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Healthcare rationing could see ‘unlawful deaths' from COVID-19, researchers claim

Thu, 21/05/2020 - 11:49

While the initial coronavirus peak is starting to pass – in Europe, at least – without the ventilator shortages many feared, the spectre of a second wave or future outbreak means questions of medical rationing still hold sway.

New research suggests that current ICU protocols and ethical guidelines lack detail, and leave doctors exposed to legal liability if another contagion surge forces them to make painful snap decisions due to insufficient resources.

While the latest analysis focuses on ventilators, University of Cambridge researchers say that many of their arguments apply to other potential medical shortages e.g. a lack of properly staffed ICU beds, dialysis machines or related supplies or equipment.

If shortages lead to denial of treatment based on disability – including ‘chronic illness’ – or age, or treatment withdrawal during sedation, it could violate patient rights and cause unlawful death, argue the Cambridge lawyers.   

They say that legal liability could extend to the UK Government if it is required to defend failures to purchase more medical supplies or publish ICU rationing guidance, despite knowledge of risks to life posed by the pandemic.

The study, published in the Journal of Medical Ethics, is based on UK law, but researchers say it is relevant to other European nations.

“We’re definitely not out of the woods,” said Dr Kathy Liddell, Director of the Cambridge Centre for Law, Medicine and Life Sciences. “With lockdown easing, we might well see a second Covid-19 spike in intensive care units, and health services should be prepared legally as well as medically.”

“The law requires more of hospitals, doctors and clinical commissioning groups than is currently set out in the guidelines provided by the British Medical Association, the Intensive Care Society and medical ethicists.”

“The legal rights of patients matter, and they are not being given the attention they deserve,” she said.

Around 2.5% of Covid-19 patients require mechanical ventilation to live while they fight the virus, and a patient can need assisted breathing for up to three weeks.

Early concerns that the virus would see patient demand overwhelm ventilator supply prompted researchers to investigate the legal limits of ventilator allocation.

They found “little concrete guidance” centrally in the UK, and argue that a shortage could see “postcode lotteries” of patient rights to life saving treatment – as decisions are taken at a local level by hospitals and doctors.

“The guidelines we reviewed differed in many ways,” said co-author Dr Jeff Skopek, from Cambridge’s Faculty of Law. “But they generally had the same goal:  save as many lives as possible. While this is of course a worthy goal, it can lead to the violation of patients’ rights – rights are not suspended merely because we are in a crisis.”

The researchers argue that a ventilator cannot be denied on the grounds that a patient has a disability. “Denying treatment because of a disability, which includes chronic illness, violates the Equalities Act 2010. Denying treatment based on age may also do so,” said Liddell.

“In fact, the Equalities Act requires efforts be taken not to disadvantage disabled people. This may mean giving people with disabilities longer assessment periods on ventilation, or actually not de-prioritising them,” she said.

The analysis points out that if an initial trial of treatment is proposed, it must not be too short. No one should be taken off a ventilator for reallocation purposes until the trial has been long enough to generate reliable evidence for predicting the patient’s outcome.

Any decision to withhold or remove ventilation must involve consultation with the patient or their family. Moreover, withdrawing a ventilator without bringing the patient out of sedation risks unlawful killing.

“Even though returning to consciousness would be deeply distressing, all patients must be given a chance to breathe independently if they have a meaningful chance of surviving until another ventilator is available,” said Liddell.

If some of these scenarios occur during another virus spike, the researchers say doctors could be directly liable under criminal law for charges such as gross negligence manslaughter, criminal battery or willful neglect.

Even the UK Government could be held responsible. As Skopek highlights, the decision taken by government in April 2020 not to provide a national policy on handling ICU shortages – despite recommendations from its Moral and Ethical Advisory group – could result in a violation of its obligations under Article 8 of the European Convention on Human Rights.

“Without a national policy, the task of drawing up ICU rationing guidelines was left to individual CCGs and hospitals, and many lacked support to ensure their guidelines were legal and ethically sound,” he said.  

Added Skopek: “If we end up with another surge in patients that overwhelms our critical care infrastructure, hospitals and doctors may end up acting unlawfully – and worse, patients may end up dying unlawfully.”

Current medical guidelines risk unlawful deaths of patients – with doctors, hospitals, and even the government potentially liable – if a second peak forces hard choices due to shortages of ventilators and other critical care resources.     

Hospitals and doctors may end up acting unlawfully – and worse, patients may end up dying unlawfullyJeff SkopekPublic Health Image LibraryHealthcare workers checking each other’s personal protective equipment


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Surging numbers of first-generation learners at risk of being left behind in education systems worldwide

Thu, 21/05/2020 - 10:24

Research by academics at the Faculty of Education, University of Cambridge, Addis Ababa University and the Ethiopian Policy Studies Institute, examined the progress of thousands of students in Ethiopia, including a large number of ‘first-generation learners’: children whose parents never went to school.

The numbers of such pupils have soared in many low and middle-income countries in recent decades, as access to education has widened. Primary school enrolment in Ethiopia, for example, has more than doubled since 2000, thanks to a wave of government education investment and reforms.

But the new study found that first-generation learners are much more likely to underperform in Maths and English, and that many struggle to progress through the school system.

The findings, published in the Oxford Review of Education, suggest that systems like Ethiopia’s – which a generation ago catered mainly to the children of an elite minority – urgently need to adapt to prioritise the needs of first-generation learners, who often face greater disadvantages than their contemporaries.

Professor Pauline Rose, Director of the Research for Equitable Access and Learning (REAL) Centre in the Faculty of Education, and one of the paper’s authors, said: “The experience of first-generation learners has largely gone under the radar. We know that high levels of parental education often benefit children, but we have considered far less how its absence is a disadvantage.”

“Children from these backgrounds may, for example, have grown up without reading materials at home. Our research indicates that being a first-generation learner puts you at a disadvantage over and above being poor. New strategies are needed to prioritise these students if we really want to promote quality education for all.”

The study used data from Young Lives, an international project studying childhood poverty, to assess whether there was a measurable relationship between being a first-generation learner and children’s learning outcomes.

In particular, they drew on two data sets: One, from 2012/13, covered the progress of more than 13,700 Grade 4 and 5 students in various Ethiopian regions; the other, from 2016/17, covered roughly the same number and mix at Grades 7 and 8. They also drew on a sub-set of those who participated in both surveys, comprising around 3,000 students in total.

Around 12% of the entire dataset that includes those in school were first-generation learners. The researchers found that first-generation learners often come from more disadvantaged backgrounds than other pupils: for example, they are more likely to live further from school, come from poorer families, or lack access to a home computer. Regardless of their wider circumstances, however, first-generation learners were also consistently more likely to underperform at school.

For example: the research compiled the start-of-year test scores of students in Grades 7 and 8. These were standardised (or ‘scaled’) so that 500 represented a mean test score. Using this measure, the average test score of first-generation learners in Maths was 470, compared with 504 for non-first-generation pupils. In English, first-generation learners averaged 451, compared with 507 for their non-first-generation peers.

The attainment gap between first-generation learners and their peers was also shown to widen over time: first-generation learners from the Grade 4/5 cohort in the study, for example, were further behind their peers by the end of Grade 4 than when they began.

The authors argue that a widespread failure to consider the disadvantages faced by first-generation learners may, in part, explain why many low and middle-income countries are experiencing a so-called ‘learning crisis’ in which attainment in literacy and numeracy remains poor, despite widening access to education.

While this is often blamed on issues such as large class sizes or poor-quality teaching, the researchers say that it may have more to do with a surge of disadvantaged children into systems that, until recently, did not have to teach as many pupils from these backgrounds.

They suggest that many teachers may need extra training to help these pupils, who are often less well-prepared for school than those from more educated (and often wealthier) families. Curricula, assessment systems and attainment strategies may also need to be adapted to account for the fact that, in many parts of the world, the mix of students at primary school is now far more diverse than a generation ago.

Professor Tassew Woldehanna, President of Addis Ababa University and one of the paper’s authors, said: “It is already widely acknowledged that when children around the world start to go back to school after the COVID-19 lockdowns, many of those from less-advantaged backgrounds will almost certainly have fallen further behind in their education compared with their peers. This data suggests that in low and middle-income countries, first-generation learners should be the target of urgent attention, given the disadvantages they already face.”

“It is likely that, at the very least, a similar situation to the one we have seen in Ethiopia exists in other sub-Saharan African countries, where many of today’s parents and caregivers similarly never went to school,” Rose added.

“These findings show that schooling in its current form is not helping these children to catch up: if anything, it’s making things slightly worse. There are ways to structure education differently, so that all children learn at an appropriate pace. But we start by accepting that as access to education widens, it is inevitable that some children will need more attention than others. That may not be due to a lack of quality in the system, but because their parents never had the same opportunities.”

‘First-generation learners’ – a substantial number of pupils around the world who represent the first generation in their families to receive an education – are also significantly more likely to leave school without basic literacy or numeracy skills, a study suggests.

Our research indicates that being a first-generation learner puts you at a disadvantage over and above being poorPauline RoseUNICEFA classroom in Ethiopia


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Opinion: Employers should cut hours not people during the pandemic

Wed, 13/05/2020 - 09:25

Millions of UK lives have been changed significantly in the last few weeks, even those who have not been infected by the virus. Three of the most widespread changes for many working age adults have been:

1. The loss of a job or a large reduction in working hours
2. A shift in the place of work from the employer’s premises to homeworking
3. Living in social isolation alone or with other members of one’s household (adults and children) who are also spending more time at home. 

We know from past research that any one of these can have negative mental health consequences, but the combined effects of these changes is unprecedented and unexplored. There are already media reports of the strain that this is putting on individuals and families. It is likely that many of these problems will be exacerbated over the coming months. 

Deteriorating levels of mental health in the population will not just cause individual misery - for instance through increased symptoms of anxiety and depression - but the research to date on unemployment suggests that this will likely lead to knock on effects on the family, particularly a spouse. It may also lead to increased breaches of social distancing rules or civil unrest.

The Chancellor’s plans to save jobs through the furlough scheme are largely aimed at the financial fallout of the pandemic: the desire to avoid widespread hunger, destitution and financial insecurity, while also recognising the importance to society’s overall wellbeing of the ability for businesses to recover quickly.

Why employment matters beyond income

As social scientists have found repeatedly, in different countries and different demographic groups, the loss of the wage only explains a small fraction of the very large mental health deficit associated with unemployment and economic inactivity.  

We now know that the ‘incidental’ aspects of having a job – e.g. time structure, social contact, shared goals, sense of achievement, enforced activity – are hugely important for our wellbeing. In our new short video, Lil Woods, a freelance arts charity worker, discusses how the lockdown has left her missing a sense of purpose: “When my work disappeared, I felt like part of my identity, my place in the world, went with it.”

It has proven almost impossible to find substitutes for jobs that fulfil the same functions: leisure activities, voluntary work or workfare just don’t provide us with the same levels of wellbeing through feeling valued.  While some post-work utopians dream of a world where work is largely eliminated, there is little evidence that it could exist as a reality. In fact, recent ONS data shows work has become a coping mechanism in this crisis.

So, it seems, we have an impossible situation – for most people good mental health requires a job, but there simply aren’t enough jobs in the right sectors or with the right skill sets to go around, and this situation is likely to last for many more months of the current pandemic.

A possible solution: short-time working

Fortunately there’s a solution to this paradox, and one that’s being taken seriously in other countries: short-time working. The hastily-introduced measures to protect jobs in the UK encourage employers to retain some or all staff where:

• there is essential work to be done, for example health and emergency workers
• the work can be done at home, as with many office workers
• the work can be done while maintaining safe distancing, such as some agricultural jobs.

Other employees and self-employed workers will be stopped from working, and either be paid to stay at home or lose their wage too. How does it work? Other European countries, such as Germany and Austria, have traditionally used short-time work programmes to deal with economic crises. Employers can reduce the hours of employees, typically with some compensation from public funds to mitigate some of the loss of hours. This has several benefits over the all-or-nothing job shedding being used in the UK. 

• Employees retain their attachment to an employer and have more certainty over their future.  
• It is easier for employers to vary their volume and type of labour power as the pandemic peaks and then we start an exit strategy.  
• Employees can be redeployed depending on their skills, adaptability of the job to homeworking or safe-distancing, or the pre-existing health conditions of the employee.

Recent research by economists from the universities of Cambridge, Oxford and Zurich suggest that, by early April 2020, 15% of people in the UK had lost their jobs due to the coronavirus outbreak compared to only 5% in Germany. 

Turning back to the psychological functions of paid work, just how much employment is needed each week to preserve the mental health of employees, and at what point does their wellbeing drop to be closer to those who are unemployed? 

Could it work in the UK?

The surprising finding from our research using UK and EU datasets is that increasing individuals’ hours of work from zero to just eight hours a week provides a large boost to their mental health, and there is little or no further psychological benefit as weekly hours are increased from eight to 40. The lesson for government strategy is clear: where possible (and with population health being the priority) keep everyone in paid work; even one day a week will keep more of us sane in these volatile times.

The Employment Dosage research team is led by Dr Brendan Burchell from the Department of Sociology, with co-investigators Dr Daiga Kamerade, Dr Adam Coutts, Dr Ursula Balderson and Dr Senhu Wang.  
 

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If the UK emulated short-time working programmes in countries like Germany it would help mitigate the mental health as well as economic crises caused by the coronavirus, argue researchers from the Employment Dosage project.    

