Science


My recent post on the case fatality ratio of the new Wuhan Coronavirus sparked a long discussion about the role of European epidemics in the colonization of the new world. There is a theory that after Europeans came to the new world (the Americas, Australia, etc) they brought with them diseases that went through the local populations like wildfire, killing huge proportions of the local populations because they were not previously exposed to these diseases, and so lethality was much higher and even simple diseases that Europeans were used to (like influenza) were highly destructive in these naive populations.

This theory sparked my statistician’s skepticism, and also my cynicism about colonial narratives. Europeans arrived in the Americas in 1492, an era not known for its highly advanced demography, and when they arrived counting the locals wasn’t their primary priority. Epidemiology wasn’t particularly advanced at that time either, and medicine incredibly poor quality, not to mention the difficulty of preserving accounts from that time. Furthermore, I don’t see any evidence that the mortality rates due to diseases like smallpox and plague have changed over time in western populations, and because our recent encounters (in the past 500 years) with immunologically naive populations have been very hostile it’s hard to believe that people bothered to adequately (let alone accurately) record what happened in that time, and it’s hard to imagine that there have been any actual, valid studies of immunologically naive populations in modern times.

Furthermore, there has been a major revisionist movement in the west in the past 20 years, which has tried to deny the reality of genocide in the Americas and Australia, and to cast the white invaders as innocent of any crimes, or at worst having made a few well-meaning mistakes. In Australia this has been spear-headed by Keith Windschuttle, whose Fabrication of Australian History series explicitly attempts to deny violence towards Aborigines and recast the destruction of Australian Aborigines as a consequence of disease and demographic decline. This has been pushed by national newspapers (The Australian, of course, fulfilling their role as propagandists for Satan) and our former prime minister, and its “success” has no doubt sparked similar narratives in other countries. There is even a counter-narrative in the Spanish world of the “Black Legend“, which dismisses claims of violence by Spanish conquistadores as propaganda by England and France. It’s very convenient for these people if they can claim that immunologically naive populations are especially vulnerable, and population decline due to violence is actually the consequence of disease. They can even claim that mass movements of indigenous populations occurred due to disease, not genocide. Handy!

This led me to ask two related questions:

  1. Are immunologically naive populations actually subject to higher mortality rates when disease hits them?
  2. Did disease kill the majority of the population in the Americas, and was that disease introduced by Europeans?

The first question can be answered by looking at the history of black death in Europe, and by genetic studies. The second depends on demographic and epidemiological data, and as I will show, there is none, and all the accounts are extremely dodgy.

The history of diseases in naive populations

A population that is naive to a disease is referred to as a “virgin soil” population, although it appears that this name is never used to describe European populations affected by the plague (which was imported from Asia) – “virgin soil”, along with terra nullius, is a concept reserved for the new world. In fact Europe was virgin soil for the plague in the 14th century, and experienced repeated and horrific epidemics of this disease from the 14th century to the 16th century, with smaller plagues later on. In total the black death is estimated to have killed 30-60% of the population of Europe, and to have precipitated huge social changes across the continent. That was 700 years ago, and yet today the case fatality rate due to plague remains 60%, so 700 years of exposure to this disease hasn’t changed European susceptibility at all.

We can also see this in influenza. The H1N1 epidemic of 2009 killed only 0.01% of people who caught it, even though it was a new strain of influenza to which people could be expected not to be immune. The Spanish flu probably killed 10-20% of people it infected, but it did not do an especially greater job in isolated communities who had never experienced influenza before. For example in Samoa it probably killed about 20% of the population, having infected 90%, which suggests it did not behave particularly egregiously in an unexposed population. Smallpox, which has existed for 10,000 years in humans, had a similar mortality rate over most of its history, with variations in this mortality rate primarily driven by the number of people infected and the quality of the healthcare system. There is some evidence that the mortality rate is lower in Africans, who had been exposed to it for longer, but if so this has taken 10,000 years to manifest, which suggests that in general infectious diseases do not behave differently in “virgin soil” populations, though they can be much worse in populations with inadequate health care or infection control methods.

It’s worth noting that many estimates of the impact of these diseases rely on extremely dubious estimates of population. Putting aside demographic methods of the 14th century, Samoa in 1918 was a colony managed by New Zealand, with a colonial management so incompetent that they allowed people to disembark from a plague ship flying a yellow quarantine flag, and then mismanaged the resulting epidemic so badly that everyone on the island got infected. Did New Zealand’s colonial administration have any incentive to accurately count the population before the epidemic? Did they accurately register newborns and elderly people, or did they only record the working age population? How good were their records? If the Samoa population is underestimated by a small amount then the mortality rate plummets, and conclusions about the effectiveness of the disease in this naive population are significantly changed. And was the population even naive? Were the NZ colonial administrators previously recording every influenza epidemic on the island?

These problems are an order of magnitude worse when we try to understand what happened in native populations.

How many Spaniards went to Mexico?

Accounts of the effect of epidemics depend ultimately on our knowledge of the population affected, and population estimation is a very modern science. How was this done in 15th century America, by people who were busy slaughtering the people we now wish they were counting? What was the variation in population estimates and who was recording population, how and why? Fortunately we have a partial answer to questions about how population was recorded, because a historian called David P. Henige wrote a book called Numbers from Nowhere: The American Indian Contact Population Debate, much of which can be read on google books, that makes a lot of strong criticisms of recording of population at that time. Sadly his specific chapters on over-estimation of epidemics are not available online, but he does provide an analysis of accounts by Spanish reporters of the numbers of Spanish soldiers present at certain actions on the continent. As an example, he reports on the number of deaths recorded during the noche tristes, an uprising in the city of Tenochtitlan in which the Aztecs rose against their Spanish occupiers and slaughtered them, driving them out of the city. Spanish accounts of that event – by people who were there – record the number of deaths as between 150 and 1170, with Cortes (the general in charge) recording the lowest number. Henige also notes accounts of expeditionary forces that vary by up to 10% between reporters who were on the scene, and may not even mention Indian attachments that probably far outnumber the Spanish forces. He reports on a famous Spanish reporter on the continent (las Casas) who misreports the size of the continent itself by a huge amount, and notes that a room that was supposed to be filled with treasure as tribute was given radically different sizes by different Spanish observers, as was the amount of treasure deposited therein. He also notes huge discrepancies (up to a factor of 10) in population estimates by colonial administrations in north America. He writes

If three record books showed Ted Williams lifetime batting average as .276, .344 and .523 respectively, or if three atlases recorded the height of Mt. Everest as 23,263 feet, 29,002 feet, and 44,083 feet, or if three historical dictionaries showed King William XIV as ruling 58 years, 72 years and 109 years, their users would have every right to be thoroughly bemused and would be justified in rejecting them all, even though in each case research could show that in each case one of the figures was correct. Yet these differences are of exactly the same magnitude as those among the sources for the size of Atahulpa’s treasure room that Hemming [an author reporting this story] finds acceptable

These are all relatively trivial examples but they make the point: almost nothing reported from the colonies in the 15th century was accurate. In the absence of accurate reporting, what conclusions can we draw about the role of infectious diseases? And what scientific conclusions can we draw about their relative mortality in virgin soil populations?

Scientific estimates of epidemic mortality in Latin America

A first thing worth noting about scientific reports of epidemic mortality in the Americas is that they often use very old sources. For example, this report of the environmental impact of epidemics in the Americas  cites McNeill’s Plagues and Peoples (1977), Dobyns’s estimates of population from 1966 and 1983, Cook’s work from 1983, and so on. It also relies on some dubious sources, using references extensively from Jared Diamond’s 1997 breakout work Guns, Germs and Steel. Some of these works receive criticism in Henige’s work for their credulity, and Diamond’s work has been universally canned since it was published, though it has been very influential outside of academia. Many of these works were written long before good computational demography was well established, and though it’s hard to access them, I suspect their quality is very poor. Indeed, McNeill’s seminal work is criticized for using the Aryan population model to explain the spread of disease in India. These works are from a time before good scholarship on some of these issues was well established.

Dobyns’s work in turn shows an interesting additional problem, which is that no one knows what caused these epidemics. In his 1993 paper Disease Transfer at Contact, (pdf) Dobyns reports on many different opinions of the diseases that caused the demographic collapse in south America: it may be smallpox, or plague, or Anthrax, or typhus, or influenza, or measles. Dobyns’s accounts also often note that people survived by fleeing, but do not ever consider the possibility that they were fleeing from something other than disease. Contrast that with accounts from north America 400 years later (such as the story of the Pince Nez reported in Bury My Heart at Wounded Knee), which make clear that native Americans were fleeing violence and seeking sanctuary in Canada. There is a lot of certainty missing from these accounts, and we need to be careful before we attribute population decline to disease if we don’t know what the disease was, and are relying on accounts from people who refused to consider the possible alternative explanations for the social collapse they are witnessing.

This is particularly complicated by recent studies which suggest that the epidemic that wiped out much of the Mexican population was actually an endemic disease, that jumped from local rats to the indigenous population, spread from the mountains to the coasts (not from European coastal settlements), and had symptoms completely unrelated to European diseases. In this account, a long period of drought followed by rain triggered a swarm of a type of local rat into overcrowded settlements of native peoples, where a type of hantavirus jumped from those rats to humans and then decimated the population. The disease started inland where the drought had been worse and spread outward, and it primarily affected indigenous people because they were the ones forced to live in unsanitary conditions as a consequence of slave-like working conditions forced on them by the invaders. Note here that the western invaders, presumably completely naive to this disease, were not affected at all, because the main determinants of vulnerability to disease are not genetic.

Further problems with the epidemic explanation for native American population loss arise from the nature of the transatlantic crossing and the diseases it carried. The transatlantic crossing is long, and if anyone were carrying smallpox or influenza when a ship left port the epidemic would be burnt out by the time the ship reached the Americas. In fact it took 26 years for smallpox to reach the continent. That’s a whole generation of people slaughtering the natives before the first serious disease even arrived. During that time coastal populations would have fled inland, social collapse would have begun, crops were abandoned, and some native communities took sides with the invaders and began to work against other native communities. In 9 years of world war 2 the Germans managed to kill 50 million Europeans, several millions of these due to starvation in the East, and created a huge movement of refugee populations that completely changed European demographics and social structures. What did the Spaniards do in 26 years in central America?

It is noticeable that many of the accounts from that time seem not to account for flight and violence. Accounts at that time were highly political, and often reported only information that served whatever agenda the writer was pursuing. Las Casas, for example, whose accounts are often treated as definitive population estimates, appears not to have noticed massive epidemics happening right in front of him. Others did not notice any possible reasons why natives were abandoning their fields and farms, and didn’t seem to be able to consider the possibility that something scarier than disease was stalking the land. The accounts are an obvious mess, with no reliable witnesses and no numbers worth considering for serious study.

