Richard North, 06/05/2020  
 


The only thing I would say about the sudden departure of Neil Ferguson is that it's a pity that he wasn't forced out because of his poor performance as a modeller.

Nor can we take any comfort from the event. There are plenty to replace him and, as long as we have a government that believes in the heap big juju that the modellers have to offer, nothing very much is going to change.

That said, it isn't just the modellers who got it wrong. That applies to anyone – including me - who projected reported case fatality rates to come up with six-figure numbers for the number of possible deaths. Quite evidently, we are nowhere near our worst expectations.

There is, of course, the possibility a second peak, which is being widely talked about. This could top up the mortality figures and save the blushes of the modellers. But it should be remembered that they not only predicted telephone numbers, they also suggested that the bulk of the deaths would occur within a six-week period.

As we now know, this was based on the behaviour of flu epidemics, with the response modified by the experience of first the Chinese and then other nations in instigating lockdowns. But, where our modellers have gone seriously off the rails – thus leading the government astray – is in assuming they are dealing with a single, national outbreak instead of a series of outbreaks, each with their own specific characteristics.

This, I might have mentioned once or twice, but the error continues unchecked. And until the government recognises this, and understands the implications, it is doomed to blunder about the bush, with hit and miss measures which do as much harm as they do good.

It is our misfortune though, that we have a government which is not only singularly inept, but one which seems incapable of listening to anyone outside its bubble. It is thus unable to learn from its many mistakes, or head them off at the pass by listening to wiser counsel.

That is very much the territory currently occupied by health secretary Hancock, who seems determined to pursue his contact tracing app, despite just about everybody in the IT world telling him it's about as much use as a bag of rusty nails in a microsurgery suite.

One of the latest to offer its advice on the subject is The Register. It observes that the UK finds itself almost alone with the centralised virus contact-tracing app that probably won't work well, asks for your location and may be illegal. The key word here, though, is "centralised". This is a government which, from the very start, has micromanaged the response to the epidemic from the centre. It continues to do so, even as the criticism mounts and performance deteriorates.

What makes this even worse is the arrogance displayed by the likes of Hancock. Last month, he was asked by Clive Betts whether local authority environmental health departments were going to have "a major role to play" in contact tracing, with the task being done at a local level. Hancock, one might recall, claimed: "We haven't made that decision", saying, "not least because the interaction with the e-contact tracing". The app, he said, "is critical and whether it's done locally or whether it's done through phone banks that are national level, that decision is not yet made".

As it turns out, that decision almost certainly had been made. We learnt from The Times yesterday that the human interface element of the contact tracing programme will be outsourced to private call centre operators, with at least two companies being asked to provide about 15,000 call centre staff.

These, most likely, will be minimum wage, gig economy conscripts who will be given about a day of training in the principles of the task. They will then be furnished with a script to handle conversations with people who have been at close quarters with confirmed cases.

Alongside an app that most certainly isn't going to work – and will have a limited take-up – this makes a nonsense of the whole scheme. Far from promoting local, intelligence-led operations to snuff out individual outbreaks, this is more of the same: centralised micromanagement.

And yet, we have Patrick Vallance yesterday telling the world that he believes a second peak of coronavirus infection can be avoided with a "test, track and trace system". Yet if he seriously believes that Hancock's half-baked little scheme will have any impact, he is either incredibly stupid or he thinks we are – in accepting such nonsense.

However, this is the same man who now says that it would have been "beneficial" to have ramped up Covid-19 testing quicker, only to have deputy chief medical officer Jenny Harries saying "things would have been done differently" if capacity had not been limited at the time.

Does this woman not realise that the reason capacity was "limited" was because the flu plan did not allow for community testing after the initial assessment phase? Since there was no expectation that large scale testing would be done, no provision was made to develop what would have been – had the plan survived – an unused resource.

One of these days, one hopes, the media and MPs are going to wake up to the implications of the 2011 Influenza plan, the structure and rationale for which was carried over into the current 2014 plan. "It will not be possible to halt the spread of a new pandemic influenza virus", the planners said, "and it would be a waste of public health resources and capacity to attempt to do so".

Once Ferguson then spooked the government with his projections of the death rate if they continued following the plan that he, himself, had a hand in devising, Johnson was forced to change tack, and the system has being playing catch-up ever since.

But whether there will even be a second peak remains moot. So far, the Covid-19 epidemic has not followed the path set out for it by the modellers, either in terms of death rate or the time frame. There is no certainty, therefore, that it will oblige by delivering a nice, neat "second peak".

One thing which is certain, though, is that hospitals and care homes have become established as reservoirs of infection, And, from the recent test results, it would appear that healthcare staff are seeding the community via their families, in a process that may well perpetuate the epidemic.

This dynamic has at last been recognised, with the egregious Vallance actually warning that there was "a risk of infections breaking back out into the community from hospitals and care homes".

The risk, though, is already the reality, and special measures will be needed to interrupt this process. And if the government has any plans in that respect, it is so far keeping them to itself.

Nevertheless, in the media, we can always rely on a "no shit Sherlock" moment from a house "expert", to add prestige to an obvious concern that has been troubling mere mortals for some time. Thus we have the Guardian citing epidemiologist Anne Johnson at University College London.

She says it is good news that transmission of Covid-19 in general community settings was now being suppressed, but "a greater degree of investigation into the transmission of coronavirus in health and social settings, including among healthcare staff", was needed.

As we noted: "no shit Sherlock!" – the comment is straight out of the Janet & John primer on epidemiology and the fact that it needs to be said illustrates how far the government has run off the rails.

But the one thing that isn't going to help is Mr Hancock, his ridiculous app and his minimum-wage call centres. Amongst other things, there will need to be a recognition that the holy shrines – otherwise known as NHS hospitals – are part of the problem, their good intentions littering the road to Hell with the corpses of their victims.

It's just as well that dead men don't clap. The noise would be deafening.






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