Richard North, 01/05/2020  
 


At first, they followed the flu strategy to the letter, a process of managed retreat. No attempt was to be made to control the disease; simply NHS capacity was to be ramped up to treat the expected surge of sufferers.

They and healthcare staff were to be dosed with antivirals to minimise the effects of the illness and the whole system would hunker down until a vaccine became available – about four to six months into the epidemic.

As for the rest of the country, everybody was expected to carry on as normal, adopting a "business as usual" mode. Limited adjustments would be made to deal with increased absenteeism, while the public at large would be encouraged to improve "respiratory hygiene" and increase hand washing.

That, in a nutshell, was the 'flu plan', and the fact that the government was following it explains exactly why the Cheltenham Festival was allowed to go ahead, plus many other public gatherings.

This wasn't a "herd immunity" policy, even if  it looked like it. Nevertheless, exposure of some of the population to the infective agent would help, albeit marginally. It would reduce the number needing to be vaccinated (assuming their immune status existed and could be verified), allowing the required level to be reached that much sooner.

But then it suddenly dawned on the geniuses in No.10 and the Department of Health that SARS-Cov-2 wasn't flu. Not only didn't it behave like flu, the antivirals didn't work and there was no prospect of a vaccine becoming available for a year to 18 months, if then. Herd immunity wasn't going to happen any time soon.

When the number crunchers started to get to grips with the idea that the SARS-Cov-2 virus wasn't cooperating with the plan, and reworked their figures, they started coming up with telephone numbers for the death toll. Policy had to be hastily revisited.

Since the government no longer had the capability to control the disease, having finally wound down the traditional system of epidemic control in 2013 – the last of many steps - it took the only option open to it. Unable to take the infection out of the people, by the test, trace and isolate system, it instituted the blunt instrument of a [partial] lockdown, taking the people out of the infection.

Such a drastic and expensive strategy was always going to be rewarded with a downturn in infection rates and – eventually, since it is a trailing indicator – a drop in the death rate.

But at no stage should this have been interpreted as controlling the epidemic. This was the equivalent of Dunkirk. We were running away from the battle, buying time to regroup and re-equip. Only then could we return to the fray, ready to vanquish the "enemy".

The only slight problem with this idea is that, unlike 1940 when we had many years before we were to return to Europe, the lockdown has bought us only weeks. That was not enough time to rebuild and re-energise the public health system, brought down by decades of institutional vandalism.

Thus, when our idiot prime minister yesterday, prattled about it being "vital" that we "do not now lose control", we were watching a man in the grip of a monumental delusion. We can't "lose control". We never had it. We haven't had it since the start of the epidemic, and we don't have it now.

Neither are we "past the peak", as this fatuous man proclaims. There isn't a peak, in the singular, as he seems to think. There is simply an aggregate curve concocted from multiple outbreaks at different stages of development. Many will be declining but the overall figures could be concealing local increases.

Thus, what Johnson is under pressure to do, in relaxing the lockdown early – to maintain the wartime analogy – is to invade France in 1941 with a bunch of Home Guards armed with shotguns and broom handles, crossing the Channel in rowing boats.

What is most likely to happen, therefore, is that when the prime minister allows a limited, cautious relaxation, the case and death rates will start to drift up again. The rise may be quite slow initially, as many of the disparate outbreaks have died out for lack of fresh meat. New ones may take time to get started.

And, of course, the government and its agencies will be fiddling the figures for all they are worth. When they can't get away with that, they will be blurring and obfuscating the data, aiming to confuse and distract, robbing the figures of meaning. They will try anything in an attempt to slow down and weaken the inevitable flood of adverse comment and political blowback.

No doubt, the government team driving the response to this epidemic will be hoping that the plans to install their mobile phone-based contact tracing system can be implemented quickly. If they are, the new system may take the edge off any increase.

It wouldn't surprise me if they were then banking on the inherent lag in the death figures buying them enough time to get us in to the early summer, when the hope will be that the infection rate will drop naturally, exhibiting the seasonal variations which are so often a feature of this type of illness.

Even if they manage to hold the case rate down, that doesn't solve the problem. Their app-based contact tracing scheme is unlikely to achieve anything other than a marginal slowdown in the progress of the epidemic. And, if the illness does exhibit seasonal variation, then come the autumn and winter, we could be back where we started

Politics being politics, though, a week is an awfully long time. If the No.10 gang can get through to next Friday unscathed, then that is as much as they need to do. The following week is the following week. Bridges are to be crossed when one comes to them, assuming they haven't been burnt down or blown up.

As for the more distant future, Prof [half] Whitty reckons that a second Covid-19 wave in winter could be worse than the one we have already experienced (if indeed, the incidence can be considered a "wave").

This, of course, may simply be a rather crude attempt at expectation management. But if Johnson is very, very lucky, there is a chance that Covid-19 outbreaks will not flare up immediately. The case numbers may thus be held down over the winter, for reasons entirely unrelated to his attempts to control the disease.

Instead, the disease may grumble along in the background to become endemic, producing a relatively low level of cases. It may even run alongside a "flu winter", with the two diseases vying with each other to kill the most people. The resultant confusion would certainly flummox pundits trying to unravel "excess deaths" data.

Given the remarkable ability of the human species to adapt, this could become the new norm. Coronavirus would lose its novelty and thus its shock value. By the winter, Covid-19 could become a non-story. The media would have become bored with parading their ignorance and move on to something else – like Brexit.

Yet, speculate as we might, everything is in the lap of the Gods. In fact, what this all goes to prove is that the Gods have an overdeveloped sense of humour. We spend decades preparing for pandemic flu and they send us SARS. Then, when the government responds with a lockdown, they give us the sunniest spring in living memory. When the lockdown comes off, we can expect non-stop rain and frigid winds.

Either way, people have had enough of lockdown. They are running out of patience and many have run out of money. The police have issued more than 9,000 fines for lockdown breaches, so it may be only a matter of time before some angry recipients give them something more than a smacking. After 194,000 snitches have been prepared to dob in their fellow citizens, there may also be some local reckoning.

Having had very little choice about imposing the restrictions, therefore, Johnson may have even less choice as to when they are relaxed. There is a limit to tolerance and as tensions increase, more people will be defying the authorities' attempts to enforce the lockdown.

Where this takes us is anyone's guess. Never in recent history (nor even in living memory) has the government had such little control over events. It is being held hostage to fortune by the dynamics of an epidemic it doesn't understand, over which it has next to no control.

Being in the grip of a monumental delusion, therefore, is perhaps Johnson's greatest asset. It is said of wartime soldiers in battle, that fresh troops made up for their lack of experience by their willingness to engage. But, after about three months, they were burnt out by the constant exposure to the horrors of war, and declined rapidly in effectiveness.

Johnson, entirely new to the epidemic game, simply hasn't the first idea of what might await him. His delusional state protects him from having to anticipate the horrors to come. If the worst comes to the worst, he will never have seen it coming.

The old adage, therefore, "ignorance is bliss" seems to apply. And, despite all the things it lacks, government has no shortage of that commodity. However, with Johnson's claim that his response might involve finding "new ways, more ingenious ways" of suppressing the disease, without letting us in on the secret, there seems a determination to share the pain. As always, we the plebs are to be kept in the dark.






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