Increased restrictions in September – too few or too many?

More on covid pandemic 2020

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

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

More on covid pandemic 2020

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

Getting closer to it – but still no real strategy in the UK covid-19 pandemic

More on covid pandemic 2020

Getting closer to it – but still no real strategy in the UK covid-19 pandemic

A review of what has been said in the last few days about the coronavirus pandemic in the UK.

Testing

When testing should have take place

In March the World Health Organisation (WHO) was saying ‘test, test, test’. But on 12th March the UK stopped testing in the community and focussed the limited testing capacity on hospital patients.

Boris Johnson’s government failed to impose mass coronavirus testing after being told that COVID-19 was only a ‘moderate’ risk to the UK (1st April).

Senior advisers admit lack of investment in mass testing ‘may have been a mistake’ as they believed influenza was a bigger threat (2nd April).

At the House of Commons Health Select Committee meeting on 5th May, Sir Patrick Vallance, Chief Scientific Advisor to the Government, said he ‘would have liked testing ramped-up sooner’. [Ramped-up is one of the a new words we have come to recognise.]

Jenny Harries, Deputy Chief Medical Officer for England, at the same meeting, said the changes to the policy in early March was because of ‘ insufficient capacity’.

Mass testing earlier ‘would have been beneficial’ (5th May).

How often should care workers be tested?

Sam Monaghan, manager of a group of care homes, arguing for weekly tests on care home staff and resident, on 2nd May;

‘A member of the resident group was diagnosed with the virus and we know that the highest probability how that came into the home was through one of our members of staff. The difficulty is that none of the staff are showing any symptoms at all so it’s a bit like ‘Where’s Wally’ – but Wally’s taken his jumper off and so the manger’s looking across her staff group asking where has this thing come from?’

The numbers game and the current situation

Stephen Powis, NHS England National Director, 4th May;

‘Testing .. has ramped-up very quickly over the last week or so and we are now at a very high level of testing with over 100,00, a little bit of a dip at the weekend but we anticipate that that testing ability will continue to increase.’

On 6th May the Buffoon was saying the aim now was to get testing up to 200,000 per day by the end of May. But it’s probably as useful in defeating the virusas Hancock’s promise of 100,000 by the end of April – which, for some miraculous reason, has only been achieved on 30th April, numbers dropping into 70-80,000 since. But all the classic questions, Who, What, Where, When, Why, remain.

Who will be tested, just those who show symptoms or a wider, random, cross section of the population?

What will the tests be looking for, just if people are infected or as part of an overall strategy of tracking and tracing?

Where will the tests take place, taking the tests to the people or the people to the tests?

When will the testing be part of a strategy?

Why is nothing forward – not even the numbers. 200,000 by the end of May is too low and too long a period for such a minimal increase in testing in relation to the population in general?

A different type of testing

Professor John Newton, the Government’s testing co-ordinator, on 4th May;

‘There are at least two large commercial organisation who have good lab based tests we are currently evaluating. But also people are looking at ways of doing anti-body tests close to the person, the patient. There are a number of options there including a saliva test. And all of the options are looking quite promising and being evaluated.’

Where is testing going – and when?

Jeremy Hunt, Chair, House of Commons Health Select Committee, on Radio 4, World at One, 5th May

‘Everyone accepts that Germany and South Korea have really done a pretty good job. Korea didn’t report more than 9 deaths on any day during the whole course of the coronavirus crisis and are now saying that are getting no new domestic infections. I think the important thing for us is; have we learnt from what is happening in Korea and do we have the Korean strategy in place? I think what we heard this morning from Sir Patrick Vallance and Dr Harries is that that now really is our strategy and that’s the most important thing.’

[Best practice was known about weeks ago. Why, in Britain, is this still going to happen at some indeterminate time in the future?]

Q. To mimic South Korean strategy?

‘Yes, I mean they are are the ones who did this test, track and trace process, very tech centred, very innovative use of apps, backed up with contact tracing on the ground. And remember they had a worse challenge that we had, they’re closer to China, they had less notice than we had, they had a super-spreader who was part of a religious cult. So they had a real challenge to deal with but they did manage to contain the virus. This is what we are now planning to do starting with the Isle of Wight.’

[South Korea and China are amongst those countries that have embraced technology in a big way, much more than in Britain. Many people don’t have Smartphones, many of the Smartphones don’t have Bluetooth and in those countries where technology was used in this way it was followed by extensive testing on a one to one basis. No plans for that have been presented here in the UK.]

