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

More on covid pandemic 2020

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

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

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

Testing

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

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

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

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

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

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

Test-track-trace

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

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

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

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

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

Q. What sort of numbers are we talking about?

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

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

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

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

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

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

NHSX app – and the pilot on the Isle of Wight

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

There are three concepts that are really important.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Swedish compared to the British experience

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

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

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

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

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

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

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

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

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

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

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

Q. You think the lock down has been pointless?

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

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

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

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

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

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

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

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

Greater surveillance worldwide on the back of covid-19

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

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

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

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

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

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

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

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

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

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

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

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

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

a) ventilators

b) reusing PPE

c) intensive care drug shortage

d) changes in guidance in using PPE

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

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

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

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

More on covid pandemic 2020

Britain and the pandemic – during an uncharacteristically sunny Bank Holiday weekend

Masks becoming the new norm

Masks becoming the new norm

More on covid pandemic 2020

Britain and the pandemic – during an uncharacteristically sunny Bank Holiday weekend

What Britain is like during the weekend that ‘celebrates’ 75 years since the western Victory in Europe (VE) Day – the event is commemorated in Russia on 9th May – and the wild comparisons as the country lives under the lock down due to the coronavirus.

Testing

When asked, at Prime Minister Questions (a peculiarly British anomaly which takes place every Wednesday at noon), in the House of Commons on 6th May, the Buffoon was asked a clear question of why they were only able to reach the target of 100,000 tests per day on one day, the day when they could say the Government had reached it’s target by the end of April – not repeated since.

‘Actually I think the Right Honourable Gentleman [another British anachronistic peculiarity] was right last week when he paid tribute to the amazing work of the NHS, the logistics team, everybody involved in getting up from 2,000 tests a day in March to 120,000 by the end of April. Yes, he’s right, capacity currently exceeds demand, we’re working on that, we’re running about 100,000 a day [an outright lie] in the first 5 days of May the number has not exceeded 85,000 per day]. But the ambition clearly is to get up to 200,000 a day by the end of the month and then to go even higher. As he knows, and the whole of the House will know, a fantastic testing regime is going to be absolutely critical to our long term economic recovery.’

So the Buffoon starts by ‘praising’ those who had ‘achieved’ the 100,000 plus, being self-effacing and then completely ignoring the question. Then continues to throw mud on the issue by introducing yet another meaningless figure, that of 200,000 per day but without any proper strategy surrounding this so-called increase.

Chris Hopson, Chief Executive NHS Providers, which represents NHS Trusts, on Radio 4, World at One, on 6th May;

Q. Do we have what the Prime Minister referred to as a ‘fantastic testing regime’ now?

‘I think we should give due credit where it should be given for the extraordinary expansion in capacity we’ve had over the last month, month and a half, and NHS staff and Public Health staff have played a key role in expanding that capacity. But there are three problems we still need to address.

The first one is today’s problem that there are still too many care staff and too many health staff who have got potential symptoms and still can’t get access to a test. I was speaking to a hospital yesterday. About a week, ten days ago, they were able to turn their tests around in a day. They’ve now slipped back to only having those tests turned around in five days. We already know there are plenty of staff in the social care sector who need to be tested because they may have symptoms where actually they can’t be tested because there aren’t enough local facilities.

So hospital, community, mental and ambulance trusts and social care homes need to test. That’s the first point.’

Q. Why does the turn around that used to take one day now take five?

‘There’s some complex things going on here but the first is that we know that there are shortages of chemicals, reagents and testing kits. To give you an example, this week one of the major manufacturers of testing equipment has actually cut back its supplies to the UK because it’s actually wanting to increase supply elsewhere. I describe it as a rather complicated game of rubics cube where, effectively, different laboratories are trying to swop tests between each other to ensure that those problems are overcome.’