When my work disappeared, I felt like part of my identity, my place in the world, went with itLil Woods Tim DennellSheffield's Women of Steel statue during the pandemic


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Opinion: Coronavirus has intensified the UK’s digital divide

Wed, 06/05/2020 - 12:54
Shorthand Story: hnQ1mOP230Shorthand Story Head: Coronavirus has intensified the UK’s digital divide " + "ipt>"); } })(navigator, 'userAgent', 'appVersion', 'script', document); //--> Shorthand Story Body:  TwitterFacebook "Pay the wi-fi or feed the children": Coronavirus has intensified the UK’s digital divide The coronavirus lockdown risks turning the problem of digital exclusion into a catastrophe of lost education and opportunity for the UK’s poorest and most vulnerable, write researchers Hannah Holmes and Dr Gemma Burgess. 

For the past four years, the Cambridge Centre for Housing and Planning Research (CCHPR) at the University of Cambridge has been researching digital exclusion. While it is a well-known fact that many elderly people are not online, the Centre’s research highlights that digital exclusion is not just a generational issue.

Digital exclusion is another facet of the deep inequalities which run through the social fabric of the UK, and is more widespread than many people are aware of. One thing is clear: the public health crisis currently gripping the UK stands to make the impacts of digital exclusion worse for the millions of people affected, and the poorest will be hit the hardest.

Since the onset of social distancing in the UK, some semblance of normality – or at least of productivity – has been possible to maintain only because of the networks of digital technologies and platforms already in place. Lockdown has certainly served to highlight our reliance on virtual means of staying in touch. Critically, it has also thrown into sharp definition the issue of digital exclusion, which has been a reality for the 22% of the UK’s population who lack basic digital skills since long before the Covid-19 outbreak.

As an aspect of deprivation in the UK, digital exclusion cannot be overlooked. The likelihood of having access to the internet from home increases along with income, such that only 51% of households earning between £6000-10,000 had home internet access compared with 99% of households with an income of over £40,001. The link between poverty and digital exclusion is clear: if you are poor, you have less chance of being online.

Children living in poverty are already significantly disadvantaged compared to their wealthier peers. Of those who have been eligible for free school meals, or who have been in care or adopted from care, only 25% achieved grades 9-5 in GCSE English and Maths in 2019, compared with 50% of all other pupils.

Now that many disadvantaged children are tasked with picking up all of their learning from home as part of coronavirus social distancing measures, and are unable to access the same online learning resources as children whose parents have access to IT, this gap is surely only set to grow further.

We spoke to five primary school head teachers working in Manchester recently, who shared their experiences of childhood digital exclusion. Several reported that only a handful of children are engaging in the online learning set by their teachers in recent weeks. For some households, wi-fi is just too expensive, as one head teacher explained.

“I was talking to one family on Friday, when I was delivering free meals, and I did take them a paper pack of work, because Mum said it was pay the wi-fi or feed the children this month… Sometimes people simply can’t afford to pay for wi-fi,” he said.

Lack of access to suitable devices is also causing problems for some children.

“The majority of children in school aren’t accessing any of the online learning that we’ve set them. I know that some of them don’t have reliable internet. Most of them who have anything have phones or tablets. They’re often shared with siblings, so their access to something appropriate to work on is quite limited,” said another head teacher.

And even where internet access is available, some parents don’t have the necessary skills to help their children use the most appropriate learning platforms. These children may have to resort to using simple websites which they can access without help. As one head teacher said, some children whose parents aren’t able to use interactive platforms have to access their tasks from the school website instead. These children miss out on valuable learning opportunities.

“We’ve already had children on the interactive platforms just clarifying things with their teachers about their learning, asking them quick questions, so that they can have feedback from their teachers. So the children that can’t access that are going to have a bigger gap in their learning, because they’re not going to have had the opportunity to interact with their teacher.”

Providing children with paper-based alternatives is itself fraught with difficulty in the current circumstances. And while digital exclusion is always prevalent, the closures mean that some measures that schools usually take to compensate for lack of internet access at home are no longer feasible. Disadvantaged children are losing out on their already limited chances to make up lost ground.

“If you can’t get on the online platform, you’re stuck with some sort of paper pack,” said another head teacher. “And now the rules are you’re not allowed out of the house other than for essential journeys, and I’m not entirely sure that coming to a school to pick up a pack of work is an essential journey... So they’re just basically cut off really, other than the fact we have made either physical or phone contact with them, but that’s all”.

“Ordinarily, digital exclusion is not an issue here, because everything we set during normal school working we would run homework clubs for... So everything we do when school’s running normally, the kids can usually do in after school clubs, so that everyone can do their homework.”

For now, there are measures which can be taken to mitigate the impact of digital exclusion on children’s learning. For instance, schools can keep in touch with digitally excluded families via phone calls or text messages to ensure they don’t miss important updates. A vast array of educational resources and ideas for home learning have been made available online in recent weeks, many of which are listed on the gov.uk website. Collating those ideas into a short printed guidance sheet to be posted to those families known to be struggling to access online resources may help to fill the gap.

“They’re not on internet banking at all. If their building society decides to close for the coronavirus, they’ll have no money."

Given that digital exclusion is ultimately a feature of poverty, many affected families will be facing financial strain. There have recently been calls to increase child benefit to help families through the crisis. Such an increase may help to ease pressures on many families, who could be facing difficulty paying for their children’s digital access.

In the long term, strategies to close the digital divide, both through widening access and improving digital skills, will be required in order to build a more equitable society. Right now, measures taken in response to coronavirus are disrupting schemes which attempt to reduce digital exclusion, as people are unable to meet digital skills tutors for guidance, and cannot join courses in person to learn essential skills.

For adults facing digital exclusion, the challenges of social distancing are many. Our research with New Horizons, a one-to-one coaching programme for people experiencing financial issues in the East of England, reveals that digital exclusion creates additional problems for people already experiencing poverty: putting together a CV, applying for jobs, managing and keeping track of money, and applying for Universal Credit are just some of the essential activities made that much harder for the digitally excluded. As one New Horizons coach explained, in the context of coronavirus, the tasks that were once difficult for the digitally excluded are now closer to impossible.

“Some of my clients are so digitally excluded it’s unbelievable,” he said. “In one couple that I work with, one of them has mobility issues so physically can’t use a keyboard, there’s no wi-fi, the 4G is weak.

“They’re not on internet banking at all. If their building society decides to close for the coronavirus, they’ll have no money. They’d have to get a bus to central Cambridge, and she can’t leave him that long because of his disabilities.

“And this isn’t new. Digital exclusion was a problem before coronavirus, but this is compounding it.”

Even where a person has access to IT equipment at home, along with the necessary skills to use it, financial concerns can be prohibitive. As another New Horizons coach explained, for many digitally excluded adults, public libraries offer the opportunity to get online without placing additional strain on already stretched finances.

The public library in Bourne, Lincolnshire. Credit: Rex Needle.

The public library in Bourne, Lincolnshire. Credit: Rex Needle.

Libraries are, of course, closed until further notice, with many offering reassurances that resources are still available to their users online. But such online provision is of no use to those digitally excluded adults that depend on access to library facilities for their already limited online activities. For these people, it will be impossible to check emails, to order groceries, to apply for jobs, or even to access essential health guidance and benefits information online until the facilities reopen.

Digital exclusion is yet another manifestation of the profound inequality which casts its shadow over the UK. For the people on the wrong side of the digital divide, the disadvantages associated with being unable to access or use IT have never been more pronounced. The pandemic has already changed the way we interact: it looks set to have a lasting effect on the way we communicate. Unless digital exclusion is taken seriously and addressed, millions of the poorest people in the UK will yet again suffer the consequences.

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The coronavirus lockdown risks turning the problem of digital exclusion into a catastrophe of lost education and opportunity for the UK’s poorest and most vulnerable, write researchers Hannah Holmes and Dr Gemma Burgess.

Image: Affiliation (schools and institutions): Centre for Housing and Planning ResearchSchool of the Humanities and Social SciencesPeople (our academics and staff): Hannah HolmesGemma BurgessSubject (including Spotlight on ... where applicable): COVID-19Digital societyinequalitySection: ResearchNews type: News

Green COVID-19 recovery packages can boost economic growth and tackle climate change, researchers say

Tue, 05/05/2020 - 09:59

An analysis of possible COVID-19 economic recovery packages shows the potential for strong alignment between the economy and the environment. The direction of these measures over the next six months will largely determine whether the worst impacts of global warming can be avoided, and research published today reveals that climate-friendly policies can deliver a better result for the economy – and the environment.

Drawing on a global survey of senior central bank and finance ministry officials, as well as learnings from the 2008 financial crisis, economists found that green projects create more jobs, deliver higher short-term returns per dollar spent and lead to increased long-term cost savings, by comparison with traditional fiscal stimulus.

“The COVID-19-initiated emissions reduction could be short-lived,” said lead author Cameron Hepburn from the University of Oxford. “But this report shows we can choose to build back better, keeping many of the recent improvements we’ve seen in cleaner air, returning nature and reduced greenhouse gas emissions.”

“The markets are not unduly worried about UK public debt and neither should we be,” said co-author Dimitri Zenghelis, Special Advisor to the Wealth Economy Project, Bennett Institute, University of Cambridge. “The key is that new borrowing is invested wisely to generate productivity-enhancing innovation, resilient output and a sustainable expansion of capacity. We cannot go back to the old model of business as usual, instead we should confront the economic threat posed by ‘fear’ through investment in building back better.”

A team of internationally-recognised experts came together to assess the economic and climate impact of taking a green route out of the crisis. They catalogued more than 700 stimulus policies into 25 broad groups, and conducted a global survey of 231 experts from 53 countries, including from finance ministries and central banks.

Noting that ‘green’ policies could be widely defined, the study focused on the reduction of greenhouse gas emissions as the key environmentally-beneficial criteria. The paper, to be published in the Oxford Review of Economic Policy, observes that desirable policies have a large return on investment, can be enacted quickly and have a strongly positive impact on climate. Examples include investment in renewable energy production, such as wind or solar. As previous research has shown, in the short term, clean energy infrastructure construction is particularly labour intensive, creating twice as many jobs per dollar as fossil fuel investments, as well as being less susceptible to off-shoring.

Other desirable policies included building efficiency retrofit spending, clean research and development spending, natural capital investment for ecosystem resilience and regeneration, and investment in education and training to address immediate unemployment from COVID-19 alongside unemployment from decarbonisation. For developing countries, rural support scheme spending, such as on sustainable agriculture, was also highly ranked. Meanwhile, non-conditional airline bailouts performed the most poorly on both economic impact and climate metrics.

Most G20 governments have implemented significant relief measures as a result of the pandemic. But, as yet, none has introduced any significant fiscal recovery measures. The study authors hope that countries will seize this generational opportunity to take account of these criteria into national plans – for their economies and the environment.

In addition, the COP26 Universities Network has drawn on this research and other analyses to create a briefing for policymakers outlining a path to net-zero emissions economic recovery from COVID-19. The network, a growing group of more than 30 UK-based universities, including the University of Cambridge, was formed to help deliver climate change outcomes at the UN Climate Summit in Glasgow and beyond.

They have put together a briefing that identifies nine fiscal recovery policies that promise to bring both short-term high economic impact and long-term structural change to ensure the UK meets its 2050 climate goals.

“Shaping the national and global recovery from the coronavirus pandemic in a way that supports the response to climate change and other environmental threats simply makes sense – not only does analysis suggest that green recovery packages deliver greater economic benefit, but investing appropriately in research, innovation, infrastructure and skills training, and matching that with robust institutional structures, will help create a fairer, more resilient, sustainable world with benefits for all,” said Dr Emily Shuckburgh, Director of Cambridge Zero. “As ever, good can be extracted from even the darkest hour, but it requires clear thinking, imagination and bold leadership.”

Among the policies emphasised are: renewable energy, reducing industrial emissions through carbon capture and storage, investment in broadband internet to increase coverage, electric vehicles and nature-based solutions. The group further called for the Cabinet Committee on Climate Change to be renamed the Climate Change Emergency Committee to reflect the urgent need for action.

“Currently, the UK directs €10.5bn in subsidies to fossil fuels. Reallocating this capital to jobs-rich renewable energy projects would be a win-win for the economy and environment,” said Brian O’Callaghan, economist at the Institute for New Economic Thinking, University of Oxford. 

The briefing highlights the leadership role of the UK in the leadup to COP26, as well as the opportunity to lead by example with a green recovery package. But the universities warned that the specific designs of any policy would ultimately determine its effectiveness.

References: 
Hepburn, C., O’Callaghan, B., Stern, N., Stiglitz, J., and Zenghelis, D. 2020. “Will COVID-19 fiscal recovery packages accelerate or retard progress on climate change? (PDF)” Oxford Review of Economic Policy, 36(S1), forthcoming.
Allan, J., Donovan, C., Ekins, P., Gambhir, A., Hepburn, C., Reay, D., Robins, N., Shuckburgh E., and Zenghelis, D. (2020). A net-zero emissions economic recovery from COVID-19. COP26 Universities Network Briefing.

Adapted from a University of Oxford press release.

 

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Researchers find long-term, climate-friendly stimulus policies are often superior in overall economic impact – not just in slowing global warming.

As ever, good can be extracted from even the darkest hour, but it requires clear thinking, imagination and bold leadership.Emily ShuckburghPhoto by Andrew Roberts on UnsplashElectric car charging in Birmingham city centre


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Bolsonaro’s attitude to coronavirus increases ‘risky behaviour’ in Brazil

Tue, 05/05/2020 - 09:44

Jair Bolsonaro’s public undermining of pandemic prevention efforts reduces social distancing in the parts of Brazil where his voter base is strongest, according to a new study using location data from over 60 million phones.