Q. Are we past the peak?

‘That’s what the government is saying and I’m sure that’s what their scientific advice is saying. And there’s a lot of gloom about the death figures and to have 11.500 more deaths than you would expect in one week in April is pretty depressing. But the very last question in the Select Committee Hearing to Sir Patrick Vallance, I thought, was, in a way, the most encouraging because I said to him that if we do the test, track and trace, if we observe the social distancing rules, on balance, do you think we can avoid a second wave, and that’s the thing all over the world people are worrying about, and he basically said, Yes. He was an optimist, he said he thought we could. So I think that they are confident we’re not just past the peak but if we implement all the policies that are now in train, we could avoid a second peak.’

Q. When do we get to the point of being able to ease the lock down? When can that system take over?

‘Well, I think we’re going to hear about that on Sunday. And we tried to shed some light on that today. What it appears is that the absolute rule is that the R, the reproductive – rate mustn’t go above 1. They still think we are between 0.6 and 0.9. But within that there’s a lot of variation. So Sir Patrick Vallance was saying that in the community the R rate is probably a lot lower, towards the lower end of the scale, but in hospitals and care homes it is still running higher. So that’s where the risk is that you can perhaps get community transmission down, because people are staying at home, but you have a re-introduction of the virus through an outbreak in care homes, for example. So that’s why I think it’s a very finely balanced judgement.’

Q. That’s where the app may become critical and as well as that human contract tracers will be important. As far as the app is concerned will you be downloading it?

‘Absolutely. I think all of us who have Smartphones should, when we’re asked to do so and I think it can play a very, very important role. But I don’t think they work for everyone. I think 40% of the population don’t have a Smartphone so there will need to be more traditional methods of contact tracing with them. But I do think it has a very important role to play.’

[The British Government recognises that technology will not solve all the problems but doesn’t have an infrastructure in place to deal with those shortcomings.]

Q. Have we been too slow? The SAGE documents were released this morning, under pressure, and the Government is becoming more transparent, except a lot of those documents have been redacted, some to the point of being useless. Were you surprised by the extent to which they had been redacted?

‘Well, there’s a tradition, obviously I was in the cabinet for nine years, and advice to ministers is kept confidential and that is very, very important because you need advice to be completely frank and people giving the advice need to be able to say exactly that they want to say without having an eye over the shoulder to what happens if the advice gets published. But there is something different when you have a crisis like a pandemic and the Governments says that at every stage ‘we are following the scientific advice’.

If they say ‘we’re following the scientific advice’ but they don’t publish the scientific advice then it’s very difficult for MP’s to hold them to account. That was one of the things I asked Sir Patrick Vallance about and I asked Matt Hancock to day in Health Questions, to whether he would consider publishing the SAGE advice that he’s receiving at the same time as he makes his decisions, so that we all have access to the scientific advice that the Government says it’s following.’

[But when will this ‘transparency’ show itself?]

Q. So it’s too slow and it’s too late?

‘Transparency is very important because that ‘s the way you keep the trust of the public. Also, it’s important because there is a lot of uncertainty in these recommendations because it’s a novel virus and I think it helps if the public understand that some recommendations are clear cut but other’s are finely balanced and it’s helpful for us to understand that as well.’

Experts and transparency

Some members of the Scientific Advisory Group for Emergencies (SAGE), are arguing for more transparency.

Sir Jeremy Farrar, formerly Director of the Welcome Trust and a member of SAGE, on 4th May;

‘Personally I would make the minutes transparently available after a certain time. I think transparency helps people to understand the uncertainty, the difficulty, the fact that actually science does have to change as the facts change. That is certainly sensible and logical. What we know today is very different to what we knew in February and March.’

Breaking the lock down

On news that Neil Ferguson, the senior advisor to the Government had broken the lock down by having his married lover coming around to his house – apart from the issue of breaking the lock down he obviously had no idea of the gutter press in this country who will be looking for any opportunity to undermine anyone if it helps to sell the paper – or get the name of the paper broadcast on other news media (it’s all about advertising).

Jo Hemmings, Behavioural Psychologist, 6th May;

‘What people are now doing, perfectly understandably, is creating their own version of what they believe to be acceptable. You also have people that were behaving in a pretty sensible way for a while, say when we weren’t going out having obvious public group gatherings. Now the situation is so muddled about what is going on a lot of people have been doing for the last few weeks, and will continue to do is ‘the it’s just me thing’.’

Danger of a second wave

On the chances of a ‘second wave’, Robert West, Health Psychologist at University College London, on 3rd May;

‘With the figure that we have at the moment it looks like, probably, around somewhere between 5% and 10% of the population have been infected. That leaves between 90% and 95% who have still not been infected. So the death rate we’ve got at the moment is with that 5% figure, so we have to be very, very cautious and very careful about how we view the lock down.’

