The issue of the beneficial effect of face masks is much in the news at the moment. Whenever you hear people clarifying the position on masks you come away slightly more confused than when you started. The “science” has moved from, they have no beneficial effects, to they don’t stop you catching Covid-19 but they may reduce substantially the chance of you spreading it if you have caught it.
But even the latter “science” is followed by advice that the general public should still not use masks. Why? Accepting that the mask does not stop you getting the disease, surely if it reduces substantially your chance of spreading Covid-19 it is worth people wearing masks. I thought the whole point was to break the chain of infection and surely it does not matter whether it is the getting or the giving which breaks the chain.
Usually, when the discussion has got to this point the government spokesperson talks about the mask becoming a source of infection if you do not take it off properly or dispose of it properly. However, I guess if the mask is infected that is because it has stopped something that would otherwise be infecting your face.
The next argument is masks promote a misplaced feeling of security and undermines the commitment to social distancing and hand washing. I suspect the contrary is true and that the face mask is a constant reminder of the risk of infection. However, that is just a hunch based on observing those with masks who seem, at least to me, to be more conscious of strict social distancing than those without. Of course that is just anecdotal, but I suspect it is the same evidence base as the “undermining commitment” theory.
Finally, they point to the advice of the World Health Organisation. That is definitely worth a look. There is a very interesting vides explaining “When to use a mask.” The video like much of the communication on Covid-19 requires close attention.
It starts with a very clear statement that masks cannot protect against Covid-19 but then qualifies this with “when used alone”. It goes on to say you need to combine with hand washing and social distancing. Which sort of suggests it does have some benefit. This seems to be clarified when it goes on to say that WHO only recommend you wear a mask if you have symptoms of Covid-19. This would seem to support the prevention of spreading theory. The “giving” bit of the chain.
But then it goes on and says “There is no evidence that they (masks) protect people who are not sick” A very clear statement on the lack of prophylactic benefit. But the very next sentence says “However, if you are healthy but you are taking care of a person who [may be infected] then you should wear a mask whenever you are in the same room as that person.”
So wearing masks does not prevent you from getting the disease from an infected person however if you are with such a person you should wear a mask. All clear?
I suppose you might say this is an example of the “precautionary principle”, i.e. we have no evidence that it works but we have no evidence that it does not work either so what’s the harm in wearing it. Or that the virus is more/less virulent inside than outside and therefore the advice differs by location.
What comes across from this advice and much of the information that comes out of the UK press briefings is the need to listen very carefully to every word. The statements made are very carefully crafted to enable alternative interpretations to be put on them.
I have no idea why the Government has taken such a clear position on face masks for the general public. My suspicion is that in a situation where front line health and care staff cannot get the PPE they need the Government don’t want any calls on supply or production that might divert the short supply that exists from them.
That is a perfectly reasonable position that I am confident the vast majority of the public would respect. I am pretty confident once supply issues are no longer a constraint the “science” on masks will change. We may then get advice on the matter which does not sound like a G7 communique that has been all night in the negotiation and which says – black is white except in circumstances where it is white.Masking the future
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Sorry seems to be the hardest word.
Priti Patel nearly got there. She nearly said sorry to the front line health workers and others who no Minister or advisor speaks of without praising for their bravery, commitment, professionalism etc. It is a compulsory part of the press briefing litany. Whilst it is wholly justified it is devalued when it appears to be used to deflect concern away from the deficiencies in the government’s management of issues such as PPE and testing.
Sadly Ms Patel did not apologise for the failings of government, she was sorry if, “…people feel there have been failings.” This goes to the heart of the weakness of the press briefings, a weakness which may undermine what is good about them.
The strengths of the briefings lie in detailed and, within understandable limitations, accurate information about the progression of the disease. They provide some objective scientific commentary on the likely trajectory of the disease. Finally, they communicate a consistent public information message about the vital importance of social distancing and the collective responsibility of all of us to limit the spread of the disease and cosequent impact on the NHS.
Where they are woefully inadequate is in holding the government to account on key government logistical responses to the disease. Questions by journalists which raise issues they have in hand get a solid response. The success of the construction of additional capacity in the Nightingale Hospitals gets plenty of detailed response.
Questions about PPE on the other hand get batted away with a restatement of how critically important they are, how hard the government is working, (always night and day), and how many billions of pieces of PPE have been delivered in the past 24 hours.
Of course front line staff don’t need to be told how important it is. Indeed I suspect there is not a person in the country who does not now appreciate, if they did not before, the importance of infection preventing clothing for staff dealing with infected people.
How hard Ministers and others are working may be laudable but it is not what the question is about. And however large the number is of pieces of equipment delivered it is of little interest to the members of staff to whom it has not been.
At the start of this process when there was the debate about lock down people were suggesting that such an action in this country would not be as effective as in China where a) they are more used to obeying official edicts and b) those failing to obey would be dealt with harshly. In the event, once the lock-down was instituted the vast majority of people obeyed and have stuck to it pretty rigorously for the last three weeks. This is a testament to the widespread common sense of people across the country.
The government would do well to respect that common sense. It is blatantly clear that the country was ill prepared for a pandemic that was certain to arrive at some point. To be fair it shared that unpreparedness with pretty much every country in the world. The UK’s history as a trading nation and leadership role in the development of globalised supply chains created specific weaknesses. However, again it was not unique in this. When there is a global pandemic it is inevitable key materials will be in short supply and difficult to get hold of.
If the government levelled on these issues and accepted PPE was not available in the quantities and the locations it was needed but they were doing everything they could to address the issue people would have more time for them. Changing the guidelines on the types of PPE that can be worn in different circumstances during a shortage sounds like, what it probably is, an attempt to get the guidelines to fit the supply.
