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On Monday England was given an indication as to how it will eventually get out of lockdown. Gradually, and in very careful stages, seems to be the answer.

We are in our third lockdown, and have staggered through two false dawns. What is different now is that vaccinations have been completed on 17.7 million citizens (last weekend’s figures), which covers all the most vulnerable people. This should have a big impact on deaths and hospitalizations. The plan is to keep going till all adults have been vaccinated, probably by the end of July. We are now in a transition phase, and each stage will follow the next stage every 5 weeks, so long as four tests are met:

1 The vaccination program continues at the present pace.
2 Vaccinations continue to be effective in reducing hospitalisations and deaths.
3 The NHS can cope with the pressure of hospitalizations
4 No risky new variants arise.

So, not exactly a slam dunk, and plenty of wriggle room for the government, but there is a reasonable likelihood of progress towards the usual freedoms of life by midsummer.

Stage 1. Starting 8th March (those vaccinated will have reasonable protection) schools and colleges will open, and small outdoor meetings can commence, and by 29 March more people can meet outside, and outdoor sports can commence.

Stage 2. No earlier than 12 April, all shops allowed to open, restaurants and pubs can serve customers sitting outdoors, and gyms, hairdressers, zoos, theme parks, libraries and community centres can open.

Stage 3. No earlier than 17 May, groups of 30 can meet outdoors or for special events like weddings; but only 6 indoors. Outdoor theatres and cinemas, and hotels can open; international travel can begin, indoor sports, exercise classes and large events also, though subject to number restrictions.

Stage 4. No earlier than 21 June. Everything open.

As the English say: “Fair enough”. Snap polls show general support, with only 16% saying the pace is too slow. However, the chance of getting infected outdoors is very low, and always has been, so why not allow all outdoor activities immediately?

One reason is that although not many of the younger-than-70-years-of-age die, they account for half the patients in hospital. There are more people under 70 than above it, so the prospect of large numbers needing hospital beds is alarming. As always, when epidemics make people very ill, hospitals become a limiting factor. They are designed to deal with our everyday needs, plus a small buffer for winter, but are not well set up for widespread community infections which happen infrequently. Also, although deaths are coming down, they are not coming down quite as fast as hoped.

This is a trifecta: vaccinations are working (but need more time and to be given to more people); many are still getting infected and dying so some restrictions need to be applied; and people have had enough of lockdown and are bursting to get out. The government are looking at the junction point of increasing vaccinations and increasing infections, and trying to balance the effects of possible hospitalizations coming, say, two to three weeks later, and vaccine produced immunity coming four weeks after the first inoculation.

As always, there is a strong political dimension: the UK has one of the highest death rates, and also one of the fastest vaccination deployments. The latter is that rare thing, a moment when the public give grudging support to their leaders, and thankful lip service to Science. They respect lab workers in white overalls, but don’t want to pay them all that much. It is dull work, and requires brains, so is best left to someone else.

As the weeks have gone by the general news about vaccination has been uplifting. The Oxford/AstraZeneca vaccine is highly effective in England, but European citizens are avoiding it, because their leaders have told them to. Vaccines are going to waste, at a time when countries outside Europe would gratefully receive them.

The vaccinated quite understandably want some public recognition of their new status. They have taken a low risk, and are now far less likely to be hospitalized or to pass the virus on. They would like a Vaccination Passport so that they can go on holiday without compulsory quarantine, and also go to theatres, cinemas, or nightclubs. The Greek Government would like British tourists on their beaches, and in their nightclubs.

The government, not initially too happy with the passport idea, is now considering it, so a committee will study the issue, including whether such passports would be discriminatory against those who “for whatever reason” did not get vaccinated. This is an inversion of what was formerly meant by “discrimination” which was that discrimination was a positive attribute showing that a person could distinguish one thing from another, as in the case of fine wines. Persons of discrimination have done a risk calculus and got vaccinated so as to protect themselves and cause less trouble and burden to others, and now the concern is that those who haven’t bothered to take up the free vaccination will be inconvenienced in some way.

Vaccination data for England as at 2 February 2021 shows:

• 14.4% of white people vaccinated so far (7.02 million)
• 9.2% of Asian people vaccinated (411,000)
• 6.8% of Black people vaccinated (135,000)
• 4.7% of people from mixed ethnic groups vaccinated (62,000)

You may remember that the surveys of intention to accept vaccination showed that this was likely some months ago. The “hesitant” remain so, and are procrastinating. The government, aware that not all will be vaccinated, and that no vaccine provides perfect protection, and that more social mixing will generate more cases is also procrastinating, but in cautious stages.

The usual suspects for vaccine “hesitancy” have been rounded up by the Office for National Statistics:

perception of risk, low confidence in the vaccine, distrust, access barriers, inconvenience, socio-demographic context & lack of endorsement, lack of vaccine offer or lack of communication from trusted providers and community leaders. [High Confidence].

To overcome these barriers, multilingual, non-stigmatising communications should be produced and shared, including vaccine offers and endorsements from trusted sources to increase awareness and understanding and to address different religious and cultural concerns (such as whether the vaccine is compliant with the dietary practices of major faiths, or with their ethical positions around medical interventions). Communication should consider the “whole communication journey” for vaccine rollout. [medium confidence]

Community engagement is essential as health messages and vaccine distribution strategies must be sensitive to local communities. Community forums should include engagement with trusted sources such as healthcare workers, in particular GPs, and scientists from within the target community to respond to concerns about vaccine safety and efficacy [medium confidence]

All this is well and good, so scientists and politicians of the relevant races and religions have been photographed loyally getting vaccinated, the better to inspire their genetic and faith cohorts. In times of tribulation, tribes matter.

 
• Category: Science • Tags: Britain, Coronavirus, Vaccines 

At a time when there are concerns that Covid is being over-diagnosed, and its impact exaggerated, it is useful to look at another claim: that traumatic events in childhood have a major effect for the rest of a person’s life.

On 18 November 1987 a fire at King’s Cross Underground station in London killed 31 people, and the next day, with two colleagues, we established a trauma service for survivors and their families. In the next decades I worked on many disasters, and in all of these we were not only providing therapy, but were also interested in understanding whether the severity of the actual trauma or the vulnerability of the victim was the main factor in them being disabled by the event. Most of the events were horrendous, with high death rates, in one case 50% dead, so we had no doubt that they close to combat stresses in their intensity. Our impression was that both the severity of the event and the personality of the victim were equally important, but the correlations for each factor with psychological symptoms were only r=.35 so not that big.

