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Increased restrictions in September – too few or too many?

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Increased restrictions in September – too few or too many?

On 24th September new restrictions came into force in England (the other three ‘nations’ in the UK following similar but not exactly the same guidelines – only making the confused situation even more so.)

It’s difficult to understand which scientific advice the Buffoon is following. The ‘lock everything down and try to suppress the virus’ brigade, who seemed to have been in the ascendant up till now, don’t think he has gone far enough. The ‘let’s get used to having to live with the virus’ brigade, on the ‘back foot’ in recent times are happy that the restrictions aren’t as severe as they could have been.

Whatever side of the argument there is an expectation that infections will rise and with the return of Universities in England, happening as I write, that’s almost a certainty. One side will argue this is a reason for more restrictions, the other side will say that’s OK, let’s adapt and protect the most vulnerable in society as the majority of those infections will be among the younger, and more resilient portion of the population.

The problem is that as the Buffoon doesn’t have a strategy (or if he does he’s keeping it a State Secret) any future response will be more dependent on the competing forces rather than ‘following the science’.

For any lay person who wants to understand the situation we are hampered by the lack of complete and comprehensive data on these infection rate. We shouldn’t be too surprised at that. Local Councils who have been arguing for a more local based track and trace system have been complaining about lack of information for months now – and I don’t get the impression the situation even now is what they would like.

A big figure of infections will be thrown around but it doesn’t tell us much if the vast majority of those just stay at home and let the disease take its course – as they would with a mild case of the flu or a common cold. What is important to know is: the number of hospitalisations; the age and gender of those infected; where they work or study; their possible health vulnerabilities; and the number of deaths attributed to covid.

And a lot of what should determine the way forward is still not in place. Tests results take too long; some people are asked to travel so far it is impractical so they don’t test and are a potential threat to others; the track and trace system is a farce; communication of what should be done in the event of being told to self-isolate is poor and a support system for those who might live alone is still no where in place. Recent cases of infections in a couple of Scottish universities where students have been told to self-isolate come with support in terms of deliveries of food and other necessities. That’s ‘doable’ in the context of a student accommodation block – not so much countrywide.

One disturbing comment (almost throw away) that the Buffoon made on the 22nd September that should be closely monitored was his mention of the use of the Armed Forces to support the police in the monitoring and control of the population. Some dismissed this as just referring to ‘back room’ operations but if that was all it implies why was there a necessity to mention it as a raft of measures to police the restrictions on peoples’ movements and activity?

Although a Buffoon he’s too – or at least those behind him pulling the strings are – smart to mention something if it didn’t have meaning.

The lack of real response from the Labour Party also shouldn’t be a surprise. From the very beginning they’ve just followed behind what the Tories have proposed, any criticism being limited to the oft repeated phrase ‘too little, too late’. They criticise the Government for not having a strategy but I haven’t seen any sign of a strategy from them.

One issue that is also worrying, in the sense that there’s a move to make it more the norm than the exception, is the increased locations and times people will be obligated to wear a mask or face covering. This is an issue which is very likely to be considered a norm once this present pandemic has passed over (if it doesn’t kill us all in the process).

At one time the Government campaign against flu was the simple, uncomplicated request to take a responsible approach with the slogan ‘Coughs and sneezes spread diseases – trap them in your handkerchief’. Simple and if not adopted by all was something that people were aware of and could act appropriately.

The obligation to wear a mask doesn’t take into account that people; don’t wash them regularly; don’t dispose of the one-use masks responsibly; re-use one-use masks multiple times; don’t wash their hands when they take them off – which is impossible once away from home as in public places all such wash room facilities have disappeared in the last 20 years; wear them around their necks when not on the face; build up the virus in the mask in between uses; touch their faces and masks before touching other hard surfaces where it could be spread to others; and generally don’t use them in a way that would possibly make the use effective.

But what do we know. The millionaire politicians and scientists know better than us.

How good is the science for the September 2020 restrictions?

The figure of 50,000 infections per days was mentioned to frighten people but how likely is it when we compare the UK situation to that which has already developed in France and Spain?

The two sides of the scientific argument – do we suppress or live with the virus?

For an understanding of the statistics the Radio 4 programme, More or Less, looked at the ‘doubling’ of infections on 23rd September, first on hospitalisations and deaths and secondly, the issue of ‘false positives’. (An interesting point in the section on hospitalisations and deaths was the fact that there are delays up to 28 days for the reporting of deaths. If these numbers are important during a pandemic – as they could have an impact upon policy decisions) shouldn’t the Government make it mandatory that these reports are sent as soon as possible?)

Living with the virus or attempting to defeat it?

This subject will probably take on more significance as time goes on and the attempts (perhaps) to suppress the virus don’t have much success. If one tactic proves to be failing then it is time to change direction. Some, including myself, think we are at that place now – the Buffoon, his Government and a sizeable section of the scientific community think not. Time will tell.

