Johnson announced five tests for ending lockdown yesterday evening. They were:
1) Making sure the NHS has capacity;
2) A 'sustained and consistent' fall in the daily death rate;
3) Rate of infection decreasing to 'manageable levels';
4) Ensuring supply of tests and PPE can meet future demand;
5) Being confident any adjustments would not risk a second peak that would overwhelm the NHS.
The problem is that these tests make almost no sense at all.
The first reason for saying so is that the first duty of medicine is to do no harm. This is as true of public health as it is of any other part of the discipline. And creating NHS capacity has done harm.
People have been forced to die at home.
Others have been denied access to hospital from care homes.
People were forced out of hospital and into care homes, taking risk with them.
And people are now frightened to go to hospital.
I am told there were 400 empty beds in Addenbrookes Hospital in Cambridge at the weekend. That should not be happening. There are people suffering to create that NHS capacity. That makes it a very poor test.
Second, the death rate is not defined. Is that Covid or excess deaths? And is it real i.e. time lagged data that is likely to be right but takes time to compile, or the widely discredited daily press conference data that no one now really believes?
As epidemiologists tell me, the only potentially reliable death rate is the excess deaths data. But, this is not a good indicator of the success of lockdown because this data is not independent of the lockdown itself. That's because, as already noted, some people are dying in care homes who need to be in hospitals, whilst others without Covid are simply not going to hospital when they should. There is then a feedback loop that makes this data an unreliable indicator as well. So what does this test mean?
Third, to know the rate of infection there has to be mass testing to establish R. But as Sir David Speigelhalter noted in comments made to Andrew Marr yesterday, there is no testing going on that can tell us what R is.
Having a test that that cannot be tested is not a mechanism to create confidence. As a result epidemiological opinion on this varies very widely. Some epidemiologists think the infection rate in London may be 10% now. Others think up to 50% may have had it. That's not a basis for evidence based policy. The evidence is absent.
Whilst, fourth, the PPE crisis is entirely of the government's own making. Is that really then a suitable criteria for testing? Reducing rates of your own incompetence is not a good test, I suggest, even if the PPE is required.
And test five restates tests 1 to 4 in various ways and so is not really a test at all.
Johnsons's delivery was lame, confusing, long and patronising yesterday.
But his content was worse.
This is not a government sending out good messages. And I believed that messaging was the one thing it did well. As a result the case for confidence is very limited. What is certain is that these tests cannot be the basis for reliable decision making as they stand. In fact, they're just smokescreen. And that won't do.
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Sorry if this sounds flippant, but this man is mad, bad and a danger to the health of everyone in the UK. It’s time for him to go.
Let me tell you a little story about Covid-19 testing. On Thursday I became very unpleasantly ill with symptoms that my sister who I contacted initially thought might be Covid-19. Because I considered at high risk it was recommended that I be seen by a professional that night, and after considerable efforts by my sister to make sure that that happened it duly did. The medic told me “you probably have got Covid-19 but attempting to get you to a testing centre would put you even more at risk, so rest and recover at home. If things get worse call 111.” There followed a suggestion of important symptoms to watch for. I have since recovered considerably, after a horrible Thursday evening, night and very rough Friday, Saturday and Sunday were decent days. Because I have not been officially tested due to the danger that would expose me to I do not count as part of the official Covid-19 stats.
Sounds like you had it to me…
Good luck Thomas
Literally, on this occasion, go well
I found Boris Johnson’s statement yesterday to be confusing.
One particular thing he did not make clear is that the situation in Scotland has not changed, other than exercise is now allowed twice per day. Nicola Sturgeon has had to spend time this morning telling journalist so.
I think his broadcast was worse than useless.
In case you missed it here’s the short version: https://www.youtube.com/watch?v=sfrThV6DJu4#action=share
Very good
[…] When anything could be worked out it was obvious that it was technically incompetent. […]
All this amounted to was a change of slogan and that made matters worse.
see Matt Lucas’ short video. Sums it up.
Let me be clear, I can’t stand the man but…..
First, he did look terrible…… I think he is in much poorer health than he is letting on.
Second, he was trying to explain that future policy was conditional on events. That is not easy to do clearly.
Third, his natural oratorical style is ill-suited to actually delivering information in a logical, understandable fashion. (Heaven forbid, but maybe this was a broadcast that would have been delivered better by Teresa May!!)
So, it was bound to be a poor broadcast…. but who, in cabinet would do better?
None of them
And I thought he might be drunk as well
It worked for Churchill….
“And I thought he might be drunk as well”
Hmmm…possibly.
As Clive notes above “his natural oratorical style is ill-suited to actually delivering information in a logical, understandable fashion.” That’s an understatement. I can’t believe that anyone taking his role seriously would have undertaken a speech of this importance to the nation without a script and I can’t believe having watched his ‘performance’ that he had one that he was following…… references to a plan are risible when the entire performance basically says ‘there is no plan we’re playing by ear’.
Hopefully Scots are paying attention to their First Minister. At least she can read and understand a brief, and deliver it coherently. The strategy might not be one hundred percent correct (who knows?) but at least we know there is a strategy and we know what it is. It will therefore be possible in future to assess whether and how well it worked and there will be something to deviate from as we attempt to regain some semblance of the new normality. On the basis of what Boris had to say yester-evening a great number of folk won’t know whether they are coming or going.
There was a script
He’s no good without being told what to do
That’s why they won’t pet him go live
But it was a poor script
And badly delivered
Constructive ambiguity characterizes every policy announcement from this government . I hope that a majority of people make up their own minds about a sensible course of action to avoid spreading the virus.
A different view…
https://medium.com/@jonjalex/johnsons-message-is-very-deliberate-and-very-dangerous-here-s-how-to-combat-it-d336cae96348
I accept the plausibility of that
It has been suggested many times on twitter, I notice
Looking at the live page on Guardian website, the headline at 16.28 is “Johnson suggests sewage testing could be used to monitor coronavirus”. So now it’s official – he’s talking shit…
The gov is trying the ” cherry picking” idea it is trying to use in its brexit negotiations. In this case it is probably looking for example at how Spain has just started its discaling of the state of emergency; how it is called here.
Really shows how inept they are and how much they lack any ideas for governing a state beyond the mindset of showing the world it is a sovereign state and that it makes its own decisions.
Spain has hospital capacity by waiting until there has been a fall in symptomatic infections and an increase in the recovery of existing patients coupled with enough hospital equipment and field hospitals and especially ppe.
Even then only certain counties have been introduced to phase 1 because they have reached those goals but yet the restrictions are still quite tight. The main cities are still on full lockdown mainly i think because they have the biggest populations against available medical resource issue.