Sunday, 15 March 2020

Criticising the Coronavirus Strategy

You don't have to be a Lisa Nandy fan to agree with her that the government's response to the Coronavirus outbreak is a shambles. A few weeks ago, their effort presented as the epitome of sensible sensiblism: track down people who'd been exposed to infection, test, isolate, and do the same for everyone else they came into touch with. And credit where credit is due, one of the reasons we're weeks behind the calamity in Italy is because containment was taken very seriously. Unfortunately, as we pass from handling a few dozen infections to thousands of ill, it's evident there are serious shortcomings in the government's approach. And you don't need a medical degree to take them to task for it.

On the media, the government's behaviour is nothing less than disgraceful. On Saturday evening, Matt Hancock's latest musings on Coronavirus - not unimportant considering he's the health secretary - were initially hidden behind the Telegraph paywall. If that wasn't bad enough, the government have indulged one of Boris Johnson's favourite tools, the anonymous briefing, to test the water for quarantine measures. The latest getting a flotation was the four month at-home containment for the over 70s. There is a website, but much more is needed. Meanwhile, Johnson appears strangely reluctant to be seen leading from the front. A couple of press conferences and handwashing photo opps are the sum total of his visibility. We know he likes to hide away when times are tough, but this is hardly the Churchillian countenance one would expect from a PM who affects to incarnate his bulldog spirit. Likewise, there is no public health advertising campaign along the lines of what we saw during the HIV/AIDS crisis - no full page adverts in the papers, no information bulletins on the terrestrial TV channels, no leaflet drops. That, however, unfolded over a period of months and years. Coronavirus is an emergency changing from day-to-day, so it's about bloody time our half-arsed, part-time Prime Minister showed some urgency with a day-to-day briefing.

The second problem is the government's secretive approach, which has undermined trust by sapping public confidence in what they're doing. A bunch of idiot hacks have put out their "oh, we all have PhDs in epidemiology now" to criticisms churning about social media, but in an emergency situation where information is lacking people will not take the reticence of the government as proof that all is hunky dory and we must follow the lead of the experts. Johnson can waffle on about "the science" as much as he likes, but his job is to manage the biopolitics, and he's making a hash of it. The good news is the data and the projections will shortly get published, which might lend itself to more informed commentary and debate.

I say might, because the government's crisis narrative hasn't been particularly coherent either. Preferring the intermittent announcement with nothing accompanying the daily death and infection rate, all we know is the government want to flatten the contagion curve to relieve pressure on the NHS now, crammed as it is with patients suffering the usual seasonal ailments. Okay - bump along the infection a few months so it gives the time for the NHS to stockpile, get more beds in, prevent it from getting overwhelmed, and all the rest of it. But then we're informed the government doesn't want to close schools and universities because they're worried it will store up a second viral explosion for when winter approaches. Excuse me? Which is it? We're asked to trust the government, but neither they nor the experts have set out why the extensive restrictions we see in France, Ireland, Denmark and elsewhere are not appropriate to the UK. Then there is the herd immunity strategy - the idea we keep the oldies locked up and let Coronavirus do its worst with the rest of the population, and once it's over they can come out again and mingle, safe in the knowledge everyone else has had it and can no longer be transmitted. How does this sit with the prevention and delay strategies? Or the risk to immunosuppressed younger people and those with underlying conditions? What a mess.

The government know complacency isn't a good look, hence the trailing of draconian measures modelled on the Danish response. But look further. When Matt Hancock says they're doing everything in their power to manage the crisis, are they? There's talk of taking back retired nurses and doctors to make up shortfalls as existing medical staff tend to Coronavirus demand, but have these former workers been contacted? Where do they go to volunteer? And how many does the govt suppose are going to come out of retirement for the duration of the crisis, especially when most of them are old enough to be in the high risk groups? How about making sure the health service has everything it needs? Rishi Sunak pledged the cash, but we need respirators as a matter of urgency. We need more beds. The govt plan on requisitioning private hospital beds, ensuring these providers adequately compensated (of course). As for the respirators, Robert Peston reports that the government are yet to contact Rolls Royce. You know, that small Derby-based advanced manufacturing concern responsible for two per cent of the UK's total exports and more than capable of switching production. As soon as it became clear Coronavirus would not be contained in China, why weren't preparations in train weeks ago?

