I watched the Prime Minister's press conference last night. I read the ‘road map'. I read expert reaction in the media and on Twitter. And I came to the obvious conclusion. That is that the likelihood is that we will be spending the summer in lockdown with very large numbers of Covid deaths overwhelming the NHS as it collapses under the strain of staff resignations from those who can take no more.
The current Covid reality is that the NHS is still at capacity with Covid and has no room for normal service.
The reality is that second dose vaccines are but a pipe dream, with there appearing to be little intention to begin supplying them, with the focus remaining on single doses.
The reality is that mutations are happening.
The reality is that some of the data on efficacy, such as the recent Scottish data, is being seriously questioned as to its reliability.
The reality is that it is still very hard to say that much of the decline in cases is due to anything but lockdown, although it does seem death rates for those with the vaccine are falling.
The reality is that death is not the only bad outcome from Covid. Long Covid is too, and we have no idea what its long term impact may be.
And the reality is that R is only just below 1 now and will rise, probably above 1, with school reopenings, and could go much higher with the date rather than data driven planned reopenings, which Johnson will find it virtually impossible to vary.
It seems that the medical, epidemiological and virological experts all agree Johnson's plan has massive risk in it. Even Laura Kuensberg commented that it appears to have the assumption of at least 30,000 more deaths built into it. Many experts seem to think that a significant underestimate. And yet the plan goes ahead.
There appears to be little sense to this. The plan is built in the hope that the vaccines might, on the basis of single doses, and few and questioned results, deliver outcomes much better than hoped. That's a massive assumption. It could very easily be wrong.
And there is even less sensibility. The assumption us that we are used to deaths now, and just shrug them off.
Based on that logic we are being told the risk is ours to take. The government says it will not lockdown again. So now it will be our fault if Covid spreads. And they will be our deaths to take responsibility for too.
But if some of the expert predictions - of new deaths of up to 100,000 people, for example - come to pass (and I hope they do not) not only does that imply an NHS wholly unable to cope, but it would make denial of responsibility impossible.
No one knows the future, of course. The assumptions in the plan may turn out to be good ones. They might also not do so. So far, none of the government's assumptions have been good. You could say it's due a break. Equally, you can extrapolate. I am in the extrapolation school of thought. This looks like reckless indifference to me.
I am not booking my summer holiday right now. I have quite a strong sense that it will be at home.
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It is possible that the government is proceeding at the correct pace….. but their track record is not good. Furthermore, we know that all policy is based on “how will I look?” rather than “what is best?”. It is entirely reasonable to be cynical.
I do think there are some difficult balances to be made. For example….
First, I would love to see simple, raw data about tests and hospitalization numbers for zero dose, one dose and two dose people by age cohort. Surely, this is available. However my son laughed “are you nuts? – the antivaxxers would have a field day!”. He has a point. Whether the delayed second dose is a good or bad idea we DO want everyone to get vaccinated….. and there is a case to “manage” the information that is put out. I must confess, I hate this idea but accept it might be sensible.
Second, public health versus individual health. From a disease management perspective a vaccine that is 50%-70% effective that is widely given may do the trick at suppressing the disease…. but I, personally, would be very concerned if I thought my vaccine was only 50% effective. In a world of limited vaccine supply this is a difficult trade off.
Also, if the policy is operated “as stated” the time line is the EARLIEST restrictions will be eased. So, if your concerns are right it should be possible to slow the unlock. The problem is that already TODAY people are noting the dates in diaries and making plans. Will Boris have the balls to disappoint if the data moves against him? Unlikely – I do fear that we are on a track that does not permit any deviation.
So, my instinct is to be cynical…… but I am (realistically) hoping it turns out better. Perhaps it is the warmer weather but I HAVE arranged my summer holiday……. on a boat in the Western Isles (but more secluded anchorages, less bright lights of Mallaig!). Who knows, I might run into Boris on his camping holiday this year – last year we anchored only 3 miles from him.
That holiday option may be safe
Few are
And your son may have a point but we still need to know
The single shot approach looked to me like a huge gamble to pin some good news on the door. There is clearly a risk of new variants emerging. You are providing the virus with both the things it needs. A survival pressure, in the form of the vaccine, and opportunities to mutate to overcome that pressure, by virtue of an incomplete immunisation program.