Conclusion

Without good quality demographic data, or at least even order of magnitude accuracy in population estimates, it is not possible to study the dynamics of population collapse. Without decent information on what diseases afflicted local populations, it is impossible to conclude that “virgin soil” populations were more vulnerable to specific diseases. There is considerable evidence that disease mortality is not different when populations are naive to the disease, drawn from European experience with plague and global experience with influenza, and there is no solid evidence of any kind to support the opposite view in indigenous populations. Historical accounts are fundamentally flawed because of their subjectivity, lack of accuracy even when their interests are not threatened, and the unscientific nature of 15th century thought. A whole generation of conquistadores acted with extreme violence before dangerous diseases arrived on the continent, so many accounts of population collapse must reflect only war, but even after the diseases arrived it is likely that they were no more dangerous in native populations than they were in Europe, which by the 16th century was experiencing endemic smallpox that regularly killed large numbers of people (in Europe in the 18th century it killed 400,000 people a year). There is no reason to think that the Americas were special, or that their local population was especially vulnerable to this or any disease.

It is important to recognize that these issues – accurate diagnosis of disease, accurate estimates of numbers who died, and accurate population numbers – are not just academic exercises. You can’t put them aside and say “well yes, we aren’t sure what disease did it, how many people died, and what the population was, but by all accounts it was bad in the colonies.” That’s not how epidemiology works. You would never, ever accept that kind of hand-waving bullshit when applied to your own community. Nobody would accept it if the Chinese government said “yeah, this coronavirus seems bad, but you know there aren’t that many people affected, the population of Wuhan is anywhere from 1 million to 20 million, and we don’t even really know it’s not seasonal influenza or smallpox.” You would rightly reject that shit out of hand. It’s no different when you’re talking about any other population. We have no reason to suspect any special impact of epidemics in the Americas or Australia, and no reason to conclude that they were especially influential in the history of those regions compared to the violence inflicted on the locals – which we know happened, and we have many accounts of. To look at the accounts we have of disease in the new world, and conclude anything about them beyond “it happened” is to put undue confidence in very, very vague and very poor reporting. There is no empirical evidence to support many of the claims that have been made in the past 40 years – and especially, by genocide deniers, in the past 20 years – about the role of disease in the destruction of indigenous populations of the new world.

This matters for two reasons. First of all, it matters because it has interesting implications for how we think about the threat of disease, and how new diseases will affect naive populations when they jump from animals to humans (which is how almost all new diseases start). These diseases can be extremely dangerous, killing 30-60% of the affected people in some cases, but the reality is that for them to become pandemics they need to mutate to facilitate human-to-human transmission, and that mutation significantly reduces their mortality rates. It is rare for a disease that transmits easily to also be dangerous, and there is very little in the history of the human race to suggest otherwise. The Spanish flu pandemic of 1918 is perhaps the sole exception, and if so it should show just how rare such events are. We should, rightly, be concerned about coronaviruses, but we should also not expect that just because we’re naive to them they’re going to be extra dangerous. Diseases do what they do, and that is all.

But more importantly, we need to reject this idea that the catastrophe that unfolded in the new world between 1492 and 1973 wasn’t the fault of its perpetrators, white Europeans, and we need to reject even partial explanations based on epidemics. It was not disease that killed the people of America and Australia. There is no evidence to suggest it was, and a lot of reasons to question the limited evidence that some people present. The epidemic explanation is a nice exculpatory narrative, which tells us that even if white Europeans had approached the people of the new world with open minds and hearts in a spirit of trade and collaboration they would still have been decimated by our diseases. In this story we may have done some bad things but it doesn’t matter, because contact was inevitably going to destroy these fragile and isolated peoples. And this story is wrong. It isn’t just uncertain, it is wrong: there is nothing in the historical record to support it. If white Europeans had approached the new world in this spirit, there would have been a generation of trade and growth on both sides before the diseases struck, and then we could have helped them to escape and overcome the diseases we were familiar with, that were no more dangerous to them than they were to us. Their communities would have been better prepared to resist the social consequences of those diseases because they would not have been at war, and would not have been experiencing social collapse, overcrowding, starvation and poverty because of western genocidal policies. They would not have been forced into overcrowded and desperate accommodation on drought-stricken plains as slaves to Spanish industry, and the homegrown epidemic of 1545-48 would not have affected them anywhere near as badly. It’s important to understand that the tragedy that befell native Americans was caused by us, not by our diseases, and our diseases were a minor, final bit of flair on a project of destruction deliberately wrought by western invaders.

This other story – of diseases we couldn’t help but strike them down with, even if we had been pure of heart – is a genocide denier’s story. It’s self-exculpatory nonsense, built on bad statistics and dubious accounts of native life presented by biased observers. It is intended to distract and to deny, to show that even if we did a few bad things the real destruction was inevitable, because these frail and noble savages were doomed from the moment they met us. It is a racist narrative, racist because of its false assumptions about native Americans and racist because of what it assumes about the balance of mortality in the continent, racist for trying to pretend that we didn’t do everything we did. It is superficially appealing, both because it adds interesting complexity to an otherwise simple story, and because it helps to explain the enormity of what Europeans did in the Americas. But it is wrong, and it is racist, and it needs to be rejected. There is no evidence that epidemics played a major role in the destruction of native American communities, no evidence that native Americans were especially vulnerable to our diseases, and nothing in the historical record that exonerates European society from what it did. White Europeans enacted genocide on native Americans, and just a few of them happened to die of some of our diseases during the process. European society needs to accept this simple, horrible fact, and stop looking for excuses for this horrible part of our history.

Since 31st December 2019 there has been an outbreak of a new coronavirus in China. It originated in the city of Wuhan, and over the past 22 days has spread rapidly, including cases in several cities outside China. Initial reports suggested it originated in a seafood market in the city, which had me hoping it was the world’s first fish-to-human infectious disease, though I think we need to wait a while before we establish exactly where it started. It appears to have achieved human-to-human transmission, which is unusual for these zoonotic (animal-origin) viruses. International media are of course reporting breathlessly on it, and you can almost feel them salivating over the possibility of another SARS-style catastrophe. But how dangerous is it?

In this blog post I would like to use some initial data and reports to make an estimate of how dangerous this disease is, for those who might be considering traveling to (or canceling travel to) China. I’d also like to make a few comments on the reporting and politics of this disease, and infectious diseases generally.

The Case Fatality Ratio

For the sake of easy writing, let’s call this new disease Dolphin Flu, since it originated in a fish market. The main measure of how deadly any infectious disease is is its case fatality ratio (CFR), which is the number of people who die divided by the number of people infected, multiplied by 100. It seems to be a natural law of infectious diseases that the more infectious a disease is the less fatal it is, and anyone who has played that excellent pandemic game on their phone will know that there is a cost associated with a disease being infectious, which is usually that – like the common cold – it spreads fast but kills no one. Understanding the CFR is important to understanding how nasty a disease is likely to be. Here are some benchmark CFRs:

  • Untreated HIV: 100% (i.e. 100% of people infected with HIV die if they aren’t treated)
  • Untreated Ebola: 80-90%
  • Malaria (Africa): 0.45%
  • Spanish influenza (1918): ~3%
  • Measles: 0.2%

Nature is pretty, isn’t she? It’s worth noting that Spanish Influenza was a global catastrophe, which had major political and economic consequences, so any disease with a CFR around the level of influenza that is similarly infectious is a very scary deal. Ebola and HIV are extremely deadly but also not very infectious (you have to have sex to get HIV, which means my reader(s) face almost zero risk). It’s the respiratory diseases (the lungers) that really worry us.

Calculating the Case Fatality Ratio for Dolphin Flu

In order to calculate the CFR we need to know how many people are infected, and how many have died. Official government data this morning (reported here) puts the death toll at 17 people, and we can be fairly sure that’s correct, so next we need to calculate the number infected. This excellent website tells us there are 555 confirmed cases, but this is not the right number to use for this calculation, because with all of these respiratory-type diseases there are many cases who never go to a doctor and/or never get confirmed. In ‘flu season we call these “influenza-like illnesses” (ILI) and they are important to understanding how dangerous the disease actually is. In fact for many of these diseases there is an asymptomatic manifestation, in which people get the disease and never really show any symptoms. So we need to have an estimate of the total number of cases including those that were not confirmed. Fortunately the excellent infectious disease team (who do a great course in infectious disease modeling if you have the money) at Imperial College have used the number of cases appearing at non-Chinese cities to estimate the total number of cases using data about travel flows from Wuhan city. Their headline estimate at this time is 4000 cases, with an uncertainty interval from 1000 to 9700.

Next we need some information on other diseases. The CDC website for seasonal flu tells us that in the 2017-2018 season in the USA there were 20,731,323 confirmed cases of influenza, 44,802,629 total cases (including unconfirmed) and 61,099 deaths. A Japanese research paper on the H1N1 pandemic tells me there were 637,598 total cases (including unconfirmed) and 85 deaths due to H1N1. The Wikipedia entry on H5N1 bird flu tells me there were 701 confirmed cases and 407 deaths (I think there were very few unconfirmed cases of bird flu because it was so nasty).

Putting this together, we can get the CFR for confirmed and unconfirmed Dolphin Flu, and compare it with these diseases, shown below.

  • Unconfirmed Dolphin Flu: 0.43%, ranging from 0.22% to 1.7%
  • Confirmed Dolphin Flu: 2.98%
  • Unconfirmed Seasonal Flu (2017-18 season, USA): 0.14%, ranging from 0.11% to 0.16%
  • Confirmed Seasonal Flu (2017-18 season, USA): 0.29%
  • Unconfirmed H1N1 (Japan): 0.01%
  • Confirmed H5N1 (Global): 58.06%

This suggests that Dolphin Flu is between 2 and 10 times as dangerous as seasonal influenza, and about as dangerous as malaria if you are infected with malaria in an African context (i.e you may not be able to afford and access treatment, and you’re so used to idiopathic fevers that you don’t bother going to the doctor until the encephalitis starts).

That may not sound dangerous but it’s worth noting that seasonal influenza is one of the most dangerous things that can happen to an adult of child-bearing age except getting in a car and childbirth. It’s also worth noting that depending on the degree to which the Imperial College team have overestimated the number of unconfirmed cases, Dolphin Flu could be heading towards half as dangerous as Spanish Influenza. We don’t yet know if it is as contagious as influenza, but if it is …

I would say at this stage that Dolphin Flu looks pretty nasty. I probably wouldn’t cancel travel, because it’s still in its early stages and the chance of actually getting it is tiny (especially if you aren’t in Wuhan). But tomorrow is Chinese New Year, the largest movement of people on the planet, so in a week I expect that it will be all over China and it may be much harder to go there without getting it. I guess in that context the decision to quarantine Wuhan makes sense – if it’s half as dangerous as Spanish Flu, it’s worth suffering the short term economic damage of shutting down one of China’s largest cities to avoid spreading a disease that could be a global catastrophe.

So, given that information, would you travel? And what decision would you make if you were an administrator of public health in China?

