UK Health Minister: exponentially dumb

Mr Burnham (the dumb Minister in question) is, I'm afraid, typical of the class of professional politician we in the UK have suffered over the past decade. We do things differently here - you usually have to be an elected Member of Parliament to be a minister. So, you may have may have no expertise in the field for which you are responsible (Burham was reshuffled into the job last month).

He's never had a proper job outside politics, he went to Cambridge University (so is bright) where he studied English. He has no higher science or medical education and is in charge of the British National Health Service. We can only hope he is getting good advice from his civil servants.

He is tipped as a future Prime Minister, although the frown of Revere may do for that.

Burnham obtains his information from the Chief Medical Officer at the Dept. of Health, one Liam Donaldson, appointed by this present Govt. Unfortunately, Donaldson is notorious for his extremely alarmist utterances, Avian Flu, BSE, ETS etc. which are generally laughable and defy all common sense. However, it suits this present administration's agenda, so we have to put up with it, atm.

Burnham is certainly naive but the danger man is and always has been, Donaldson.

...just another example of modern epidemiological modeling.

The world is so much better off now then it was back in the dark ages, the 1980's, when this sort of thing wasn't allowed.

@1 It's universal for people anywhere to hate their politicians. You don't honestly think Burnham sits down and does the calculations himself, do you? He's probably barely numerate.

As Frank J says he's receiving announcements from somewhere else.

Sorry, should have said...back in the dark ages, the 1970's.

Tom: Dumb is older than we are. And you know incredibly stupid things were done in the days you seem to pine for. Unfortunately you don't also know this isn't typical of epidemiological thinking because epidemiology is a subject you know nothing about. That doesn't stop you from just making things up.

Peter, etc.: I know Ministers in the UK are not the experts, but I assumed (wrongly) they know enough to pick counselors who aren't idiots. That is a responsibility of a Minister, isn't it? Or are they just ventriloquist dummies for ventriloquists who are dummies?

You thought that was funny, read this side splitting behaviour from health and lab officials, they might as well have driven 80mph through a school.LOL

"Normally, the three phases take seven years to complete. However, in view of the lead ...whose drug had already completed the phase II clinical trials... management boldly scheduled the introduction of GS 4104 for the year 2000. That left just three years for the clinical trials and the marketing authorisation process, which generally takes about a year by itself. "

"Almost seven years had passed since Norbert Bischofberger.... spurred on the development...an uncommonly short time, given that the process normally takes ten to fifteen years. "

Source: Http://www.nzzfolio.ch/www/d80bd71b-b264-4db4-afd0-277884b93470/showarticle/52…

What a funny name, and what a crazy schedule, those Germans are worse than the British. LOL.
Getting things done as fast as that, you'd think they'd realise something wouldn't be nailed down in time,

"Hang on what's that H274Y doing eating through the finish?" LOL What a Wheeze!

Those UK health ministers certainly deserve to be singled out as expodentially bumb. Yes indeed. LOL

The latest installment of xkcd seems apropos: http://xkcd.com/605/

another: LOL. Yes. Although I've been married 37 years, so it's a big time constant for me.

Here are some precise datas Reveres from Australia

From NSW Health's chief health officer Kerry Chant of Australia.

For the first 3 weeks of Winter of last year there was 91 presentations of flu-like infections, this year figures from NSW Health show in the first three weeks of winter, 1487 people presented with flu-like symptoms. (420 confirmed human swine flu cases in NSW)

NSW Health Minister John Della Bosca said 7900 extra home-based care visits from nurses and 550 extra hospital beds would be rolled out across the State to manage the increased demand on public hospitals.

http://www.news.com.au/story/0,27574,25736720-421,00.html

Reveres,

For the next Boreal Hemisphere could we cope such increases presentations of flu-like infections?

Honestly these figures are worrying IMHO.

Snowy Owl

I ran this out on the number by percentages and in reality using their own posted numbers the entire population will be infected twice over.

I think this is a pure case of butt covering Revere. Kind of like Argentina... But they shoot the ministers there every couple dozen years or so.

One thing is sure and that is that their med system is teetering with just the cases they have now. No place to put them.