Maria Van Kerkhove, World Health Organisation (WHO), on a second wave, on 4th May;

‘What we’re seeing in countries like Singapore is almost like a second wave. Essentially what it is actually outbreaks that are happening in shared dormitories. So the virus has found a place where it can take hold and can resurge again. So all countries must remain on alert for the possibility of additional transmissions.’

The app that will solve all our problems – or not?

There are a number of issues with the Smartphone app – produced by NHSX (together with an unspecified private company) – that will be tested on the Isle of Wight from 5th May;

the test itself,

  • the Isle of Wight has fewer Smartphones than is the avaerage in the UK (older population)
  • there has been a low incidence of infection to date
  • the island is still on lock down so people won’t be going out of their homes much
  • how effective will the test be?
  • even if the results are ‘positive’ the app won’t be used throughout the UK until towards the end of March

the aspects of the app,

  • still not sure if it will work if the app is not showing on the screen
  • there’s the possibility of the app running the battery down
  • still many people have questions and doubts of the reassurances about privacy

This is on top of the issues discussed in a previous post.

Dame Wendy Hall, Southampton University, Government advisor on technology, on 3rd May;

‘It won’t be storing huge amounts of data about us in central servers, that’s not the case. Almost all of it stays on the phone, it’s all encrypted and what they store is anonymous. There’s no absolute right answer to this but I’m pretty convinced the way the UK is going, for the moment, is the right thing to do.’

Professor Susan Michie, Director of the Centre of Behavioural Change at the University College London who is also on the government’s Behavioural Science Committee for Covid-19, on 5th May;

‘I’m slightly concerned that there hasn’t been enough consultation with the public and a lot of concerns have been raised by the public about the governance of it, the security and privacy of it, the private company that’s owning it and so whether or not the public will take the app in the number that’s needed is a question mark. I do hope the Government quickly gets the trust that’s absolutely needed.’

Robert Hannigan, former National Security Advisor and Director at the Government Communications Headquarters (GCHQ), the Radio 4 World at One, 5th May;

‘It’s very good that they have said so much about it, there has been a great deal of technical policy detail published by NHSX [the NHS digital section] in the last week about how they’re doing this and I think that’s a very sensible approach and it’s reassuring to anyone who’s concerned about the technical aspects and the privacy aspects. I think they’re doing really well. This is attempting something which has never really been tried before, to use the Bluetooth technology, on this scale right across the country. It’s unprecedented so fair play to them for moving at such speed and trying to get it up and running. I’m sure there will be lots of things that go wrong and they will be putting right but that’s always true with new technology.’

Q. Is it the right decision to go down their own centralised route and not the Apple/Google decentralised route is correct?

‘It’s a balance but I think the downside of the Apple/Google localised route is that it leaves Public Health England and the NHS with no information about the overall spread of the virus and where it is spreading and all things they need to make really important decisions about public health and about how we may be released from the lock down, which is, after all, the major point in this.

The privacy aspect, I don’t think there’s a huge difference. I think given the steps that the NHS have taken to protect privacy and the involvement of the Information Commissioner in all of this it’s sufficiently anonymous not to be a threat to individuals. All the app records is the first part of a postcode and the make of the phone and, of course, this is co-operating with Apple and Google in a sense that it’s using those two operating systems, albeit not with the model they preferred. But having said all that, of course, there will be a good debate about privacy. My own feeling is that this should be time limited, so at the end of the pandemic we need to pause this experiment and have a proper public debate and parliamentary debate about the use of these apps in the future.’

Q. Are you reassured on the security of the data?

‘Yes, obviously the question of a centralise model, for which we are going down, is that the data has to be kept in one place and then it’s a question of who has access to it and for what reason. They have been very clear that it will only be public health authorities or public health reasons, that it will not be linked to other data about people in their health system. There is a question about how this data is kept and when it is destroyed. It will be useful to academics in the future to tackle future pandemics so we shouldn’t suddenly chuck it out, but equally I think we should bring this experiment to a clear close at the end of the pandemic and review it and have a proper debate about it. The key is that it should not be made available to the private sector, to companies to advertise and everybody agrees that this must be severely limited to public health experts and local authorities.’

Q. Do you think that in the way it has been set up it will be impossible for external users to get to this date?

‘Yes I do because I’ve read a lot of detail about how they’re been doing it in the last few days. You can always construct some edge case for how somebody could subvert this and that’s true of any system you build but frankly the conspiracy theories that I’ve seen put out there are pretty far fetched and would require so much effort and would be almost impossible to scale up.’