About Cover Ups and Authoritarianism

Media coverage of disease outbreaks almost invariably follows western stereotypes about the country where they happen. With Ebola it’s all about bushmeat-eating primitives who can’t understand modern medicine; with MERS it was secretive religious lunatics; and with anything coming from China it’s a weird mix of Sinophobia, orientalism and obsessions with China’s authoritarian government. Because China fucked up the SARS response, we can see Western media basically salivating at the chance to report on how they’re covering this up too. But it’s important to understand that unconfirmed cases are not covered up cases. With respiratory diseases there will always be unconfirmed cases and there will always be someone who slips through the net and goes traveling, spreading the disease to other cities. Indeed, with a completely new disease it’s entirely possible that there are asymptomatic cases that no health system can detect.

In fact this time around the Chinese response has been very quick, open and transparent. They notified the disease to the WHO on 31st December, probably very soon after the first cases appeared, and the WHO Director-General has been fulsome in his praise of the Chinese response. Within perhaps 10 days of notifying the disease to the WHO they had isolated the virus and developed tests, and now they have quarantined a city of 12 million people because they know that the impending Chinese New Year could cause major transmission risks. Before complete quarantine they had introduced fever checks at exit points to international destinations, another sign of taking the disease seriously. This is unlikely to be successful if the disease has an asymptomatic phase (since you get on the plane before you have a fever) but short of blood-testing everyone in the city, there is little more that anyone could expect the government to do.

How to handle western media panic

None of this will stop western media from playing to the west’s current fear of China, and once the disease is over you can bet they will start talking about how the Chinese response was too authoritarian. You can also bet that the mistakes the administration inevitably makes will be discussed as if they are hallmarks of a Chinese problem, rather than mistakes any government could be expected to make when trying to control a disease that spreads at the speed of a cough. And this will all be made worse by the way western media get into an absolute lather about infectious disease stories. So be cautious about stories about China’s cover-ups, about authoritarianism, and avoid believing disease panics. Check in with the WHO’s updates, read the Imperial College website, and be careful about the western media’s over-hyping of disease threats and Chinese collapse. For a balanced view of infectious disease issues generally (and excellent coverage of the tragic, ongoing Ebola Virus outbreak in DRC) I recommend the H5N1 blog. For understanding how to interpret risk, I recommend reading David Spiegelhalter’s twitter. And remember, when you’re balancing risks, that getting in a car, or choosing to have a child (if you’re a woman) are probably the two most dangerous things anyone in a developed nation can do in their lives. You don’t need to go to China to experience any of those risks!

Let’s hope that this disease turns out to be another fizzer, keep a level head, and don’t let western media hype scare us!


About the picture: The picture is from the Twitter thread of @CarlZha, an excellent independent Chinese voice. It’s a photo of some guys doing renovation work on a clinic somewhere in China. There isn’t actually a Zombie outbreak yet!

Australia has been burning since New Year’s Eve, with bushfires spreading across a huge area of the eastern seaboard. The entire New South Wales coastal region from the border of Victoria to north of Sydney has been affected, along with a big swathe of eastern Victoria (Australia’s most densely-populated state) and communities up and down the coast are slowly being consumed. The main highway linking Western Australia to the eastern states has been cut, and towns on the route are running out of food. As I write this 21 people are listed as missing in Victoria, and about two score people have died along with the loss of hundreds of houses. These figures are preliminary because fire experts predict the fires will burn for weeks still, and the emergency services have not yet had any chance to assess damage in many areas. The federal government has mobilized 3000 army reserve soldiers, troop transports are being used to evacuate entire towns, and in many areas the fires have been left to burn because there are insufficient resources to fight them. Today, 4th January 2020, multiple records for maximum temperatures were toppled, with Canberra setting a new record of 43.8 C, 47C in western Sydney, and all of the south east under a blanket of intense heat and strong winds. The fires may change direction later in the day as a southerly change moves in, though intense winds may spread them even then. From a personal perspective, multiple friends of mine have been marking themselves safe on Facebook, or updating social media with information about their preparations for the incoming fire fronts. Although Australia is used to bushfires, the biggest ones usually occur later in the year and they do not normally all occur at once, across the entire country. This is the effect of global warming, and there is much worse to come over the next few decades.

Australia is currently labouring under a conservative government. For the past 40 years – barring a couple of years in the early 1990s – this party has refused to accept the reality of climate change, has denied its human origins, has fought tooth and nail in international forums to prevent global action against climate change, and has refused to do anything to stop climate change locally. After the past Labour government introduced real measures to begin mitigating climate change the incoming conservative government reversed them, hobbled the renewable energy industry, and used accounting tricks to meet its commitments under the Paris Agreement. Even when they admit that climate change is real they refuse to link climate change to any of the environmental challenges Australia faces, whether drought, storm, flood or fire, and they refuse to take action to mitigate global warming, insisting instead on adaptation.

Today is what adaptation looks like. Communities destroyed, tens of thousands of people evacuating from their homes, huge stretches of forest and national park burnt out, wild animals and stock burnt alive, infrastructure ruined, and the entire country brought to a standstill as it watches the fury of nature in helpless horror. There is nothing that can be done, and ultimately nowhere to run. Climate change has reached the driest, most fragile continent on earth, and its inhabitants are adapting: running, hiding, burning, gasping and hiding on beaches and boats as they watch the sky turn black with the ashes of their homes and communities.

This is what adaptation looks like. This is what the climate change deniers have been demanding of us for the past 20 years. Mitigation is too expensive or impossible, they say, it is better to adapt, to prepare ourselves for the warmer future. Instead of preventing what is coming we should build robust communities that are ready to deal with it. These communities certainly have shown how robust they are as they adapt to the coming firestorms, crouching in the midday dark on beaches or waiting hours in crawling traffic as they abandon their homes. Robust communities, fleeing for their lives from a storm they have been forced to adapt to by 40 years of inaction.

This is what adaptation looks like, and it will get worse. Not only will it get worse, but the people who refused to take any action to prevent this storm coming will also abandon you to its fiery maw. They said you should adapt, but they won’t give you any money to adapt, because when conservatives are faced with a community challenge their answer is always: there’s no money. The same people telling you it’s too expensive to prevent climate change will also tell you it’s too expensive to adapt. Don’t believe me? Look at this government’s response to requests for funding for fire prevention. For two years the fire chiefs have been pushing the government to increase funding for fire services by a mere $12 million per year, and they have refused because “there’s no money.” Today they released $20 million for emergency fire fighting planes, which will arrive two weeks too late and probably won’t help anyway. Up until yesterday they were refusing to consider funding firefighting volunteers. That’s what they think of adaptation. You can burn, for all they care. They and their rich mates will hide in the cities, pretending to be friends of the communities that are forced to adapt, while they refuse to spend a single cent of the money they have made selling coal to the world. They will let you burn before they’ll share the profits of global warming with you.

This is what adaptation looks like, for communities that in many cases were staunch supporters of these conservative governments. Many of the towns and rural areas burning this new year are in staunch Liberal/National-voting seats, people who voted for the governments that deny climate change, and are now running because those same governments won’t help them adapt. Meanwhile the rich columnists of the conservative media sneer at them for not buying insurance, or for not preparing properly, as their homes become uninsurable and undefendable in the face of global warming. Conservatives don’t care about their own rural electorates, and will throw them to the fires of their greed. Nor will they show them the respect of even pretending to care: the prime minister, who in his victory speech last year said he would “Burn every day” to make the lives of the “quiet majority” better was on holiday in Hawaii as his country burned, and hosting a party for cricket players by the Sydney harbour as the disaster escalated. These people will never burn for you, nor will they show you even a modicum of respect or compassion.

Conservatives are traitors, economic wreckers, and ecological vandals. They will destroy this country before they will admit they are wrong, they will watch it all burn down before they will give up their ill-gotten gains, and they will never ever show compassion to the people whose lives are destroyed by their policies. Conservatives are the biggest threat to industrial civilization that humanity has ever faced, and their political movement needs to be destroyed utterly before it destroys us. Wherever you are in the world, you need to get these preening, greedy cowardly traitors out of office. The only hope for the future of civilization as we know it is the destruction of conservative political parties, their expulsion from the body politic, and their complete humiliation intellectually, culturally and politically. Get rid of them, before they get rid of you.

Some commentators on Twitter and in the media are saying that Labour lost the 2019 General Election because it lost too many votes to remain parties, and that failure to retain support from remainers was the problem. Angry Labour activists on Twitter have been listing off the remain seats that were lost, and saying that a strong remain strategy would have saved the party.

This is completely wrong, and I will show this using data from the 2019 election and the 2016 referendum.

Methods

First I used the dataset of constituency-level results I assembled over the weekend, which contains results for 339 constituencies, semi-randomly sampled from the list of all constituencies on the BBC election site and linked to leave voting data from the 2016 EU referendum. The detailed methodology for assembling this dataset is given here. I then assembled a separate data set of only the seats Labour lost, using this handy (but not quite alphabetical) guide from the Metro newspaper. I merged these with EU referendum data.

Using the full constituency data set, I created a logistic regression model of probability of retaining a seat against constituency leave vote, for all the seats that were held by Labour at the 2017 election. I plotted the predicted probability of losing a seat against the proportion of the population in that seat. Then, I conducted a crosstabs and chi-squared test for the seats held by Labour in 2017, showing the probability of losing a seat in 2019 by whether or not it was a leave-voting constituency. I defined a “leave-voting constituency” as any constituency voting above the median leave vote (which was 53.55).

Next, using the data set of the 59 constituencies Labour lost, I calculated the mean vote in this set of constituencies, and the proportion of constituencies that were leave-voting constituencies. I compared this with data for all Labour held seats that were not lost in the 2019 election.

Results

In my constituency data set there were 142 seats held by Labour in the 2017 election, of which 30 (21%) were lost in the 2019 election. Figure 1 shows the cross tabulation of leave seats with seats Labour held in 2019[1].

Figure 1: (Hideously ugly) cross tabulation of Labour-held seats by whether those seats voted leave

As can be seen, 92% of remain seats were held, compared to 66% of leave seats. This is extremely statistically significant (chi-squared statistic 14.35, p<0.001). That’s a nasty sign that the main risk of losing a seat was that it was a leave seat, not a remain seat.

We can show this explicitly using logistic regression. Figure 2 shows the predicted probability of a seat being held by Labour in 2019, plotted against the proportion of the seat that voted to leave in the EU referendum. The red dots on this figure indicate whether it was held by Labour in 2019: red dots on the top of the figure are seats retained, plotted at the value of their leave vote; red dots at the bottom are seats that were lost, plotted at the value of their leave vote.

Figure 2: Probability of losing a seat in 2019 by leave vote

This model was highly significant, and showed that every 1% point in the leave vote reduced the odds of Labour holding the seat by 7%. Note that this figure includes Scotland, so the results might be slightly different if only England were considered, but even the strongest remain-voting seat that was lost – even were it in Scotland – is well above the remain vote of some seats that were held. This model shows that at the extreme end of the leave spectrum, up above 60% of the electorate voting for leave, the probability that Labour retained the seat dropped to around 50%. That’s terrible!