I think that the words highly pathogenic thrown in there will tip this cart over on its side. I for one wouldnt fly anywhere right now based upon what could happen. They have seen the "mild" stuff and they might think about shutting the borders for severe. Trapped like an expatriate rat.

At the peak of a pandemic influenza wave the prevalence rate may well reach the order of magnitude of 10% of the population, so for the 60 million population of the UK, assuming reasonable reproductive rates and standard influenza generation times (2 days) the estimate of 100.000 new infections per day during the peak of the wave does not seem that far off ...
At least this statement does address the worrying effects of exponential growth at all and is therefore a long needed contrast to the usual belittelment of the pandmic from officials.
Actually, this statement does show more understanding of exponential growth than most other official statements I've heard (for example here in germany) where they still use plain simple
linear extrapolation(!) of the daily number of new cases in order to trivialize the pandemic... showing their not understanding of the concept of exponential growth at all>/b> :-(

Actually it seems that some epidemiologists don't know much about epidemiology...but they sure seem to understand the financial benefits of creative accounting and snake oil.

We should all be epidemiologiss...since they are completely unregulated, we all can be.

The thing I don't quite understand is the good ones sit on their hands and say nothing.

Tom: I'm sorry, but the epidemiologists and public health people I know are working their asses off for little pay during this. And you?

TOM Sez
"The thing I don't quite understand is the good ones sit on their hands and say nothing."

That's because saying dumb stuff in public often has real world consequences, Tom.

Tom DVM:

Want folks to speak up when someone is exploiting a situation for person gain? Okay, how's this: You seem to be intentionally baiting and derailing this dialogue without adding anything constructive to it to satisfy your own personal agenda.

Anti has it pretty well covered in a few words. They will simply walk into a press conference soon and say that the pandemic has now reached "severe" limits. They will say that they have done their best, spent all the money they can, produced a vax that may or may not work which by the way goes to me and my family FIRST and all you dumb asses who heeded no warning (which were vague-WTF does mild mean when you cant breathe or the numbers are in the millions?)

Then suddenly as it has with Argentina and now the UK starting to feel the pinch, the booty covering is starting. We simply wont be able to cover this one even if its only mild so severe is just a step of declaration. If 100,000 cases show up in a day then it goes without saying that one day would be enough. Then what? Robust healthcare as Revere wanted for everyone wouldnt if they went critical likely change more than a few outcomes and at a huge cost. It cannot be healthcare at all costs to a nation. At some point in time the numbers as a cost against the outcomes of any kind are going to come to play...They will simply be unable to spend any more money in the UK or the USA. Both were goat roped into the great spendathon and that for some reason didnt include robust healthcare systems....So we really know what the outcomes for those that get sick and go critical after the beds are taken are.

Its not looking good, is it?

Speaking of attempted derailings of conversations...

No it is not looking good, but there is the Historical Layout and still a lot of Good Will from Folks with Boots on the Ground.

Solidarity, consensus and coordination at the Regional Level, (Because of the Narrow Relations still present in Regions and Natural Inclinations) can be more effective in their responses towards a pandemic than any plan made behind a desk from a central position projected wall to wall or coast to coast.

We can complain and rightly so but it appeared more obviously week after week that we are on our own, lets used our energy the best way and work on the local levels and coordinated with our Regions with the resources within it and yes Cash from the Central Gov would help us in reducing morbidity and mortality.

Snowy Owl

When looking at how inept the UK Government is being here (although in fairness, Scotland, Wales and N. Ireland seem to be doing fairly well) it's worth bearing in mind what a terrible year they are having. Being absolutely battered in the polls, deeply unpopular and completely incapable of getting any good press for themselves, they're throwing their full weight behind swine flu as something they might actually be able to manage capably.

Except the messages coming from regional and national organisations are confusing at best and contradictory the rest of the time. Not to mention that everyone seems so keen to get new advice out there, that by the time you've finished cascading one lot of information, another lot of information has landed on your desk - and this lot is completely different.