Q. It’s not by ramping tests in drive-in centres you are depriving hospitals and care homes?

‘What we are basically saying is that we can see why there was a logic of setting up these drive-in centres but one of the problems which we have heard from NHS and care home staff is that these drive-in centres are quite a long way away from where these people work and therefore they’ve been having long trips of an hour or even two to get to these centres and if you really want to have an effective testing regime you need to ensure that they’re sufficiently local to people who want to be tested.

Point two is, exactly as we have heard the Prime Minister say today, we are heading toward coming out of, easing, lock down and we know that testing, tracking and tracing is really important and we need to get going on that really fast but the NHS organisations that we represent, none of them know at this point what we are meant to be doing in terms of the process.

If we want to mobilise the NHS to deliver that test-track-trace approach we need to know really very quickly what our organisations in the NHS are required to do,’

Q. They’ve heard nothing?

‘From what we’ve heard so far is that it’s a step forward, we’ve heard that there’s a pilot of the approach in the Isle of Wight, but what we need is the lessons of that pilot to be learnt and shared very quickly, but critically our organisations, particularly, for example, 111, GP surgeries, pharmacies, which are absolutely at the first point of contact of the patients of the NHS, they need to know what role they’re going to play in test-track-trace. At the moment they don’t know.

The third one is that there is a growing argument, and a really important one, that if we want the NHS to really re-start its ordinary business and if we want to control, and hopefully reduce the number of deaths in care homes, we really should be testing every single member of staff, every single patient in a health and care setting, because one of the pernicious features of the virus is that, actually, you can have it for 2 or 3 days, be infectious, but have no symptoms. If we want to create safe care homes, if we want to create safe hospitals … (interruption)’

Q. That was promised some days ago.

‘What we were told was that it was important and, to be fair, there are some pilots going, there are eleven hospital pilots going, testing staff on a systematic basis but the issue here, again, is the complicated logistics, which is, at a really conservative estimate, there are a million front line health and care staff that you probably want to test once a week. And if you wanted to do that you need the capacity to be 142,500 tests a day. What was said in the House of Commons today we are currently running at 80,000.

And the other point to make is, if you are responsible, as some of our hospital trusts are, for 20,000 staff getting them tested once a week is a huge operational and logistical undertaking. So they need to know now when they are going to be able to start testing these staff, where are they going to be tested, how is the capacity going to grow from the current 80,000 to 140,000 that will be required as a minimum to do that? And the need to know when that’s going to happen. The problem is we don’t have a clear strategy about how that’s going to happen.’

What’s behind the new tracking and tracing apps?

In previous posts I’ve expressed my reservations about these apps (whether the ‘generic one, used or that will be used by a number of countries or the one (using a centralised database) which has been developed by NHSX (an ominous acronym for a health related issue) and which, at present is part of a pilot scheme on the Isle of Wight. How that pans out will have to be seen – as well as what will be the results if or when it gets used throughout the UK.

The ‘debate’ will go on for a long time, I’m sure, with fears and theories abounding. On 8th May there was a story that the NHSX contact-tracing app reportedly failed cyber security tests.

Here I want to highlight issues that might well follow from this supposedly ‘temporary and specific’ form of personal surveillance. If people look at the consequences of what accepting this app could mean then they might not be so keen to accept the reassurances of the Government. Well, some people may not, others are sheep and will do whatever they are told.

On 4th May it was revealed that Britons without the Apple/Google tracing app may not be able to travel abroad. Even before the app has proven itself to be effective governments worldwide are already thinking about making this mandatory for any visitors from another country. And if this is being thought about in many other countries then it’s guaranteed a similar regulation will be applied in Britain.

So in one fail swoop what is being sold now as being voluntary is de facto obligatory – if you want to travel – and who wouldn’t want to get out of Britain as soon as possible after the months of lies and incompetence we have been submitted to since the declaration of a pandemic.

In something I read recently (can’t remember the exact reference) in relation to visas for Russia it was suggested that the installation of such apps would be conditional on obtaining a visa. Presumably there would also be an obligation to keep it switched on and so movements would be constantly monitored.

I assume it is not impossible to have two, or even more, apps installed on a phone so no free movement will become possible in the near future.