How do we live with the virus? We have to plan what to do when there are ‘circuit breaks’ or local lock downs/increased restrictions. David Nabarro, from the World Health Organisation (WHO) gave his view of what should happen in an interview on Radio 4’s World at One on 18th September.

Local ‘lock downs’ – what prompted that in the North east of England?

An item on Radio 4’s World at One on 17th September considered the background to the decision by the Buffoonette to declare the North East of England a special case.

What does ‘follow the science’ really mean?

Six months (at least in the UK) into the pandemic and divsions in the scientific community are becoming more polarised. On Monday 21st September, in expectation of something changing within days two ‘open letters’ were sent to the Chief Medical Officers of the four ‘nations’ of the United Kingdom.

One was written by Professor Sunetra Gupta and Professor Carl Heneghan of Oxford University, the University of Buckingham’s Professor Karol Sikora and Sam Williams, director of the consultancy firm Economic Insight – also being signed by a total of 31 prominent scientists in the field of epidemiology. This letter suggested a different strategy should be followed rather than just shutting the doors and hoping the virus would go away.

The other letter (from the Government’s toadies) can be read by following the link from an article in the online British Medical Journal.

Both these letters came to light on the same day as an ‘unprecedented’ press conference from No 10 Downing Street (the office of the British Prime Minister) by the two most senior scientists who have been ‘advising’ the Government since the very beginning.

In a country that constantly harps on about the media being ‘objective’ it was interesting to see, in two concrete circumstances, where impartiality was certainly lacking. That doesn’t surprise me, even less so bother me, it’s the crass hypocrisy that is most annoying.

The Radio 4 programme, the World at One, at 13.00 on Monday 21st September was almost totally devoted (it’s a 45 minute programme) to presenting the issue as presented by the Government’s scientific commentators earlier that day. But to show ‘impartiality’ the programme had an ‘interview’ with Karol Sikora (one of the authors of the anti-Government policy open letter mentioned above). He was asked 2 questions and the whole ‘interview’ lasted less that 2 minutes 20 seconds.

The British Medical Journal also followed the Government line by having a direct link from the article to a copy of the pro-Government open letter but only a link to a tweet for those arguing for a change in strategy. Here there was a difference in the emphasis that demonstrates the hypocrisy.

The messages from the Government

Some of the adverts produced by the Buffoon’s Government since the end of March are becoming incredibly annoying. The latest, ‘Hands – Face – Space’ doesn’t even get the most important message right, according to some scientists. It should be the other way around with social distancing being the most effective tactic for people to adopt.

Testing

How is the ‘world beating’ testing system operating in Britain during September – before an increase in restrictions. This is a constantly changing situation.

Government to prioritise NHS and care homes for testing.

Matt Hancock – we will ration tests.

Cases are rising rapidly and the UK’s testing infrastructure is straining at the seams.

Hancock says Covid testing crisis may last weeks.

Coronavirus testing chaos ‘puts children at back of queue‘.

Not only are potential vaccines being hovered up by the richer countries, the most simple tests (which would be most effective in countries with less access to laboratory facilities and with poor transport infrastructures) are also being taken selfishly for the ‘rich’.

Problem: private companies have been making a pig’s ear of the test and trace system. Solution: give more work to private companies. This time Amazon are in the frame.

Schools, colleges and universities re-start in September at the same time as many people would return to work following the summer holidays. This has been the situation for decades yet those at the head of the Test, track and trace programme didn’t foresee a huge upsurge in requests for tests. If you made it up it would have been considered fantastical.

Chaos, confusion and anger – welcome to a new Covid test centre.

The failures in the testing centres is starting to put pressure on hospital Accident and Emergency (A&E) Departments.

More and more areas of the UK are undergoing their own local lock down caused by the higher than the average number of infections. However, even in these areas the test and trace regime is not up to the job.

But in all crises there are those who benefit – here it’s ‘consultants’.

The head of the Government’s test and trace system didn’t fare so well as an internet provider – she brings the same level of expertise to dealing with the pandemic.

Technology doesn’t always work – so beware putting too much faith in it.

Scientists hit back when accused by the head of the test and trace system, Dido Harding, that she wasn’t given adequate information about the surge in demand for tests in September.

The long-awaited NHS tracing app is due to be launched on 24th September – however (as is normally the case) there’s not a lot of information about some of the crucial aspects of this technology which will determine its success. On 23rd September there was an interview with Lilian Edwards (an expert of technology law) about the known – and unknown – details of this new app, on Radio 4’s World at One.

More or Less, on Radio 4, on 20th September, looked at the numbers on both covid testing capacity in laboratories and also whether the Buffoon’s ‘Operation Moonshot’ makes any statistical sense.

Vaccine

The rise in ‘vaccine nationalism’ continues despite warnings that more will die unless there is equal access to a vaccine globally.

Food Banks, food policy and a lack of a strategy

A recent report by the Trussell Trust (one of the biggest providers of food banks in the UK) demonstrates how the pandemic has made the situation worse for those already using them and is forcing others to go to food banks for the first time.

