Will vaccinated people end up in ICU?

When I posted about Australia’s slow vaccination progress we were ranked dead last among OECD countries in the full vaccination “race“. We have now nosed past South Korea into second last place. Sydney’s COVID outbreak and lockdown is certainly a factor, but whatever the reason, the increased rate of vaccination we’re seeing is good news.

The Sydney outbreak is also leading to growing numbers of COVID victims being admitted to intensive care units (ICUs) and, sadly, to a number of deaths. So far, while a small number of the patients in ICU have had one vaccination shot, none have been fully vaccinated. But based on international experience, it’s only a matter of time before that will change. We should also expect to see some deaths of fully vaccinated people. I am sure that the minute that happens there will be enormous media attention, but will it actually say anything about the effectiveness of the vaccine?

In fact, it won’t. It will simply be a statistical consequence of an increasingly vaccinated population. It’s sobering to recall that in the race to develop vaccines last year, 50% efficacy in trials was set as the hurdle for regulatory approval. As it turned out, the vaccines all did far better with trial efficacies around 80-90%. These are extremely good vaccines, but they are still not 100% effective at preventing disease, hospitalisation or even death. As more and more people are vaccinated, we should therefore expect to see a higher proportion of fully vaccinated patients in ICU or dying (see chart below). Of course, many people will still see this outcome as an indictment of the vaccines. Friend of the Mule, Dan, gave me this ironic analogy for this confusion: “Now that nearly everyone in Australia wears seatbelts, it turns out that nearly 100% of people who die in road accidents were wearing their seatbelts. Proving that seatbelts are not effective anyway in preventing road fatalities!”.

Expect to see more vaccinated people in ICU as vaccination rates rise

Focusing on the proportion of people in ICU or dying who are vaccinated misses the important point here: as vaccination rates increase, the total number of people in hospital or dying will be dropping. John Burn-Murdoch of the Financial Times illustrates this point nicely with a clever infographic.

How much of a reduction on ICU admissions should we expect to see as a result of increased rates of vaccination? It will depend on how effective the vaccines are at preventing severe disease. While current estimates of the effectiveness of the vaccines are around 80% (with some variation across the vaccines), there is some evidence that the effectiveness of preventing severe disease is over 90%. The impact of vaccines on hospitalisation will also depend on how much COVID is circulating in the community: when the risk of contracting COVID is low, even unvaccinated people are unlikely to end up in hospital.

The chart below shows the expected effect of vaccination on rates of admission to ICU for four different assumed effectiveness rates of the vaccine and for three different scenarios for the prevalence of COVID in the community. These scenarios are taken from the Australian Technical Advisory Group on Immunisation (ATAGI) paper “Weighing up the potential benefits against risk of harm from COVID-19 Vaccine AstraZeneca“. The “low” risk scenario corresponds to an infection rate similar to the first COVID wave in Australia (29 infections per 100,000 over 16 weeks), “medium” to an infection rate similar to the Victorian second wave (275 per 100,000 over 16 weeks) and “high” is similar to Europe in January 2021 (3,544 per 100,000 over 16 weeks).

When the risk of contracting COVID is high, higher vaccination rates will dramatically reduce hospitalisation. This is particularly evident in the UK experience, where COVID peaked well above the “high” scenario in this chart in January 2021 and then again in July. In the intervening six months Britain has had one of the more successful vaccine roll-outs and, as a result, hospitalisation and death rates in July were a fraction of the January experience.

I hope Sydney’s lockdown will be successful in containing the current outbreak, but if it’s not, the faster we roll out the vaccine, the fewer people will end up in ICU and the fewer people will die.

Careful with that thing – you could kill someone

It’s been a while, but guest author Mark Lauer is returning to the Mule. While in COVID-induced lockdown, the mind naturally turns to armchair epidemiology, but here Mark goes beyond mere amateur probability to add a sprinkling of ethics.

So, you’re in lockdown during a COVID-19 outbreak in your city. And you’re wondering, now that most of the elderly are vaccinated, if all the fuss is really justified. After all, only a tiny proportion of the city has caught COVID so far, and even if you get it, statistically speaking it is unlikely to harm you. The number of people dying is a small fraction of the population, especially now that effective vaccines are being rolled out. So just how dangerous would it be if you popped down to see that friend you’ve been missing?

It turns out, if you happen to have COVID, it could be rather dangerous indeed.  It may not be too risky for you, or your friend, but let’s do some simple mathematics to see what the consequences might be for others if you do pass on the virus.

In what follows, I’ll focus on the current outbreak here in Sydney, which began on June 16. It’s unusual at this stage of the global pandemic, since the population has lived largely unrestricted for over a year and perhaps some have become complacent about dealing with the virus, despite the carnage and sacrifices of freedom seen overseas. But the general gist applies anywhere that has significant case counts which aren’t falling dramatically.

Please note though, I am not an epidemiologist. There are many more qualified people, building far more sophisticated models. Listen to them and follow their advice.

