Thursday 19 March 2020

COVID19 By The Numbers

Yesterday, the government's chief scientist, Sir Patrick Vallance, confirmed something I have said previously. He pointed out that the total reported number of cases was misleading, because Britain only tests those going into hospital to see whether they have the virus. Not only does that test not detect whether the person has actually had the virus and recovered from it, but it leaves a much larger number of people who do not go into hospital, who have, or have had the virus, who are not tested, and so not reported. He confirmed, therefore, that the number of people in Britain who have actually contracted the virus is likely to be around 100,000, which means that there is only 1 death per 1,000 of cases, giving a mortality rate of 0.1%, which is the same as for seasonal flu. That is not to say that COVID19 is the same as seasonal flu, it isn't, because, for one thing, we have vaccines for seasonal flu, but so far none for COVID19. However, the mortality rate of 0.1% is important in determining whether the responses to the virus are rational or not. 

For one thing, it tells you who should be isolated and who should not, and, thereby, how resources should be best allocated. For example, with Ebola, 90% of those that contract the disease die. That is 900 people out of 1,000, as against 1 for COVID19. For Ebola, everyone is in an at risk category, likely to die if they contract it. Consequently, the best means of stopping deaths from Ebola is to try to prevent as many people from contracting it as possible. If it spread easily, you would then want to close everything down quickly to prevent that spread and risk of death. You would also want to quickly identify the carriers of the disease, and isolate them to prevent them spreading it to anyone else. South Korea have not introduced a closing down of everything, in the way that China and Italy, and now much of the rest of the world, has done, but they have had few deaths, and quickly slowed the spread of infection, by rigorous and extensive testing to identify carriers of COVID19, and thereby to isolate them. 

However, given that the mortality rate from COVID19, according to Vallance's figures, is only 0.1%, the closing down of the economy, and attempts to thereby isolate the whole of the population from infection, in the same way you would do with, say, Ebola or Smallpox, which have very high mortality rates, seems perverse in the extreme. If only 0.1% of those infected with the virus are likely to die, and you know who these people are – and we do, because the data shows which groups are at risk – then the obvious thing to do is to isolate this relatively small group of the population, so that they do not get infected. That is where all of the resources should have been directed. From Day One, the government should have told those over 60, and all those who have underlying medical conditions, whatever their age, who might be at risk from contracting the disease, to self isolate. They should have done all they could to ensure that those groups did so, and that they were provided with the necessary resources to enable them to do that. But, the government failed to do either. 

Many of us in that group didn't wait for the government to tell us what to do, we already did it. My household began self-isolation over a week ago, and I heard Joan Bakewell saying something similar on TV a few days ago. This is a bit like Grenfell Tower all over again, and where anyone who thinks about how best to protect themselves can usually identify that with a bit of common sense, and experience, and its often contrary to the advice that the government and authorities provide. We know from the government's data that, although 0.1% of those infected are likely to die, around 20% of those infected could also have serious consequences from having done so. That 20% are those in the at risk groups. In Britain, 20% of the population is still a big number, of around 13 million people. But, a large proportion of that 13 million people are retired, and so not working. Another significant proportion are people who are sick, in hospital or in care, and so also not working. Isolating that 20% from infection, therefore, does not have any dramatic effect on economic activity, and production of goods and services; goods and services which are vital for everyone. 

But, instead of following that entirely rational approach, the government, followed on from the irrational approach that other government's have followed as they responded to populist appeals, and popular delusions and mass panic to “Get Something Done”, by closing everything down. The effect of that is, then, also perverse. For example, when I started to self isolate, a week ago, we thought we had enough things like fresh milk to last, on the basis of being able to periodically replenish supplies via online shopping, whilst keeping such contact to a minimum. But, all of our fresh milk has now gone. We are using long life milk from cartons, but with three adults in the house that too is likely to go soon. Yet, all of the panic that the government has created – though to be fair most of the panic has been created by populist newspapers desperate for readers via sensationalist headlines, and 24 hour news channels, which simply repeat those headlines ad nauseum every 15 minutes, and who continually harry politicians and their advisors into taking irrational actions, in order to show that they are “Getting Something Done” - has resulted in panic buying, at the same time that the government is shutting down the production, required to replace those supplies. It means that supermarkets, and people like Ocado, have closed down their online sites, or where they remain open, there are no available slots for over a week. Moreover, it means that they have restricted items to 2. That again is irrational, because a single person household is then able to effectively get 3 times as much as a three person household. Being able to get 2 1 litre cartons of milk is unlikely to last the three adults in my household for long, for example, which, thereby creates pressure for us to break our self isolation! 