Suggesting those on the front line may be contributing to shortages by underusing equipment or using higher grade equipment than is strictly necessary is not helpful. It smacks of blaming the victims.
I, and I suspect most people, have a fund of good will towards the Government. They are dealing with something which none of us have experienced before, which moves at an unforgiving pace. A pace which magnifies any failures or delays in action with awful consequences. That good will fund however can be built upon by honesty and transparency or it can be squandered by obfuscation and transparent attempts to avoid responsibility.
We are where we are. It is clear there are shortages of PPE at the hospital ICU front line and clearly much worse problems in the social care sector. There is no point pretending otherwise. After Coronus we will need an Inquiry into what has gone wrong. I am sure the Government will come in for a share of criticism. However, there are failures in the response which transcend individual governments. National and global preparedness was clearly inadequate. Now is not the time to engage in a an inquisition.
The government should recognise the true state of affairs. They should apologise, not for peoples perceptions of failure but for their failure. They may be surprised how far a genuine apology goes.
AC/DC – After Covid-19 / Deep Change
Covid-19 is having an impact on peoples lives and the economy unseen outside of war time. Untimely deaths, isolated from loved ones; radical isolation; family separation; economic stagnation. These are just some of the most obvious negative effects of a virus no one had heard of four months ago.
Given the speed of the transmission of the virus it is doubtful we have seen anything like the worst of it yet. Developed nations with effective state infrastructures and sophisticated health care systems have not been able to keep up. The UK and the US face many more deaths before this scourge is brought under control.
Unfortunately, in developing nations the situation is likely to be much worse. As I write there is something like 50k deaths attributed to Covid-19 around the world, and given issues about recording this is probably an under estimate. The harsh reality is the ultimate death toll is more likely to be in the hundreds of thousands or even millions than in the tens of thousands.
Given all this it may seem premature to start thinking about what happens after Covid-19 however, I am confident there are those who are very much focused on exactly that. They will not want to waste a crisis nor will they want to pay for it. I do not think we should give them a free run.
As we battle with Covid-19 it is teaching us some profound lessons. Ones which we should not allow to be lost or spun to the advantage of a minority at the expense of the majority. What are some of theses lessons?
First, how unprepared we were as a nation and a world for a pandemic that we have had a century to prepare for and numerous warning shots (SARS, MERS, Ebola etc.) to prompt us to take seriously.
Second, the importance of those whose work is fundamental to maintaining and keeping open the essential arteries of society. People often on low or minimum pay: long distance lorry drivers, local van delivery drivers, supermarket checkout assistants, carers, nursing staff; first responders of all sorts. During the crisis we have all literally applauded these workers and we should not forget our debt to them AC.
Third, what a flexible and yet limited science economics is. TINA (There Is No Alternative) is lost, society is found and we have stumbled into a forrest of magic money trees. Debt is not problem, we will do what it takes. Efficiency, with its low stock levels and just in time global supply chains are not all upside. What rational utility maximiser would expose themselves to a deadly virus for minimum pay?
Fourth, when the role of the state has been rolled back through a radical programme of Austerity and tax cuts it has little capacity to respond to sudden shocks.
Five, hundreds of thousands of people are now being thrown onto a benefits system that is not fit for purpose. You can understand why there are delays in answering calls when there is such a massive increase in demand in a short space of time. However, why claimants should have been routinely expected to hold on the line for an hour as the new system of Universal Credit was being rolled out over the past decade is inexplicable and inexcusable. As a brighter light is shoe on the benefits system we should start to address the basics of what amount of money people should have when they are unable to work in a rich civilised nation. At the moment it is shamefully and comparatively low.
Last but by no way least, who will pay? When the bills start to come in how will the debt be serviced? We have all been in this together and we all need to to come out together. Equity, demands those with the broadest shoulders need to contribute most to the cost. This means an industry whose role is to reduce taxation is not acceptable. It cannot be right that those who build fortunes by hiding their incomes and avoiding their taxes expect to be paid interest on money they lend to governments from those fortunes.
We must not accept that the longer term impact of Covid-19 is continued Austerity with a capital A. There are questions about the levels of inequality and public financing which need to be addressed which take account of the interests of the many not the few. After Covid-19 we need the depth of change we achieved after World War 2 when national debt was 200% of GDP but we built a social state and established the NHS.
It could have been worse.
The past week has seen the most significant transformation of peoples lives across the whole of the UK in living memory. The vast majority of the population has been confined to their homes and the economy has effectively closed.
These dramatic measures have been taken by the government in order to combat the spread and death toll of Covid-19. Most would agree that the virus has had enormous consequences for the country. It could however have been a lot worse.
On 19 March 2020 Covid-19 was reappraised by the public health bodies in the UK and The Advisory Committee on Dangerous Pathogens, their collective opinion was that, “Covid-19 should no longer be classified as an HCID.” That is, a High Consequence Infectious Disease. This a a technical assessment based on growing confidence in the mortality rate, the availability of laboratory tests for the virus, and no doubt much more. As awful as this virus is and as badly prepared as we seem to be it, it could have been a lot worse.
I do not know what a HCID looks like but presume it has a higher infection rate and a higher mortality rate. On line there are various epidemiological models which you can use to manipulate a range of variables which determine the outcome of the virus. Whilst some are not very sensitive, ie. you can move them quite a distance and they do not significantly change the overall out come. That is not true of the infection rate and the mortality rate.
Covid-19 is set to kill hundreds of thousands, if not millions of people. From a standing start, in the space of three months it has circulated to over 150 countries and resulted in around 800k deaths. The response to the virus has, in some cases been slow. What is clear is that days matter and decisive action is needed early. If we ever get a HCID our response has to be quicker and even more decisive. Hours will matter. We should not assume we have a century to prepare for the next one.
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