At that time the concept of post-trauma stress was far less known and accepted, but as time went by it became applied to a very broad range of life events. In particular, one type of trauma, child sexual abuse, became far more frequently used as a diagnosis, usually on the basis of therapist-assisted recall of childhood events. This became a minefield, as more and more patients claimed their lives had been ruined by their parents.

There were certainly well documented cases of child sexual abuse, so distinguishing between real and possibly imagined cases became important, but very difficult to achieve in therapeutic practice. In a disturbing move, some therapists said it was wrong to doubt any patient’s account of having been abused as a child. Other therapists circulated credulous accounts of satanic ritual abuse which, if true, would have been far easier to track down and prosecute than the hidden abuse taking place by individuals in private houses or children’s care homes, simply because there were more witnesses, and more chance of blackmail and denunciations and a collapse of the conspirators. Also, in the accounts of child sacrifices, there were further lines of police inquiry.

There is no doubt that some adults abuse children and are rightly convicted of their crimes, and that the plea of “no harm done” is rightly rejected because children cannot give informed consent. There is no doubt that child abuse is often difficult to prosecute, because children may not be able to understand what is happening. At the same time, some assumptions may be wrong. At a big conference of therapists I was astounded to hear a lecture discussing satanic rituals as if they were both real and frequent, and even more astounded to find audience members agreeing, without supportive evidence.

Bewildered by this, I wondered why no one was following up actual documented cases of child abuse, to see what psychological effects could be traced back to actual real events. I knew some people were doing a prospective study, and also knew it would take a long time to be completed, so it was a matter of waiting. Now that study has been published, and in my view the results are explosive. The big determinant of bad effects from traumatic childhood events is whether you think they happened, not whether they actually happened.

Objective and subjective experiences of child maltreatment and their relationships with psychopathology Andrea Danese & Cathy Spatz Widom. Nature Human Behaviour volume 4, pages 811–818 (2020)
https://doi.org/10.1038/s41562-020-0880-3

The authors say:

Does psychopathology develop as a function of the objective or subjective experience of childhood maltreatment? To address this question, we studied a unique cohort of 1,196 children with both objective, court-documented evidence of maltreatment and subjective reports of their childhood maltreatment histories made once they reached adulthood, along with extensive psychiatric assessment. We found that, even for severe cases of childhood maltreatment identified through court records, risk of psychopathology linked to objective measures was minimal in the absence of subjective reports. In contrast, risk of psychopathology linked to subjective reports of childhood maltreatment was high, whether or not the reports were consistent with objective measures. These findings have important implications for how we study the mechanisms through which child maltreatment affects mental health and how we prevent or treat maltreatment-related psychopathology. Interventions for psychopathology associated with childhood maltreatment can benefit from deeper understanding of the subjective experience.

This is a pivotal issue in psychology. Should we be helping people overcome a real-life event, or correcting a damaging mis-perception? The therapeutic approaches would probably be very different. Court cases are highly detailed specific events, which act like a radioactive tracer for later life outcomes. If childhood traumas have the status they are accorded in Freudian thinking, then children whose abuse is bad enough to have the parents taken to Court should be highly disturbed, and permanently so. The results will be worse than that caused by ordinary parents, who sometimes argue, punish unfairly and are generally tedious, or worse, embarrassing. If parents mess you up, then these Court cases will be picking up the extreme examples of parental mistreatment.

On the other hand, Court cases are not sensitive, in the sense of picking up all cases of abuse, but they will provide a solid benchmark for evaluating outcomes in those actually abused.

We have studied one such unique sample. Maltreated participants (n = 908) were identified as victims of child abuse or neglect based on official records from juvenile (family) and adult criminal courts in a metropolitan area in the Midwest United States during 1967–1971. A comparison group was painstakingly drawn of children without official records of abuse or neglect matched on the basis of age, sex, race/ethnicity and approximate family social class at the time of the child maltreatment (n = 667). During a follow-up assessment between 1989 and 1995 (mean age 28.7 years), 1,196 study participants underwent a 2-hr in-person interview, which included assessment of retrospective reports of childhood physical abuse, sexual abuse and neglect, as well as assessment of current and lifetime psychopathology.

Objective and subjective measures of child maltreatment identified largely distinct groups of participants (Cohen’s κ = 0.25) with poor agreement across all maltreatment types (child physical abuse κ = 0.09; child sexual abuse κ = 0.17; child neglect κ = 0.32, consistent with meta-analytical findings.

It was possible to separate the relative contribution of objective and subjective measures of child maltreatment to psychopathology studying three target groups: (1) adult participants who were identified as victims of child maltreatment by virtue of official records but did not retrospectively recall the experience (objective measure); (2) adult participants who were identified as victims of child maltreatment by virtue of official records and also retrospectively recalled the experience (objective and subjective measures); and (3) adult participants who retrospectively recalled being maltreated in childhood but were not identified as victims of child maltreatment by virtue of official records (subjective measure).

 

In this part of the world, the first side effect of vaccines has been political. Europe’s nations are now competing to get vaccinated, and the ructions have been considerable. From the start, the UK took a vaccine friendly stance. Early on it decided that vaccination was the long-term solution, and all else was merely a grim holding pattern.

By March 2020 Kate Bingham (a scientist and venture capitalist with a long track record in pharma research and development) had begun discussions with what she and her team saw as the front runners, having done a careful calculation about which were likely to work, and time has proved them right. They identified the best candidates in each of four platform types, and engaged them all with a winning formula: we will buy in advance, at a reasonable price without much haggling, and in vast numbers, so long as you can deliver as fast as possible. As a quid pro quo will give you a fast track to conducting trials and gaining approval. We will pay for results, and use emergency legislation to cut through all the paper-work. We will check for safety and follow all the usual procedures, but will avoid any time-wasting box-ticking. In most cases we accept that our pre-booking investments may come to nothing, so we won’t ask you for our money back. If, as we hope, your candidate is successful, we have ordered more than we need so as to ensure supply for our citizens. Unused drugs we will sell, or give away to other countries, once all our citizens have been offered vaccination.

In this way they quickly and wisely spent 2.7 billion sterling. They ran all processes almost in parallel, so that vaccinations started on 8 December 2020. They also published their priority lists so that people could calculate roughly when they would be called up.