Q. You will be very happily downloading it?

‘I will and I think it’s important that it shouldn’t be compulsory to downloaded but it is going to help all of us stop the spread of this virus which is affecting all of our families and help all of us to get out of the lock down. So it’s in our interests to download this. It will not keep any personal data about you and I’m satisfied that the very limited data it does have will be properly protected.’

Q. You say is shouldn’t be compulsory but you sound if it’s everyone’s duty to download this app?

‘It’s in everyone’s interest and so far everybody I know, who I meet, wants to stop the spread of this virus, wants to protect the NHS and wants to get out of lock down as quickly as possible and are really desperate for that. And this is a really helpful way of doing it. It isn’t a major solution, it’s only part of a system that really depends on testing and proper tracing. It won’t be perfect, there will be problems, there will be false positives but it’s definitely worth a try.’

If someone who is (or was) a part of the British intelligence ‘community’ likes the idea then that alone is reason to be suspicious. And why is there a former (and not a present) Director giving this interview. That’s a way for the State to distance itself from any comeback.

Contact tracing and the lock down

David Nabarro, World Health Organisation (WHO) Special Envoy for Covid-19, on getting contact tracing up and running, 1st May;

‘This is something that every government is having to make a choice and I understand that the contact tracing process is now well advanced. You don’t need to have 100% tracing in order to get the R number down. You certainly can release the lock down while you’re building up the case finding and contact tracing capacity. That’s what most other countries are doing. They don’t wait until things are absolutely ready.’

Professor Susan Michie, Director of the Centere of Behavioural Change at the University College London who is also on the government’s Behavioural Science Committee for Covid-19, on 3rd May;

‘The Government message has become a lot more complicated, partly because this will need to be a different message for different people. Some people will be asked to go back to work when they are not happy doing that, concerned that there won’t be enough social distancing, giving risks of bringing back infections to the household whilst others, who are wanting to get out of their houses, won’t be able to.’

Chances of dying from the covid-19

David Spiegelhalter, Professor of Statistics at Cambridge University, on Radio 4, the Today Programme, 1st May;

‘If you’ve got the virus your chance of dying is roughly about the same as you would have had this year anyway. And if you’re worried about dying this year you shouldn’t be so worried at getting the virus. But I think we do need to have some sort of campaign to encourage people who are at very low risk to actually get out and start living again, when we’re able to.’

Ending the lock down

Robert West, Professor of Health Psychology, University College London, on how we should get to the easing of the lock down on Radio 4, World at One, 1st May;

‘It’s going to be a very odd moment and people will react to it very differently. Some people will say, ‘well actually I don’t really want to because I feel frightened and others will be champing at the bit and perhaps take it too far. I think it’s really important to say that it won’t be juts an all or nothing, it will be a very graded thing and this is going to present some quite significant challenges, in the sense of how you communicate that.’

Q. What sort of challenges does the nuance present?

‘It’s hard enough to get the message across when you are saying thinks that are black and white like ‘Stay at home, protect the NHS, Save lives’. Even there you get exceptions with people saying, ‘well, actually, I realise one should do that but in my case it differs’. When you make a more nuanced message which is that you can go out more, there are certain things you can now do that you weren’t able to to do before you can imagine the problems that you’ve got with people interpreting that is all sorts of different ways. Ad that means that the politicians who are giving the messages are going to have to chose their wording very carefully because a single throwaway remark could be misinterpreted and cause all sorts of critical problems.’

Q. How do you solve that because you have to come down on one side or the other?

‘Yes, the way you handle it is that you, whatever message you put across, you make it very clear who it applies to, what the situations are and give specifics about the situations you are referring to and, as always, you give very clear reasons as to why that is the case and a very important part of that is that if you’ve got an easing of the lock down which applies to some group in society more than it does to others you can imagine that it’s going to start to create problems with a resentment in some cases and people saying, ‘well, why should they be allowed to do this and I can’t’.

Q. The Government says even talking about that is dangerous, do they have a point?

‘They have no choice. They have to talk about it because what people can very clearly see is movement in other countries and that when this Government is already saying, ‘well, we have turned the corner on this one’, they can’t just pretend that it’s business as usual. So they have no choice. They have to talk about it. So then we come to how do you talk about it. The key thing is to help people to realise that this is a very risky time, tight now. This is probably as risky as it has been on any part of this crisis. If we get this wrong then we will be back where we started, possibly even worse. So people have to know that whatever the easing of restrictions, they don’t go beyond it.’

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