The media, including The Guardian, and most certainly the BBC, are happy to spew out whatever “good news” the government primes them with. Johnson is now portraying himself as the haggard hero, battling through to victory.
The risks are enormous. A variant could undo all our good work and set us back to step one. Our government has learned it need not worry about the consequences. It has near complete control of the information people are receiving. It has managed to frame its dire performance, somehow, in positive terms.
My fear is that we are beyond the point anything can be done to bring back a more sane approach to this national disaster.
Martin
I’ve been struggling to properly evaluate Johnson’s plan — beyond scratching my head at his obsession with dumping the kid’s back at school- just get the teachers to baby-sit & give their voting parents a break-
Your comment then made complete sense to me
The Govt. ” ,,,, has near complete control of the information people are receiving ”
I put up with the BBC & read the Guardian, but its only this blog that really gives me a different perspective
to work things out a bit more clearly
Get on Twitter and find me @billkruse and then follow the people I follow to get yourself started. That way you get the news before it’s news and often it simply won’t ever be the news in this absurd blinkered country. Here for example is a thread from Dr Eric Feigle-Ding @DrEricDing in which he details extremely disturbing current outbreaks of Covid in schools internationally, Canada, Israel, Denmark, Austria… https://threadreaderapp.com/thread/1363693739085099008.html
This is the environment into which Boris proposes to precipitate our kids. It’s clearly homicidal lunacy, however, Boris being Boris it’ll never happen. For him it’s the big announcement itself which is the impoortant thing. Having made one when it’s clearly needed, he’s now free to retract at his leisure over the coming weeks which he will as realisation of the impending horrorshow dawns. None of this helps anyone but himself of course but this is the price the nation pays for handing authority over to someone whose clear and obvious issues make him entirely unsuitable for office. I too, incidentally, anticipate being in lockdown all through the summer, next year too probably. We and the world need a zero-covid strategy and Boris, I gather, is simply too frightened of the adverse reaction from his financial backers, sociopaths to a man, to even contemplate the idea. Mutating vaccine-resistant Covid variants together with the prospect of Britain as an international pariah loom before us then. Fun times.
I tend to agree – right down to your last line.
But it is this ‘trying to look to the rosy future’ bullshit that gets people to let their guard down that is the the real problem.
The whole thing should be about managing the bloody virus – not the message or perceptions. It’s typical PR bullshit that is causing the problem and obfuscating the more factual stuff that will keep people alive.
I also reflect on Tory MPs who are putting the Government under pressure to ease things more quickly. If only we ‘d seen the same pressure applied on issues like Universal Credit and Windrush!
They seem to be trying to get to the right strategy ‘data not dates’, and allowing some more time to assess outcomes, but they can’t seem to take the final step. Countries that have pursued a suppression strategy rather than ‘living with it’ have actually made it work – managing to control local outbreaks, with track and trace and isolate or even very short, local lockdowns of a few days. They have deaths in the tens, hundreds or low thousands, rather than the 100’000’s that we have.
Johnson & Co are now explicitly rejecting ‘zero covid’ or elimination – as extreme. But in fact it is easier to manage outbreaks when infections are near zero, whereas it is still unproven pie in the sky that R can be kept at or below 1 and infections constant or declining, when new infections are in the thousands per day as they now are.
As Stephen Reicher of St Andrews points out – govt has never done any of the many other things they could have done – to make schools and workplaces safe, to support the many people who cannot afford to isolate, and to fix the disastrous track and trace. – all of which would have brought infections down much quicker.
Working with a group on this – it seems that if infection is not suppressed right down and these other things fixed, Richard will be right about further lockdowns.
https://drive.google.com/file/d/11Ud0qVGC7qSh9Zwi9hyI3zXRE_tDEtvL/view?usp=sharing
By chance I came across a very interesting thread on Twitter just before I reached your Tweet that brought me here. Hope you enjoy it! Eeeek! Link is to first post in thread.
https://twitter.com/HZiauddeen/status/1364022757344890891?s=20
Maggie
I retweeted that…..