As of 1st February 2021 the UK has given a first jab to:

First dose total
9,646,715

Second dose total
496,796

As of today the total number is above 10 million first jabs, and daily totals vaccinated are about a third of a million.

For comparative purposes, this is about 12% of the adult population, and European countries are at about 2%. The European Union has reacted oddly, deciding to attack both the UK and AstraZeneca. In a flurry of uncoordinated blows, it threatened AstraZeneca with not being able to sell into the European market unless they stuck to their interpretation of their contract (signed at least 3 months after the UK one) which the EU read as meaning that, although they had signed late, they should be able to take some deliveries which were earlier promised by AstraZeneca to the UK. For a while the EU attempted to put forward legislation which would require any pharma company producing vaccines in Europe to apply for permission to export it to the UK, strongly suggesting they would not get it if Europe had a need for it. At this time the AstraZeneca vaccine had not yet been approved for use in the EU.

They then attacked the UK strategy of concentrating on giving the first dose to as many people as possible, saying it was unwarranted and risky. More recently both German newspapers and the French president said that the AstraZeneca vaccine was ineffective in older people, which is of course the target population. Thus, they were simultaneously demanding more than their fair share of a vaccine which, they said, did not work particularly well. As a consequence, it is now a staple of conversation in England to hear the phrase: “I voted Remain, but this European thing about our vaccines………”

As you will know, some people having been arguing for some time that the actual data show that the first jab does the heavy lifting, and afterwards it is best to have a longish delay (say up to 12 weeks, not the previously tested 3 weeks) before getting the second jab, which will not add much, but which might make immunity last longer.

Now a paper is coming out suggesting that this is precisely the best course of action. The study, which is under peer review and is expected to be published in The Lancet, concludes that leaving a 12-week gap between shots “may be the optimal for rollout of a pandemic vaccine when supplies are limited in the short term”.

The vaccine was 76 per cent effective from three weeks after the first injection and this level of protection lasted until 90 days after the first jab.
After a second dose, vaccine efficacy was 82 per cent with the three-month interval between shots that is being used in the UK.
The report also suggests that the vaccine could have a “substantial” effect on transmission of the virus, with a reduction of positive PCR tests among those vaccinated of more than 50 per cent. This suggests a pronounced reduction in the number of people who carry the disease but show no symptoms.

So, the first AstraZeneca jab gives you 76% and the second jab adds another 6%. The Steve Sailer shrug effect. It is almost as if the immune system can take a hint first time round.

A medical colleague explained why the Johnson and Johnson “Jansen” vaccine gets such good results with a single jab. “The front runners were desperate to show efficacy with this new virus, and thought that two jabs would improve their chances of getting a good result. Also, selling two vaccines is a sensible business decision, even given the not-for-profit stance AstraZeneca took. Now that it is clear that a single jab works, Johnson and Johnson, late to the party, cannot say that their two-jab version is any better than anyone else’s two-jab version, so they can now boast that theirs is the best because it only requires one jab”.

Another side effect of vaccines being available is that people question whether they should have a vaccination at all. What are the odds? Modern vaccines are rarely released unless they achieve the safety standard of no more than one severe reaction per million. The measles vaccine is at that level. People still worry about it. Let us be far more cautious, and assume that these vaccines will kill one person in every 100,000 vaccinated.

How many people would you have to vaccinate in a trial before you got a dead volunteer? Intuitively, one would need at least 100,000 subjects to have a reasonable chance of detecting a 1 in 100,000 condition, and the calculators I have looked at suggest that the number might be two or more times that, to be 95% sure of finding it. This is because rare events do no queue up to happen at a rate which we later observe and summarize. Nothing may happen for a long time, and then several events come together over a few months. Real world tests of vaccines and medicines are the harshest and truest.

If you dropped the redundant placebo arm of the trial, your chance of observing any rare serious side effect would be doubled. Given the intense focus on Covid at the moment, there is good actuarial data about deaths and hospitalization for severe case in most advanced economies. It would be more efficient to just monitor the newly vaccinated against the unvaccinated general population. It would also give you the best chance of finding rare adverse reactions. Perhaps placebo arms of Covid trials should be dropped. Another option is that new vaccines could be tested against older ones, particularly against new variants.

 
• Category: Science • Tags: Coronavirus, Vaccines 

A General Practitioner is the English term for what in other countries is called a Family Doctor. She rang us up last week to offer us vaccinations, asking three questions: are you fit and well; have you had a flu vaccination in the last week; have you had allergic reactions to anything? Then we were offered the vaccination appointment, which we accepted. We asked one question: which sort? and the answer was: Pfizer.

Several days later we received official invitation-to-be-vaccinated letters. Redundant, because we had immediately after the phone call received confirmatory text messages, but reassuring anyway. This morning we went to the clinic. As we came down the London street and approached the door, one of the three masked attendants standing outside came towards us, saying our surname out loud, and that he had guessed it was us, since we were due at that time, and were coming to be vaccinated together. After a very brief chat about whether our neoprene masks steam up our glasses (no) we were motioned inside. There we were met by another three masked attendants. One of them took our temperatures, another asked if we were feeling well, while the third, seated at a computer recorded our details and printed cards for us. We had to disinfect our hands. We were given a card each with name, date of birth, National Health Service number, and date and time of second vaccination appointment 70 days later.

In the next room were patients, all masked, seated at separate chairs, waiting to be allowed out after observation. We were beckoned forward by a further attendant, and at the end of the corridor by another, and finally yet another who asked us to stand together at an appointed and marked spot, 2 metres from the other person waiting. Every attendant wore a mask, and gave cheerful greetings. This area had two or three attendants.

Soon we went into a room where two chairs were provided. There we met what appeared to be the Vaccinator in Person, with her attendant on a computer. The vaccinator gave an excellent, clear explanation of the procedure, and the likely side effects, and the pain killers which could be taken in the case of pain or headache. To my great satisfaction, she said that the protective effect would be pretty good by two weeks and would continue increasing thereafter, and that the second vaccination would be up to 10 weeks later and would add to the protective effect. I should have recorded her, but at least I commended her afterwards. We were given a detailed document about the vaccination we had received.

