From bad to worse – August 2020 in Pandemic Britain

More on covid pandemic 2020

From bad to worse – August 2020 in Pandemic Britain

England Number One in Europe – when it comes to the number of dead. Scotland Third. The economy in the worst state of all the so-called G7 countries. Test, track and trace still not reaching enough people, results not coming out quick enough, huge percentage of contacts not being reached. Care homes (and those cared for in the community) still being marginalised, not getting regular testing – and storing up a problem for the future. Unemployment almost certainly going to rocket when support schemes (which were probably not the best long term solution – but made headlines and gave the impression the Government was doing something) come to a gradual end in the next couple of months. School children, who couldn’t take their exams due to the (not necessarily necessary) lock down and closure of schools at the end of March, are being badly served and let down by a system that seems unfair to lay people let alone education professionals.

The only good news is that summer has finally arrived – after a disappointing and cool start. However it’s still too hot for some of the British.

The vast majority of the population of the world should be pleased they’re not trapped within the boundaries of the island – yet thousands are risking their lives to come to the place that was one of the causes of all their ills in the first place.

Covid-19 hasn’t caused all these problems, it’s just torn down the facade.

England Number One in Europe – when it comes to death – Scotland Third

Now official, England Number One when it comes to excess deaths.

David Spiegelhalter, Professor of Statistics at Cambridge University, Radio 4, World at One, July 30th;

Q. When you look at the statistics from the Office of National Statistics (ONS) what stands out to you?

‘I should first say that the Buffoon went on to quote me that we shouldn’t be making these league tables. But I think the time has come with this gripping analysis.

They look at data up to the end of May, using Eurostat data and, quite correctly, they look at the excess number of deaths. They completely ignore what any country labels as a covid death (because we know that varies so enormously) and they adjust for the different age patterns.

The data is very well presented, they’ve got an interactive map showing how the virus spreads across Europe and it’s really chilling to look at. You can see these strong hotspots in northern Italy and central Spain bursting out early. But then it erupts fairly evenly across the UK and my understanding this was the result of hundreds, maybe thousands, of ‘seeds’ being planted, individual outbreaks happening after people came back from holiday in Spain and Italy.’

Q. What do these statistics tell us that we didn’t know before ?

‘It does reinforce what we knew before but some areas had a massive impact. Bergamo had more than eight times the normal number of deaths and to have those sorts of huge local impacts reinforcement is very strong. …

In the UK it happened quite late, it happened very evenly across the country and it’s gone on and on, much longer than other places. It peaked very highly and then came down quite rapidly. The proper analysis they’ve done allows us to see we are top of the league table.

There’s Belgium which, if you look at a normal league table of covid deaths per million, Belgium is top but because Belgium has been quite generous in labelling someone as covid, then they drop right down to about half of that.’

Q. What about those at the bottom of the league table? Arguably we should be learning lessons from them?

‘Yes. Back in April I did say that we should be comparing, instead of arguing who’s top and who’s second which, in fact, now we can do, we should be looking at the country at the very bottom.

It’s interesting that Germany doesn’t feature in this analysis at all – which is unfortunate. The way that Germany’s statistics are calculated makes it much more difficult to do the calculations.

We can look at countries which are back to ‘no excess’ over the five years, France and other places, and that’s really valuable to see. But it is difficult to go straight to a conclusion about why this is the case and I would be very cautious ascribing differences, to particular interventions and when they occurred.’

Q. The difficulty for the UK was that there were so many points across the country where it was ‘seeded’.

‘I think the uniformed spread which was different from anywhere else in Europe just illustrates that very strongly indeed. We travel a lot as a nation. Sweden has done very badly and people might say that’s because they had a very relaxed lock down but it’s also been suggested that huge numbers of Swedes go on skiing holidays whereas Norwegians stay at home to go on holiday. So the similarity had very large numbers of people coming back from areas where the virus was spreading and ‘seeding’ it around Sweden.’

Devi Lalita Sridhar, Professor and Chair of Global Public Health at the University of Edinburgh, Radio 4, World at One, 30th July;

Q. What went wrong?

‘The decision to lock down incredibly late (I think a lock down in early March would have saved many lives) as well as abandoning testing and tracing on the 12th March. If the Government felt on 12th March that capacity had been reached for testing and tracing then that would have been the appropriate time to go into lock down and build up the appropriate public health infrastriuture and use the lock down time to do that.

I think that period of days when the virus was spread throughout the community is probably one of the reasons that it was very hard to undo that and the longer we had to spend in lock down to try to bring it under control.’

Q. Is there another factor in treatment that effected the UK?

‘Yes. I think there are a few issues there. First, that the NHS became the covid health service. So people stayed away from the NHS who had other issues, for example, heart issues, respiratory issues that are non-covid related but were interpreted necessary to protect the NHS, stay away from the NHS.

The second thing, and this is what South Korea and Germany have pointed to for their low fatality rate for covid cases is that if you were tested positive and, let’s say, had mild symptoms, you would be monitored by the health system and brought into hospital at quite an early stage of your disease.

I think in other places, Italy as well as Britain, people were only admitted at quite a late stage in the disease, often when they had multiple organ failure and that’s why, at one point in the outbreak, it’s been estimated a third of people dying were being admitted to hospital with covid because they were only being admitted at such a late stage and people were only getting tested if they were quite severely ill unlike in other settings people were being tested when they only had mild symptoms or having more of the classic covid-19 coughs and fevers.’

Q. Do you think that as the figures show that deaths at present are lower than the average that eventually Britain will drop down the league table?

‘With the fall in the death rate I think we will see that across the world in places that have health care capacity because, first of all, we have better therapies, so we have a drug that is known to save people. Added to that doctors have gotten better at clinically treating this and understand more when to put people on ventilators, when to use drugs, when to use blood therapies and also people are being admitted to hospital at an early stage so we might see hospitalisations staying flat but that reflects more people being admitted to hospital with milder symptoms and so it shouldn’t only be interpreted as a bad sign. It’s flattening off because people are being brought in at an earlier stage and that’s quite a positive trend.’

Q. Does that mean we should change the way we think of the disease and the risk we associate with it?

The thing I’ve been trying to convey to young people is that it still is like gambling with your health. There is this emerging class of people called ‘long haulers’, ‘long tailed’ covids, aged 30 to 59 on average, who are generally healthy, who develop covid who aren’t necessarily hospitalised, they might just be unwell at home, but develop lasting issues which might be chronic fatigue or heart problems, whether it’s issues with lung scarring, it effects their quality of life and it’s not really clear how long it will last. Will it last for a few months on may continue for years? Is it becoming something almost like an anti-immune reaction your body has to this virus and that we’ll have to find medical ways of controlling this into the future. The message is clear. This is not like a flu which you get and recover. You don’t know when you get the virus how your body will react and how long you might be ill with it.

The message to the Government is that you do not wanting anyone getting infected with this and we should be pushing infections right down instead of thinking we can infect certain sections of society safely.’

Q. So the idea of ‘herd immunity’ is a bad one?

‘Herd immunity is fine if you don’t mind a lot of illness and death. And also if you think some kind of immunity is coming.’

Q. What is different from the way Scotland has handled the disease from England?

‘They were aligned in the crucial moments in March in terms of lock down and in terms of abandonment of testing and tracing but since April you saw a convergence.

The first convergence was in strategy where the Scottish government published a framework saying there was no acceptable level of infection and the push was towards zeros, the zero covid approach. This then set the stage for local testing and tracing so actually giving the responsibility to local NHS Boards to build up their capacity so they could go after their infections.

Scotland was lucky to go into lock down slightly earlier and our epidemic curve, compared to England, has also held it longer. In England you said to ‘stay alert’, in Scotland ‘stay at home’ and the highest risk situations like pubs and bars, hospitality weren’t opened up until cases were in single digits and actually testing and tracing was robust enough to be able to investigate clusters and bring them under control.’

Q. All four nations have today extended self isolation from 7 to 10 days. The WHO has long recommended this. Has the UK been slow in following some of the advice?