I can't help but feel a little sorry for Andy Burnham since he's had this mess dumped in his lap. The key centrepoint of the whole pandemic plan was going to be the National Flu Line; a service that has failed to materialise so far and, when it does arrive, will only be an interim measure. The Department of Health are trying to work this out as they go along and they're doing a very bad job of it so far.

River.

Point well taken. Let me try and explain myself a little bit better...and I do think it is relevant to the topic at hand.

Revere. I believe has his gun trained on the victim rather than the perpatrator.

The title of this post is UK Minister exponentially dumb...rather than World Health Organization exponentially dumb or British Health authorities exponentially dumb.

In my opinion, he is making the classic mistake of shooting the messenger while being an apologist for those who are feeding the minister misinformation.

And why this is releveant is because this as I have tried to explain, this misinformation campaign has been going on for more than five years...in the most part unchallenged by those who have an obligation to confront them.

The modelling issue is not new. The World Health Organization had a model saying that they, in my opinion, deliberately misinterpreted to 'prevent panic'. They stated repeatedly over several months in 2004-2005 that the range of deaths from a pandemic was between 2 and 7 million lives.

They weren't put in their place then and the problem has continued to their comment that the pandemic is mild...in fact it is so mild that it is no more of a problem than seasonal influenza...

...and now as a result, we have mothers considering deliberately exposing their young children to this infection...which may very well produce tragic results.

We have observed and read about many natural and manmade catastrophes in the past century. When I look at pictures of people in these situations, I don't see panic. I see persons resigned to their fate but doing the best they can to improve their personal situations.

Therefore, I believe those who are really responsible, the World Health Organizaiton, have completely misjudged this situation...

...Human nature is not consumed with panic...instead it is largely 'consumed' up with apathy. This must somehow have evolutionary advantage or it wouldn't be here.

If you think about it, when we are scared by a sound we may initially jump up and run for the door...but if there is no actual threat, the next time it happens, we will be perfectly calm and act accordingly.

So therefore in my opinion, the critical thing is that the initial 'panic' occur when there is no threat.

The days of the World Health Organization and other Health Regulators sitting in the background snickering while a Government minister who has been fed a load of shit takes the heat for it...are over.

If that is an agenda then I am guilty as charged...and I will continue to speak my mind until Revere prevents me from doing so.

Thanks.

tom: Outside of the fact that you mix statements about avian flu with those about swine flu, you have no basis for anything you say because you don't believe any epi data or any modeling, by your own statements, so you have nothing to base your complaints upon. You know absolutely nothing by your own rules because you believe all the data are bogus, manipulated, poorly thought out or otherwise invalid. So you live in a state of ignorance, without any evidence except what you believe on the basis of a former career tending to large farm animals. Why should we rely on your opinions, given your own ground rules?

As for your opinions about WHO, do you know what WHO does besides flu? Do you know what they do regarding, say, malaria or River Blindness, or schistosomaiasis or any of countless other activities? Or do you just want to rant about them because you disagree with them about flu, a disagreement for which you have no basis because you don't believe any epidemiological data or the sources it comes from or the methods it uses?

Revere.

You seem to know me quite well considering we have never met.

/:0)

The World Health Organization may or may not be doing a better job on the other diseases you name...but given my long and direct experience with apathy in regulatory agencies, I don't think so.

In my opinion, they have 'screwed the pooch' on influenza, per usual, and there are going to be consequences for all of us...and I guess, given your opinion, it is alright for them to continue to do so.

The fact remains that the Minister did not come up with his own data...he was fed that data...and you have let them off the hook and shot the messenger.

The traditional pattern is for the government to appoint an MP as Minister to hold the responsibility in cabinet and the Assistant Deputy Minister to be a career civil servant who stays in the department, knows what's going on, and tells the minister. If the minister is sensible, he or she takes the advice of the ADM. The aim of the ADM is to get the right things done and make sure that the effort goes to the right problems. The aim of the Minister, supported by the ADM, is not to give the Opposition any targets--to make sure that Questions Aren't Asked in Parliament about the Ministry's actions. That means picking the right priorities. It means that Covering the MP's Arse is a higher priority than Doing the Right Thing. It's one of the reasons that the mills of government grind slowly.