Economists used electoral data and anonymised geo-location from devices across Brazil to investigate whether the president’s outspoken anti-quarantine attitude influenced numbers of citizens staying at home to stop coronavirus spread.

Researchers from the University of Cambridge and Sao Paolo School of Economics-FGV found that municipalities which came out strongly for Bolsonaro in the last election have seen much higher levels of movement and travel among the population during February and March.

Additionally, in the days immediately after Bolsonaro’s televised dismissals of COVID-19 mitigation – e.g. publicly defying quarantine guidance or calling for schools to reopen – Brazil’s social distancing fell in general, and fell much more sharply in pro-Bolsonaro areas.           

“Our research suggests that statements on public health behaviour from political leaders are taken seriously by their followers, regardless of how scientifically accurate they are, or how damaging they might be,” said Dr Tiago Cavalcanti, study author from Cambridge’s Faculty of Economics.

“Bolsonaro actively challenges the regulations imposed by sub-national governments to stem the coronavirus tide. He dismisses WHO recommendations and even those of his own minister of health, who he has recently fired.”

“Using big data research, we see the president’s attitude play out at a population level. Brazil is a polarized nation with a populist leader. The patterns we see in Brazil could be echoed in nations with a similar political situation, such as the United States,” he said.

Cavalcanti and his colleagues Dr Nicholas Ajzenman and Dr Daniel Da Mata looked at the percentage of mobile phones that remained within a 450-metre radius of their home location between February 4 and April 7 2020.

They compared this “social distancing index” with the voting record of each of Brazil’s 5,570 municipalities, in particular whether Bolsanaro received more or less than 50% of the vote in the first round of the 2018 election.

Social distancing has gone up across Brazil since the contagion began. In the top 3% of cities with the highest Bolsonaro vote counts*, such as Ascurra in Santa Catarina and Nova Santa Rosa in Parana, this increase was an average of 24 percentage points.

However, in cities at the bottom of Bolsonaro’s support spectrum*, such as Paricoa in Alagoas and Irapuan Pinheiro in Ceara, social distancing was much higher: a 31 percentage point increase.

The study suggests that, on average during February and March, the cities where support for Bolsonaro is highest had levels of social distancing that were almost 30% lower than cities where Bolsonaro has very little support.

The economists also analysed two key televised appearances by Bolsonaro in March, during which he openly disparaged efforts to control the pandemic.

The first was on March 15, when Bolsonaro – who was suspected at the time of carrying COVID-19 – appeared at a supporters rally in Brazilia, flaunting public health guidelines by taking selfies and doling out fist bumps in the throng.

The second was on March 24. In an official presidential pronouncement he called for schools to reopen nationwide, and criticized Brazilian media for too much reporting on the pandemic in Italy, suggesting he would only get “a little flu” at worst from COVID-19.

The research shows how both these appearances caused social distancing levels to drop in the ten days after each event when compared to the ten days leading up them. The drop was particularly significant in municipalities with high numbers of Bolsonaro voters.

In fact, Cavalcanti suggests that, based on their data, a rough calculation for the effects of the March 24 appearance sees approximately one million additional Brazilians across the nation straying more than 450 metres from their home on each of the ten days following the televised speech. 

“Leadership matters,” said Cavalcanti. “The attitude of a leader can have a significant and possibly devastating impact on individual health and the healthcare systems of a nation.”

“When Bolsonaro minimises the pandemic, we see significant increases in what is now risky behaviour within large sections of the Brazilian population.”

“As coronavirus cases and fatalities continue to rise across Brazil, the behaviour of its leader may be having a very real and dangerous effect,” he said. 

The researchers also found that Bolsonaro’s televised appearances, and the press coverage that ensued, much of it negative, was linked to a more significant drop in social distancing in areas with “high media access”*.

The team calculated the overall change in Brazil’s social distancing during the period for which they have data. In early February, before the pandemic took hold, around 20% of the Brazilian population stayed within 450 metres of their house. By early April, this had increased to around 53%.   

The researchers worked with technology company In Loco to produce the phone data analysis, and the complete findings are published as a Cambridge-INET working paper here: http://covid.econ.cam.ac.uk/

Study suggests that TV appearances by Bolsonaro led to millions more Brazilians ignoring social distancing in the days following broadcast.

The attitude of a leader can have a significant and possibly devastating impact on individual health and the healthcare systems of a nationTiago CavalcantiJeso CarneiroJair Bolsonaro, President of Brazil


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Economic damage could be worse without lockdown and social distancing – study

Wed, 29/04/2020 - 09:21

There is much debate over the economic costs of our lockdown lives: whether the price of disease mitigation is worth the risk of an enduring financial crisis.

New research from the University of Cambridge suggests that there is no absolute trade-off between the economy and human health – and that the economic price of inaction could be twice as high as that of a “structured lockdown”.

A Cambridge economist, together with researchers at the US Federal Reserve Board, has combined macroeconomics with aspects of epidemiology to develop a model for the economic consequences of social distancing.

The study uses US economic and population data, but the researchers say their findings have implications for most developed economies.

It divides the working population into “core workers” – those in healthcare as well as food and transportation, sanitation and energy supply, among others – and then everyone else, and models the spread of the virus if no action is taken.

“Without public health restrictions, the random spread of the disease will inevitably hit sectors and industries that are essential for the economy to run,” said co-author Prof Giancarlo Corsetti, from Cambridge’s Faculty of Economics.

“Labour shortfalls among core workers in particular strip more value from the economy. As essential team members within this core sector drop out of the workforce, it impairs production far more than losing those in other areas of the economy.”

By separating the core and non-core workers, the study suggests that the economy would shrink by 30% or more without lockdown and social distancing. “By ignoring this division in the workforce, we may badly underestimate the true depth of economic damage,” Corsetti said.

Using data from the US Bureau of Labour Statistics, the researchers then quantified the share of workers who could “reasonably keep performing occupational tasks at home”: 15% of those in core sectors, and 40% of everyone else currently working – along with 30% of all non-working age people, from children to the retired. This puts a third of the entire population on lockdown.   

In this scenario, the infection curve is smoothed out through social distancing, and the rate of loss in economic output is around 15%, just half the level of damage if no action is taken to prevent disease spread.

Sickness rates for core workers would be the same as the rest of the population, the high levels of social distancing elsewhere act as a shield.  

“This overarching policy flattens the curve,” said Corsetti. “The peak of the infected share of the population drops from 40% to about 15%. However, this is still far too high given the capacities of healthcare systems.”

So the researchers also modelled a scenario where infection rates are kept to a manageable level for healthcare services of under 1.5% of the population for 18 months – the length of time many believe it will take for a vaccine to arrive. 

This would mean lockdown shares of 25% of core workers, 60% of workers outside of core, and 47% of non-working age people. Under this scenario, the economy contracts by 20%.

The study also looked at a very strict lockdown – 40% of core workers and 90% each of non-working age and everyone else – that lasts for just three months. Such a scenario simply delays the infection rates but prevents “herd immunity”, creating an economic drop comparable to that of taking no action in the first place.

“As well as containing the loss of life, committing to long-term social distancing structured to keep core workers active can significantly smooth the economic costs of the disease,” said Corsetti. 

“The more we can target lockdown policies toward sections of the population who are not active in the labour market, or who work outside of the core sector, the greater the benefit to the economy,” he said.

“What seems clear to us is that taking no action is unacceptable from public health perspective, and extremely risky from an economic perspective.” 

However, Corsetti and colleagues caution that the lingering uncertainties around just how the coronavirus spreads means their scenarios are not forecasts, but should be taken as a “blueprint” for further analysis.

The research is published as a Cambridge-INET working paper: https://www.inet.econ.cam.ac.uk/working-paper-pdfs/wp2017.pdf
 

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The worst thing for the economy would be not acting at all to prevent disease spread, followed by too short a lockdown, according to research based on US data.

Taking no action is unacceptable from public health perspective, and extremely risky from an economic perspectiveGiancarlo CorsettiWhite HouseA reporter takes a photo of Donald Trump during a White House coronavirus briefing in April


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UK and US firms ‘lag’ in race to commercialise COVID-19 diagnostic tests

Wed, 22/04/2020 - 11:47

Nations with high rates of coronavirus testing such as South Korea and Germany are also leading the world in commercialising COVID-19 diagnostic tests – far outstripping the domestic UK and US diagnostic industries, new research shows.

Researchers also argue that lax EU regulations for diagnostic devices could make the region a “dumping ground for poor quality tests”.

A team from the University of Cambridge’s Department of Sociology has produced what they say may be the most comprehensive global dataset of companies developing molecular diagnostic tests for COVID-19.

They found that 88% of South Korean firms working on COVID-19, and 80% of those in Germany, now have tests either on the market or ready to be rolled out. In the UK, just 54% of firms developing COVID-19 tests have a commercialised product. The US also lags behind at 67%.

China has 93 diagnostic firms working on COVID-19, the overall highest number, 90% of which have commercialised tests.

The latest analysis is available on a website set up by CancerScreen, a Cambridge research project funded by the European Research Council on the political economy of diagnostic innovation.

 “The COVID-19 testing strategies adopted by different countries are now under intense public scrutiny,” said Dr Stuart Hogarth, who leads the research.

“The UK and US have been criticised for failing to ramp up capacity compared to places such as Germany and South Korea. We can see this playing out in the global molecular diagnostics industry.”

Building on previous work, the CancerScreen team have trawled media coverage and drawn on lists of COVID-19 tests from organisations such as the Foundation for Innovative Diagnostics (FIND) and the UK National Institutes for Health Research (NIHR) Innovation Lab.

They now have 303 firms in their dataset of COVID-19 molecular diagnostics firms and their main database has increased to 830 firms.

The Asia Pacific region already dominated the global industry, with 40% of all molecular diagnostics manufacturers, compared to 29% in the US and 28% in Europe. In terms of the COVID-19 market, Asia Pacific is even more dominant, with 55% of all firms.

The region is also ahead when it comes to commercialising COVID-19 tests. In Asia Pacific 90% of firms have a test on the market, compared to 78% in Europe and 67% in the US.

“The lag is striking because it mirrors the spread of the pandemic, starting in Asia Pacific and then moving to Europe and North America,” said Hogarth. “It suggests that firms in the US and Europe could have responded more quickly when the pandemic began.”

He points out that some of the countries with an effective commercialisation response to COVID-19 diagnostic testing needs are those where there is a strong relationship between the state and manufacturing sector.

“A country like South Korea exemplifies a pattern of industrialisation in which the state directs economic development,” said Hogarth.

“Our data suggests that strong leadership by the national government plays a role in industry responsiveness, at least at the extremes of leaders and laggards,” he said.

There are also important distinctions between regions and nations when it comes to the pace and nature of regulatory approval, says Hogarth: “Although most countries have put in place fast-track emergency approval mechanisms, the European Union already had a very low barrier to market entry.”

He points out that the ‘CE-mark’ – indicating a test complies with EU regulations – is self-certified by nearly all types of diagnostic tests manufacturers: the firm simply awards itself a CE-mark.

“The lack of regulatory scrutiny makes the EU an attractive market for firms,” said Hogarth. The CancerScreen research shows there are 50% more Chinese firms with CE-mark for EU market than actually have approval in China itself, a pattern that is almost identical in South Korea.

Some 62 firms across China, South Korea and Singapore, as well as the US, currently export CE-marked COVID-19 tests to the EU. In China, South Korea and the US, the position is reversed: most firms with approved tests are domestic.

Meanwhile, only South Korean firms have approval in South Korea, very few firms that are not Chinese have approval in China, and this trend is replicated in the US.

Last week, the New York Times reported that the UK government bought two million kits for detecting antibodies for the coronavirus from two Chinese companies, only to find them ineffective.

“If the EU is to avoid becoming a dumping ground for poor quality tests, then further action must be taken,” said Hogarth. “That is already happening at a national level, as individual member states are forced to undertake post-market evaluation to assess the quality of tests to inform their procurement decisions.”

“Over the last few days the European Commission has begun to establish a more active role as a coordinating body and I welcome that very important development.”

The CancerScreen team is now working in collaboration with FIND to gather more data on the industry response to COVID-19 and Hogarth hopes to build links with the NIHR Innovation Lab for future work.

Added Hogarth: “It is important to share resources and expertise. FIND and NIHR have the definitive lists because they have data on immunoassays, as well as molecular diagnostics, but our strength is our broader understanding of the molecular diagnostics sector that we have developed over many years.”

The diagnostic industry in countries such as Germany, South Korea and China lead the pack on getting coronavirus tests ready for market. Researchers warn that lax EU regulations could see it become a “dumping ground” for bad tests.

The lag is striking because it mirrors the spread of the pandemicStuart HogarthSenior Airman Rhett IsbellCOVID-19 testing at Kadena Air Base, Japan


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Women bear brunt of coronavirus economic shutdown in UK and US

Tue, 21/04/2020 - 10:29

Women on both sides of the Atlantic are more likely to have lost their jobs or suffered a fall in earnings since the coronavirus pandemic took hold – even after accounting for differences in types of occupation, a new study suggests.

Economists from the universities of Cambridge, Oxford and Zurich have collected two waves of data in the UK and the US – the first toward the end of March and then again in the middle of April – from almost 15,000 people.

The second wave of data from mid-April suggests that – across gender, age and occupation – a total of 15% of the UK population have lost their jobs due to the economic impact of coronavirus. In the US it’s even higher: a total of 18%.

However, significantly higher rates of women and workers without a degree had experienced job loss or wage drops in the four weeks prior to questioning, compared to men and those with a university education.

In the UK, 13% of workers with a degree lost their job compared to 18% without a university education. In the US, the rate of job loss was 22% for those without a college degree compared to 15% of college-educated workers.

