COVID-19

by

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.

 

by

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.

 

 

by

The distance between the Prime Minister and the President

So the PM, the Health Secretary and the Chief Medical officer are confined to quarters. We do not know whether they practiced what they preached when off-screen, however,  what this does demonstrate is that if you continue working the chance of avoiding infection is low. The multiple infections are perhaps not surprising amongst a group of people who have had to work intensively and closely together for some time however it is unfortunate in terms of the governments messaging.

To date I think I would give the Prime Minister 7 out of 10 for his handling of the Covid-19 crisis. Due account has to be given to the sheer scale and multi-dimensional nature of the problem and the speed at which it has evolved. It is one thing to hear descriptions of the spread and see graphs it is another to live it. On the positive side, he has taken the issue seriously and, has deferred to the science or at the very least taken serious account of it. He has “pivoted” when necessary, albeit a touch abruptly.

Overall I think, from the distance of the North, he has done as good or bad a job as many of the other West European leaders have. The leaders of countries in the East, like South Korea and Japan have had much more recent experience of what a national epidemic can do and might have been expected to be better prepared both logistically and mentally to respond with more appropriate alacrity and concern.

There are of course questions to be asked. The timing of lockdown looked more a like a response to mounting political and external scientific pressure than the next step in a carefully crafted, strategic timeline. It would be interesting to see what mortality rates were attached to the herd immunity strategy which was disavowed as soon as the Imperial College Report was in the public domain.

Communication has been and continues to be a problem. The daily press briefing, meant to reassure the public by demonstrating a transparent approach to keeping the nation informed, was a good idea. Its very existence communicated a sense of urgency. The professional and business like way they were conducted and the presence of subject experts transmitted seriousness but also reassuring competence. Unfortunately the message was not clear enough.

This may have been that the strategy was evolving from mitigation to suppression however the social distancing message was just not strong enough. Details about what it involved keeping 2 meters apart, staying at home etc. was undermined by a failure to communicate the need for rigid adherence. The Prime Minister talking about continuing to shake hands and hoping to visit his mother on mothers day weakening and confusing the message.

As the potentially catastrophic consequences of the disease began to sink in, driven it would seem by the Imperial College Report the Prime Minister stiill appeared to be struggling with either his libertarian instincts, his concern for the economic consequences or fear that stricter controls would be ignored. He started out by “asking”,  then moved to “telling”, but then in very short order he moved to  “instructing” as emergency legislation was put in place. It may be argued that the language followed the legislation or that it was part of a strategy to take the population on a journey, however, a pandemic is not a time to be “nudging” people. It is a time for decisiveness and clear, consistent, simple messages. Days mattered.

Unfortunately as time has gone by the communication strategy has become more problematic. If you start out claiming you want to be transparent and that you are following the science you set yourself up to fail if you start to obfuscate. As the media have asked increasingly specific questions about, how many ITU bed spaces are available – now, how many ventilators the NHS have – now, and where the PEP is – now, the vagueness of the answers has become a source of concern and, for front line staff, anger.

Nadhim Zahawi, Minister for Business and Industry, was writhing like a fish on a line when being pushed to provide detailed figures on this and dates when more of all of these items would be available. It looked as if at one point he would crack and shout out, “You can’t handle the truth.” He would have been wrong. People prefer truth, however unpalatable, to obviously untrue platitudes about “ramping up”.

It is obvious to all that the requirement for rigid social distancing is absolutely critical and that anything less will mean the NHS is overwhelmed. It does not have the equipment or staff it would need to address anything other than a limited spread of the virus. False reassurance will come back to bite when reality tragically contradicts it as the infection rate accelerates and peaks.

Having said all this, I still hold to my 7 out of 10 for the Prime Minister. He may not have acted as decisively and early as he should  to implement rigid social distancing and he may not have been clear enough in the initial messaging, however, he appears to be someone doing the best he can in a fast moving crisis. He remains courteous to the media, even in the face of difficult questioning, he respects the views of the scientific advisors and at least seems to understand what it is, and he is trying to communicate that medical advice to the public.

By comparison,… a picture is worth a thousand words, and here are two.

However effectively implemented by the PM and his team there is a real attempt to communicate the social distancing message.

If you watch the two briefings the contrast could not be greater. In the US version, depicted here, three advisors stood like lemons on the stage of the press briefing  room waiting for the President. There was an awkward, nay embarrassing silence. Eventually, presumably when the time had built up enough tension for a grand entrance, the President appeared.

There was then a rambling, incoherent presentation by the President, talking mainly about what a terrific job his administration and he personally was doing. His one strength is consistency, whenever he speaks he is saying something which is either a lie or stupid or both. Firing on all four cylinders he managed the double on most of what he had to say.

His overriding concern to ensure re-election tempered his concerns for the thousands who may die from this virus. His view is that we must ensure the “cure is not worse than the disease”. He talked about the 50k people who die each year from flu and those involved in road traffic accidents to reassure the American people he had their welfare at heart.

He probably struggles with numbers (other than $ bills) but if the US do not get a grip on Covid-19 the fatalities could be in the hundreds of thousands not, the clearly more acceptable to the President, tens of thousands. From the start the President has treated Covid-19 as an annoying distraction from the main business of getting reelected for another four years of self aggrandisement and national corruption. Variously he has referred to Covid-19 as a “hoax”, the “Chinese virus”, only affecting 15 Americans, something where the “cure cannot be worse than the virus”, and which is likely to be pretty much over “by Easter”.

I had been thinking a suitable sobriquet for President Trump might be, “The President that Broke America.” Sadly, if the individual States don’t save him and their citizens I think a more appropriate one may be, “The President that Killed America.” At least the distance between him and the Prime Minister is reassuringly large.

by

A Frightening Disease

This is not about Covid-19, although it is related. It is about Richard Burr Republican Senator from North Carolina and Kelly Loeffler Republican Senator from Georgia. Both were given a private Senate briefing on the seriousness of the coronavirus by the US government’s top scientific advisors. 

This happened on the same day as President Trump tweeted some inane comments including “It will all work out well.” Did these two Republicans contradict their President or even attempt to shade his comments with some serious concern about the possible consequences of the disease they had just been briefed on. No. Not a word.

Was this because they thought the scientific advisors were part of the deep state attempting to undermine their President. Did they think the advice was exaggerated or unduly pessimistic. Did they think it was plain wrong. No.

They thought it was almost certainly very accurate. How do we know this? Because they went out of the meeting and sold large portions of their shareholdings before the market collapsed when the likely economic impact of the virus became public. Senator Loeffler sold a minimum of $1.2m of shares and bought shares in Citrix, a provider of teleworking software. Senator Burr sold a minimum of $600k in hotel shares which have subsequently dived.

Hard times bring out the best and the worst in people.

Some work long hours without the right level of PPE in hospitals trying to save those with Covid-19. Some expose themselves to the disease as they sit on the tills in supermarkets serving hundreds of customers to ensure the food supply.

And some use inside information to protect their wealth and increase it. You would like to hope they feel ashamed but the worst thing is they probably do not. I hope their constituents hold them to account as they should.

Covid-19 is a frightening disease but so is greed. We urgently need a vaccine for Covid-19, but just as importantly we need a vaccine for greed, and my preference is the latter should be in the form of a suppository.