From David Maughan Brown in York: A second wave, a second botched response

October 12th

The second wave of the coronavirus pandemic is now assertively with us in the UK, and the government of England, having apparently learnt nothing whatever from the experience of the first wave, is busy botching its response to the second wave just as badly.  For the past five days the media have been trailing a momentous speech that Boris was due to make in parliament today in response to the rapidly increasing number of infections and hospitalisations, to be followed by the news conference I can hear droning on in the background as I write.   Boris’s unique contribution to the history of governance – government via deliberate leaks to, and covert briefing of, the media – has saved everyone who pays any attention to said media the pain of having to watch him and hear him telling us what, well before this last weekend, we already knew to be coming up the track at us.   After six months of concentrated deliberation by the great minds in Downing St., they have had the bright idea of instituting the kind of tiered lockdown system successfully implemented in South Africa six months ago.  All that today’s grand announcement amounted to, apart from the predicted three-tier system, was the equally well trailed fact that Liverpool is destined to enter Tier 3 – the severest level of restriction, with no social mixing, no pubs open, etc. – on Wednesday, the only area to do so.

The government’s dilemmas as the pandemic threatens to get out of control again, which I don’t envy them, include:  how to balance the competing demands of public health and the economy; how to communicate the extent of the crisis to an increasingly sceptical public; how to establish an appropriate balance between centralised and regionalised decision making; and how to provide the necessary resources to combat the virus in terms both of equipment, person-power and an efficient test and trace system.  

At every level the response is being botched again.  Where the Public Health/Economy dilemma is concerned, the painfully obvious question to ask is, why on a Wednesday start covertly briefing about further restriction measures that won’t be formally announced until the following Monday and only implemented on the Wednesday?  That could only serve as an invitation to anyone who felt so inclined to spend the weekend doing his or her best to contract the virus, with only one possible outcome where the infection statistics are concerned.   And what conceivable logic can there be to introducing exactly the same restrictions for pubs etc. in the Tier 3 areas as in March, but reducing the financial support offered to employers to the point of making both the retention of staff, and meeting the costs of living for any staff who are retained, unviable?  Where communication is concerned, it is probably too late to simplify and improve the desperately poor communication of the past few months with any realistic hope that everyone will listen: too many people in England, in marked contrast to Scotland and Wales, no longer trust government.  After very belatedly waking up to the idea of consulting the leaders of the supposedly devolved regions in ‘the North’ (after already having decided what he intended to do), Boris claims that he now has the agreement of those leaders to his decisions: this, like so much else he says, is untrue, as evidenced by the intention of a group of them to bring legal action against the government for implementing the measures without providing adequate support.  The test and trace system is, in spite of Boris’s boasts and promises, still wholly inadequate – and must have had a part to play in the surge of new infections.  

Associating Boris with botching brought a distant echo to mind, which, when I thought about it, I realised came from very vague memories of reading stories about Billy Bunter (Boris Botcher/Billy Bunter), the corpulent clown of the Lower Fourth Form at Greyfriars School, when I was about ten years old.  For a very quick memory refresher I resorted to Google where one can find Wikipedia listing Billy Bunter’s chief characteristics besides his corpulence. He was, we are told: ‘obtuse, lazy, racist, … deceitful, slothful, self-important and conceited’ but combined these with a ‘cheery optimism’ and ‘comically transparent untruthfulness.’   It would be very unfair to imply that Boris is corpulent, given his partly successful efforts to reduce his weight after his hospital experience.

From David Maughan Brown in York: Insanity

24th September

Regular readers of our Covid2020diary blog will have noticed that Covid-19 testing or lack thereof has become a source of morbid fascination for me.  It’s like watching an incompetent clown trying to ride a unicycle round and round a circus ring, falling off in an ungainly and far from funny heap at regular intervals, but endlessly persisting in getting up and trying again in full view of a tent full of varyingly astonished, bored or increasingly angry spectators, some of whom have been unsuccessfully trying to boo him out of the ring ever since his first pratfall. The tragedy being that people’s loved ones go on dying outside the tent.

