Wednesday 16 December 2020

Government Covid Guidelines

The government's messaging on Covid continues to be confused and confusing. That is because the underlying narrative used to justify lockdowns has been that everyone is equally likely to die or be seriously ill from the virus, even though we know that it is the elderly who are almost exclusively at serious risk. So, at Christmas, the government, concerned not to be unpopular for spoiling the festive season for everyone, and also risking its laws being widely flouted, decided that it would basically suspend them. As scientists have pointed out, criticising the government decision, that would imply that the virus itself took a break for the holidays! 

Now, as it comes under pressure, the government is changing its tune. I wrote, some weeks ago, that, just because the government had said it was relaxing the rules for Christmas, that was no reason, if you were in an at risk group, to take advantage of it, for precisely this reason. The government's initial message was dangerous, because it suggested to elderly people, or people with underlying medical conditions, that they would be okay to socially interact over the holiday, even though this would, inevitably, put some of them at risk, by coming into contact with the virus. Now, the government lock downs, in their various flavours, have again failed to prevent deaths rising, as the policy of suppressing the virus, which meant slowing the development of herd immunity, has also given the virus time to be able to mutate into a new strain. In other countries, including those in East Asia, which had suppressed the spread of the virus by extensive test and trace systems, we see its spread increasing again, and the number of deaths rising. 

The government is, now, under pressure from scientists to reverse its previous message about social gatherings at Christmas. It is basically saying what I said in that previous post, i.e. that just because the government has relaxed the rules restricting who you can come into contact with, it is no reason for you to do so, if you are in an at risk category. It requires you to exercise your own common sense. But, the government has put itself in this position, because of its continued insistence on the narrative that everyone is equally vulnerable. The government says, in its current messaging, that it was relaxing the rules, because it did not want to criminalise anyone for meeting with their families over Christmas. But, why did the issue of criminality need to come into it in the first place. 

If we take smoking, for example, it kills, each and every year, 80,000 people in Britain. That is more than have been killed by COVID, in this year. In addition, it leads to a further 320,000 serious illnesses each and every year, again far more than COVID, or the rather ill-defined long COVID. Yet, smoking is not criminalised. The government has spent a lot of money telling people that smoking will kill you, and will also make you seriously ill. It gives strong advice not to smoke; it provides funding for programmes to help people to stop smoking, and so on. However, the government does not say, if you smoke, and so put your life at risk, we will criminalise you. So, why could not the government similarly say, “If you are over 60, or you have some underlying medical condition, then you are at serious risk from COVID. So, we strongly advise you to avoid coming into contact with the virus. We will do what we can to help you achieve that goal”? 

The simple reason the government cannot say that is because it contradicts its narrative that everyone is equally at risk from COVID, rather than it just being this 20% of the population over 60, or with underlying medical conditions. There is, of course, no reason why the 80% of the population, not at serious risk from the virus, should have their Christmas impaired by government laws restricting their social activity, and not just at Christmas, but for the rest of the year too. However, the government cannot say that, as it contradicts its narrative, used to justify the lock downs. So, it, instead, has to give this confusing message that, everyone can mingle, but if you are in an at risk group don't, even though we previously told you that over Christmas it would be okay! The alternative would be for it to impose lock downs on everyone over Christmas, which would have the merit of at least being clearer, and consistent, even though wrong and unnecessary, and probably being ignored. 

The reason the government ends up in such ludicrous and confusing messaging is down to its basic narrative that everyone is equally at risk from COVID, and that it represents some existential threat. The first is simply untrue as all the data illustrates, with those over 80 being more than a thousand times more likely to die, or become seriously ill, than those under 40. More than 90% of all deaths are of people over 60, with the average age of death being 82. The second is also not true. As stated above, smoking kills more people, every year, than has COVID in this one single year, and the Hong Kong Flu of 1968, killed as many people in Britain, on a population adjusted basis. The large majority of people who have died from COVID, are old people in care homes, or in hospitals, which means that the real story of this pandemic is the atrocious level of protection provided by the NHS and wider welfare state for the old and vulnerable. There is absolutely no reason why people in hospitals or care homes should not have been completely shielded from contact with the virus, and their lives thereby not put at risk. Had that been done, the number of deaths would have been lower than for seasonal flu. 

But, in pursuing this narrative that everyone is equally at risk and that the virus represents some kind of existential threat to everyone, the government has fuelled the moral panic surrounding the virus, and the irrational behaviour it has spawned. The government messaging, along with the sensationalism of the media, has convinced many parents that their kids are at risk from the virus, even though the facts show that kids are at no risk from the virus whatsoever. Parents are inevitably protective of their kids, and so this false messaging leads them to want to protect them, leading to calls for schools to be closed. Those calls were fuelled by teachers unions, which appear to have been acting politically, and misguidedly, to encourage school closures. But, the result is that Councils also come under pressure to close schools, such as at Greenwich. Then we have the government having to intervene to insist that schools remain open, and again the question of involving the law is introduced. 