Then the vaccination itself, quick and painless, afterwards taken to a waiting room with one other patient, and monitored for a while. The time of vaccination had been written on sticky labels stuck on the back of our hands. It felt like about 7-10 minutes, but we were checked by attendants twice during the period, whatever it was, and there was time to use mobile phones, scan the explanatory document and put jackets back on. A last an attendant opened the exit door to let us out of a side entrance (the whole thing was one-way flow) warning us the rain had made the wooden ramp a bit slippery, and that was it.

It ran well, was welcoming, and even had a holiday feel to it, as if we were there for vacation, not vaccination. The explanations were particularly good. In the context of a raging European Union argument about whether the United Kingdom, having signed contracts with AstraZeneca at least three months ago and paid in advance, should nonetheless divert UK production of vaccines to Europe, so that despite having been late to strike a deal, and only now being willing to approve the vaccine, Europe could get its fair, moral and reasonable share, it was hard not to feel pride that Britain, however much it may have screwed up the management of Covid (valuing freedom over public health controls) had at least redeemed itself by being ahead of the curve with securing vaccines for its people.

Indeed, most major European Union countries are so far behind Britain that even normally long-suffering Europeans are wondering quite how their governments screwed up a simple matter of procurement. Britain’s total vaccinated exceeds the European Union total.

Those to be vaccinated this morning were elderly British, mostly singletons, more women than men. The attendants were middle aged. There was at least one cheerful Australian, but these things cannot be helped.

 
• Category: Science • Tags: Britain, Coronavirus, Vaccines 

In the continuing story of coronavirus, this week brings two stories about limitations. The first is that production of both Pfizer and AstraZeneca vaccines in Europe is faltering, and from Monday supplies will be reduced for the next few weeks. There have been production problems, of the sort which happen in all manufacturing. It should get better later, but it means that some vaccination centres will lie idle for a while. This is a public health problem, since the gains which have been made in vaccinating, and which will have reduced the population at risk, may be overwhelmed by new cases in the unvaccinated, particularly as numbers increase, thus increasing the probability of new variants.

Nonetheless, by the time you read this, 6 million will have been given the first jab, and half a million the second jab. Not bad, given the cold chain requirements of the front-running Pfizer vaccine. Pragmatically, the AstraZeneca vaccine will now take over the main burden, and the rates of vaccination will probably increase considerably in a fortnights time.

For most people, getting the jab as soon as possible is the main aim. Vaccinations offered for later next week come with an associated second appointment on 8th April, so 70 days, or 10 weeks later. The UK has taken the reasonable view that giving as many people as possible the first dose should take priority, and that the second dose can be given up to 12 weeks later. Only 8% have had the second jab by this week, but that will increase considerably, so long as supplies last.

The British Medical Association (doctor’s union) has said that a 12 week delay is fine for the AstraZeneca jab, but for Pfizer there is no evidence it will be OK after 42 days. It is a bit hard to see how the immune system would forget a vaccination so soon. Prof Anthony Harnden, deputy chairman of the Joint Committee on Vaccination and Immunisation feels the data support the view that one jab confers acceptable protection. The Moderna data (using an mRNA approach like Pfizer) shows 90% immunity two months after the first jab. Prof Adam Finn, University of Bristol, a paediatrician with an interest in infection, immunity and vaccinations, says that within a week or two, unpublished data under analysis will be likely to show that there will be increasing protection in the 12 week period after the first vaccination. I think this was also suggested by Steve Sailer, having eyeballed the data some time ago.

However, vaccination is not universally popular. The media have been tentatively discussing the fact that some populations, in some parts of the country, are turning down vaccination not at the white rate of 8% but at the rate of 50%. As usual, the discussion of this phenomenon is somewhat coy. First of all, they call it “vaccine hesitancy”. Secondly, they talk about cultural and historical factors, and the importance of Faith leaders. Finally, later down the newspaper column, religion and race come into the picture.

A recent survey of 12,000 participants looking into “vaccine hesitancy” found that 72% of black respondents said they were unlikely to have the coronavirus. This was sky high compared to other groups.

https://www.medrxiv.org/content/10.1101/2020.12.27.20248899v1

So, intended vaccination rejection by ethnicity is: Black 70%, Pakistani/Bangladeshi 30%, Indian 16%, White 14%. A summary is that black citizens are disproportionately likely to reject being vaccinated. By a country mile, as they say in the country.

Just as a reality check, the same data show that elderly citizens are most at risk, and accordingly the least hesitant. The young don’t need a vaccination themselves (though it may well reduce the probability of passing it on to others) and so don’t see a need for it. It is a simple linear age effect.

In the real world, in Asian and African-Caribbean parts of Birmingham the refusal rate (offer of vaccination turned down immediately) is up to 50%. In Ealing, London, black residents refuse at 10-15% compared to all other groups at 5%. In Stoke on Trent there is a 20 to 30% non-attendance rate among black and ethnic minorities, compared to 2-3% in other groups. What ever the reason, a 20 to 30% non-attendance rate shows a sublime disregard for the needs of others, who will have had their chance of vaccination unnecessarily postponed.

What is going on?

A former Equality and Human Rights commissioner and frequent commentator, Trevor Phillips, said it was due to “a sincere rejection on religious or cultural grounds and quite probably a deep suspicion of anything proposed by white authorities. That doesn’t make it right, but it means we have to tackle he sceptics with seriousness. The underlying suggestion that we are all just a bit backward or don’t understand the arguments for the jab is just belittling people of colour”.

The idea that a rejection is “sincere” because it is thought to derive from religion or culture is certainly open to question. Cultures and religions can be wrong about immunology. Equally, “deep suspicion of white authorities” is bizarre, since those minorities are willingly and freely living in a white majority country, which provides education, health, social services, and welfare payments when required. Indeed, not only bizarre, but apparently totally wrong. Government surveys show that Black citizens have a strong sense of belonging in Britain, in actual fact fractionally more so than White citizens, which makes for an interesting talking point about the effects of mass immigration.

https://www.ethnicity-facts-figures.service.gov.uk/culture-and-community/community/feeling-of-belonging-to-britain/latest

Finally, the suggestion that rejection of vaccination is based on not understanding the arguments can be tested by looking for any racial differences in the understanding of science, or racial differences in scholastic attainment in total.