My constituency data set contains only 142 Labour seats, and 30 seats that were lost, but actually 59 seats were lost. Since my data set is semi-random, there is a small chance that it will misrepresent the results. So I checked with the dataset of all seats that were lost. This data set contains 59 seats. Here are some basic facts about this data set, and comparisons with the constituency data set and the full list of Labour-held seats:

  • Labour lost 14 remain-voting seats (24% of all seats lost) and 45 leave-voting seats (76%). This is very similar to my crosstabs, where 24 of 30 seats lost (80%) were leave
  • The average leave vote in the 59 seats that were lost was 57.7%, slightly above the median, ranging from 31.2 – 71.4%.
  • In contrast, the average leave vote in the 112 seats in my constituency data set that Labour held was 48.8%, ranging from 20.5 – 72.8%
  • The average leave vote in all seats held by Labour going into this election was 51.1%, ranging from 20.5 – 72.8%

This is clear statistical evidence that Labour went into this election having a slightly remain-leaning set of constituencies, primarily lost leave-voting constituencies, and emerged from the election even more remain-focused than when it went in.

Conclusion

Labour did not lose this election because of a large swing in votes to the remain parties. It did not lose a large number of remain-voting seats, but was decimated in the leave-voting areas. Labour held on to all of its most heavily remain-focused seats. In attempting to appeal to both leavers and remainers, Labour managed to retain most of the remainers and lose a lot more leavers. Labour emerged from this election even more remain-focused than it was when it went in[2]. There are some very simple reasons for this:

  • The swing to the Tories and away from Labour was much bigger in leave-voting seats
  • The Brexit party was only active in Labour-held seats, and got its largest vote share in the strongly leave seats
  • The swing to the Lib Dems was much less closely related to the leave vote than was the swing away from Labour (see my last blog post, Figure 4)
  • The intensity of the relationship between leave voting and swinging to Lib Dems was lower in Labour-held seats than Tory-held seats (see my last blog post, Figure 4)

In trying to please both sides of the Brexit divide, Labour failed to satisfy the leavers. Pro-brexit Labour voters were simply much, much more committed to Brexit than pro-remain Labour voters were to remain, and so Labour lost the leave areas. There are lots of remainers out there who want to claim that remain is wot did it, but they are simply wrong. I’m super pro-remain myself, but the data makes it very clear: British Labour voters want to leave, and they were willing to pack in their allegiance to the Labour movement to get that done. Whatever you might think of their politics, that is the simple hard fact of the electorates Labour represented.

It’s worth noting that in 2017 Corbyn campaigned on Brexit. The Labour manifesto explicitly accepted Brexit and said Labour would negotiate and leave. At that election Labour won a historically high share for a party in opposition, a higher share of the vote in fact than Blair won in 2005 (when he retained government). In that election they came within a bees’ dick of winning government, and in that period before Corbyn accepted the compromise of a second referendum two Tory PMs left, and Johnson only held onto government by the skin of his teeth (recall there was talk of a unity government). Blair and Cameron have both shown it’s possible to hold government with 35% of the vote, so it’s perfectly possible that had Corbyn gone into this election on a leave platform he would have seen a much smaller swing against him, and could have won it. We don’t know, but on the basis of all the evidence here it seems like the second referendum policy was a disaster for Labour.

This gives two clear lessons for Labour to take in over the next few years and as they choose a new leader:

  1. Labour’s policies and Corbyn were not the primary problem, and dropping them is not going to help. Obviously Corbyn is going to go, it’s traditional, but the manifesto’s policies were not the problem. The Labour right is going to push for the party to throw the Corbyn years down the memory hole (in today’s Guardian we have Suzanne Moore begging for a vet to “sedate” the Corbyn supporters!), because they are and have always been intent on fighting these genuinely left wing policies. Ignore them, and stick to the real Labour platform that will really help the country as it recovers from the horrors of this Tory leadership
  2. Labour – and the British left generally – have to get over Brexit. There is no option left to remain, and no chance it will ever happen now. The Labour right want to claim that Corbyn doesn’t understand working class voters but his original policy – of full-throated Lexit – was much more in tune with what ordinary working class Labour supporters want than anything that the Blairist rump have to say. The debate now for Labour has to be about the type of Brexit, and how to make it work. This means fighting Johnson’s bullshit deal, but on the basis that they can make a better one – obviously this doesn’t matter now but it is the job of the opposition to hold the government to account, and they should do so from the clear perspective of their voters, that Brexit has to happen. This is going to be hard for some of the urban remainers from the south and east, but that’s life if you’re a politician. Further talk of remain just has to end

For 20 years the EU was a thorn in the Tory side, constantly causing them trouble. Cameron ripped that thorn out with this referendum, and although May spent some time botching the healing process Johnson has patched up the damage and squeezed out the last remainer pus from the Tory body politic. If Labour don’t face the reality of Brexit and what it did to this party at the 2019 election, then the issue will fester for them – as it did over so many years for the Tories – and hold them back just as it did the Tories. It is time for Britain to move on from Brexit, and for the Labour movement to accept the reality of the disaster that is coming. Once people realize how Johnson’s Brexit has screwed them, they will turn to Labour – and Labour needs to be ready with a transformative, genuinely left wing agenda in order to recapture its heartland and do what is right for working people. Corbyn was right about Brexit, right about the policies Britain needs, and after he is gone he will still be right about what has to be done. Don’t repudiate those lessons, and in the process destroy the movement.


fn1: My apologies for pasting this as a picture directly copied from Stata, instead of making a nice pretty table – I hate it when people do this but it’s late and I hate making tables in html. Stata offers an option to copy as html but it doesn’t work. Sorry!

fn2: This final conclusion is shakey because it depends on my constituency data set, and I don’t know if it would still be true once all the remaining Labour-held seats are entered into the dataset. I think it will, but there’s a chance the final data set will end up the same level of leaviness as the 2017 constituencies, statistically speaking. But this conclusion is not a very important one anyway, so it doesn’t matter if it isn’t held up by the full dataset.

The UK General Election has just finished, with Labour losing badly to Boris Johnson’s Brexit-fetishizing Tories. The media are describing Labour’s loss as the worst since 1935, which is true if you look at seats lost but not at the vote – with 32.2% of the vote share it’s the best result for a losing Labour party since 1992, and although the swing against Labour was very large – 7.2% – this is partly because the previous share of the vote that Labour achieved, at 40%, was phenomenally high – Blair only beat 40% once, and many post-war Labour governments have ruled a majority with a much lower share of the vote than Corbyn achieved in 2017.

In the early post-election recriminations people are laying the fault entirely at the feet of Corbyn and the Labour manifesto, but I’m not convinced that a different leader or a less radical manifesto could have helped. The 2019 election was a historic election, similar to the 1945 election, with a huge decision about the future of the UK to be made and a major recent event hanging over the election. In the 1945 election the huge decision to be taken was the establishment of the modern welfare state, and the recent event was the war. In the 2019 election the decision is Brexit, and the EU referendum is the major event overshadowing the election.

This Brexit issue overshadowed the whole election, and in this blog post I will show that it had a huge impact on the Labour vote, which made this election almost impossible for the Labour party to lose. I will show this using a statistical analysis of 2019 election results.

Methods

I obtained 2017 election results and 2015 EU Referendum results from the UK Parliamentary Research Briefings website. I merged these data sets together using ONS ID (the unique number that identifies parliamentary constituencies) so that I had the percentage of each constituency that voted leave in 2016, and their 2017 election results, in one dataset. I then conducted a semi-random sample of the 2019 General Election results using the BBC Election results website. The sample was semi-random because there is no publicly available official dataset at this stage, so I had to enter them by hand looking at each constituency in turn on the BBC website[1]. I started by ordering my dataset by constituency name from A-Z and working sequentially through them on the assumption that I have limitless patience and 10 hours of my life to give to this, but gave up somewhere around “D” and took a random sample of another 100 or so constituencies. Because names are approximately random, this means I have 200 or so approximately random samples from the first stage, and another 100 or so genuinely random samples from the second stage. I may have had a hangover, but there are limits to how much time and effort I am willing to put into rescuing the UK Labour party from bad analysis!

I dropped Northern Ireland from my analysis because a) I don’t understand their political parties b) Sinn Fein’s decision not to enter parliament is weird and c) Northern Ireland should be part of Ireland, not the UK. I kept Scotland but excluded it from some of my figures (see specific figures for more details). I excluded the Speaker’s seat (which was Labour) from analyses of the Labour swing because there was no opponent so the swing was weird; I also excluded another Labour seat with a very high positive swing from these analyses, and dropped one Conservative seat (Buckingham) with the same problem.

Once I had done this I then calculated the swing against Labour, Lib Dems and Tories by subtracting their 2017 result from their 2019 result. I confirmed this works by comparing calculated Labour swing with actual Labour swing from the BBC website (which I entered as I went through my semi-random sampling). I obtained Brexit party vote shares from the BBC website, leaving this field blank if the Brexit party did not stand a candidate[2].

I then conducted several linear regressions of the swing:

  • A linear regression of conservative party swing as a function of leave vote in the EU Referendum
  • A linear regression of Labour party swing as a function of leave vote in the EU Referendum
  • A linear regression of Lib Dem swing as a function of leave vote in the EU Referendum
  • A linear regression of Labour party swing as a function of Brexit party vote

For all regressions I tested a quadratic term in leave vote, and I included a term for whether the constituency was in Scotland or Wales. I included a term for whether or not the constituency experienced a Brexit party challenge in the first three regressions, and tested an interaction with leave vote. I dropped any non-significant terms in order of their non-significance to get the best model. I also centered the EU referendum vote at its median (53.5% of people voting to leave), so that the constant term in all linear regressions measured the swing against the party in question in the median leave-voting seat.

I then obtained predicted values from all regressions to include in the plots of the swing against the leave vote or the Brexit party vote. Brexit party vote is effectively being used here as a proxy for Labour voters’ decision to abandon Labour over Brexit. I did not model the relationship between swing against Labour and Brexit vote because I think this swing is the Brexit party’s fault, but because I expect it represents the likelihood that Labour voters abandoned Labour over Brexit. One might suppose they abandoned Labour for Tory over general policy, or because they respect BoJo, but the only reason for abandoning to the Brexit party is Brexit, and so this acts a proxy for the possibility that they also jumped ship to the Tory party over Brexit. Because the Brexit party only stood candidates in Labour-held constituencies it is impossible to test what might have happened if the Brexit party stood against a Tory incumbent.

Results

I had data on 341 constituencies, just over half of all eligible constituencies. Among these 341 constituencies 146 (43%) had a Brexit party challenger. Of the 142 seats that were Labour held in 2017, 112 (79%) survived to be Labour-held in 2019. None of the 199 non Labour-held seats in my dataset switched to Labour in 2019. The mean swing against Labour in seats it held was 8.7%, and the mean swing against it in seats it did not hold was 7.5%.