Free school meal vouchers

The situation is not getting any better since I first wrote about these vouchers that have replaced free school meals now that all the schools are closed.

The incidences about the difficulty of getting online to apply, receiving the vouchers and then actually using them just keep on growing. All through the structure there are problems and although the scheme may be ‘working’ for the majority of people there is a sizeable minority where there are problems and it is causing a lot of distress.

And, I would argue, the problems stem from the way that this arrogant, free market Tory Government has decided to ‘help’ some of the poorest in society through the pandemic. Those whose companies having applied for ‘furlough’ money get up to £2,500 paid directly into their bank accounts by the Her Majesty’s Revenue and Customs (HMRC). Those who have had to sign on for Universal Credit at the Department for Work and Pensions (DWP) similarly get money paid into their bank accounts. Yet those families who need help to buy basic foodstuffs are paid in vouchers – for which they have to jump through hoops.

Complaints about them include; a scheme that has changed a number of times since its introduction; a restriction on which stores they can be used (each voucher has to have a designated store); not being accepted online – especially difficult for one parent families with young children who will have problems going to the supermarkets with a gaggle of children and even more so if they are supposed to be self-isolating if one (or more) of those children have special needs; the vouchers are regularly arriving late; they can be temperamental if not printed out perfectly causing humiliation when they are refused in a very public manner; and even if parents manage to get an online order the supermarkets are still charging for delivery – a charge which is disproportionately carried by the poorest by not reaching the ‘free delivery’ threshold.

This contract was handed to a private company which is making money out of the poorest in society (even if their profits come from any additional money from the Treasury it takes that away from helping those in need) and yet, to use that awful cliches, the system ‘is not fit for purpose’.

So far more than £55 million has been spent on these vouchers but there’s no details about how that may be short if all who were eligible had used them and neither is there information on the amount of profit for the private company, Edenred.

But the most important aspect of this is that a society which provides free school meals for those who can’t afford to feed themselves properly, as well as the provision of food banks, does not indicate a caring society but one that is irretrievably broken – and should be, itself, destroyed and replaced with a more just system.

Personal Protection Equipment (PPE)

As with testing this is another issue that will not be with us as long as is the virus. The Government continues to argue that it is doing its best and has provided ‘billions of pieces of PPE’ but six weeks into lock down both NHS but especially care home staff are saying there is still a shortage.

A big issue was made a couple of weeks ago about PPE coming from Turkey. Forget the farce of when it would all arrive with the RAF sending out a couple of transport planes to bring it to Britain. It has now (7th May) been revealed that the gowns ordered from Turkey fail to meet safety standards.

Like most people I have no idea what the safety standards are or how they are measured. It’s not my job – but it is someone’s. Also if there are strict safety standards then why aren’t those specifications transmitted to the company that’s making the equipment? And why didn’t someone make sure that the consignment met those requirements before the cargo was even put on the planes? If they were no more useful that large black bin bags why did we have to go all the way to Turkey to get them – surely there’s enough here already.

European Union disunion

There has been no common approach on how to deal with the virus in the European Union with virtually every country following a different procedure. Then when it came to paying the costs some of the richer members were less than forthcoming when there were requests from the poorer nations, principally Italy. This could cause a lot of resentment in the near future and will only serve to feed the cause of the ‘anti-unionists’ and there will be a lot of uncertainty about the future of the EU.

We in Britain had to go through almost four years of mind-numbingly boring and tiresome ‘debate’ about leaving the EU and this virus sorts matters out in a matter of weeks!

Constant leaking and speculation about what will be announced

It’s not the virus that’s the problem it’s the system that is ‘dealing with it’. And one of the characteristics of those politicians is the grandstanding that accompanies all they do. Everything’s a game to them and that’s the way they play with those they are supposed to lead.

This attitude has characterised the whole business of the pandemic from the ‘recommendation’ that pubs and bars should close (way back at the beginning of the lock down) to the ‘suggestion’ that people in Scotland should wear masks when shopping (later on in April).

