Sunday, 15 March 2020

COVID19 & The Government's Irrational Response

The government's response to COVID19 is irrational. Its statements and policy are contradictory, and unclear. It has responded to a moral panic in the way that governments often do, by conceding to demands that “something must be done”, by introducing measures that are large and visible, but which contradict its underlying strategy, and are themselves damaging. Its another version of the populist response to the demands for Brexit, and to stop immigration. 

The government's scientific advisors came up with a two stage strategy. The first stage was containment. That means identifying those that have the virus, isolating them, treating them, and thereby preventing the virus spreading amongst the population. That is the policy that China has adopted along with South Korea and elsewhere. China implemented it rather late, after large numbers in Wuhan were already infected. To implement it required the kinds of measures that only an authoritarian regime can apply. South Korea implemented it earlier on, and devoted a lot of resources into testing so as to quickly identify carriers and isolate them. A containment strategy is unlikely to work. Neither China nor Korea can survive in a state of permanent lock down. In China, hundreds of millions of people have no immunity to the virus. Its virtually impossible to ensure that everyone in China who is a potential carrier has been identified and contained. As soon as the containment ends, the virus is almost certain to re-emerge, and spread amongst that vast unprotected population. As one virologist put it, its like trying to fight a forest fire by means of containment, it only requires that you have missed the odd ember, and a gust of wind will reignite the entire forest. 

In a forest fire, the fire services have to decide what is their main goal. Is it to stop the forest burning down, or is it to prevent nearby residential areas, and the people in them being destroyed? Hopefully its the latter. That means that resources have to be focused on protecting those residential areas. It means water is used to dowse down the properties; it means that fires may be deliberately lit so that firebreaks around those properties are created, separating them by a safe distance from the forest fire, and so on. That is essentially what needs to be done in the case of coronavirus. The main goal should not be to limit the spread of the infection, but to minimise the number of fatalities and serious illness. With a forest fire, its spread means that trees are destroyed, and if possible that would be avoided, but only after the risk to nearby residents had been addressed. But with coronavirus, not even this analogy applies. The equivalent of the forest here is the 80% of the population who suffer either no symptoms or only very mild symptoms as a result of contracting the disease. And, having recovered from the disease, these people have the benefit of then being immune to it, and so no longer being carriers of it. It would be like if a tree in a forest fire, only suffered surface charring, and as a result became immune to further fire. 

And, in fact, this is essentially what the government's scientific advisors have told it. In the absence of a vaccine against COVID19, the best protection against it spreading, and affecting those in the population at risk of death or serious ill-health from it, is from the rapid build up of herd immunity. This is, in effect, only what vaccination achieves artificially and on an industrial scale. The government's scientific advisors have said that if even 60% of the population achieved this herd immunity, it would mean that the virus would be unable to spread, and pose a danger to the population as a whole. Its the same reason that its necessary to get a large number of people vaccinated against things like measles. But, this wholly rational strategy of building up herd immunity has been attacked by some from familiar quarters, who portray it as being some kind of conspiracy by dark forces. Its portrayed either as being a covert strategy of social Darwinism to kill off unproductive sections of society, or else as being some kind of strategy to cause the NHS to collapse. Its all chem-trails, and tin foil hats kind of stuff, from the same kind of people who also spread lies and conspiracy theories about MMR and other vaccines. 

But, in an age of populism, especially populism driven by social media, which is reinforced by a mainstream media which knows good sensationalist headlines when it sees them, and has created a moral panic surrounding it, its not surprising that a government that itself came to power on the back of Brexit populism finds itself again having to respond to the demand to “Get Something Done”, even if that something, as with Brexit, is itself totally irrational and damaging. To its credit, the government had not fallen into the same capitulation to that moral panic that the Irish government and others have done. Ireland has already closed down a large part of its economy; something that is likely to lead to far more deaths and bad consequences than COVID19 itself, whilst also being a bonkers means of dealing with the virus. But, it is buckling and beginning to fall into the usual trap of ending up falling between two stools. 

The Irish strategy of, for example, closing schools, is bonkers because, for one thing, children appear to be either immune to, or have no effects from, the virus. So, what purpose does closing schools serve? Even in China, the strategy of closing everything down essentially meant closing everything down in Hubei Province, but it meant that it could still be supported by the rest of China. Just taking the closing down of schools, in Ireland, the obvious immediate consequence will be that all those kids parents also have to stay home to look after them. Some of those parents will be health and social care workers. That means that the health and social care that those actually suffering severe consequences of the virus need, will not be available! Some of those parents will be employed in other vital services, which will then also shut down. After all, an effective strategy of closing everything down, means that its not just schools that close. Add in the strategy of social distancing, of anyone with a cough or sniffle being told to stay off work for a fortnight, or even just if they think they might have had contact with someone who might have been infected, and before long the entire economy shuts down. 