Let us consider the relationship between the swing against Labour and the Brexit vote in seats where it was challenged by this party. Figure 1 shows the swing against Labour in England plotted against the proportion of the vote that the Brexit party won, with the predicted trend in the swing from my final regression model. The final regression model explained 54% of the variation in the swing against Labour, included a quadratic term for the Brexit vote, and included significant terms for Scotland (a 3.5% larger swing against Labour) and Wales (a 2.2% smaller swing against Labour). The intercept term in this model was -3.8, which indicates that in the absence of a Brexit party challenge these seats would have seen a mean swing against Labour of about 3.8% (95% confidence interval 2.6% to 5.0%). In this counter-factual[3], most of these seats would not have changed hands if there was no Brexit party challenge.

Figure 1: Russian Ratfuckery, in its most exquisite form

It is very clear from Figure 1 that the Brexit party had a massive impact on the Labour vote, pulling it down by a huge amount in the seats where they ran a candidate. The Brexit party did not win a single seat in this election, but they cost Labour a lot of seats. Once again, Farage had a huge impact on British politics without ever sitting in parliament. In some of the northern seats the Brexit party got a huge share of the vote, and it is very likely that almost all of it came from Labour. In the seats with a middling Brexit vote, between perhaps 5 and 15% of the total vote, Labour lost between 10 and 20% of the vote share. I think this is a strong indicator that Labour was bleeding votes due to Brexit.

We can confirm this by examining the relationship between the swing against Labour and the proportion of the electorate who voted for leave in the 2016 EU referendum. Figure 2 shows the swing against Labour in England and Wales plotted against the leave vote, separately for constituencies with a Brexit party challenger (red) and those without a Brexit party challenger (blue). Most seats with a Brexit party challenger were Labour seats, while those without a challenger were mostly Tory. The blue and red lines show the predicted swing against Labour from my linear regression model, which explains 39% of the variation in the swing against Labour. This model had a term for Scotland (which had a 2.4% larger swing against Labour), a quadratic term for the leave vote, and an additional effect on the swing due to the leave vote in areas with a Brexit challenger. In the median 2016 EU referendum leave-voting constituency, the swing against Labour was 6.5%, and this was 2.1% higher in seats with a Brexit challenger.

Figure 2: Relationship between the swing against Labour and the leave vote

It is clear from Figure 2 that the swing against Labour was smaller in seats with a Brexit party challenger that voted to remain in the EU. In seats not held by Labour, the swing against Labour was larger in seats that were either strong leave-voting seats or strong remain seats. In these seats – the seats Labour had to win to win government – Labour was being squeezed in both strongly remain and strongly leave seats. In the seats Labour already held (mostly with a Brexit party challenger), or that it did not hold but faced a Brexit party challenger and a Lib Dem or SNP incumbent, the party faced intense pressure due to brexit. In seats it held that had a large leave vote Labour was completely smashed. These seats are mostly in the famed “red wall”, the northern seats that Labour has always been able to rely on. Note the largest positive swing to Labour occurred at about the median leave vote, between 45 and 55.

An interesting phenomenon in this election is the failure of the conservatives to gain a large swing from Labour. The national swing against Labour was 7.9%, but the conservatives only gained a 1.2% swing. The primary beneficiaries of that swing were the Lib Dems and the Brexit party. Of course, these national figures hide major variations within constituencies, which are easy to see if we look at the swing to the Tories at the constituency level. Figure 3 shows the swing to/against the conservatives in England, plotted against the leave vote in the 2016 EU referendum. Red points are points where there is a Brexit party challenger, and blue points are those without a Brexit party challenger (mostly Tory-held seats) At the median leave vote my model estimated a swing to the Tories of 1.3%, with a further swing to them of 1.4% in Wales. This model included a quadratic term in the leave vote, and explained 57% of the variance in the Tory swing.

Figure 3: Observed and predicted swing to the conservative party, by EU referendum leave vote

It is noteworthy that in the seats that voted to remain the Tories experienced a swing against them of as much as 10%, but in the strong leave-voting seats they experienced a huge swing to them. This swing was larger in seats without a Brexit party challenger, presumably because there was no Brexit party to absorb the leave sentiment, but even in pro-leave constituencies with a Brexit party challenger the Tories gained a very large swing. Note, however, that in some pro-leave seats there was a swing against the Tories where there was a Brexit party challenger. These were Labour seats that saw all their pro-leave vote go to the Brexit party. But in pro-leave seats with no Brexit party challenger – the seats that Labour needed to win to form government – there was a consistent large swing to the Tories. We again see here the value of Farage’s decision to stand candidates only in Labour seats.

Finally let us consider the role of the Liberal Democrats, the greatest frauds in modern politics, in destroying the UK. Figure 4 shows the swing to or against the Lib Dems in England, plotted against the 2016 EU referendum leave vote, with the predicted swing from my regression model. Again, red points are for seats with a Brexit party challenger (Labour- or Lib Dem-held seats) and blue points are for seats without a Brexit party challenger (mostly Tory-held seats). This model has no quadratic term for the leave vote: in non-Brexit party seats every percentage point increase in the leave vote was associated with a swing against Lib Dems of 0.2%, but in seats with a Brexit party challenger this swing was only 0.1%. At the median leave vote the Lib Dems experienced a swing towards them of 6.0%, reducing to 2.8% in seats without a Brexit party challenger. Scotland and Wales saw large reductions in this swing to the Lib Dems, of 5.3% in Scotland and 2.1% in Wales. Basically, the Lib Dems performed best in Labour seats in England that voted to remain in 2016. In these seats the swing against the Labour party was often almost entirely towards the Lib Dems. This model explained only 29% of the variance in the swing, probably because the Lib Dems win by very local-specific campaigns, not so strongly affected by national factors.

Figure 4: Look at these arseholes spoiling the Labour vote

Note that in some Tory-held remain seats (the blue dots to the left of the figure) the Lib Dems had huge swings to them, but in many seats they did not win. A good example of this is Cities of London and Westminster, which was Tory before this election and did not have a Brexit Party challenger. The Lib Dems fielded Chuka Umunna, a class traitor who abandoned Labour to join TIG, then jumped ship from them to join the Lib Dems, natural home of fickle and untrustworthy people. He won 30.7% of the vote, scoring a swing to the Lib Dems of 19.6%. This enabled the Tories to hold this seat with just 39.9% of the vote, against Labour’s 27.2%. Had he not stood, it is possible that a large proportion of that vote might have gone to Labour. In the seat he used to represent for Labour, Streatham, Labour held on despite a surge of 17.0% in the Lib Dem vote (this seat is not in my data set so you can’t find it in Figure 4). Cities of London and Westminster voted 28.1% leave in the EU referendum, making it one of the least leave-voting seats in the country; Streatham voted 20.5% leave, making it the second least Brexity in the country. Thanks to Chuka’s “efforts”, the citizens of both these seats will now have to leave the EU.

What it all means

These figures and the associated regression models should make very clear that Labour was screwed by Brexit. The Tories scored huge swings in pro-leave seats, which shored up their vote in seats that Labour had to win and forced Labour to defend seats it could normally rely on. Worse still, Farage’s decision to stand Brexit party candidates only in Labour seats meant that Labour lost large numbers of voters to this no-good Russian con-job, while also facing defection to the Tories. At the remain end the Lib Dems were stealing their votes, so they were bleeding votes at both ends of the leave spectrum. The only way they could have averted this problem would have been to go to the election with a full-throated Brexit strategy – a Lexit manifesto – which would have shored up the red wall and ensured they didn’t lose many of those seats. However, even if this had been successful in the North, it would have cost seats in the cities, where the Lib Dems would have stolen many seats. This is worse than useless, since we know from experience that if they have the choice the Lib Dems will betray the country to the Tories, and will never form a government with Labour.

I don’t think a Lexit strategy would even have been that successful. Just as when Labour goes full racist, the people they’re trying to win back just don’t believe it, and vote for the Tories anyway. Had Corbyn gone to the election with a full-throated Lexit manifesto a lot of the people he was trying to convince would have assumed he was lying, and he would have lost the northern voters anyway, at the cost of the cities and the youth vote. Jo Swinson truly could have become PM!

Given this squeeze I think Corbyn made a sensible decision to run on a big left-wing manifesto and try to make the election about something other than Brexit. This was especially important given the Labour position on Brexit was consistently misrepresented by the media. I saw multiple media figures on Twitter claiming Labour did not support free movement (they did; it was in the manifesto) and saying their position on Brexit was “too complicated” (it wasn’t: they were going to negotiate a good deal and put it to a referendum). Given this their best bet was to try and turn the debate to one on honesty, the NHS, poverty and inequality. I think this is wise messaging and important: the UK is heading into the abyss, and at some point the Labour party is going to have to save the UK from ruin, so why not make this point at a time when you can’t win the Brexit debate?

I think it’s also important to consider what would happen if the party had made a choice to go full Remain or full Lexit. In the former case they’re abandoning their northern seats, telling them that they don’t care about their concerns and won’t listen to their democratic voice. In the latter case they’re abandoning young people, who are much more likely to be Labour supporters, and telling them they will destroy their future. Given that the future is all that young people in the UK have, this is political suicide. The only way to square this circle is to present a policy that offers hope to both these core groups. Labour is the party of the urban poor, industrial labour and young people, but when these three constituencies have radically different demands on the overwhelming issue of the time it’s impossible for Labour to win.

If Labour failed in this election I think it was in failing to convince the electorate of the value of their Brexit policy. But given they weren’t able to express it without the media mangling it and misrepresenting it, and given how dishonest and vicious the campaign was, I don’t see how any other leader could have done better. Even if you credit the notion that Corbyn is hugely unpopular, and assume some part of the swing was hatred of this genuinely decent guy, it makes no difference: the figures I’ve shown here make clear that Labour were fucked no matter who their leader was and what their manifesto was. This was a Brexit election, and the Tories are obviously the party of Brexit.

Three years after he exploded the Brexit bomb, and 30 years after he face-fucked a dead pig so he could win Johnson’s approval, David Cameron has achieved what he originally intended: the destruction of the Labour party by unleashing a racist monster in the UK. History will not judge any of these awful men well.

Where to now for the Labour party?

I think the Labour party should keep Corbyn and keep his manifesto. They aren’t going to win with another Blairist monstrosity – Ed Milliband tried that in 2015 and was sunk by a viciously anti-semitic media campaign that portrayed him as a Jewish communist with dual loyalties[4] who can’t eat a bacon sandwich. By the time the next election comes around the world is going to be desperate, trapped in the throes of global warming and looking for new ways out. Why throw away what the country needs? This election Labour’s manifesto was the best and most inspiring left-wing project in the UK for 30 years, and it was right. Jeremy Corbyn is right – he won the arguments. He just couldn’t beat Brexit.