As with so many other issues surrounding poverty in the 6th richest nation on the planet the fact that so many people struggle to feed themselves with wholesome and healthy food has been highlighted due to the pandemic. Not because the pandemic itself has caused this poverty (although that is part of the problem) but in the present climate of openness and people talking about their problems the rest of the population is being forced to hear about, if not necessarily do anything to prevent, the matters that effect millions in the British population.

On 23rd September Radio 4’s You and Yours consumer programme had an interview with Professor Tim Laing who has long been arguing (and so far not successfully) for the need for a comprehensive and well thought out food strategy to ensure that food poverty is eliminated.

Universities and the student return

If the university experience for young people isn’t bad enough they are now being threatened with the end of their university careers with automatic suspensions if they break any of the ‘oft times not very well thought out’ regulations.

The anti-lock down movement

Protest songs against war, unemployment, climate emergency and now against the imposed lock down on people in the UK.

Care Homes

Life in care homes isn’t getting any better – even though they were the locations of the majority of deaths in the first six months of the pandemic. There are doubts whether they are fully prepared in the event of another general outbreak and some family visits are being curtailed by those providers who are ‘over cautious’.

You can’t change the culture that has developed in care homes in the last decade (poor wages, low staff levels, lack of training, no career path, minimum wage/zero hour contract agency working, etc.) overnight. Glib statements made by the Tories about improving the situation in care homes are merely empty words when confronted with the reality within British society. The current situation was outlined in a  section of Radio 4’s You and Yours programme on 17th September.

The ‘Nationalists’

The Scottish Nationalists don’t only want to determine what happens in the area ‘north of the border’ they also want to determine what happens in the rest of the UK. After spending the last six months constantly wanting to demonstrate their ‘independence’ from England (although they are quite happy to have matters decided for them in the European Union) and arguing that the border between Scotland and England means they can make their own decisions they now interfering in the affairs of another country.

Flu jabs

For some time now there has been talk about increasing the number of people who have been (for a number of years) considered vulnerable to the regular influenza outbreaks – those over 65, pregnant women and those with certain respiratory diseases – to include those over 50. However, if the talk is there it’s not entirely clear that the infrastructure exists to cope with the increased demand. Instead of expecting people to ask for the injection why weren’t they contacted so that the programme could be followed in an orderly and structured manner, ensuring that the most vulnerable were not left out. The situation that seems to be developing is similar to the panic buying that follows the announcement of any new restrictions on movement due to the pandemic.

Even the scientists are millionaires

The forelock-tuggers of Britain have been happy enough for the rich politicians to tell them what to do for the last six months, they must be over the moon now to know that even one of the scientists who are passing on advice to the government are also millionaires. And will be even more wealthy if the GlaxoSmithKline (GSK) vaccine proves to be effective.

(One of the interesting developments in the last six months, since the pandemic started to close down British society, is that it’s what are considered the ‘right-wing’, pro-Tory, pro-wealth newspapers (such as the Daily Mail and the Daily Telegraph) are more likely to publish scoops about the abuses of wealth by the very politicians they used to support.)

‘Herd immunity’

Even though they (the government’s chief scientific adviser, Sir Patrick Vallance, and the chief medical officer for England, Professor Chris Whitty) painted a ‘doomsday’ scenario in their presentation on the 21st September – softening up the public for whatever the Buffoon would announce in the next couple of days – it wasn’t enough to save them from being criticised for one time arguing for the ‘herd immunity’ approach in dealing with the virus.

Prospects for employment in the coming months

A recent report by the Resolution Foundation suggests that unemployment levels, in the coming months, will reach those in the 1980s (the ‘Golden Thatcherite Years’).

Poor Housing

Those living in badly maintained and decaying private rented accommodation will be at increased risk this coming winter due to the added threat of covid-19. The report, produced by the Centre for Ageing Better, has repercussions for others than the old, there being people of all ages who are already suffering from ailments caused by their living conditions.

Government strategy

What’s a strategy?

More on covid pandemic 2020-2?

July 4th – ‘Independence Day’ or Armageddon

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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.’

More on covid pandemic 2020-2?

Britain at the time of ‘Our Plan to Rebuild’ – a strategy of sorts

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More on covid pandemic 2020-2?

Britain at the time of Our Plan to Rebuild – a strategy of sorts

I wouldn’t go to the extent of calling it a strategy, but things have changed slightly with the policy of restoring some aspects of life in Britain to the time before the start of the pandemic – what we are having to call the ‘new normal’, which has an indeterminate end.

This was introduced to the British people by means of a muddled and confused television broadcast by the Buffoon on Sunday evening 10th May (although with speculation about what he would say going on for the best part of a week before) and then a ‘detailed’ document – Our Plan to Rebuild – made public on the afternoon of the 11th May. (I’ve linked to an annotated version, where I’ve highlighted things which struck me as I read it. Might make quicker reading for those who don’t want to go through the 51 printed pages.)

