Richard North, 22/03/2020  

We were spared a press conference from Johnson yesterday, but that didn't prevent him from using the Sunday Telegraph as a platform to tell us that the NHS could be "overwhelmed" like the Italian health system in just a fortnight.

The trouble is, as Marina Hyde observes in the Guardian, this comes from a man "whose entire career, journalistic and political, has been built on a series of lies". And he can't turn that round and suddenly reinvent himself as a trusted statesman. He has far too much baggage.

And if the prime minister is finally warning that the NHS is about to be overwhelmed, it is already too late. Most of the people who are going to add to the case statistics next week have already been infected, and many of those who will be reported dead are currently in hospital undergoing treatment by overworked staff.

To deal with this burden, estimates indicate that London needs a 130 percent rise in critical care capacity. Rural locations fare even worse, needing an increase of 600 percent. There are few who believe that this is possible to achieve in the time.

Yet these uncomfortable facts are part of the brutal reality of this epidemic. This time last week, we were just topping a thousand cases while yesterday saw 1,035 reported in one day. This brought the cumulative total of reported cases to 5,018, with the 56 deaths bringing that total to 233.

But, by the end of next week, if the current trend continues to follow the Italian example – as Johnson is warning – we will be looking at close to 20,000 cases and well over 1,000 deaths. That much is almost certainly pre-ordained.

Furthermore, things are set to get measurably worse. Italy, with far more rigorous controls than the UK, suffered a rise in deaths to 793, bringing the total to 4,825 – not far short of our recorded cases – requiring Italian Army intervention to move bodies from the overwhelmed mortuary facilities in Bergamo, the most badly affected city.

And yet, the mayor of Bergamo, Giorgio Gori, is saying that the true number of fatalities in his area is four times higher than officially reported. "Many of the elderly are dying in their houses or in old people's homes, without anyone testing them either before or after they die", he claims, adding that a dozen mayors of other cities had confirmed the same thing to him.

To an extent, this is tempered by suggestions that the Italian health services may be substantially over-recording coronavirus deaths, picking up patients who are dying for other reasons. In an epidemic situation, when systems are under extreme pressure, such confusion is inevitable when dealing with patients is the first priority and everything else takes second place. And there may in any case be contributory factors such as a high rate of smoking and poor air quality, with high levels of pollution.

Against that, the UK is less well equipped with critical equipment such as ventilators, and has a lower ratio of ICUs than the Italian health services. The NHS can actually be expected to perform less well than comparable European services – despite the boost from the private sector.

This welcome addition to the health service resource includes nearly 1,200 more ventilators, more than 10,000 nurses, over 700 doctors and over 8,000 other clinical staff. London is a significant beneficiary, gaining over 2000 hospital beds, and more than 250 operating theatres and critical beds.

Still, though – despite Johnson's rhetoric – there seems to be a determination to under-estimate the scale of the epidemic and the capability of the NHS to deal with it. No moves are being reported to extend treatment capacity outside the NHS estates, other than to the relatively limited private sector.

By contrast, Spain, which vies with Italy as the third-hardest hit country, is converting the 240,000 square metre IFEMA conference centre on the outskirts of Madrid into a 5,500-bed hospital, including intensive care units.

What seems to typify the UK approach, therefore, is the half-hearted response to the epidemic. We have a weak lockdown, which relies largely on voluntary action and is being widely ignored throughout the country, especially by younger people.

And, with no provision to stop "refugees" fleeing the cities to rural areas, potentially bringing the infection with them, we are seeing incredible scenes of stupidity and selfishness.

Thus, if the UK is to get a grip of this epidemic, Johnson will need to take far more resolute action than he has done so far, right across the spectrum of activity, from control measures to the treatment of patients.

Instead, despite obvious and well-publicised evidence that his measures are not working (and strong indications that they are not likely to work), this prime minister seems to be exhibiting a characteristic weakness, pleading with people to heed "advice" to stay at home.

Thus he is calling for what amounts to cooperation from the public to save "literally thousands of lives", calling in aid the Italian example and pressing the solidarity button with a resort to high-flown rhetoric, declaring: "Unless we act together, unless we make the heroic and collective national effort to slow the spread - then it is all too likely that our own NHS will be similarly overwhelmed".

This is to a population, parts of which are not only ignoring his "lockdown" but which, for several days now has been indulging in an orgy of "panic" buying, despite multiple pleas from all manner of authorities, seeking to assert that there is no shortage of food or essential supplies.

The lack of wholehearted response from the public to the entreaties may represent an anarchic streak in the British, but it could also reflect a growing loss of respect for government and authority figures – driven in part by the behaviour of MPs, going right back to the expenses scandal and the weekly bear garden of PMQs.

Most of all, though – one suspects – this could be a response to the lack of leadership, where Johnson and his cabinet have been seen to be consistently behind the curve, responding to events rather than trying to get ahead of them.

That goes right back to the delay in Johnson's attendance at his first Cobra committee, where he left it over the weekend, before finally attending on the Monday, followed by a chaotic and unconvincing press conference.

The credibility of this government is not helped either by numerous articles on the consistent theme of "incompetence" and lack of leadership, typified by this, which argues that the incompetence and dishonesty of the current administration "is now crashing into reality – with devastating consequences".

Even the august Politico has published a piece headed, "The incompetence pandemic", suggesting that the first victim of the coronavirus has been "leadership". On top of that comes BuzzFeed which is suggesting that the "science" is tinged by dogma and political opportunism, with the scientists far from united behind the government's strategy.

No doubt this sense of incoherence and disunity is feeding into the public, where people are becoming used to taking government pronouncements with a pinch of salt, and taking whatever action they believe is necessary - with the withdrawal of children from schools forcing the government's hand.

Politico has somewhat captured the mood, noting that if there's one leader who should recognize the historic gravitas of the moment and rise to it with stirring rhetoric matched by action, it's the man who modelled his political career on Winston Churchill. Yet, instead of offering "blood, toil, tears and sweat" at the critical time, Johnson has sounded more like the Grim Reaper.

With the Sunday Times concluding last week that a "haunted and exhausted" Johnson had lost control of the epidemic, nothing has happened over the last week to change that view.

And when the Army comes to London to collect the dead, fulfilling Johnson's prophecy that we are following in Italy's wake, the boyish charm and the tousled head is not going to be enough. One senses that a political watershed is not far in coming.

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