Politicians are constantly playing to their ‘core’ audience, to those they need to keep on side. In 2020 the exemplar of this is the US President Trump, but we have the same situation in Britain. The Buffoon plays the clown as he thinks it makes him (an over-privileged, rich, overweight, white male) ‘attractive’ to those who are everything he isn’t – the average working class Tory voter.

The Nationalist First Ministers in both Scotland and Wales are playing to their constituency to whom they want to impress the idea that they are in control for what happens in the periphery of Britain. They continually attempt to score points over the Buffoon in Westminster – and this was even more obvious when the Buffoon was in hospital and none of the other Tories deputising had the courage to slap them down.

What this leads to in normal circumstances, but which is accentuated at present with the covid-19 pandemic, is that issues, decisions and policies are trailed to build up some sort of anticipation. Everything is directed to a particular time (as with the daily press conferences) or a day (as with the statement to be made by the Buffoon on Sunday afternoon, the 10th May).

The problem is that the time delay, whether it be hours or days, provides time for too much conjecture. When clear leadership is needed all this provides is speculation and ultimately confusion. And almost always the grandstanding just leads to disappointment and further frustration.

Susan Michie, Behavioural Psychologist, Radio 4, World at One, 7th May;

Q. Is it going to be very difficult (in the next stage) to get the message across to the different audiences and how people hear it?

‘It’s going to be very complicated because you’ve got such a huge range, type of persons, and also types of sector. So some people who’ve not actually gone outside for the last six or seven weeks, even though they’re not in the vulnerable group, because they’re very anxious about the situation. They’ve begun to associate home with safety so for that group there will need to be messaging reassuring them that spending time outside is going to be very negligible in terms of the risk of infection.

At the other extreme, polling data has shown, especially with younger men, are getting increasingly bored and frustrated and really wanting to get out there and be back in life as things were before. For that group it’s going to be increasingly important to really stress the staged approach, really stress that all the issues about social distancing, hand hygiene, tissue use, not touching your eyes, nose and mouth, are even more important than when we’re spending more time at home.

So that’s just two examples of different parts of the population that will require different messaging. We are also in a situation where different sectors will be coming back into business at different rates, in different ways even within the same sector. You may have some organisations that could start up because they are able to meet health and safety regulations and others that won’t. So I think there’s another layer there of potential perceived unfairness that will need to be handled and managed incredibly skilfully.’

Q. This will be changing each week. Is there a way of ensuring clarity?

‘One thing that’s very problematic is what seems to be happening at the moment when first messages are being trailed. We’ve heard that we are going to be told about the plans on Sunday and I think what’s so important is the whole plan is given at once so people can understand it in the whole round and the explanations for it can be given very clearly.

What’s happened at the moment, and the only thing I’ve heard trailed is about sun bathing and having picnics outside. Now, I can see the rationale of positing outside as being not a risky situation but this is really potentially very damaging because what seems to be happening is that people, or the press, certain groups, have over-generalised, over-extended, and now there are messages about ‘this is the end of the stay at home message’ – which I’m sure won’t be the case.

My concern about this is that people will hang on to what they want to hear, build on that. Prior to Sunday we’ve got a three day Bank Holiday weekend coming up, I think the weather will continue fine and people may say ‘well, we’re going to hear on Sunday of the end of the stay at home policy, let’s all go out because that’s going to happen on Sunday anyway’. And once people have stopped obeying the rules then it becomes very difficult to get them back again.’

Snippets

Below are a number of snippets I have come across in the past few weeks. Some of them are old (not enough time or space to include them before) but the aim of this blog is not to provide up tp date news – people get that from other sources. Here I just want to create one space where the idiosyncrasies of how the pandemic has unfurled here in the UK can be found. Some may have been superceded by events, others may just be waiting to come to fruition.

Supply of testing kits

British firm that can deliver 1 million coronavirus tests per week left waiting for Public Health England order.

