Covid Corrections Part 2

Other writers might be horrified to discover that I am the sort of person that generally delivers copy way ahead of deadline. This is not because I am particularly conscientious, and is actually something I consider to be more of a deficit than a virtue. My book writing method tends to be frantic and all-consuming, taking over every aspect of my life for several months. Whenever I have large writing tasks hanging over me, I get up at 5 each morning and put in 12-14 hour days, seven days a week, until it is done. I’m not saying I am obsessive…

I am. You’re definitely fucking obsessive. You recently got told off by an editor for insisting you’d work over the weekend.

…but I do need to limit how much writing work I take on, especially if I am keen for my family to remember what my face looks like.

That might not play out so badly. Perhaps if Mrs AC forgets enough, we could convince her that our face is just like Theirry Henry’s.

As a result, the first draught of my new book was finished way ahead of schedule, and at one point there was talk of launching it early, perhaps sometime this summer. When we were having those discussions, I vaguely remember dismissing the seriousness of reports that a respiratory disease was emerging out of a place in China I’d never heard of, although I was quite excited that it seemed to have something to do with pangolins (I really like pangolins). By mid-February, about the time we were being warned that it might be worth touching elbows rather than shaking hands, I flew to Milan for work and was surprised at the temperature checks and face masks everywhere. When Covid-19 exploded in our complacent faces, so did any thoughts of an early book release, and we are now re-focused on the original 7th January launch date (pre-order here to avoid disappointment).

In truth, although an early launch would have resulted in me getting paid a bit sooner, I am glad that plans didn’t change. It would be nearly impossible to successfully launch a book like mine right now, and I am devastated for anyone who has released something over these last few months and is trying to get it into the news cycle. Although people are still reading, it is incredibly hard for authors to feel relevant, especially when plugging books they wrote before the world went weird. I am sure that the cream will still rise to the top, but it is also likely that many great books will drop under the radar of public consciousness. Not the biggest cost of this pandemic I know, but tough for those who poured heart and soul into their creations.

The problem right now is that if you are not an viral disease researcher, a renowned epidemiologist, an experienced public health professional, an ICU doctor, or someone with expertise that specifically relates to our current predicament, it is extremely hard to stay relevant and have your voice heard. Most of us have nothing of importance to say right now, which is why most of us have stayed quiet.

Well, you’re writing this blog, so that’s hardly staying quiet.

Shut up.

It is possible to make a bit of noise if you are just a humble writer covering science and food matters. I have never claimed to have much specific expertise, and simply spend as much time as possible speaking to people who have. My only relevant skill right now is telling interesting stories and reporting things in an engaging way, so I can easily transfer that ability to cover the issues of the day. But plugging a book written before the pandemic, would be tough in the extreme.

It must also be difficult if you have built your reputation on a specific expertise that has no pertinence to the current situation. For a whole swathe of people, who until recently were lauded by the media as fonts of essential knowledge, their life’s work has suddenly become irrelevant, at least while Covid rages. Previous masters of the universe have morphed into experts without portfolio. Some have done the sensible thing and decided to shut the fuck up for a bit. Others…well, others have taken a different path.

There are a few different routes to Covid stupidity. Firstly, there are the amateur virologists, modellers and epidemiologists, who have taken a ‘how hard can it be’ approach to some of the most complex and confounding problems in science. Many used lockdown to indulge in some intellectual masturbation, dreaming that they might solve the pandemic with some Silicon Valley disruptive thinking, all from the comfort of their bedroom. There were the software developers who thought they had cracked disease modelling, before being slapped down by those who had been modelling actual diseases for years. There were the countless tech bros who insisted that the seriousness of the pandemic was being overplayed, even as the bodies piled up.

Then there were the curious paths taken by many low carb diet fanatics, who seemed to latch on to every conspiracy, and believed that their diet would make them immune. Zoe fucking Harcombe, who early on claimed that Covid-19 was not much worse than flu, has recently been suggesting that two meter distancing should be abandoned because there is no randomised controlled trial to prove it works, demonstrating once and for all that she doesn’t understand what a randomised controlled trial involves. And if you are the sort of person who enjoys seeing someone being punched repeatedly in the face, Elon Musk is worth a follow to watch him clashing with epidemiologists and virologists, exposing his own ridiculous pomposity every time.