One lesson that should be drawn from the COVID experience is the different approaches of collectivism and individualism. If we take the fact that the vast majority of deaths have been of old people in care homes or in hospitals, what does this tell us? Firstly, as stated above, there should have been no reason for such deaths. Both are institutions in which residents and patients should have been completely shielded from the virus. Covid patients in hospital should have been in isolation wards so that they did not come into contact with other patients, which also would have meant that there would have been no cause for people with other complaints to stay away from hospitals, a fact that has itself led to more deaths from these other illnesses than has occurred from COVID. New patients could have been placed in quarantine, if no reliable COVID tests were available. All hospital staff should have had proper PPE to prevent them contracting the virus, or any potential of them spreading it to others. 

This would have been an effective collective response, but the fact is that such a collective response on its own is not enough. The reality was, of course, that this effective collective response was not forthcoming. Instead, the NHS actually infected many patients, who had come in for other complaints, with COVID, from which they subsequently died. The NHS also sent patients, with COVID, back to care homes, where they then spread the virus amongst the other care home residents, many of whom then died. The collective response was not just ineffective, but downright destructive, because it was not democratically controlled. The NHS is not some kind of socialist venture, but is a capitalist enterprise, just one run by state capital rather than private capital. Its purpose is not to cater for the needs of workers. If the NHS were under the democratic control of the workers within it, and was also subject to the oversight and control of committees of local workers, dependent on it for their health, then it is far more likely that they would, together, have ensured this effective collective response. As it is, it is under the control of a huge NHS and Department of Health bureaucracy, tied closely to the Medical-Industrial Complex, and whose actions are guided by the needs of the state, and profit making not the needs of workers. 

The same is true in relation to care homes, and other social care provision in the home. The trouble is that much of the Left has lost sight of the basic message of Marx and Engels about the need for such workers' self organisation and self-activity. So, it sees the alternatives as being only individual provision and activity, or reliance upon the capitalist state. It reduces workers' collective activity to being merely periodic protests or demands put to that state, which necessarily means that it conveys the message that this state is somehow class neutral, as well as also necessarily demobilising the workers self-activity and self-government outside these very episodic occasions. The reason Marx and Engels emphasised the role of the worker owned and controlled cooperatives, was precisely because it represented this permanently mobilised class struggle activity, by workers, who presented the vision of the future society, in practical opposition to the capitalist organisation of society. 

Take this comment in a recent article by Martin Thomas of the AWL. Martin correctly criticises the SWP for its policy of support for lock downs in respect of schools. 

“But the socialist ideal is not where schools are sufficiently suppressed that no-one learns how to do anything productive. It is not a proposition of setting “lives” above “the economy” (as lockdown-enthusiasts often phrase it) as if the socialist ideal would be for “the economy” to be suppressed except presumably for some external class of providers who keep the blissfully-uneconomic socialists fed and housed. The virus blights lives, but so does excluding children from learning and from socialising.” 

But, then shrinking back from the logical rejection of lock downs, as if afraid of being caught out too much on a limb, for putting forward the rational development of this argument, he says, 

“Some writers have talked about “shielding” of the more vulnerable (elderly, etc.) as an alternative to lockdowns. That was always difficult. The elderly in care homes or with domiciliary care were probably, in spring 2020, the most exposed to the virus rather than the most shielded. Even with a better care system, the frail elderly by definition need other people to help them and can’t quarantine themselves off as completely as young and fit people can. 

In fact, the least vulnerable adults have mostly been “shielded” best. Namely, the prosperous, who can snugly and securely work from home, who have comfortable and well-equipped homes, congenial households, gardens, access to other nearby open space. And who are usually in better health to start with... 

The high-rise council block of flats we live in is in good condition, and not a slum. Nevertheless, lockdown for our neighbours, who are a seven-person household in a tiny flat, is different from lockdown for a small household in a big house. 

Lockdown for a similar family on the 16th floor is different again from all of us on the 6th floor, who can choose to avoid the confined space of the lift and use the stairs instead (my arthritis isn’t that bad yet. But when it is…). 

Even for us, the stairwell isn’t big enough to allow two metres distancing, and on most journeys up or down the stairs we cross paths with someone else.” 

In other words, here we have the counterposition of the individual, in the large home, with gardens and so on, who can cater for themselves, with the only alternative being that for the resident in the high rise flats, where this is not possible, the whole of society must be closed down, which is something that only the state can impose. Martin sets out the problems of the person in the flats who needs to go to work, rather than being able to work from home, as well as the problems of getting supplies delivered and so on. Let's look at these arguments. 

