March 7

Knut Witkowski Discusses Dynamics of Epidemics

I’m here today with Dr. Knut Witkowski who has been a very interesting voice in the Covid story, Knut could I ask you just to introduce yourself to our viewers who haven’t had the privilege of listening to you.

Okay I started I think getting a PhD in computer science, a master in statistics and a doctor of science and medical biometry which covers epidemiology and genetics. I worked for 15 years with Klaus Dietzen, tubing in who is one of the leading infectious disease epidemiologists in the world.

… I am again facing lots of accusations and criticism, for just doing what epidemiologists should do, and that is explain to the public and the politicians if they want to hear, what is behind the dynamics of an epidemic, and what you can learn from it.

02:02

Let me start off with a very open and simple question really, when it comes to lockdowns is there, epidemiologically, any reason to expect that lockdowns would reduce mortality from the disease, that they whose spread they aim to slow?

Not really, just let us lock downs were originally, introduced actually not to reduce the, number of deaths, just to flatten the curve a bit to make, sure, that hospital systems don’t get, overwhelmed, now that was in march and in april, we had the data and the data was very, clear, the hospital systems at least in europe, and, in north america other than in italy, where the situation was banned it would, never, be overbound and so we could have, reopened and said well we aired on the, site of caution, we made a lockdown for three or four, weeks, it wasn’t really necessary but, sorry it was a reasonable concern, but then how the whole objective changed, and lockdowns were sold is reducing the, number of deaths, and the only way that could happen is if, you, look down and prevent infections, from happening until there is for, instance a vaccine, or a treatment.

03:50

However, if you have to if that takes nine months, as i did something like that or eight, months, that you cannot totally stop the spread, and we have seen that in the united, states with the sole, exception of the very south, where the virus appeared, after the lockdowns started, the knockdowns came at a time where the, virus had already spread, and so the lockdowns had no effect, whatsoever, and even in the south then eventually, the lockdowns were lifted and at that, time, we saw exactly what was predicted and, what i published earlier, end of march the number of, infections would rise because they were, just delayed you would have the, cases and then real cases, really with illness and, finally you would have the delayed death, and now we have a vaccine, the where the efficacy is somewhat, questionable, so we haven’t achieved the goal of reducing the number of deaths, at all in fact we have increased the, number of deaths.

So you you mentioned that in places, where the lockdowns came after the, spread, had already occurred they they didn’t, have the, desired effect but can you talk to, countries that lock down early so for, example, the country that i live in south africa, had a lockdown before there was a single, death or maybe after the first death i, can’t remember precisely, and it did seem that we went through, five weeks of lockdown with virtually, nothing happening um, do you think that lockdowns have a, stronger effect or do you think that, it’s a very slight effect in those, circumstances.

05:50

If the lockdowns start before the number of infections peak, then they can in fact flatten the curve a bit so it takes a bit longer, until the same number of people get infected and die, but it doesn’t have any other effect.

Does that delay potentially result in subsequent peaks, or does it all come in one go?

In the models um, what i predicted was exactly what we, have seen in the south of the united, states, if the lockdown start early you’re, flattening the curve, and as soon as you end the lockdowns you, get another, peak and these are the events, that have been delayed they are coming, because the only thing that in the end, or that ends an epidemic a respiratory, disease, epidemic is the dreaded, herd immunity.

About 50 of all people, need, to be immune 25, were already immune from previous, coronavirus infections, so we needed to get 25 percent of people, infected, and to get to the point where the, epidemic ends and, that happened at different times, again in the united states in the, northwest, so in the northeast it happens very, early, so the epidemic was over in april may, may in other parts of the united states, in the west the virus got a bit later so, it came a bit later, they didn’t really lock down that much, in the south they locked down, and then we saw that effect where you, have the flattening and then the, re-emergence of a new wave as soon as, you, loosen up and you get to the point where, you have heard immunity and then it’s, over, and in the united states that happened, in until about, august september but at that time. 

08:02

Unfortunately, something has happened that we were, already afraid of, but we had never seen and that is it, started in Spain, and then in France that the lockdowns, were giving the virus enough time to, mutate, away to develop escape mutations and, then we had, strains of viruses that are immune, against human immunity and also, against the virus induced immunity, from the viruses that were modeled, against the previous, virus that had been spreading 

Okay, let me check if I’ve understood your point.  I’m going to try and simplify it into layman’s terms and you can then tell me what I’ve got wrong. If you spread out infections over time, a greater proportion of infections will, come in the form of a sort of, daisy chain of one person infecting, another infecting another infecting, another, yes and that leads to the possibility, that mutations will, accumulate as opposed to a situation, where the infections take place quicker, because there are, more instances of one to many spread in, which case the infections die out, because they have nobody left to infect, there’s a saturation, early on so you get a peakier curve in, this kind of approach, but less scope for compound, mutations.  Is that a reasonable way of summarizing it?

