Richard North, 24/03/2020  
 


The last time we saw the police in our road was early in 2019, when two uniformed officers came to question me about squirting a garden hose at a neighbour's noisy dog.

I got two more visits, each time the plod coming in pairs to investigate this heinous crime - the last lot threatening to arrest me – followed by a summons to the central police-station for an hour-long formal, taped interview, accompanied by a solicitor (who advised me to say "no comment" to every question).

Since West Yorkshire Police seem so generously provided with resources that they can afford to pursue such adventures, they should have no problem swooping on me and the rest of the citizens in my street as we take out our wheely bins for the collection next Friday.

Theoretically, it would seem, such a harmless activity has been made illegal by prime minister Johnson who, in yesterday's address to the nation imposed a form of house arrest, all so that we could "beat the coronavirus".

But, while we can't put the rubbish out, we are allowed to go shopping for basic necessities, "as infrequently as possible" – a period which has yet to be defined – and we can also leave the house to take "one form of exercise a day - for example a run, walk, or cycle - alone or with members of your household".

We can also leave to satisfy any medical need, to provide care or to help a vulnerable person, and those who have jobs can travel to and from work – "but only where this is absolutely necessary and cannot be done from home".

One can imagine, though, that any group of scrotes from the council estates in London – or any other urban area – could easily find in these exemptions sufficient excuses to stay out in the streets all day. After all, no one has yet specified how long an exercise walk should take.

In short, therefore – until we hear otherwise – Johnson's "lockdown" will bind those who want to be bound by it, but those who wish to ignore it will be able to exploit so many loopholes that it will become unenforceable.

And that is without those lawfully taking advantage of exemptions, those who can travel to work as normal, without any restrictions apart from the retail, hospitality, entertainment and sports industries. Rubber duck makers – if there are any in the UK – can thus continue their activities, dragging in staff for that purpose.

Thus, while we are told that the police will be able to enforce Johnson's new rules, and impose (unspecified) fines on people who do not abide by them, one wonders whether Johnson is actually serious about controlling the coronavirus.

It seems more likely that he is simply going through the motions, laying down the foundations of an alibi for when the cases hit six figures, whence he can blame us all for failing to observe the rules.

But then, as I pointed out in yesterday's piece, for the next two weeks or so, the die is already cast, with a high probability that we will be seeing around 60,000 cases by the end of the fortnight, with getting on for 5,000 deaths.

With the faux lockdown initially in place for three weeks, that will give Johnson and "team Covid-19" a nervous week waiting to see if the epidemic curve starts slackening off. If it doesn't by the end of the third week, the prime minister will doubtless come under strong pressure to tighten the restrictions still further, reinforcing his reputation for staying firmly behind the curve.

At that point, NHS critical care capacity will be saturated, and the service may be close to collapse. Hence we are seeing reports of plans to turn London's ExCeL centre (pictured) into a makeshift 4,000-bed "field hospital", following in the wake of Madrid.

According to the Guardian, it will be staffed by a combination of NHS staff and military medical personnel. NHS planners are said to think they will need to press it into service in around a month's time. That seems to be their estimate of when all the critical care beds in London hospitals are likely to be full – although it seems hardly likely that they will last that long.

Interestingly, the initial work seems to be being handled by a team of military planners. They have been reported to have visited the ExCeL centre to determine how the centre might benefit the NHS response to the outbreak.

And while this is a welcome move, the intention seems to be to use this as an overspill facility, rather than it being used as a treatment centre in its own right, keeping infected people out of the hospitals – where the concentration of infection puts existing patients at risk, while their treatment interferes with the provision of other medical services to the community.

Madrid, of course, is seeking the same overall solution, using a conference centre to provide an extra 5,000 beds, but one wonders whether it is possible, effectively to manage a unit of this size, to say nothing of the provision of basic services, such as provision of electrical power, drainage and even toilets for such a large number of people on a continuous basis.  

It would surely be easier to organise a network of smaller units, such as converted leisure centres and community halls, each providing care to about 100 patients, dispersed throughout London and the regions.

Disturbingly, while central government seems keen to use the military, there seems to be no role for local authorities, which collectively manage a huge estate and are used to dealing with emergencies, such as the recent spate of floods. Their properties might be more suitable for conversion, and impose less stress on the system as their provision would be on a more human scale.

But this is not the only area where local authorities appear to be left out of the action. As even some Dutch authorities realise the folly of not carrying out testing of all sufferers, with aggressive contact tracing, there are some 10,000 trained and experience staff in local authority environmental health departments who could undertake these tasks and are not being used.

In England and Wales, the very history of modern local government is the history of infectious disease control, with local health boards and their medical officers of health and sanitary inspectors providing the first-line response in the management of epidemics, providing the template for local authorities as we now know them.

Prior to the 1974 local government reorganisation, there were over 400 local authorities, each with their local public health teams but, through progressive reorganisations, their functions have been absorbed into the NHS, executed by "local" public health protection teams (HPTs).

But with the reorganisations came a savage contraction of the system, with better than 400 semi-autonomous local authority units being replaced by a mere nine HPTs, with only one covering the whole of London. When it came to testing and tracing, therefore, there simply wasn't the resource, while the service has lost touch with its local authority roots and is unable to handle a massive increase in workload.

Many years ago, I met Roger Freeman in his office in London, when he was Major's Chancellor of the Duchy of Lancaster. Rather wistfully, he compared his role with that of a signalman in an old-fashioned signal box, lined with gleaming levers. These, he said, were his levers of power. "But, do you know what, Richard", he said, "they're not connected to anything".

I was reminded of this when thinking of ministers trying, in the early stages of this epidemic, to organise a "test and trace" routine. But in this case, not only are the levers not connected to anything, the signal gantries have been pulled down and the points grubbed up.

It is all very well writing grand conspiratorial pieces about why Johnson failed to act, but the more prosaic reason is that the public health system in this country is so far degraded that it no longer had the resources or the capability to deal with an epidemic on the scale we are now experiencing.

Thus, with the most effective means of control having been abandoned, we had yesterday a prime minister imposing draconian limits on our liberties in an attempt to control an epidemic that should never have got to this stage.

The tragedy is that, even in the unlikely event that the new measures actually work, the damage done and the suffering caused will far outweigh the rather marginal saving achieved by contracting public health services to a level where they could no longer function effectively.

That much, to be fair to Johnson, is not all his fault: when finally he started to pull levers, nothing happened. And now, with a total of 6,650 people found positive for coronavirus, and 335 patients having died, even the full resources and power of the state hardly seem enough.






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