I have seen rumours that some on the Labour right were cheering when MPs lost their seats. I have seen in the media and on Twitter Corbyn’s old enemies in the Labour party gloating over the Tory victory, laughing at the Labour movement’s disappointment and salivating at their chance to retake control of the party. Perhaps they envisage another illegal war, where they can kill another million muslims? Or perhaps they look forward to palling around with rich non-doms, being “intensely relaxed about people being filthy rich”. Oh, the larks! These people are not part of the labour movement. They’re scabs, and their obvious joy at this defeat is disgusting. They need to leave the movement, and leave it to those British people who actually want to save the country from ruin. During this period of reflection, we should be clear: it was Brexit that defeated Labour at this election, and the direction it was headed under Corbyn is the only future for Britain other than ruin. So these scabs need to get out of the party and leave it for people who actually care about the future of the UK and the future of the world.

Once Brexit is past, and these class traitors are out of the labour movement, we can hold the Tories responsible for what they have done. We couldn’t beat Brexit, but we can hold its architects responsible for the great evil they have perpetrated on ordinary British people.


fn1: It’s okay, I had a hangover and nothing better to do on Saturday

fn2: Or “chump”, to use the preferred terminology for these sad-sacks

fn3: Which is bullshit

fn4: Oh the irony …

In April 2018 I was struck by Ramsay-Hunt syndrome, and half my face was paralyzed. For about two months I had to somehow struggle through a new job with my face sliding off and my entire body completely exhausted and stricken with pain. I recovered over the following year until my face was about (in my estimation) 90-95% better, and probably no long term consequences. Then two weeks ago this awful condition hit me again, though this time I felt it coming, got the treatment early, and avoided any serious trouble. After this last 18 months of face-eating hell, I feel like I’m an experienced Ramsay-Hunter, but when I was trying to understand this disease last year I found precious little information on the internet about it. So, I have decided to use this blog for what blogs are good for, and to give my experience of Ramsay-Hunt Syndrome, as well as some suppositions and general suggestions for dealing with it based on what I experienced, my own hazy research and discussions with different people. Ramsay-Hunt Syndrome (hereafter referred to as RHS) has a very wide range of effects, if the internet is to be trusted, and a lot of them are pretty subtle and unpleasant. So I’d like to outline here what I experienced, some things I think about the disease based on my experience, and some stuff I picked up around the internet. To be clear if you read on: I am not a doctor, I have no medical advice for you, and if you’re coming to me for medical advice you’re in a dire place. This is just my experience, and you should not use it as anything except supportive anecdotal knowledge. Nonetheless, I hope it will help you. If you have experienced RHS yourself and want to add your own experiences in the comments, or are experiencing it and have questions (or want reassurance) then please also comment.

What is this godawful disease?

Ramsay-Hunt Syndrome is basically shingles inside your face. It is caused by Herpes Zoster (shingles) which is a consequence of being infected with chicken pox when you were a child. Basically the chicken pox reactivates, but instead of coming back as an intensely painful rash on your skin (as happens with most people) it comes back as a vicious, cruel, and completely godless infection of your facial nerve. Once it gets its hooks in it does the following things:

  • It causes intense pain in the back of your neck/head/jaw, that is like no other pain you have experienced
  • It causes a rash in one of your ears and/or your tongue
  • It paralyzes half of your face so that nothing moves. Nothing.

This facial paralysis is the worst part of the disease, because it completely disables half of your face, which makes speaking and eating difficult, and also stops you closing your eye[1].

There is no cure for this disease, because it’s one of the herpes family, a cluster of diseases that were designed by satan to annoy human beings. It is easily treated into remission however using acyclovir, an anti-viral drug. If you’ve had cold sores or genital herpes then you’ll probably be familiar with this family of stupid little viruses and their treatments.

Chickenpox is very common, since the vaccine was only available in 1984 and isn’t on the mandatory vaccination schedule of many countries. So if you’re older than about 38 years old chances are you had it, and if you are younger than 38 but from one of the many countries that don’t (or didn’t) have the vaccine in their schedule you may well have had it. If you’re like me you carry the scars of that idiot little disease on your face, but if you don’t have the scars you may not remember if you ever had it, in which case check with your parents. You need to know what’s coming for you.

The common view seems to be that RHS is triggered by stress, just as shingles is. So if you had chickenpox as a kid there’s basically only one way to prevent it: don’t get stressed. Hrmph!

Also RHS is not the same as Bell’s Palsy. Bell’s palsy is a sudden paralysis of the facial nerve, but it doesn’t come with the rash and intense, unrelenting pain, and it doesn’t do the other dodgy shit that RHS prides itself on (see below). I had Bell’s Palsy about 20 years ago, probably as a result of stress in combination with some stupid infection. Bell’s Palsy is a walk in the park compared to RHS.

What happened to me?

So let’s describe my experience. I was just finishing an extremely stressful job where I had been bullied for years by the most vicious pig of a man you can conceive of, and had secured a new job. I was taking a few weeks off and exercising daily, doing two hour morning kickboxing sessions. One Friday in mid-March I visited my new employer to fill in some forms and was informed that my job was guaranteed and I would definitely be starting on 1st April. When I left the workplace I could feel the stress falling off of me like water, and my spirits uplifted, really uplifted, for the first time in a long time. Since I had been training all week I was tired and I had muscle pain in my left shoulder but I didn’t think much of it.

On Saturday morning I woke up relatively early to go to role-playing, and noticed in the bathroom mirror that my eye and face was a bit weird, but I again didn’t think much of it. It was a bit weird but I’d gone to bed late and I think I’d been having celebratory drinks, so I just figured whatever and headed off to role-playing. By the time role-playing started two hours later I was in great pain that intensified over the day. At first I assumed it was some strain from kickboxing, but by mid-afternoon my face was beginning to fail and my speech was noticeably slurred. The pain by then was intense so I was icing the spot and trying to keep my shit together (fortunately I was playing not GMing). My friends started suggesting the possibility that I was having a stroke (I was 45), but as my face slid off I realized what was happening, and assumed I was just having a bad bout of Bell’s Palsy, brought on by the relief of stress on the Friday[2]. Since I’d experienced Bell’s Palsy before I knew what needed to be done: I had to go to a doctor to get some eye drops, buy an eye patch, and wait a few months. A pretty depressing start to a new job but whatever. So I finished the game, went home, slept as best I could, and the next morning I went to a doctor.

So Sunday morning my face was wrecked, and I felt like an operation was being conducted on my jaw. My eye was also now open permanently so things were touch and go, but I got to a doctor by lunchtime. The doctor was a standard internal medicine specialist (in Japan this is basically what you go to when you don’t know what’s up) with a nice surgery who I trusted, and he was very sure it was not Bell’s Palsy. He made me sit in the waiting room while he booked some urgent tests at the local hospital, to rule out a stroke, but then came out after ten minutes or so to check my forehead. He made me raise my brow like a reverse frown (what do you call that?) and upon seeing that my left forehead was completely static – not moving even a millimetre – he decided it must be RHS, canceled the tests, and gave me the medicine I needed. He gave me acyclovir to kill the herpes, pain killers, steroids to help my face recover, and eye drops for my eye. I went to a local pharmacist, hit the drugs, and crashed.

Acyclovir is a miracle drug, it works on the virus fast and within maybe two days the pain was gone, but my face was done for. I had to go into my new job the next week to begin preparing classes, setting up my work space, transferring grants (which takes sooo many forms!) and so on, but I couldn’t work my face at all and also I was exhausted. I could only work perhaps 3-4 hours a day before I had to struggle home and crash. But the worst was yet to come. After 5-6 days the acyclovir finished, and the disease came back within a day – worse than before. The pain was even worse, and it was hellish. This was when the other symptoms began (see below). Fortunately my new work has a very good hospital attached, so I saw a doctor there and they told me that I had been given an older, weaker version of acyclovir, and the steroid dose I’d been given was way too low to help my face. This doctor gave me valacyclovir, which is I guess the incredible hulk of acyclovirs, and nearly doubled my steroid dose. The pain subsided pretty quickly and over the next two weeks things calmed down. By the time April finished the secondary symptoms had gone and my face was beginning to move. In May the doctor shifted me to a rehabilitation plan, and I set about the long path to recovery.

What are the secondary symptoms?

If you google around you’ll hear all sorts of horror stories about this nasty little bug. I read people saying they lost their sense of balance, that they were always dizzy, that they nearly went blind, and that their ability to think or calculate was messed up. I found this out because in that first week I noticed I was doing things that are really unusual for me, including:

  • Taking the wrong train home
  • Getting confused about where in the train platform to go to get to my work
  • Forgetting names, words and basic facts
  • Confusing chats and sending the wrong messages to the wrong people

I went to hanami at my former work near the end of March and met a PhD student who I had known for three years, who had completed a master’s degree in my department and gone on to finish her first year of her PhD: I asked her when she was starting her PhD. I sent messages for my role-playing group to non-roleplaying friends, and vice versa. Also I was getting tired very quickly, and putting on weight (which may have been the steroids I guess). I went back to kickboxing after maybe a month, and that was okay, but for the first two weeks my whole body was a mess. I also discovered, once my eye could close again, that I had become photophobic. I didn’t notice this until mid May, which is when the sun really comes out in Tokyo, and it made my eyes tear up as soon as I went outside.

I’m also sure that this disease fucked my eyesight. I am longsighted and wear reading glasses but between March and May my eyesight suddenly deteriorated so I had to get new glasses. I also thought I was seeing double, but couldn’t get anyone at the eye doctor to believe me or confirm it.

I also had small pings of pain in the back of my jaw and neck for months after the main source of horror had gone away. It was there, reminding me that I was its bitch.

In preparing this post I did some searching and discovered this review article which describes the peripheral nervous system consequences of RHS. It can do a wicked and wondrous array of nasty little things to you, many of which resolve with rehabilitation and treatment, but some of which I think are permanent.

Rehabilitation experience

Rehabilitation for RHS is primarily the task of recovering facial movement, since this is the main physical consequence of it. For this I was given facial exercises (gurning, basically) and massages to do to try and regain facial function. The recovery rates for RHS are apparently not very good – less than 70% of people get full facial recovery, and the chance declines with age of course. I did my exercises reasonably assiduously, and the facial massages, and after a year I think I got back to about 90% function. I have two remaining problems with my face:

  • If I read while I’m eating my left eye gets strained and sometimes lets a few tears out (it can hurt a bit)
  • If I purse my lips my left eye closes slightly

I can also feel a bit of plasticity in the cheek around my mouth on the left side, and I can see a little pocket of muscle above the tip of my mouth on the left side that is dead and just kind of sits there like a lump of uselessness whenever I smile. That’s not a killer – I’ve never thought much of my smile, and whatever charm I have for the ladies is built on something else I’m sure. Most people don’t notice my face is lopsided, I haven’t lost any speech or anything, so I’m mostly good.

In fact, during rehabilitation I learnt finally how to wink with my left eye, something I never used to be able to do. A career of comedy awaits …

Rehabilitation for this disease isn’t hard. I noticed that my face hurt to touch, all over the left side, which the doctors told me was because the nerves are waking up and getting aggravated, and some of the rehabilitation exercises would make my face hurt as I strained to move shit around. Just like exercising your body, the muscles were weak and underworked, and they got worn down by practice. I also noticed some parts recovered quicker than others, and sadly the fine motor control around my eyes is the slowest to recover.