‘Yes. From the start other places have had a 14 day quarantine because of how long you can be infectious with the virus and the WHO showed a minimum period has been 10 days. I am happy we are moving towards that but I think the next stage is trying to use your testing to release people early from quarantine. Currently if you are in contact with someone with the virus you have to isolate for 14 days. I think that’s quite a long stretch so if you’re able to test people say on day 5 and then on day 8 and you have two negative tests could they be be released early? Is that enough assurance? I hope the debate will go in that direction so we can start to use our testing capacity to find better ways through.’

Q. What stands out to you in today’s ONS report?

‘Firstly, that all countries should not be competing who’s the worst, we should only be competing of who’s the best, how we’ve learnt from them, what had been done correctly, what have they been done badly and how we can improve on that.

There’s been the idea of who’s the worst in Europe. I think that’s the wrong debate. How do we become one of the best in the world? And how, for example, the UK can lead Europe and not have a second wave, we try to be pro-active and trying to lead. We can take on a leadership role in clinical research and how that can be accompanied by strong public health measures to contain the virus.’

One of the reasons for the high death toll might have been due to the fact that the UK did not take any action on the matter of quarantining people coming into the country – either British citizens or not – soon enough.

‘Herd immunity’

Raj Bhopal, Emeritus Professor of Public Health, Edinburgh University, on the issue of ‘herd immunity’, 2nd August;

‘I’m not sure actually why we are asking them [young people] to undergo local lock downs, with severe restrictions, on their life styles, rather than doing it for older people like myself who are at higher risk.

My view is we should be allowing young people to be getting on with their lives and their careers while we make special effort to look after the older people.’

How does the pandemic look in the UK?

John Edmunds, Professor of Infectious Disease Modelling, London School of Hygiene and Tropical Medicine, 17th July;

‘If we go back to working more normally and the schools will open in September, they have to, then we will effectively link up households and an infection in one household can much more easily jump into another household and from there to another household and so on. That’s how the virus spreads. …

If what you mean by normality is what we used to do up until the middle of March this year, which was go to work normally, go on holiday without any restrictions, meet friends, shake hands, hug each other and so on, that’s a long way off. We won’t be able to do that until we are immune to the virus.’

Arooj Shah, Deputy Leader Oldham Council, Radio 4, World at One, 29th July, addressing the rise in the number of infections in the town;

Q. Why do you think we have seen this increase?

‘We are testing more, so that could be one of the reasons. The fact we can’t hide from in Oldham is that we do have areas of high deprivation, we do have people who are in high risk employment, such as taxi drivers, barbers, hairdressers and they will be in contact with people. We do have areas where people live in poverty. All these social economic factors make people vulnerable to the virus.’

Q. The rise in infections – can you link it to younger people?

‘We certainly see in recent findings that we have had a lot of younger people between 20 and 40 who have contracted the virus.’

Q. So whilst they may not be suffering from it may be spreading it?

‘Yes, definitely. This is why we’re saying limit the people that you do see outside of your household, maintain social distancing, wear your masks, wash your hands, do not embrace each other, son’t shake hands.

We understand with the younger generation it’s been difficult for them, they’ve not been able to see friends from school, college, university and their having to be locked down has had an impact on their mental well being, which is something we are so alive to. …

Q. Is it possible to make some sense from the different communities in Oldham?

‘We’re a diverse community and we take great pride in that. I don’t think this is an issue around ethnicity, or anything specific like that. I do think it has a lot to do with social economic and health inequalities that need addressing.

That is a concern for me and that’s where we are focussed because we have to understand and address the inequalities we have in towns like Oldham.’

Q. You think it’s making a link to poverty that’s driving this?

‘I, right now, think it’s absolutely linked to poverty and there’s no denying that.

A significant number testing positive from our South Asian communities is a fact but we know this community are more likely to work in high risk occupations, live in larger households with multi-generational occupation as well.’

Q. And the reasons for the larger households is down to poverty?

‘Yes, absolutely, and density in our housing stock.’

Q. So what is the answer?

‘It’s just addressing and focussing on health inequalities but we have been encouraging testing and the more testing we do the more positive cases we are going to see but what we don’t yet have is access to the data on those who test negative which means it’s harder to identify where more cases are linked to increased testing and more importantly it’s harder to identify areas where people are not accessing testing or where the virus might still be circulating.’

Q. Does somebody have access to the negative tests so you could know, as a percentage, therefore you would know if it is down to increased testing?

‘Well government may do but we don’t have access to that data and it’s really important because the focus has been so much on the disproportionate impact on BAME communities and actually I want the focus to be on health inequalities as that’s the issue, but we can’t outright say that there’s a significant issue just with BAME communities because we don’t have access to the negative testing. If we did we would be able to present a clearer picture.’

Another example of muddled thinking – put as always put down to ‘following the science’ the self isolation period was extended.

Time, lack of clear leadership has meant the UK has passed through the ‘honeymoon period’ and fraying tempers are leading to a fracturing of solidarity.

However often the Buffoon repeats the phrases such as ‘world beating’ there are still many scientists who don’t believe it. Are we ready to prevent or deal with the hypothetical ‘second wave’? Not according to the British Medical Association.

The hypothetical ‘second wave’ could target the young, so says one scientist, attempting to draw conclusions from the 1918-19 Spanish Flu pandemic. As with many of the ‘predictions’ that came out, are coming out and will come out before all this is over often the aim seems to just frighten people to get them to do what the State wants. One of the problems is that there is never a look back at what some scientists predicted to see how valid their original arguments were. Do these statements help or hinder the battle against covid? What they all have in common, however, is that there is an assumption is that the virus is in charge and there seems to be an increasing divide between those scientists who only react when things happen and those who argue for a rational and considered pro-active approach – an approach that should more reflect the 21st century than the fear and ignorance approach of the 14th and 17th centuries in Britain.

Public trust in the Government in Britain continues to suffer from the ‘Cummings effect’ – although it has produced fertile ground for comedians.

And, for the potential future, experts have warned of patient misery and pain if there were to be another ending of normal NHS care in the event of a ‘second wave’.

Is the Buffoon really contrite?

Not really. Still pushes criticisms of his Government’s policies, U-turns and total chaos on to the shoulders of the scientific community – ‘following the science’. Still no real strategy. Still not taking responsibility for anything, e.g., high death rate, poor test, track and trace, confusion over face coverings, lack or reassurance over the return of schools, etc. Hoping any ‘review’ will be so far in the future he can weather any storm (which is probably correct).

Personal Protective Equipment (PPE)

Five months in and this issue still far from being resolved. And ‘fully prepared’ for a ‘second wave’?

The ‘eugenic’ virus

Over 70, dementia, diabetes, respiratory problem and now obesity. This is the list, which gets longer as time goes by, of those who are most at risk from serious complications if eve infected by covid-19.

So what’s the best way to end obesity (which we must remember has been a developing issue in Britain for more than a decade and which, in certain parts of the world – the Americas, but north and south standing out – has reached pandemic levels)? Give people money to do up their old bikes and GPs (General Practitioners) prescribing bikes on the NHS. When money could have prevented many of the issues effecting society at the moment it wasn’t available – for all the crass ‘reasons’ we became tired of hearing – yet, all of a sudden, and to give the impression that the incompetent Government of the Buffoon is doing ‘something’, billions of pounds are just conjured out of thin air. I’ll be making an appointment to see my GP, a £1,000 bike would make a pleasant summer gift.

And being too tall can also increase your susceptibility.

Mandatory wearing of face coverings

I can foresee a number of incidents around the mandatory wearing of face coverings increasing over the next few weeks. Frightened people causing grief for others and leading to potential conflicts. As a consequence of the incompetence of the Buffoon and his Government in dealing with the pandemic there will a development of ‘mob rule’ where the ignorant, arrogant and officious will consider they have the right to police the regulations.