Business

CEOs cutting salaries is mostly a ‘publicity stunt’.

Food Banks

UK food banks face record demand in coronavirus crisis. And as with the need for the provision of free school meals, their very existence should be considered a disgrace by any reasonable nation.

International situation

France’s first known case ‘was in December’. This is an interesting one as it starts to ask questions of how the virus spread. I’m sure that the general idea was that the outbreak started in China and then gradually moved westward. That was definitely the situation in historic pandemics but in the present ‘globalised’ world that’s not the case. Yet another aspect of the covid-19 pandemic that could lead to a greater understanding which will could mean to a much more co-ordinated and efficient reaction to the next one – not if but when.

Shopping during a pandemic

There’s a lot to be said about ‘shopping’ and how the State ensures that all of the population get access to what they need in a situation such as this pandemic. Until then a couple of items.

Shoppers stock up on alcohol amid lock down – not really surprising this and it really has been going on since the pubs were closed way back in March. The future of the so-called ‘traditional’ English pub has been in question for some years now – the pandemic might be the last straw. However, the brewers aren’t concerned about pubs closing as they’ll make their profits from supermarket and off license sales.

Shops ‘exploiting’ pandemic by profiteering – yet another news story that shouldn’t come as a surprise. Once the pandemic was an accepted fact there should have been a monitoring of shops, at all levels, to prevent profiteering, but such a move is an anathema to the free market Tories – no matter how much that might adversely effect some people.

Where did the virus originate?

It’s interesting how some stories dominate the airwaves for a few days and then (if only for a short time) completely disappear. The Trumpites were making all kinds of accusations about the cause of the virus – without providing a shred of evidence. (It has to be said that equally wild accusations have been made in response – which is as foolish.)

Although not being a biochemist I think I’ve understood from various episodes in the past that it is relatively easy for experts to determine whether a virus was manufactured or was just a natural occurrence. That would make proving the matter one way or the other, I would have though, relatively easy.

What always strikes me in situations like this in the past is the demand from governments in the west that the facilities in other countries should be opened up for ‘international inspection’. It happened in Iraq (and we know how that turned out) and also in Iran (but that didn’t make life easier for the Iranians). After the poisonings in Salisbury a couple of years ago there was speculation in Russia that the poison came from Porton Down (the UK chemical and biological warfare facility) which is just down the road. Would the British government have been ‘open and above board’ if the Russians had asked for an ‘international inspection’ of the laboratories?

Dr Michael Ryan, head of Emergencies, World Health Organisation (WHO), 1st May;

‘We have listened again and again to numerous scientists who have looked at the sequences and looked at the virus and we are assured that the virus is natural in origin and what is important is that we establish what the natural host for the virus is.’

After public sympathy

The Buffoon ‘revealed’ that ‘contingency plans’ made during his treatment for the virus a few weeks ago. He was obviously playing for the ‘sympathy vote’ here. Why his case should be any more revealing of the reaction to this virus is beyond me. But I did think he was taking it a bit far when he described these contingency plans. When it comes to comparing himself with any other world leader the Buffoon comes way down the scale – when it comes to comparing himself with Joseph Stalin he’s way off the scale. And if such ‘contingency plans’ were indeed needed then woe betide us.

Toxic leak at chemical plant in India

The world, and especially the wealthier countries in the northern hemisphere, are totally obsessed with the pandemic. But the rest of the world goes on, having to deal with serious issues that they have to confront – covid-19 or no covid-19.

The tragedy of the leak of toxic and deadly chemicals at the LG Chem factory in Andhra Pradesh shows that the capitalist ‘normality’ is a bigger threat to health than the present pandemic – it’s been going on for centuries and kills millions a year due to starvation, non-potable water and general oppression and exploitation as well as surrogate wars fought by the imperialist powers which has a greater impact upon the poorest on the planet.

This leak also should make us remember the crime of the incident at Bhopal in 1984 – where people are still suffering the consequences and the American based company has never (and will never) be held to account.

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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