Friday, March 27, 2020

Covid-19, the press and the government

The British people have been seriously let down during the current pandemic by the dithering of the Government and its reluctance to take decisive action earlier. This indecisiveness will undoubtedly cost lives. And, whilst it may seem that this was more a consequence of the speed with which the crisis developed than any malignant intent on the part of the Tory Government, that is a very generous interpretation of events. 

The Government adopted, and continue to adopt a strategy, which runs counter to the best scientific advice. They have been supported in this cavalier attitude to your life by their own scientific advisers but mainly by a compliant press corps who still see their main function as providing cover for the inadequacies of the people they worked so hard to put into Government. 

Whether the real scandal is that people will die, including health workers, as a result of the Government failing to act appropriately. Or, that the British people have been kept in the dark about much of what is happening by a press corps, particularly the Westminster pack, who have resorted to lying for the Government in order to hide their inadequacies, depends on your perspective. 

The fact that most news organisations have continued to treat this public health crisis as a political rather than scientific story tells us much about the status of science in our society. 

At the time of writing (Fiday 27th) the coronavirus has been responsible for 25,427 deaths worldwide, including 578 in the UK. The virus is active in virtually every country of the World, meaning that there is literally no hiding place. The largest number of deaths, so far, have been in Italy (8,215), Spain (4,934), China (3,292), Iran (2,378), and France (1,696). South Korea which was hit by the virus shortly after China, from where it emanated, has had 139 deaths. It is interesting that countries in Europe, Germany has also had 304 deaths to date, seem to be coping so badly with a pandemic they should have been prepared for.

As others have pointed out this is a failure of neo-liberal economics, and the policies of austerity imposed and supported by the World Bank, the European Community, and nowhere more enthusiastically than by the Tory Governments of the UK since 2010. Whether it is, as some have suggested, the end of neo-liberalism we have yet to see. Too many people, but particularly the Government and big business, just want this over with so they can get back to life as normal. Even those without a political interest in maintaining the status quo are talking of taking to the streets to party rather than demand a settlement that protects us from the next virus. 

At the moment Johnson and his government are enjoying something of a honeymoon period in terms of public support. Of course, people are criticising aspects of the ‘lockdown’, definitions of essential workers, and lack of financial support for some workers, but overall Johnson’s poll ratings remain high. He is not seen, by the general public, as responsible for the virus which, to be fair, would have presented a considerable challenge for any Prime Minister.

Whether this public support will be maintained as the death rate rises and the lockdown is potentially extended into and beyond the summer is still to be seen. Though the fact that he has tested positive for the virus will play well for him with the public, who rather than seeing him as having been reckless with both his own health and ours will see him as a heroic sufferer, a role that will be popularised through the normal channels.

One thing that Johnson and his henchmen can rely upon is that the press, particularly the Westminster lobby, will continue to provide him with cover. It really is incredible that so-called journalists some three months into a pandemic seem to have developed so little actual knowledge of either the disease or the way in which it is being dealt with elsewhere. 

I would have thought that it was the job of any self-respecting journalist to prepare for briefings. That might be expected to consist of rather more than having a coffee with a minister to get the inside track, and actually doing a little bit of independent reading. The public are certainly being let down in a major way by the politicians who are supposed to protect their interests but they are also being let down by a press corps who are failing in their duty to hold those politicians to account.

Now it might be said that given my antipathy to the Government and my previously expressed frustrations at the press, this is exactly what I might be expected to say. It is worth reminding ourselves how this crisis has developed and how Governments across Europe, but particularly the UK because that is where I live, have reacted. 

Let’s be clear this crisis has occurred relatively quickly, but nonetheless, it was first identified as a potential pandemic by the World Health Organisation, on January 10th 2020. In other words, the UK Government have had over 3 months to prepare. Moreover, they have had access to both the gene sequence and the good practice provided by Chinese researchers since January 12th. At that stage, the disease was clearly viewed as something happening overseas. In short, they did very little because they didn’t expect it to get here.

As the virus hit China domestic issues dominated
At a time when the Government could have been making preparations they were focused only on domestic issues. By February 15th The WHO were calling on Governments everywhere to start preparing for what was coming. Our Government did nothing constructive at all. Indeed, Boris Johnson joked about the virus and refused to engage with the scientific evidence as it emerged. 

Allegedly, according to Politico website, during a conference call with 60 British manufacturers which took place on March 10th, about securing more ventilators Johnson said that the task of building more desperately needed ventilators could be known as ‘operation last gasp’.  It’s not the funniest joke of all time and was stupid and insensitive, but it is typical of Johnson’s attitude to politics and life generally. It is easy to be flippant when virtually everything you have has been handed to you on a plate.