Such people are myopic and will jump to conclusions and show their general intolerance, such was the case on a train in Merseyside on the 16th July. With the mandatory use being extended to cover more indoor locations these cases will become more and more bizarre.

Although in California, USA, incidents where frightened people ‘take the law into their own hands’ will certainly be repeated in Britain in coming weeks. Here a woman uses mace on couple for not wearing masks in a park.

Supermarket workers facing torrent of ‘mask rage’.

Paul Gerrard, Campaigns and Public Affairs Director, Co-op supermarket chain, on the increase in the number of assaults (verbal and physical) on staff, Radio 4, World at One, 28th July;

Q. What do you think is going on?

‘What’s happened there are more flashpoints now. What we’ve seen over the last 14 weeks is people under greater pressure and there’s more flashpoints.

Last week people were being asked to queue because there were too many people in the store and that resulted in abuse. I’ve seen people being reminded of social distancing and the one way system around stores and that results in foul abuse.

Last Monday, as one example, a customer didn’t want to wait, there were too many people in the store, he barged in, took milk and ended up seriously assaulting a female colleague. …’

Q. Are you suggesting that the mandatory use of masks is turning out to be another flashpoint?

‘I think it is, yes. There are certainly examples where our collegues are gently reminding people in a queue to put a mask on and that’s resulted in abuse, security guards have said it and other members of staff have said it.’

Q. What do you advise your staff to say to somebody who comes into a store without a face masks?

‘We make sure that all our customers have all the information they need. There’s information outside, there’s signage inside. … What we’ve told out staff is do not challenge people for not wearing a mask because you don’t know how it will end up.. Our priority is always to keep our colleagues safe.

It’s our responsibility to make sure customers know what they are supposed to do, it’s the customers responsibility to follow the law, it’s the police’s responsibility to enforce the law.’

Melinda Mills, Nuffield Professor and Director, Leverhulme Centre for Demographic Science, University of Oxford, Radio 4, World at One, 28th July;

Q. What would you advise shop staff who are in the situation of facing assaults by customers over not using face coverings?

‘It’s distressing to hear that that’s happening, and it’s happening to other front line workers. We have to reflect on why it is happening in the first place. It sounded like they were trying to diffuse the situation as much as possible and had prepared their information, signage and other stuff. I think it comes down to the fact that the guidance on face coverings was published less than 12 hours before the new rules came into force and its the inconsistencies that the public are getting confused about. For example, for shop workers it is strongly recommended that they wear them but it’s not mandatory. It’s not mandatory, but optional, in things like hairdressers, cinemas and concert halls. And that’s, frankly, confusing to the public.

I’m not justifying why they’re having this reaction but you can possibly understand it because of all the confusion.’

Q. The Government hasn’t been clear enough?

‘Yes. I think from Day One it’s been very slow to react but also not being clear about face coverings.

On June 5th the World Health Organisation (WHO) recommended to governments across the world to recommend that the general public wear face coverings in closed and crowded places.

This is really late that this has happened but it’s also been very unclear, it just drifts out, slow information. If you think about a country like Japan. They had the 3C’s – avoid close faces, crowded places and close contact settings and then you can understand across multiple settings.’

Q. To be fair to the Government the WHO hasn’t been clear on this.

‘Yes, that’s a good point. The WHO actually did a U-turn. At the beginning of April that for healthy individuals they don’t have to wear face coverings and then they changed their opinion. And the governments across the UK are also differing, so it’s all very problematic.’

Q. Is part of the answer to provide them free, part to do a public health campaign as had been done with the likes of condoms in the past?

‘We’ll have to learn form countries that have already figured it out from SARS and previous pandemics. The key is that people have to understand why they’re wearing them – so it’s the behavioural factors.

Protection is not 100% [to the wearer] but it protects others around them. People have to understand the risks but also that they are wearing them for altruistic reasons, to protect those around them.

In countries that have universal take-up and wearing they are not introducing fines and they’re not calling the police. The public understands why they are wearing them and, I think, we have to back up the education in that way.’

Q. At the moment it’s the public that’s ‘policing’ this rather than the authorities.

‘Yes, it’s creating real flashpoints.. The question is should we be having to police this so much, should we be allowing misinformation about face coverings and masks to be propagated. There are some real issue here and we just have to support those shop owners and also support the public in understanding why they are doing this.

There’s been a lot of abuse, also to myself and other scientists working on this as well as to the shop workers. So we just have to be really clear and say this is a public health issue. This isn’t about rights, just like washing your hands, it’s a public health issue.’

One of (the very few) advantages of the use of face coverings – it scuppers the State’s efforts to control people’s movements by facial recognition technology.

Although normally a supporter of crowds and the ‘mob’ it can have it’s negative effects. With face coverings it’s the frightened who control the agenda.

On 8th August the face covering use was expanded – more than likely not for the last time.

People who need extra care in their own homes or care homes

The lack of a testing regime for ‘extra care’ staff who visit vulnerable people in their own homes.

Radio 4, You and Yours, 30th July;

Representative of ‘extra care’ home provider.

‘All our staff are making sure that they are social distancing, they’ve been wearing the appropriate and correct PPE from the start but if we could get everybody tested because of the difficulties of not knowing if somebody’s got the virus if they are asymptomatic it would just make sure that our staff weren’t walking around unintentionally passing on the virus if they do have it. So I can’t understand why ‘extra care’ locations have been excluded from the mass testing’

Spokesperson for MENCAP.

‘At MENCAP we absolutely agree with that principal. We support over 5,000 people with a learning disability across England, Wales and Northern Ireland, most of those people live in supported living settings not care homes.

So we’re really calling upon the Government to act to make sure that everyone is protected for testing and has access to the rolling programme.’

Care homes and those who work caring for people in their own homes continue to be ignored. The lessons of where the greatest number of deaths have occurred so far, and the reasons for it, have not been learnt with ministers being accused of ‘negligence’ when it comes to the matter of regular testing. How long will this situation be allowed to continue? These matters were being discussed way back in April – but still no resolution.

One of the knock on effects effects will be to possibly delay regular visits to care homes.

How families cope – or don’t – during the covid pandemic

One in three parents ‘out of their depth’ as children struggle with pandemic fallout.

Housing and homelessness following covid-19

Housing is one of the areas which demonstrate how much on the edge to which many in British society have been reduced, primarily as a consequence of the more than a decade of ‘austerity’ imposed (and with little or no opposition) upon the country following the self-created financial crisis of 2008.

Unemployment has been rising since the lock down and is predicted to go through the roof once the present system of the Government paying a high proportion of the wage bill for millions come to an end in a month or so. One of the results of this increasing unemployment will be the inability to pay the high rents demanded in the private sector. Shelter, the homeless charity, in Scotland have predicted a steep rise in homelessness but there’s no reason to doubt the problem won’t be any different in the rest of the United kingdom, almost certainly worse in England.

Not only is the change in stamp duty helping those who use homes as a speculative investment (and therefore pushing up prices in general) it has not been revealed that it is region specific as well, having its biggest ‘effect’ in London.

Easing of planning restrictions

The Tories have been attacking regulatory bodies for decades, especially following the dismal time of Thatcher in the 1980s. Under the guise of assisting the ‘recovery’ from the consequences of the lock down they have already indicated that restrictions on developers with be relaxed.

Brian Berry, Chief Executive, Federation of Master Builders, on the sector calling for ‘reform’ for years, 2nd August;

‘We do have a housing crisis in this country. We should be building about 300,000 homes a year, we’re not doing that, just 200,000. So anything that speeds up the planning process to increase the supply of housing is welcome now but we particularly want to get more local house builders involved.’

Short comment, big propaganda.

Local Government Association, 2nd August;

‘When the process has been sidelined in the past, allowing office space to be converted into residential buildings, for example, too often the result is sub-standard housing. … It’s not the planning process holding up new build but developers sitting on land since more than a million homes have been given planning permission in the past decade but haven’t been built.’

Other professionals and experts predicted such ‘reforms’ would create a ‘generation of slums’.

And the changes could also have the effect of killing off affordable housing.