One obvious factor to consider is how likely it is that you’re infected.  This will vary depending on the number of cases in the outbreak, how many cases are near you, and how often you go shopping or meet others.  But remember it takes several days for testing to reveal where cases are, during which time the outbreak can spread far across the city.  Also many people with COVID are asymptomatic, or at least asymptomatic for a period while they are infectious. None of the people who’ve passed on the virus so far have thought they had it at the time.  And it seems the Delta strain may take as little as a few seconds of contact to transmit.  But let’s set that question aside, and look at what happens if you do transmit it.

So suppose you unknowingly have the virus, and choose between two courses of action, one that passes it on to another person, and the other that avoids doing so.  From an ethical stand point, just how bad is it if you opt for the former?

To start, let’s consider the average risk of death for the person you infect. Case fatality rates for COVID-19 are in the range of 1-3% in most countries, but of course these will vary depending on many factors: the standard and capacity of health facilities, who in the population is getting the disease, how many of those are vaccinated, and the virulence of the prevalent strain.

In the Sydney outbreak we’ve had relatively few deaths. As at July 26, there have been 10 in this outbreak, whereas total case counts are now above 2000. However, that neglects the delay between cases being identified and consequent deaths. A study in the Journal of Public Health published in March finds the average lag is 8 days (even longer if a lower proportion of those infected are over 60 years old).

So a more comparable estimate of cases might be the number of locally acquired cases reported up to July 18, which is 1364. That yields a case fatality rate in this outbreak of 0.73%, which is indeed low by global standards of COVID. But while it might seem like a small number, that’s 7300 micromorts, which is equivalent to spending over 7 months as a British soldier serving in Afghanistan.

Now perhaps you and your friend are vaccinated, in which case the mortality risk to you is substantially lower. But while vaccination helps prevent your death, it is far less effective against transmitting the virus. And ethically speaking we need to consider what happens if your friend then passes the virus on further. The probability of this will vary according to the situation. If your friend is actually someone you’re  keeping locked in your cellar as a slave, then there’s no way for them to pass it on, and you can feel relieved of any moral qualms about deaths due to passing on the virus further (we can set aside other moral considerations in this scenario, since we’re talking about manslaughter here, so why worry about a minor case of enslavement).

Since normally we have little control over how others behave, even friends, let’s assume the friend is exactly like the average other Sydneysider in this outbreak. We can roughly guess the effective reproduction rate of the virus in the conditions of this outbreak by looking at case counts over time. Here is a chart of the number of new locally acquired cases by date during the outbreak so far.

Bar chart of new locally acquired cases in NSW 16.6-26.7.2021

Source: NSW Government

In the 24 days through to the imposition of city-wide stay-at-home restrictions on July 10, new cases grew exponentially to reach 103. For the purpose of this argument, I’ll assume a fixed cycle of infection lasting 3 days (this is not essential, since values below are still valid albeit with slightly different timeframes if the cycle is longer or shorter). A quick calculation yields a reproduction rate, r = 1.8.  That is, each infected person infects an average of 1.8 other people every three days.

At this level of transmission, 100 people will infect 180 people in three days, who will infect another 324 people after six days, and so on. If this continues for 15 days, the total number of resulting infections will be 4126, or 41.26 people per original infected person. If each of the 41 people infected via our friend has a 0.73% chance of dying from the virus, there is over 25% chance that at least one person will die. And that’s only counting infections in the next 15 days.  Giving the virus to one person is significantly worse than Russian roulette under these conditions.

Of course, as Sydneysiders are uncomfortably aware, the government here has been instituting successively more stringent restrictions across the city. And in the two weeks or so since July 11, the growth in case counts has happily slowed somewhat. Unfortunately, lockdown efforts so far appear to be insufficient to bring case counts down dramatically, with over 170 new cases reported on July 25.

But let’s be wildly optimistic and say that the reproduction rate is now down to 0.9. In that case, 100 people infect 90 people who infect 81 people, so that after 15 days the expected total number of resulting cases is 469. Your single transmission to your friend then leads to around 3.4% chance of at least one death as a result of infection in the next 15 days.

While that’s much better than before the citywide restrictions, it is nothing to shrug off. It’s similar to the chance of dying:

Most would agree that all these events have a “reasonable chance of killing someone”. And so too does passing on the virus under the current Sydney outbreak conditions.

So please, please be careful. Your choices can save lives.

Vaccination of the Nation

To date Australia has fared relatively well by international standards in terms of its COVID-19 infection rates. Now, however, its vaccination progress does not compare so favourably to other countries. Charts showing Australia languishing at the bottom of a vaccination league table have been circulating widely online. The specimen below, which appeared in last weekend’s Saturday Paper, is a typical example.

(Click image to expand for full view)

The challenge when producing charts like this is that there are far too many countries to squeeze onto a bar chart, requiring a somewhat arbitrary choice of the countries to include. This chart suggests that Australia’s full vaccination rate is the worst and Chile’s is the best. Australia does not in fact have the lowest rate in the world, although it is the lowest among OECD countries. Chile, at the other end, is certainly doing very well, but is not the best in the world – that honour sits with Gibraltar (or Malta if we restrict to sovereign nations). Even considering only OECD countries, the chart omits Iceland and Israel which are both a little ahead of Chile.

