Monday, 27 April 2020

Corona: behind the learning curve


Very early on in the Corona epidemic it was known that the virus was more than likely airborne. A new study confirms this. You didn't need to be an epidemiologist to see that cramming people on underground trains was going to spread the virus - but they carried on doing it.

Anyone with practical experience in outbreak control said we needed to treat this as several outbreaks rather than a single epidemic - which needed local coordination rather than the West Wing soap opera we have seen in recent weeks. The very basics of outbreak control says test and trace procedures are our best bet. This government didn't think so and stopped doing it early on. Only on Wednesday, some weeks behind other countries, did it decide to recruit a test and trace task force.

Meanwhile some of us have been saying for weeks that the Nightingale hospitals should be used as primary treatment centres to keep the virus out of hospitals to prevent the re-seeding the virus. This they did not do, killing thousands of people in the process. Only now does the government consider a change of policy. This is all a bit like that saying about American foreign policy. They will always do the right thing - but only after they've tried everything else.

This is not a matter of 20:20 hindsight. This is the fundamentals of outbreak control where the government has abandoned all good practice in favour of its own hapless blundering - much like its handling of Brexit. Its Corona track record is a litany of failures. The decision to infect care homes ought to be something of a national scandal - and it would be were the media capable of concentrating on anything instead of producing valueless noise.

It would seem the current policy reversals are in preparation for an easement of the lockdown - which is about right. The public don't have the stamina for it, the economy cannot afford it, and politically it is unsustainable. If the government can get its act together with test and trace, and can shift the workflow away from hospitals and care homes then it is feasible to ease up. Some seem to think the issue is binary, but every policy has to be look at in conjunction with whatever other measures are in play.

There does, though, seem to be a unfounded air of optimism. Twitter is mostly useless but it does have moods and yesterday morning the mood was one of expectation in the belief that it was almost over. Between unused Nightingale hospitals and misleading statistics, there is a sense that this is all just a massive overreaction and we can return to the normal we knew. Even a government as crass as this one doesn't believe that. If there a plateau it's because the lockdown is working and a sudden end to the lockdown would see a flurry of activity that would set off a second wave. This is going to have to be managed over the long haul and it will take some time before easement measures are in place.

Though country to country comparisons are to be met with scepticism and suspicion, It seems that New Zealand did get it right in the early days. It brought in some of the toughest restrictions in the world when it only had a few dozen cases and closed its borders while enforcing quarantine of all arrivals. It brought in a stringent lockdown and an extensive test and trace regime. It is now presently Corona free.

Obviously the UK and NZ are massively different countries with different topography, demographics and climate, and NZ is not host to a global city like London. The chances of containing it outright were slim. But had we gone back to first principles we might well have contained it outside of the capital and lockdown measures outside of cities may not have been necessary. This government has made every avoidable mistake in the book. We now prepare for the second act when the first was treated as a dress rehearsal. There's no question about it. This government is incompetent.

As explored previously this is the culmination of decades of maladministration, but cucually there is a talent drought at the top of government and no institutional knowledge of how to meet a biosecurity threat of this magnitude. It is now playing catch up, weeks behind the learning curve, and needlessly killing people as it goes. 

This government has enjoyed a certain immunity in the polls thanks to the self-immolation of the opposition, and with the public largely not informed about the mechanics of trade, Johnson's Brexit bloviation has gone largely unpunished. The rap sheet on Corona, though, is growing longer by the day. The right has it that the media has misread the mood of the nation, and perhaps it did initially, but this is like driving through plague of locusts. Eventually the windscreen is covered, the wipers jammed, and the radiator gets gummed up. Tory drones can deflect and defuse, but the sheer ineptitude of Johnson's administration will soon overwhelm even their capacity for self-deception. There has to be a political price - and I suspect we shall not have to wait long to see it. 

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