Who will suffer from the fall out of the pandemic?

There’s barely a section of society that will come out of this pandemic – and the way it has been handled by the Government. A recent report (‘The experience of people approaching later life in lock down’) highlights the problems faced by those over 50 during the lock down. A further report (‘Back on Track’) looks at issues related to employment.

Medical collateral damage of covid-19

It’s been recognised for some time that devoting all of the resources of the NHS to dealing with the covid pandemic has created ‘collateral damage’. Slowly, as time goes by and the averages of previous years can be compared, the covid deaths become only a part of the the main story.

Immunity

Another day, another report about immunity – or not – to covid-19. If there’s no immunity, if a vaccine won’t be the ‘magic bullet’ then a new way of living has to be developed. Lock downs, evacuations or quarantine won’t resolve the collapse of societies – even if it means that more people die. Even at present rates of deaths worldwide from covid-19 the ‘collateral damage’ – in various areas, be they other diseases having lower survival rates, the increased problems associated with poverty (in developed countries but more so in the countries of the geographic south) and the general collapse of support infrastructures – is starting to approach or even overtake that number. And the consequences of this ‘collateral damage’ will have a greater effect upon the young who are, generally, less seriously effected by covid-19.

At some time society has to make that decision. It would be better sooner rather than later.

The blame game

The Buffoon talks about an inquiry at some indeterminate time in the future but the blame game is already starting. In the sights of the Tories at this time is Public Health England. This also shows the hypocrisy that has been played out from the beginning when it comes to ‘following the science’.

Going back to school

But not with a pint.

Graham Medley, Professor of infectious disease modelling, London School of Hygiene and Tropical Medicine, and on official SAGE suggested that pubs might have to close when schools return in September.

He’s got an ally in Calum Semple, Professor of child health and outbreak medicine, University of Liverpool, 1st August;

‘Come October I think some hard decisions will have to be made about what restrictions will need to be re-introduced and whether that’s, potentially, the pubs and the hospitality sector are taking a hit in preference to education. It will be a political decision.’

But it’s not unanimous in the scientific community. Allyson Pollock, a doctor and consultant in public health medicine and the Director of the Institute of Health and Society, Newcastle University argues for a more pro-active approach – rather than just push the panic button if things go awry, 1st August;

‘We need to be much more confident that the Government is playing its part and has a coherent testing strategy, which it doesn’t have, that the test results are interpretable and that they’re putting in the necessary public health and primary care measures.

Then we would not need to see these ‘trade-offs’, as they are called. It’s a diversion and we’re in danger of going down a rabbit warren here.’

The role of trade unions in general has been pathetic from the very beginning of the pandemic. Instead of being the organised (social democratic) voice of the workers they have shown themselves to be merely sheep – reacting (sometimes) to events, decisions but never taking the lead. The teachers unions have been some of the most vocal – but each time they say something I find myself speechless and open-mouthed. Now they’re calling for all returning secondary (11 and over) school children to be made to wear masks. One school, Holmes Chapel comprehensive in Cheshire, has already told parents that masks will be part of the school’s required uniform.

Where’s the science? Or is it just another manifestation of paranoia?

Camille London Miyo, President, Leicester National Education Union, 2nd August;

‘We understand how critical it is for our young people to get back into school. What we need is the importance of clarity and consistent messaging that we need in terms of the guidance in order for us to do the best that we can.’

There are various views developing about the return of children to school (August in Scotland, September in the rest of the UK) but there does seem to be agreement that a properly functioning ad efficient testing and tracing system is the key to success.

An effective system of testing and tracing would also give students and parents the confidence to support a full return.

The rich not happy – another result for covid

You may be struggling to feed your family; facing the fear of eviction as you can’t pay the rent; been made unemployed or facing the threat of redundancy; surviving by using food banks; afraid to turn on the tele or the radio in case there’s something else to worry about – but the rich are not as happy as the poor a Cambridge study has found.

It has been said that many people have been struggling to find things to do in lock down (which just goes to show the paucity of their lives before anyone had ever heard of covid-19) but do we really need people to spend time and effort (and money) on such useless reports?

Vietnam evacuation

This one I don’t understand. Vietnam had a very quick and severe lock down. We were then told that was the reason why the infection and death rate was so low. After a relaxation of movement restrictions three people were tested positive in Danang a few days ago and as a result 80,000 domestic tourists are being evacuated.

Why? Isn’t this the antithesis of a lock down? Why send so many people in such a tight time frame all over the country? Wouldn’t it have been better to deal with them in Danang (even institute a lock down there) rather than spread the risk?

The Swedish ‘Experiment’

It’s necessary to look at how matters developed in Sweden as it was one of the few countries that didn’t follow the rest and introduce a forced lock down – but isn’t it too soon to decide whether it worked or not? Surely that shouldn’t happen until we are way down the line, after any potential ‘second wave’ and when ‘spikes’ are more generally understood?

Repatriation at the beginning of the lock down

It’s all well and good coming out with reports saying that the Government failed Britons abroad, who wanted to get back home, way back in March but shouldn’t this all be part of a proper review that looks at the failure of the Government in it’s dealing over the pandemic not on its individual aspects but as a systemic problem caused by capitalism and austerity.

Contact testing and tracing

‘World beating’ according to the Buffoon. The saga of testing always introduces something new.

The app is dead, long live the app – in a few weeks (perhaps).

Test results still not coming back quickly enough, in Wales for certain but no faith the situation elsewhere in the UK is any better.

Some good news? There’s a ‘new kid in town’.

But it’s still ‘jobs for the boys’.

The capacity goes up, and then it goes down again. This time having yet another adverse effect upon care home residents and staff from whom these tests were taken. How can these tests be ‘dangerous’? And who is going to pay for the disaster, both financially and on the responsibility level?

From the very beginning local health authorities have been arguing that a national based test, track and trace system wouldn’t work unless there was a significant use of, and investment in, a local back up arrangement to catch those not easy to trace cases. In yet another U-turn (although not, so far, referred to as such) the Buffoon’s Government is pulling back on the national numbers and placing responsibility on local areas. But will the funding be there?

As more information leaks out it is becoming known that not only was the national system ineffective (reaching few people) there was no real organisation and many of those employed – with great fanfare a couple of months ago – have just been sitting at a computer with nothing to do but watch films. Why a surprise? That was reported on this blog way back in June.

Poverty in Britain

A huge increase in the number of children receiving free school meals might be considered a ‘good thing’ but hardly fits in to the idea of a prosperous society. Just the opposite. With the rich getting richer (even continuing to do so during the pandemic) such changes in policy only go to highlight how it’s the poor that are paying for the concentration of wealth in fewer and fewer hands.

It’s almost certain that the real – and most long lasting – economic effects of the pandemic are still ahead of us. Unemployment is certainly about to sour and the brunt of this will be borne by the poorest in society and predictions are that this will all have a serious impact upon the nutrition of many children.

Another report (‘Poverty and Covid-19’) looks at how people have been effected in the last five months and their prospects for the future.

Tourism, quarantine and the consequences

Marcello Ricci, United Nations World Tourism Organisation, Radio 4, World at One, 28th July, on the decision of the UK Government to impose a 14 day quarantine on anyone arriving in Britain from Spain;

Q. What do you think of this decision of the UK Government?

‘The World Health Organisation recognises that government’s have a duty to put the health of their citizens first. Nobody disputes that. One of the true lessons of all of the situation, the criss that we are going through, and it transcends tourism, and it’s really about co-ordination.

How do we face literally uncharted territory and we’re not sure that going it alone is really the way to do it. It undermines confidence and this is critical when it comes to a sector, a service sector and probably the people sector par excellance, which is tourism.

Trust is a precious commodity … going it alone undermines it and this will not just effect tourism but the new reality we will have to deal with.’

Q. Isn’t every country going it alone, they are only doing it in different ways?

‘Yes, but because they are doing it doesn’t mean it is the right way. What we need is a convergence, in terms of protocols, measures of testing, tracing … and then decide how we do it in a co-ordinated manner. Isolation and building up walls we know don’t work, not for pandemics or other avenues.’

