July 4th – ‘Independence Day’ or Armageddon

More on covid pandemic 2020

July 4th – ‘Independence Day’ or Armageddon

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

‘Abandon all hope, ye who enter here’.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Leicester locked down before it was unlocked

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Q. Who were the warnings from?

‘Ultimately the WHO [World Health Organisation].’

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

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

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

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

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

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

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

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

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

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

Care Homes

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

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

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

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

Q. What do you make of the ONS survey?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Britain, covid-19 and poverty

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

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

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

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

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

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

Test, track, trace and isolate – perhaps

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

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

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

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

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

11th June

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

19th June

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

26th June

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

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

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

29th June

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

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

30th June

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

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

The app that never was – or ever will be?

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

‘Immunity passports’ rise their heads – again

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

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

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

Devolution means the need to do things differently

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

The problem of ‘symptomless transmission’

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

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

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

Not protecting the NHS for ever

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

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

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

Schools returning in September

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Quote of the week

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

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

More on covid pandemic 2020

When you thought the situation in Britain couldn’t get any worse – the Buffoon opens his mouth

More on covid pandemic 2020

When you thought the situation in Britain couldn’t get any worse – the Buffoon opens his mouth

If you are unfortunate enough to be living in Britain in 2020 – during the covid-19 pandemic – you are used to waking up hoping you had seen the worse – and then you would see, hear or read the latest cock up of the Buffoon and his gang (and pinch yourself hoping it was all some surreal nightmare).

Every time the present Government is questioned or criticised about its ‘handling’ of the pandemic the stock answer is that we should concentrate on dealing with the crisis in a united manner and that any review of what was, or was not done, will be part of an investigation at some time in the indeterminate future. Obviously the Buffoon and his Government hope that at that time people would have forgotten what a pig’s ear they had made of the situation from the very beginning – a wish that, unfortunately, will probably turn out to be true.

However, a short ‘review’ just short of three months into Britain’s response to the pandemic;

  • the death toll is around 64,000 (as of the end of May) – that being the difference in the average number of deaths in the last five years in the same period and what has happened in 2020 (considered as being the most accurate estimation as many deaths, especially in the early days, were not being put down to covid-19)
  • the ‘world beating’ test and trace programme is an embarrassment (see below)
  • the situation in care homes continues to be dire (see below)
  • most (if not all) policy decisions are taken by the Government in an ad hoc manner surprising those who have to carry out these policies (see below)
  • there’s a ever growing major difference of opinion between the scientific advisors and the politicians (see below)
  • there’s seemingly no strategic plan to get as many children as possible back to school as soon as possible (see below)
  • the prospects for the economy in the coming years is predicted to be the worst in Europe

Fourteen day quarantine for anyone entering the United Kingdom

The plans are announced – and immediately people ask the question – why now?

Robert West, Professor Of Health Psychology, University College London, on Radio 4, World at One, 2nd June, talking about the plans to introduce a 14 day quarantine for all travellers coming into the United Kingdom from 8th June;

‘There is science behind it but of course the science is ambiguous here with regards to exactly what policy you adopt. …

It’s a cautious approach but the science would also support other chunks of measures such as those being adopted by other countries which might involve having more testing of people as they come into the country and other preventative type measures. ….

What’s puzzling a number of people is that this seems a particularly cautious approach for people coming into the country when we’re seeing a relaxing, to some degree against the scientific advice, with the approach we are adopting for the people already here.

It would be fine if the Government were to say …. there are reasons for doing so while other countries are taking a different approach.’

Q. The line ‘we owe it to victims to impose a quarantine’ [Priti Patel]. Is that how you see it?

West laughs. ‘It doesn’t make any sense. [Laughs again, then stutters looking for words to express his reply in the face of such a ludicrous statement.] That’s just a very generalised, emotive argument you could apply to anything.

We owe to the victims to apply appropriate cautious measures across the whole gamut of what we are doing and that includes getting a decent contact, testing, tracing and isolation system in place – which we should have started on a long time ago.

Talking about ‘we owe it to the victims’ is not a particularly helpful contribution.’

Universities opening in September

Julia Buckingham, Vice-Chancellor of Brunel University and President of Universities UK, on what situation students will possibly face at the beginning of the academic year in September 2020, Radio 4, World at One, 2nd June;

‘There are some wonderful examples of digital eduction now, techniques like virtual reality, so I do see this as a really exciting opportunity. If I’m honest it’s something I’ve been wanting to do for a long time and I think our students will actually embrace it.’