So, how can we get a better picture covering all countries around the world? One approach is to use a map instead of a bar chart. The map below shows countries grouped into quintiles (five of them, of course), ranging from the 20% of countries with the lowest rates of vaccination through to the 20% of countries with the highest rates. On this basis, with a full vaccination rate of 7%, Australia just scrapes into the middle quintile along with countries with full vaccination rates ranging from 6-18%. So Australia may not be last in this “race”, but the countries with lower rates are all far poorer than Australia.

The striking band of top quintile blue between Russia and China is Mongolia, which has an interesting story behind its vaccination success (thanks to Dan for alerting me to that article).

World Map of Vaccination Rate Quintiles
(Click image to expand for full view)

Some notes on the data:

  1. The data here is all sourced from Our World in Data (OWID), which in turn sources data from national authorities. A significant number of countries do not appear in the dataset and these are likely to be countries with very low rates of vaccination. If this data were available it would push up Australia’s ranking.
  2. “Countries” includes dependencies (such as Gibraltar) and disputed territories not just widely recognised sovereign nations.
  3. OWID reports a vaccination rate for Gibraltar of over 100%. This appears to be because vaccination figures include guest workers and, given Gibraltar’s small population, this has a big impact on the rate. Since there continue to be some cases of COVID-19 among unvaccinated people in Gibraltar, the true rate must be below 100% but as I have seen some estimates that the figure is more like 90%, Gibraltar is probably still in the lead.

COVID-19 by Suburb in New South Wales

The New South Wales Department of Health has now released a breakdown of COVID-19 data by suburb. The website – and much of the media reporting of this data – displays this in the form of colour-coded maps, highlighting the hotspots. But the data is also available in more detail as part of the government’s open data initiative. This provides the opportunity to explore the data in different ways.

As an example, the chart below shows the evolution of confirmed COVID-19 cases over time for all postcodes with more than 20 total cases. This shows clearly the impact of the social distancing measures from early April. Many areas have seen no new cases since mid April. The large spot that pushed Caddens near the top of the list is result of the cases in the Anglicare Newmarch aged care nursing home.

Note that most of the postcodes in New South Wales include multiple suburbs. Here I have picked a single representative suburb to label the chart.

What’s Going On In Sweden?

Reportedly, Sweden has not gone into a COVID-19 lockdown, unlike its neighbours. While I am sure this is a deliberate policy choice, it will also serve as an interesting epidemiological experiment to test the effectiveness of different social response measures.

It is still early in the course of this international experiment, but a look at the growth in cases intially suggests that Sweden’s strategy is not leading to a significantly higher infection rate.

COVID-19 cases

However, confirmed cases are difficult to compare across countries as they can be heavily influenced by the testing regimes each country implements How many tests are performed? Do they target particular groups (international travellers, those in contact with confirmed cases or are they driven by symptoms? It is very hard to account for these factors. Instead it is easier to compare the number of deaths. While there can still be differences (Under what circumstances are post-mortem deaths tested for COVID-19? How are co-morbidities accounted for? Are there more older citizens?), I think it is reasonable to expect less significant variation across neighbouring countries.

Looking at deaths, Sweden looks far worse than its neighbours. Sweden has approximately the same number of confirmed cases as Norway, but more than five times the number of deaths.

COVID-19 deaths

Interestingly, Sweden’s case count is very close to Australia’s, but Australia has to date seen 23 deaths, compared to 239 in Sweden – almost 10 times as many.

This suggests either that Sweden’s confirmed case count is significantly understated – it would be understated everywhere but likely more so in Sweden than elsewhere – or Sweden is suffering a far higher mortality rate.

The experiment is not yet over, but so far Sweden’s no lockdown strategy does not seem to be working.

COVID-19 data

There is no shortage of commentary on COVID-19 online and off. There is also an abundance of data available, which is as good a reason as any for the first Mule post of 2020.

One of the best data resources online is the Johns Hopkins dashboard created by the Center for Systems Science and Engineering (CSSE). For those interested in performing their own analysis, the CSSE has also made the underlying data available in a Github repository.

It has become commonplace to refer to the “exponential growth” of the disease. For many, this is just short-hand for “really” fast. Others may recognise an exponential curve in the charts below, with the exception of South Korea.

Confirmed COVID-19 cases

However, displaying the case data in this way does not give a very clear picture of what is actually going on. A better way to display the data (New York Times) is to use a logarithmic scale. In these charts, the values on the vertical axis increase exponentially (the labels here are successive powers of 10) and pure exponential growth would appear as a straight line. Of course, the real world is never pure, so the COVID-19 data do not appear straight lines, but for a number of countries – including Australia – there are periods where it comes very close.

Confirmed COVID-19 cases (log scale)

When plotted on a logarithmic scale, the slope of the line corresponds to rate of growth. In late February, the slope of the curve for South Korea turns sharply up, as the number of cases exploded, only to flatten again as drastic measures began to slow the growth rate. In contrast, the slope of the curve for the USA is becoming steeper – disturbingly the rate on growth in confirmed cases is increasing.