Q. Do we know that testing and tracing works? It’s isolation, it’s quarantine, they are the only things we know absolutely will work.

‘If we go back to the Spanish Flu of 1918 it was isolation, wearing masks and really wait until something happens, This is, of course, the orthodox way. We should be in a position, it may be politically idealistic, but when the greater good is really identified to better co-ordinate.

It is an illusion to, maybe, aim for total security and lack of risk. That wasn’t the case before covid-19 hit us with its full strength. It’s certainly not the reality now. We live with uncertainty, we crave concrete and specific answers nobody is really in a position to provide. Definitely not if we go it alone.’

Q. What would your answer be?

‘Testing out, testing in. Of course we want to return as healthy as we left. The proper social behaviour and then the understanding that we’re not facing a static situation. There was not tracing, for instance, at least not at the levels we are witnessing now, back in March. We have moved on, we have learnt. I mean the learning curve has been steep for everybody, government, institutions, civil society and citizens at large. We have to trust there is a common interest in moving on and adapting to the new reality. But certainly pulling down the blinds and locking the doors and locking ourselves in is not the way.’

Q. There is a huge number of travellers going between Britain and Spain, Surely it’s reasonable to take action to prevent the disease ‘re-seeding’ itself here?

‘Nobody disputes that really. The discussion goes along the economic ripple effects and the huge toll that this is taking on the sector. Tourism is far more than just having a good time. The valuation of tourism is the biggest one we have in the economy. … We’ve visited these destinations, we’ve been to the Canaries and the Balearics. The one size fits all policy is easy, it’s a good headline but it doesn’t really pay tribute to the diverse reality we are facing.’

Q. Do you think the UK will face repercussions because of this policy?

‘I don’t have a crystal ball, I wish I had. There has been some talk around this. But I’m not sure that retaliation on this level is a wise way to go. It’s a dialogue we need to follow. And weighing up the political costs and all it involves, and also to really adapt and change your decisions. We still haven’t finally learnt how the virus works, we don’t have a vaccine, but still we’re demanding the precise answers on tracing. It has to be a gradual approach, we need to go this way.’

The economic effects of the pandemic on the tourist industry was highlighted in a report by the United Nations World Tourism Organisation three months ago.

And on a local, UK level, unemployment is already starting to show the skewed effect on those parts of the country dependent upon tourism compared to other areas.

Incompetence leads to more wealth in private hands

Private hospitals to benefit from the backlog of operations and treatments caused by the emphasis on covid-19 to the exclusion of all else.

And the Tories look after their own when it comes to the awarding of contracts. How many more are there we are not aware of?

But there’s nothing for the ‘heroes’ of April, May and June.

Another example of incompetence was the report of 50 million face masks not being adequate for use in medical circumstances. These masks were part of a £252 million contract.

More information is coming out following a case brought by The Good Law Project which indicates nepotism (if not corruption) in government and a whole catalogue of ‘extraordinary waste [and] basic incompetence’. This could get interesting.

Quote of the week

On 30th July, the very same day the Office of National Statistics published a report that showed death rates in England were higher than anywhere else in Europe the Buffoon confidently declared;

‘This country has had a massive success now in reducing the numbers of those tragic deaths, and we’ve got it at the moment under some measure of control.’

More on covid pandemic 2020

July 4th – ‘Independence Day’ or Armageddon

More on covid pandemic 2020

July 4th – ‘Independence Day’ or Armageddon

With less than 24 hours to go before ‘The Great Relaxation’ how prepared is England to face the ‘new normal’?

‘Abandon all hope, ye who enter here’.

How will people act in the relaxation of the lock down?

Robert West, Professor of Health Psychology Health Behaviour Research Centre Department of Epidemiology and Public Health, University College London, Radio 4, World at One, 23rd June;

Q. What is your understanding of how the public will react to the easing of the lock down on 4th July?

‘We’ll see a mixed response. There are people who, definitely, are nervous and rightly so, and not just because they are nervous people but also because they’re in a vulnerable group … and there will be others who will take the opportunity [to live a more normal life].

One thing that is really important to understand is that if the Government does decide … to reduce the social distancing level from two to one metres essentially what they are announcing is the end of social distancing. It’s not just the question of whether people have a choice, to decide whether they are going to go to the cinema, what this means is that employers will be able to, in effect, require people to come to work even if they don’t necessarily feel safe. There will be compulsion here and that’s something that needs to be taken into account.’

Q. Rightly nervous because they won’t be able to stay at home?

‘The reality is we still have something in the region of 3,500 new infections a day, which down the track is going to lead to 25 deaths a day at the current level, which is low, or we are considering it low, but without a test/track/isolate support system … there will be outbreaks and we’ll probably be quite slow to detect those outbreaks and act on them.’

People are essentially being put in a situation where they are having to manage risk without adequate information. For some people that will be fine, for others it won’t be.’

Q. You think the Government’s moving too quickly on this?

‘I think they are. I know it’s really hard news for people who want to open up businesses and so on but the reality is that without an adequate test/track/isolate system in place we are putting people at risk. Not to put too fine a point on it across the country lives will be lost. That’s a political decision and I understand why the Government makes that but they have to be clear about, transparent about, their reasoning. We haven’t seen the SAGE [Scientific Advisory Group for Emergencies] advice, what they’re saying about this so that people can weigh it up and make their own decisions.’

Q. Isn’t it always going to be a balance of risk?

‘There will always be a balance of risk but we’re used to that in society. We still have more than 1,000 road traffic deaths a year, we have several thousand people a year dying of smoking. This is something that we’re used to but what we really need in a situation like this is good information on what the level of risk is and what is being done to absolutely minimise that risk and that’s what’s lacking at the moment.’

Q. Would you like to see the SAGE advice published as soon as possible?

‘Yes, I, and independent SAGE, and many other people, have been calling for this, for much greater transparency, not least because it’s not just for our edification but also because we need to be able to trust the decisions that the Government is making and if they say they are making this decision on a balance of risk versus benefits let’s see the evidence on what the risk and benefit is.

…. One of the problems is that some of us have felt that the kind of behavioural advice that we’ve been giving, it may be getting as far as SAGE but the Government hasn’t always been acting upon it. This is an example of that.’

Q. Professor Peter Piot has said that he would prefer to be a metre from someone wearing a mask that two metres from someone without. Is that part of the piece missing here?

‘That’s one relatively small part of it, to be honest. What he’s absolutely right in saying is that you have to look at the whole risk situation. For example, outside, when you’re passing people on the street or in a park, the risk is really minimal because you’ve got a lot of ventilation, the concentration of virus you will be exposed to is very low even if you’re right next to someone for a short period of time.

But if you’re in an enclosed space, with a lot of people with not necessarily good ventilation, then you’re risk is greater. So it’s a combination of time spent in a risky environment, how many people there are, how close they are and, potentially, face masks, if they are worn properly – which mostly they are not [my emphasis].’

Leicester locked down before it was unlocked

We are constantly being told that the Government ‘is following the science’. But when it comes to dealing with the covid pandemic there’s more than one ‘science’ – it’s just a matter of following those views which agree with the policies the Government wants to follow.

Much of what has developed in the last 100days/14 weeks/4 months has been very much a knee jerk reaction to events. The Government has tried to gauge what will get it the most support from the general population – their eye always being on the popularity polls.

But it has to be said that the Buffoon and his cronies have been spectacularly inept in dealing with the first major crisis since the General Election of last December. Witness the increasing number of U-turns in policy and the cries of despair and disbelief which inevitably follow in the wake of any of their decisions, witness the imposition of the 14 day quarantine for anyone entering the country and whatever ideas they might have of getting schooling back in some form or other, to mentuion just two.

That reaction also followed the re-imposition of restrictions and the postponing of the greater relaxation on the lock down in Leicester on 30th June.