Testing

As always pole position in these posts. Unfortunately not good news for the Buffoon and his government.

On 4th May, Grant Shapps, the Transport Secretary, admitted that;

‘If we had had 100,000 test capacity before this thing started and the knowledge that we now have retrospectively, I’m sure many things could be different.’

Hindsight’s a wonderful thing – everyone can be correct after the event. However, another pandemic, because of the way society is organised at present, is more than likely in the not too distant future. That means the lessons from the present, covid-19 pandemic have to be learnt by those who have the ability to influence matters. From what we’ve learnt about preparations for a potential pandemic (prior to the covid-19 outbreak), where we were told was all in hand and that the country was well prepared for whatever any pandemic would throw at us, we will have to monitor, very closely, what happens after covid-19 is a bad memory.

On 7th May it was reported that Coronavirus testing restricted across London after chemical shortages – this at the same time as the Buffoon ‘promised’ the number of tests by the end of May would be 200,000 per day (still a remarkably small number to that which is really required to ensure efficient and meaningful contact tracing).

A week ago an article reported the UK Government was in talks with the huge pharmaceutical company Roche over the provision of an antibody test – this is the test that tries to see if someone has had the virus (whether with symptoms or asymptomatic) and whether they are, therefore, possibly immune. There’s been some controversy over the reliability of these tests but that won’t stop 1) Roche selling such tests and making millions, or 2) this Government buying such tests which don’t do what it says on the tin – ref. PPE from Turkey last month.

Test-track-trace

Dr Jeanelle de Gruchy, President of the Association of Directors of Public Health (UK), Radio 4, World at One, commenting on the UK’s test-track and trace strategy, 7th May;

Q. What role can local health authorities play in the programme of contract tracing?

‘I think, as we have found in the last few months, local public health teams and indeed local councils and the voluntary sector have played a huge role in actually addressing or tackling covid on the ground in local places. And what we’re trying to do, and say to national now, is ‘you need to listen to the experiences of how things work on the ground’. We know we all have a lot of work to do on the ground in making contact tracing accepted and the best that it can be at stopping the disease.’

Q. Can you explain why its important this is done at a local level?

‘Somebody has got a phone and they have been asked to go home and self-isolate, what we need to know is does that person live by themselves, do they have access to food or medication? Then what if that person is a teacher or parent or a pupil and the school wants to know and understand what to do next. So who can explain and advise the school? What if its a business owner? They might need support. So from the phone call we say ‘please go and stay at home.’ There’s a lot of work that needs to go into making accepted the programme that people stay at home and self-isolate.’

Q. What sort of numbers are we talking about?

‘18,000 is what they are talking about nationally. Councils have got teams of people already working, as I said, in supporting local communities that are coping with covid. This is now the next phase of that. We will be using all our local teams working on this.

What we would say is that a lot of this does need resourcing. Local Government, local Public Health are working at full capacity and we need to ensure that we’ve got the funding and resources available to make that be the most efficient programme that we can locally so we really get a grip on the disease.’

Q. Resources you don’t have at the moment?

‘We have experienced a lot of cuts over the last few years and that has meant fewer people on the ground so we are working from a lower base. We know the Government’s made money available for local government to respond to covid but we would say it still falls short of what’s required. Some of the contact tracing needs to be real show leather on the ground. Getting out, finding people who might not have access to a phone or might be in a certain circumstance where they don’t engage with a national service at all. We need to be out there ensuring that we find those people, that we support them to self-isolate and that does take resources so that’s something we would ask for. As you design a national programme, that absolutely needs to be delivered locally, as well, and in an integrated way. We need locally to have those resources to make it happen.’

What is highlighted here is that the cuts the Tories have made in the last 12 years or so, all as part of austerity (to mitigate the disaster the very system they represent had caused in the first place) has resulted in the country being unable to confront the pandemic. This is in all services that have been stretched in the last couple of months due to these cuts in finance, the NHS, local government as well as the education sector which will face problems in the future to get things back working.

There have also been criticisms of the way the contact tracing is planned to be implemented – some of which are based on the Government trying to follow this policy ‘on the cheap’ (10th May).

NHSX app – and the pilot on the Isle of Wight

Professor Tim Spector, professor of genetic epidemiology at King’s College, London, criticising the, what he considered, failings of the NHSX app which is presently being piloted on the Isle of Wight and which is planned to be rolled out across the UK later in the month. The Government has refused to work with his team on a symptom app which has been collecting information from, now, more than three million people since March. On 10th May he said;

‘The virus effects people in many different way, we have about 15 different symptoms, all of which can be associated with having a positive virus swab test. So the idea that we reduce this really complex, mysterious, virus just to two little symptoms and rely all of our strategies on that is going to miss about half the cases really makes no sense in the current environment.’