To get a better sense of these growth rates, the charts below show the daily growth rate in confirmed cases. The data is noisy, so smoothed curves are added to give a sense of the trend. In mid-February, the number of confirmed cases was growing extremely rapidly. As containment measures were introduced, the growth rate was quickly reduced, but not before cases had reached the thousands. After that, the gains became harder fought and, while the growth rate is still falling, but only slowly and is currently around 12-13% daily. In contrast, South Korea has managed to bring its growth rate down to only 1%.

Growth rate of confirmed COVID-19 cases

Although the case count in Australia is still only in the hundreds, it is growing at a similar rate to that seen in Italy in mid-March. Confirmed cases inevitably lag actual cases, as detection takes time, and as a result there will be a lag in the impact of any containment measures. So, it is too early to tell how much impact the recently imposed travel and social distancing restrictions will have.

Everyone will be hoping these measures will help, but if they do not and the current growth rate persists in Australia, the confirmed case count in New South Wales will be over 7,000 in two weeks, around 30,000 in three weeks and heading towards 200,000 in a month. The prospects in the USA look scarier still: there are already over 5,000 cases and the daily growth rate is around 30%. If that rate doesn’t slow, in a month there will be around 50 million confirmed cases.

Here is hoping those log scale curves start to flatten.

Alive and kicking

It has been almost two years since there has been a new post here at the Mule, so you would be forgiven for thinking that the blog was defunct. But, I have now been prodded into action by the need to change my hosting provider.

For over 10 years a friend has very generously hosted the Mule on his servers but he is now shutting down the operation. So a big thank you to Brendan for those years of hosting.

Now that I have successfully moved the site to its new home, I will have to prod myself into action and start posting again more regularly.

Keep the date, and Vote

James Glover is back with another guest post, this time digging into some poll figures ahead of the postal plebiscite on same sex marriage.

Hey, there is a survey/plebiscite/referendum on, in case you haven’t heard. It’s on same sex marriage or marriage equality. Leaving aside the fact that this is a survey and not at all binding on MPs, this post is not about the rights and wrongs of SSM but about how to interpret the results of a recent Newspoll. Unlike most Western democracies voting in Australian elections is compulsory but as this is voluntary we are left with the additional problem for psephologists of determining not just how people would vote but whether they feel strongly enough to vote. The Newspoll produced two sets of results. The familiar one of whether people supported SSM or not, but also whether they intended to send in their postal surveys. Strangely enough they didn’t include information on the voting intentions of those who actually intend to vote.

So I made a spreadsheet model to try to determine some possible outcomes and what were the real drivers of the result based on what we gleaned from Newpoll but with some possibilities of one side or the other getting more people out to vote and the underlying vote being skewed towards the “Yes” vote. We know from dozens of polls going back 10 years that the majority of people, when asked, support the general notion of SSM. The results are usually in the range 60-70% in favour, 15-25% against and about 15% undecided. Newspoll has the overall level of support at 65%, about in the middle of that range. And if the ABS, who are conducting the survey, were to conduct a statistically significant poll they would almost certainly (the probability theorists technical get out statement) say a clear majority support it. Game over. Surely?

But there are other factors coming into play here. Here is a table of the Newspoll results by age, probably the most significant determinant, outside political views, of whether they support, or not, SSM.

Support for SSM by Age18-3435-4950-6465+Overall
AEC enrolled population 4,271,2894,271,2904,271,2914,271,29217,085,162

To determine the ”overall” figure, and what I will refer to as the “voting population”, I am using the AEC’s own figures on people enrolled to vote, as of June 2017, which is the last line.

As has been noted support for SSM decreases with age. But the number of people in each age cohort is about the same. The overall figure for support of 62% is towards the bottom end of most surveys but let’s leave it at that.

The Newspoll also provide figures on whether people actually intend to return their surveys.

Intention to vote18-3435-4950-6465+Overall
Definitely will vote5864737668
Probably will1916111114
May or may not129889
Probably won't45323
Definitely won't35323

One obvious thing to note is that older people, who are also more likely to vote “No” are more likely to vote. That will skew the results towards the “No” case.

But polls two months out may not reflect the final vote as happened in the recent US and UK elections, and support for the “Yes” case may soften. And the “No” case is probably doing a lot more to ensure they get as high a turnout as possible. So, in my model, on a spreadsheet of course, I included some assumptions and variable inputs which are:

  1. I assume all people who say they definitely will vote is 100%.
  2. “Probably will vote” is an input
  3. “May or may not vote” is an input
  4. Probably won’t, definitely won’t and uncommitted is set at 0%
  5. Turnout for the “No vote”. Based on the polulation figures the turnout, overall should be about 83%. So one input is the turnout for “No vote” assuming they make more of an effort to get their supporters out to vote. The turnout for the “Yes” vote is then deducted from this number to match the overall turnout, 83%, by age group so higher turnout for “No” automatically leads to a lower turnout for “Yes”.
  6. For people who will claim that the “Yes” poll result is exaggerated and is actually lower, or will soften closer to the closing date I have included an adjustment term. So “-5” means I have reduced the polled support for “Yes” by 5% making it 57% rather than 62%.
  7. Splitting the “undecided” vote between “Yes” and “No”. “P” means I have allocated it proportionally to the level of support, but there is a parameter which splits it, say, 25% to “Yes” and therefore 75% to “No”.