I’ll be reading some of the experts’ opinions fairly soon, but based on this government’s record, the obsession with ‘lifting the lockdown’ by too many Tories, and Johnson’s known characteristics as an idle, lying charlatan, I don’t feel any optimism. Everything with this ‘government’ is news management and manipulation of perception, rather than getting to grips with the facts. Just as PSR says.
And, as you point out Richard, if their plan doesn’t work, they’ll blame it all on the public. I’ll be keeping my head down for a long time to come, thanks.
The emphasis seems to be driving down hospitalisations and deaths, without much regard to the number of infections.
While hospital admissions are down from the peak, and the number of people still in hospital with coronavirus has halved from the awful peak of nearly 40,000 in mid January, the number in hospital today remains around 20,000, close to the peak of last March. The hospitals are still under immense strain. The total number of hospital beds in the UK is around 160,000.
Second, while deaths are down, it is still over 400 per day on average, as it has been since early November. People get used to the numbers. That is around 3,000 people dying per week, every week, for 13 weeks, about one in five deaths, as bad as any other leading cause of death such as heart disease or dementia. Many weeks have been much worse – the total has gone from around 50,000 to over 120,000 and counting. And it is not inevitable.
Third, we appear to be reaching a floor of somewhere around 10,000 new cases per day. If fatality is still around 1%, that might lead to 100 or so deaths per day, but also thousands of people with long Covid for months. About a third people with mild or worse Covid still report symptoms 6 months later. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560
Allied to that, permitting thousands of cases per day, while many people remain only partially vaccinated, gives a situation with selection pressure and opportunity which is ripe for new variants to emerge. It is not enough to recognise the risk: what we do has to address and manage it.
Many people I speak to are optimistic. I wish I shared that Panglossian view. Perhaps everything will look rosy in two week, but where is the vaccine effect? Show us the evidence, dammit.
Agree with all that
Including the last, dammit
Agree with everything you say, except the claim that with an extra avalanche of deaths the government could not escape responsibility. With an electorate of useful idiots, a press most interested in the forthcoming Oprah interview, and an opposition that has gone walkabout, I fear the opposite. There is no moral hazard in the UK for being persistently and horribly wrong with the most valuable asset – a life.
The critical initial factor is how safe will the schools be on 8th March mass opening. There seems little evidence that additional social distancing measures such as hiring extra classroom space is happening or that all pupils and teachers will be adequately tested. The rapid continuous flow test seem dubious and don’t pick up low concentrations of the virus in children. It was because the schools went back too early and unprepared last September that caused the Autumn surge last year.
Agreed
Richard,
It’s easy, from a left perspective, to disagree with everything that a right wing government proposes to do. Add a resentment about Brexit into the mix and there looks to be a desire, on the part of many on the left, to see them fail at everything. It’s not a good look.
But what would you do, starting on the 8th March? Reopen the schools or keep them closed? How do you balance the loss of life chances with the loss of actual life? I’m just happy not to be the one to be making that decision. As one who is in a higher risk category I’m happy to take my chances, even with the benefit of just the one jab so far, if that means we can get children back to being properly educated as they have every right to be.
Just what we do afterwards is matter still to be decided. The plan to wait a month before deciding any further changes seems sensible enough at this stage. And from a socialist perspective too!
I would open with half in and half not
That way transmission risk is reduced
Alternative weeks at home
Why not?
Yes half a loaf would be better than nothing. The Covid danger to schoolchildren is small so we would still be asking them to give up half their education for the sake of us oldies. I wasn’t totally happy about being prioritised even before we were all at least partially vaccinated. But now that we are, this has shifted the balance.
I am critical of the government’s decision not to vaccinate teachers to a higher degree of priority. I would also want to allow local authorities to have some flexibility in deciding exactly how schools should reopen. And the parents to have a say too. If cases do rise again we can reduce the transmission risk by encouraging pupils who aren’t in important examination years to have on-line lessons.
There are many ex teachers, either retired or maybe temporarily unemployed, who are potentially available to help out by offering tuition on-line or by carefully social distancing in a household. If they are vaccinated the risk should be acceptably low.
You miss the point: children may not suffer much from Covid in the main but it is a massive transmitter
R will go well over 1 and within weeks we will be on the way to the next lockdown
And exactly how would the half at home receive on-line lessons if teachers are teaching the other half in the classroom?