The reason for including this quote are twofold. The first is that this use of technology, especially when coupled with the ‘bubble approach’ being discussed at the moment, will change the whole ethos of attending University. If you can do all the work at a distance (which is the case for the majority of the students not involved in hands on practical courses) then why go in the first place.

With the cost of University fees and living costs this is a very expensive way of having a party – which you won’t be able to have because of the ‘bubble approach’ and social distancing. You might as well sign on to a university, go across the world where the sun shines most of the time and living costs are cheap and just pay for a good internet connection.

The second is what follows the phrase ‘if I’m honest’. This is just one example where different organisations and businesses will use the effects of the covid-19 ‘new normal’ to bring in practices they have wanted to introduce but couldn’t due to potential opposition. They will now make it a fait accompli and push the blame on a guiltless virus. It won’t be able to say that it wasn’t its idea.

To make the experience of being a students totally miserable (as well as expensive) it is being suggested they might have to stay in ‘protective bubble’.

Already universities are nervous – especially those which are over dependent upon foreign students, even more so those which have been cultivating the very lucrative Asian, mainly, Chinese ‘market’ – education is more of a business now and education seems to be a bit of a sideline. But even domestic students are thinking about their future and deferrals are certainly being considered by many. What to do if they don’t go to University might be what swings it – a ‘gap year’ travelling, finding a job for a year might not be viable alternatives.

The Buffoon and his Government inept and incompetent? – of course not

The Buffoon at Prime Minister’s Question Time in the Houses of Parliament, 3rd June, in response to a challenge on the ineptitude and incompetence of his Government’s approach to the covid-19 pandemic;

‘I really do not see the purpose of these endless attacks on public trust and confidence. What we’re trying to do is to …. [communicate] clear messages about how to defeat this virus.

Test and trace is a vital tool in our armoury and, contrary to what he [Starmer, leader of the Labour Party] says, actually we did, by the end of May [he meant April] get up to 100,000 [although that figure is generally accepted to have been ‘massaged’] tests a day and we got to 200,00 by the beginning of this month [another figure that has been extensively challenged].

That was an astonishing achievement, not by government but by tens of thousands of people working to support government. [Interesting how here the Buffoon turns a question of the truth of what Ministers have said and claims it as an attack on people carrying out the tests and the tracing. Also how those people are doing the job ‘to support the Government’ – as if they have faith in what it is doing.]

I think he [Starmer] should pay tribute to them and what they’ve achieved. [Here the Buffoon reiterates his ‘support’ for those who are being ‘questioned’ in the validity of the figures.]’

And this is the problem (one of many) of Parliamentary so-called ‘Democracy’. These characters aren’t concerned about dealing with the issues of the day, they are more concerned with playing to the gallery of their supporters. In Britain it’s played like a Public (in Britain that means private) school debating society. It’s not what is said but how it is said in order to win support – the solution to the problem doesn’t come into it.

If you can stomach it you can see a performance what is called PMQs (Prime Minister’s Questions) of the 10th June.

The mandatory use of face masks on public transport

The World Health Organisation doesn’t do itself any favour when faced by the cretins such a Trump. Now, seven, eight or even nine months (depending upon who you listen to about the actual first appearance of the virus) they reverse their policy on the general population wearing masks whenever they might have close contact with others outside of their immediate circle.

Devi Lalita Sridhar, Professor and Chair of Global Public Health at the University of Edinburgh, Radio 4, World at One, 5th June;

‘There’s emerging evidence [although no mention of what or from where] about the positive impact that mask usage can have in reducing transmissions. … it would have been nice to have had this done earlier.

I agree with the British Medical Association that the latest proposals don’t go far enough. What we need to be seeing is mandatory masks whenever distancing is not possible. This means in shops, on public transport, in work places, airports, train station. This is a first step but there’s a long way to go.’

Q. Has mask wearing worked elsewhere?

‘It’s difficult to say. A lot of countries introduced a package of measures at the same time. We also need to look at a package of measures, we need to look at the cumulative effect that they can have together, even if each alone has a weak evidence base.’

This is a matter that’s been really badly handled in Britain by both the politicians and the so-called ‘scientific experts’. Also the introduction of the mandatory use late (as is that of the 14 day quarantine for those entering the country) doesn’t help to inspire confidence.

The pros and cons as I understand it;

Pros.

If someone is infected with the virus, and especially if they are not aware of it, the wearing of a mask will capture some, but not all, of the virus if they were to cough or sneeze – or even talk to someone close to them. The figure varies widely, down to below 50% by some estimates, but that would still make for a reasonable lowering of risk. And that’s it.

