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In conversation with The Conversation

Yesterday I had a real pleasure to meet the Editors of The Conversation as well as some fellow authors. The 10th-anniversary celebration was a great occasion to talk about our past work and to make new connections.

Prizes were given, drinks and refreshments were served, and we also heard a very interesting talk about false media news. It was also great to meet in person two editors I had worked with, Clint Witchalls and Phoebe Roth.

My journey with The Conversation started in March 2020 with a request from Clint, a health editor, to contribute a piece on COVID-19 pandemic. Before that, I had never even considered writing a popular science article.

But, having already done some blog posts – and getting positive comments from friends about the articles – I embarked on the task of writing about the ways in which the pandemic could unfold. 

Throughout the process of writing this piece – and many others that followed – Clint was very helpful and supportive. He was critical but also encouraging, checking all details and improving the style, making it more accessible. It quickly got over 100,000 reads and 33 comments – and a request for more articles.

Over the last three years, I have worked with three editors, Clint, Rob Reddick and Phoebe. Each of them prefers to work in a different way, but they have all been professional, efficient, and friendly.

Without their help and attention to detail, I could not have written 19 articles (plus 2 translations for Spanish and Indonesian The Conversation outlets). 

Gathering 1.8 million reads demonstrates that we have managed to struck a balance between scientific accuracy and accessibility to the general public. The engagement with the readers has gone even deeper, with 402 – both positive and negative comments – placed online. The articles have also been reprinted in many outlays worldwide and I am still the most-read The Conversation author at my University, with nearly four times more reads (1.8m) than the next person. 

I do not really have any particular favourite in the list of the 19 articles. Some were more difficult to write than others and some were written at very short time scales. Some were read very widely (both the June 2020 and the December 2020 pieces were read nearly 400,000 times), and some less so (the October 2021 piece on the Autumn spike with 15,000 reads). 

But, I have enjoyed writing each of them and I stand by the accuracy of all that I have written. For two articles, the time has invalidated the points I originally made there, but I still think that at that time of writing, they captured what had been known.

In my December 2020 piece (read nearly 400,000 times), I was sceptical about the rate at which the UK vaccination programme would unfold. Assuming it would largely be run by GPs, I expressed my concerns about the speed of the operation. The events of the next few months proved me wrong – the vaccination programme was a huge success, primarily because of the scale of the operation and the involvement of many people beyond the doctors.

More recently, in my January 2023 piece on China, I predicted another wave to follow the Lunar New Year. I was wrong, as it turned out that China was in fact much closer to the “herd immunity” than I had originally assumed. Given the notorious secrecy of COVID-19 reporting in China, I feel at least partially excused for overestimating the course of the epidemic there.

On the positive side, in my first The Conversation article, Four graphs that show how the coronavirus pandemic could now unfold, we included a scenario that actually represented the future (although the relative size of the peaks was not correct…)

I am also proud of having seen very early that herd immunity is not likely to be achieved and instead is a bogus idea that has serious public health consequences. I am also proud of continuously advocating the need for the governments and the public working together, building trust and taking into account both population and individual needs.

The public interest in COVID-19 is now slowly receding, although the pandemic is still continuing. I hope to continue publishing articles on this topic, but maybe there is now time to switch to other areas. But, having so much enjoyed writing popular science articles, I would very much want to continue my journey with The Conversation. 

Thank you, @CWitchalls @Phoebe_Roth @redique and the whole The Conversation team for making it possible. 

Major infectious diseases – England and Scotland update, week 15

This will be a quick update only as I am officially on holiday. The weather on the North Coast of Scotland has been fabulous this week – sunshine, blue sky, warm for April except for a nippy cold wind, and no midges. Wish I could stay here longer.

All disease indicators seem to be going down except Rhinovirus positivity. UKHSA has not released the Pillar 1 data in their spreadsheets, but the most recent data show some decline, albeit at a possibly slower rate – 15-19 and 85+ might actually be going up again!

Scotland follows a similar pattern, with sharp declines in most age classes, except for 85+. Their wave seems to be following the English one by about 3 weeks.

English Flu and RSV are also (slightly) down, following the seasonal pattern.