Dr Nathalie MacDermott, Clinical Lecturer in Paediatrics (Infectious Diseases), Kings College London, Radio 4, World at One, 30th June;

‘It’s crucially important to follow the data, in part to try and find a reason why we might be seeing an increase in cases in a certain area. For instance, it might be that there is a virus outbreak in a school or following a specific event, in that circumstance all of those individuals could be traced and asked to self-isolate at home. It then avoids the need to do a lock down of an entire region.

But if you have a situation where the case number is increasing and you can’t pinpoint an exact reason behind that, or there may be many reasons, or you can’t trace everyone who might be involved then you have to start considering implementing more stringent lock down measures.

That doesn’t necessarily mean introducing a full lock down but it might be, for instance, closing schools again if the increase is all seen in children of all ages or it might be not opening restaurants and bars because you’re concerned about the direction the trend is going in.’

Q. Where else should we be looking at the numbers to see how to get on top of this?

‘Everywhere should be looking at the numbers the entire time and monitoring the situation. But looking at the data that was in The Telegraph this morning [isn’t it strange that scientific commentators have to use a newspaper to get up to date information and not finding it from an official, Government source?] I would suggest that Doncaster would be the most concerning at the moment simply because the numbers have tripled from last week to this. The case number is relatively low anyway so a tripling isn’t that big a jump but obviously what we’re looking at is a trend.

What we want to understand is; is there a reason that we know of why the cases might have increased there or is there a general trend that we’re seeing and would further lock down measures be required in that area.’

Q. We’re still talking about low numbers, aren’t we?

‘Yes, but what we need to remember is that these are the individuals that presented themselves for testing. For all those that test positive there’s probably quite a big group behind that haven’t been tested who may well be also positive to the virus.’

Professor Carl Heneghan, Director Evidence-based Medicine, Oxford University, Radio 4, World at One, 2nd July;

Q. What does the evidence from across the world, that we now have, tell us about what we should do in Leicester, for example?

‘That’s a complex question. But firstly let’s say the first thing about deaths is that in March and April they went up very sharply in a number of countries – Italy, Spain, France and the UK, and in America but more so in New York. The death rate as we currently stand has diminished.

This is a radically different disease now than what it was a few months ago. About 6% of all people in hospital were dying then, now it’s down to about 1%. The key about lock downs is that it’s a very blunt tool and it should be used for one reason, and for one reason only – because the health system is becoming overwhelmed.

What we see in Leicester is an increase in the number of people coming forward for testing and an increase, but a small increase because we are at low rates, of the number of people with covid. I would say that right now [a lock down] is a very blunt tool and a mistake for us to be locking down Leicester. It’s a perfect opportunity to let the test and trace system start working. In fact we’ve seen a 30% reduction in the cases in the last week already – so it is having an effect.’

Q. You’re saying it has nothing to do with lock down or not?

‘What you are trying to achieve with lock downs is to preserve the health system because you’re being overwhelmed. This is a very complex disease and, in fact, when you do lock down people for a week or two you will increase the rate of transmission because we know the ‘attack rate’ in households is very high and in particularly multi-occupancy households it is high.

Let’s be clear. The system that we should be putting in place is a test and trace and working through the summer preparing for the autumn when we’ll see rates of respiratory infection go up. The current rate does not require a lock down.’

Q. If test and trace was working you would still have a situation of people isolating and have a higher incidence of the disease?

‘Let’s be clear. When we talk about respiratory infections through the summer some infection will have to circulate and it’s generally – in the summer – about 40/50 people per 100,000. In Leicester right now we’re talking about double that rate.

Now, in winter, we get up to rates about tenfold higher and we don’t close down areas. So what’s happening in Leicester is what we’ll see in most other areas, a slight spike, but the key is how you can control this by saying we’ll close whole cities.

This will be so difficult to do in London or Manchester, the real ‘super-cities’, that we need a different approach and we need to be very clear – what is it that defines the number of cases that the Government thinks we should shut down on.

At the moment it seems to be made up in a sort of ad hoc way.’

Allyson Pollock, Consultant in Public Health Medicine, formally Director of Public Health and Society, Newcastle University, Radio 4, World at One, 2nd July;

Q. Do you accept what Professor Heneghan is saying there that what we see in Leicester should have been dealt with by test and trace?

‘You’re absolutely right. The whole purpose of the lock down is to try and stop the transmission of the virus, that was the really important thing and it is a very heavy tool and that’s partly because the epidemic was rising. But by now, four months into it, we should now have a really effective test and trace system in place and that’s a very real anxiety that it’s taken four months and we still haven’t got evidence of an effective test and trace system.

That’s for two reasons. One is because the local Directors of Public Health and the Councils have not been receiving the data they need of the positive tests and the cases. And that’s essential to do effective contact tracing. What we know so far is that only just over half of all the cases this month that have been transferred to the test and trace system have given their contact details.

And another problem is we don’t know how many of the cases and contacts are actually going into self-isolation and quarantine and how easy or difficult it is for them to do that. That’s another part of the system that isn’t being monitored and about which we have no information. And that’s particularly important for Leicester.’

Q. It seems there was a large data dump but it didn’t include post codes. It seems the Councils have to sign up to data protection laws to be able to do that.

‘The data privacy is just a red herring. The fact is that the data was flowing centrally, they were being processed in an aggregate and what people need on the ground is the post codes, occupations, age and gender so they can actually map the places, and the clusters, in order to identify the community where the outbreaks are happening. That’s particularly important when you’ve got multi-generational households as you have in Leicester. This data was not being made available until 24th June and they are still not being made available in some local authorities.’

Q. If this was working properly would it mean local lock downs could be avoided?

‘Yes, if it was operating successfully, in combination with all the other public health measures, then you would be able to do this as has happened in Germany, in Switzerland. In Zurich recently they had an outbreak in a night club of 300 people who were asked to quarantine and actually they were monitored and supported because an important aspect of this is that it is very difficult to self-isolate if your financial situation, your housing situation, is precarious.

So the Government, again, needs to put in the support part of effective contact tracing and we have no knowledge of that and how it’s working.’

Julian Le Grand, Professor of Social Policy at the London School of Economics and formerly Health Policy advisor to Tony Blair when he was Prime Minister, Radio 4, World at One, 2nd July;

Q. You have written that the policy followed in the UK was a major over-reaction.

‘Yes, that was the experience that we had … during the avian flu epidemic. We got some dire warnings about dreadful consequences if we didn’t close down ports, if we didn’t shut down airports, if we didn’t engage in all the lock down measures we have followed this time. … We were told there would be seven million dead and, of course, it was very alarming and it turned out, of course, to be wildly exaggerated and luckily we did not respond.’

Q. Who were the warnings from?

‘Ultimately the WHO [World Health Organisation].’

Q. Essentially the same people who put out warnings about this disease [covid-19]. But this disease is more dangerous than avian flu.

‘It’s clearly worse but the lesson we learnt from that experience was that you have to be careful about applying the ‘precautionary principle’. Epidemiologists tend to operate very much on the ‘precautionary principle’ which basically says ‘if you’ve got no data, no information, you’ve got a dreadful risk of some calamity, it’s better to be safe than sorry’. Which makes a great deal of sense at the first stages but what it doesn’t take into account of are the costs involved and what you do when you’ve got a little more data.

We are now in the situation where actually we do have more data. … We do now know that infection rates in Leicester are incredibly low, it’s something like 140 out of 100,000 – which is 0.14%. This is a tiny risk … which I don’t think [as do a number of other people] are worth the costs involved in locking down the city.’

Q. Except we do know what the worse case scenario is, as we saw in Northern Italy.

‘That’s when there was a cost, or a certain advantage, to an early lock down which was trying to prevent the NHS from being overwhelmed and that was successfully achieved. We’re not in that situation now and it has got to a point when the blunt tool of a lock down is, essentially, too blunt, it carries the ‘precautionary principle’ too far and we ought to move to a much more targetted system of trying to curb the transmission of the disease.’