On 6th May there were other doubts about the NHSX app when some ‘experts’ were suggesting it was vulnerable to ‘malicious false alerts’, although to be fair this has also been said about the Apple/Google app which is being used in many countries.

Another aspect of depending upon technology to do the work in the UK is the fact not everyone updates their Smartphones at the same way they change their underpants – as is the case in a number of the more prosperous countries in Asia. That means the app won’t work in a Smartphone a few years old, mainly as they don’t have Bluetooth – as mentioned in a previous post.

A little bit of the technical aspects of the pilot – and also a schematic of how it will work. It includes reference to the source code in an effort to ally fears of those who don’t trust the authorities when it comes to surveillance.

There was also bad news for the app when it came to security. Anonymous sources revealed the app had initially failed all of the tests required in order to be included in the NHS app library, including cyber security, performance and clinical safety.

To add to confusion from Government’ statements on Sunday and subsequently an article on one of the IT websites reported that NHSX was even developing a second app – which is without the privacy and security issues mentioned above. If so it makes you wonder what will come next.

Experts – and when (or if) they will arrive at a consensus

Since the beginning of the lock down we have been constantly told the Government is ‘following scientific advice’ – the problem is there’s no real consensus when it comes to that advice. There are many examples of this and although in the situation of an unknown virus it shouldn’t be a surprise theories differ, in fact that’s the way science advances.

However, there must come a time when a general consensus is arrived at for the world to go forward – we have it with the climate emergency why not in how to deal with a pandemic? Confusing scientific advice on top of confusing political advice is a recipe for disaster. There are a number of examples of varying points of view in the last five weeks but one that stands out is the wearing of face masks/some sort of covering over the nose and mouth.

Although some ‘experts’ were fighting their corner over this at the beginning of March there does seem to have been a move. It is now accepted the wearing of masks won’t, in any meaningful way, protect the wearer, however if someone is unknowingly infected the wearing of a mask may (and it is considered only a may and not really a significant, measurable effect) prevent that person from passing the infection on to another.

However, the way it has been dealt with is that mask wearing is becoming more common but by the fearful – as they think they might be protected if they wear one – and not by those who understand it might possibly prevent the spread from themselves. Hence not, in the main, based on scientific evidence but because the scientists couldn’t get their act together early on.

We then have the crazy situations of high profile scientists going against their own advice. The recent case of Neil Ferguson having a visitor to his home which breaks the lock down guidelines is one thing, his excuse/reason is another. He stated that as he had already contracted the infection, and survived, he had an element of immunity and so it was OK for him to do what he did. However, that’s the very argument used by other scientists who disagreed with the lock down in the first place. They were arguing for testing and selective isolation and letting the rest of the population carry on as normal so that, over a period of time, a certain amount of ‘herd immunity’ would be build up in the population.

Views on the ‘next stage’ and how to go forward

As the Buffoon turned the transition from the lock down to ‘a still not entirely clear’ move to the ‘next stage’ many have been expressing their views on how this should be done – and also expressing their fears if certain issues were not addressed sufficiently well.

(Here I’m including a couple of interviews from commentators who were talking about this a month ago – so readers can consider if a) those ideas were correct and b) if any good points have been taken on board by the Government.)

David Nabarro, World Health Organisation (WHO) Special Envoy for Covid-19, speaking on the Radio 4 programme ‘Today’, 13th April;

‘This virus isn’t going to go away and we don’t know if the people who have had the virus stay immune afterwards and will not get it again. And we don’t know when we’ll have a vaccine. … So what we’re sating is get society defended. Yes, we’ll have to wear masks, yes, we’ll have to do more physical distancing, yes, we must protect the vulnerable but most importantly we all learn how to interrupt transmission. It’s a revolution!’

Professor Susan Michie, Behavioural Science adviser, speaking on Radio 4, World at One, 14th April;

‘There’s a lot of new behaviours that people will have to learn to adopt and that’s going to require different types of things. In addition to that it’s living with uncertainty and carrying on for a long time, many many months, if not years into the future. And I think there is something new that people won’t accept. I think people had thought this was going to be a few weeks, or may be months of difficulty, then we’ll be able to get a test and then we’ll know we’re immune and then we can go back to our normal business.

What’s become very clear is that that won’t be the case and so its absolutely imperative that if we are to keep the number of deaths down that people really do learn very simple steps that are very difficult to adopt behaviours.

Not touching your eyes, nose and mouth. Washing your hands when you come in from buildings, before eating and preparing food. And these things take time to build into habit. But we need to make them habit just as cleaning our teeth is now habit.

…. People touch their face 20 plus times an hour without being aware of it.

… The government needs to be very clear, very precise and very evidence based and really explain to people why these measures, that are effortful, that may be restricting what we want to do and why are these necessary? So we need specific clear advice but also explantation if the government is going to carry on taking the people with them.

… There’s been so much uncertainty about the nature of the virus, the nature of the transmission, the nature of the type of tests we need. All of these issues are still being studied and new knowledge is coming up every week.