Our supposedly world-beating Test and Trace system is disintegrating, as was apparent from my entry a few days ago about people with coronavirus symptoms being sent hundreds of miles for a test.  Fewer that 28% of test results are being returned from the inaptly named centralised ‘Lighthouse’ laboratories within the targeted 24 hours.  Some are taking up to 8 days, with rumours circulating that some tests are being sent to USA (improbable) and some to Germany or Holland (much more likely) for processing.  Contact tracing is nowhere near the 95% efficiency that experts are saying is required if the virus is to be kept under control, but, unsurprisingly, contact tracing by local health authorities is proving much more successful than the centralised outsourced system favoured by government for purely ideological, rather than health-related, reasons.  Serco, a private company with no previous experience whatever in the field has recently had its £300 million contract renewed by government without any invitation for competitive bids being issued.  NHS hospitals that have been doing their own testing out of desperation to have their staff tested so that they can continue to work have been instructed not to conduct their own tests.  Boris is at it again, pulling a new numerical rabbit out of the top hat and promising that 500,000 tests a day will be achieved by the end of October.   Either he has forgotten, or thinks that we will have forgotten, that he pulled exactly the same rabbit out of exactly the same hat on July 17th.   Then he had over a hundred days to play with, now he has 36.  We are still only managing around 40% of his target and the rabbit is getting a bit long in the tooth.   It won’t be coincidental that the latest figures on infections show that we have just exceeded the highest number of Covid-19 infections across the UK ever.  Increases in the number of hospitalizations and deaths will follow inexorably.

Today the Chancellor of the Exchequer cancelled this year’s budget speech, making it clear that now is not the time to start thinking about how to fund the hundreds of billions that have been spent so far on Covid.  As the furlough scheme comes towards its scheduled end, Sunak also announced another, much less generous, job-support scheme that may help to stave off some of the impending redundancies, but he also accepted that many of the jobs the furlough scheme had been supporting have effectively disappeared and should no longer be funded.  A huge rise in unemployment is inevitable.  Morrison’s is rationing toilet paper again because people are starting to hoard it again.

Today we also learnt that one of the benefits of the Brexiteers’ promised Brexit-land is going to be a police-patrolled border, not between Northern Ireland and Ireland after all (or not yet), but between Kent and the rest of the UK.  In anticipation of the real possibility, acknowledged by government, of queues of up to 7000 heavy goods vehicles spending up to two days each queuing as they try to negotiate the customs and other hurdles involved from January 1st in getting across the 21 miles of the English Channel, lorries without the necessary paper-work are going to be stopped at the Kent border.  That is probably not what people thought was meant when they voted to ‘take control of our borders’.  Concreting over large swathes of the Kent countryside to accommodate 29 giant lorry-parks is apparently not considered likely to be adequate to accommodate the HGVs.  Perishable goods will perish.  Entirely undaunted by such mere details, our stately ship of fools sails determinedly on into the sunset.  Under no circumstances will our Brexiteer cabinet contemplate postponing the end of the Brexit transition period from January 1st 2021.  It has been entrenched in law, they say, ignoring the fact that if their parliamentary majority could see to its entrenchment it could presumably equally easily make sure that it is disentrenched. 

Add Covid-19 + Mass unemployment + an economy in deep recession + No deal Brexit, and how do you describe anyone who thinks the sum of the four makes a good enough mix to be even vaguely contemplable?  Perhaps as suffering from a “mental illness of such a severe nature that a person cannot distinguish fantasy from reality”?   That happens to be the first part of law.com’s definition of insanity.

From David Maughan Brown in York: The Crown and Cushion

September 21st

It has been an exquisite early autumn day: perfectly cloudless; the temperature in the low twenties (Centigrade); a light wind, with just the faintest edge of a hint that we had better make the most of the sun as it will not be anywhere near as welcoming for much longer.  Probably not beyond tomorrow, in fact, as another cold front is due to arrive on Wednesday.  Definitely a day to be celebrated by an escape into the North Yorkshire countryside, particularly as the cold front seems likely to arrive in the unwelcome company of another tightening of the lockdown screw.  Our Chief Medical Officer and Chief Scientific Adviser were due to perform a pas de deux in Downing Street, warning us about the exponential rise in Covid-19 infections, this time without the encumbrance of our scruffily inept Prime Minister but, even so, well worth avoiding. This can only mean that the latter is, once again, taking pre-emptive precautions to ensure that someone else can be blamed for what is about to go wrong

But why worry about that on such a beautiful day?  So we head for The Crown and Cushion at Welburn, near Castle Howard, an ‘award-winning’ pub where we can book an outside table, a scenic and leisurely 40 minute drive from our house. Provided, that is, one can avoid the perpetually coagulating stream of traffic along the A64 ‘main road’ by going through Strensall, Sheriff Hutton, and Bulmer.  But we are turned back by a pair of police people on the main street in Strensall, which is swarming with police cars and ambulances responding to an accident of some sort, and we have to go across Strensall common – feeling relieved that the military operations that prominent notices are warning us about appear not to be taking place – and join the A64 after all.  It occurs to me that the army may well be somewhere in the city being trained on how to police the lockdown, a possibility currently being leaked to the media.   As we drive, I find myself wondering aloud, as I probably do every year, what it is that determines the order in which the trees decide that it is time for their leaves to ‘turn’ and take on their autumn colours – horse-chestnuts first, then oaks, and so on.  The trees, once again, don’t divulge their secret.

