Richard North, 21/03/2020  
 


Not yet are we seeing the hospitals at saturation point, although this is soon to come. Yesterday's milestone was the news agenda, where so much is happening that it is impossible for any mortal to keep abreast of all the developments. And no sooner do we absorb one set of headlines than they are replaced by another, at breath-taking speed, sufficient almost to induce symptoms of Covid-19.

The news that drives all other news, however, are the cumulative figures for cases and deaths attributable to coronavirus, first on a national level and then, as we take them in, the rising levels elsewhere in Europe and the world. Whatever their inaccuracies and limitations, they all tell their own stories.

As to the UK, recorded cases were put at 3,983 cases, up from 3,269 the day before – 714 cases in the space of a day, representing a 24 percent increase on the day. The cumulative total for deaths was 177, up 33 in 24 hours, a 23 percent increase.

Of as much significance as the daily figures is the trend: over the most recent period, we have been seeing them double every three days. If anything like this rate keeps up, by the end of next week the total will be well into five figures, setting at between 15-16,000 and with deaths topping a thousand.

That would keep us on a parallel with Italy, where the trend over the weeks has been remarkably similar – even despite the differences between the nations and in the way figures are collected. The relationship between the two datasets is too powerful to ignore, and close enough to support the idea that we are just two weeks behind Italy.

Given reports of stresses in London hospitals, the latest coming yesterday, and the fact that by far the biggest cluster of cases is located in London, it takes little imagination to visualise the shitstorm that is about to hit the capital.

In terms of numbers, the die is already cast. The median incubation period for Covid-19 is just over five days, so the bulk of cases to be reported over the next week have already been exposed to infection. Nothing can be done about them. And while the enforced closure of bars, restaurants and gyms may have an effect in the longer term, the rule of thumb is that it takes at least two weeks for the controls to show up in the figures. Thus, it is a sober thought that, for the next fortnight, cases will continue to increase exponentially, even if the controls announced yesterday are an outstanding success.

In a sense, Johnson – and the rest of us – are lucky this disease does not share with typhoid the incubation period of 21 days, otherwise the wait for a slight slackening in incidence would be even longer and more nervous than it already is.

But, as recorded yesterday, Johnson is looking to June to turn the tide, when it will be safe for us to go on holiday – or not. But, from his remarks, it was not clear what he meant by "turning the tide". One assumes it was more than tilting the epidemic curve in a downwards direction – that would mean case numbers into the millions.

But, it seems, that was yesterday's story. Today we have to get used to the idea of social distancing extending for a full year. But the latest clever wheeze is to manipulate controls, turning them on and off like a tap, to produce an epidemic curve with a profile similar to a sine wave. 

Conveniently, each peak produces a level of illness with which the NHS can cope without disintegrating into chaos. Still, therefore, there is this underlying arrogance – the belief that we are actually in control of this epidemic and can orchestrate the affairs of the nation in such a manner that incidence can be tailored almost at will.

At least now, though, we can begin to see the basis of this thinking, as the government has now published (some of) the scientific and technical advice which is supporting government decision-making during this emergency.

No better example of news saturation can be given in that this evidence, much in demand before today's events, has disappeared into the media maw, to be lost without trace – partly, no doubt, because of the sheer volume, the fragmentation of the documents into different subjects and the obscure terminology.

To discover the summary views on social distancing, for instance, one must refer to a document entitled: "Potential effect of non-pharmaceutical interventions (NPIs) on a Covid-19 epidemic".

Now we learn where we stand in the anal-retentive minds of the academics who are advising the government. Closing the bars, restaurants and gyms is, in their terms, a "non-pharmaceutical intervention".  

To each of several such interventions is allocated a percentage reduction in the epidemic peak, with school closures delivering around 30 percent (if the universities are closed as well) and home isolation of symptomatic cases delivering maybe 20 percent. However, social distancing for 13 weeks - when enacted early – delivers "substantial reduction in peak", maybe up to 50-60 percent.

Now we can see where the prime minister gets his "turning point" from, with an expectation that the current measures will have reduced the incidence of disease by that magic 60 percent by the end of June.

Presumably, under the new regime, at this point people are so fed up with the constraints, as "broad support" of the public is only expected initially, following which it will tail off. Relaxing the measures, though, will see an immediate increase in the disease incidence, when controls are reintroduced and the rate declines, only for the same cycle to be repeated at intervals until a vaccine is available.

The key objective, though, is no longer the suppression of the disease outright – or even the saving of lives. The primary concern is to avoid "overburdening the NHS". The plebs may still die, but they must do it in an orderly progression.

The government's apparent indifference to the welfare of its citizens is remarked upon in an article in the Guardian. There it is asserted that, prior to the Second World War, the Chamberlain government foresaw the deadly air raids but, rather than building shelters, it focused on building munitions factories and expanding the armed forces. This was supposedly far more important aim than protecting the majority of the population.

Actually, this was not the case. Not only were air raid precautions neglected, but so were munitions for the armed forces, especially the Army. The BEF was left to venture into France with tanks armed with wooden guns and bakers' vans impressed into service, painted brown rather than Army green, as there was a shortage of the correct paint.

As to air raid policy here, in my book, The many, not the few, I record that, during the London Blitz, Churchill posted armed guards on Underground stations and had them locked during air raids to prevent people using them as shelters. He was concerned that the crowds would interfere with the movement of essential workers.

It is also a matter of record that, in the inter-war years, several central London local authorities wanted to build deep shelters (doubling up as underground car parks) but were refused permission. The fear was, in these revolutionary times when several inner London councils had Communist majorities, that the shelters would be used by agitators intent on bringing down the government, beyond the power of the RAF to put them down.

In another instance, we see that the RAF did not see the need to provide air sea rescue services for downed airman, assuming that they would be picked up by commercial shipping. As a result, during the early phase of the so-called Battle of Britain, we were losing more fighter pilots than the Germans.

Finally, in late 1941, the RAF set up an air sea rescue service but the government then lied about the date, using PR film footage taken at the launch to include in BoB propaganda films of the events a year before. Thus we see films of BoB airmen being plucked from the sea by a service that hadn't existed at the time.

I thus wrote in my book that, "if you rely completely and uncritically on government, its neglect may kill you. Having done so, it will seek to obscure its actions and its responsibility for them".

That much, even today, has not changed. Delving further into the government's current scientific and technical advice, we see a section entitled, "Emerging evidence about COVID-19". And there resides a paper entitled "Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts". It tells us that: "In most scenarios, highly effective contact tracing and case isolation is enough to control a new outbreak of COVID-19 within 3 months".

This, as I have constantly remarked, is the traditional and most effective way of controlling outbreaks, yet it was abandoned by the government in this epidemic. Never in the field of communicable disease control, it seems, have so many been put at risk by so few.

For all that, the Express would cast this fight in the mould of a new "Battle for Britain". Little does it know how close it is to capturing its spirit.






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The Many, Not the Few