But perhaps worse, at least in terms of consequence, are those desperate to contort their own speciality into relevance. Hundreds of public health experts and lifestyle disease specialists, many of whom have dedicated years of their lives to abusing fat people and vilifying the food industry, have suddenly found themselves with a problem on their hands. Whilst the grown up, useful public health professionals have been focusing on stopping infectious diseases and preventing viral contamination, those that have spent their careers pontificating about obesity and salt reduction have suddenly found themselves out of the public eye. Food manufacturing and food retail have became a place of heroes, leaving lifestyle obsessives with nothing to do but look down at their feet in embarrassment and desperately hope that the food system fails. To their surprise and barely concealed disappointment, it never has. The much vilified decision to ‘leave it to Tesco’ at the beginning of the crisis, actually turned out to be one of the better moves our government made. Anyone who has ever studied what happens when governments attempt to take central control of a nation’s food supply, should probably be thankful that our current hapless bunch of chancers never did.  

So it is hardly surprising that these food moralisers jumped at the chance to feel relevant, seizing onto a perceived correlation between Covid deaths and obesity. Aseem Malhotra led the charge, desperately searching for a patch of limelight to stand in, realising that he could breathe the precious oxygen of publicity if he attacked NHS staff for enjoying doughnuts, or fat shamed Boris Johnson. His reward has been a shiny new book deal, where he will outline a 21-day diet plan to fight Covid-19. I am sure this will be legally different to his previous 21-day Pioppi diet, something developed specifically to fight people’s enjoyment of food. His family must be so proud he has shamelessly profiteered from the deaths of thousands of people, releasing a book that will play on the anxiety and fears of a damaged nation. 

Others have been equally culpable, desperate to find relevance in a world that now belongs to epidemiologists, virologists and intensive care nurses. Many have clung on to the obesity angle, seeing it as a way to squeeze through the door of public relevance. A ‘something must be done’ mentality has arisen, with fat people cast as the enemy. And so we arrived at the BMJ piece mentioned in Part 1, which was co-written by Graham MacGregor, formerly of Action on Salt, then Action on Sugar where he was a contemporary of Malhotra’s. It is hard to think of a more egregious example of someone hunting for relevance in a world that no longer makes sense to them.

Just when it looked as if things couldn’t get any worse, The Royal College of General Practitioners, the professional membership body for family doctors in the UK, organised a Zoom conference that claimed Covid-19 was a ‘lifestyle disease’, enlisting various ‘experts’ to speak about the importance of shaming people’s bodies and behaviours. The title, ‘Covid 19 – A lifestyle disease and the role GPs have in preventing it’ , was reportedly chosen to be deliberately provocative, as if provocation was needed in a response to something that has already taken half a million souls. Despite intense criticism from other medical experts, those who preach the importance of lifestyle advice in primary health care could not get their heads around the idea that a culture of blaming and shaming is spectacularly irrelevant right now. In fact, it is worse than useless at a time when a pandemic is brutally targeting the poor and oppressed. 

Our brave band of lifestyle experts presumably envisage that a few words of advice about not eating chocolate or going for a run, will somehow counter the affects of social depravation, poor housing, living with disability or not being able to pay your rent. I suppose that if the only tool you have is sanctimony, you see every problem as one of choice. This even seems to be the case when the problem is a rampant respiratory disease that has devastated the global economy and kept billions of people locked in their homes. We are now witnessing supposedly intelligent, qualified medical professionals claiming you can put out a raging wildfire with a tack hammer. Now that’s something dystopian fiction never predicted.

A desire to stay relevant and in the public eye at a time when their services couldn’t be needed less, has led many to say and do stupid things. Even politicians, who probably have enough of the public eye right now, have fallen prey, with Boris Johnson apparently demanding action on obesity in the wake of his recovery, and the increasingly out of his depth Matt Hancock calling for the same. The UK government has even given voice to the bariatric surgery loons, looking to put out the same wildfire by dragging thousands of vulnerable people directly into its path and slicing up their insides. In desperation for some sort of solution, and in the thrall of irrelevant experts who want to feel needed, we are being asked to writhe around in the quicksand, sinking deeper every time we do. 