Let us look at the GCSE results (age 16) by ethnicity for2019, the last year of uninterrupted schooling, and rank them by their Top 8 scores.

https://www.ethnicity-facts-figures.service.gov.uk/education-skills-and-training/11-to-16-years-old/gcse-results-attainment-8-for-children-aged-14-to-16-key-stage-4/latest

Chinese 64.3%
Indian 57.3%
Bangladeshi 50.6%
Black African 47.3%
Pakistani 46.2%
White British 46.2%
Black Caribbean 39.4%

Examiners tend to prefer average scores, not wanting to stand out and have their marks questioned, and mark up or down from that average only when the student performance calls for it. These group averages would show, by a very wide margin, that Black Caribbeans could be said to have had difficulty understanding things. However, it does not match well with Indian subcontinent results, so it seems to be a part of the story, but not all of it.

As regards science, in 2007 it was found that:

(At 16) Pupils with a Chinese, Indian, White and Asian or any other Asian background showed a preference for the separate sciences (biology, chemistry and physics), while pupils with Black backgrounds were less likely to take any of these subjects and showed a preference for the single award in science.

 

I had always imagined that death had a certainty to it. Taxes are a close second, but death is easier to diagnose. The problem comes when the cause must be written on the certificate. A heavy drinker who falls downstairs has an accidental death, but it was brought on by his habitual drinking. Someone who dies as a consequence of type 2 diabetes may have died from over-eating. An elderly person with several chronic conditions might die of influenza, but his comorbidities deserve mention.

Official guidelines explain:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877302/guidance-for-doctors-completing-medical-certificates-of-cause-of-death-covid-19.pdf

Information from death certificates is used to measure the relative contributions of different diseases to mortality. Statistical information on deaths by underlying cause is important for monitoring the health of the population, designing and evaluating public health interventions, recognising priorities for medical research and health services, planning health services, and assessing the effectiveness of those services. Death certificate data are extensively used in research into the health effects of exposure to a wide range of risk factors through the environment, work, medical and surgical care, and other sources.

The document makes it clear that “COVID-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death”. Although there is an issue in attributing a death to Covid-19, the same has been true for death certificates for a long time: underlying causes are always a bone of contention. There may be over-attribution to Covid now, but if so then it will not influence the excess deaths measures, since those count deaths by the dates on which they occur, regardless of cause, and compare them to the average of previous years, generally the previous five years.

A more pressing problem is that the date on which Covid deaths are announced is usually not the dates on which the deaths actually occurred, merely the date on which a whole lot of deaths have been bundled together for reporting purposes. Some authorities are faster than others at reporting death certificates. So, daily death rates are usually no such thing, and dramatically inflate the size and variability of actual daily deaths. When dates are correctly allocated to the actual dates on which they occurred, then the second wave totals are less extreme, probably just somewhat higher than December averages.

At the same time, it is all too true that intensive care facilities are over-stretched, sometimes dangerously so. Having more resources seems desirable, but most of the time they won’t be used, and are not resource effective. Allocating scare resources is always hard, and intensive care requires well trained staff plus very bright people who are able to improvise and draw on existing medications and treatments when faced with novel illnesses. Perhaps it is possible to have more resources and be flexible in their use, training many and using only a few most of the time, then getting all hands to the pump during epidemics. Devoutly to be wished.

Against all this, the rollout of vaccines continues. Here a whole cluster of factors combine. The status quo ante is that the NHS delivers an annual flu jab to elderly or vulnerable persons, inviting them into General Practitioner surgeries for their vaccination. It is now a simple, well tried system, mostly using text messages and then patients phone in to book their session.

In the 2019/20 flu campaign, around 15.3m vaccinations were administered to eligible groups, covering patients over 65, those in clinical at-risk groups, pregnant women, children aged two to three years old, primary school children and healthcare workers. (This year it will be offered to 30 million).

So, why has the same delivery system not been used for Covid? Freezers. The cold chain requirements of the Pfizer vaccine are very demanding. Minus 70 Centigrade requires careful and expensive handling, with a requirement to use what you thaw out pretty quickly. Individual GPs can’t handle this, so a whole new system has had to be put together, meaning that new locales, new staff and new procedures have had to be developed. Most GP practices grouped together to use a common local facility. They became the providers of the patient names, according to national age and risk criteria. Their function was to tell their patients they could now ring up that central provider to confirm that they wanted to be vaccinated. Later, that central provider comes up with a date and time.

I promised you complexity, and here comes more of it. Pfizer had agreed to provide a large number of vaccines. In order to do so in Europe, they had a look at their factory and decided that this winter, in the middle of the second wave, it would be a good time to slow down production to make factory changes which will later speed up the pace and volume of vaccine production. The immediate consequence is that there are shortages, such that the local centres cannot work every weekday as expected. They wait till they are told that they will be getting a batch, and then book 500 patients a day for two days. Other days each centre is idle.

All is not lost, because there is a further complexity. If you form a mega-centre, and can do 2000 jabs a day, then you can order direct from Pfizer. It is said to be automatic. These mega-centres are due to open on 1 February, though the locales have yet to be finalised. Happily, one of the London ones might be the Science Museum. That would be joyful.

Some of you may find this all too simple, so I will do my best to serve up the complexity I promised. Despite booking months in advance, and I think paying well in advance, it seems clear that there will not be enough Pfizer vaccine to meet demand, and to provide the doses originally promised in good time. Oxford/AstraZeneca is now coming on stream, and patients formerly promised Pfizer are being told they will now get AstraZeneca. That vaccine can be kept in an ordinary refrigerator, lasts longer, and is thus far, far easier to use.

The published results appeared to show Pfizer was better, say 93% against 70%, but that turns out to be yes, more complex than it may seem. The trials were different and used different criteria for effectiveness. AstraZeneca is said to have monitored symptoms more thoroughly than Pfizer, and as of 20 November 2020: No hospitalisations or severe cases of COVID-19 in participants treated with AZD1222.

That seems to be a good bottomline measure. By any measure, both vaccines are as good or better than flu jabs.

Despite all this, current estimates are that 4.6 million UK citizens have received their vaccination against the coronavirus. Not bad at all. Israel is at 35%, United Arab Emirates 13.5%, UK 6.8% and then US 4.8%.

Israeli data is coming in, with predictably conflicting results. Despite having a great and increasing sample size, there has been insufficient time for a full evaluation of the long term protective effect. For example, case-ness is counted against a vaccine from the moment it is injected. Some patients will have come in with Covid without knowing it. Others will catch it before the vaccination can take effect. It seems prudent to look only at the 14 day onwards results. Those look good, as they did in the trial period, and eventually the evaluative process will be standardised.