Women in the UK are four percentage points more likely to have lost their job than men, with 17% of women newly unemployed compared to 13% of men. The gap in the US was even wider: 21% of women compared to 14% of men. 

The researchers found that this gender gap in job loss due to coronavirus persisted even after controlling for education, occupation and regional location within each nation.

“We found that people without university degrees are more likely to be working in jobs with tasks that just can’t be done from home, making them more vulnerable to loss of employment,” said Dr Christopher Rauh, a report author from the University of Cambridge’s Faculty of Economics.  

“While we can fully explain the education gap for job loss probabilities by differences in the types of work, the same is simply not true for the gender gap we see in job loss,” he said.

Despite this, the survey study found that – on average across both countries – women are more optimistic than men about their chances of keeping their job going forward.

The researchers suggest that one potential reason for the gender gap they identify might be found in hours spent homeschooling and caring for children.

Data gathered from 9-14 April show that, on average during a typical working day, men in the UK spend under 2.5 hours on childcare, and do under two hours of homeschooling.

Women in the UK, however, spend over 3.5 hours on childcare, and do over two hours of homeschooling. In the US this childcare and homeschool gender gap is very similar, although slightly smaller.

The type of occupation makes a massive difference to whether the coronavirus economic shock had taken your job in the last month. In the US, food serving and preparation was by far the worst hit type of occupation with 40% losing their jobs, followed by transportation and then production.

In the UK, the cleaners and maintenance workers have fared worst with 33% losing their jobs, closely followed by personal care services, then food workers and construction. In both countries, those who work in computing and occupations such as architects and engineers were least affected by loss of employment.

The research also found a stark difference in job or earnings loss across the board between those on permanent contracts compared with temporary contracts, and those who can fully work from home compared with those who cannot do any. However, these inequalities were far greater in the US than the UK.

The latest research builds on the first wave of survey work conducted near the end of March, which showed that those under the age of thirty and on lower incomes were more likely to have seen wage and job losses.

Added Rauh: “In general, younger individuals across the board, as well as women and those without university education, were significantly more likely to report experiencing drops in income.”   

“The outlook on the future is bleak. Of all those still employed, 32% of people in the UK and 37% of people in the US believe they will lose their jobs in the next few months,” he said.

“Our findings highlight the need for immediate policy responses that target those most affected by the economic crisis.”

The findings by the research team composed of Abi Adams-Prassl, Teodora Boneva, Marta Golin and Christopher Rauh are published as a working paper through the University of Cambridge Institute for New Economic Thinking: https://www.inet.econ.cam.ac.uk/working-paper-pdfs/wp2018.pdf.

The Cambridge-INET Institute has now launched a dedicated website for all their coronavirus-related research: http://covid.econ.cam.ac.uk.

 

New data shows women and people who did not go to university are more likely to have lost work and earnings since mid-March.

Of all those still employed, 32% of people in the UK and 37% of people in the US believe they will lose their jobs in the next few monthsChristopher RauhCraig WhiteheadChef in Soho, London.


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Economic activity has halved during Spain’s coronavirus lockdown, study suggests

Wed, 15/04/2020 - 09:57

A new analysis of 1.4 billion credit and debit card transactions during the first three months of 2020 show that spending in Spain post-lockdown was an average of 49% lower than the same date the previous year.

Economists from the universities of Cambridge, Edinburgh and Imperial College in the UK worked with the Spanish bank BBVA, one of the largest financial institutions in the world, to study the “real time evolution” of economic activity during the COVID-19 pandemic.

“This is an unprecedented dataset of millions of everyday transactions, revealing the underlying costs of the coronavirus crisis,” said study co-author Vasco Carvalho, Professor of Macroeconomics at the University of Cambridge, and director of its INET Institute.

“We can see in high resolution the impact of extreme mobility restrictions on a major western economy. We find an abrupt and persistent decline in spending during lockdown, amounting to about half of what we might normally expect.”

The researchers found evidence of a major spending increase in the few days just before Spain’s lockdown began on the 14 March 2020, when daily expenditure growth shot up by 20 percentage points above average for the year.

Once lockdown began, daily spending halved on average. The researchers say that, while bank transaction data is “substantially more volatile” than overall consumption by households in Spain, they are closely linked.

As such, a “back-of-the-envelope calculation” for consumption movement during the pandemic suggests growth of just over 4% prior to lockdown dropped sharply to a -13% decline in average household consumption – a key indicator of GDP – once lockdown restrictions were in place.

“While considerable uncertainty surrounds these calculations, is seems hard to construct a scenario where average consumption of Spanish households is not declining somewhere between minus 10% and minus 15% during the period of lockdown,” said Carvalho.

The dataset charts the dramatic shift to online purchasing once lockdown was enforced. While both offline and online spending fell overall, the decline at physical points of sale was massive. As such, online shopping increased its market share by about 50%.

The detail in the anonymised transaction data allowed the researchers to analyse the best and worst performing types of goods and outlets as people adapted to their new lockdown lives.

While outlets unable to conduct business were obviously the worst hit – from bars to fashion retailers – the study shows that small local food shops and convenience stores benefited the most, increasing their market share more than even the “Hipermercados”, or superstores.

Other categories of spending that have seen market share grow during Spanish lockdown include mobile phone credit, as telecommunications become even more vital to social lives, as well as pharmacies and insurance.

“Spending on commodities related to basic necessities, such as foodstuffs and the pharmacy, more than doubled during the lockdown period, while trade in fashion or personal services declined heavily,” said Carvalho. “Restrictions to movement mean proximity to the customer is now of key importance.”

The study found that – all together – the top 10 best performing spending categories during lockdown went from an average of 10% market share in the first two months of 2020 to 50% by late March.

The economists additionally used anonymised geo-tagging of the transactions to study the economic effects of coronavirus on the different regions of Spain, as well as among the neighborhoods of one of its major cities.  

Unlike the country’s autonomous regions, which all followed a similar pattern, economic activity evolved very differently within Madrid’s postcodes during the crisis. “Those neighborhoods where there were more sick and infected people saw substantial declines in spending,” said Carvalho.

“Within a big city, inequality in disease burden appears to be linked to inequality in economic burden.”

Study co-author Professor Sevi Rodriguez Mora, of the University of Edinburgh’s School of Economics, said: “Over the coming weeks governments will grapple with how to relax social distancing measures, but have few means of understanding the impact of different policies on economic activity.

“Transaction data can provide immediate feedback on how spending patterns across space and sectors react to restriction measures, but also their relaxation.”

“Given that this seems to be happening in Spain before the rest of Europe and America, whatever happens in Spain will show us what we should expect everywhere else."

Álvaro Ortiz, Head of Big Data at BBVA Research, added: “Tracking these kind of events in real time and high definition provides an important strategic advantage for policy makers, as they can react more quickly to limit the economic damage.” 

The new research is published as a Cambridge-INET working paper on the Institute’s dedicated COVID-19 research page here: http://covid.econ.cam.ac.uk/

 

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Almost one and a half billion spending transactions reveal “real time” reactions of consumers in a major western economy during the nation’s peak pandemic period. 

Within a big city, inequality in disease burden appears to be linked to inequality in economic burdenVasco CarvalhoNemoA deserted Grand Via, in the heart of Madrid, a week after the lockdown started.


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Workers under 30 hit harder by coronavirus economic shock in UK and US

Fri, 03/04/2020 - 10:53

Workers under the age of thirty, as well as those on lower incomes, on both sides of the Atlantic are already bearing the brunt of the economic shutdown caused by the COVID-19 pandemic, latest research finds.

Data collected by economists towards the end of March shows younger workers in the UK and US were more likely to have either recently lost their job or seen a drop in hours and earnings compared to workers in middle age.

Researchers from the universities of Cambridge, Oxford and Zurich also found that those under 30 and still in employment believed they were much more likely to lose their job by August, compared to those aged 40-55.

The research suggests that in the UK, 8% of all workers employed in February had already lost their jobs. A third of all those still in work expected to lose their jobs within the next four months.

In the US, 11% of all workers had already lost their jobs due to COVID-19, and 40% of all those still working expected job loss by August. 

Workers on lower incomes – those earning below 20,000 pounds or dollars a year – across all age groups in both countries were more likely to have lost their job in the preceding four weeks than workers earning over £40k in the UK or $50k in the States. 

Those still employed on lower incomes in the UK and US could conduct a much smaller percentage of their normal working tasks from the safety of home.

Data was collected from “a large geographically representative sample” in each country say researchers. A total of 3,974 people in the UK were surveyed on March 25, two days into the government-imposed lockdown. The US data came from 4,003 people on March 24.

“Our findings suggest that the immediate impact of the coronavirus downturn on workers has been large and unequal, with younger workers and those at the bottom of the income distribution hit hardest,” said Dr Christopher Rauh from the University of Cambridge’s Faculty of Economics, who led the research.

“In the short term, there is a need to provide quick assistance to help those hit hardest to cover their bills in the coming weeks. Around half of all workers on both sides of the Atlantic expect to have difficulty paying their usual bills,” Rauh said.

“In the long term, the economic shock caused by the pandemic is highly likely to increase inequality between young and old, between higher and lower earners, and between those on secure and insecure contracts.”

The survey found that workers on UK statutory sick pay, and those without paid sick leave in the US, were more likely to say they would to go into work with a cold or light fever. Researchers say that “paid sick leave policies should be rethought not only in light of workers’ welfare but public health as a whole”.

In both countries, far more self-employed people earned less than usual the week prior to the survey compared with those on permanent contracts.

The research was done before the UK Chancellor announced new measures for the self-employed, beginning in June. However, the researchers caution that it “might be too late to prevent severe economic hardship”.

Added Rauh: “Preventing this shock from scarring the employment progression of the younger generation and the less-economically advantaged is vital if we are to avoid permanent damage to economies and individual welfare.”

The findings have just been published as two working papers through the University of Cambridge Institute for New Economic Thinking: Working paper, UKWorking paper, US

Key UK findings:

  • On average across all UK workers, people expect to earn 35% less in the next four months compared to usual.
  • 69% of workers under 30 reported working fewer hours the previous week compared to usual and 58% reported earning less, compared to 49% and 36% of workers aged 40-55 respectively.
  • 10% of workers under 30 are now unemployed because of COVID-19, compared to 6% of workers aged 40-55.
  • On average, those under 30 and still employed believe they have a 39% chance of job loss by August, compared to 27% for 40-55 year olds.
  • Workers earning under £20,000 can do 30% of the tasks in their main job from home compared to 55% for those earning more than £40,000.
  • 12% of low-income workers earnings are now unemployed because of COVID-19 compared to 5% of higher earners.
  • Workers earning less than £20,000 expect to earn just 58% of their usual income between now and August. Those earning more than £40,000 expect to make 69% of their usual income on average.
  • 43% of workers with just statutory sick pay said they usually go to work with a cold or light fever, compared to 31% of workers with additional paid sick leave.

Key US findings:

  • On average across all US workers, people expect to earn 39% less in the next four months compared to usual.
  • 72% of workers under 30 reported working fewer hours the previous week compared to usual and 61% reported earning less, compared to 62% and 55% of workers aged 40-55 respectively.
  • On average, those under 30 and still employed believe they have a 43% chance of job loss by August, compared to 40% for 40-55 year olds.
  • Workers earning under $20,000 can do 42% of the tasks in their main job from home compared to 57% for those earning more than $50,000.
  • 16% of low-income workers earnings are now unemployed because of COVID-19 compared to 7% of higher earners.
  • Workers earning less than $20,000 expect to earn just 48% of their usual income between now and August. Those earning more than $50,000 expect to make 69% of their usual income on average.
  • 26% of workers without paid sick leave report they would go to work with a cold or light fever, compared to 24% of those with paid sick leave.

 

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In addition, those on low incomes are more likely to have lost jobs or pay, and less able to complete work tasks from home. Researchers warn the COVID-19 downturn is likely to “increase inequality between young and old”.

The immediate impact of the coronavirus downturn on workers has been large and unequalChristopher Rauh


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Opinion: Patient Zero: why it's such a toxic term

Wed, 01/04/2020 - 16:14
Shorthand Story: z7fBK49GgmShorthand Story Head: Patient zero: why it's such a toxic term " + "ipt>"); } })(navigator, 'userAgent', 'appVersion', 'script', document); //--> Shorthand Story Body:  TwitterFacebook Patient zero: why it’s such a toxic term

Heightened fears surrounding COVID-19 have once again brought the idea of “patient zero” into public consciousness. Ever since it was coined by accident in the 1980s, this popular yet slippery term has regularly – and misguidedly – been applied to infectious disease outbreaks and public health efforts to control them.

Steve Wozniak, co-founder of Apple, tweeted earlier this month that he and his wife might be “patient zero” for the epidemic of COVID-19 in the US after they returned from a trip to China with symptoms. He later described his use of the phrase as “kind of a joke”.

Less frivolously, “the hunt for patient zero” formed part of a recent BMJ headline for an editorial examining the devastating epidemic unfolding in Italy. The piece described local attempts to find the country’s initial coronavirus cases, hypothesising that they might be a pair of visitors from China’s Wuhan region, where health authorities were confronting the world’s earliest recognised large-scale outbreak.

Amid heightened contact-tracing efforts to locate cases linked to a doctor in the UK who was displaying symptoms of the infection, the Daily Mail used similarly dramatic language. An article described “the desperate hunt … for an unknown coronavirus spreader” who “gave” – note the implied volition of this word – “the deadly illness to the UK’s 20th victim – the first Briton to catch it in the country”.

