Monday, 23 March 2020

Corona UK: caught with our pants down

Admit it. To begin with you didn't pay any attention to the Covd19 outbreak early on. It was happening in foreign lands. That's just what happens there. We've seen them come and go - swine flu, SARS, bird flu etc. We don't pay attention because it's just something that happens to other countries. And rightly so. We civilised superior Brits don't boil dogs alive, eat bats or munch down on Kentucky Fried Pangolin. Why should we bother maintaining an expensive disease control policy?

Really when it comes down to it, it's only the poor ignorant people in the slums of Lahore who get the plague and it's only the darkies who get ebola. Brits on the other hand are clean and well educated. The icy hand of death does not knock on our door. That's the underlying assumption here. We got complacent.

One Tweeter "Tosh" has it that; "The global economy is basically being destroyed, freedoms sacrificed because global healthcare operates on such a narrow margin of expected needs that when we get a surprise event we let go a full throated shart". Superficially that sounds about right but with 2020 hindsight we could and should have done better. We should have had an early warning system and a contingency plan ready to put into action on the basis of foreign experience - of which there is plenty. We just didn't think it was a priority.

It turns out, though, that Johnny Foreigner is well ahead of the game. The government of Hidalgo, Mexico, has set up an inflatable hospital in Pachuca to deal with a possible influx of patients infected with the coronavirus Covid-19. At time of publication there were no confirmed cases of Covid-19 in the state. They had a plan and they were ready. Not so the UK where the picture is grim.

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I just got this from a friend whose daughter is a care nurse in a provincial hospital. A short series of messages combined.
(Daughter) reports Corona 'bed cases' up from 3 to over 50 in a week reaching capacity. Staff starting to go down with virus and a shortage of protective kit (PP3 masks). She thought that it was pretty inevitable (she would get it) She has just finished a 72 hour six day week and now her days off are cancelled. Work load is off the scale. Evidence that severity of infection proportionate to infection dose. Two ENT doc's in London (late 20's) were on ventilators having contracted the virus, having received heavy doses of the virus through work. All F1 doc's being promoted early (5 months) to F2 without pay rise and med students being brought in to replace them. Volunteers urgently sought from Biochem students (unpaid) to deal with increase in testing. I try not to think about it but it's not so easy. The virus got into the geriatrics ward and killed 7 of the 12 patients. Three of her team are in isolation with it out of just 10. She is also at risk of being a carrier so is not meeting anyone. Now her partner (a bio chemist) has been called into to set up new testing facilities. The hours she is putting in are ridiculous. All of them have dermatitis from the frequent hand washing which puts them at additional risk.
It seems that system failure is probably days away. After that, deaths increase, but reported deaths don't match the increase because so many will die at home untreated. The number of medical staff ill and dying will become significant.

Like Mexico, we should have set up the emergency treatment centres to keep the infected out of the hospitals. Now, the hospitals are very dangerous places to be, where people with ordinary illnesses dare not go. As this progresses, the untreated - and especially, but not exclusively, cancer patients, will die unnecessarily (or early) through lack of treatment. We then see, in effect, a collapse of the NHS. After that... god help us. 

There is presently no reliable picture overall but if that one little insight above is representative of the system as a whole (which it probably will be this time next week) then we are super screwed. The moment we let Corona into our hospitals was the moment we lost the war. Now the best we can hope for is effective test and trace response to contain new outbreak clusters - where local authorities really should be ready to respond but are likely working to outdated undrilled procedures without the proper equipment with no real plan in place. Our civil contingency planning appears to be nonexistent.

This combined with a muddled and incoherent response from central government, coupled with the selfish actions of a largely spoiled and overindulged population, and you have a perfect storm. So acute is the immediate problem, we have yet to even entertain the idea that public order will break down and food supply will become a problem. We are supposed to take reassurance from government but these are the same people who only recently woke up to the significance of the Dover port in their Brexit estimations.

When the history of Corona in the UK is written it will speak of a country where governance was tested - and failed. Social democracies in the west have been absorbed by trivialities and indulgences, using state funds to buy off their respective voter bases, hollowing out resilience in the system while neglecting the basics - the very foundations of national and local government. Local government began as sanitation authorities. That was their primary function then and now, but this week my local rural council was using my council tax for LGBT sensitivity training.

The most depressing finding of any future enquiry will be that Britain, a first world rich nation, had every possible opportunity to contain this outbreak just by having an outline of a plan and half a clue when and how to implement it. But as we have seen with Brexit, Britain doesn't do plans nor does it do leadership. We've had  it too good for too long and it shows. Britain forgot how to do good government - and now we count our dead. 

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