Coronavirus might be indifferent to who it infects, but some people are more exposed than others and this is where the sectional character of this government stands indecently exposed. It will be easier to access social security, and those on JSA won't be required to attend regular Job Centre interviews said Johnson last week. But still nothing about protecting employees who take time off ill. Nothing about statutory sick pay for the self-employed, or those on short time working and zero hour contracts. Nothing about mortgage and rent relief. And yet the rail companies and airlines queue up for corporate welfare hand outs, and on past experience are likely to get it. The left have long argued the Tories' affected concern for the north is prolewash, and they've more or less conceded that themselves, but to see it manifest nakedly in their Coronavirus strategy is breathtaking. Compounding these matters of class is the awful Tory legacy of attacks on the public sector. Any infrastructure for mass testing has been decimated thanks to their closure of walk-in centres, nurses driven out by pressure of work and recruitment shot by introducing tuition fees, the billions wasted on the internal market, and council public health budgets raided by cash strapped authorities. The Tories have severely hampered the state's capacity to act in an emergency by gutting its capabilities and handing services over to Tory donors. A summation of Tory decadence for which we will all pay the price.

You don't have to be an epidemiologist to criticise the government's approach and we - the left - aren't criticising for the sake of being critical. In this one instance, we all want Johnson and the Tories to succeed. We want to government to keep down infection, save as many lives as possible, and ensure we come out of this crisis the other end. The problem is because of the choices he and his party have made and are still making, hundreds of thousands are getting exposed to unnecessary risk. If the left doesn't put its own critique of Johnson's obvious inadequacies out there, the conspiracy theorists, the reactionaries, and the racists will. Questions of power and policy doesn't stop when there's a nationwide medical emergency, when we're in a life and death situation. Politics becomes all the more present and potent because of it.


Jim Denham said...

"If the left doesn't put its own critique of Johnson's obvious inadequacies out there, the conspiracy theorists, the reactionaries, and the racists will": the trouble is, most of us are not scientists.

Phil said...

But some of us are, and epidemiology is a social science. Besides, the issue here isn't the science - it's the political response.

Jim Denham said...

We know it would be foolish to pretend to be experts on matters we are not - disease control and epidemiology.

We *should* be asking: what is your employer doing? What is the government doing? The labour movement should fight for public scrutiny and workers’ control.

Employers will, of course, seek to minimise sick pay and keep all decisions behind closed doors.

An informed, structured, measured democracy is the best way to make the crucial decisions.

The NHS needs emergency funding to ease its current overstretch and so that it can take emergency premises and emergency staff if necessary.

The government should prepare emergency production facilities, under public ownership, to produce more of the masks, gowns, etc., which NHS workers and medical workers elsewhere lack.

Local authorities need emergency funding to help them provide support locally.

Medical services in poorer countries will be much more overstretched than even the NHS. The labour movement should demand massive aid from the richer countries to help out.

A big spread of a disease like Covid-19 would cause economic disruption even in the best-ordered economy. In a capitalist world there is the additional risk of a snowball effect, as disruptions cause a sudden decline in workers’ purchasing power and in capitalist investment spending, and an implosion of credit and financial markets.

The best way to forestall the risk of a credit implosion and snowballing economic crisis is to put high finance under public ownership and democratic control.

In every workplace, we want the unions to demand the employer publish their plans for dealing with Covid-19 risks and to discuss those plans with the trade unions, with the help of as much qualified advice as available.

Unions, as much as employers, should respect the scientific advice. But there will be many questions in blurred areas between scientific answers and social issues such as sick pay and job security. Unions should insist that the trade unions, as the chief democratic and representative bodies of the people who make the workplace function, should have the decisive voice here.

But we shouldn't pretend to be scientific experts when we are not. WEe *are* experts on trade union and employment law matters - but not science. And, Phil, epidemiology is *not* (primarily) a "social science" - it's a *science*..

Blissex said...

Some dark suspicions:

* If many relatively healthier voters in their fifties end up inheriting high valued properties from elder relatives that is good for the tory vote.

* Affluent tory voters who don't need to go to work (e.g. pensioners and other rentiers) or anyhow don't have lots of contacts with random strangers are least likely to be affected by a flu epidemic, and/or have lower mortality rates. What happens to the proles, usually cooped up in large numbers in small places, and who have to work for a living, matters less because anyhow they don't vote tory.

Blissex said...

«But still nothing about protecting employees who take time off ill. Nothing about statutory sick pay for the self-employed, or those on short time working and zero hour contracts. Nothing about mortgage and rent relief.»