And even more recently, the Mail on Sunday followed news of prime minister Boris Johnson’s positive COVID-19 test result by publishing a two-page spread asking its readers: “DID BARNIER INFECT BOJO?” With little evidence, the authors intimated that Michel Barnier, the chief negotiator for the EU, “might be the ‘Patient Zero’ who brought [the] virus to No 10”, representing “the ultimate revenge for Brexit”.

The Mail on Sunday intimated that Michel Barnier infected Boris Johnson with coronavirus. Credit: GUE/NGL.

The Mail on Sunday intimated that Michel Barnier infected Boris Johnson with coronavirus. Credit: GUE/NGL.

With the words “patient zero”, you have a distinctly catchy phrase. This was the reason Randy Shilts, the American journalist whose work on the AIDS epidemic initially amplified the term, adopted it in the first place. It sounds scientific, and as if it signifies the absolute beginning of an epidemic. It shares a linguistic link to 20th-century military expressions such as “zero hour” (when an action begins) and “ground zero” (the point below where a bomb detonates), so it conveys a sense of excitement too.

But apart from its attention-grabbing tone, the phrase is hopelessly confusing. Its lack of precision and accidental formation disqualify it from formal usage, so most researchers will not touch it. And stories about unknown disease “spreaders” triggering a “desperate hunt”, whether or not they explicitly refer to a “patient zero”, are frequently giving expression to communal fears about dangerously reckless behaviour. On the surface, these stories seem motivated by science. Scratch a little deeper, though, and you will often uncover a desire to assign blame.

We should abandon the toxic phrase “patient zero” and discuss contact tracing – the process of locating individuals who have crossed paths with people who are infectious – with great care. Otherwise, we risk increased confusion, scapegoating and under-emphasising the significance of asymptomatic cases. These are all things which are deeply unhelpful for our collective response to COVID-19.

Confusion

First, let’s tackle the confusion raised by the term itself. “Patient zero” is often used interchangeably for three different scenarios: first case noticed, first case here, and first case ever. While there are legitimate reasons for discussing each of these situations, better terminology exists for doing so.

Speaking of “cases” instead of “patients” allows us to be more specific. By doing so we include those who may be infected and infectious but who don’t acquire official “patient” status by seeking treatment.

In terms of “first case noticed”, since at least the 1930s, health investigators engaging in contact-tracing work have used the phrase “index case” to mark the first person in a household or community whose symptoms grabbed their attention. Researchers studying tuberculosis in Tennessee during the Great Depression defined “index case” as “that person through whom attention was drawn to the household”.

Crucially, these same researchers were quick to emphasise that this person might not be “the initial case in the household in point of time”. Turning our thoughts to COVID-19, there are many reasons why this might hold true. An initial case whose symptoms were so mild that she did not seek assistance. A child who picked up the infection first but took longer than his siblings to develop a fever. Or perhaps a grandparent with all the signs of infection, but without medical insurance and afraid to seek treatment.

The Tennessee tuberculosis researchers also pointed out that the index case might not be a true case of disease at all. Someone might appear to be ill, draw attention to a household, but ultimately test negative for tuberculosis.

To refer to “the initial case … in point of time”, epidemiologists coined the phrase “primary case”. In understanding how a disease might spread through a household or community, it can be useful to know who was the primary case here, in a particular location. By knowing when this person was infectious and by tracing their movements through a community, investigators can identify other people who might be at risk of infection and, ideally, test and treat them.

Where epidemiology lacks a good alternative phrase is for the first person ever to become infected. “Patient zero” often springs up to fill this void in informal discussions.

There are many reasons why this person, the first human case ever in a particular outbreak, is seldom located: the absence of recognisable symptoms, gaps in disease surveillance, delays in recognising an outbreak, lack of effective testing. In some cases, the person popularly and arbitrarily crowned as “patient zero” may simply be the person with a positive test result whose likely date of infection is the earliest on record.

As such, any purported “first case ever” is largely figurative. Lacking a better phrase, we might choose to call this person the “alpha case” or “ur-case”, or, for infections such as HIV or COVID-19 where a virus transfers from an animal host to humans, the “crossover case”. “Crossover case” is readily understood. And “alpha” and “ur” are two words commonly used to describe absolute beginnings, each also hinting, appropriately, at a mythical realm (“In the beginning…”).

Each of these designations is meaningful. Index cases are helpful in terms of seeing how disease comes to authorities’ attention (“index” literally meaning “that which serves to point”). Primary cases are useful in terms of organising the key elements of epidemiology – time, place and person – into a narrative chronology that helps bring order to the complexity of rapidly accumulating data during a health crisis.

Likewise, it can be important to talk of crossover cases – even if they are seldom directly identifiable. Understanding their habits and living conditions might reveal risks that can be avoided in the future. Studying how a virus has evolved over time from its first interactions with humans can offer insight into its past trajectory as well as possible future points of intervention for treatment and vaccine research.

In short, each of these situations is worth discussing with precision. With its many possible meanings, “patient zero” is simply not up to the task.

Blame and scapegoating

Identifying a “patient zero” is also rife with potential to incite blame and scapegoating. To understand how, it’s useful to think historically about the overlapping but divergent interests of two different groups keenly following the spread of infection during an epidemic: members of the public and public health workers.

Long before they had the ability to test for specific germs, those studying epidemics – whether religious, civic or medical authorities – found value in locating the first cases. Like now, they were keen to work out what identifiable factors might have led to ill health in the community.

Many medieval Europeans believed that disease could spring up from dangerous miasmatic air. From the 14th century onward, conspiracies also circulated about specific minorities – lepers, Jews, heretics and sodomites – causing the plague, either directly by poisoning wells, or more generally by provoking God’s punishment with their behaviour. Members of minority groups who were judged to have disobeyed community standards often faced isolation, banishment and sometimes death in the aim of seeking atonement.

Humans are storytellers, and through several centuries of epidemics in Europe and North America (where my research has focused) they have told stories of how outbreaks started and spread. These included tales of how foreign travellers brought non-native disease (the malady from X country) – a phenomenon later aptly described in relation to AIDS as a “geography of blame”.

On a more local level, observers also described real and fictional chains of disease transmission between named people (“Our town was free from infection until so-and-so came”; or “A infected B with the pox, who infected C and D”). With their similarity to family trees, I call this second kind of story a “genealogy of blame”.

Both types of stories tend to feature people behaving inappropriately, immorally or wickedly, especially by transgressing important boundaries. These might be natural, religious or geographic divides. One finds examples of proposed “ur-cases” of the pox generated by crossed celestial bodies, crossed species or crossed borders.

These ancient and widespread stories that explain disease and misfortune link to the popular stories of a “patient zero” still told today. They trace real or perceived connections between different people to understand how illness spreads. But unlike the main motivation of public-health contact tracing, a much more recent practice, these stories enact personal distancing through words, aiming to provide reassurance by locating the responsibility for disease elsewhere.

Contact tracing as we now define it developed in the late 19th and early 20th centuries when investigators and health departments drew upon the remarkable discoveries of bacteriological researchers and applied them to public health problems. Scientists had developed new techniques that allowed them to identify specific germs as the cause of specific diseases. This powerful breakthrough in studying infection, in turn, gave health authorities a much better understanding of how a specific germ was moving through a population and where to allocate resources for prevention.

For diseases such as typhoid fever, tuberculosis, syphilis and gonorrhoea, investigators could now identify potential cases with more confidence. Increasingly, public health workers tested these cases to see if they were carrying specific germs, followed up their contacts, and then applied measures such as treatment, quarantine or isolation to prevent further spread.

The most famous instance of these tools being put to use was with typhoid fever and the case of Mary Mallon in early 20th-century New York. Authorities found this Irish American cook to be a “healthy carrier” – capable of infecting others while remaining symptom-free herself – and they advised her against continuing to work as a cook. When they later traced numerous infections and two deaths to a maternity hospital where Mallon had resumed cooking, she was forcibly confined to North Brother Island for more than two decades until her death in 1938.

Mary Mallon, a ‘healthy carrier’ for typhoid fever, in hospital, 1909. Wikimedia Commons.

Mary Mallon, a ‘healthy carrier’ for typhoid fever, in hospital, 1909. Wikimedia Commons.

In carrying out their responsibilities, public health workers have long benefited from media stories that borrowed heavily from crime fiction, portraying them as tireless “disease detectives”. Alexander Langmuir, the godfather of the Epidemic Intelligence Service at the US Centers for Disease Control, actively cultivated such media accounts of his organisation’s epidemiologists from the mid-20th century onward.

One downside, however, to this popular public image is the overlap in word choices and story conventions drawn from crime fiction. Describing public health workers as “disease detectives” opens the door to characterising the contact-tracing process as a “hunt” for guilty “suspects”, people who choose to “give” their infections to innocent “victims” (another harmful story formula with a long history). This is especially troubling if the people in question are going about their lives without the knowledge that they are infected.

It is obvious that a public health method that investigates the same person-to-person connections that have long fascinated members of the public will be particularly vulnerable to mixed messages like these. As a result, writing about contact tracing in relation to a public health emergency must always be done with extreme care. Word choice matters.

Journalists focusing on a “patient zero” risk invoking widespread and historically rooted social impulses to attribute responsibility and blame to the people linked to chains of infection. On their side, public health workers might think twice about using the term “superspreader”. This evocative and stigmatising phrase, still in relatively wide use, describes an infected person who transmits an infection to many others, and has often been applied to the first-ever “patient zero”: Gaétan Dugas.

What we don’t see

Many people will know the story of Gaétan Dugas, the French-Canadian flight attendant wrongly accused of being “patient zero” of the North American AIDS epidemic. Briefly, this man emerged as a person of interest in 1982 when American public health investigators received reports that a number of gay men with AIDS in California had had sex with one another. This was before a virus was known to be the cause and before a test was available to determine who was sick.

In the absence of a definitive test for AIDS, this sexual network of cases, all of which fit the narrowly defined official case definition for the new syndrome, offered an opportunity to study whether the syndrome was caused by a sexually transmissible agent. The Canadian appeared to provide the sexual link to several Californian cases that otherwise did not have any apparent connection. He was labelled the “out of California” case because he lived outside of the state, and “case O” or “patient O” for short.

Gaétan Dugas, photographed by Ray Redford in Vancouver, 1972, before becoming the prototypical ‘patient zero’.

Gaétan Dugas, photographed by Ray Redford in Vancouver, 1972, before becoming the prototypical ‘patient zero’.

The investigators’ detailed contact-tracing work revealed a web of sexual connections, eventually linking cases in California with others in New York and cities in other states. The investigators initially represented this network with “patient O” at the centre. After other researchers later misread the letter O for the numeral 0, many began to misinterpret the person at the centre of the diagram as “patient zero”, the “primary case” for the North American epidemic.

This example has received more attention recently for the personal consequences it had for Dugas’s memory and the pain it brought his loved ones, as well as for the stigmatising story frame that it set up for subsequent “patients zero”. Initially, Randy Shilts’s popularising account, And the Band Played On, even emphasised – using dubious evidence – that Dugas’s refusal to heed public health guidance demonstrated that he was intent on deliberately infecting others.

However, this historical example also offers a useful cautionary tale for thinking about identifiable individuals linked to a cluster of infections, and about asymptomatic cases more generally.

Dugas, the prototypical “patient zero”, did have a very large number of sexual contacts, and some of the connections depicted took place before his symptoms became apparent. But several other men with AIDS represented in the same diagram had as many or more sexual partners. The main difference was that they could not, or would not, share the contact details for their partners in the way that the cooperative Dugas did. The result was that while Dugas’s identified sexual partners radiated out from him in the diagram like spokes on a wheel, these other men were surrounded by empty space.

In this way, the limits of a contact-tracing model focusing on identifiable cases become clear. When we represent something visually, it becomes much easier to focus on what is depicted instead of what might be missing. Similarly, by representing the known connections between people with symptoms, we risk overlooking the just-as-important connections between those who are infectious but symptom free, and who are less likely to be linked to a chain of infection.

There is another way we can now understand the cluster diagram to direct our attention away from what is important. In 1982, it was reasonable to hypothesise that it might only be a few months between someone being exposed to whatever caused AIDS and subsequently displaying signs of the disease. Representing these men’s sexual connections in a diagram made sense because it seemed likely that these depicted exposures were the ones that had permitted a transmissible agent to infect them.

But it became increasingly apparent that it took much longer for people to display symptoms after they were infected, a process which we now understand to be in the order of eight to ten years, in the absence of other health issues. And we now know that by the time that investigations into AIDS began in earnest in 1981, many thousands of Americans were already infected, going about their lives without realising they had acquired a virus that they were transmitting to other people.

So, by the late 1980s, and certainly from our current viewpoint, it is clear that most if not all of the sexual connections depicted in the cluster diagram were not the acts of sexual activity that led to these men becoming HIV-positive. Those exposures would have occurred years earlier, in the early to mid-1970s, beyond the focus of the investigation and therefore left out of the diagram. Not only does this further remove any particular significance attributable to Dugas, but it also importantly reminds us of what we too may be failing to see from our own limited present-day perspective.

In short, by focusing too much of our attention on a “patient zero” or the cases uncovered in a contact-tracing investigation, we risk diverting our attention from the hazards posed by infectious people without symptoms. Also, if we spend too much time thinking about individuals, we risk overlooking steps we can undertake together in our communities.

In other words, the more we can do to think of infection being here among us, instead of over there among them, the more it will allow us to focus on behaviours – things like hand-washing, self-isolation and physical distancing – that can collectively reduce our risk of infection now.

Contact tracing will, and should, remain a vital part of the response to COVID-19 for many months to come.