Cons.

The wearing of a mask will not prevent the virus from infecting you if someone coughs or sneezes in the vicinity. The problem here is that most people believe it will protect them. That’s why you see people alone in vehicles wearing a mask. And the majority who wear them when they are outside, and alone, are not doing it in an effort to not spread the infection they don’t know they have on to others. It’s fear which drives this wearing of masks and creates a false sense of security, which itself can cause problems.

The biggest ‘con’ that was being ‘promoted’ weeks ago was the fact that if someone is infected and they are breathing into a mask, that mask will accumulate millions of spores of the virus. Any mask, especially in the heat of summer, will soon get sopping wet and an infected person (who doesn’t know they are infected) is supposed to take that mask off in a controlled manner, dispose of it safely (or bag it if it is to be used more than once), wash their hands with sanitiser without touching any surface at all, including their own face.

That’s not going to happen.

To actually breathe and feel comfortable people will be constantly touching the mask and – if infected – then spreading the virus on anything they touch. It is just not possible to go through any daily routine without touching anything, including the face which we touch hundreds of times a day due to evolution.

For those who are good with the sewing needle – or were brought up on Blue Peter – here’s what you should do to prepare for the 15th June.

The British Medical Association has asked for the wearing of masks to be extended beyond public transport to any potential contact between individuals – and that they should be provided free. However, although there are plenty of hints at how to make your own masks those to buy are in relatively short supply – and/or expensive. Other countries where masks wearing is mandatory supply them and have controlled the price. For example, to just less than a Euro each in Spain and they have even gone down in price in Holland, where a pack of ten was €10 but are now selling (in normal supermarkets) at less than €7.

A slightly different take on ‘mask wearing’ and as an example of the Buffoon and his Government’s inability to deal properly with those who have to implement their policies – seemingly thought of after cigars and brandy (copious amounts of) they decided that everyone that enters a NHS facility (either workers or visitors) should have to wear a mask. However, the Government ‘forgot’ to consult with the NHS trusts – those responsible for enforcing such a policy.

Schools – when or even if – they open

Mary Bousted, Joint General Secretary of the National Education Union, Radio 4, World at One, 8th June;

Q. What is different about September that will allow whole schools to open?

‘The joy must really be out about whole schools being able to open in September. It all depends where we are with the coronavirus at that point; whether the R rate is down, whether the number of cases is low enough and whether we’re confident that schools can operate. If you’ve got a whole school in there’s no way you can have social distancing. There’s much that is dependent on the spread of the virus, how well it’s controlled.’

Q. Isn’t there a point when certain children are more at risk not going to school than doing so?

‘Disadvantaged children, perhaps should be the priority. I was surprised when the Prime Minister said that first year groups should go back first. My union would have said that disadvantaged children should go back first because, you’re right, they need school the most, they benefit from school the most and they suffer when they can’t go to school. [If such a policy were adopted that would make the children feel good, wouldn’t it? There’s the whole rejects from society in one place at the same time. In a culture where bullying is rife surely such stigmatisation is the last thing that’s needed?]

We do know that in secondary schools there is a focus on disadvantaged children and vulnerable children being in school but the problem we’re got is that many of the families are extremely concerned. [For example] many Bangladeshi families won’t send their children back to school as they live in multi-generational households and they’re afraid they’ll bring the virus home.’

Anne Longfield, Children’s Commissioner for England, on the debacle and confusion around if/when/who on schools re-opening in 2020, on 9th June;

She accused ministers of ‘failing to prioritise schools and lacking the necessary will and ingenuity to overcome the difficulties that are involved in social distancing’. She also found the ‘delayed return deeply worrying’ and it was ‘a disruption not seen since World War Two’. Further that ‘a decade of catching up on the education gap may well be lost’.

Andrew Snape, Professor in General Paediatrics and Vaccinology, Radio 4, World at One, 9th June;

Q. Children don’t seem to be badly effected by the virus. Is that correct?

‘That’s right, as a paediatrician that’s really important. Children don’t seem to get sick from covid-19. There is a small number of cases of post-covid inflammatory syndrome but in the overall picture the risk to individual children is very small.’

Q. Do they spread it to adult?

‘Although children can carry the virus ….. perhaps 1 in 200 children, but they seem not to be the super-spreaders that they are for influenza. Children are fantastic at spreading influenza … but that’s not the case for covid-19. … It’s much more common that adults bring the virus into the household.’