For all I know, in such a system some people prefer to sound alarmist rather than being accused of ignoring a problem. Others might prefer to sound In Charge and assure the public that Everything is Under Control rather than sound alarmist.

Tom: The bottom line here is that you know very little about WHO (although you feel free to cast aspersions on anyone who works for them) and don't even know they aren't a regulatory agency. No facts remain.

Revere.

Revere

Do you think we have a right to know if WHO supervisory staff have stocks in Roche (TAmiflu) or work for Roche at the same time they work for the WHO or or whose immediate familly mamber work for Roche?

Tom: Yes, I think conflicts of interest are germane. I don't know what their policy is. If you know, let the rest of us know, too. If you don't know, don't accuse anyone of being on the payroll unless you know it's true. Don't you think that's reasonable?

Revere.

I agree. I didn't accuse anyone of anything.

The World Health Organization is a subordinate of the United Nations...which is not the best example to follow with respect to graft.

...Did anyone go to jail for the 'Food for Oil' debacle of a few years ago?

Under these conditions, if I was underpayed as you describe or believed I was underpayed...I might feel entitled to my entitlements...or in other words, graft in all its 'nudge-nudge-wink-wink forms'.

So think what do you think of a code of ethics for World Health Organization members enforced with independent oversight?

Sorry, I should have said that I didn't accuse anyone of anything other than incompetence.

The possibility of increased virulence later in the year cannot be entirely ruled out. Given the problems of Tamiflu resistance (already documented in H1N1 strains), and the flu virus' genetic instability, making it very likely that the vacine makers will be playing catch-up; we should consider alternative public health strategies. There is a case for integrating naturally occurring CR-3 receptor agonists into the food chain. This approach has been shown to work in two animal models including swine, a good model for politicians and most of the rest of us.

Revere, within the context of your professional analysis regarding the British Health minister, Andy Burnham, and his basic lack of epidemiological knowledge when addressing the House of Commons, shouldn't the following sentence use exclamations (!), and not question marks (?) as emphasis!?!

Revere, "Did I mention this doesn't happen? Ever? What a bloody moron."

Tom: I think you have more than implied graft and corruption among WHO, CDC and epidemiologists in general. There is graft and corruption around -- even greedy veterinarians who enable and promote agribusiness, with no accountability -- but most people aren't greedy or corrupt. And public health has more than its share of people who want to do the right thing. That's why they do public health when they could make more money doing other things.

As for how I should punctuate my posts, I do it in a way to make the point I want to make, not the ones someone else wants to make.

paul: you can't put something into the food chain -- legally or morally -- because a couple of animal studies suggest it might be of benefit.

Revere

"Implying" requires your interpretation of what I said...not what I said.

Since you did not comment on my previous question to you...than I guess you are against a code of ethics for the World Health Organization and independent third party oversight...even in light of 'food for oil'...fair enough

I have met a lot of good people in regulatory agencies...in private they spoke themselves clearly but when it came time to confront the incompetence of their agency-supervisors they suddenly lost their voice...which in my opinion makes them guilty by association...as the same occurred before and during the Second World War.

My issue at the time was massive (the regulators words not mine) levels of embalming fluid-extaneous formaldehyde and massive levels of sulphytes in an imported Chinese Food. The findings were proven in our tests, government tests and third party independent lab tests.

In response, Health Canada and the Canadian Food Inspection Agency made Formaldhyde in food products legal (actually only in imported products) and also increased the sulphyte levels for imported 'fresh' produce above the highest level of the independent testing...all of these steps was contrary to the Food and Drug Act of Canada which they over-ruled with impunity.

When we tried to confront them...those on the inside clammed up.

When they eventually got caught in the Melamine squeeze, the Chinese Government admitted that they had been using formaldehyde as a food preservative.

What happened to those who made the decision to overrule the Canadian Food and Drug Act...they were promoted!

..but maybe they were underpaid too.

So if you want all of these agencies to work on good-faith...so be it...I have seen the consequences first hand.