 
• Category: Science • Tags: Coronavirus, Vaccines 

Science and politics make awkward bedfellows. Science is more concerned with the truth, or ought to be; politics more concerned with expediency, survival and the avoidance of blame. For that reason, politics is closer to human nature.

It is natural to simply hope for the best, to take precautions a little too late, and relax them a little too early. In the UK there was a reluctance to go Full Chinese, and shut everything down, particularly in the early days when there seemed no reason to panic. Business is business, and the lack of gainful employment brings poverty, gloominess and even ill-health. Instead, the Government’s response was hesitant, often somewhat contradictory, and generally too optimistic. The virus was faster to adapt than the government was to control it.

Bureaucrats followed an influenza model they had designed in 2011. They screwed up by not stopping Wuhan flights immediately; kept worrying about globules (wash your hands) and not aerosols (wear a mask indoors), so thus screwed up about masks; and did not enunciate or illustrate the key advice: don’t breathe in what other people have breathed out. Too many infected people had come into the country for the test and trace systems to be able to function. Too little was done to protect care homes. Too many people breathed in stagnant air in buildings and public transport. Too many rules were established, with too many variations and exceptions, and not enough repetition of the general principle that the contagious element is airborn and hangs around in crowded, closed spaces where people are exhaling a lot. Don’t breathe in what others breathe out.

Has too much fuss been made of Covid-19? Many skeptics felt it was just a bad case of the flu, plus general hysteria. Of course, asking whether a seasonal epidemic is bad invites the reply: “Compared to what?”. It now seems pretty clear that compared with the usual 5-year death rates, Covid-19 has been bad. It is hard to be precise in the middle of the current resurgence of cases, but it looks as if excess deaths are about 12% higher than base-rate. Here is a snapshot:

Just by eye, current death rates are similar to the first outbreak in March/April. The next 4 weeks will show if they go any higher, but given the almost 82,000 deaths, we are highly likely to be over 100,000 deaths before Easter. Given that about 600,000 Brits die a year it is an appreciable increase.
Long term data is often far more instructive. The Office for National Statistics has been churning out the figures. As befits a sturdy and thorough institution it has an extremely open website which quickly gives you everything except what you want to know. So, here is an abstracted picture derived by others from the ONS data. I like this one far better.

What they list as WW1 could also be described as WW1/Spanish Flu. That was the worst, worse even than the Irish potato famine. WW2 was pretty close, the 1951 flu very bad, the Hong Kong one far less so. Covid-19 in its early stages had certainly been against trend and clearly significant. The current leap in cases gives it the status of the worst event since the World War 2. And remember, these are just deaths, not measures which rely on diagnostic tests or death certificate categorizations. People are dying in larger numbers than usual.

Vaccinations have been given to roughly 2.5 million.

This is good news. I pay most attention to 1st dose totals, which seem to provide far more protection per jab than the second one (which just makes a good level of protection somewhat better), and quickly reduce the likelihood that a person will need a hospital bed. As you know, I don’t do policy, but if I was asked, I would suggest the second jabs supplies should be redirected towards giving more people their first jab.

Less good are the accounts of some vaccines going unused on some occasions; of vulnerable people having to sit together indoors for 45 minutes as they go through the entire bureaucratic procedure; and of some people missing their precious appointment slots (possibly because appointment messages did not get through) and staff then having to ring round their friends for last minute vaccinations of short-shelf-life phials.

Tales abound of some young 81-year olds getting their jab before their more worthy 90 year old seniors. An 82 year old male friend had to talk staff into also vaccinating his 77 year old wife (eventually they agreed to do it if she could arrive in 30 minutes, which she did); and a few impetuous 71 year olds have jumped the queue, apparently because health workers in some parts of the country are just jabbing anyone who looks mildly decrepit. Queuing is a very important activity in this country. It celebrates fairness, justice, status, precedence and a supreme contempt of those deficient immoral deviates who try to push ahead to rise above their station. Latecomers (those who are young, or healthy old) should be further down the pecking order, and preferably out of sight in another distant street. “We are all in this together, but I was first.”

Variations in rates of immunization are referred to in the Press as “postcode lottery”. This is seen as a bad thing, so much so that some successful clinics are being denied supplies until others catch up. This has been denied, but in a way which suggests that the laggards have been favoured, on the principle that those who are poorly organized need to be rewarded in some way. A good policy, justly delivered, will still have some regional variations, and there should be less alarm at some inevitable differences in the speed of advance, given that we are all advancing.

More recent data, obtained by the simple expedient of phoning and emailing friends and colleagues suggests that things have changed for the better over the last week. A local centre is said to be working with great efficiency, texting appointment invitations and waiting times are only about 5 minutes out in the street before being called in for vaccination. We await the call.

Although the initial focus was on the different types of vaccine, attention has now shifted, quite rightly, to the UK’s ability to deliver the vaccines that they had pre-purchased months ago. There is an international battle to get more vaccines now, and to jab them into arms as quickly as possible.

The UK missed a trick. As a supposedly rational, science based nation, it was in a position to have run a very large (say 400,000 health workers) volunteer Phase 1 study of the Oxford/AstraZeneca vaccine in March 2020, and to have done so without a formal control group. Showing the efficacy of the vaccine would have been done by comparing the vaccinated with the far larger unvaccinated population. If the trial had been extended in stages from the young healthy to the older healthy, and then the even older but less healthy, we could have effectively vaccinated 2.5 million people by late Autumn 2020 (supposedly as part of a very large trial for volunteers), and would not be going through our current lockdown.

 
• Category: Science • Tags: Coronavirus, Disease, Vaccination 

You know the story, but here we go again. The standard account of sex differences in intelligence is that there aren’t any. Or not significant ones, or perhaps some slight ones, but they counter-balance each other. The standard account usually goes on to concede that males are more variable than females, that is to say, they are more widely dispersed around the mean. Although this is an oft-repeated finding, in some circles it is still referred to a merely a hypothesis. There is a standardisation sample in Ro mania which did not show this difference, and others epidemiological samples where the differences are slight, but usual finding is that men show a wider standard deviation of ability.