So we’re in a very uncertain situation. But in that uncertain situation there’s a real need to be clear and evidenced based as we can in terms of what we’re expecting who to do what. And there has been confusion, we still carry on receiving confusing messages. For example, the whole issue about non-essential work. There seems to be a lot of people who are having to do non-essential work and working in unsafe working conditions when that doesn’t seem to be policy.’

One idea that doesn’t seem to be have been included in the ‘Our plan to rebuild’ is one from Edinburgh, 6th May, which suggested a lock down exit plan which allowed for restrictions to be eased for 60% of population. Aspects might be in the next stage but what are missing are the two words ‘segmenting and shielding’, which is a concept I hadn’t seen described as such before.

Carl Heneghan, Director of the Centre for Evidence Based Medicine at Oxford University, on Radio 4, World at One, 7th May;

Q. You’ve always been sceptical of the need for the whole economy to be shut down. Is the Government being too cautious?

‘There comes a time in what we’re calling the [economic] depression in the lock down and people need to remember that austerity is a major threat to people’s livelihoods but also a major threat to health. Post 2010 120,000 excess deaths occurred because of austerity. What we now need to do is move to a situation where we can feel confident about moving back to what we call ‘mitigation’. And ‘mitigation’ is what is happening in Sweden and you do that in a staged way.

There are three concepts that are really important.

The first is the concept of health security, the ability of our nation to secure proficient, affordable and consistent health care supply for our requirements, a resilience to cope and then we use the evidence and data to drive a regional approach to this because it’s a very different outbreak to places like the south west compared to London, and if we do that well and we remain confident, we can use the evidence to understand what’s happening.

This virus will be with us for a few more months, into July, and then we will have pockets of outbreaks but in this stage, if we manage that well, we test, track and isolate, we can be confident we can overcome this infection and get to a point where we can rebuild the economy.’

Q. We keep hearing the Government is focussed on R rate. Are you suggesting there should be a different approach in different parts of the country?

‘R is a very interesting concept, generally the R number will be calculated after the event when people come back and say we understand what has happened. With this infection we are clear there are people spreader events, its very difficult to manage in confined spaces like nursing homes, in hospitals. What we should be doing is using the data that can reassure us.

For instance, since the peak admissions have come down by 72%, deaths are also halving every two weeks. So I would focus on the evidence at hand, use the data from admissions and ambulance calls, and check 111 calls. And if they start to go up when you open schools you understand the impact of what you’re doing, in terms of the evidence that matters.’

Q. Would opening schools be one of the first things you should do?

‘With a staged approach next week I would get some of the businesses going, I would monitor the evidence, then I would start to roll out primary schools, bring them back in a staged manner. Now I’m only talking about what our neighbours are doing, do it in a staged way and you use the evidence to understand the response of what you are doing. For example, if you opened up the Tube and it started to get overcrowded and what we saw was a spike in admissions, a spike in concentration, you would understand clearly that was a threat you’d need to reduce.

So what I’m saying is use the evidence to drive response and not use models to try and think about what you might think is going to happen in the future. Evidence shows we need to manage it.’

Q. One of the ‘Five Tests’ was whether the NHS will be overwhelmed. Would it be so in a ‘second wave’?

‘What I think needs to happen is a resilience to cope. The NHS now has to think about structure and strategy. Our neighbour Germany has more beds so they did not have to do what we had to do which was to build Nightingale Hospitals. The second concept is that we need to go back to the concept of ‘fever hospitals’, where we understood that to manage infection you had to have personal protection equipment there all the time. So I say we need more hospitals built in the community, more beds and some of them to be repurposed as infection hospitals … If we do that we can train for an infection outbreak and when they come we can have added facilities so we don’t have to shut down all of the NHS – which we’ve done this time, which has a potential to cause collateral damage to other conditions.’

Mark Woolhouse, professor of infectious disease epidemiology at the Usher Institute in the College of Medicine and Veterinary Medicine, University of Edinburgh and presently one of the Government’s scientific advisors, 10th May;

‘There should be a change of approach. We can’t stay at home forever, with the current R number as it is, the rate of the decline of the virus. If we’re trying to get down to positions where there are literally only hundreds of new cases a day in the UK we are going to be in lock down for months. So something has got to change both to our approach in controlling the virus but also in the messages that goes with that.’

Francis O’Grady, General Secretary Trade Union Congress (TUC), on ensuring employers should be legally responsible for providing a safe working environment for workers returning after lock down, on 10th May;

‘At the moment we’re in the strange situation where people can’t socialise particularly with their extended families, without risking a big fine. Yet what goes on behind workplace doors, according to the Government, is a matter for individual employers discretion.’

The Swedish compared to the British experience

Since the coronavirus started to take hold in Britain I was sure the ‘run and hide’ approach proposed by the incompetents in control of the country surely couldn’t have been the best way to approach a pandemic. We were, in effect, doing nothing other than what the population did during the Black Death of 1348 or the Great Plague of London in 1665. Hadn’t our increase in medical knowledge and out immense technology taught us anything in those intervening hundreds of years?