Half in, half out – half baked idea.
It’s called zoom – they see the classroom
I think the PM said the route out of lockdown was “irreversible”. What does that mean? Either it means it isn’t irreversible because nobody could be so foolish to make that commitment when they are not in a position to know what the future holds (like a new, resistant and ferocious new variant); or because virtually noting Boris Johnson says is irreversible, usually within days. Or it means that Britain is determined not to pursue an elimination strategy no matter what; and that I simply do not understand.
It is clear that an elimination strategy does work. Taiwan – 24m population, closed borders since March 2020; <1,000 total cases, and a total of 9 (nine) deaths. QED.
In addition open borders invite new variants, and no elimination strategy gives more room for variants to mutate; the worst of all outcomes.
Britain carried out Brexit in order to control its borders (and a pandemic is precisely the time you require to control them most); but for Britain 'control' of its borders means that it intends to ensure only that it has no control over it borders. You tell me how this makes sense.
It does not make sense
I agree with everything you say, and (obviously) prefer the cautious approach taken here in Scotland – with at least an aim to achieve “elimination”. From what I hear, it doesn’t sound like many of the experts are in tune with Boris’s approach.
The Matt Hancock mantra, approved by much of the media, is still to stop the NHS being overwhelmed. This really annoys me every time I hear it, and must be really disheartening for front-line NHS staff. Surely the aim should be to get hospital admissions to a very low level, such that the staff can have a well earned respite and then get back to increasing non-Covid healthcare.
There are at least two potential failure modes here. One would be smashing the NHS with a sudden enormous wave that it is unable to deal with. We came close to that with over 20,000 COVID patients last Spring and again when it had to absorb almost 40,000 COVID patients this January (having adapted in the meantime to be able to take that additional burden – but it won’t cope if the next wave is 80,000 ). People will die is the capacity is insufficient – indeed, people have already died because capacity has been taken away from other priority areas to deal with this emergency.
The second is to maintain continuous high stress – or repeatedly load and unload – until something gives way. That is where we are. Few people can survive constant high stress for months, or repeated episodes of extreme stress over a year, without deleterious effects. The situation that NHS workers have been dealing with for months and months is unremitting and heart breaking – so many very very unwell people, so many deaths. There will be people who reach their limit and and change careers, and others who suffer PTSD or worse. Mostly highly trained and experienced people who are dedicated to public service, and who we will struggle to replace.
When might we expect to see the 40 new hospitals we were promised, and the 50,000 new nurses (18,000 of whom are existing nurses who are encouraged not to leave)?
Agreed with all that
A relative has given up nursing
She could no longer face daily unnecessary deaths
“There appears to be little sense to this. “
Professor, a great essay, I am inspired to add a short comment, but it may get longer.
The only way to make war time levels of profits is to weaponise vaccines, every new war is fought with new weapons, that’s where the money is. It always means collateral damage – blood money.
I’ll break a little bit of cover at risk of losing my contract on the front line of daily Covid testing for the last 9 months.
The effort to do that started so well, all hands on deck, brand new protocols, in at the deep end with some kit, learn on the job, no ppe. Just some brave people prepared to take it on for a paltry £100/day. There are £billions, hundreds of, spent within months. Some extremely large foreign companies (US mostly) providing the material in this war. I wondered at the tech! The ‘Spitifires’ if you will, that got me recruited into this Battle of Britain (transmuted into England now with different protocols for each country in the Union – ever changing protocols, which are now handing blood to foreign companies for their ‘own use’! That’s another story)
As we operated daily on doorsteps/our makeshift personal smart phones and variable testing equipment , travelling the empty roads through May to September, we grew our daily testing missions, enrolling tens of thousands.
It worked. We were winning. The data became useful. It started driving decisions.
Too quickly it seems for the high command. They didn’t want their (preplanned) strategy to be usurped by the success of our effort. It was only supposed to be for show and channeling the hundreds of millions flowing out of the Treasury daily.
October – we are suddenly covering multiple far distant tests as opposed to groups in localities. Impossible to cover all in a day. We also suddenly find failure of resupply of testing kits. Meaning we couldn’t cover the tests due that day – our spitfires had no bullets!