Scarlet Fever levels have again massively dropped and I hope this is a real drop, not due to reporting.

Finally, there is a slight uptick in the Rhinovirus positivity, although the number of positive samples going slightly down. I expect the numbers to be stable before rising up again in summer.

India update

There is a bit of evidence of slowing down in India, where the Arcturus strain continues to grow. After a “usual” few days’ drop, the numbers are picking up again.

India’s Covid resurgence

As you might have seen from my earlier posts on this blog, I am very fond of India. It is a fantastic country, with a wonderful landscape and even more wonderful people. I have had the privilege of visiting India every year since 2019 (except for the lockdown in 2021), and I really enjoyed every minute I spent there.

India’s Covid history

India has had a rough time over the Covid pandemic. Its attempt at Zero Covid in early 2020 went spectacularly wrong (note that on the 0-100 scale of the Stringency Index, India reached 100 and the UK only 80 during the 2020 lockdowns). I still remember videos of Indian police beating those escaping the lockdowns with bamboo sticks.

Relaxation of the rules in mid-2020 coincided with the late 2020 and mid-2021 outbreaks and the rise of the Delta variant (which originated in India before spreading throughout the world). The Omicron wave in the winter of 2021-22 was similarly devastating, although, by that time, vaccination helped reduce the death toll.

Although the primary vaccination cover is remarkable for a country of this size and with social and economic conditions, 67% were vaccinated compared to 75% in the UK. The booster programme was not as successful – only 16% compared with nearly 60% in the UK.


But the biggest problem with the official statistic has been its massive underestimation of cases and deaths. It is particularly visible for the Omicron wave in 2021/22 and casts doubts on the current records.

Compare the official notifications and the estimations of excess deaths below. Excess mortality is a difficult thing to calculate, but it is a fairly reliable measure of Covid impact. The official death toll, in turn, relies on reporting which is often unreliable.

Firstly, the estimates of excess deaths in India are way larger than the actual records. In fact, most Indian deaths which can reasonably be attributed to Covid (deaths in excess compared to pre-pandemic years) are not recorded at all.

This is in contrast with the US, where the two lines follow each other pretty accurately. There might be some argument that some excess deaths in the US are attributable to non-Covid causes (e.g. lack of medical care during lockdowns) or long-term effects of lockdowns, but most of them are clearly attributable to Covid.

Secondly, there is a big difference between how the second (Delta) wave and the third (Omicron) wave look for recorded Covid deaths and for excess deaths. In official records (see the first graph in this post), the number of deaths in the Omicron wave is much lower than for Delta.

But, for the excess deaths – which arguably better capture the impact of Covid – the difference is much smaller. This suggests that the deaths in the Omicron wave were even more severely under-reported than in the Delta one.

Thirdly, there is a massive uncertainty in the estimation of excess deaths in India throughout the pandemic. Contrast this with the US, where the excess deaths are well known, except for the last few time points. India simply does not keep a good record of births and deaths.

Return of Covid

When I was in India in February, there were no signs of an ongoing pandemic. People mixed freely and there were only a few masks seen around. In fact, I have repeatedly heard people talking about the pandemic as something from the past. A nightmare dream that it is now gone.

And indeed, at that time, the number of cases and deaths was very low. From December to about mid-February, India was reporting only about 100 cases per day, more than 100 times fewer than the UK – despite being 25 times larger. Even accounting for under-reporting, Covid seemed to have almost disappeared.

But, this period has not lasted long, and the Indian government was aware of the change already in March. The rise of a new variant – XBB.1.16 – has been creating a new wave.

Indeed, the increase in the virus prevalence is now seen both in official records:

and in wastewater measurements:

We are still far from the previous waves, but the current growth is indeed something to be concerned about, particularly due to a very low booster vaccination cover.

What is the future?

Is India likely to be a source of another global variant similar to the Delta outbreak in 2021? It is definitely possible, but there is hope that we are globally in a different position now than we were two years ago.

Globally, we are in a much better position now than even a year ago. The combined “immunity wall” of both vaccine- and infection-induced protection probably still holds. Yes, we are likely to see repeated outbreaks, but they are likely to be limited in size and duration.

Unless, another Covid variant appears that manages to break the wall…