Firstly, Martin rightly talks about the fact that people in care homes, and so on were the most exposed to the virus. But, was that changed, let alone improved, by the imposition of lock downs? Of course not. The residents of those care homes were not the people going out to the pub, the gym and so on, all of which activities were ones that were shut down by the lock down. The argument then is that, because other people, younger people, not at risk from the virus, were doing all those things, that meant that the virus spread amongst them more rapidly, and it was from there that care workers, or hospital workers contracted the virus, and then passed it on to care home residents, hospital patients and so on. But, in that case what an indictment of the welfare state, and of the NHS and those care homes that is.

Patients and residents are always at risk from infections brought in from outside. That is why, infection control always has to be a priority in such places, even though, as was seen by the number of deaths in NHS hospitals from MRSA, a few years ago, such control is often lacking. It is why, surgeons and so on, have to ensure sterile conditions in operating theatres and so on. As soon as it was known that the COVID19 virus was circulating, the appropriate measures should have been implemented in hospitals and care homes. They were not, and it is that which resulted in the large number of deaths, not whether lock downs were or were not introduced into wider society. 

In fact, by introducing the lock down regimes, things were made worse. For one thing, production, in some areas, shut down, people began to stockpile goods, communication and just in time systems began to break down, which meant that the ability to provide the resources required for responding to the virus were also disrupted. But, the focus on the implementation of lock downs, and the suggestion that everyone was equally at risk, distracted attention away from the reality that it was only the elderly that were actually at risk, and so prevented the focus from being on ensuring that the proper PPE, and procedures were implemented in hospitals and care homes. 

Instead, the media were more concerned with looking at people safely walking their dogs out in the Peak District, or who was driving where in breach of regulations, all of which was irrelevant to the massacre that was going on in those care homes. Lock downs, and concern over these kinds of activities simply acted as a form of sleight of hand, distracting attention from where the real action was. Even simple measures like wearing masks could have saved thousands of lives, but as it tried to make lock down the sole focus of activity, mask wearing was frowned upon, as not effective, and even the WHO originally argued against it. 

Care homes and hospitals should have been the places where shielding could and should have happened most effectively. That it didn't is not an argument in favour of lock downs as an alternative, it is an argument for hospitals and so on to be under workers ownership and control, so that such effective, collective action can be undertaken, organised by workers themselves. The same is true in relation to Martin's comments about blocks of flats. A block of flats is similar to a hospital or a care home. It is a building in which its residents can be collectively shielded, but also in which the family units can also be shielded, by simple measures of collective action, and democratic control. 

What solutions are appropriate in such conditions for a Marxist to put forward? The first question I would ask Martin, specifically is, whether he, and his comrades, had used the method of Marx and Engels, and their proposals for workers self-government, and creation of cooperatives, to establish a Tenants and Residents Association in the block of flats, and had sought to use it so as to exercise democratic control over them. That is a form of permanent mobilisation of workers for the purpose of self-management. It is also a means, under such conditions, to collectively pressurise the Council (or private landlords) to provide the necessary resources to ensure that the flats can be isolated from external contacts with the virus. Better still, a cooperatively owned and controlled block of flats would do that as a matter of routine. 

Again, lock downs are irrelevant to such collective and cooperative action, and if anything, by restricting production and distribution, make it more difficult. A Housing Cooperative, or a Tenants and Residents Committee could demand that the local Council provided resources to ensure that residents could be supplied with their groceries and so on, but even without that, the Cooperative or Tenants Committee could take on this function. A Cooperative or Tenants Committee, could even bulk buy provisions required by Tenants, so as to obtain better prices, for example. They could certainly ensure that all tenants could submit their requirements to them, and via collective provision, have them delivered to the tenant's door, thereby, obviating any need for them to come into contact with anyone who might be carrying the virus. 

A democratically controlled block of flats could deal with Martin's objection about the lift, by ensuring that a rota was established for its use, for anyone needing to go to work, and so on, or even just needing to go out for daily exercise. It could ensure a similar rota for the frequent disinfecting of lifts and stairways, and so on.  That is the way someone with a democratic and collectivist mindset would approach the problem, as against Martin's approach which can only see all of the tenants as individual units, and the only collective entity being the state at its national or local level.  It is the difference of approach of Marxism to that of statism, of a democratic, bottom up, activist approach, as against a top-down passive approach.  It is also the difference of approach of a revolutionary of creating new structures and property forms, based on workers self-government, that prefigure the society of tomorrow in the society of today, creating the dynamic of transition, as against the approach of the reformist who merely seeks to modify the structures and property forms of the existing society, so as to ameliorate the condition of the workers, and so necessarily locks them into a continuation of that existing society.

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