Q. You think it’s a mistake for the lock down in Leicester to be extended?

‘Yes, I certainly do. What we should be doing, and what we should have done from the beginning actually, is to concentrate on old people in care homes and hospitals. Those are the principal routes of transmission and infection and are also the ones who are the most vulnerable.

… The fatality rate for under 45s is virtually zero so we should have been concentrating on the elderly and we should have been concentrating on the care homes. And that’s basically where the focus should be now.’

Q. And those people who refer to the experience of Sweden?

‘In Sweden they are making the point I’ve just made. What the experts in Sweden say is that the problem is in old people’s homes, its care homes and to some extent hospitals and that’s where the restrictions should be more generally applied and not in a blunt fashion, city wide.’

Care Homes

Once it was clear that infection and deaths rates were particularly high in care homes (not really a surprise when it was known long before the virus hit the UK that the elderly were much more at risk, especially those with other underlying health conditions) there had been a call for more support to that sector, especially in the region of Personal Protective Equipment (PPE) and regular testing of both staff and residents.

When it came to testing I thought that had been resolved some time ago, but no. This will only take place from the start of next week. Why does everything always take so long?

On 3rd July results of a survey carried out by the Office for National Statistics (ONS), about fatalities in care homes, showed that there were 29,000 ‘excess deaths’ over the five year average since the outbreak of the covid-19 pandemic in the UK – full, downloadable report

Nadra Ahmed, Chief Executive of the National Care Home Association, Radio 4, World at One, 3rd July;

Q. What do you make of the ONS survey?

‘It’s an interesting survey … and what it tells us is that the people we knew had to be shielded from the very start, the services that needed to be shielded, were the ones that have had this enormous impact of the virus entering those services.

What it shows is, perhaps, at the very beginning, when we were being told that care homes were not going to be impacted [the report] blows a hole in that and that the impact was going to be substantial.’

Q. What is the lesson for the future and a possible ‘Second Wave’?

‘What we’ve learnt is that at the very start of this PPE [Personal Protective Equipment], which was not something we knew much about, was something we needed as a matter or urgency. [Care home] providers are now prepared, we need to ensure they have a good supply of PPE – it was all being requisitioned by the NHS at the point all this started.

The other thing is we have pushed and pushed and pushed to make sure that testing became available and we know, of course, today it’s been announced that testing will now be available in care homes but it should have been from the very beginning. It would have been one of the things that would have mitigated the challenge.’

Q. What about the point of agency staff and sick pay?

‘One of the things we have to remember is that coming into this pandemic there were already 122,000 vacancies in our services. So the recruitment of care staff has been a challenge for the past decade at least, if not longer. The image of social care has been such that we don’t have a professionalised pathway and then, of course, there’s the matter around the low pay bit, which is the National Living Wage when I know many providers pay above that just in order to recruit. That led us to the fact that we were already using agency staff, which is why we’ve seen a growth of recruitment agencies for care staff.

As the pandemic hit and we started to see 20 – 30% of staff self-isolating, going off sick, the numbers were quite enormous. What we found was that people were transmitting from one home to another. A lot of homes tried to stop that by shutting the doors to agency staff.’

Q. What about sick pay? I have heard that people were going into work sick because they needed the money.

‘That’s something we would need to dig a bit deeper into. Because the majority of providers that we have spoken to have said that they were very keen, as soon as there were any symptoms, that staff went off sick.

The problem is the asymptomatic bit where people were continuing to work. Because we didn’t have the testing we didn’t know they had the symptoms.’

Q. The correlation is sick pay, isn’t it?

‘People [care home providers] were paying sick pay because they wanted people to come back and that’s why we will need to look a bit further into this. We’re required to pay Statutory Sick Pay so you can’t not pay sick pay if somebody goes off sick. ….

Q. Do agency staff get sick pay in the same way?

‘That depends on the agency staff. They should do. If you have a contract with an employer then you are entitled to Statutory Sick Pay.’

The Buffoon and his ‘Roosaveltian’ speech in Dudley, 30th June

About the inefficiency and inability of his Government to properly deal with the pandemic;

‘There are plenty of things people will say we got wrong and we owe that discussion and that honesty to the tens of thousands who have died before their time, to the families who have lost loved ones and, of course, there must be time to learn the lessons – and we will.’

A mea culpa but nothing about a promise of an investigation or a holding to account.

About how the Buffoon thinks the country will get out of the deepening economic crisis following their inefficiency and inability to deal with the pandemic in an effective and constructive manner;

‘I just serve notice that we’ll not be responding to the crisis with what people will call ‘austerity’ [then what would he call what has been forced on the British people in the last eleven years or so?]. We’re not going to cheese pare our way out of trouble because the world has moved on since 2008. We not only face a new but, in some ways, a far bigger challenge.

… Next week the Chancellor will be setting out our immediate plan to support the economy through the first phase of the recovery. But this moment also gives us a much greater chance to be radical and to do things differently.

To build back better and to build back bolder and so we will be doubling down on our strategy – we will double down on levelling up [rhetoric with no substance, what does it actually mean? – just playing to his ‘core’ audience].’

… This Government is not just committed to defeating coronavirus. This Government is determined to use the crisis finally to tackle this country’s great unresolved challenges of the last three decades [three decades which are a result of the fundamentalist, monetarist policies introduced by Thatcher in the 1980s].

To build homes, to fix the NHS, to solve social care, to mend the indefensible gap in opportunity and productivity and connectivity between the regions of the UK, to unite and level up [all allowed to get worse under the previous Tory (and Labour) Government’s. If these services and social policies had been strengthened the country would have been much more able to confront the problems caused by the pandemic].

And to that end we will build, build, build. [Although often misquoted, Danton has a lot to answer for. Every pretentious politician in Britain seems to think they have to repeat one word three times at least once in their miserable political lives – and often more than once.]

Build back better, build back greener, build back faster!’ [This one’s down to Aristotle.]

Britain, covid-19 and poverty

Just as Trump has done the most for the Black population of America since Lincoln, the Buffoon claims that the Tories have done the most in the last ten years to reduce poverty in the UK. How true is that?

A report from the Resolution Foundation, published on 9th June, shows how the pandemic (and the lock down) has had an impact on families throughout the UK – the brunt of the negatives being taken by the poorest in society.

Things also don’t look so good for those in the 50s and 60s – the next generation of retirees.

And the Joseph Rowntree Foundation found that things are getting worse for poorer families with children. The Foundation also published ‘diaries’ of four different so-called ‘key workers’ and the problems they are having just getting by during the covid pandemic.

The Resolution Foundation also produced a report on the prospects for youth unemployment.

Another report, this time by the Social Metric Commission, shows that the UK has seen a 39% rise of those living in ‘deep poverty’ – meaning their income is at least 50% below the official breadline.

Test, track, trace and isolate – perhaps

Testing was the key to getting on top of the covid-19 outbreak. That was universally agreed from the very beginning – even before the first cases were reported in the United Kingdom. However, the problem the British people have is the government they ‘democratically’ elected to manage such situations – at almost the same time as the first reports were coming out about a new and not understood virus – has quickly proven itself to be one of the most inept in history.

What the Buffoon and his gang has never understood is that if you wish to win any war – and the statements made about this pandemic have been replete with military analogies and language – then first and foremost you need a strategy. There has not been, there is not now and, in all probability, there will never be one in place.

When the decision was taken, way back on the 12th March, to end testing and to go for the lock down approach that shouldn’t have meant that testing was just forgotten. A ‘task force’ [even I’m getting into the military terminology] should have been set up so that when testing was restarted the infrastructure needed to make it truly ‘world beating’ was actually in place. No such force was set up, the testing has been a shambles (to say the least) and all decisions have been made based upon what was seen as the best way to deal with a particular crisis. In management/politician speak ‘there was no joined up thinking’.

And as the independence day/end of the world as we know it approaches, whose success will very much depend upon the testing regime in place, there have been a deluge of articles, reports and commentaries on the perilous state of the testing system which is being provided in one of the richest countries in the world.