That is not really a popular concern: the "ant and cricket" story is quite popular. Why should the "ants" who failed to put aside savings to cover the risk of an epidemic have those savings confiscated by the government to be handed out to the "crickets" who saved nothing against future risks? For a critical and popular example consider rent, where the "ants" are BTL landlords, and the "crickets" are renters:

* If the government simply waives or even just postpones rents for a while, the "ants" who saved up to put down the deposit for a BTK property to have security of living standards from rents will have their income cut, to give security of living standards to renters who did not.

* If the government makes the state pay for rent, so that neither BTL landlords nor renters have their living standards crashed, sooner or later tory voter taxes will have to be increased to pay for that.

There are actually good arguments that the left can use to counter the "ant and cricket" narrative, but usually leftoids just ignore them and merely advocate "loser liberlism" (as described and criticized by Dean Baker).

Blissex said...

«And, Phil, epidemiology is *not* (primarily) a "social science" - it's a *science*.»

If by "science" you mean the ability to perform repeatable controlled experiments so independent verification is possible, try to do that with epidemiology, but I am not sure it would be popular. :-)

But arguably the UK government believes so much that epidemiology is a science that they have decided for the UK to be the "control group" to which a placebo policy is given :-).

1729torus said...

It's pretty simple IMHO. Boris and Trump are scared witless that if they introduce a lockdown they'll be ruined by the economic damage and be exposed as charlatans because they both previously decided that letting Coronavirus run rampant was no big deal. As a result, they're now in denial and desperately procrastinating in the hope that Coronavirus somehow goes away.

Likewise, a public education campaign would risk showing Boris Johnson up in a similar fashion to a lockdown.

For the next week or two both Johnson and Trump will be hoping that 'light touch' measures such as an (insufficient) increase in testing, closing airports, asking old people to self isolate, and telling people to wash their hands will be enough to stall Coronavirus' growth. These steps won't be enough at all.

Between the dawdling and the poor administration, Coronavirus will be given at least another week or two to spread nearly entirely unimpeded. Considering that the number of Coronavirus cases tends to grow tenfold every two weeks, you can see how this is a problem.

By the time people start taking the situation seriously, Coronavirus could be too rampant to contain. The British state might not have the apparatus needed to track down and contain cases, ensure that people stay in quarantine etc. Needless to say that this will be far more economically damaging than if they had just introduced measures early on. Other countries might simply refuse to allow people from the UK in. There will be mass graves filled with people who could have survived had there been enough ventilators. (A similar analysis applies to Trump.)

1729torus said...

This article by Richard North, who has a PhD in Public Health, is worth reading. He argues that the UK's system of public health is simply not capable of containing Coronavirus because it's too run down:


By far the most effective tools in this epidemic, is disease reporting, so that you pick up the maximum number of cases. Then, as emphasised by Anthony Costello, a UK paediatrician and former director of the WHO.

His view is that: "You test the population like crazy, find out where the cases are, immediately quarantine them and do contact tracing and get them out of the community". This, he says, "deals with family clusters. That's the key bedrock of getting this under control".

This will work, even with incomplete social distancing. The sort of social distancing that we will be able to enforce, without this programme, will not work on its own. Yet, the government has abandoned such testing, and is not even attempting a programme of contact tracing. This is a recipe for failure.

Why the government should have abandoned what amount to the basic tools of epidemic control is hard to fathom – until you realise that a system, which in the late 1980s and '90s which was already substandard, has so far deteriorated that it is not longer capable of executing basic control functions for an epidemic of this scale.

Thus, it does seem as if the government is setting itself the objective of failure, dressing it up in the fine clothes of "flattening the curve", which has some "experts", much of the chatterati and the Johnson fanboys singing its praises. And in so doing, they are wrong.

But now, it seems, the government doesn't even believe its own rhetoric. The Guardian has picked up a secret Public Health England document which warns that the coronavirus epidemic in the UK will last until next spring. As many as 80 percent of the population are expected to be infected, and up to 15 percent (7.9 million people) hospitalised.

If the mortality rate turns out to be the one percent that many experts are using as their working assumption, then that would mean 531,100 deaths – a death rate of just over six percent of hospital admissions, which is in-line with Italian experience with is reporting a death rate of 7.1 percent.

This is, in effect, an astonishing admission of failure, and one for which there is no excuse. A rich, developed country is now at risk of being brought down by a tiny microorganism, in what is an entirely preventable disaster.