The doctors also warned me against starting rehabilitation before my viral symptoms were fully gone. They told me that if you begin rehabilitation too soon you can develop bad habits, like for example closing your eye every time you bite, because the nerves learn new pathways (like how I got my new left-eye wink superpower). In fact I think I have this when I yawn – my left eye shuts involuntarily.

The doctors also told me – and I also saw through google sensei – that getting the anti viral medication in early is important. Basically, if you don’t start the miracle acyclovir within 72 hours you’re done for, and the earlier you start the better. I waited a day and then started the weaker old one, so I guess that made my experience worse than if I had scuttled straight down to the best hospital in town, begged my way in on the claim that I was having a stroke, and got myself on valacyclovir from the morning it started. I won’t make that mistake again! But it’s also possible the doctors wouldn’t have recognized the problem and would have sent me in for a series of pointless and expensive stroke checks, and started me late on the anti-virals. The anti-virals really are key.

Actually when I went to the doctor at my university hospital after the pain returned (and got the stronger acyclovir) he wanted to hospitalize me, and put me on a drip for the medicines. He confessed to me that he didn’t think I needed IV acyclovir especially, but he wanted to force me into a bed away from my work so that the stress would stop and my face would recover. He thought stress was the real problem here, driving the whole thing, and was worried the medicine wouldn’t work until I get my work under control. But the thing is I had just started a new job, and he wanted to hospitalize me on the day of my first lecture. It’s not a good look! And in truth I couldn’t stand to spend a week in bed with nothing to do, so I begged off of that. Maybe my recovery would have been better if I’d agreed to that.

So if you want a good recovery:

  • Get on the antivirals as soon as possible (and if your doctor offers bog-standard acyclovir tell him to go jump – go straight for the strong stuff)
  • Get the stress out of your life, including by hospitalization if necessary
  • Don’t start rehabilitation until the awfulness is settled down a bit
  • Do your gurning exercises ruthlessly, and keep an eye out for weird new facial behaviors

Then bingo, a year later you’ll be able to (mostly) get your face back.

And trust me: you don’t realize how important your face is until it falls off. Life without a face sucks!

The second bout and the prodrome

So this year I went on a series of business trips and had quite a bit of stress, and a week ago I could feel this bastard disease creeping in again. I could feel my face getting a bit tired, and when I took a selfie on Monday night last week I could see my smile had retrogressed. Bastards! I could also feel a twinge in the back of my jaw, and when I went to work on Wednesday I was getting confused about train doors and having strange emotions. So I went to the hospital again, explained the whole thing to an otolaryngologist and got the miracle valacyclovir into me before the disease was fully up and running. My face sagged a bit but I’m already doing rehabilitation a week later, because the virus never got started. This time I caught the stupid thing as it was sneaking in the door, and slammed it shut. This time also the doctors were worried it was something else and so put me through some tests: MRI and some blood tests. The MRI came up completely clean and pure, even confirmed I have a brain (who knew!), and after a long and exhausting conversation with the neurologist in which he refused to believe any of the symptoms I just exhaustively described here, I was free to get out and begin the rehabilitation. My next appointment to track facial progress is in two weeks.

This tells me two things about this disease. First of all, it tells me that stress is really bad once you’re at risk of this disease, and you need to keep it well under control. No one warned me that this little shit would come crawling around scratching at my door a second time, but it did. So if you have RHS, and there seems to be a good chance it was triggered by stress, then you need to get that stress out of your life. I would say this means doing whatever you have to do – change jobs, meditate, murder your boss (don’t get caught obviously), whatever it takes. My new job is relatively low stress and all the stress I experienced was from a cataclysmic series of tightly timed overseas trips, and I think I can control that easily by never again making such a series of business trips in such a short time. Compared to the stress that triggered the first bout of RHS what I’m going through now is trivial, and I didn’t even notice I was stressed until this disease hit. I guess I’m weaker than I used to be.

The second thing this tells me – and this is not medical science here – is that this disease has a prodrome. It has early symptoms that warn you it’s coming, and if you notice them you might be able to sense its presence. Looking back at my first experience of this neuropathic party, the neck pain and the slight tiredness in my face were there before the evil little bastard stuck the shank in behind my jaw, and had I known I might have been able to react more quickly[3]. Those same symptoms came this time around, so I went to the doctor early and started the valacyclovir before it could take hold. This theory makes sense to me because it is well known that other herpes viruses have a prodrome: Herpes 1 and 2 both have a kind of itchy weirdness in the area where the sores are going to arise, and if you hit the acyclovir then you may be able to prevent or lessen the resulting outbreak. So I guess chickenpox – which is a herpes virus – could have a similar course. I couldn’t find anything on this on the internet, but it’s my feeling that this is what happens.

A brief note on UHC

Japan has Universal Health Coverage. I don’t recall how much this disease set me back last year but this time the tests, drugs and bothering the hospital doctors without a referral cost me a total of about 30,000 yen, so it would have set me back 100,000 yen (about $US800) if I didn’t have insurance. I’m sure that it would cost a lot more in America’s weird-arsed system, since Japan has strict price controls, but I think it’s safe to say that 100,000 yen is tough for a lot of people to fork out, and the prospect of not being able to get treatment for this because you can’t afford it, and having to live your life with this intense, unbearable pain and the slow degradation of your face for what I can only assume would be weeks before the virus gave up and left – that’s awful. UHC is an absolutely fundamental part of a civilized society, and every political party should be 100% about getting it if you don’t have it, or protecting it if you do. Never let that wonderful part of modern social democracy slide away or be weakened by the vicious jackals who control our conservative parties. Or your face will fall off.

Preventing this disease

The best way to prevent this hairy bastard from coming and fucking your face through your ear is to get vaccinated against chickenpox. Sadly though the varicella vaccine is not in most countries’ mandatory schedules, so you won’t have received it even if you were born after 1984 unless you’re in one of the few that does cover it. Therefore, if you’re a parent in a country without this vaccine on the schedule, and you’re reading this, my advice is: pay the extra amount to get this vaccine for your kids. They will never thank you, partly because they’re ungrateful bastards but also because they’ll never know the fun they’re missing, but trust me it’s worth it. If you’re a policy-maker in a country that doesn’t have this vaccine on the schedule, hurry up and add it.

If you’re an adult who had chickenpox as a child then the first line of defense against this nasty thing is to avoid stress, make a life for yourself that has manageable stress and don’t let whatever stress you do experience last for too long. I went through years of intense stress before the first bout was triggered, but once it was there my next bout required a much lower threshold. So be careful with stress, and get control of your work as much as you can (I appreciate that this is useless advice for a lot of people, whose industry or career options are top-heavy with unpaid work, bullying superiors, and shitty conditions, but it’s the only advice that I have, sorry).

There is some evidence that the varicella vaccine, given to adults who had chickenpox, may reduce the risk of this disease. I’m thinking of getting it once this shit has died down, but it’s also possible that the same people whose low-paid high stress jobs put them at risk of RHS are also unable to afford the out-of-pocket costs for this vaccine. If you’re reading this I’m sorry, I’m out of options. Kill your boss, or find a way to move to a country with a better health system. Or vote Democrat and get that shit fixed[4].

Conclusion

The most important lesson for this is that you need to reduce the stress in your life to avoid this disease, and that as you get older the risk will increase so you need to purge that stress as you age. It might also help to get a vaccine against varicella even if you’re an adult who had chickenpox in childhood, just to get that extra bit of protection, but your doctor may not like that idea.

If you go to a doctor with the first symptoms of this and he/she offers you mere acyclovir, tell him/her you’ll pay the extra for valacyclovir. Wave this blog post at them, and explain the issue. What do they care?! Trust me you don’t want this thing hanging around, so push for it. Then take your rehabilitation seriously, and you may be able to get to a fully functional face once the shitshower passes on. Another thing I think I should have done but didn’t was demand a second course of valacyclovir, to really curbstomp this ugly fucker. Once those drugs are done though, you’re going to be looking at an unpleasant couple of months regardless, so good luck.

If you had other experiences of RHS, or want to rant about this nasty little hitchiker, or are having it now and need reassurance or have questions, put them in the comments. I’d love to hear how other people got through this virus, and I really hope that this blog post can help someone to deal with the horrors of this disease. You are going to get better and you will get your face back, I promise you!


fn1: I don’t know what kind of person designed human beings but requiring a muscle to activate to close your eye, rather than open it, is phenomenally stupid. You don’t realize how stupid that design flaw is until you can’t use that muscle, and suddenly you’re staring at everyone like a pscyhopathic cyclops.

fn2: I have this weird thing, that has existed since my teenage years, where I handle stress well but then when the stress disappears my body completely breaks. Used to happen with migraines, seems to happen with RHS. Others get sick during their stress but my response appears to be delayed.

fn3: I wouldn’t have, because I’d have thought it was Bell’s Palsy and just gone and bought an eyepatch.

fn4: I’m not American, but I’m aware that most people who read blogs like mine are, for some reason, and I have to remain aware of your society’s … shortcomings … when I write medical-related things.

No doubt many of my readers are aware that there is a stream of feminism, which calls itself “gender critical”, that rejects the idea that transgender women are women and aims to “protect” cis women from having these women in women-only spaces. In the 1970s and 1990s this manifested as an internecine feminist turf war over whether trans women should be allowed into women’s spaces. This battle appeared to die down in the 2000s but a new generation of gender critical feminists are now attempting to defend women’s bathrooms, sports and changing rooms from transgender women. They seem to be particularly active in the UK, where feminists like Professor Kathleen Stock are attempting to fight changes to the Gender Recognition Act that would lead to people being able to use the bathroom of the gender they identify with, rather than the gender they were born as.

A core demand of these feminists is that only women who were born female should be able to use women’s bathrooms. In this post I am going to use Bayes’ Rule to show that the inevitable consequence of this political position, if it were to be enforced, would be the widespread harassment of natal women. I will also present anecdotal evidence that this is exactly what is happening now as their ideas gain traction, and discuss the inevitable hypocrisy and contradiction in the gender critical position in light of their responses to the concerns that some (primarily butch-presenting) lesbians have raised about their cause.

Content warning: This post will use a lot of language associated with the “woke” American left, like the prefix “cis”, and also the language of these gender critical feminists, like “natal woman” and the weird distinction they insist on between “woman” and “female.” I will explain my choice of language at the end. Bear with me!

Applying Bayes’ Theorem to Bathroom Exclusion

So how does bathroom exclusion work? The goal of gender critical feminists is that women who were not born female – that is transgender women – are not allowed to use women’s bathrooms, and that this exclusion should be enforced through codification in the Gender Recognition Act. They don’t specify exactly what follows from this but the obvious implication is that if a natal woman in a bathroom fears that another woman in the bathroom is actually a natal man she should be able to confront that person and demand they leave and go to the men’s bathroom, fully supported by the force of the law, public opprobrium and if necessary state force (represented in the US, let us remember, by an armed and trigger-happy police force that has little regard for people who do not follow strict white middle-class standards of dress and behavior).