Against this orthodoxy, Irwing and Lynn (2006) have argued that boys and girls mature at different speeds, with girls ahead till about age 16 and with boys moving ahead thereafter, such that men are 2-4 IQ points ahead of women throughout adult life.

https://www.unz.com/jthompson/men-4-points-ahead/

Lynn further argues that if men are 4 points ahead, and have a standard deviation of 15 as opposed to women’s standard deviation of 14, those two findings almost fully explain the higher number of men in intellectually demanding occupations. There is no glass ceiling. Fewer women are capable of the higher levels required for the glittering prizes. Furthermore, this explains why men know more things. At the very highest levels of ability there are more men, and they have more knowledge, which is why they win general knowledge competitions.

https://www.unz.com/jthompson/sex-on-the-brain/

This, the seditious faction suggest, is just a fact of sexual dimorphism. Male brains are very, very much bigger than women’s, and each of the component regions of the male brain are bigger than the same regions in women, and also more variable in size.

Standardization samples ought to be good, and often are so, but they are not as good as birth cohorts or major epidemiological samples, so the latter are to be favoured when looking for reliable sex differences.

However, here is another paper on standardization samples confirming the same pattern of male advantage, though not greater male variability in one of the samples.

Sex Differences on the WAIS-III in Taiwan and the United States
Hsin-Yi Chen and Richard Lynn. Pages 324-328.

https://drive.google.com/file/d/1N3qokmbgctVMktN5pU8dUbrzMmHns1CJ/view?usp=sharing

Sex differences are reported in the standardization samples of the WAIS-III in Taiwan and the United States. In Taiwan, men obtained a significantly higher Full Scale IQ than women of 4.35 IQ points and in the United States men obtained a significantly higher Full Scale IQ than women of 2.78 IQ points. The sex differences on the 14 subtests are generally similar with a correlation between the two of .65. In the Taiwan sample there were no consistent sex differences in variability.

The authors say:

There are three points of interest in the results. First, in the Taiwan sample males obtained a higher Full Scale IQ of .29d, the equivalent of 4.35 IQ points. This confirms the thesis advanced by Lynn (1994, 1998, 1999) that in adults, males have a higher average IQ than females of around 4-5 IQ points. Males obtained a higher Full Scale IQ in the American standardization sample of the WAIS-III of .185d (2.78 IQ points). These two results disconfirm the assertions of Haier et al. (2004) and Halpern (2012) that “Comparisons of general intelligence assessed with standard measures like the WAIS show essentially no differences between men and women” (Halpern, 2012, p. 115).

Second, the sex differences in the Taiwan and American WAIS-III are generally similar. On the 14 subtests the correlation between the two is .65 (p <.001). Thus, in both samples men obtained their greatest advantage on Information and their lowest advantage on Digit Symbol – Coding.
Third, there was no consistent sex difference in variability. On the Taiwan Full Scale IQ the VR of 1.02 is negligible, and males had greater variability in 9 of the 14 subtests while females had greater variability in 5 of the subtests. These results do not confirm the greater variability of males reported in numerous previous studies e.g., Arden and Plomin (2006) and Dykiert, Gale and Deary (2009).

This study, on the gold standard Wechsler test, seems to confirm a male advantage in general intelligence. As discussed, standardisation samples are designed to be an excellent representation of the population on which the test will be used (with changes to make it culturally accurate), and there is no reason to believe that this balanced selection would favour males. Birth samples would be even better, but this is a good test of the male advantage proposal.

The Information subtest is a measure of very general General Knowledge, not requiring any specialist interests, but asking about the things which would generally be known in the general population. A .44 sd advantage on this subtest is enormous. The greater male representation in high level general knowledge competitions seems well founded. On the US sample there is almost as big a male advantage for Maths, and a large deficit for the digit symbol coding task, which measures simple processing speed.

The lack of a greater standard deviation in the Taiwanese sample goes against the general finding, as did the standardisation sample for Romania. Standardisation samples are not as representative as larger epidemiological surveys, but it is interesting nonetheless, in that it suggests some sampling restriction.

 

The UK is under lockdown again. According to YouGov (4340 adults surveyed on 5th January) 85% of citizens approve. There may also be Tiers, of the four former sorts, and a possible fifth for very serious cases, but these have probably been superseded, and should be considered old news. Now it is just lockdown, and the Tiers have been shed. There are exceptions, some special circumstances, but the general invocation is: DON’T MINGLE WITH OTHERS. Essential shopping is allowed, and essential going to the doctor, and essential exercise, but not the other stuff of life, unless absolutely essential. Doctors can still be trained at medical schools, which is comforting.

On a strategic front, the good news is that we are now better prepared for the next pandemic, which is due in about 4 year’s time. That prediction from South Korea is based on the observation that we are continuing to increase in population size, pushing against the remaining wild spaces, and that some people at those margins like eating the flesh of wild animals. We can be pretty certain that the next epidemic will come from China, where millions still live in close contact with animals (pigs and ducks, mostly) and have broad appetites; and also from the Congo, where bushmeat is prized. Viruses long circulating among bats, for example, will jump to other species, at a rate which broadly correlates with the spread of human settlements into the remaining wildness. That is the conventional story.

The unconventional one is that for years some virology labs have got trigger happy, or grant income happy, and have been doing wild “gain of function” experiments (artificially boosting the infectiousness of viruses so that they can jump to humans) which have doubtful utility and pose considerable dangers. Bats were just hanging in caves 900 miles from Wuhan, and if they had tried for some reason to fly there, they would have infected animals and perhaps people on the way. That did not happen. The virus that actually spread across the world was, the official Chinese authorities say, collected from those caves back in 2011 or so, and then safely kept in a test tube in Wuhan. Yes, it was taken out of storage and used in bench experiments in that lab, which may have included “passing” it through other hosts so that it learned how to infect them. That detail has not been disclosed.

American labs were front runners in this technique, which was supposedly done to create future hazards and then try to deal with them. Prevention, it was argued. The US funded this research at home, with very occasional fatal errors when things escaped from the lab, and the same swashbuckling researchers trained up and sent money to the Bat Lady of Wuhan. I would rank the “lab leak” view as a Plausible Hypothesis. It is possible that this pandemic is the result of the Chinese not properly containing a virus which was trained up to be more infectious. A year has gone by, and as of today, the team who are trying to investigate the year-old scene of the incident, or scene of the accident, have not yet gained access. The Chinese authorities, with straight face and great politeness, explain that the delays are being created by their wish to have everything absolutely ready for the inspectors. A preliminary view is that we did not get the full story from China, to our great and continuing cost, and are unlikely to get it for a long time.