The story that has been unfolding in the last seven or so days can speak for itself.

11th June

This one from the beginning of the restarted test, trace, track system – mainly to remind people of how the system is supposed to work and also why sometimes it doesn’t – or hasn’t.

19th June

This one goes back a couple of weeks but hasn’t been reported here before so worth adding. Issues over supply of necessary material, from Personal Protective Equipment (PPE) to ventilators, have bugged the battle against the pandemic from the beginning. To that list can now be added testing kits.

26th June

You would have thought that the Government was aware that not everybody in this country has access to a private vehicle and the placing of drive in testing sites on the outskirts of major towns made it virtually impossible for a huge proportion of the population to take advantage of the facilities. ‘Walk-in’ testing centres, a whole 6 of them, were announced more than three months AFTER the lock down was declared.

One of the impacts of a ‘not fit for purpose’ testing regime is that it doesn’t inspire confidence and in the climate of fear that has been created in the last three months those anxiety levels are likely to increase.

You would also have thought that with all the publicity about potential covid-19 carriers being released into the community without first being tested (and probably/possibly one of the main causes of the spread of the disease in care homes) that by the beginning of July this wouldn’t be happening. Not in Hertfordshire it seems. And where else?

29th June

And, not surprisingly, it’s more than likely that the poor testing system has cost lives.

And will the testing regime be robust enough to deal with any potential ‘second wave’?

30th June

What has been like working in one of the testing laboratories? Again a sign of lack of planning.

That’s the way to do it. Instead of just talking about being ‘world beating’ the UK Government should have been learning from elsewhere. Germany can do it well, why can’t Britain?

The app that never was – or ever will be?

There might be a working app in Britain – whether it talks to the ones used in any other country is another matter – before the arrival of the next pandemic (or even the one after that) but whenever it arrives there will still be issues over privacy and who does what with what information and for how long. Perhaps worthwhile bearing this in mind. As stated before states are quite adept at using ’emergencies’ to introduce policies and practices ‘under the radar’ or under the pretence that it will only be temporary. Once such practices are entrenched they are very difficult to get rid of – the genie is well and truly out of the bottle.

‘Immunity passports’ rise their heads – again

This idea has been around since the beginning of the pandemic and not just in Britain. It ties in with both the testing regime and the use of a Smartphone app and starts to become complicated as it starts to divide societies into people who can do certain things and those who can’t. And when it crosses borders it determines who can travel and to where.

The desire of States to know as much as possible about their own citizens – as well as those of other countries – it’s almost certain that some sort of system will be introduced in the coming months/years. But it comes with its own problems – not least it’s unlikely to do what it promises, that is proving that the carrier is no longer a threat from transmitting the disease.

And as if we didn’t need any other divisions in society these ‘immunity passport’ could potentially create an ‘antibody elite’ – as well as providing opportunities for fraudsters and gangsters.

Devolution means the need to do things differently

The nationalist continue to follow their ‘independent’ course. The most recent decision of the Scottish variety is making the mandatory use of face covering in shops north of the border.

The problem of ‘symptomless transmission’

Away from the best measures to deal with the pandemic the covid-19 showed itself to be tricky and the virus was able to spread more widely as the concept of symptomless transmission was difficult to accept in many countries.

Does ‘symptomless’ possibly indicate increased ‘herd immunity’?

The lack of a vaccine definitely makes the idea of herd immunity very attractive to speed the return to normality (even though a ‘new’ one). In a way that makes those locations (be it cities or countries) with high infection rates possibly those locations with a greater herd immunity, so suggests a study from Sweden.

Not protecting the NHS for ever

With so many billions of pounds being thrown around it’s difficult to keep track – and that’s what the Government wants, to confound people with numbers. Now that the pressure has been taken, somewhat, off the NHS the Tories start to show their true colours and what they give with one hand they take with another.

A quote from the Buffoon when he was released from hospital at the beginning of May;

‘We are making progress in the national battle because the British public formed a human shield around the country’s greatest national asset – our National health Service.’

Schools returning in September

This is another to watch. The so-called ‘guidance’ published at the beginning if July, will without a shadow of a doubt, go through so many revisions before September that it won’t be recognisable in two months time. Just an example that even when the Buffoon and his gang make a decision it is so badly thought through that has to be changed beyond so much it’s really a new one – something that could have been avoided if all the plans of how the Uk comes out of the lock down were part of an overall strategy.

Kevin Courtney, Joint General Secretary, National Education Union, Radio 4, World at One, 2nd July;

Q. One of the concerns of the unions has been safety. Are you re-assured by what you’ve read in the guidance?

‘We need further re-assurance, both from Public Health England (PHE) and SAGE [Scientific Advisory Group for Emergencies]. That re-assurance is in two areas.

… It’s important that SAGE tell us explicitly that they have modelled what the guidance is in practical reality, what the effect of that would be on transmission networks. We are talking about big groups of children where there is no social distancing. Within a class of 30 there won’t be any social distancing, in reality our classrooms aren’t big enough for us to allow it.

In Secondary Schools that will often be that group of 30 within a year group of 280/330, so they are very big groups. It would be important for public confidence for SAGE to say that they have modelled that.

The other form of re-assurance that SAGE needs to tell us about is the question of vulnerable parents and vulnerable staff. If you are a member of staff, a teacher or a support assistant, who is on the clinically vulnerable list … certainly in a primary school you cannot do your job and stay socially distant from the children. Teaching assistants there work alongside the children so if they are clinically vulnerable what do Public Health England and SAGE say about the level of risk for that person? Obviously it depends upon the level of the virus within society

The same thing in Secondary Schools for clinically vulnerable people. The Government is saying ‘try to stay two metres away’ but you’re in a class of 30, it’s quite an enclosed environment, often with not very good ventilation. Thirty children who aren’t socially distancing, who are meeting lots of people during the day, those things we need re-assurance on.

We want children to go back, we want the virus level to be lower in September so that makes it possible but the Government does need to work on re-assurances.

That needs to be about practical reality because this idea of big ‘bubbles’ which can be distant from one another at break time, at lunch time, that feels like it’s quite an organisational challenge in a big school.’

Q. Do you think the ‘bubbles’ are too big?

‘Yes, we do. We prefer a situation where there are lower numbers of children in the ‘bubbles’. That’s why we’ve been arguing, from earlier on, that they might need to have to look for extra classrooms, ‘Nightingale’ classrooms. We’ll have to bring teachers back who have left the profession, mobilise supply teachers.’

Q. There are many challenges. Is there anything that can fully satisfy you on the matters you are raising?

‘We absolutely recognise that there’s a balance of risk in this. There are risks with children being at home. We want children back at school. As the virus level drops then obviously the balance of risk shifts in favour of children being at school.

But there are people with particular risk factors. … If you’re a 55 year old man from a Black background, then you’re at more risk than other people. So the idea that some teachers should be doing work that is supporting children who will still be at home and other teachers being brought in to teach the classes. That doesn’t seem to me to be an unreasonable thing to ask about. That does give you, then, a graded way of looking at the level of risk. It’s not the same for every teacher, it does depend upon the vulnerability that you have as an individual.’

The fact that children have been out of school for a few months is bad enough – the fact that when they return they could be receiveing a much worse education is another. Due to lack of imagination and will instead of confronting the problems of a return to proper full time education it seems that too many are looking to reduce the provision to make a basic return easier to manage. The curriculum could be altered for most children and the guidance is far from clear on how matters will progress in September.

And in a demonstration that Government ministers don’t understand that the idea of local schools is a thing of the past and far too many children have to travel long distances every day the plan that they should find alternatives to public transport is laughable – if it wasn’t so serious.

Quote of the week

Buffoon at Prime Minster’s Questions, Houses of Parliament, Wednesday 24th June;

‘ … [Starmer] has been stunned by the success of the tracking operation … [that it was] a formidable achievement … [in response to the UK app failure] no country has, so far, developed a successful tracing app … [and it] got up much faster than the doubters expected.’

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