So the results? Well here they are:

% "probably will vote" who do vote75%75%50%25%
% "may or may not" who vote50%50%32%0%
"No" vote turnoutP95%95%100%
undecided split to "Yes" votePP30%0%
adjust yes vote00-5-5
Vote Yes66%62%50%40%
Vote No34%38%50%60%
Support Yes67%67%59%57%
Support No33%33%41%43%
Overall turnout84%84%78%71%
Yes turnout83%78%67%50%
No turnout85%95%95%100%
Population Yes vote56%52%39%28%
Population No vote28%32%39%43%

There is good news, and bad news, depending on your viewpoint. My own view is a “Yes” vote is a good thing but if you feel otherwise feel free to substitute “Best” for “Worst” in the above table. So here are the 5 scenarios. Note that once you fix the “No vote” intention to vote at, say, 95%, you remove people who intend to vote “Yes” in order to keep the Newspoll and AEC derived figure of 83% intending to vote.

  1. BCS – Best Case Scenario. Based on the Newspoll numbers I have split the intention to vote and undecided vote equally among “Yes” and “No” voters. I have also assumed 75% of the “Probably will vote” and 50%” of the May or may not” voters will vote. The result is a clear win 66:34 for the “Yes case”. Also the overall number of people voting “Yes” is 56% of the voting eligible population so hard to argue this isn’t a decisive result.
  2. Expected – I am assuming that the people on the “No” case will be better at getting people out to vote than the “Yes” case, 95% of them. Here there is still a clear win for “Yes” at 62%. And overall that represents 52% of the population. A clear win for “Yes” on the vote and over 50% of the population vote “Yes” as well.
  3. RWSC – Reasonable Worst Case Scenario. This is a term that I (and the Mule) picked up in our early days at DB to describe a scenario which assumes negative (from my point of view) parameters that could nonetheless be possible. Here I am assuming only 50% of probably wills and 33% of may or may not’s vote. Because I have fixed the “No” voting rate at 95% this leads to less “Yes” votes” to keep the overall participation rate at 83%. Here the result is a line ball at 50:50. It could go either way. The population “Yes” vote is close to 40% so people might argue that less than 50% vote “Yes” and hence conservative MPs shouldn’t take the result as definitive.
  4. WCS – Worst case scenario. Only 25% of the maybe votes and none of the may or may nots vote and 100% of the “No” votes do. I’ve reduced the support for the “Yes” case by 5%. All undecideds get allocated to “No”. Despite the overall support being 57:43 in favour of “Yes” the actual vote goes 40:60 in favour of “No”. And the overall population vote is 43:28 in “No”s favour. Under these circumstances the PM has said the vote for SSM won’t come to parliament. Largely this is driven by the 100% turnout for “No” and only 50% turnout for “Yes” as well as softening of support for “Yes” and undecideds voting “No”. This is the result the “No” campaign will be, literally in some cases, praying for as it will be difficult for the Opposition and proponents of SSM to argue the issue hasn’t been settled for the time being.

My own guess? It will be 55:45 in favour of “Yes” with overall support at 65:35. That will be enough for the anti SSM lobby to say support was never as high as the “Yes” camp claimed. But a win is a win and only the most devout glitter sellers won’t be running out of stock by Xmas.

Extra: How do I think the ABS should actually conduct this poll? Not by post for a start. There are 150 electorates and one of the arguments against using results from 1,400 people is that it barely samples many of those, less than 10 people is some cases. In actual fact the mathematical 95% margin of error for sampling N people is (approximately) 1/sqrt(N) or for N=1400, 2.67%. So the overall sample size is sufficient if the result is 60:40. But to give everyone the feeling their voice and their neighbour’s voice is being heard how about sampling 150,000 people? That is 800 people in Australia’s smallest electorate, Kalgoorlie. The MoE by individual electorates would be better than +-3.5% and over the whole Australian voting population 0.25%. And it would only cost $10m. It might even become a regular thing.

May day was in June

The father of the Mule is currently in  the UK and penned the following piece as he reflected on the outcome of the election. With the speed of the election cycle, the election results may already seem a distant memory, but any tardiness in publishing this post is entirely due to a slow editor (me) rather than late filing!

The only word to describe Theresa May’s unnecessary recent decision to call an early election in Britain is “hubris” and that hubris has now led to irremediable humiliation. “Strong and stable” could have described her political position before the election, but as a campaign slogan, delivered with numbingly motoric repetition, it became risible as “Jobson Growth” had been in Australia last year.

Beyond May’s trouncing, the election has also invalidated many British political verities: “Young people don’t turn out to vote” is, probably, the most significant of them and this is a healthy reminder that the future is theirs not (as with the referendum in 2016) that of the frightened older generation. Politics is more than the “reality” of hard-headed professionals; it is about hopes and dreams. Young people rightly have those; we oldsters have largely lost them. Ironically Jeremy Corbyn revealed a striking ability to combine the use of modern social media with old-fashioned mass rallies to persuade the young, especially women, to listen and to support them in their yearning for a better future. As a result, the overall voting turn-out (69%) was the highest since 1997 and exit-polls indicated that the increase was 12% amongst the under-35s. A post-election poll of over 50,000 people showed that the age cross-over in voting preferences occurs at 47, with increasing Labour support below that, reaching over 60% in those younger than 30.