Okay we develop if we get infected, we develop not just one type of, antibodies, we develop maybe about six types of, antibodies, and the reason is the virus could ever, mute always mutate, and we want to have enough, back up antibodies to fight a virus, okay even if it starts mutating, so we would see in a single person never, more than one or two, mutations and if we have six antibodies, that takes care of that, so if everybody would be infected in the, extreme, at the same point in time then, people would never have more than two, escape mutations, and that would not be enough for the, virus to, become resistant if instead only 10, of people get infected at any point in, time and then, another 10 and then another 10, then the virus goes through 10 different, generations of people, and if there are 10 different people the, virus has, enough time to develop successive, mutations and in the end there will be a, few people where the virus was able to, escape, and then these escape strains, will spread essentially as a new virus, in the population as if nothing had been, there before.

11.09

This is what we have seen in October-November we saw another wave, of viruses and the wave looked initially exactly the same as the wave, in March and April looked it was just, a virus that we had never seen and even though it had similar symptoms or the same symptoms it was, epidemiologically, something entirely different and that spread like something entirely different.

Now a couple of weeks ago, some authors uh park and, colleagues published a paper where they, claimed that this was unlikely to happen, the idea was i think that there the, number of epitopes that are recognized, by, a typical infected person is higher than, the five or six you mentioned as many as, 17, and that in total across the, um the individuals that they studied as, many as 100, epitopes were recognized in some, cases i think there were c t cell, responses to up to 40, epitopes in a single donor is this, am i um misinterpreting that paper, is that a finding that surprises you or, that differs from what you’re saying can, you help me out there.

Well it’s never exactly the same in all, people, yeah so there’s always some variation, but what we have seen now consistently, is, and we have people have done simulations, on computers they have done that, experimentally in cell cultures, it takes on the average about, 80 90 days so about three months, for a virus to develop to escape, it won’t happen all the time and, sometimes it can happen a bit earlier, but that is something we have seen, originally in spain and in france, and then in the uk and in south africa, in brazil, and also now people find that in the, united states.

13:21

Although they didn’t look very carefully before, and it happens everywhere and, once you have seen that happening so many times you know that this is just a normal thing that happens.

The reason i think it’s important to, get this, right is it has seems to have a lot of, political ramifications, governments have in my opinion been, using the threat of mutations to justify, continuing, non-pharmaceutical interventions, including lockdowns, border closures quarantining of, travelers, this kind of thing and so you know, in some to some extent what you’re, saying adds fuel to that fire.

14:08

Of course it doesn’t mean that it’s your, opinion that those policies are correct, in the first place in fact i, i it’s pretty clear from what you’ve, said so far that you think they’re wrong, but it does it does seem to, as i say lend fuel to that fire, and it’s just what it is it is, so every form of mitigation, from wearing masks to lockdowns, to border closings, all of that delays, the spread of the virus that’s what they, are supposed to do, and that gives the virus more time, to mutate and so we’re incubating, the next virus that then causes, another series of lockdowns and if we, don’t, break that vicious cycle that can go on, for years

17:33

… okay i want to try another one of these, summaries in plain english, just to see if i’ve got it right. We can say that humans have co-evolved, with, viruses and indeed probably all mammals, or, maybe even all organisms since, eukaryotic life started co-evolved with, viruses we actually inherited a lot of, genetic material from viruses and, inherited material from viruses, over time there’s a kind of arms race, where our immune systems become ever, more, sophisticated in an attempt to deal, with viruses that are also, mutating and and changing and, finding ways to heat our immune systems, if you like, along we come to the point of the of, humans and our, our current level of sources of social, interaction and society, and we have an immune system that is, able to deal with, mutations by recognizing multiple, epitopes, but then we introduced something that, evolution has never seen, called a global lockdown, or at least a lockdown that is covers a, sizeable point, portion of the planet and that, in effect is what you believe has the, potential, to mess up the entire system. 

… why are we only hearing this, from you if it is so logical where are the other scientists?

19:50

…the politicians are very selective, in which scientists are, allowed to speak or called or, invited and, many scientists i would say mostly, all professors are funded by government, institutions, so if you are a professor today at a, university you don’t have, all your staff funded by the university, you have to write grants all the time to, get money to hire your postdocs, for for your whole operation and most of, that mommy comes from, government in institutions, 

In the united states from the nih, and many people, are afraid of saying something the, government, might not want to hear because that, could compromise, the funding they get from the government, so you don’t bite, the hand that feeds you and that’s why, many scientists are very careful, uh even if they know that what, this is wrong to actually criticize this, and if you listen carefully to what, scientists, say at least some of them and read, between the lines, then you can hear where they are just, being politically correct and where, they’re, talking about the science.