In practice what this will mean is that a natal woman will need to judge whether another woman in the bathroom is a “real” woman or not by her face, clothes and manner. She certainly won’t be able to demand a genital check[1], so her entire means of discrimination will be by a visual check. Now, discrimination of this kind is a statistical process on which a large amount of theoretical work has been done since the 18th century, and in particular in public health we use Bayes’ Rule to determine the effectiveness of a discrimination process. Bayes rule provides us with a formula that links the sensitivity and specificity of a test to the probability of correctly discriminating between two groups. It depends on three essential quantities:

  • The sensitivity of the test, which is the probability that the test will correctly identify a person with a condition as having the condition
  • The specificity of the test, which is the probability that the test will correctly identify a person without the condition as not having the condition
  • The prevalence of the condition being tested

Wikipedia offers an example based on drug testing, but the rule is universal: it applies to any attempt to discriminate between two classes of a thing with a test that is imperfect, and it has some alarming and counter-intuitive results in the case that the condition being tested is rare.

In the case of bathroom exclusion, we want to know the following three things:

  • What is the probability a normal person[2] will correctly identify that a transgender woman is a transgender woman?
  • What is the probability a normal person will correctly identify a non-transgender woman as non-transgender?
  • What is the prevalence of transgender women in the population?

How good do you think you are at the first two of these things? I’m not aware of any tests of ordinary bathroom users, but facial recognition software has reached high levels of accuracy above 90%. So, let’s suppose that we were to put a facial recognition device on a bathroom door that had 90% sensitivity and specificity, and assume that 5% of women are transgender. Bayes’ Rule tells us that we would have a positive predictive value of 32%. That is, only 32% of the women refused access to the bathroom would be transgender women: 68% of women rejected (2 in every 3) would be natal women who had been misclassified as transgender.

Now, I think that 5% is way too high an estimate of the prevalence of transgender women. At 3%, with the same specificity and sensitivity, only 22% of rejections are correct – 80% of women refused admission to the bathroom are natal women. Figure 1 shows the relationship between specificity and this proportion at a prevalence of 3% for three different levels of sensitivity.

Figure 1: Proportion of women harassed in a bathroom who are natal women, for three different levels of sensitivity. Prevalence of transgender women is set at 3%. The x-axis shows specificity (percentage chance of correctly identifying a non-transgender woman is not a transgender woman)

As should be quite clear from this figure, even at very high specificity – for example where you are 95% likely to correctly identify natal women as natal women, and 99% likely to identify transgender women as transgender women, more than half of all women rejected from the bathroom will be natal women, not transgender.

Do you think that most women using bathrooms have greater than 95% accuracy at accurately determining other women’s birth gender based solely on their appearance? Do you think they have better than 98%? If not, then you are basically setting up a system of harassment of natal women. I have prepared figure 1 in terms of specificity because it is specificity that determines how many natal women you harass in your project to exclude trans women from bathrooms. By way of comparison, the specificity of commonly-used HIV tests is better than 99.998%: less than 1 mistake in 50,000. Can you be that good?

How will discrimination work in practice?

Bayes’ rule is an absolute law of discrimination tests, not some weird philosophical notion. If you set out to discriminate between two groups of people your results are determined by Bayes’ Law, without exception. It applies equally to HIV tests, gender selection, screening terrorists at airports, or picking penis size from nose length. Those three numbers – prevalence, specificity and sensitivity – determine how well you discriminate, without any exception in any cases. When you stride across the bathroom to grab that girl and tell her she’s not a “real” woman and should go to the urinal, you make yourself subject to Bayes’ Law.

Of course in practice your sensitivity and specificity depends on something: you don’t discriminate randomly, but on the basis of certain visual cues. What are those cues? Of course they will be markers of femininity: breasts, long hair, feminine facial features, make up, feminine style clothes. This will be especially the case if the Gender Recognition Act is not changed and a narrative of exclusionary behavior is established that encourages ordinary cis women with no experience of trans issues to begin singling out women for exclusion. These women will have no idea what trans women look like, how much they can “pass” as natal, or what kind of styles and manners butch-presenting lesbians use. The result of this will be what we always see when we establish discriminatory systems: non-conforming people, poor people, non-white people and people with disabilities will be singled out for discrimination. The gender critical feminists will achieve a strange paradox in which in order to be protected from trans women in the bathroom, natal women will have to act extra feminine and hew more clearly to gender stereotypes. We see this being reported now as the bathroom exclusion principle begins to apply. Consider this tweet from a queer Scottish woman:

This woman has had to begin wearing a badge that specifies her birth gender, because feminists keep mistaking her for a transgender woman. This problem will also affect any other women who do not look sufficiently womanly: women with a little bit of facial hair (which is more prevalent in women with certain sorts of illness), sportswomen who don’t dress femme, non-white women who confuse the white majority’s facial recognition, butch-presenting lesbians, and (particularly ironically) feminist women who reject standard stereotypes of feminine dress and behavior. That 80% of women excluded from bathrooms who are actually natal women and not transgender are more likely to be non-white, disabled, or non-gender conforming. They’re also more likely to be lesbians.

This is what gender critical feminism’s completely uncritical approach to bathroom exclusion will do. Here is another example of this, tweeted by a butch-presenting lesbian:

How have gender critical feminists responded?

The first thing to note about gender critical feminists is they seem to be very ignorant of the history of this debate. Holly Lawford-Smith seems to think the whole thing became a feminist issue in the 2010s, and appears to be completely ignorant of the history of transgender wars in women’s spaces in the 1970s and 1990s. Kathleen Stock, one of the major proponents of bathroom exclusion in the UK, responded to the above tweet with this:

“Worse things happen at sea.” Clearly, Stock is willing to throw her lesbian comrades under the bus in order to attack transgender women, and has given no thought to the relative balance of probabilities. She and her colleagues in the gender critical world know nothing about how this discrimination will actually work, haven’t bothered to consider who will be the real victims of their exclusionary practice, and don’t think it will affect many natal women. As I have shown, quite the opposite is the case: the majority of people affected by this exclusionary approach will be natal women.

But the gender critical feminists have become increasingly radical as they have been challenged more on this. Not only do they not take the risk of exclusion seriously, they have also begun to make their definitions stricter and more exclusionary. We see this particularly in response to the controversy around Caster Semenya, where a lot of gender critical feminists appear to have decided that she is “male” on the basis of having difference in sexual development. See, for example, this reddit thread in which they debate whether she is a man or not. So in response to criticism of their original exclusionary position they have extended their definition from “born with female genitals” to “born with female genitals AND normal testosterone.” I don’t think it’s a coincidence that these white feminists from a rich European country have decided to define a black woman who beat feminine-presenting white women as actually a man: this is another example of how their discriminatory practices will play out in practice, as a series of overlapping forms of prejudice work to punish the poor, the dark-skinned and the disabled far more effectively than the wealthy, white, feminine-presenting heterosexual women who make up the majority of the female population. Their concern with “protecting” women is really only about middle class cis white women.

The inevitable hypocrisy of trans exclusion

The underlying principle of gender critical feminism appears to be that sex and gender are different, and that gender differences need to be eliminated. Somehow this has been twisted to mean that trans women who choose to present as feminine – wearing dresses, make up and long hair – are simply “acting” female and aren’t really women at all. Before she was banned from twitter Holly Lawford-Smith liked to criticize transgender women who expressed happiness at successfully passing as women, deriding them for thinking that their appearance and their gender had any connection. Yet when it comes to pushing trans women out of women’s spaces these feminists will necessarily have to judge on the basis of how women present, not who they are. Sure, if they successfully get transgender women excluded from women’s prisons and women’s sport they may be able to do it on the basis of checking genitals (though see my footnote 1 below), but when it comes to bathrooms, women’s spaces on campus or at work, prayer rooms, women’s swimming pools and women’s beaches, they’ll have to do it entirely on the basis of how these women present. And like all human beings everywhere, they will be most likely to believe a woman is a woman if she looks femme. The more strongly they push this transgender exclusionary principle the more they will be forced to judge by feminine presentation.

Worse still, once they release their prejudices into the wild with the backing of the state, ordinary non-feminist women with no experience of trans issues will be the ones doing the judging and excluding. And you can bet that when those women decide to exclude a girl from the bathroom they won’t do it by themselves: they’ll call their masculine-presenting cis white boyfriends, or the police, to help them do it. This will lead to women with facial hair, manly physiques, and non-femme aesthetics being harassed, beaten up and potentially imprisoned (in male-focused custodial settings!) for the simple crime of not looking girly enough. Once it is released in the wild, gender critical feminism will become a feminism of harassing women who do not conform with patriarchal expectations of their physique, clothing and manners.

And that is not feminism.

Conclusion

Gender critical feminists need to drop this bathroom exclusion stuff and their opposition to the changes to the Gender Recognition Act. It is leading to the harassment of lesbian and transgender women now, and if their campaign is successful it will lead to much more harassment of non-conforming women. Rather than protecting natal women from men, it will lead to natal women being harassed by cis women, their natal male boyfriends, and the violent agents of the state. They also need to recognize that there is a fundamental hypocrisy at the heart of their exclusionary policies, and the only way that they can be put into practice is by accepting and reinforcing the worst patriarchal norms of gendered behavior and appearance. Their feminism is very bad for transgender women but it is also bad for all women who do not conform to gender stereotypes. It is toxic, dangerous, hypocritical and confused, and they need to rethink their whole approach to gender.

A note on language

I want to target this post at people who support gender critical feminists’ approach to exclusion of transgender women from women’s spaces, and so in the title and much of the text I have used their terms for things: I have used their name for themselves, and their language of “natal women” and “born women”. I also haven’t touched on the issue of trans men, an issue that gender critical feminists are extremely uncomfortable talking about because it completely ruins their ideological certainty. However, I think that the language they use is wrong and also highly unpleasant. They aren’t “gender critical”: it has been made clear by their feminist critics that they haven’t read the literature on this, and don’t understand the history of or long-standing theoretical debates about transgender issues within feminism. They also haven’t bothered to be very critical of the potential consequences of their beliefs. I think they are far better described by the acronym their opponents give them: TERF. They want to exclude trans women from women’s spaces, which makes them trans exclusionary, and their feminism is certainly radical, though not in the sense they want to believe. So they should be called TERFs, and we should not subscribe to their false dichotomies of “natal” versus trans women. We also should not adopt the horrible American practice of calling women “females” as if they were animals. So although I have used their language in this post, I don’t like it at all and I think it’s another part of their philosophy that needs to be kicked to the curb.


fn1: It’s worth bearing in mind that even a genital check is possibly not sufficient if the trans woman in question has had gender confirming surgery, since most cishet women have very little experience of or exposure to other women’s genitals in any detail, and might not be able to identify the difference between “real” genitals[2] and surgically designed genitals. We’ll come back to this issue later in the piece.

fn2: Here I use the word “normal” to indicate that the person is a member of the population with a standard education, upbringing and level of political awareness, not to suggest that natal women are “normal” and transgender women are not normal

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