Q. Are you confident to send your children back to school?

‘Yes, I’m confident of sending my children back to school. The risk as an individual would be very low. The bigger question is ‘does my children’s school re-opening increase the spread through the community?’ because it’s not just the children at school. It’s the teachers who are mixing in the staff room, it’s the parents mixing at the school gate and bringing their children to school. So there’s all the other elements that need to be very carefully looked at and managed to avoid the actual opening of the school creating a spread of the virus through the community.’

Q. How important is mitigation?

‘It’s really important. There’s not a lot of evidence that children are spreading it. … A lot of effort would need to go into ensuring there’s not a lot of mixing of parents and the teachers, to try and minimise their social interactions might even be more important in reducing the spread.’

David Blunkett, former Education Secretary in a Labour Government, Radio 4, World at One, 9th June;

Q. What’s the problem about schools not going back as was previously announced?

‘To be honest I think it’s a lack of will, it’s a lack of ‘can do’, it’s a failure to do what we’ve already done with the health service and the economy, which is to say ‘there are challenges, there are real problems but we are going, as a nation, to actually seek to overcome them’. It’s easier for Scotland, they go back much earlier in the summer anyway but for England and Wales it’s a different matter.

Why is it that other countries, not just in Europe but across the world, can have the ambition to get their children, in all kinds of creative ways, back into school and we can’t?

I can only conclude that the Government are losing the plot.’

Q. You are saying it’s a lack of will on the part of the Government, not that it’s the parents taking a precautionary approach?

‘Well, it’s a Catch 22. the less confident the Government is, the less clear they are about what steps they’ll take themselves to help those local authorities and education trusts to manage this transition, the more parents get worried,

This is an endeavour for all of us to work together. We have 600,000 people taken on as volunteers nationally to help with vulnerable people at home. We’ve got supply teachers who are not being paid anything. We’ve got excellent teachers doing their utmost to work with children at home.

We can take up the suggestion … of using other buildings, we can do what the Americans do … which is to close roads around schools to make space available. All of this could be done with a bit of thinking creatively and everyone working together.

Q. However much space you give them aren’t children going to break the 2m or 1m rules? And it’s six months, it’s not the end of the world. What price do you think will come with this?

‘If it’s not the end of the world why do we have the education systems we have here and in the rest of the world?

I spoke to someone who said her nephew, who is in his mid-teens, spends everyday until 12.30 in bed. That won’t be because teachers aren’t trying or parents aren’t actually encouraging it will be because a kind of lethargy comes out in teenagers if they don’t have a structure and they don’t have encouragement. … I just know that we’ve got to do this.

If we can set up the Nightingale hospitals in the time we did why on earth can’t we invest in the future of out children?

Q. Where does the initiative need to come from?

‘The Government should say to local authorities and education trusts – get together, come up with a plan which includes mentoring and recovery programmes in certain schools as well as staggered hours and new premises. Come up with that plan and we, as a nation, will fund it. The funding from the middle of June through into August, we’ll pick it up again in September if the scientific advice is that we can’t actually go back to complete normality. We’ll reduce the distancing for schools to a metre – which is being done across the rest of Europe and is the advice of the WHO – and above all we’ll say to people at local level use your initiative, have confidence to develop programmes locally.

Of course, take the advice of the directors of public health at local level but try and do it in a very positive way so that you can deal with any spikes, you can be confident there’s no infections at the present time … and then we can ensure that we not only give the confidence to parents and to teachers and children but we also allow those parents to go back to their jobs where they will be contributing to the recovery of our economy.’

Was the lock down worth it – and effective?

Sunetra Gupta, Professor of Theoretical Epidemiology at the University of Oxford, Radio 4, World at One, 9th June;

Q. Would you have argued for ‘herd immunity’ all along?

‘Yes, I would have said that but with the proviso that we put as much money as possible – and to make up for what hasn’t happened over the last 30 years – to support the vulnerable sectors of the population.

I think at that point we had enough information to know that there were certain sectors of the population that were particularly vulnerable and that we needed to protect them – and the word ‘protect’ carries with it all sorts of implications – but essentially it seemed to be that there was a real gap in the resources available to achieve that.

Let’s now try and divert as many of these resources as possible to protect the vulnerable population and to reduce their risk. And the way to reduce this risk to the vulnerable population – as we have done unwittingly in many cases with the pathogens that do kill us … is by having enough immunity ourselves such that the risk posed to the vulnerable population is low.’

