COVID-19: Unravelling the Uncertainties

From the Archive: First published on May 5, 2020, on CEBM

We are republishing some of our early writings from the pandemic for your consideration in light of TTE's series on the UK’s COVID inquiry Module 1 recommendations.

The Great German strategist Helmuth Von Moltke encapsulated uncertainty as follows:

“No plan of operations extends with any certainty beyond the first contact with the main hostile force”. 

In the arena of respiratory infectious agents, Moltke’s ‘tactical genius’ could aid our current thinking.

Moltke thought it was only possible to plan the beginning of a military operation. He meant that leaders cannot foresee the future and, therefore, need flexibility in their planning, as uncertainty will always happen.

The uncertainties

We have no idea how many respiratory agents there are. Since 1970, 1500 pathogens have been discovered, 70% of which have come from animals. Some authors report that up to 40% of respiratory infections have no recognised cause. In our analysis of the RCGP surveillance data (week 17 of 2020), out of 428 sam…