EU Referendum


Covid: distorting the debate


18/06/2021




Matt Hancock, according to The Times is set to be exonerated over claims that he lied to the prime minister, despite Cummings dropping his "totally f***ing hopeless" bombshell.

And now Rees Mogg has sprung to the defence of the health secretary, calling him a "successful genius", I suppose we must come to terms with the possibility that Hancock might only be "totally hopeless" in a very specific and limited way.

Hancock himself might have cause to worry about being labelled a "genius", though. That's what the chatterati were once calling Cummings. But now he is challenging his former master, the knives are out, with two article in Johnson's house journal, attacking the former advisor.

The first, by a couple of Telegraph staffers, runs under the headline "There's nothing worse than unpredictability: Was Dominic Cummings unfit to lead from the start?", virtually answering its own question with the sub-heading, "A maverick who marched to the beat of his own drum was never going to be a calm leader in a crisis".

And just in case you have any residual doubts about the fundamental unsuitability of Cummings for his former job, we have a contemporary telling us that, "The Dominic Cummings I knew at university should never have been handed the reins of power".

"As a student", the sub-healing goes, "he was argumentative, awkward and arrogant - it isn't much of a surprise to see him throwing his toys out of the pram now". However, given that Cummings himself admitted that it was "completely crackers" for him to be at the very heart of government, that isn't much of a call.

Nevertheless, having some direct knowledge of the man, I would completely agree with Cumming's own estimation of his worth, but recall that it was Johnson personally who went round to his flat and pleaded with him to come and work in Number 10. The decision to employ Cummings simply represents another flawed judgement to add to the many perpetrated by the prime minister.

But what is more than unusually unhelpful at this time is that Cummings should decide to have his strop, just when the Covid situation appears to be deteriorating once more. Daily cases, reported yesterday, stood at 11,007 – up 3,614 on the week, while the number hospitalised is 1,227, stubbornly above the thousand mark.

We could thus do without the distraction of this eternal soap opera as we try to make sense of a scenario where the French government has lifted Covid restrictions and the country hails a return to a "form of normal life" (pictured – football fans in Paris), while from our own government we get consistent gloom.

The latest dose of pessimism comes from the chief medical officer, Chris Whitty, who is telling us that the winter will see a further wave of Covid-19 cases, adding that the virus "has not thrown its last surprise at us".

In remarkably non-specific warning, he declares that the UK is now going into "what is likely to be a third surge and possibly a third significant wave", with the scale not yet clear but with further hospital admissions and deaths.

He expects "a further late autumn/winter surge", but offers no rationale for this other than to say that "respiratory viruses found it easier to spread in colder months". How big a problem this will be, he says, "depends on the success of vaccines and how the present wave progresses".

Once social contact restrictions are lifted, he adds, next winter will also see resurgence of flu and other viruses such as respiratory syncytial virus (RSV) in children. Therefore, in his view, the NHS should "brace for the fact that the coming winter may well be quite a difficult one".

This is, he concedes, "a slightly gloomy point". But he thinks the NHS should be "realistic" and prepared for that eventuality. And not only does he think that Covid has not thrown its last surprise, he expects there to be "several more over the next period".

But tucked into these points, Whitty also says that the illness has had the greatest impact in communities where deprivation is "prolonged and deeply entrenched", calling for redoubled action on the issue.

This evasive language undoubtedly obscures a more serious point, as the term "deprivation" in relation to communities is often used as a euphemism for groups of immigrant origin. And in this particular case, we know that communities of Indian origin are heavily involved, even though Whitty doesn't have the courage to say so.

And it actually matters that he should be more explicit. While deprivation is associated with immigrant communities, cause and effect relationships are by no means clear. But what is evident is that special measures will be needed to deal with the special problems thrown up, and it is by no means certain that these have been identified, or that there are the resources to implement them.

It is an entirely uncontentious fact, widely known in epidemiological circles, that the spread of infectious diseases with communities has a strong cultural element, so it is equally uncontentious to asset that the behaviour of Covid-19 will vary in different communities, requiring modifications to the basic control strategies.

Consideration for the sensibilities of racial equality warriors should not be allowed to prevent the acknowledgement that different communities require different measures, and some are more resource-intensive than others. The interests of us all lie in eliminating reservoirs of infection which have the potential to seed the wider community.

That said, it is not only in this respect that one sense we're not being told the whole story. And we have yet to come to terms with the effects of Covid on the disruption on routine NHS operations, with a report that hospitals completed 1.5 million fewer surgical procedures in 2020 than would be expected from trends in previous years, a drop of about 33 percent.

Overall, there have been 7.1 million fewer people referred for treatment than normal over the course of the pandemic, the lack of treatment contributing to a premature death toll which has not been properly explored. There must come a point – if it hasn't already been reached – where the allocation of resources to dealing with Covid must be costing more lives than it is saving.

Notably absent from the discourse, though, is any serious discussion of how we are to deal with a disease which is obviously here to stay. Whitty talks glibly of five years' time, when he expects there to be vaccines that would protect against multiple strains.

But there only needs to be a few unexpected glitches – in an environment where the unexpected has become the norm – for a vaccination programme to fail, wholly or partially. Then we would be back to the desperate times of the early part of the pandemic, where intensive care and lockdowns were the norm.

One would have thought by now that, with the reminder that infectious disease requires its own special management procedures, we would be starting to build custom hospitals, on the traditional "fever hospital" lines, better to deal with a disease where a significant mechanism of spread has been nosocomial infection.

Of that, though, we hear nothing – alongside only a grudging acknowledgement of the role of hospitals in spreading the disease, and no explanations for the evident failure of the Nightingale programme.

It is indeed a shame, therefore, that the focus is on the soap opera themes orchestrated by a failed prime ministerial advisor, rather than the wider issues of immediate relevance to the management of Covid, with important implications for the future.

Also published on Turbulent Times.