With the inevitable result that FEWER tests were being carried out. Which meant fewer positives compared to other regions. Which meant London didn’t have the ‘numbers’ to effect the higher tiered and earlier closing down.
I got a further inkling of their ‘sense’ then.
Like Austerity, a political decision, which led to unnecessary deaths and penury for many in the previous decade; this decade has begun with a multiplication of these deaths, great profiteering, and many more unnecessary deaths. In fact, it seems many more deaths are encouraged.
There cannot be the periodic profiteering for years, if the disease is eliminated, but with encouragement it can mutate and the waves of death can be maintained as an excuse. Hundreds of £billions, trillions altogether is being made in this war time profiteering.
That’s the only sense there is.
–––-
Please feel free to not publish prof, but your article is excellent and I hope to add some direct testimony to what you address and my personal opinion.
Excellent piece in The National today (24/2/21) by columnist Kevin McKenna
https://www.thenational.scot/news/19112765.rottenness-uks-core-salutary-reminder-scotland-needs/
The thing is, people are still buying into the notion that children ‘aren’t vectors’ for the virus. They certainly are.
A good friend of mine lost her brother to Covid in December …a brother who was in his late 60s, and in perfectly good health beforehand. The virus was brought home to his family by a 9-year-old boy, who caught it at school. (In the USA.) The entire family got sick, two required hospitalisation, and one (my friend’s brother) died within a week of becoming ill. The boy got sick as well, but fully recovered.
Children can–and do–spread the virus. Until everyone is fully vaccinated and the vaccine is proved effective, there is no reason to assume it’s ‘safe’ for children to go back to school.
If I were BoJo (OMG, there’s a thought…) I would concentrate hard on getting everybody fully vaccinated, while providing financial support and reassurance (in the form of NOT threatening to end furlough payment) to those whose businesses are being hurt by the lockdown. That’s a more sensible strategy, in my opinion, than reopening the economy, just because people are getting fed up with lockdown.
It’s stupid to keep repeating an action–like yo-yo lockdowns–expecting the outcome to change. Wishful thinking doesn’t replace hard reality. Ever.
Agreed
Precisely Jan, precisely. As with Covid, so it is with this “government’s” other disaster, Brexit. Lies and delusional nonsense don’t beat hard reality.
As the IoM has realised. I see that the Isle of Man is making a separate fishing treaty with the EU to save it’s fishing industry from collapse, as the EU is of course that industry’s prime market; 80% according to the London Economic Review.
Apparently they can do this as a Crown Dependency! And it’s infuriated George Eustice, one of Johnson’s ministerial clowns, who attacked it as petty, and indefensible. Perfect, absolutely perfect.
One of the few (the only) good thing about Brexit. The schadenfreude. These days, there’s nothing else to take pleasure in in UK affairs.
The Conservative Covid Research Group is determined to maintain UK’s World-Beating Covid death rate. Go on Boris, Boost it again.
Earlier on Jenny Smith said this:
“And exactly how would the half at home receive on-line lessons if teachers are teaching the other half in the classroom?”
“Half in, half out — half baked idea.”
I can’t reply directly to it so forgive me for adding this on the end
Schools have *never* been closed. I wish people would take this on board.
Children of key workers have been attending school since last March. So teachers have been doing lessons for children in school and children at home ever since the first lockdown . Contrary to public perception teachers have been at work all that time and having to devise completely new ways of working. So a rota system or alternate weeks wouldn’t be a novelty.
I am aghast that people seem to be forgetting that children are a prime source of infection and can pass the virus on to their parents and grandparents. Their parents won’t have had even a first dose of the vaccination and we really don’t know how protective the single dose, that most grandparents will have had, is. From what I’ve read it seems that you can still get c19 (and transmit it) even if vaccinated, just not quite as badly. I’m predicting a rise in cases about the end of March, beginning of April as a direct result of cramming classrooms again.
I am annoyed, though not at all surprised, that the government has done nothing in the way of financial support to schools to improve ventilation even though we know that aerosols are the key route of infection. Social distancing is a sham and waste of effort if it’s in classrooms where aerosols can hang in the air for a significant length of time.
Other commenters are right, though, aren’t they? It all boils down to childcare and getting everyone back to work…
Thank you
And agreed