Meanwhile, back in Blighty, we are watching and living in the sequel of a low-grade horror movie. All the frightening indicators are up: cases are up, even when controlled for extra testing, positive test results are up, particularly for the new variant, and in recent days, so are deaths. As a rule of thumb, deaths are 5000 per million infected. That is low, from one point of view, but 5000 times higher than the likely side effects of vaccinating one million people. Even the most prudent of gamblers is likely to consider vaccination to be a good bet. Projected uptake in the UK is expected to be 70%, and possibly 80%. Care home workers, who are prime vectors for passing the virus on to the most vulnerable are said to be less keen, with 40% doubting they would take it, but that was a brief survey of 300 workers, so may not be accurate.

Now the story is “why are we waiting?” General practitioners cannot answer that question, but sincerely request that their patients shut up and stop asking them when they will be vaccinated, because the doctors don’t know. For some days the government blamed the pharma companies for hesitant supplies. The companies replied they were delivering as promised. Then it turned out that volunteer vaccinators, even with impeccable medical and nursing credentials, were facing bureaucratic hurdles such as diversity training which were putting them off. That was denied by official sources. Then it was alleged that the vaccines were being subjected to an additional inspection regime, imposing at least another 4 or 5 days of watchful waiting. Normal practice, and prudent, but many of these organisations were working 5 days a week, while the death rate was over 1000 a day. The virus works weekends. Few bureaucrats do. The testing of stock inspection was in addition to the first phase, in which only hospitals gave the vaccine, in case of bad reactions. That is now over, and ordinary clinics can do it, but some have not been receiving any supplies.

Meanwhile Israel was stealing the headlines by using its four nationwide health service organisations to compete with each other to vaccinate as many citizens as possible. (If you don’t like the one you are in you can sign up with another). Drive through and walk through clinics were working with military efficiency. The old socialist basis of health care winning kudos at last. Other countries are still trying to cut deals with Pfizer, and making slow progress.

In the spirit of capitalism new entries in the market, like Johnson and Johnson, are offering (once approved in a few week’s time) to do an effective job with one jab. If so, then their Janssen vaccine will be a clear winner. The price is also good, which impacts take up in poorer countries, where most people live. A purely capitalist approach would be to pay good money to vaccinate one’s self. A socialist approach is to subsidise the vaccination of most people so as to live in a safe herd. Both approaches have their benefits. An ideal approach would be to target all health workers, potential super-spreaders, and then the most vulnerable.

The latest advice to family doctors is that they should prioritize vaccination above all other activities, since this will provide the greatest benefit to the health of the nation. All we need to do is to join the dots, and get the products to the vaccinators so that they can get them into the arms of the public. The Prime Minister has promised that this will happen at the rate of 2 million per week “within weeks” such that 14 million will have been vaccinated by mid-February. Only 31% think it likely that this will be achieved.

Who will be the modern day Boccaccio?

 
• Category: Science • Tags: Coronavirus, Disease 


Despite providing a lot of unsolicited spare time, 2020 was not the best of years. Enough said.

Each post got an average of 6000 pageviews, and generated 19,600 comment words, resulting in a total of 530,000 comment words for the year. Since starting in 2013 I have posted 976 items, containing a total of 876,000 words, attracting 1.368 million pageviews. I have received 31,000 comments totaling 3.773 million words. Thank you for reading, and commenting.

My top 10 posts for the year are shown below:

Top of the pile was Warne’s compendium of myths about intelligence, so it is very pleasing to see it reaching a large audience.
The second was about the genetics of racial differences in intelligence, and whether skin colour per se could explain differences in achievement. It seemed that they did not, weakening the case that people do poorly because they are discriminated against on that basis.
The third was about the current Covid epidemic in the UK, as was the fifth.
The fourth was about country IQs, and was written last year, but is still being read.
The sixth was a critique of a polemic about racial differences.
The seventh was a review of Charles Murray’s excellent book on human diversity.
The eighth was about a paper being withdrawn just before publication because of criticisms made to the editors and authors. (The usual practice in more scholarly times was to reply to a paper with which one disagreed with a papers of one’s own).
The ninth was about a successful national response to the coronavirus in Uruguay.
The tenth was a discussion of human limitations in controlling complex systems, with country variations in coronavirus responses as examples.

Talking of human limitations, many visitors to this site last only one session. I hope they find thing more to their taste elsewhere.

Indeed, most visitors turn and run after 10 seconds.

Older people are more likely to read my posts, though the 25-34 group continue to be particularly interested. Four fifths of readers are men.

One country dominates the readership. The UK and the Netherlands tend to stay longer, the Turks, like last year, either lose interest very quickly, or perhaps find the content out of line with political requirements in that country, and face viewing restrictions.

My Twitter followers have risen slightly to 6,189. I use the medium simply to link to my posts, signalling what they contain, so probably don’t tweet enough.

I am always pleased to get comments. Some commentators provide a wealth of detail and further analysis, and I am particularly grateful to them. They are fellow bloggers. A minority get into a fury of name calling. This must be one of the most lightly moderated discussions anywhere, so it seems particularly pointless when others are trying to be as evidence-based as possible. Concentrate on the argument, and not the race, religion and presumed low ability of other commentators. Be kinder. As always, I’d like anonymous commentators to pick more memorable names so that we can understand your character, if not your identity.

Is blogging worthwhile? I sometimes doubt it. It is certainly time consuming, and any opinion once expressed will be challenged, condemned, and sometimes misunderstood. Confident but erroneous claims about intelligence still keep coming, so progress appears to be very slow. A brighter light is that some readers find things here which help them understand more about human differences. That is always a cheering discovery. Every month we get more results showing the power of intelligence in human outcomes. The social class explanation for different life outcomes is no longer supported by any study which includes intelligence measures in the overall analysis. Theories about genetic contributions to racial differences can now be tested directly. If you can keep reading, I will keep writing.

 
• Category: Science 
James Thompson
About James Thompson

James Thompson has lectured in Psychology at the University of London all his working life. His first publication and conference presentation was a critique of Jensen’s 1969 paper, with Arthur Jensen in the audience. He also taught Arthur how to use an English public telephone. Many topics have taken up his attention since then, but mostly he comments on intelligence research.