21:32

I would still, expect there to be, retired scientists or scientists who’ve, moved into the private sector, who you’d be able to pick the phone up, to and have the conversation with is, that happening are we simply not hearing, their voices and if so, while they’re not speaking out it’s, happening, so there is balti in germany, and bordered there is levitt, he was a nobel prize winner so he can, say whatever he wants he gets funded, even if he criticizes the government. 

 there where, in sweden the, retired previous expert who, advised the government you see these, experts, these retired experts but they it’s only, a relatively short period of time, once you get too old then, and you’re beyond your time where you, get involved in politics, at least many people are and some of, these people, you engage with them and and they agree, with your opinion about the cons that, your concern about the immunological, escape definitely

That’s really important i we, certainly, have detected the same throughout this, that there’s a certain, um political correctness if you like, uh that has invaded science and that, causes, key pieces of knowledge to go missing in, the equation, and completely false pieces of there’s, something, and you can see that and i don’t want to, call, names here and but you hear, a scientist explaining something that, makes perfect sense, and then the scientist is switching and, saying something, that essentially is inconsistent with, whatever he said before.

23:23

Yes, and then you know exactly that the scientists say okay that i was, talking about science, but now i have to, add some political correctness because otherwise the government will be unhappy with what i said and I’m not getting funded anymore, and then suddenly they say something that is inconsistent with what they said before.

…. so we’ve covered the territory of, the basic question of whether, lockdowns are expected to reduce deaths from the disease, the answer is, no given the time frame that it’s that, vaccine development has involved and you propose nine months.  I’ll just point out that that’s the short end actually, for some countries in the world it’s going to be way longer than nine months before a vaccine is available in any, large numbers.

24:23

You’ve covered the question of how lockdowns and various spread mitigation methods can provoke immune escape and you’ve covered the question of the potential for that process of mutation to involve a humanization of the viral RNA. 

What apart from this do you think is, when i say apart from this message of, explaining that this is a potential or is happening, what else do we need to do, okay the aim that came with vaccines, is actually reasonable vaccines do not, prevent infection people who have been, vaccinated get infected, as much as everybody else right?

29:07

… when we, consider the question of asymptomatic transmission, because an asymptomatic person almost by, definition is one who is, not struggling with a high viral load so, if we are to motivate the argument for, vaccines reducing transmission which i’m, comfortable with, surely that same argument also motivates, for, asymptomatic not being a driver of the epidemic.

Okay, we have to differentiate between, asymptomatic and pre-symptomatic. Yes, somebody who is asymptomatic never develops symptoms right, and if you never develop symptoms it means you have a low viral load and a low risk of spreading.

If you are pre-symptomatic you are in, the process of, creating more and more viruses while, your immune system, is struggling to find the right, antibodies, and so somebody was pre-symptomatic the, last, one or two days before having symptoms, may well spread the virus, however spreading a virus, is not bad per se. 

30:27

I said that before we need 25, of all people becoming infected, otherwise it will not end, so what we need to do is two things, first is we have to give, the vulnerable people the option, to self-isolate and people have done, that all the time, and when there was a flu season um elder, older people those with comorbidities, would say you know what, i’m not taking the bus today i’m staying, in home.  this is normal and that makes a lot of sense because these, people are at high risk of dying, children with very rare exceptions like, the hard health, situation they don’t die they don’t even, have symptoms they may have a running, nose one day, or sneeze but that’s about it. young adults who are otherwise healthy, yeah they may have a flu, they may have some fever for, two or three days feel a bit malaise, and then they get over it and are fine, that is not something that justifies jumping on the country. 

I agree and so we have to separate those who are vulnerable, and those who are not.  Those who are vulnerable should self-isolate and we should help them.  We should pay that uber deliveries and, or taxi deliveries and then pick up laundry and whatever they need, they should get it, no questions asked but everybody else should be allowed to move on.

32:16

What can you do in, third world countries or developing, countries where, um uber and such nice things, are not really feasible solutions what, can you do in those instances, you have some people just walking, from a store to a head somewhere and, deliver some food to the person in the, heart? 

The same principle applies: everywhere you may need to do that, do that differently but you may not be able to do it perfectly, but to the extent that you can you are, achieving something, whereas you’re achieving the very opposite of what you should be trying to do when you shut down schools.

33:08

Yes, it was known from the very beginning that this was the most nonsensical thing that one could ever come up with, so what, happened in the United States, and in other countries they tracked the, schools, and kept the nursing homes open that’s amazing that was exactly, the wrong thing to do. they should have isolated the nursing homes, rather than sending infectious seniors, into the nursing homes, so that they could infect other seniors. they should have isolated the nursing homes and kept the schools open and the economy, so the right policy was the Great Barrington Declaration, and what they did was a reverse Great Barrington Declaration.

….in med archive the, same, pre-publication server where neil, ferguson, and sinatra gupta published their early, models, i published the models that i applied, where i showed that second bump that’s, coming, with flattening and also argued, that the elderly and the vulnerable, should itself should be allowed to, self-isolate, while everybody else should live on and, i think that’s an important thing to, pick up on there.

35:02

…  every other year we have, lots of the coals that we have are from, corona viruses, colorado viruses are nothing new they, have been around, all the time and if we had not been able, now to sequence, the genome and say oops this flu is not, influenza it’s a coronavirus we would, never have known that this is anything, different from all the other flu so it’s, that’s a bad flu we had a bad flu, 2017-18, and this is another one happens every, couple of years,


Tags

covid, pandemic


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