If by early March the Government was preparing to take fairly drastic action it had already wasted as Richard Horton, Editor of The Lancet, has pointed out the whole of February. On February 27th The WHO issued a list of 9 questions for Governments. They included questions about dealing with the first case, having vital equipment (including ventilators), ensuring health workers had protective equipment and the training to use it, and the knowledge and capacity to deal with the number of cases that were likely to occur.  

It is now March 27th, a complete month later, and the answers to some of those questions are still not known. That can only be described as a dereliction of duty. I am not saying that there was nothing happening in February at all, but it was not happening at Governmental level, where the policy can best be summed up as a state of denial. As Richard Horton writes in this week’s Lancet:

February should have been used to expand coronavirus testing capacity, ensure the distribution of WHO-approved PPE, and establish training programmes and guidelines to protect NHS staff. They didn't take any of those actions. The result has been chaos and panic across the NHS. Patients will die unnecessarily. NHS staff will die unnecessarily. It is, indeed, as one health worker wrote last week, “a national scandal”. The gravity of that scandal has yet to be understood.
Moreover, given this list of questions was publicly available it is absolutely incredible that Peston, Kuennsberg et al did not raise these questions at every opportunity, but then that would have meant lifing their heads out of the Westminster trough for long enough to actually act like journalists. Far easier to simply repeat whatever inane briefing was fed to them for the day.

As one minor example of how poor these “award winning” journalists are, when the UK Government committed its U-turn on March 16th Laura Kuenssberg justified it on the main BBC News by saying that “the science had changed”. That was simply untrue. 

There had been no change at all in either the science or the advice coming from the WHO about what needed to be done. What had happened was that Imperial College had modelled the science and come up with a figure. 

The UK press dutifully report the changing science
Something that they could have done weeks before, and something, in fact, that may or may not turn out to be either an over or under-estimate of the actual death rate. For the BBC to keep repeating the lie that “the science has changed” is not just misleading it turns them into government propagandists not independent journalists capable of holding the government to account.

We now know that we do not have enough ventilators, that health workers lack the equipment they need, that we have woefully inadequate supplies of test kits, that we are likely to very quickly run out of critical care beds and that the information being given to the public has been confused and ambiguous. 

As for procedures to deal with an infectious disease, I have a unique insight into this. I was in hospital from February 11th until March 18th. Early in that time I found myself in a ward with a man who had flu. I saw first hand the lack of adequate procedures for dealing with flu, an infectious disease don’t forget, let alone Covid-19 for which there is currently no vaccine. 

It was clear that the hospital had no isolation room available (I was left in a ward with somebody with an infectious disease for three days), that the procedures changed from shift to shift largely dependent on how averse the nurse was to catching flu themselves. I knew that Covid-19 was on its way and raised the issue with a doctor that if they couldn’t cope with one patient with flu, how on earth were they going to cope with a major epidemic? I can’t say I received a very expansive answer and many of the health professionals clearly did not believe that the virus was coming their way. This, in part, was because there appeared to be no urgency at Governmental level and as Richard Horton notes no planning or training.