Whilst not wishing to undermine the problems involved nor the threat this most simple of organisms poses to human life it will not be defeated if all we do is let it run its course without attempting to tackle it face on. If not outbreaks will be causing disruption and chaos for years.

Military phraseology has been used constantly since the first cases and deaths were reported in the UK, ‘we are at war’, ‘front line’, ‘collateral damage’ (an odious term that’s unfortunately become part of the language now), etc. But to use other military analogies the British response is similar to the disastrous retreat of Dunkirk in 1940 – which was then turned into an amazing victory. What followed Dunkirk was four years where there was no significant British army presence in Europe and the brunt of the fighting against the Hitlerite forces was taken on by the Soviet Union and the Red Army. In a similar way the British response to covid-19 is one of waiting, hoping, praying, some one, some where will come up with a solution to the problem.

Doctor John Lee, retired Professor of Pathology and former NHS Consultant Pathologist, Radio 4, World at One, 12th May;

Q. What’s the most important thing we should bear in mind about the R number?

‘The trouble with what’s happened is we are in such an extraordinary situation that governments are looking for a sort of secure way out. I think they fastened on to the R number as an idea of certainty to allow us to map a road out of this.

The trouble with the R number is that it is a modelling output, it’s not a number we actually know what it is. It’s based on a lot of variables which are constantly changing, things like; how infectious the disease is; how the population behaves; what the immunity is doing and even, possibly, how nasty the virus is. It’s nastiness might have been changing during the epidemic and obviously lots of people are starting to get asymptomatic infections and we don’t know who they are, we don’t measure them, its all going to make a difference to the R number.

The thing we have to understand is that epidemiological modelling is even more like weather forecasting rather than laboratory science and the lock down, changes in behaviour that we’ve had, social distancing, we have to ask ourselves, ‘would we be willing to undergo this sort of change in our lives on the basis of a long range weather forecast based on poor data?’ That’s essentially what we’re doing with epidemiological modelling with the R number.’

Q. Is every country measuring R in the same way?

‘I don’t know to be honest. I would imagine it’s similar because epidemiology is a subject and people draw to each other amongst that subject. Whether the data is the same, whether measurements and the testing is the same, whether the population measures are the same, clearly there are differences between countries. What is quite striking to me is the fact the R number is very similar in lots of countries and you have to ask the question whether anything could have been done which made a big difference to it. Everybody’s assuming the lock down has been changing the curve and that social distancing has been changing the curve but actually, when you compare different countries, the curves aren’t that significantly different.

This is a respiratory virus that probably spreads on the wind and in the air. We’re sharing air spaces in shops and in work and all this and it’s not clear, to me, that those drastic actions that we’ve been having have really been making such an enormous difference to the curves which might have been slightly similar anyway.’

Q. You think the lock down has been pointless?

‘Well, I wouldn’t say pointless because this is a new virus and so what we were going to have was a big spike of cases and that is what we have seen. The lock down has, possibly, flattened that spike a bit and it has allowed us to build up extra capacity in the NHS but the point is, when we look back on this in 3, 4 or 5 years time, it’s not clear that the actions would have made any difference to the actual total number of people who have died due to the virus because it’s now out there, it is going to spread in the population so what we’re doing at the moment is prolonging an economic misery and damage to health, direct damage to health, because of the lock down.’ (Interruption.)

Q. Don’t we have the evidence of other countries who acted more quickly having lower death rates?

‘The thing is this is a new epidemic so some countries seem to have been able, by very rapidly acting on the very severe model of disease containment, to have contained the disease. But, of course, unless they keep themselves isolated for ever the virus is going to spread again. It seems to me surely what we should be doing, and I think the Swedish model is a better model, what we should be doing is to find a sustainable way to live with this virus rather than go into a panic mode of shutting everything down and then we have to persuade ourselves sooner or later that the sky is not falling and come back out again in which case the virus will start to spread again, that we have to live with it.

I think we’re in much better position to live with it now than we were before because we do have extra capacity in the NHS, we do understand more about the virus, we have got better supportive treatment.’

Sweden and Denmark took wildly different approaches to handling the coronavirus pandemic – but so far, it hasn’t made much difference.

Johan Giesecke, who helped shape Sweden’s approach to coronavirus, says lock down does not protect vulnerable in care homes. The important aspect here is the care homes. In Britain it was known from the very beginning that it was in care homes where the vast majority of the very much most vulnerable would be found.

But what did the Government do in Britain; basically ignored those vulnerable people; denied the care workers Personal Protective Equipment (PPE); was slow in doing anything when both the deaths in care homes started to rise and there were countless calls from those working in the sector that decisive action was needed, yesterday; never accepted that cuts in this sector over years had made the vulnerable even more so; and continued to play to the gallery in its so-called policy of containment. And it took the Government weeks to even start to count people dying in care homes (or in their own homes).