The pub lunch lived up to its ‘award-winning’ standing in suitably leisurely fashion.  Leisurely for those doing the eating and drinking, that is; anything but leisurely for the three members of staff doing the serving.   The pub’s already extensive outdoor seating area has been extended further by cannibalising the corner of the car-park nearest to the back door.  For lunch-time on a Monday, with the weather as perfect as it was, there was no shortage of customers, most of whom appeared, like us, to be retired.   It was a good fifty yards from the back door to the furthest occupied table and I commented to the member of staff who was serving us that she must be keeping very fit.  She told me that last Friday her Fitbit had recorded more than 20,000 steps between the kitchen, bar and tables.   After traditional pub fare of beer-battered fish with chunky chips and mushy peas, for me, and steak and ale pie for Susan, we were intrigued by the names of the (inevitably ‘award-winning’) cheeses on the cheese-board – Stottie Goat’s cheese, Swaledale, The Duke of Wellington, Ewe Beauty, and Flatcapper Northern Brie – and decided that (with the possible exception of the worthy Duke) they would be more appropriate to a Yorkshire pub lunch than our usual ‘affogatos’, which were also on the menu.  

The lunch was excellent, the release from the endless news about our increasingly dysfunctional Test and Trace system was almost palpable, and I only found myself on one brief occasion wondering fleetingly how many of our fellow customers – only two of whom I saw wearing the face-masks we dutifully put on when we went into the building – would still be with us by next Spring if the dire warnings about the second spike are proved accurate.  When it came to paying the bill, I was pleasantly surprised to discover that The Crown and Cushion has extended its ‘Eat Out to Help Out’ £10 discount per person, scheduled to end at the end of August, all the way through September.  It seemed the least I could do to split the unexpected windfall with the staff by way of a compensation for the wear and tear on their footwear.

From David Vincent in Shrewsbury, UK: Corrigendum

On this my hundredth diary entry, I begin with a correction.  On August 7, I wrote: “It is generally accepted that the only way of ending the pandemic is the discovery of a vaccine and its manufacture and distribution on a global scale by multi-national drug companies.”  A day later, a study conducted by King’s College London and Ipsos Mori reported that only 53% of the British population was definitely or very likely to accept being vaccinated, whilst one in six said they would definitely be very unlikely to go ahead with such a treatment.

This finding is in fact very similar to a survey I discussed on July 6, based that time on a YouGov poll.   

At face, the finding is deeply depressing.  It suggests one of two things.  Either the community spirit that has carried us through is decaying just when it matters.  The widely-observed initial lockdown depended on an act of collective altruism.  Those unlikely to suffer greatly from an infection controlled their social lives on behalf of the elderly, and those with co-morbidities, who were much more vulnerable.  In the new study the young (16-24 and 25-34 year-olds) are twice as likely to refuse a vaccine as the old (55-75).

Or the proportion of the population prepared to disregard medical advice is much larger than we supposed.  It is not so much a matter of disputing a particular scientific finding.  There will always be argument about which remedy is most appropriate, even amongst researchers themselves.  Rather we are faced with a Trumpian disdain for science altogether as a mode of advancing the truth.  It is a wholesale rejection of the Enlightenment project, the notion that the natural world could be progressively understood through evidence-based rational discourse. 

There is, however, a caution against despair.  The opinion poll surveys are asking a hypothetical question.  There is no vaccine, merely encouraging reports of several clinical trials.  Conversely there are any number of bogus cures being widely discussed in books and online forums.  John Naughton in his Observer column on Sunday column traced in convincing detail how the algorithms on sites such as Amazon are promoting anti-vax literature with little to counter it.

As and when the vaccine is found, manufactured, and distributed to doctors’ surgeries, then the whole debate will shift.  Governments will stop issuing vaguely optimistic promises and get behind a determined programme of mass vaccination.  If it is seen to work not just in random trials but in real populations, the proportion of refuseniks will surely shrink to a marginal though possibly damaging fringe (at least in the UK; all bets are off in the States, whoever wins the presidential election).

It may be that the poll findings are not so much a cause as a reflection of a collapsed optimism.  I have been writing entries every weekday for nearly five months.  During that time public spirit has made a transition from panic contained by collective endeavour to weary disillusion with every aspect of the official effort.  We come to the end of the first period of the pandemic with the highest per capital death toll in Europe and the deepest projected economic recession.  Whether it is a second phase or a renewed surge, there appears no end in sight to the level of infections, which in England climbed back over a thousand at the weekend. No-one believes the assurances of any part of government, from face-masks to care homes to test and trace to reopening schools.  Dominic Cummings’ Flight to Durham in late March and subsequent non-apology in the Downing Street garden is held to mark the turning point in public confidence.  He’s still inside Number 10.  It will take a real vaccine, actually and widely available, before spirits change.

But by that time, we will be in the throes of Brexit.