Q. So the majority of the population carry on as normal and catch the virus and build up ‘herd immunity’?

‘That’s how we have traditionally dealt with the pathogens that do at the moment kill the elderly and the vulnerable.

It’s a terrible thing that that happens but it happens.

I guess we’ve made the decision that we need to balance out that problem against the problem of completely shutting down the economy or compromising out social interactions to the point of farce.’

Q. Has the lock down been a farce?

‘We are trying to wriggle out of this situation in a way that is quite farcical. We come up with rules that are arbitrary, to my mind.’

Q. The idea would be to change the strategy with the vulnerable staying indoors?

First of all we need to go out there and make a proper map of what their risk is. The risk to the elderly and frail is not just contingent upon how elderly or frail they are but how immune the rest of the population surrounding them is. We need to go out and test, to the best of out abilities, knowing now that some people are not going to register positive on these tests simply because they happen to be entirely resistant to the disease.

We need some clever statisticians and people who are disinterested in promoting any kind of sense of what they think is going on, to make proper, clear, best assessments about what the risks are to the vulnerable in every part of the country.

Just in the UK there is a huge variation in who has been exposed given the locality. There’s enormous heterogeneity and homogenising this data just to fit certain precepts or preconceptions is not helpful.

What we need to do is go out there, look at who’s been exposed in different regions and come up with a strategy, put public money into supporting the people who are vulnerable given the risks that they face. … We need to make sensible decisions about how to protect people.’

Q. Should we be relaxed about the R number, lift the lock down quickly and not be phased by the idea of a second wave?

‘There will be a resurgence of this like any other respiratory pathogen in the winter and we need to prepare for that.’

Q. We hear there’s some regret in Sweden due to the death toll. Would that not have happened here if we didn’t have lock down?

‘I think it’s unfortunate that people are focussing on that point. … What was said was that they could have done better to protect the care homes and indeed that’s what we should have done.

It’s unfortunate people are jumping on that [failing in Sweden] to say they should have had a lock down earlier.

What I don’t understand about the lock down is what is the exit strategy from it anyway?’

Q. Would you lift it as quickly as possible?

‘Yes, right now, absolutely.’

Q. Do you think the disease arose earlier in China than was suggested?

‘Absolutely, yes,’

Q. When did you think it appeared?

‘… In any normal system by the time it takes for deaths from the disease [to be recorded] it’s been around for at least a month.’

Q. So October rather than November?

‘Yes, something like that.’

Related to this idea is the uncertainty of how many people might, for whatever reason, already be (or have always been) resistant to covid-19.

Care Homes

This issue will run and run. This sector was in a dire state prior to covid-19 and the political philosophy and attitude of the Tories – which is to step back from any social welfare that benefits the general population – won’t just evaporate. And even when they make a big splash about giving to the sector it’s more giving with one hand and taking with the other.

More than 25,000 patients discharged to care homes in crucial 30 days before routine testing.

Even thought he care homes have become the epicentre of the disease in Britain they are still not getting the priority they need. And the stupidity of the Government is demonstrated by the fact that they are seemingly incapable of avoiding criticism by making sure care homes are at the top of the list for any developments in the battle against the virus. Instead of giving the impression they see that mistakes were made in the past (and will do their best to do better in the future) they continue to try to score political points – even when the facts stand in opposition. This was the case about testing kits – and the difference between being delivered and used. (Note how Hancock gets testy when challenged in the video clip.)

Another view on Hancock and numbers.

Test, track, trace – and isolate

Only 4 in 10 Covid-19 patients contacted at start of government’s ‘test and trace’ scheme.

The people of Britain were promised a ‘world beating’ test and tracing system. However, in the first days of June there was nothing for many of the staff employed to do this had a great deal to do.

Matt Hancock under fire over incomprehensible testing targets.

Sir David Norgrove, chairman of the UK Statistics Authority, sent a letter to Matt Hancock, the Health Secretary, on 2nd June where he stated that the figures being presented were ‘still far from complete and comprehensible’ and that many of the ‘key numbers make little sense’. This was partly in response to the Government’s ‘massaging’ of their testing ‘target’ numbers, mainly the 100,000 by the end of April and the 200,000 by the end of May – both of which were ‘met’ but with dubious counting.

But the ‘world beating’ system is not going to be with us soon. The autumn might be more likely.

The privacy issue also keeps on running.

Open Rights Group to challenge UK over test and trace data retention.

This might be academic. We still don’t know exactly when the magic app will be in general use.

And which app? There’s now the possibility that the NHSX will ditch their own, centralised app and revert to the ‘off the shelf’ system developed by Apple and Google and which is being used in other countries.