What all the above has meant is as of 13th May, almost half of all the deaths attributed to covid-19 have now occurred outside hospitals; the daily death rate is now greater in care homes than hospitals; and it’s almost certain that before this first wave is over (let alone any subsequent ‘waves’) more people would have died due to the virus either in care homes or in their own homes. And that doesn’t take into account any ‘collateral’ deaths – when people have died due to lack of access to normal NHS facilities and treatment.

Greater surveillance worldwide on the back of covid-19

Some time ago, can’t find the exact reference, there was suggestion in South Korea that those who might be ordered to stay at home, if they were identified as being a risk through the electronic contact tracing, and had been ordered to self-isolate, would have to wear an electronic wristband – connected to their Smartphone to ensure they didn’t break the quarantine.

Coronavirus lock down causing ‘creeping’ expansion of intrusive surveillance tactics. It’s in times of crisis capitalist governments use the fear and chaos, which is normally a backdrop to the event, to introduce laws and ‘temporary’ measures to help them deal with the situation. However, there has been a tendency for these laws to remain (if only in the background – consider the Prevention of Terrorism Act 1974, which was renewed, almost as a formality every six months for fifteen years) and the temporary becomes permanent. And then it’s too late.

In the article of The Independent, 26th April, Clare Collier, the advocacy director of the human rights group, Liberty, said;

‘We will make it through this crisis but we must do so with our rights intact. … The police have been handed sweeping powers in response to the coronavirus outbreak, and the expansion of intrusive surveillance is troubling. …. Overzealous policing will undermine public trust in the authorities, which is vital for protecting public health. Meanwhile, the normalisation of surveillance and the concerning techniques we have seen in recent weeks could have impacts which last far beyond this pandemic.’

Snippets of news – which I haven’t had the chance to put here before

As before some of these bits might be slightly out of date, but they are all part of the story of how this pandemic raged through Britain – not least due to the incompetence of the Buffoon and his cohort.

I reported on this a few weeks ago, shows the sort of society in which we live the charlatan is still getting away with it – Camberwell church continuing to sell fake Covid-19 cure.

Being at home all the time causes all kinds of problems, some which have existed long before the arrival of the virus but also some that have been exacerbated by the forced lock down. Domestic abuse cases have already been recorded as increasing in number in the last five weeks and the Government threw a few crumbs to the problem. Almost immediately declared too little and too late.

Sarah Green, of the End Violence Against Women Campaign, said, way back on 11th April;

‘a lot more money needed for support services throughout the country.’

Airlines are always in the news, either begging for bail outs or not abiding by their legal requirements when it comes to refunds. As with many issues they are flagged in the media before they actually become policy, so was the case with the 14-day quarantine for air passengers’ arriving at UK airports. (A policy which I think is somewhat strange, even though it is happening in other countries in Europe, and is, as are many policy decisions, a refusal to face the problem and look for solutions.) This is also mentioned in the Our plan to rebuild document.

Also in the most recent document is the new covid-19 alert system.

A few points about the lack of planning by the Government when it came to providing the necessary equipment to the NHS and care homes as well as the drugs necessary to keep people alive in Intensive Care.

a) ventilators

b) reusing PPE

c) intensive care drug shortage

d) changes in guidance in using PPE

Public support universal basic income, job guarantee and rent controls to respond to coronavirus pandemic, poll finds. Many say things will be different after the virus is brought under some sort of control – however the situation of the majority of the population could get worse or better. If it is left to the politicians and the establishment to decide it will be the former.

A BBC Panorama investigation broadcast on Monday, 27th April, revealed key items of PPE were not included in the government’s pandemic stockpile when it was established in 2009. According to the BBC, the government subsequently ignored warnings from its expert pandemic committee recommending the purchase of missing stock. The investigation also revealed millions of medical face masks are currently unaccounted for. The 2009 stockpile list included 33m masks, but only 12m have been handed out.

There’s an ongoing debate on how the virus is spread. Most people, myself included, from what we’ve been told so far, believe the virus is spread in the air, small droplets from an infected person then entering the system of another near by – the whole social-distancing theory revolved around this form of transmission. However studies have proposed transmission might be through virus aerosols.

What will happen to the climate emergency when covid-19 is history? Many of us would like the matter to be addressed seriously and there are already calls for that. However, that will be an uphill struggle. The economy will be in a mess (and unless things changed radically) the ‘recovery’ will follow the same pattern as it had in the past, i.e., looser regulation ‘to get things moving’; less control of those regulations that do exist; lack of money to invest in projects which might not give a quick return; less money so people use older materials, as in cars and other less environmental equipment; unless a solution is found soon – a growing dependence upon private transport as public transport is discouraged and will get even worse than it was pre-March 2020; and the issue falling from the headlines.

More on covid pandemic 2020-2?