One of these men is elected, the other is running the
country
What the Government, and their advisers could have done was study very carefully what was happening elsewhere. This would have required members of the Johnson entourage, particularly the odious but highly influential Dominic Cummings to remove their heads from their own rectums for long enough to realise that ideological purity had no answers. That an Eton education alone does not give you all the answers. They needed to do something they remain reluctant to do and that is listen to people who actually know what they are talking about. Until March 15th their policy was the unscientific and highly dangerous ‘herd immunity’ strategy which had been attempted in Italy. 
Italy’s death rate started to rise exponentially throughout February after a period in which they had failed to act decisively. Their first Covid-19 death was on February 21st. At first they did very little, much like the UK authorities. A policy that was based more on hope than science. Moreover, a policy that was driven by keeping the Italian economy running not protecting the workers who are the backbone of that economy. After 10 days the death rate had risen to 52, after 17 days it was 463, reaching 1,441 on March 14th. It continues to rise and at the time of writing it is 8,215. 
Italy should be of great interest to the UK because it is a country with roughly the same population. It is also close enough to us that it does not appear, like China say, a distant and strange place. People in this country go on holiday to Italy, many of us have Italian friends or neighbours, we have established sporting rivalries. Indeed, we have far more that binds us to Italy than divides us. Despite what some Brexiteers (remember that?) would have you believe. 
The Coronavirus is like a storm moving across continents. You can be sure it is coming your way and you can be sure it will reach you having already visited all your near neighbours. What you can’t be sure of is exactly when it will arrive. The UK was somewhat behind Italy. Given that it makes sense to start battoning down the hatches as soon as you hear about it. 
Our first Covid-19 death was on March 5th. Nine days later Covid-19 had claimed 55 lives, and after 18 days that figure had risen to 465. Very similar to Italy. Indeed, uncannily like Italy. Today (Friday) the number of UK deaths stand at 578, having risen by 113 in 24 hours. This is much the same pattern as was seen in Italy, Spain and is also now happening in the USA. 
There is not a unique and clever way of combatting Covid-19. It is highly contagious regardless of where you are and how good you might think your health system is relevant to others. The advice to contain it has always been the same, no change of science, just good advice being ignored. 
Jenny Harris, spreading misinformation fir the government
Jenny Harries, one of the Government’s advisers and Deputy Chief Medical Officer, said on Thursday evening in relation to the WHO’s urging to ‘test, test, test’ that the UK was not the same as other countries. Her claim that “They are addressing every country, including low and middle income countries” seems absurd and it is also untrue. The claim is that the UK does not have the same public health systems as other countries. That is true, the majority of developed countries have better health systems than we do.
I have studied the World Health Organisation advice very carefully. They do not distinguish between countries based on wealth or income. Indeed, they have been urging a rigorous testing regime since February. To  claim that the WHO advice does not apply to the UK based on the spurious claim that our health system is better prepared is not only wrong it is dangerous. And, it shows how the scientists flanking the PM see, at least part of their role, as justifying the inactivity of the government rather than protecting the citizens of this country.
In terms of the claim that our health service is somehow better prepared than elsewhere it is worth noting that in common with most of Europe we have spent the past 10 years, possibly more, chipping away at the NHS. The goal has always been to privatise the profitable parts, hand the funding to insurance companies and to leave a charity sector to mop up the rest. 
That this policy of slash and burn has been enthusiastically adopted by the UK Government can be seen by how much we spend, relative to others on our system. If you use percentage of GDP the UK is 10th among 32 countries in Europe. We invest 9.7% behind Switzerland (12.3%) or France (11.5%). Also behind Germany, Sweden, Denmark and Belgium. Who are we above? Italy (8.9%) and Spain (9%) both in the epicentre of the Covid crisis.
It is not just GDP which, to be fair, means nothing to most people, but more significantly the spending per head of population. Now unless you happen to believe that you are worth less than German, French or Irish citizens, or that healthcare is not worth spending on, you should feel angry at the way that successive governments have been allowed to get away with this.
In terms of per person spending the UK comes in a dismal 16th out of 32 countries. The UK spends just €3,566 per person. This compares to €4,271 in Germany, €4,242 in Ireland or €3,847 in France. These figures are not accidents but part of a deliberate policy to reduce public spending of which in the UK the NHS takes £129 billion per year.
In January 2019 the National Audit Office (NAO) said that “Spending in [areas of the Department of Health’s budget aside from the NHS] could affect the NHS’s ability to deliver the priorities of the long-term plan, especially if funding for these areas reduces. It also said “There is a risk that the NHS will be unable to use the extra funding optimally because of staff shortages.”
In other words, even before this current crisis the NHS was facing staff shortages and reduced spending. My own recent stay in hospital was revealing. On most shifts it was obvious that there was a shortage of nursing staff. Very often staff were overwhelmed by the demands on them and often agency nurses who barely knew the ward or how to use some of the equipment were plugging the gaps. Given that the NHS is, by design, underfunded it is hardly surprising that they had not stockpiled masks, or sanitiser, let alone ventilators. Yet, since 2002 epidemiologists and virologists (again people who actually know what they are talking about) have been warning that a pandemic was imminent.
As the New York Times editorial put it on February 29th:
Back in 2002, when the SARS virus made its fateful leap from bats to civet cats to humans, global health experts warned that the ensuing outbreak was a harbinger of things to come: Climate change and globalization were conspiring with an array of other forces to make it much easier for old animal diseases to morph into new human ones. It was only a matter of time before one of those diseases proved truly catastrophic. The world could avert the worst consequences if it started planning.
Yet SARS was contained and it was business as usual for those who dominate our political life. In the UK successive governments have obfuscated about the amount spent on the NHS. But, you don’t have to be involved with the NHS for long to realise that if it was indeed true that huge sums were being spent on the NHS that the money was neither going to staff (remember stories of nurses needing food banks?) nor frontline services.
One way in which extra monies were spent was by transferring them to large multinational (Tory donating) pharmaceutical companies. Another story from my own recent sojourn in hospital. When the flu outbreak occurred in my ward I was given Tamiflu a drug produced by Roche. Never having heard of this I looked it up to see whether I could trust it. 
I found out that Tamiflu had been bought in massive amounts by the NHS in preparation for a flu pandemic. A Cochrane Review, which is a review of all the studies on a drug or procedure, was carried out and published in 2014. The bottom line was that the £424 million spent on Tamiflu could have been saved since the drug was actually no more effective at stopping flu than over the counter paracetamol. 
The British Medical Journal reported recently that a regular contributor to the BMJ, Tom Jefferson was suing Roche for falsely claiming that Tamiflu could stop a pandemic. I did my bit to clear some of that stockpile by taking it for 10 days and although I never got flu, I was never going to. 
NHS Heroes are being let down by government
During this pandemic we have been quick to condemn ordinary people who have panicked, but those who are a real drain on our resources are not people taking 10 packs of toilet rolls but large multinationals who have too close a relationship with the architects of a system which seeks to both undermine and rip off our NHS. And, to come full circle, how do they get away with this? Journalists who should be scrutinising government, who should be providing us with international comparisons, who should ask questions of politicians have become merely mouthpieces for government repeating briefings as fact and, as we have seen lying to cover their mistakes.
In normal times, the too cosy relationship between broadcast and national print journalists and the Conservative Party is scandalous. Right now it is dangerous to all of us. There has been no proper analysis of what happened in a Italy because to do so would expose the Government to criticism that it is desperate to avoid.
According to Wired Magazine it was a failure to realise that the virus could be present in people who were not showing symptoms but were circulating freely that is the root of the current situation throughout Italy. At the moment, it looks like the outbreak started in early January, so it had time to grow to a considerable size,” says Christian Althaus, a computational epidemiologist at the University of Bern.  And, what was happening here during February?
In other words, the Governments decision not to isolate and suppress the virus earlier allowed the virus the freedom to circulate among the healthy population and find its way to the most vulnerable. By the time, Italy instituted a lockdown, it was too late. The opportunity had been missed. Sadly, it looks as though the very same strategy was adopted by the UK government. We do not know yet whether the results will be the same, but the signs are ominous. And, the Government and the media must accept their share of the blame.