Anonymous said...

Yesterday the UK death toll (35) reached the same level as Italy two weeks ago (notified infections were also similar). Yesterday in a single day, Italy announced 368 dead. The death toll today will presumably reach 2000.

Italy does have an older population, habitation tends to be denser (apartments v houses) and there is all that kissing. However, by the time Italy had reached 35, affected areas had already been on lockdown for 10 days. Around 10 days ago, total nationwide lockdown began to come into force.

The UK has so far instituted no lockdown. It is still permitting mass events. The 'science' behind 'herd immunity' is arguable, to say the least. And given that no restrictions have yet been enacted, it is probably too late to save many lives now - and in the future. First, the lives of those who are currently incubating - and spreading - the virus. Then the lives of many during any lockdown because by then the number of infected will probably be so overwhelming - a self-isolating pensioner collects their shopping from a neighbour but picks up the virus while they are unpacking it. This is why baggage handlers at airports were among the first to go down.

The politicians have been too open to persuasion by the 'experts' (ironic, when you consider it). Yes, for cultural reasons they have dragged their feet, but the suspicion must be they have allowed the 'inevitability' voiced by the house specialists (the NHS simply won't cope if you close the schools for eg) to overrule the necessity of political leadership - the ability and brio to make decisions that may run contrary to received wisdom but are necessary. Apologies for invoking Churchill, but the sort of thing he used to do. Incidentally, projected civilian deaths (and these are deaths entirely predicated upon action, there is nothing inevitable about 90 per cent of them) is five times the 70,000 civilian lives in WW2 - 380,000.

There is nothing sinister about the UK gov's failure, they've just got it horribly wrong.

Anonymous said...

Science is very valuable but not always value free of course- nonetheless evidence based science welcome and valuable for us all!!! ... And no comment from Tony Blair thank god.

Deviation From The Mean said...

The sheer level of incompetence of this government is breathtaking, only matched by the sheer levels of ignorance among the masses! The Thatcherite, Blairite chickens are really coming home to roost! The world is heading for complete lockdown, death rates in Italy are above 10% and tey some idiots claim there is nothing to see here. Quite incredible.

But the chickens around ‘free trade’ and markets work best fundamentalism are coming home to roost. Francis Fukuyama and almost everyone else didn’t reckon the the historic power of the virus!

I suspect the UK government have been basically ordered to ramp up their policies by the G7.

I suspect the ‘science’ behind the UK’s strategy iswas too focused on trying to carry on as normal and the publication of the facts behind this science can’t hold water and therefore they are beginning to follow what the actual science is saying, namely the W.H.O. and the European centre for disease prevention who have totally contradicted the UK's so called scientific approach.

Incidentally if Kevin Mcguire says just carry on as normal one more time can someone punch his lights out?

This is by a mile the most significant historical event since Moses stepped down the Mountain, only this time the commandments are being carried by a very nasty little virus. Thou shalt not go to bars, pubs and restaurants, thou shalt not raise the price of hand sanitiser to make a few bucks, thou shall not buy non essential goods, thou shall not fly here, there and everywhere.

All the market assumptions are breaking down and we have effectively arrived at State Capitalism, the sort of society that Rosa Luxembourg might has criticised in the same way she did with the Soviet Union. Boris Johnson must have imagined he would be leading a deregulated tax haven a few months ago and now he is thrown into the role of Chairman Boris!

Who knew that the biggest single and most significant moment in modern history would not be the computer, or the discovery of the genome or the general strike but some modest little virus, springing out of seemingly nowhere.

Political debates will never be the same again, I suspect we may end up saying the same about society!

The anarchy of capitalism, so brilliantly examined by Marx and so steadfastly ignored by Marxists, is exposed before our eyes and this anarchy is ending and the people ending it are the most devoted ideologues of the anarchy! Talk about irony, talk about events that are bigger than any individual!

But some things remain the same, Jim Denham is still a total idiot.

Anonymous said...

"Why should the "ants" who failed to put aside savings to cover the risk of an epidemic have those savings confiscated by the government to be handed out to the "crickets" who saved nothing against future risks?"

Its a fair point, someone on the average wage might have saved up, never taken holidays and never owned a home. If you are considering what someone is worth and how wealth should be redistributed you need to look beyond a bank balance or a savings plan.

Which brings us to real change, it is not to be found in redistribution but is to be found in changing production, so the question should we devote resources to this or that product, should we allow people to pave over their drives etc etc etc