So, for example, the electricity supply industry could be shut down, because of social distancing, even though energy supply workers might have slight symptoms and so on. But, then without electricity COVID19 starts to look like a minor problem. No electricity, even for a couple of days, would cause major problems. Millions of lives would be at stake because of heating systems not working, electricity for communications systems disappears, electricity for hospital equipment, including the ventilators required to keep COVID19 patients alive stops working. And, why on Earth would you want to do that, when at least 80% of those workers are amongst those that will suffer no or only mild symptoms, even if they contract the virus? 

The government has rightly identified that the most important thing is to protect those in the community in the at risk groups. That is those over 60, and/or who have some underlying medical condition. But, they have not said that those in this category should immediately self isolate. Why not? Its like saying to someone with a nut allergy, at some point we will be telling you not to eat nuts, but not yet! If you are in the at risk group, as I am, you will self isolate now, if you have any sense, because otherwise you are likely to come into contact with someone who has the virus long before the government tells you to. For one thing, its a good bet that the actual number of people carrying the virus is several times the official numbers. Failing to tell people at risk to self isolate is a dereliction of duty. 

The government couples this by saying that its current strategy is to delay the spread of the virus. The argument behind this is that it needs time to be able to build up capacity in the NHS, and stop it being swamped with patients. But, again this makes no real sense. If 80% of the population have no symptoms or only mild symptoms, why would they swamp the NHS. They could carry on life as normal. And, if the government, now, told the other 20%, and specifically those in the at risk category to self isolate, then they would not be infected, and so they too would not swamp the NHS. Its the government's own failure to tell people in the at risk group to self isolate that is the only reason why it should not want to see the virus spread as rapidly as possible, and thereby build up the required herd immunity as quickly and efficiently as possible! Of course, the lack of readiness of the NHS is itself the consequence of a decade of austerity measures introduced by Tory and Liberal-Tory governments since 2010. It is further hindered by the reactionary Brexit decision, which is denuding the NHS and social care of the EU migrant labour on which it depends. 

So, the government says that, at some point, it will tell those in the at risk category to self isolate. In the meantime, it has responded to the criticism of its scientifically sound strategy of building up herd immunity, by denying that that is part of its strategy. Instead, it says it wants to delay the spread of the virus, which is the opposite of what you would want if you wanted to build natural immunity amongst the population. The consequence of that strategy of delay is that, instead of the virus being spread quickly and immunity being developed over a matter of weeks, the virus is only spread slowly, and immunity takes many months to develop in a sufficiently large proportion of the population. A rapid development of herd immunity means that those in at risk groups only need self isolate for say 2 months at most, but a strategy of delaying its spread means that those in at risk groups would have to self isolate for 4, 6 or more months, which begins to look difficult to achieve. 

This illustrates other contradictions and irrationality in the government strategy and statements. The government says at some point it will advise self-isolation. Indeed, if everything was closed down that is equivalent of everyone self-isolating for a couple of weeks or so. But, to self isolate means that you need to have the necessary supplies on hand to last through the period of isolation. Yet, the government is also telling people not to hoard! Its impossible to do both at the same time. Either its necessary to hoard supplies to last through a period of isolation, or you can't effectively isolate. The longer the period of isolation, the greater the degree of hoarding required. Given that the government is now talking about self isolation lasting 4 months and more, that is a considerable amount of hoarding that is required. 

Last year, I bought a new house that came with a large built in fridge and large built in freezer, along with large amounts of cupboard space. It meant that my existing fridge/freezer could be set up in my garage. So, I have plenty of opportunity to hoard the necessary supplies to last me through my voluntary self isolation that I have already embarked upon. When the government gets around to telling others in the at risk group to self isolate they will have to do something similar. Of course, many do not have the advantage I have in that regard. But, the government is saying nothing about the support it will give to enable them to do so. In the meantime, if the government does get pressured into closing everything else down, then, of course, my additional fridge/freezer will be of little use, because with electricity supply disappearing along with electricity supply workers, every such appliance will cease to work. 

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