Another challenge to conventional wisdom is that it is now accepted that threats to “law-and order” such as the recent terror attacks, no longer seem to favour right-wing parties. There may be a resonance in this for Australia.

For those of us who love data, consider the vote in Corbyn’s own constituency of Islington North: he won in 2015 with a 60.24% of the vote and a majority of 21,194; this year his vote was 72.98% and the majority 33,215. By contrast, consider Canterbury, amidst a sea of Conservative blue in the south-east, where a Tory ascendancy of more than 150 years has been turned from a 9,798 win in 2015 to a Labour majority of 187 (in a swing of 9.33%). Significantly, it is a university city.

The house next to where I am staying in London, displayed a “Vote Labour” poster, and vote Labour the constituency did, with a 30,509 majority for the member Keir Starmer, the former DPP and human rights lawyer. In fact, London (with 49 Labour seats, a gain of 4, to the Conservatives’ 21, a loss of 5), remains an astonishing Labour stronghold.

The overall national vote for Labour was 39.98%, very close to the 41% of the 2001 “landslide” for Tony Blair. This secured them 261 seats (a gain of 31 seats) compared to 318 to the Conservatives (with 42.45% of the vote and a loss of 12 seats).

But the traumas were for more than for the Conservatives alone. North of the River Tweed the Scottish National party has been reduced to 35 seats (a fall from 50% support in 2015 to 35% this time, at a cost of 19 seats). Another independence referendum there now looks pretty unlikely. The other loser – unsurprising, perhaps, because the 2016 “Brexit” rather pricked its balloon, leaving it “a rebel without a cause” – was UKIP (the “UK Independence Party”) which fell, overall, from about 13% to less than 2% of the vote, leading to the immediate resignation of Paul Nuttall, its third leader in a year after Nigel Farrage’s retirement; Nuttall finished an ignominious third (with only 3,300 votes) in the constituency which he contested.

So where does this leave the hapless Theresa May? And, more important, where does it leave Britain – without a plausible government and the Brexit negotiations looming within days? She has been looking weak and opportunistic in seeking a “deal” of sorts with the members of the so-called Democratic Unionist Party from Ulster (one of whom is the son of the Rev Ian Paisley), “our friends” as some shameless Tories have been calling them. She will find them uncomfortable allies, with special interests as well as regional and sectarian concerns. When a former Conservative PM strongly criticises this deal, as John Major did on radio a few days after the election, the political right looks as fractured as Britain, itself.

Yet, oblivious to all of that, May returned from an interview with the Queen on Friday 9 June and made a speech saying, “The government I lead will put fairness and opportunity at the heart of everything we do”, as if the Corbyn ethos and campaign hadn’t existed, and all of that would happen “over the next five years”. She appears to be the only person in the country who thinks that she can last even 5 months, let alone five years. Ever since the shock of election night, numerous members of her party have been trenchantly critical of her campaign and, no less importantly, of her performance as PM. Her two vilified senior advisers promptly resigned; it was as if, somehow, they were to blame because she listened to them so exclusively and ignored everyone else. Somehow the reality was forgotten that consequences flow from accepting advice: a politician (like everyone else) has the freedom to reject it. For example, I saw one former minister say that “Mrs May must now obviously consider her position after a dreadful campaign.” And a former Cabinet Secretary (Lord Turnbull) bluntly said that May “isn’t up to it……she doesn’t have the skill-set to be Prime Minister….and should resign”. May has prodigally thrown away her limited political capital, most likely having over-estimated it from the beginning.

Of course, the British political and historical perspective is limited. They seem to have a fierce aversion to coalition governments and hung parliaments (though te PM seems the one being hung this time) and fail to understand that such arrangements are the norm in many other successful (even “strong and stable”) societies. That word “hubris” comes to mind again. Meanwhile, as the political classes fret intensely, life for everyone else goes on: the fickle weather alternates between sunshine and bleakness, it’s still possible to do research in libraries and archives; there are still fine exhibitions to be visited. And there will be a record number of women in the Commons – more than 200. So there’s always a bright side in politics – we just need to look properly.

John Carmody

More on Brexit

After observing the Brexit poll at close quarters, guest Mule contributor John Carmody travelled on to Europe and continued to reflect on the significance of the vote. In this follow-up post he reflects on the historical journey of the European Union and his reasons for thinking that the Leave vote was a terrible mistake on the part of British voters.

I have also continued to reflect on the vote and have arrived at a similar conclusion for different reasons. I do have some sympathy for some of the political sovereignty arguments for Leave (although not those based on Farage and UKIP xenophobia), but I still think that Remain is the better option. The best analogy I have come up with is someone regretting the decision to get a large tattoo. While it may have been better never to have had the tattoo, removal can be painful and leave an ugly scar. In the same way, Britain does not have the option to wind back the clock and eradicate the last 40 years of history: it did join the Union and an exit will lead to a very different Britain. There is no way to transition to a counterfactual Britain that never joined back in 1973 and had developed its own trade agreements, human rights legislation, environmental legislation, funded all of its own infrastructure, scientific research, etc, etc. Exit will be painful and, even if joining in the first place was a mistake as some would argue, leaving will be worse.