Watch this space.

For an interesting view on the ‘complications’ surrounding tests and how the figures we are told about and reality are not always in line listen to the first 15 minutes or so of the BBC Radio 4 programme, ‘More or Less‘ on Friday, 5th June.

Food Banks

The obscenity gets even worse.

The stories behind the statistics.

Two metres – or less

This has now become part of the debate.

Two-metre rule halves chances of catching coronavirus.

Although there is a push to reduce the social distancing rules – especially as in Britain the 2 metre rule is out of kilter with many other countries.

How did covid-19 land on the sceptred isle?

Through the ability of scientists to break down the genetic sequence of the virus – and with the sharing of information between countries of their particular outbreaks – it’s possible for scientists to identify from which part of the world those in Britain contracted the disease – normally by close contact from someone infected from those countries. And that happened on more than 1,300 occasions.

That puts the idea of instituting a quarantine for visitors to the UK from 8th June into context – stable doors and bolting horses come to mind.

And for the xenophobes the majority of those cases came from two countries – France and Spain. That shouldn’t come as any surprise as with the explosion in recent years of air travel with the budget airlines those are the two most popular countries for British travellers – and the UK for the French and Spanish

Asymptomatic spread of coronavirus

It has long been argued that it’s the asymptomatic individuals that were the biggest spreaders of the coronavirus – not out of Mary Mallon fear and ignorance – but because they don’t know they are infected. That seemed to be challenged somewhat by a statement from Dr Maria Van Kerkhove, the WHO’s technical lead for Covid-19. However, there was later some ‘clarification’ that she was arguing for emphasis to be placed on tracing contacts with anyone who was proven to have had the disease. But I still slightly confused.

Has the Dominic Cummins affair gone away?

Perhaps not. Reminiscent of Al Capone being imprisoned for tax evasion (and not the countless murders for which he was certainly responsible) Cummins – or his family – might have broken local government planning regulations when a farm building was converted for residential use. Haven’t heard any more of this so don’t know if it is just bubbling under the surface.

And as neither Cummins not the Buffoon are prepared to do the ‘right thing’ it is being left to private individuals to make the rich and powerful abide by the same rules that the majority of the population are expected to do with a private legal case being progressed to get the prosecution service to take the matter seriously.

Risk of getting severe case of covid-19

To the conditions that have become recognised as presenting a higher risk in the present pandemic (older than 70, being male, from a BAME community, suffering from ‘underlying health conditions’, diabetes, dementia/Alzheimer’s) can now be added another – baldness.

What we might learn to face the next pandemic more efficiently

The virus has been around long enough now – with hundreds of thousands of scientists trying to learn as much as possible about all of its hidden characteristics – for a fuller picture to be constructed which might make the next pandemic less traumatic.

Should the lock down had happened earlier?

Forgetting for the moment whether the lock down should have happened at all (see the section above arguing it wasn’t the right tactic if other provisions had been in place) there are scientists who are now arguing it was imposed too late – by about a week.

On Sunday 7th June, Professor John Edmunds, an epidemiologist at the London School of Hygiene and Tropical Medicine and a member of Sage, told the BBC ‘We should have gone into lock down earlier’ and that by not doing so it ‘has cost a lot of lives’.

The response from Matt Hancock, the Health Secretary was ‘There’s a broad range on Sage of scientific opinion and we were guided by the science, which means guided by the balance of that opinion’.

I suppose we would have a better idea of what the ‘scientific advice’ was if the Government were to publish any of their reports in a timely fashion. Even though calls for the publication of, at least, summaries to these reports being published more or less at the same time as the decisions upon which they are ‘based’ have been made for months we seem to be no closer to a situation of openness.

On the 10th June, Neil Ferguson (remember him? He was one of the ‘naughty’ boys and girls who broke their own rules but at least had the good grace to fall on their own swords – unlike Dominic Cummins) weighed into the ‘controversy’.

At a meeting (virtual) of the Commons Science and Technology Committee he said ‘We knew the epidemic was doubling every three to four days before lock down interventions were introduced. … ‘So had we introduced lock down measures a week earlier, we would have reduced the final death toll by at least a half.’

Whilst not openly agreeing with this one of the other top scientific advisers, Professor Chris Whitty, the chief medical officer, said he had a long list of regrets – the most important being the stopping of the testing regime.

The Buffoon, on the other hand, whipped out a straw boater and cane and gave a rendition of Edith Piaf’s ‘Non, je ne regrette rien’.

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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