Tom: I commented directly on a conflict of interest policy. I don't know what WHO has and asked you for information. No response from you. I am in favor of COI policies. Period. I submit to disclosures regularly in my work and do it without complaining. It is required by my job as an academic, although you seem to think there is no such thing for researchers. You are just wrong about it, ignorant about it, or both. As for your frustrations with government, I must assume you are an anarchist and want to abolish government. Good luck with that. And good luck to the rest of us if it goes any farther than it already has. I'm sorry Canada is corrupt. There is corruption in the US, too, although less than there used to be. There are corrupt vets, too, and corrupt bloggers and epidemiologists. Yawn.

"Yawn"

the status quo.

Exactly the problem.

Corruption is acceptable in todays modern medical-health regulatory environment...so be it.

...and by the way, 800,000 lbs per month was going into the USA at the time labelled 'Fresh Product of Canada'...so there was implications for us all.

I might mention the exponential growth of the human population that follows the exponential growth of extraction and use of oil. "Anyone familiar with exponential growth ...knows that exponential growth cannot and does not continue for very long" http://www.paulchefurka.ca/Population.html

I recommend to everyone who wants to understand exponetial growth especially with these two issues in mind the following lecture by Dr. Albert Bartlett. http://www.globalpublicmedia.com/dr_albert_bartlett_arithmetic_populati…

Revere,

I'm not sure why you find this so implausible.

Models of spread in the US (Ferguson et al. Nature 2006) predict a peak disease incidence of 4 million per day in an unmitigated pandemic, and in the UK about 800,000 per day for a moderately transmissible virus, possibly a bit more transmissible than this one. 100k per day is not crazy at all. Needless to say those models take into account the depletion of susceptibles, hence the peak.

It does seem likely that transmission should slow a bit with the change in weather and the summer school holiday, but weather's effect is not very impressive so far, and schools don't let out there until late July, so that remains to be seen.

Marc: It is not the figure itself but the method that I reacted to: assuming the present rate of increase, doubling each week.

Hi Tom,

I can see your point and I would say that you are partially right: the minister is basically a parrot that repeats the data which was fed to him on his briefing. So whoever is feeding incorrect data and information about the issue should be to blaim.
But this is only part of the problem, because, as a minister, he should be carefull with the sources he uses to colect his information.
And the big problem in the UK corrently in public bodies is that the people running the departments are NOT interested in listening to the scientific opinions of the specialists, even their own specialists. I know this because I work in one of such departments. Although the speech is one of scientific based decisions, the reality that I observe is that most political decisions are first decided by ideology and THEN they turn to the scientists to justify it, and if they don't then... tough!
You can see this with the treatment of the flu, I am seeing it first hand with the bovine TB epidemic handling over the past decade, the UK, and more specifically England and Wales, are now the only country in Europe where bovine TB incidence is still increasing and yet nobody is interested in discussing the role of wild life reservoirs... This is not the fault of vets or epidemiologists, this is not "bad science" this is purely a political decision to avoid a non-popular animal health decision backed by pseudo-science in the form of a non-peer reviewed scientific report.
More visibly to the common public is what happened before the invasion in Iraq: the specialists on the ground were ignored.
I doubt, very much in deed that this particular minister had his briefing done by an epidemiologist, at most what he probably received was second or third hand account of the available data with a third hand interpretation from a specialist, or, even more likely with the interpretation being made by a non-specialist

Thanks for the explanation Lowlander!

Yes, that method has problems, but at the beginning of an epidemic it is perfectly reasonable to assume continuing exponential growth, unless something (behavior change, school closing, weather) changes it -- for better or for worse. Ultimately the limitation in susceptibles kicks in, but that won't be a major factor till after late August.

Marc: You make a valid point. I would just say this. That when someone says, "Yikes. It's doubling every week. At that rate, by August it'll be 800,000 new cases a day!" I am not impressed with the thought processes being expressed. Nor do I think it was more sophisticated than that. Maybe I"m too cynical, especially as the same government was actively denying there was a problem just a month before. Exponential grow at the outset, yes, but no expectation of continued exponential growth seems reasonable. Nor does it seem to me that the peak of whatever is going to happen will be in August. But we'll see. Flu has a way of making bloody morons of all of us, I guess.