But back to the guest post…and I would be interested in reactions to this post, so please post your thoughts in the comments.

As with beauty, the rights and wrongs of the British “Brexit” vote will lie in the eye (or the prejudices) of the beholder.  Certainly, innumerable words are still being deployed about it, though many of them (notably, but certainly not exclusively, in Britain) are rather self-interested or poorly informed.  I believe that the Anglophone world, in general (including in Australia), has a poor understanding of the structure and operations of the European Union and a fortiori of its genesis in the fraught history of Europe, since the Reformation.

It is in part a historical institution and in part a philosophical one. It has grown from the fraught history of European religious, territorial and mercantile wars as well as the growing sense, notably in the twentieth century, if the “idea” of Europe. As an island (even insular) nation which has not been successfully invaded since 1066, Britain has played only a sporadic often simply self-interested part in those developments. And Australia, influenced so powerfully by Britain (as, indeed, it still is) shares much of that ignorance of European history and thought.

Experience commonly determines understanding.  As time passes and people forget or, without that lived experience of adversity, become complacent (especially, in this specific case, about Europe’s peace since 1945): it is the serious responsibility of politicians, as well as teachers and journalists, to impart this knowledge.  Even writers in the International New York Times, who ought to understand a federation, use such demeaning words as “bloc” or “imperfect union”—as if the USA is any different in its fallibility.  Of course, the EU is “imperfect”: it is (like every human institution) “a work in progress”; but commentators need to acknowledge that it has made astonishing progress.  Of course, for a diversity of reason (not the least of which is language) it is not as mature a federation as those of the US and Australia, but in fields as diverse as health and the environment, education and agriculture, for example, it has transformed Europe.  There is, for all its limitations, a far greater sense of a European identity than when I first went there 40 years ago.

Regrettably, for years, journalists and politicians—in particular those in Britain (and hence in Australia, because our journalists are essentially compacts)—have failed in their responsibility to inform, rather than manipulate, their constituencies.  In fact, it has often seemed that they were determined, for their own partisan interests, to misinform and profit from prejudice — especially in that recent “Brexit” campaign.   Australians are all too familiar with some of this behaviour: we have seen many comparable instances when our politicians have engaged in what is called the “blame game” between the states and Canberra.  Thus, British politicians have blamed “Brussels” for decisions which were democratically made in the European Parliament, even when they were elected members of it and they actually voted for the contended measures.

All too frequently the talk is about some sort of opaque and unaccountable bureaucracy, whereas the truth is (as I have been advised by well-informed lawyers) that the administration exercised by the European Commission (as that civil service is called) is pretty lean, and smaller than pertains even in some of the larger cities in Europe.  Furthermore, is it overseen by two levels of representative oversight. Contrary to what many in Britain believe, or are told to believe, this Commission does not control Europe, any more than the public service in Whitehall “controls” the United Kingdom or the Canberra bureaucracy “controls” Australia.  That authority is exercised, jointly, by the Councils of Ministers and the European Parliament. Those several Councils are composed of the relevant Ministers from the legislatures of the constituent countries of the EU, all of whom are accountable to their home Parliaments and electorates.  The European Parliament is made up of directly elected members and is, therefore, no less democratic a body that the House of Commons (and it is decidedly more democratic and representative than the House of Lords).  Of course, as happened with Federation in Australia, when the uniting colonies ceded some powers to the Commonwealth but retained others, this sharing of power is undertaken for a greater good, but it has costs: it is certainly not a “loss of control” as Boris Johnson and his henchmen duplicitously asserted and (either through lack of ability or conviction) David Cameron failed to properly contradict.

That was not the only lie of the recent British referendum.  Another was the claim that a vote for “Brexit” would return to the National Health Service an amount of £350 million each week (the asserted, but seriously inflated, figure for the current British payment to the EU budget).  Almost as soon as the referendum results were declared, the “Leave” proponents were repudiating that promise.  A former Conservative Leader, Iain Duncan Smith, brazenly insisted that “I didn’t say that”, even when he was reminded that the posters and leaflets which his group issued had promised exactly that.  His revised promise became, instead, that the NHS would receive “the lion’s share” of whatever was left over after the essential compensation was paid to British farmers for the loss of their substantial subsidies from the EU.

Other falsehoods, though, continued to be promulgated after the referendum.  In a column in the Daily Telegraph, Johnson wrote that “there will continue to be free trade, and access to a single market.”  In other words, the insular British could continue to have their current cake and eat it too (Johnson once said that this was his “policy”).  It was a reiteration of the campaign propaganda—that it was possible, in effect, to remain a member while avoiding all of those inconvenient costs of membership, political and financial.  That is utter nonsense.  Either Britain is a member or it is not.  There is no possibility of being “a little bit pregnant”.  The situation of Norway was often mentioned.

But, I am advised that, as a non-member wishing to enjoy free-trade, Norway must pay about 90% of what its contributions would be if were actually a member.  Britain would have to pay something comparable if it wanted access to the European market and, given the stern attitudes which, understandably, are currently attributed to such leaders as Dr Merkel and M. Hollande, more attractive rates are highly unlikely.  The bitter result for Britain from Johnson’s interpretation of “free access” would be a comparable cost but with absolutely influence on EU laws and policies.