Since public health responses to a global pandemic generally fall within national jurisdictions, it makes sense that a country’s health authorities will give heightened attention to the first cases of a disease recognised within its borders. Yet authorities should remember that some will interpret this attention as an encouragement to blame outsiders for the disease, feeding into long histories of viewing other parts of the world as disease incubators.

In locations where the virus has not yet become apparent, vigorous tracing of new cases and testing their contacts in a bid for “containment” can help prevent a shift to undetected “community spread”. And in areas where the virus is widespread and the population has been subjected to restrictive measures, any relaxing of controls will also require the careful investigation of new cases to avoid a re-escalation of infections.

Regardless, there should be no more “patient zero” in our stories of COVID-19. We must be conscious of the stories we tell and the connections we trace, remaining mindful of the ripple effects these can have. Writing of a “patient zero” is a damaging red herring that distracts from constructive efforts to contain the epidemic. Let’s wash our hands of this toxic phrase. Our general health, and our ability to understand epidemics now and in the future, will be stronger as a result.

Dr Richard McKay, Wellcome Trust Research Fellow, Department of History and Philosophy of Science

Richard specialises in the history of epidemics, public health, HIV/AIDS, and sexually transmitted infections. His book, "Patient Zero and the Making of the AIDS Epidemic" (University of Chicago Press, 2017), was named by CHOICE Review as an Outstanding Academic Title for 2018 and produced as a documentary feature film, "Killing Patient Zero" (Fadoo Productions, 2019).

This article was first published on The Conversation.

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Dr Richard McKay from the Department of History and Philosophy of Science discusses the history of the 'patient zero' idea during epidemics such as HIV and typhoid, and the return of this trope with COVID-19.

Image: Affiliation (schools and institutions): Department of History and Philosophy of ScienceSchool of the Humanities and Social SciencesPeople (our academics and staff): Richard McKaySubject (including Spotlight on ... where applicable): COVID-19epidemichistory of sciencehistory of medicineSection: ResearchNews type: News

Cambridge researchers awarded European Research Council funding

Wed, 01/04/2020 - 14:19

One hundred and eighty-five senior scientists from across Europe were awarded grants in today’s announcement, representing a total of €450 million in research funding. The UK has 34 grantees in this year’s funding round, the second-most of any ERC participating country.

ERC grants are awarded through open competition to projects headed by starting and established researchers, irrespective of their origins, who are working or moving to work in Europe. The sole criterion for selection is scientific excellence.

ERC Advanced Grants are designed to support excellent scientists in any field with a recognised track record of research achievements in the last ten years.

Professors Mete Atatüre and Jeremy Baumberg, both based at Cambridge’s Cavendish Laboratory, work on diverse ways to create new and strange interactions of light with matter that is built from tiny nano-sized building blocks.

Baumberg’s PICOFORCE project traps light down to the size of individual atoms which will allow him to invent new ways of tugging them, levitating them, and putting them together. Such work uncovers the mysteries of how molecules and metals interact, crucial for creating energy sustainably, storing it, and developing electronics that can switch with thousands of times less power need than currently.

"This funding recognises the huge need for fundamental science to advance our knowledge of the world – only the most imaginative and game-changing science gets such funding," said Baumberg.

Atatüre’s project, PEDESTAL, investigates diamond as a material platform for quantum networks. What gives gems their colour also turns out to be interesting candidates for quantum computing and communication technologies. By developing large-scale diamond-semiconductor hybrid quantum devices, the project aims to demonstrate high-rate and high-fidelity remote entanglement generation, a building block for a quantum internet.

"The impact of ERC funding on my group’s research had been incredible in the last 12 years, through Starting and Consolidator grants. I am very happy that with this new grant we as UK scientists can continue to play an important part in the vibrant research culture of Europe," said Atatüre.

Professor Judith Driscoll from Cambridge’s Department of Materials Science & Metallurgy was also awarded ERC funding for her work on nanostructured electronic materials. She is also spearheading joint work of her team, as well as those of Baumberg and Atatüre, on low-energy IT devices.

"My approach uses a different way of designing and creating oxide nano-scale film structures with different materials to both create new electronic device functions as well as much more reliable and uniform existing functions," she said. "Cambridge is a fantastic place that enables all our approaches to come together, driven by cohorts of inspirational young researchers in our UK-funded Centre for Doctoral Training in Nanoscience and Nanotechnology – the NanoDTC."

Professor John Robb from Cambridge’s Department of Archaeology was awarded an ERC grant for the ANCESTORS project on the politics of death in prehistoric Europe. The project takes the methods developed in the ‘After the Plague’ project and the taphonomy methods developed in the Scaloria Cave project and apply them to a major theoretical problem in European prehistory - the nature of community and the rise of inequality.

"This project is really exciting and I’ll be working with wonderful colleagues Dr Christiana ‘Freddi’ Scheib at the University of Tartu and Dr Mary Anne Tafuri at Sapienza University of Rome," said Robb. "The results will allow us to evaluate for the first time how inequality affected lives in prehistoric Europe and what role ancestors played in it."

Four researchers at the University of Cambridge have won advanced grants from the European Research Council (ERC), Europe’s premier research funding body.


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Opinion: United we stand, divided we fall

Wed, 25/03/2020 - 12:18
Shorthand Story: pSfJUS6nhRShorthand Story Head: United we stand, divided we fall " + "ipt>"); } })(navigator, 'userAgent', 'appVersion', 'script', document); //--> Shorthand Story Body:  TwitterFacebook United we stand,
divided we fall
Our interdependent economy means the COVID-19 pandemic will cause unavoidable short term pain, but presents important choices about the long term recovery, says economist Prof Diane Coyle from the Bennett Institute for Public Policy.

Social distancing, lockdowns, all the essential public health responses to the coronavirus pandemic, also impact one of the foundation stones of economic prosperity: the division of labour. This implies that the economic and social shock being caused by the measures to halt or slow the spread of the disease could well be severe.

Unfortunately, this reality has led to a polarised debate when there is no choice about the immediate policy response. It is unwise to suggest governments can think about trading off a higher death rate from the virus for a lesser impact on the economy. There is simply no way out of the immediate economic hit. But it is essential to be aware of why the pandemic will be particularly damaging to living standards, and to ensure these lessons inform future policy choices, including health policies. 

It was Adam Smith’s great insight – illustrated by his famous example of the pin factory where one person draws out the wire, another cuts it and so on – that productivity is the result of dividing production into smaller tasks. Individuals or firms can produce much more if they specialise, and trade their increased output and income for other goods.

Economic growth since his publication of The Wealth of Nations in 1776 has been driven by ever-greater degrees of specialisation. The invention of the assembly line spread specialisation throughout industry. Globalisation since the 1980s has turned almost the whole world into a distributed factory. Modern urban life has made each of us dependent, daily, on a vast cross-border web of transactions and exchanges.

Over the course of recent decades more of these have become intangible, relying on digital communication, including electronic payments. This is why so many people can work from home in the current crisis. But many transactions are still tangible (buying food, or machine tools) or person-to-person (going to school, having a haircut).

The long list of categories regarded by the UK Government as ‘key workers’ is testament to how reliant we are on each other, even within one country.

It includes health and social care workers, other essential public services (police, fire, prison and probation staff, undertakers, public service broadcasters), some government administrators - both local and national, everyone involved in food production, processing, distribution and sale, pharmacies, and vets, transport staff, utilities, banks, IT and data infrastructure, chemicals, civil nuclear power, post, waste disposal – and the teachers and nursery staff to care for the children of these workers. This list adds up to roughly a third of the total employed workforce.

The economist Paul Seabright captured our mutual interdependence in the title of his book The Company of Strangers. He described the vast extended network of connections between all of us in today’s economy as ‘the Great Experiment.’ Now, in the face of coronavirus, this experiment is turning critical.

Already there are signs of plunging economic activity in many countries, not just in areas such as entertainment and restaurants, but also manufacturing. This means jobs are being lost, incomes falling, and perhaps some people may even lose their homes. The extended supply chains operate throughout manufacturing and retailing, including the supply of food to supermarkets. We should all be bracing ourselves for shortages of some of our favourites.

Above all, an economic downturn leading to sustained loss of income means people’s mental and physical health will deteriorate. People can be tipped into a lasting downward spiral because income improves health but good health in turn affects people’s earning capacity. Rising life expectancy is strongly correlated with growth in incomes, and hence GDP (although the GDP link has broken for some groups in the US population in recent years, as Anne Case and Angus Deaton have shown). There is an unavoidable judgment involved in taking action to save lives now, about the long term implications for loss of health and life in future.

And for young people entering the job market this year, doing so in an economic recession or depression will affect their earning capacity – and health and well-being – from then on1. Others at an earlier stage are experiencing disruption to their learning and assessments.

There is no menu of short-term options; but there are choices about what kind of future path to take. All these potentially scarring effects on the lives of millions make the hunt for quick tests to assess the presence of covid19 and the potential for immunity so urgent, as this is the only possible way to contain the economic damage and the vast distress that will be caused globally if the web of transactions joining us all together is severed for any length of time. 

Governments around the world have, rightly, turned to massive spending to try to limit the immediate damage to people’s livelihoods. But fiscal sticking plasters, no matter how big, need something to stick to. It will not be long before the crisis management focus needs to turn from short term public health to getting the economy growing again by repairing the engine of prosperity, our mutual dependence.

Watch Prof Coyle and colleagues from the Bennett Institute discuss moving beyond GDP to make economies fit for the future.

Professor Diane Coyle, Inaugural Bennett Professor of Public Policy

Professor Coyle co-directs the Institute with Professor Kenny. She is heading research in the fields of public policy economics, technology, industrial strategy and global inequality. 

Burgess, S., Propper, C., Rees, H., and Shearer, A. (2003), ‘The Class of 1981: The Effects of Early Career Unemployment on Subsequent Unemployment Experiences’

Image credit: Cheng Feng/Unsplash

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Our interdependent economy means the COVID-19 pandemic will cause unavoidable short term pain, but presents important choices about the long term recovery, says economist Prof Diane Coyle from the Bennett Institute for Public Policy. 

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Cambridge creates new Professorship in education and mental health

Thu, 12/03/2020 - 11:02

The University of Cambridge is creating a new Professorship in education and mental health, to further strengthen a growing research programme aimed at improving the wellbeing, and associated life chances, of children and young adults.

The post was announced on Wednesday 11 March, 2020, by the University’s Vice-Chancellor, Professor Stephen Toope, as he opened the Yidan Prize Conference: Europe, a major, international gathering of leading education researchers. The university, he said, had a ‘critical’ role to play in addressing the challenges of mental health.

The Yidan Prize Conference Series is linked to the Yidan Prize, the largest international prize in education, which is made annually to two outstanding individuals responsible for transformational changes in education research and development. The European conference is hosted by the Intellectual Forum at Jesus College, Cambridge.

One of the Yidan Laureates honoured this year was Usha Goswami, Professor of Cognitive Developmental Neuroscience at the University, and a Fellow of St John’s College. She received the award for her work deepening understanding of children’s early language acquisition, which has created a basis for new, effective interventions for dyslexia.

The conference more broadly aims to profile world-leading research that demonstrates how education can address major global challenges, and this year focused on wellbeing and education as one of its main themes: examining how schools, teachers and the education system in general can support children with mental health problems.

Opening the event, Professor Toope announced that the University will be creating a new role – Professor of the Psychology of Education and Mental Health – which will be based in its Faculty of Education. The first post-holder will be Professor Gordon Harold, currently at the University of Sussex, who has led several, field-changing studies into the relationship between domestic adversity and young people’s mental health, enabling schools and teachers to do more to support pupils with depression, anxiety and other mental health problems.

He will join a wider research network on wellbeing and inclusion within the Faculty of Education which is aiming to develop practical interventions and guidance for education professionals by addressing key, unanswered questions: such as how young people’s social relationships affect their learning, and how pupils and teachers can be better supported to cope with the various pressures of the education system.

“We must not lose sight of the fact that mental health, as well as a scientific challenge, is also one of social science and education,” Professor Toope said.

He added: “This goes beyond developing interventions for depression, anxiety, or other disorders. The promotion of positive mental health goes hand-in-hand with the task of helping future generations to enjoy greater opportunities and to become everything they can possibly be.”

Although many countries treat mental health as a matter primarily for health and social care services, education researchers and professionals have long highlighted its relevance for education.

That relationship was highlighted again in February, in Sir Michael Marmot’s '10 Years On’ review, which directly links poor physical and mental health in deprived parts of England to a pattern of social inequality that includes cuts to education funding and children’s services. His findings echo recent NHS research into children’s mental health, which suggests that 12.8% of five to 19-year-olds experience at least one mental disorder, and that these are more common among those from low-income backgrounds.

Professor Harold’s work has demonstrated the significant impact that adversity early in life – such as conflict between parents – has on depression, anxiety and behavioural disorders, and, through this, young people’s attainment at school.

He also led years of research that successfully challenged a thesis, popular among some education policy-makers, that young people’s academic attainment and behavioural development are principally governed by genetics. Professor Harold’s research has contested this assertion by studying the progress of children with biologically unrelated parents, such as IVF babies or those adopted at birth. This research has reinforced the significance of a child’s upbringing and environment for their mental health and development and how these experiences interact with and shape their genetic make-up.

He is now leading the national ‘enurture’ network, a UKRI funded initative, which aims to provide effective advice to parents, teachers and policy makers about how emerging digital tools and social media can be used to influence their mental health positively, rather than hinder it.

“One of the most exciting things about coming to Cambridge is that there is so much globally impactful work on education and wellbeing already being done here, offering a unique opportunity to complement and enhance the focus on families, schools and mental health that my research and impact activities represent,” Professor Harold said.