I suppose all this should come as no surprise to someone who has written about pseudoscience and the exploitation of uncertainty for such a long time. Covid-19 is a disease full of uncertainty, and although the learning curve has been steeper than for any previous virus, there is still so much that we don’t know, it’s almost embarrassing. We currently, at least at the time of writing, have very little knowledge of how it affects the body, how it is transmitted, what the most effective way of stopping transmission is, what the long term health effects are, what the ideal distance to stay away from people is, why age groups are affected so differently, whether or not children can infect adults, how long immunity will last and whether a vaccine will work. That sort of profound uncertainty about something so fucking devastating is about as frightening as things get. 

Science is often, quite wrongly, cast as possessing a list of definitive facts and having a limitless capacity to discover new things. We have telescopes that glimpse the beginnings of the universe, detectors that can sense gravitational waves, and microscopes that can pick out individual molecules. Surely we have some sort of machine, or some type of experiment, that can work out why children are largely spared, or fathom how the disease is most likely to spread. But the reality of scientific advance is that it is often about accepting uncertainty, especially when we are perched on the cutting edge, as the entire world is right now with Covid-19.

When we know so little, our desire is often just to do something. To act immediately on the the tiny amount of knowledge we do have, even when that fragment might be worse than useless. Too often, we just end up blaming and attacking, mistaking anger for action. Blaming fat people has been a useful outlet for many during this pandemic, as it has been so often in the past. Fat people are a drain on our health service, fat people are lazy and stupid, fat people are wrecking the economy, fat people deserve to die. It is, after all, their fault for being fat. Greedy and selfish, putting all of us at risk because they can’t stop eating cake. What most people fail to appreciate, either through ignorance or obstinance, is that obesity is an outcome of many different things. It is not a behaviour. It is never simple. Human bodies are not infinitely malleable, able to contort dependent on the whims of fashion and fear.

Whether you are a politician, a public health professional, or just a concerned individual, it is vital to remember that obesity is not the modifiable risk factor that we think it is, and certainly not the easy fix it is often framed as being. People are drawn to it as a point of attack because of this misconception, seeing it as the only risk that might possibly be altered. As always, the potentially catastrophic unintended consequences of trying to force change are casually disregarded. It might be true that there is a correlation between obesity and Covid deaths, largely down to the confounder of Type 2 Diabetes. But are we sure that starvation diets, slimming pills, hormone treatments, brutal surgeries, increased hospitalisation, gastric bands, stigmatisation and blame are all risk free? Or might those things actually increase risk, leading to even more deaths? 

Obesity has been targeted because many of the other important risk factors, such as age, sex and ethnicity, cannot be modified. But there is another highly significant factor that could potentially be changed, and that is socio-economic status. It is true that we cannot make everyone wealthy, especially right now, but we could reduce inequality if we really wanted to. If we are serious about saving lives, we would insist that billionaires give up the occasional island or jet, and pay as much tax as a proportion of income as their cleaners and cooks. We would prevent tech industries from dishonestly channeling profits abroad, insisting they pay a fair amount of tax in the countries they do business. We would regulate multi-billion dollar companies to stop them diminishing the profits of local traders. We would view the accumulation of billions in personal wealth as the obscenity that it is.

As many have noted, the global recession that will inevitably follow this pandemic will kill many millions, a toll that may well exceed the virus itself. But it has been curious to see how many right wing commenters have presented this as an argument for lifting lockdown restrictions, seemingly showing uncharacteristic compassion for those on low incomes. What they fail to acknowledge is that it will not be the recession that causes these deaths, but the cruel and unequal society that a recession plays out in. It is only in an unfair, unequal world that millions will die. And as they die, billionaires will sip Champagne on luxury yachts, impenetrable algorithms will deny low paid workers the chance to make a living, and the wealth share of the top 1% will continue to rise. 

But as ever, these problems are complex and hard to resolve. It has always been easier to blame fat people and foreigners. I have no doubt that as the world struggles into a post-Covid future, that blame will will get stronger and more cruel. Those who look to profit from our fears will continue to tout irrelevant expertise, emboldened by their clever exploitation of our darkest hours. More Covid diet books will appear. ‘Eating for Immunity’ TV specials will be made. Lifestyle experts will arrange expensive paid consultations, and pre-existing agendas will be contorted to sound relevant, allowing them to hop on board the panic train. I only hope that at some point, people see these things for what they are, and realise that many of those who pretended to care, were simply exploiting fear and wrongly apportioning blame. If you needed the power of a million deaths to push your agenda onto the world, perhaps it is one you should have kept to yourself.