Why the UK CoVid-19 plan is destined to fail

Some on the political opposition will enjoy watching the government of Boris Johnson and Dominic Cummings struggle over the unfolding Covid-19 crisis. Others will profit from it. All the while, the threat of thousands losing their lives early beckons menacingly, when there was always a better plan in plain sight.

 

We were told several years ago by members of this government to not believe experts when it came to the big decisions like Brexit. Today, we are told to believe not just experts – but their experts. The problem with this government is that they refuse to taint their hands with other non-populist countries – so Britain, like America, stands out more for its inaction, miscommunication and miscalculation than simply doing the right thing.

Contrary to how many countries are reacting, having seen the scale of problems experienced in Italy, the Government is now refusing to release details of what their plans actually are. They are employing psychology and not the use of medical facts and deploying David Cameron’s shady ‘Nudge Unit’ to be the conduit to their success.

The term “Herd Immunity” is banded around by the government as if somehow this is a virus whose characteristics are well known. But they are not. Herd immunity is known to work on mass vaccination programmes but never with the management of deadly viruses. It type of worked with the black death and Spanish flu but by then, it was too late.

The rest of the world is taking a different stance and it might have bypassed the ‘experts’ in No10 Downing Street – but these other countries have scientific, medical and psychological experts too.

Oxford University’s Peter Drobac on the coronavirus action taken in the UK, compared to elsewhere is a simple message –  “The UK is really out on a limb here, and they are taking an approach which puts them alone in the world, I think it’s a gamble” (source). Imagine gambling with tens of thousands of your own people just to make a point.

Channel 4 News has surveyed almost 1000 NHS staff about CoVid-19 preparedness. They found that only 1% of medical staff working on our healthcare front-line feel that the NHS is coping with the outbreak – (source).

EU health ministers now have a daily conference call over the crisis – and Switzerland has joined them in order that they can coordinate their response to rapidly changing information. The UK has declined because that somehow would be seen as asking for assistance from the EU at a time of crisis. It feels like a Brexit thing. In other words – we know better and don’t need anyone’s help.

Community testing in the UK is not part of the current plan. Indeed, any community testing that got started has now stopped. This means that the full scale of cases in the UK is now unknown and that any other numbers that relate to the outbreak is utterly meaningless.

Dr Tedros Adhanom Ghebreyesus, WHO director-general has made his understanding of the UK’s position quite clear –  “The idea that countries should shift from containment to mitigation is wrong and dangerous.”

So far the USA, Spain, Czech Republic, Hungary, Denmark, Poland, Italy are either in a state of emergency or in lockdown. Middle-eastern countries are rapidly reacting with lock-down, border closures and restricted civilian movement. There are over 45 countries where schools and universities are closed along with public events.

So far, the UK has advised the public to wash their hands and it will be another week before public events such as football matches and the like are closed. This is because the British government wants the nation to be infected and then manage the numbers entering critical care.

 

“Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off”

 

Professor Ian Donaldson is a Psychologist and specialises in social & environmental research and behavioural factors in Anti-Microbial Resistance. He is Emeritus Professor, University of Liverpool. He is an expert who views this stragey as follows.

“The govt strategy on Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to. But it looks to me like the UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it. There are limited health resources so the aim is to manage the flow of the seriously ill to these.

The Italian model aims to stop the infection. The UK’s wants infection BUT of particular categories of people. The aim of the UK is to have as many lower-risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection. That’s herd immunity. Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that point, they want to reduce, but not stop infection rates. Ideally, they balance it so the numbers entering hospital equals the number leaving.

All the time people are being treated, other mildly ill people are recovering and the population grows a higher per cent of immune people who can’t infect. They can also return to work and keep things going normally – and go to the pubs. The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates need to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point, they close the schools. It is politically risky for them to say this. The same for large scale events – stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, and with a growing immune population. This is sustainable

After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the government is aiming for and could achieve. But a key issue during this process is the protection of those for whom the virus is fatal. It’s not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met – people do what they think they will. The Italian (and others) strategy is to stop as much infection as possible – or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So they will need to be relaxed. But that will lead to the re-emergence of infections.

Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It’s perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are – especially behavioural. Most encouraging, it’s way too clever for Boris Johnson to have had any role in developing it.”

 

This explanation helps a lot in trying to understand what the government is planning and it does ease the mind that this is indeed a plan and it’s a technical plan that might just work.

But this plan is also based on simply accepting that the over 65s are acceptable losses – just like cannon fodder against an unseen foe on the battlefield. And the fact that our youngest are to be used (unknowingly by their parents) in an experiment to gravely infect their own grandparents ensures that the moral case for this plan is destined to outright failure and it should have never been considered in the first case.

The former regional director of Public Health England has issued a furious condemnation what he described as the UK government’s “complacent” response to the coronavirus pandemic.

There is only one known way of defending an entire population of people from a highly contagious disease like coronavirus Covid-19.

South Korea has a population of 52 million living on a landmass of 100,000 sq km. England (not including Scotland, Wales, and Ireland who will develop their own strategies) has a population of 55 million living on a landmass of 130,000 sq km. Its capital city has 9.6 million people, London has 9 million. Both countries are highly industrialised. SK has a border on a large continent, Britain has the advantage of being an island. Both have significant shorelines and trading ports, both enjoy temperate climates (although SK is drier) not dissimilar to each other.

South Korea opened up drive through CoVid testing centres. 20,000 people a day are tested. You get a text if the test is negative or a call if positive. This is the highest testing rate per capita anywhere in the world. From just under a hundred centres and laboratories, these results come through within 24 hours. The whole network was up and running within 17 days of the first cases being reported. In fact, it was patient 31, who triggered SK’s response.

The fatality rate for coronavirus in South Korea is 0.7%. Globally the World Health Organization has reported at 3.4%.

The South Koreans were affected by the Mers outbreak and saw 36 of their own taken by it – and that was simply not acceptable. It forced the country to reassess its approach to infectious diseases.

And no-one really listened to Prof Kwon of SK, who said –  “To learn from the past and prepare systems in advance… that might be the true power to overcome this new kind of disaster.”

The big difference between the UK’s model of controlling the infection so it can handle the critical cases (mitigation model) and South Korea’s (containment model) is simple. Five times more people will die in the UK per million infected than they will in SK. One is an experiment, the other is based on experience, sound scientific expertise and most importantly preparedness.

Today, the penny has dropped. Nearly 250 scientists have accused the government of “risking many more lives than necessary” over its plan to tackle the coronavirus outbreak. The group of experts from a wide range of departments, including mathematical science, biology, pharmaceuticals, physics, zoology, employment law and economics have pointedly attacked the government that their plan will leave the nation suffering like Italy currently is. They accuse the government of taking the wrong strategy and that the herd immunity game plan is not just nonsense – its plain dangerous.

Political panic will evolve as Downing Street loses what they consider to be more important than anything – the narrative.

From 20 of Sunday’s top stories on Sky News, 17 were about CoVid-19. On the BBC it was 19 of 25 and ITV 26 out of 26 (leaving aside the weather reports). All the major newspapers are running headlines on the crisis without exception. If this outbreak goes wrong and people die needlessly – the government will pay dearly.

In the meantime, we understand that there are measures to speed up funerals in the UK which include: removing the need for jury inquests, enabling health professionals other than doctors to sign off cause of death certificates and doctors will not be required to see the body of the deceased. If this is true, it is confirmation of the significant failure of the British government to act in accordance with their objective – to keep us all safe.

 

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