“There are still big questions that we need to answer to help promote positive child and adolescent development, both from a scientific and a social perspective. By drawing on all of these different areas of research we can start to equip parents, teachers, practitioners, and policy-makers with the evidence, support and resources they need to promote positive mental health among young people today – and the adults of tomorrow.”

This year’s Yidan conference also honoured the work of the 2019 Laureate, Sir Fazle Hasan Abed, who died in January this year. Sir Fazle was the Founder and Chair of BRAC, one of the world’s largest non-profit development organisations, which has set up hundreds of early childhood development centres, where close to 40,000 children are presently enrolled.

Dr Charles Chen Yidan, the founder of the Prize, said: “The 2019 Laureates represent two very different approaches to ensuring that our children go on to lead happy, productive lives, but they also intersect. Both point to the need to achieve a better, deeper understanding of children’s needs. Through their work, we now see promising ways to help millions of lives around the world.”

Further information about the Prize is available from the Yidan Foundation website.

The new post will strengthen existing research into how better to support young people’s well-being and mental health, in particular through the education system.

We must not lose sight of the fact that mental health, as well as a scientific challenge, is also one of social science and educationStephen ToopeProfessor Gordon Harold, Cambridge’s newly-appointed Professor of the Psychology of Education and Mental Health


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The climate crisis: towards zero carbon

Wed, 26/02/2020 - 07:35

If we are to avoid climate disaster we must sharply reduce our carbon dioxide emissions starting today – but how?

In a new film, Cambridge researchers describe their work on generating and storing renewable energy, reducing energy consumption, understanding the impact of climate policies, and probing how we can each reduce our environmental impact.

We hear about the ambitious new programme Cambridge Zero bringing together ideas and innovations to tackle the global challenge of climate catastrophe – and inspiring a generation of future leaders – and how the University is looking at its own operations to develop a zero carbon pathway for the future.

 

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Visit our spotlight on Sustainable Earth

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'Lab in your phone' lets you play the scientific life

Tue, 25/02/2020 - 14:01
Shorthand Story: VI2mhPT4taShorthand Story Head: 'Lab in your phone' lets you play the scientific life " + "ipt>"); } })(navigator, 'userAgent', 'appVersion', 'script', document); //--> */ Shorthand Story Body:  Share this story on TwitterShare this story on Facebook ‘Lab in your phone’ lets you play the scientific life A unique, free new game – “part Sims, part Tamagotchi” – lets players inhabit a stem cell researcher as they rise through the ranks: growing cells, scientific collaborations, and reputation.    

The scientist inside your phone is having a stressful day. Trying to finish a research paper while keeping a batch of cells alive, the last thing they need is “something funky” in their petri dish.

As demigod of this pocket-based laboratory, what will you do? Feed the famished stem cells, or console an upset colleague? Order the latest lab tech, or book a flight to the big conference?

Now the boss is frantic, your cells are contaminated, and the rest of the lab have disappeared on holiday. Maybe it’s time to seek shelter in the tearoom…

A new phone game from the University of Cambridge puts players in the lab coat of a young stem cell research scientist as they navigate the tough route from undergraduate to the top tiers of modern science. 

Dish Life, launched today and free to download on iPhone App Store, Android App Store and Steam (PC), has been developed by Cambridge sociologists and stem cell scientists from the University’s Stem Cell Institute. It aims to provide a flavour of the lives and labour behind biotechnological advances. 

“The route to scientific discovery can feel like a mystery to many of us,” said Dr Karen Jent from the ReproSoc group in Cambridge’s Department of Sociology, who led the game’s development. “A lot of people only encounter the process of science through hyperbolic headlines or cinematic tales of the lone genius.”

“We want to use gaming to have a different kind of conversation about science,” said Jent. “Science involves teamwork and care as much as reason and logic. We aimed to create an interactive experience reflecting the nurturing of experiments and building of social relationships at the heart of good science.”

For her research fieldwork, Jent has been embedded in stem cell labs, where she observed not just the dynamic between scientists, but the curious connection researchers have with the cells they grow, which need near-constant care and attention – a bit like microscopic kids.

These relationships are central to the gameplay, which the team describe as “part Sims, part Tamagotchi” with a dose of strategy and dilemma. Players must balance competing demands: growing a range of ever-hungry cells while adding to their lab’s wellbeing and reputation – all as they negotiate the scientific career ladder through publication and promotion.

The game follows on from a short film produced in 2016 by stem cell scientist Dr Loriana Vitillo and Jent in collaboration with director Chloe Thomas. Also called Dish Life, it cast a group of children in a paddling pool as stem cells in a dish.

The film featured scientists discussing their oddly intimate rapport with cell cultures: the constant checking, feeding and coaxing – even talking aloud to them – for months on end to keep cells happy, in the hope they bloom into healthy colonies.

“It was an ordinary day in the lab, feeding cells, when it occurred to me that we often talk about what we discover but not how we discover, about our real lives,” said Vitillo, game and film co-producer, and Cambridge Stem Cell Institute alumni. “I wanted to tell a different story.”

“With stem cells set to change healthcare, we want to make biotechnology more accessible by showing how this science is really done.”

In the game, players zoom in to feed chirruping cells with “medium” – nutrient-dense liquid used in labs – then split up overfull petri dishes and convert cells into specific types, from blood to neurons. This helps build experience points, unlocking new abilities such as hiring researchers and buying equipment.

But the continual nurturing of cells, digital pet-style, must be reconciled with social life in the lab, where contentment of your scientist avatar and colleagues needs to be managed alongside “quests” that take in everything from drug spinouts to job interviews.     

“The first thing a player does is to make their own scientist,” said co-producer and Cambridge sociologist Dr Lucy van de Wiel. “You can choose your body type, skin colour, hairstyle and whether you are male, female or transgender.

“Gender and ethnicity are at the heart of game. Players encounter some of the broader social challenges experienced by people in science, whether it’s gender pay gaps or trans rights issues,” she said.

“We hope the game offers new ideas and stories for imagining what a scientist looks like, and how the modern scientific life is lived.”

Dish Life is littered with dilemmas that occur while players are racking up research and cell cultures. From workplace issues such as bullying and maternity cover, through to societal dramas – e.g. media controversies and government committees – and ethical quandaries encompassing animal testing and CRISPR.      

As players rise from student to PI and eventually professor, they acquire extra dishes and rooms, as well as broader perspectives. “Once you run a successful lab, the game opens up questions of medical ethics, environmental impact, the bioeconomy and equality in science,” said Jent. “Although those cells will always need feeding.”

Dish Life has been designed by Dundee-based games company Pocket Sized Hands, and funded by the Wellcome Trust and ESRC. As well as a general release, the Cambridge team will continue to test the game with groups of stem cell scientists and update gameplay accordingly.

Cambridge Enterprise, the commercialisation arm of the University, negotiated a licence with Pocket Sized Hands on behalf of the academic team. The licence reflects continuation of the collaborative nature of the relationship and secures a future for the game.

TopBuilt with Shorthand Summary: 

A unique, free new game – “part Sims, part Tamagotchi” – lets players inhabit a stem cell researcher as they rise through the ranks: growing cells, scientific collaborations, and reputation.  

Image: Affiliation (schools and institutions): Department of SociologyReproductive Sociology Research GroupSchool of the Humanities and Social SciencesCambridge Stem Cell InitiativeWellcome-MRC Cambridge Stem Cell InstitutePeople (our academics and staff): Karen JentLucy van de WielSubject (including Spotlight on ... where applicable): gamingStem cellssociologySection: ResearchNews type: News

Global coalition needed to transform girls’ education - report

Tue, 25/02/2020 - 11:26

A ‘global coalition of parliamentarians’ needs to be set up to meet the urgent international challenge of delivering a quality education to millions of girls who are currently being denied access to any at all, a new report says.

The study, written by academics in the Research for Equitable Access and Learning (REAL) Centre at the Faculty of Education, University of Cambridge, and commissioned by the Foreign and Commonwealth Office, urges politicians to collaborate ‘across geographical and political divides’, in a concerted drive to ensure that all girls gain access to education by an internationally-agreed target date of 2030.

According to data gathered by UNESCO, an estimated 130 million girls are currently out of school. Over half of all school-age girls do not achieve a minimum standard in reading and mathematics, even if they do receive an education.

The call for collective, inter-governmental approaches to address this is one of seven recommendations in the report, which together aim to provide a framework for ‘transformative political action’.

Among others, the authors also stress that marginalised girls will only be able to access education if governments adopt a ‘whole-system’ approach to the problem. That means addressing wider societal issues that currently limit women’s life chances beyond education – such as gender-based violence, discrimination, or social norms that force young girls into early marriage and childbearing.

The full report, Transformative political leadership to promote 12 years of quality education for girls, is being published on 25 February, 2020, by the Platform for Girls’ Education. It is being launched in Geneva, as ministers convene for the 43rd session of the Human Rights Council.

Co-author, Pauline Rose, Director of the University’s REAL Centre said: “Everyone – or almost everyone – agrees that improving girls’ access to quality education is important, but progress has been limited. The report aims to provide a framework so that governments and those in power can turn goodwill into action.”

“More than anything, we need to look beyond what individuals, or single Governments can do, because we will only address this challenge successfully through bipartisan coalitions and collective approaches.”

The need to improve girls’ access to education is recognised in the UN’s Sustainable Development Goals, set in 2015. These include commitments to provide inclusive and quality education to all, and to achieving gender equality and the empowerment of all women and girls, by the year 2030.

With the clock ticking on that deadline, initiatives such as the Platform for Girls’ Education have been launched to lobby for quality education for girls. The Platform is part of the international ‘Leave No Girl Behind’ campaign, which calls for all girls to receive 12 years of quality education – an ambition restated by the present British Government in the December 2019 Queen’s speech.

In a statement accompanying the report’s release, however, the UN Girls’ Education Initiative (UNGEI), which provided feedback on the study, observes that: “Political momentum is not being sufficiently translated into reforms that will put us on track to achieve our Global Goals by 2030. The world is failing to deliver on its promise of quality education, and girls remain the most marginalised.”

Building on earlier studies, the new report identifies seven ways in which governments can take concrete, sustainable and effective action to resolve this.

It was based on a global review of current efforts, with a focus on low and lower-middle income countries. The researchers also carried out interviews with 11 current and former political leaders involved in championing girls’ education.

Its seven main recommendations are:

  • Heads of government, ministers and MPs must use their platform to demonstrate commitment to the development of policies supporting the aim of 12 years of quality education for all girls. Senior civil servants should be equipped to ensure that this continues across election cycles.
  • Women leaders should be represented at every level of government to improve gender-balance in decision-making and to act as role models.
  • A global coalition of parliamentarians should be established to advocate for girls’ education, working across political divides.
  • Senior civil servants should invest in and use data on education that separates out information on gender and other sources of disadvantage, so that this evidence can inform policy-making.
  • Political leaders must collaborate with key stakeholders in gender equality and education issues – such as women’s and youth organisations, civil society organisations, and religious leaders.
  • Government ministers and civil servants should take whole-system approaches to embedding gender equality in national plans and policies, given the multiple barriers to girls’ education.
  • Governments should implement gender-responsive budgeting, that ensure sufficient domestic resources are applied to girls’ education.

“Successful reform rarely depends on individuals acting alone,” the authors add. “It relies on alliances, collective action and advocacy. Networks and coalitions are vital to tackle issues that are beyond the capacity of individuals to resolve, as well as to provide a stronger, collective voice.”

The full report is available at: https://lngb.ungei.org/ 

A new report aims to provide a framework so that "governments and those in power can turn goodwill into action”.

We need to look beyond what individuals, or single Governments can doPauline Rose


The text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified.  All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Shanidar Z: what did Neanderthals do with their dead?

Tue, 18/02/2020 - 12:11
Shorthand Story: 4a6AN5Rq3cShorthand Story Head: Shanidar Z: what did Neanderthals do with their dead? " + "ipt>"); } })(navigator, 'userAgent', 'appVersion', 'script', document); //--> */ Shorthand Story Body:  SHANIDAR Z Traces of pollen among a cache of Neanderthal skeletons discovered in the mid-20th century led to contentious claims of a ‘flower burial’ and human-like death rituals. Now, the legendary site has been re-excavated, revealing a further body – the first articulated Neanderthal skeleton to be unearthed anywhere in 25 years.  The opportunity to use latest technologies on this new find could help answer a much-debated question:
what did Neanderthals do with their dead?  In the foothills of northern Iraq is a cave that has sheltered shepherds from winter winds for generations.
It concealed Kurdish families during the reign of Saddam Hussein. As well as aiding the living, Shanidar Cave harbours the dead...

A graveyard of 35 people lain to rest over 10,000 years ago was uncovered in Shanidar Cave by archaeologist Ralph Solecki in 1960.

This cemetery was found at the end of four seasons of excavation, during which time Solecki discovered something more extraordinary: the partial remains of ten Neanderthal men, women and children. Mid-20th century techniques could only date them to over 45,000 years ago.

Stockier than us, with heavy brows and sloping foreheads, it had long been assumed that Neanderthals were primitive and animalistic: subhuman. Evolutionary losers ultimately rendered extinct by their own deficiencies.

Illustrated reconstruction of a Neanderthal man. Hermann Schaaffhausen, 1888.

Illustrated reconstruction of a Neanderthal man. Hermann Schaaffhausen, 1888.

However, Shanidar Cave suggested a far more sophisticated creature. One male had a disabled arm, deafness and head trauma that likely rendered him partially blind. Yet he had lived a long time, so must have been cared for. Signs of compassion.  