What we know from Italy is that the reason it has such high mortality rates, despite having implemented a closing down of society, is that the virus appears to have got into the health system itself. This is rather like the spread of MRSA in hospitals, in Britain, some years ago. Because those in hospital, or similarly in care, are, by definition, those already in the high risk groups, if you allow the virus to spread into these environments, you will get much higher mortality rates. Not only do you get a spread from patient to patient, but you get spread of patient to health or care worker, and from them to other patients, unless the health and social care workers are provided with the adequate personal protective equipment, and every patient is adequately isolated from one another. This does not appear to have happened in Italy, but we also know that health workers and care workers are not being provided with adequate PPE in Britain either. Its not the risk of catching the virus by those health workers and carers that is the problem – unless they are themselves in that at risk 20% of the population – but the fact that, in contracting it, they would then pass it on to those patients they come in contact with, who by definition are in the most at risk categories. But, another perverse part of the government's strategy is that, in order to cope with additional hospital workloads, they are talking about bringing back retired health care professionals, that is by definition more elderly workers, who are themselves at risk of serious consequences from infection! 

But, given that only 20% of he population is at risk of needing hospital treatment, if that 20% is isolated effectively, there would, in any case be no reason why hospital admissions should rise significantly.  Indeed, on the basis of the current number of deaths at just over 100, and the number of confirmed cases at 2,600 (only those admitted to hospital are tested to see if they are infected), its hard to see why this should currently be causing the NHS to be overloaded.  100 deaths is a fraction of the average 8,000 deaths from flu each year, and the 2600 number is hardly large compared to the number admitted to hospital with flu.  Last year, 2,000 people needed to go into intensive care because of flu.  So, currently, the situation in respect of the NHS is an indication of the pitiful state it has been reduced to as a result of ten years of austerity rather than the impact of COVID19.

The decision to bring back retired health workers is rather like the government's about turn on closing schools. What we also learned from Sir Patrick's press conference, yesterday, was something else I have pointed out. But, it was not something that he said directly. Sir Patrick repeated the points that have been made before about why not to close down schools, because, in doing so, parents need to stay home to look after them, and some of those parents will be healthcare workers etc. The government is now addressing that objection by saying that kids from certain families will be able to continue to go to school. They have specifically mentioned the kids of parents who work in healthcare, the police, and food delivery. But, they will quickly discover that the capitalist economy is one based upon extensive social division of labour, and cooperative labour. It has been so for more than 200 years, and that integrated and interdependent nature has become greater and greater with every year it has existed.  It is the basis of its amazing productive capacity, a capacity that will be required also to build socialism.

So, for example, all of the above will be a complete waste of time if energy supply workers have to stay at home to look after kids away from school. Last year, it took just two power stations to go down, to bring the entire national grid down, shutting down electricity supply. That was only for a few hours, but showed what a threat to millions of lives that poses. If energy supply workers stay away from work to look after kids, also encouraged by all of the scare mongering about a non-existent threat to the lives of 80% of them, then it will not be electricity shut off for a few hours, but for days, or even weeks. The deaths from that, both direct and indirect, will run into millions, far exceeding the worst case scenario of deaths from COVID19. Or take refuse collectors. If refuse collectors stay home to look after children, or in response to the government's calls for perfectly health workers to self isolate, what do you think the result will be from rubbish piling up in streets, with rats running rampant through it. Or take sewage workers. If they similarly stop work, then sewage will begin to escape into water courses, blocked sewers and drains will disperse raw sewage into streets, and so on, creating a spread of death and disease with it. We established all of those things in the 19th century, precisely to stop the millions of deaths from cholera and so on.  Or take the petrol tanker driver. If they all go off sick, then petrol is not delivered to petrol stations, and no one can drive to work, deliveries of food and vital supplies cannot be made to hospitals and so on. 

The already depleted numbers of the armed forces could not possibly act to replace all of these workers. One good consequence of it will be that everyone will see that life could go on without all of the highly paid company executives, but that life is dependent on the labour of the shop worker, the delivery driver, the power worker, the refuse collector, the sewage worker, the doctor, the nurse, the care worker, and so on. What would, at least, be seen in plain sight is that the wealth of the nation is founded upon, and dependent upon the labour of workers. 

