if we don’t present a real case, to counteract the real lockdown group, to say:

“You know what? This is — for the reasons we’ve been discussing — we didn’t need to lock down this time. It has a far worse harm than benefit.”

So I think that is a real danger now that everyone will say:

“Okay, I’ve only got to wait another four months. I can just stay at home for four months, I can do that.”

And we don’t know, it’s going to be four months. It could well be, more likely, by the end of the year. And we’ll be in this false limbo land doing nothing.

So, I still think we do need a plan to get back to normal, to accept that we’re going to have continued infections, continued deaths, really, for the rest of the year. And come up with a plan about how we, we deal with that as a country. And it’s got to be some form of consensus. We can’t just have these opposing groups all the time. Because most people are still more in the lockdown camp than the freedom camp. I think, if you did population surveys, partly, because of the information that have been given.

Unherd: On the vaccine question we’ve talked about the controversy around herd immunity. I suspect that is nothing compared to the controversy around the vaccine that is about to come. You know, the whole question of whether it is “anti-vax” to be hesitant about taking it. Who should have to take it? Should anyone have to take it? What is a responsible approach when it comes to the vaccine? Should it be offered to vulnerable groups only? Should everybody be offered it? How would you navigate that?

Prof Spector: Well, partly it’s gonna be dictated by the supply of it. And certainly, the number one group to sought out are the vulnerable. Because at least if you cover them and their carers, you could effectively shield them pretty well. And everyone, you know, could just put up with the virus. And apart from some cases of long Covid, we could cope as a country and get economically back to normal. So definitely start with that group.

And I think, yeah, I think you’d try a voluntary approach.

Unherd: So you wouldn’t mandate it? You wouldn’t force anyone to take it?

Prof Spector: I’d want to know more about it first. Because a lot of these vaccines are very novel. I think if they were exactly like the flu vaccines and things, you could mandate it. I wouldn’t have a problem with that. I think, in some cases, you do need to do that. But I’d want to know more about the risks people are taking. And I think people wouldn’t necessarily accept that.

And one thing we are thinking of doing in the [Zoe] app is actually adding a vaccine function to it. So people could actually take the vaccine and report side effects long term, to feel safer about doing it themselves.

Unherd: That’s going to be very interesting. So you’re gonna have data from people who’ve taken the vaccine. What would you say to people who say:

“Well, I think I’ll hang back. Thanks. And I’ll wait a few more months and check that it’s all right before I take it.”

Prof Spector: Um, well, I would understand their concerns. And depending on what their job was, … you know, if they were a health care worker, they wouldn’t have a choice. They’d have to have the vaccine.

You know, I’m a doctor, there’s certain things we have to have. We have to get our hepatitis boosters, and all our vaccinations up to scratch. So, I think we’ve got to be pragmatic about it.

It’s fairly easy for people to delay being vaccinated if they’re worried. Generally, those people, you know, will have problems with the vaccination anyway, psychologically. So again, I think a soft carrot approach, rather than a stick, it would be the way to go forward.

But just as an aside, we emailed I think two million people on the app, and one million signed up for vaccine trials, experimental ones. So I think, whereas there are a few anti-vaxxers there’s the vast majority of the population that are pretty keen to take it. And even if it has risks.

Unherd: I mean, probably the kinds of people who would be hesitant about taking a vaccine would also be hesitant about joining a kind of health blogging community, possibly?

Prof Spector: Yes, yeah, exactly. I think the conspiracy theorists, etc., would stay away from our app as well.

Unherd: As a doctor, do you think there’s any medical case for giving the vaccination to under 40 year olds?

Prof Spector: Under 40? Probably, yes. I mean, under eighteens? Probably not. We are seeing some cases of long Covid in people in their 20s. It obviously increases with age. But there are some cases. So medically, I’d have to say yes. But in young children, they’d be the last people I would be vaccinating.

Unherd: Well, it’s going to be really interesting to see how these next few months play out. And I think your platform is really important! Because it enables people collectively to prove things that otherwise might be denied by official government statistics.

Prof Spector: Yeah, and I think so. And obviously, our costs are about two million pounds a year. Track and Trace, they’re spending about 12 billion. And we think the other, ONS surveys, you know, perhaps half a billion.

So we are competing against the big guys. So we’re not gonna be the biggest, but we are trying to be the most flexible. And the one that gives people the results fastest. And now you can get the whole report into your app if you log every day, seeing exactly what the government’s being sent in real time.

So that’s always going to be our ethos. Is to get the data out there and get it shared. And get people to become experts in this area themselves, so they can make their own judgments. These are all very difficult issues, anyway. But I think just raising the level of data and education is really important at the moment.

Unherd: Professor Tim Spector, thank you so much!

Prof Spector: My pleasure.

Unherd: That was Professor Tim Spector of King’s College London telling us about the Zoe app, which he founded. Collecting data from 4.4 million people around the UK of their symptoms. Fascinating to see another set of data more democratically produced, able to push back at some of the official numbers. So, thanks Tim for that.

Hope you found it interesting too. This was LockdownTV.

[30:19]

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UnHerd – Why Lockdowns are the Wrong Policy – Swedish Expert Prof Johan Giesecke – Apr 17, 2020 — Transcript

UnHerd – Scott Atlas – I’m Disgusted and Dismayed – Oct 20, 2020 — Transcript

Ivor Cummins – Amazing Debate on Lockdown Ideology Versus Scientific Approach – Unmissable! – Oct 23, 2020 — Transcript

UnHerd – Prof Tim Spector – Hopes of a Vaccine Will Lead to More Lockdowns – Nov 11, 2020 — Transcript

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