Four individuals were found clustered together in a “unique assemblage”, with ancient pollen clumped in the sediment around one of the bodies. Solecki claimed this as evidence of Neanderthal burial rites: repeated interments; the laying of flowers on the deceased. Human-like ritual behaviour.

Controversy ensued, and still lingers. Does Shanidar Cave show that Neanderthals mourned for and buried their dead? Were they far closer to us in thought and action? What does this mean for the evolution of our lineage? 

“Undergraduates across the world studying pre-history get asked a version of: Neanderthals were nasty, brutish and short – discuss. The Shanidar flower burial always comes up,” says Prof Graeme Barker, Fellow of St John’s College and former Director of the McDonald Institute for Archaeological Research.

“Shanidar Cave is iconic in 20th century archaeology.”Graeme Barker

One such student essayist at Cambridge would eventually be among the first archaeologists allowed back into Shanidar Cave for more than fifty years. “I stood at the bottom of the hill leading up to the cave and thought: how am I getting to do this?” says Dr Emma Pomeroy, now a lecturer at the University.  

She first heard about the cave while studying at St. John’s College. “It was mind-blowing. School hadn’t taught us about human evolution, and I was fascinated by what Neanderthal behaviour might tell us about our own species.” 

Ralph Solecki didn’t finish excavating at Shanidar. He tried to re-excavate several times – reaching the foot of the hill in 1978 – but was stymied by political unrest, and his neglected trenches filled with rubble. Solecki died in March last year aged 101.

Shanidar 4 (the 'flower burial') in situ in 1960, with Ralph Solecki on the left. Credit: Ralph S. and Rose L. Solecki papers, National Anthropological Archives, Smithsonian Institution .

Shanidar 4 (the 'flower burial') in situ in 1960, with Ralph Solecki on the left. Credit: Ralph S. and Rose L. Solecki papers, National Anthropological Archives, Smithsonian Institution .

In 2011, Barker was invited by the Kurdistan Regional Government to re-excavate Shanidar. “Most archaeologists would jump at the chance,” he says. “The fact that Solecki was enthusiastic was a clincher.” Initial digging in 2014 stopped after two days when ISIS got too close, but resumed in earnest the following year. Pomeroy joined the team in 2016 as the project’s palaeoanthropologist.

The Neanderthals had been found by Solecki between three and seven metres down, and the idea was to reopen the trenches to get samples of soil, in the hope of pulling new evidence for age or climate from microscopic mineral and animal fragments.   

“We thought with luck we’d be able to find the locations where Solecki had discovered the Neanderthals, and see if we could date sediments with techniques they didn’t have back in the fifties,” says Barker. “We didn’t think we’d be lucky enough to find more Neanderthal bones.”  

In 2016, down in the “Deep Sounding” of the Solecki trench, while working on the eastern face, a rib emerged from the wall, followed by the arch of a lumbar vertebra, then the bones of a clenched right hand. Archaeologists would have to wait until the following year to begin excavating the delicate remains from beneath metres of rock and soil.

During 2018 and 2019, the team uncovered a seemingly complete skull, flattened by thousands of years of sediment, and upper body bones almost to the waist – with the left hand curled under the head like a small cushion.

Quick sketch of the Neanderthal body position by Dr Emma Pomeroy.

Quick sketch of the Neanderthal body position by Dr Emma Pomeroy.

The first articulated Neanderthal skeleton to come out of the ground for a quarter of a century is over 70,000 years old. Sex is yet to be determined, but it has the teeth of a “middle- to older-aged adult”.

The Neanderthal skull, flattened by thousands of years of sediment and rock fall, in situ in Shanidar Cave, Iraqi Kurdistan.

The Neanderthal skull, flattened by thousands of years of sediment and rock fall, in situ in Shanidar Cave, Iraqi Kurdistan.

The bones are “heartbreakingly soft” says Pomeroy. Barker describes the consistency as akin to wet biscuit, and soil had to be slowly and meticulously scraped away, sometimes using bamboo kebab sticks. “Emma’s got an eye for where the various protuberances of bone are likely to be,” says Barker. “It took her weeks of intense concentration working in what is pretty much a sauna in terms of heat and humidity.”

Dr Emma Pomeroy at work in Shanidar Cave.

Dr Emma Pomeroy at work in Shanidar Cave.

A glue-like consolidant is then brushed on, soaking in to bolster the bone, before sections are lifted out and wrapped in foil. But the bones are just the headline act. Scoops of surrounding soil are also ferried to camp where they are washed and picked through. Barker says they collect everything larger than two millimetres.  

The painstaking work of excavating in situ is risky as the bone is so fragile. An alternative is “en bloc”: to coat the area in plaster and extract it wholesale, then excavate fully in the lab.

“We considered en bloc, but it can be quite brutal,” says Pomeroy. “Crucially, it risks destroying precious evidence that may determine whether the Neanderthals were buried in a purpose-dug pit – a grave – or not”.  

In the 1950s, Solecki opted for the en bloc excavation of the ‘flower burial’. Pomeroy thinks it was this extraction that left the latest Neanderthal find chopped at the waist. “In their notes they describe bones trickling out of the block. Solecki numbered the individuals; we think we have the top half of Shanidar 6, but until we can confirm this we call ours Shanidar Z.”

What thrills both archaeologists is the wealth of evidence to be gleaned from Shanidar Z, using technologies unavailable to Solecki. “In the Neanderthal burial debate, archaeologists are always going back to the reports of finds from sixty or a hundred years ago, but that only gets you so far,” says Pomeroy. “Now we have primary evidence.”

She is currently CT-scanning each segment of Shanidar Z in the lab at the Cambridge Biotomography Centre, and will rescan them once the layers of silt – the “matrix” – are removed. Ultimately a digital reconstruction will emerge.

Members of Ralph Solecki’s team, Dr T. Dale Stewart (right) and Jacques Bordaz (left) at Shanidar Cave in 1960, working on removing the remains of Shanidar 4 (the ‘flower burial’) en bloc. This block of sediment was later found to also contain the partial remains of 3 more individuals.  

Members of Ralph Solecki’s team, Dr T. Dale Stewart (right) and Jacques Bordaz (left) at Shanidar Cave in 1960, working on removing the remains of Shanidar 4 (the ‘flower burial’) en bloc. This block of sediment was later found to also contain the partial remains of 3 more individuals.  

Ralph Solecki’s excavation team carrying the block containing Shanidar 4 (the flower burial), 6, 8 and 9 down from the cave to be transported to the Baghdad Museum for further study.

Ralph Solecki’s excavation team carrying the block containing Shanidar 4 (the flower burial), 6, 8 and 9 down from the cave to be transported to the Baghdad Museum for further study.

A 3D rendering of the in situ positions of the Neanderthal left hand and torso as it emerged from the sediment of Shanidar Cave. Credit: Ross Lane.

A 3D rendering of the in situ positions of the Neanderthal left hand and torso as it emerged from the sediment of Shanidar Cave. Credit: Ross Lane.

Scans have revealed the petrous bone to be intact. Named for the Latin petrosus, or ‘stone’, it’s a wedge at the base of your skull, behind the ear, and one of the densest bones in the body. The petrous is a grail for hunters of ancient DNA, as it can preserve genetic data for millennia.

We have ancient Neanderthal DNA from the North, where colder climates aided preservation. That’s how we know they bred with modern humans at some point. All non-African people still carry an average of 2% Neanderthal DNA, and a study from Princeton last month suggests most Africans also have around 0.3%. 

What we don’t have is Neanderthal genetics from hot and dry South West Asia, where this interbreeding most likely occurred, as modern humans spilled out of Africa. Shanidar Z might be the best hope yet.

Cross-sectional CT image showing the petrous part of the temporal and inner ear (within red box) of the new Shanidar skull.

Cross-sectional CT image showing the petrous part of the temporal and inner ear (within red box) of the new Shanidar skull.

Many argue that competition from our species was the catalyst for Neanderthal extinction. Other theories include an inability to cope with changing climates. In the office above Pomeroy, PhD student Emily Tilby is sifting through shards of shell and bone from Shanidar snails and mice, searching for traces of temperature shift.

“Small animals are particularly sensitive to climate change,” explains Barker. “Greenland ice cores give us a general global picture, but these tiny bones can tell us about changing climates in Kurdistan at the time when Neanderthals were roaming its mountains.”

Some estimates suggest that – despite ranging from the Atlantic coast to the Urals and South West Asia – there may have only been around 20,000 Neanderthals at any one time, says Barker. “Living in widely dispersed small clans yet somehow staying connected across the landscape.”     

Part of that connection may have been locations of cultural significance to which they returned again and again – places like Shanidar Cave. “We have Neanderthals at different levels, as well as this cluster of bodies next to a very large rock, perhaps some kind of marker,” says Pomeroy. “Not only are they returning to the same cave, but they appear to be putting bodies in the same spot.”

“While it’s common across human cultures to have places in the landscape earmarked for the dead, maybe we are seeing traces of this behaviour in a different species.” Emma Pomeroy

Time between deaths is a mystery. Solecki proposed that some of the Shanidar Neanderthals were killed instantaneously by rockfall. Pomeroy thinks this unlikely, but whether the bodies are separated by weeks, decades or centuries is a major challenge for the new research. “Getting scientific evidence for this is going to be one of the hardest nuts to crack,” says Barker.

Terms like ‘cemetery’ and ‘grave’ are problematic for the researchers. “We can’t yet be absolutely sure if Neanderthals were actually digging holes for the dead, then covering them over,” says Pomeroy, who prefers the phrase “mortuary behaviour”.

Early evidence from the new excavations suggests that some of the Neanderthals had been deposited in natural dips in the cave floor created by water, but also that “intentional digging” around the bodies had occurred.  

If Neanderthals were living in the cave there may have been practicalities (“you don’t want decomposing bodies to attract hyenas”), but Barker cautions against modern mindsets – death as medical fact – when considering their behaviour.

“In many traditional human societies, death is a long process, with stages of interment and ceremony. And funerary rites can sometimes be more about making sure the dead really are dead and are not coming back than helping them with their onward journey, ” he says.

He points out that isolated groups spread across Europe and the Near East over many thousands of years won’t have left a single Neanderthal “way of death”. “Between a body being dumped and elaborate funerary activity involving items such as flowers, there’s a vast range of possibilities.”

The pioneering pollen work of paleobotanist Arlette Leroi-Gourhan in the 1960s, which led to Solecki’s ‘flower burial’ claim, has been criticised in the years since (although Pomeroy and colleague Lucy Farr have uncovered documents in the Smithsonian they believe may rebut the rebuttals).

Some argue it was animals dragging flowers into burrows that caused pollen clumps. Others say Solecki’s workers tramped in petals from their daily cave commute. With colleagues at Liverpool John Moores, the team are reopening the case of the flower burial by analysing resin-imbued sediment from the scene, sliced wafer-thin.

Micromorphology thin section through the cut feature containing the new hominin remains. Credit: Lucy Farr.

Micromorphology thin section through the cut feature containing the new hominin remains. Credit: Lucy Farr.

Shanidar Z came back from Iraq as hand luggage. When Pomeroy moved from Liverpool to Cambridge in 2018, she drove the Neanderthal down packed in a suitcase, in a car that also contained the remains of John of Wheathampsted, a 15th century abbot of St Albans (“I introduced them to ‘80s cheese on the radio”).

Analyses of bones and sediment from the excavations are now in full swing at Cambridge’s Department of Archaeology and Liverpool John Moores University. “An archaeological project like this involves an ever-growing circle to help with specialist analyses,” says Barker. “The current list includes colleagues at Belfast, Bordeaux, Copenhagen, Leiden, Liverpool, London, Orléans and Oxford Universities.”  

“We also depend absolutely on the enthusiastic support of local Kurdish people and the Kurdistan archaeological authorities, for both of whom Shanidar Cave is core to Kurdish identity.”

In the intervening decades since Solecki described the flower burial, mounting evidence of Neanderthal culture and cognition suggests a species much closer to humankind than the “brutish cavemen” of common conception.

Just the last few years have seen use of decorative shells and even specific cave daubings attributed to Neanderthals. However, the repeated ritual interment of the dead within a site of memory, possibly over long periods of time, would suggest cultural complexity of an even higher order.     

“The questions are big, and go to the heart of what makes us human,” says Barker. “But determining the death practices of these Neanderthals will be far from easy. It’s as if we’ve got ten or eleven bits of a million-piece jigsaw, and we haven’t even got the picture on the top of the box.”

Inset image credit: View looking out from Shanidar Cave, taken in October 2016. Credit: Hardscarf from Wikimedia commons.

Dr Emma Pomeroy on site at Shanidar Cave.

Dr Emma Pomeroy on site at Shanidar Cave.

Professor Graeme Barker onsite inside Shanidar Cave, with the emerging Neanderthal behind him. He’s holding a soil block to be analysed microscopically in Cambridge.

Professor Graeme Barker onsite inside Shanidar Cave, with the emerging Neanderthal behind him. He’s holding a soil block to be analysed microscopically in Cambridge.

TopBuilt with Shorthand Summary: 

Archaeologists have unearthed a Neanderthal skeleton in a famous cave in Iraqi Kurdistan. They say the new discovery provides a unique opportunity to use modern technology to try and understand Neanderthal “ways of death”. Did Neanderthals dig graves? Over the next few years, Cambridge researchers will be trying to find out. 

Image: Affiliation (schools and institutions): Department of ArchaeologySchool of the Humanities and Social SciencesPeople (our academics and staff): Emma PomeroyGraeme BarkerSubject (including Spotlight on ... where applicable): ArchaeologyNeanderthalprehistorySection: ResearchNews type: News