1 comment:

  1. Hi Dave.

    Yes, you were spot on. I was interested, very interested in this article.

    There is something about the written word, as opposed to say video and audio journalism, commentary and opinion that can make it, if well practised, a visceral experience for the audience.

    Whether it is our inner monologue, always telling us how it 'should be' that instantly compares itself with what we are reading. Maybe it is the skill of the writer to be able to 'poke' us with pointed facts that make us feel something in response. Perhaps it is simply that unlike other media it is self contained, the experience is really all happening within us to make it very, very personal and therefore real for us.

    I wouldn't like to come down on the side of any of those individually or collectively. What I do know is when I read:

    'At the time of writing (Fiday (sic) 27th) the coronavirus has been responsible for 25,427 deaths worldwide, including 578 in the UK.'

    It instantly took me back in time. I felt myself exhaling and could feel my stomach tighten with anxiety. This was not just because I know that we would have taken those numbers as a final result right then knowing what we now know or because of the pain and suffering that would continue upwards for the entire world. No, it was, selfishly, because my wife, Laura, was one of the nursing staff on the Covid ward in Stafford hospital from day one.

    It has been an exhausting time since then for her. However, the one thing that your writing took me straight to was the memory of a veteran of the NHS for 16 years, coming home and breaking down because there was nothing she could do for patients that were going to die and in the most horrible of circumstance.

    Those that deal with the tragic circumstances leading to death and the aftermath are obviously affected by it. However, over time, they learn to manage it. Seeing committed and seasoned practitioners of care having to find a whole new resistance, a new method of 'keeping it together' because they didn't have the tools or support they needed to help those in their care was almost unbearable.

    I thank you for helping me connect with those feelings again. I can be guilty of getting a bit too 'comfortable' with certain aspects of the way we organise our society. Sometimes that is simply because I am unable to corral all the different aspects of where the majority of us are being exploited and abused. If I am honest, sometimes it is because I feel exhausted by it.

    I may have that luxury because, for the moment, there's a roof over my families heads, we have just enough money to cover the bills and I have a family that love me. Not everybody does and I need reminding of that, everyday.

    For me, it would require an exceptional piece of videography or an audio podcast or TV documentary to evoke those feelings. Your writing managed that by the fifth paragraph!

    I read the whole article and wanted to comment on so much. There's more diigo highlighter than there is article by this point! When you talk about the claims of minor pilfering within the NHS and how that is headline news, that set my hair alight. However, there's not a peep about corporations that are not just buddy buddy with the those that create a 'trading' system but are essentially party to the creation of it, my hair was truly aflame. Of course, this 'arrangement' was an agenda to allow for the public to be ripped off. Then my hair was not just on fire but had gone up in a puff of smoke.

    Thanks, Dave. This piece has done what any good factual writing should do for me. It provided information, based on facts that can all be established. There's analysis that is logical, interesting and compelling. Above all, it was human. It made me feel something, a great deal in fact. Couple that with my own thoughts and it creates that visceral sensation to compliment the thoughts I referred to at the top.

    Thanks again, Dave.

    Dave

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Many thanks for reading this post and for commenting.