Sir Patrick, however, also reiterated a point he and others have made previously. That is that the children going to school are not at risk – at least those that do not themselves suffer from respiratory or other diseases, are not – because children appear not to be affected, or only to be affected in a very minor way by the virus. Nor, he confirmed, are the majority of teachers or other staff at risk from the virus. That is because, like the rest of the population, 80% of them will suffer either no or only mild symptoms from it. The only teachers and other staff at risk are those who are elderly, or who are pregnant, or who have other underlying conditions that puts them in the 20% of the population at risk. Yet, having spelled all of this out, Sir Patrick confirmed that the government was going to close down schools anyway. In other words, the conclusion was completely at odds with all of the facts, and argument he had just set out as to why schools should not be closed down. In other words, he was basically saying, here are all the actual facts that lead to the rational conclusion that schools should stay open, but the government has decided to close them anyway, because that is what all of the media and mass panic is demanding, and we are providing cover for it, because we too, as scientists, are under pressure to conform from politicians, and from that public opinion too. The studies of Milgram about conforming behaviour, and why millions of people in Germany could be led to go along with the Holocaust prove their relevance once again. Its the same conforming behaviour that led to Mccarthyism, and the Salem Witch Trials. 

But, the government's policy, in closing down schools, is perverse for another reason. If millions of workers do not heed the government's advice to stay away from work so as to self isolate, and protect themselves from a virus that poses no threat to the lives of 80% of them, then all of the conclusions about the economy shutting down will not follow. Already, it seems that many younger people, with more critical minds, and access to the facts, are ignoring the government's calls for them to stop social interaction, and they continue to go to pubs and so on. Many may, of course, stay away from work, even whilst continuing to engage in their normal social interactions. Being encouraged to take two weeks additional leave with sick pay, may be attractive, especially if the government increases sick pay to 100% of wages. The added incentive to stay at home, because your kids are now permanently off school may be enough to get others to stay home. But, with millions in precarious employment, self employment, and so on, and no clarity about sick pay, many of these workers may decide they have to go to work to get the income required to live. So, what will they then do? They will, of course, put pressure on grandparents to take up the burden by looking after the millions of kids now off school. The grandparents are themselves in the at risk group, and so the kids will then pass on the virus to their grandparents creating an unnecessary surge in deaths from the virus. The kids will also quickly get bored after a few days stuck in with grandparents, and so will begin to break out of their isolation, creating additional problems, as the grandparents are also led to break any self isolation of their own, to take the kids out to some place of entertainment or distraction. Instead of enabling the small proportion of the population at risk from the virus, to isolate and thereby minimising deaths, the government policy, by foolishly trying to isolate the whole of the population – which is  not achievable – whilst making no real attempt to enable the small proportion who actually are at risk to self isolate, will actually maximise the number of deaths, in the vain attempt to restrict the number of infections. 

If we take Sir Patrick's figure of a 0.1% mortality rate, then, if 50 million people were infected that produces 50,000 deaths. However, the actual figure would be less than that, because the scientific advice is that if 60% of the population become infected, then herd immunity is established so that it becomes impossible for the virus to spread on any significant basis, because it does not have sufficient new hosts to infect. In that case, at the point that 60% of that 50 million were infected, it would not spread further. A 0.1% mortality rate, then, on this 30 million, produces a total number of deaths of 30,000. That is probably the basis of the advisors saying that, if they can get deaths below 20,000, they will have done well. It compares with deaths of 17,000 from flu in 2018, and an average annual number of around 8,000 for flu deaths. But, even this figure of 30,000 deaths implies that the virus had simply been allowed to spread willy-nilly into the population. If a rational strategy of building up herd immunity was undertaken that would not be the case. If the 20% of the population were effectively isolated for a period of two months, herd immunity would be built up in the rest of the population during that time, whilst those people continued about their business as normal, and experiencing no serious ill-health from it. At the end of that period, the virus itself would have been killed off as a result of that herd immunity, and the at risk 20% could again safely go about their business without risk of infection. 

But, the government is not doing that, as it responds to the moral panic. Its policy of trying to slow down the spread of the virus, whilst not effectively isolating and protecting the at risk 20% of the population, means that no herd immunity will quickly be developed, and with no vaccine likely for at least a year to 18 months, that means that economic activity is shut down indefinitely, and everyone in the at risk group is put in danger for a much longer period than need have been the case. And the consequence of shutting down the economy will be much more severe than the potential deaths from COVID19. China's economy shrank by 14% from its closing down of economic activity. The US is expected to contract by a similar amount, in the second quarter, as it shuts down its economy. Its expected that US unemployment could rise to 20%. If the US does shut down its economy, in a perverse attempt to stop the spread of the virus, that 14% drop in the second quarter would be extended, and deepened into the third and fourth quarters, if not beyond, as attempts to slow down the spread of the virus simply means that it remains a threat for a much, much longer period. Latest estimates think that, with China shrinking by 14%, the US shrinking by 14%, and undoubtedly, at least, similar contractions in Europe, the global economy will also shrink by around 14-15%. That is unsustainable. It is a much bigger drop than from the 2008 financial crisis. 