Some Independence Day for Nigel Farage and his “UKIP”!  Some “regaining control” for the Colonel Blimps and their powdered ladies of “Middle England”! And even worse prospects for the struggling under classes, especially in the north.  Wrongly, they feel neglected by Brussels (the reverse is actually the truth), but, for decades, Westminster has shown little regard for then.

Even if, to other than close observers, the outcome of the poll were unexpected (it had seemed highly likely to me), the heterogeneity of the results – age by age, region by region, class by class—were a harsh reminder of what a fractured county Britain currently is.  The “United” part of the name UK, is meaningless.  Scotland (68%), Northern Ireland (56%) and London (60%), for example, voted strongly to stay in the EU; much of the rest of England voted to leave (52-58%).

Various analyses have shown that education played an important role.  In regions where fewer than 22% of the population have a degree, 62% voted “Out”, but that vote was only 42% where more than 32% of residents have a degree.  The age disparities were even more stark.  Commercial polling, after the voting closed, showed that 73% of 18-24 year-olds support EU membership but only 40% of those over 65.  Those with a future have been trumped by those who may not live to see the promised “independent future”.  As a Cambridge colleague recently said to me, “We feel in free-fall”.  Many Europeans to whom I have spoken are just as perplexed.  Perhaps the real truth was recognised by an astute and experienced Italian journalist, Beppe Severgnini, who wrote, “One should understand that it wasn’t fear, or anger, that brought so many English to vote for Brexit on June 23.  It was nostalgia…….nostalgia for a self-sufficient, cosy Little England that is long gone.  But they don’t seem to realise that nothing, not even voting to leave the European Union, can bring it back.”

Of course, there were as many individual reasons as there were voters: but in some places there seemed an almost wilful determination – notwithstanding that the rage was probably directed at the wrong target – to inflict self-harm.  In some places which depend upon EU finances for their very lives (and certainly their jobs), it ironically became art transformed into life with the “What have the Romans ever done for us?” cry in The Life of Brian turned into “What has Europe ever done for us?”  When reality eventually strikes, it will certainly be harsh and those misled communities will feel the greatest pain and social upheaval.  Certainly, given the deep and serious rifts in her party—let alone British society at large—the task which faces the new Prime Minister designate, Theresa May is immense.

The voting figures indicate that there are clear political divisions as well.  On the day after the vote, the formidable Nicola Sturgeon was unequivocal.  As the First Minister in the Scottish Government, she pointed out how strong the “Remain” vote had been north of the Tweed.  A new referendum on independence for Scotland, she declared, is certainly “on the table”.  Indeed, without Scotland, Britain would shrink to “Little England”, with the serious risk of a crippling reduction in its importance as a financial centre, let alone its potential scientific losses.  Furthermore, whether the enduring sectarianism of Northern Island would prove an implacable impediment to some sort of union with the Irish Republic in the south has become a hot topic because, otherwise, their border would also become the British border with the EU and securing it would be an enormous challenge for both sides in every conceivable respect.

Much has been made of the concern that “Brexit” might encourage more breakaway movements.  While the focus has been on Madam Le Pen and her National Front in France, or the extreme Rightist party of Geert Wilders in Holland, concern will also be felt about the intentions of such nationalist groups as the Basques and the Catalans.  It is ironic that, as the world is supposed to becoming more integrated, notably as electronic communications and transport become ever faster and less expensive, smaller communities and political groups seem so alluring.  Currently, this is simply speculation, but to many people (not just politicians) it is troubling just the same.

Even so, the final card may not have been played in Britain.  The political and legal power of such a referendum as was recently held there are far from clear in that nation’s diffuse constitution.  A corollary of the contemporary rhetoric is that the people want the British Parliament to be supreme.  The logical consequence of that aspiration would be that the parliament must make the ultimate decision about whether to act on that slender 52%:48% margin (keeping in mind the principle that a greater majority—say of 66% or even 75%—ought to have been mandated before any radical action was triggered).  To deny the people their “choice” might seem politically foolhardy (or, even responsibly statesmanlike); but that it why so many nations have parliaments, rather than frequent national plebiscites.

Yet, legally speaking, the position it far more complicated.  It is certainly not a matter of the new British Prime Minister sending a letter to Brussels to trigger exit negotiations.  That action, under the terms of membership agreements, requires action by the appropriate law-making bodies in the member country in question: in Britain that it the parliament—it certainly is not the cabinet, let alone the individual PM.  So, this can hardly be done – in the legal way which Brussels would require, before Parliament returns from its scheduled summer recess, if only because the required legislation (especially if it is to specify the conditions of the negotiations with the EU in the requisite detail) will be difficult and time-consuming to write and debate.

For all that many are said to be calling for a speedy resolution, it simply cannot occur in a hurry.  Lady Macbeth’s wish that the deed should be done quickly might be appealing, but it is not practicable.  Patience is less often understood as the political virtue that is should be.  Like beauty and its appreciation, it is uneven in its distribution.  Sagacity, not seduction, is what is now required on all sides.