Enjoy the rest of your summer.  I’m taking a break.   

From David Maughan Brown in York: In praise of the NHS

June 20th

Having rigorously shielded myself from the Covid-19 virus for three months,  adhering scrupulously to all government regulations about self-isolating and social distancing – give or take the ambiguity about whether or not it counted as two forms of exercise to ride a bike to the allotment – and having only darkened one set of doors, those of the cycle shop, other than our own in all that time, I found myself venturing not once but twice this week into the York Hospital, the one place in North Yorkshire I was most likely to encounter the virus.

The risk analysis didn’t involve the amount of time the above introduction might seem to imply.  Not a whole lot more, in fact, than it took to make the choice some ten years ago when my brilliant surgeon at the same hospital spelt out my choice prior to an entirely unrelated emergency operation:  “Look at it this way, if I don’t operate, you have an 85% chance of not being alive in 24 hours; if I do operate, your chances of not being alive tomorrow evening go down to about 15%.”  Not a difficult choice, and not a fragment of dialogue one is likely to forget in a hurry.   The occasion for my visits this time was my body’s decision last weekend to take it upon itself, fortunately very fleetingly, to let my brain know that it didn’t think the latter was paying it nearly enough attention, getting its message across by way of a first unwritten warning.  Direct and to the point like the surgeon, it momentarily cut off my brain’s blood supply, in a way vaguely reminiscent of the way our housemaster used to flick the dormitory light-switch off and on again to alert us to the fact that we needed to put books away before the lights went out.   I blame various combinations of Boris and Priti with the odd, very odd, Dominic or two thrown in for good measure.  Considering a visit to A&E a risk too far, and phoning 111 a waste of time, I followed the (wise) advice I would have been given 50 years ago: I took an aspirin and went to bed, deciding to phone the GPs’ surgery in the morning.

Over the course of a total of around six hours across two days, with abundant directions from random, but invariably helpful, hospital staff, I managed to find my way variously to the stroke clinic, the phlebotomy department, the X-ray department for ultra-sound and the diagnostic imaging department – all widely distributed along numerous intersecting corridors.  As I made my way around the hospital, dutifully wearing the face-covering my wife, Sue, had manufactured for me, I made a point of looking at the names on the doors I went past and listening to the accents of the people I spoke to and overheard:  German names, French names, South Asian names, Chinese names, and a variety of other East European names whose origins I couldn’t identify as well as British names. Unsurprisingly, I heard a similar range of accents from the nurses, cleaners and porters I encountered on my way.  

There was a three-hour interval on Friday afternoon after my 40 minutes in the MRI/MRA sardine scan before the specialist could see me, while she waited for the images to come through to the stroke clinic and the vascular surgeon to come out of an operating theatre to peruse them.  My iPhone was almost out of battery and I hadn’t taken anything to read, so I had three hours to sit in the waiting room, focus on what was going on around me and contemplate existence. It didn’t take much contemplation to arrive at the conclusion, yet again, that we are unbelievably lucky in UK to have the NHS, whose 72nd anniversary comes around in a fortnight.  Wherever I went in the hospital I encountered warmth and friendliness, and a high degree of competence and efficiency.   I had absolute confidence in the skill of the doctors I encountered, which is by no means automatically the case, and, having paid R11,000 for an MRI in Cape Town in November, it didn’t pass unnoticed that nobody asked me for a penny.   I was relieved at the end of the day when the conclusion was reached that the hiccup in the blood supply could be dealt with medicinally rather than needing surgery, but after my previous experience I would have had perfect confidence that, whoever at that hospital was wielding it, the scalpel would be in good hands.

Although the waiting room of a stroke clinic would no doubt be as good a place as any, and better than most, to have one, as I sat there I had very deliberately to avoid thinking too much about our current government in relation to the NHS.  For all their deceitful claims to the contrary, many of them would like nothing more than to see the NHS broken up and privatised so that they could profit from shareholdings and use our health services as a bargaining chip in their attempt to get their yearned-for trade deal with the US.  Many of them would also like nothing better than to see that rainbow collection of foreign names on the doors, to borrow Desmond Tutu’s analogy, replaced with Smiths and Browns, and all the intriguing and varied accents replaced with standard English ones.   Anyone who ever needed proof of this government’s utterly cynical attitude towards the NHS has only to look at its criminally long-delayed, and still largely useless, Test and Trace programme.  Having painstaking avoided utilising the NHS’s network of GP practices and our local Councils’ Public Health departments, which stood a good chance of success, in favour of its perennial, ideologically driven, commitment to shrink-the-State outsourcing, our government has the bare-faced cheek to duck its responsibility by labelling its dog’s breakfast of a programme with the NHS badge: ‘NHS Test and Trace.’  But best not spend too much time getting enraged by that, lest the senior housemaster in the sky switch the lights off without further warning.