Its unsustainable for several reasons. Firstly, for the reasons set out at the start. Bourgeois economists and pundits are a bit like the (probably) apocryphal stories about city kids who, having for the first time having seen a cow, are surprised to find out that this is where milk comes from rather than the supermarket. Their ideology systematically undermines the role played by labour in creating new value, and thereby also of creating accumulated value on the form of capital. Even now, they continue to be deluded into the idea that money can simply be pumped out into the economy, so that people can continue to buy goods and services, but fail to ask the question of where those goods and services are to come from if no labour is being performed, because all workers are staying away from work! As stated about electricity supply workers, shut down electricity supply, even for a couple of days, and deaths will soar, society will begin to break down. In 1999, when oil supplies were disrupted, it took, again, only a couple of days before petrol stations ran dry, and all transport began to grind to a halt. Supermarkets and other stores have only enough stock to last a couple of days, and it needs to be replenished every day. If no one is working, there is nothing produced to be able to replenish the stocks; if no one is working, there is no one to distribute supplies; if borders are closed all of the food and energy that a country like Britain needs to constantly import, gets cut off. As I've said before, what is happening now, is just a taster of what would happen with a crash out Brexit. 

But, its also unsustainable financially. I set out yesterday how, if you just print money and hand it out, whilst slashing production, the inevitable consequence is hyperinflation. But, a 14-15% slashing of the size of the economy is much greater than 2008. A sustained contraction of the economy of that order would lead to massive unemployment, such as the 20% now being discussed. Living standards would plummet, and we know from the recent study that such falls in living standards themselves cause deaths ill-health, not just for a year, as with a virus, but for year after year. The reason that life expectancy is higher in developed economies, is precisely because of the higher standard of living. The cause of that process ending in Britain was the implementation of austerity after 2010. But, a 15% contraction of the economy, let alone if that were to persist, as trying to constrain the spread of the virus led to the economy being closed down for a more protracted period, would be far more devastating, even in a single year, than was the ten years of austerity. If unemployment were to rise to something like the 20% talked about for the US, it would mean UK unemployment rising to around 8 million people. With the rest of the economy being quickly destroyed, especially if Brexit were to go ahead and add to that catastrophe, there is no way a government could pay out unemployment and other welfare benefits on any kind of meaningful level. 

Deaths and ill-health from the resultant destruction of welfare, of health and social care, which the economy could no longer support would lead to deaths rising into the millions. And, Paul Mason is wrong in his conclusion recently that, 

“By the end of the month there’ll be only two kinds of people in British politics: reluctant socialists and enthusiastic ones.” 

In these conditions, there will undoubtedly be an increase in support for greater state intervention, but that is not something that socialists, certainly not Marxists, should support. In these kinds of conditions that state intervention will take the form it has always taken in the past, and which current measures to implement near martial law, the closing down of elections and so on are already pointing to. It will be state intervention by a right-wing, authoritarian state. It will be intervention that attempts to hide the mistakes and crimes of the government, as happened in China and Russia, and which ramps up even further the accusations of blame for the crisis on to foreigners, making the xenophobia built up over Brexit look timid by comparison. Already, we are hearing talk of the police arresting people for being ill, and we know who the first people arrested on that basis will be. It will be anyone who looks or sounds foreign. We have already others now using Trump's description of COVID19 as “the Chinese Virus”, and we have seen attacks on Asian looking people, as the moral panic is whipped up to grotesque proportions. The next stage for right-wing authoritarian regimes is then to round up such people willy-nilly, and place them in concentration camps or worse. 

Now is not the time to confuse economic nationalism and statism with socialism, nor to confuse national socialism with real socialism. Mussolini, Hitler and Moseley all proposed massive state intervention, nationalisation, and an extension of the state. There was nothing socialist about it, not anything even progressive. That such solutions are even being confused with a socialist response, at the moment, shows the dangers that lie ahead, and the degree to which socialist principles have been lost over the last century.

No comments: