COVID-19 in Great Britain and Northern Ireland

Introduction

Fig 1. Confused messaging (ref)

The overall HMG response to the Covid-19 pandemic has been flatfooted, slow and confusing. Mixed messages have been given as in Fig. 1. This video from Joe.uk shows total inconsistency from PM Johnson. This mixed messaging has the potential of being disastrous. According to Sonia Sodha: Media experts despair at Boris Johnson’s coronavirus campaign.

Warnings from Italy have been ignored. The belief than the NHS is the best health system in the world and that it couldn’t happen here are ill-founded. In a recent Lancet Study the NHS was ranked in 30th place, well behind Italy on 12th. Warnings from China were dismissed despite the fact that President Xi Jinping phoned PM Johnson personally on the 18th Feb to warn of necessary virus control measures.

Only a week ago Herd Immunity was being pushed as a strategy. While other similar countries in Europe were putting in various social distancing communication strategies and isolation measures, the UK was very slow to act and it was not till the 23 March decisive measures were taken.

As Charles Adams has previously discussed on this blog, the rate of exponential growth of Covid-19 cases is staggering. The speed at which it can overwhelm the country is unprecedented for over a century. The 1918 so-called Spanish ‘flu (it was probably American) was the last pandemic on this scale. It killed an estimated 50-100M people including President Trump’s grandfather.

Though it is undoubtedly true that all countries should have reacted earlier, the UK has been an outlier in Europe almost to the extent of being an international pariah. The US response has also been chaotic.

For Northern Ireland, preparedness is considerably worse than for Great Britain. The NI NHS was badly overstretched already and the critical care base very low. Health is a devolved competence and depressingly sectarian instincts have informed policy. HMG decision making has been determined by GB-specific factors which may be entirely inappropriate for NI.

Why has the UK response been so dismal? There are a number of theories.

There are strands from Behavioural Science, British Exceptionalism, cold callousness and herd immunity, philosophical inability and disaster capitalism, which need to go into the mix. These will be examined in turn. The specific problems for NI will then be discussed. Finally, conclusions will be drawn.

Behavioural Science

The official line is that the UK response has been based to a large extent on Behavioural Science. Too early a lockdown will cause people to get bored and to ignore social distancing guidelines just at the time the epidemic is hitting its peak. Better shutting down later rather than risking people ignoring guidelines later.

This may have made sense if the guidance from the epidemiologists was correct and that fatalities would be similar to seasonal or even pandemic ‘flu. This, however, seems to have been a major miscalculation and only possible because of British Exceptionalism.

British Exceptionalism

British Exceptionalism was, of course, very evident throughout Brexit, not only during the referendum campaign but has continued ever since. Believe in Britain!

A classic of the genre is this tweet from Sir Christopher Meyer (former Ambassador to the US).

Fig 2. Showcase tweet on British Exceptionalism

The sheer hubris, arrogance, stupidity and contempt for other nations is staggering.

HMG ignored international advice, preferring its own small circle of experts. The drive to show that Britain is a world leader is an imperative in the post-Brexit world.

The New Statesman article: The United Kingdom is flying blind on Covid-19 sums up the pig-headed dismissal of international advice and data:

The British government did not listen. We had two months to get prepared for large-scale tests in the population, contact tracing and quarantine, to be like Guangzhou rather than Wuhan. Yet the advisory committee, comprising clinical knights of the realm, virologists, mathematical modellers, and behavioural scientists led by a former director of David Cameron’s Behavioural Nudge Unit, decided British science knew best.

No matter how brilliant or elegant the models are, results are only as good as the underlying assumptions and the accuracy to which various key parameters are known. Peer review and disseminating the models widely is essential. The complexity of such models is normally so great that even the most brilliant can miss something.

In the case of Covid-19, there are so many unknowns such as R0, the average number of people a carrier can infect. Estimates vary from 2.2 to 6.6, with 3 being a likely figure without social distancing. As Prof Hugh Montgomery explains in this video it makes Covid-19 far more dangerous than normal ‘flu.

The overall mortality rate is also unknown. While the WHO figure is 3.4%, it may well be that many cases are so mild as to be essentially asymptomatic and the true figure may be around 1%. Can asymptomatic people spread the infection? It seems so and I highly recommend How the Coronavirus Could Take Over Your Body (Before You Ever Feel It) by Jeff Wise. The incubation period (how long it takes from catching Covid till the time symptoms occur) is also unknown, but maybe around 10 days.

An interactive epidemic calculator is shown in Fig 3. Outcomes vary widely depending on parameter assumptions and I highly recommend spending a few minutes trying various scenarios.

Fig 3 Epidemic calculator. Click on image to use interactively

According to the Byline Times article by Nafeez Ahmed, Prof Neil Ferguson head of the Imperial College epidemiology group advising HMG admitted that some of the key assumptions made by the Imperial College (IC) team were wrong.

[The] model assumptions were written more than 13 years ago and based on the specific dynamics of a flu pandemic. In other words: the model was not calibrated for COVID-19 and failed to sufficiently incorporate new relevant data.

I’m sure the IC group is very good, but even within the UK, there are a number of excellent epidemiology groups. Had the model been peer-reviewed such errors could and very likely would have been caught earlier.

Cold Callousness and Herd Immunity

It seems the Sunday Times (22 March) confirms that the herd immunity strategy originated from Dominic Cummings (article behind a paywall). As Richard Murphy has written on his blog: There is a choice on coronavirus: we can save people or the economy but not both, and the government is choosing the economy.

Extract from Sunday Times article (22/03/20)

It seems that only when “some pensioners” turned out to be potentially hundreds of thousands the strategy was dropped as being too politically damaging. Alternatively, as reported in Libération, it was only after France’s Macron threatened UK entry ban without more stringent measures that he acted and introduced distancing measures.

Has the “Herd Immunity” strategy really been dropped? Testing is still at an abysmally low rate. It is also the strange there has been no social media campaign to explain the new social distancing strategy. From True Republica:

There was a Herculean effort to drag Brexit across the line in 2016. It involved the efforts and money of billionaires, hedge fund managers, corporate leaders and some seriously dodgy Russian characters. It involved front charities, think tanks and dark money from America. It involved military perfected systems designed for the battlefield to win ‘hearts and minds’, specific technologies, algorithms and the world’s largest social media giant to wage a war against British democracy.

And yet, our government, in the face of a true crisis hasn’t run a single advert about coronavirus from its official Facebook or Instagram accounts. Or the PM’s official account. Or Boris Johnson’s personal account. And this is despite being offered millions in free ad credits by Facebook. The herd immunity programme has not really been abandoned, has it?

Philosophical Inability to handle the Crisis

The current populist government seem unable to judge risk. The current HMG consists of people who “Believe in Brexit” and seem incapable of objective judgement. Their approach is that of Newt Gingrich’swhat people feel about an issue is more important than what the actual facts behind the issue are“.

As George Monbiot has written in the Guardian: Our politics isn’t designed to protect the public from Covid-19.

The worst possible people are in charge at the worst possible time. In the UK, the US and Australia, the politics of the governing parties have been built on the dismissal and denial of risk. Just as these politics have delayed the necessary responses to climate breakdown, ecological collapse, air and water pollution, obesity and consumer debt, so they appear to have delayed the effective containment of Covid-19.

and

The theory on which this form of government is founded can seem plausible and logically consistent. Then reality hits, and we find ourselves in the worst place from which to respond to crisis, with governments that have an ingrained disregard for public safety and a reflexive resort to denial. When disasters arrive, its exponents find themselves wandering nonplussed through the wastelands, unable to reconcile what they see with what they believe.

This indeed seems to be where we are, compounded by the fact that we have the least talented Cabinet for a generation, one whose only criterion for appointment is “Belief in Brexit” rather than any capability of doing the job.

Disaster Capitalism

Some of the Tory Pary’s major backers have made fortunes on the back of the Covid-19 crisis. Crispin Odey, for example, made £115 million from this month’s coronavirus stock market crash.

Uncertainty is key. In this analysis, the mixed messaging and incompetence of HMG was deliberate and the fact that thousands of pensioners would die as a result, mere collateral damage.

It is possible that I am being cynical about the Tories but as Nye Bevan famously saidSo far as I am concerned they are lower than vermin” and “They have not changed, or if they have they are slightly worse.”

As a general rule, it’s recommended never to attribute to malice that which can be explained by incompetence, but with the Tories one does, sometimes, have to wonder.

Northern Ireland Specific Factors

Northern Ireland is the only part of the UK that shares a land border with the EU. It has two dominant communities: Nationalist and Unionist. The Nationalist Community historically looks towards Dublin for a lead, the Unionist towards London.

The Nationalist community is overwhelmingly pro-EU and anti Brexit. Faith in London was at an all-time low even before Covid-19 struck. Nationalists didn’t understand why London was so far out of line with international guidance and in any case have no confidence in HMG.

Unionists, as usual, were being “More British than the British Themselves” and were desperate to believe in HMG’s approach. Many have an exceptionalism which would make Sir Christopher Meyer proud (Fig. 2). One may have thought their faith would be dented by the introduction of an “Irish Sea Border“, but this seems to have made them even keener to show their loyalty to HMG and the Tories.

The fundamental difference between the two communities has caused major tension in the past few weeks. Dublin has been much faster to act in response to the pandemic than London, despite the fact that it has a caretaker government rather than one with a large majority. Varadkar’s handling of the crisis has been widely praised, in total contrast to Johnson.

There is no question that the Dublin approach, though by no means perfect (it too should have reacted far earlier), was far superior to that of London and very much based on international advice from the EU and WHO.

Nationalists were pushing for an all-island approach, which to me makes absolute sense, given the totally open border. The island is already treated as a single epidemiological unit for for plants and animals with common Sanitary and Phytosanitary Measures.

When schools “south” of the border were shut, immense pressure was put on both Sinn Féin and the SDLP from the Nationalist community to do the same. Rather than any understanding from the hard-line Unionists, headlines such as Nationalists for political ends tried to overturn measured advice to schools on coronavirus appeared in the fiercely pro-Union News Letter seem to indicate panic and desperation in the Unionist community.

Hopefully, now that measures are very similar on both sides of the border tensions will decrease and a joint approach can and will be taken.

State of the NI and IE Helth Services Ventilators

It seems all the rage to praise the NHS and look at the IE Health System as a poor cousin. The above mentioned Lancet Study, however, ranks the IE system in 13th place well above the 30th placed UK.

In addition, the NI health service is on its knees. Waiting lists are a total disgrace as opposed to England and Wales as illustrated in Fig 4.

Fig. 4 NI wasting lists as compared to England and Wales.

In terms of ventilators which will be of crucial importance in saving lives, NI has only 139 ventilators with 40 on order (though some of the Dyson ventilators may be earmarked for NI ), whereas there are 1,229 ventilators in the “South” now plus 900 ventilators ordered. This is 12x the provision with only c 2.5x the population.

Ireland, of course, had the advantage that one of the worlds largest and most widely respected manufactures of ventilators, Medtronic, which is based in Galway. They are unsurprisingly ramping up production to 24/7 operation.

Testing

In terms of testing, Ireland is ramping up the number of tests to South Korean levels and converting Naval Ships and sports stadia such as Croke Park (Dublin) and Páirc Uí Chaoimh (Cork). Best WHO practice of identifying victims, isolation and contact tracing is being used.

The approach in GB and NI seems to assume that Covid-19 is so rampant that the horse has bolted and this strategy will not work. Testing is at very low levels and there are anecdotal stories of sick frontline medical staff who remain untested.

This may well be the case for London, but probably not so for NI, Scotland, Wales and some remoter parts of England such as Northumberland.

It seems that British Exceptionalism is again a factor. There seems an attitude that the WHO is just for poor countries and “we know better”.

Conclusions

HMG seemed totally unprepared. It used to produce a National Risk Register of Civil Emergencies. This stopped in 2017 presumably because HMG devoted all available resources to Brexit. Each and every edition of the Register had pandemic flu as the most probable and devastating threat to the UK. The government knew it would likely happen and that it had cataclysmic potential.

The “exceptionalist” approach of HMG was a combination of a variety of factors. I suspect primarily the need to show the world that British exceptionalism was indeed real – that the UK was truly World-Leading. This seems to have backfired, first in needing to get into line with the rest of the world, second in the higher cost it will surely entail, both in lives and economic impact.

It may even prove disastrous. Again from the Byline Times article by Nafeez Ahmed:

My back-of-the-envelope projections suggested that the Government’s refusal to attempt to slow and curtail the spread of the virus could lead to as many as 458,752 deaths – possibly as high as 1.6 million in an absolute worst-case ‘do nothing’ scenario.

We need to hope and pray that this is not the case. If the truth is remotely like this it makes the Brexit miscalculation seem minor by comparison.

Another very worrying issue that, as Peter May has written, obesity seems to significantly increase susceptibility to Covid-19. The UK with a 28.1% obesity rate is one of the highest in Europe. Italy’s rate is 21%. The US on 33.7% is even worse.

The way the epidemic may play out is outlined in this excellent article by Tomas Pueyo: Coronavirus: The Hammer and the Dance. It seems that the WHO may know what it is doing after all.

We will not know for some months, but within the next few weeks, the UK could have a higher death toll than Italy. Covid-19 may well be rampant in the UK population and the official number of infections (8,264 at 9am 26th March) may be a vast underestimate as testing levels are very low.

Ireland which has much higher testing levels has 1,564 cases with 1/14 of the population. IE has only reported 9 deaths but the UK 435. This corresponds to a c 5% death rate in the UK but a less than 1% death rate in IE. The likely explanation is that far more people in the UK are infected than the official figure indicates.

There is a very useful dashboard from Johns Hopkins University shown in Fig. 5. this is interactive, click on the figure to open. (For a quick summary statistics of the situation in the US see https://covidtracking.com/data — a site created by open source software developers and journalists to attempt to remedy the CDC’s inability to collate and share data, purportedly as result of Trump administration cutbacks).

Fig. 5. COVID-19 Global Cases by the CSSE at Johns Hopkins University. Click on image for interactive map.

There is also a UK specific dashboard from Public Health England.The priority now must be to save as many lives as possible. I hope the strange decision to use Dyson as a source of ventilators, rather than established EU manufacturers proves a wise one.

In Ireland, given the asymmetry in preparedness, any spare resources in IE should be made available in NI. Given the impossibility of closing the border if it is not done, NI would well become a “petri dish” of infection for the entire island. We are definitely all in this together.

The UK, Ireland and the wider world are in for some very difficult months, and the overall death toll could well be at levels not seen since World Wars I and II. I do hope when this is over a better, more equal and caring society results in both Islands. This is not, however, a given. As Martin Kettle wrote in the Guardian:

We are sailing in the dark towards an unknown future. Britain’s mood after the first world war and the flu pandemic has been described by the historian Richard Overy as “the morbid age”. It was, Overy says, an era of fear and paranoia about a dystopian future. Few put their faith in traditional politics. Britain after the second was very different. “Never again” was its more optimistic motto. No one can say which of these moods, or what other mood, is likely after the Covid-19 pandemic. Instead of insisting that the pandemic confirms everything we thought beforehand, it would be better to start thinking about all the unwelcome changes that the pandemic may bring in the decade to come.

Comments

  1. Bill Hughes -

    Thanks Sean, a most comprehensive survey of the situation. Regarding ventilators is does seem curious that Dyson is being called to manufacture them when they havn’t even designed one yet. What is to stop other manufacturers copying the Medtronics’ model (the UK goverment can give Medtronics a tidy sum for the patent rights). Also engineers at Oxford University have developed a simple one that can be produced easily they say but the government are not interested.

    1. Sean Danaher -

      Its all very strange regarding Dyson. There are suspicions that as Dyson is one of the few major business that support Brexit it is very much a British Exceprionalism thing. I’m sure something could be worked out with Medtronic, but HMG seem to not want to have anything to do with the EU and have turned down participation in the EU precurement program.

      Interestingly Gtech have been told nor to bother: https://www.worcesternews.co.uk/news/18339699.worcesters-gtech-told-not-produce-much-needed-ventilators-government-chief-executive-says/?ref=twtrec

  2. Graham -

    Seconded. An excellent exposition.

  3. Bongo -

    Your world view is tragic, Sean, You bring the point about the UK not being an EU member into your argument, but fail to develop it. Fighting communicable diseases is not a competence centralised to Brussels. The main item, in fiscal terms at least, which is centralised to Brussels is a subject which you never engage with.
    But your best point is that the Republic is handling this better than the UK. Why the Republic should be superior is something you barely discuss. I suspect bashing the UK because of your attitude of “I’ve got English friends so I can’t be racist” which actually betrays your more general anti-Englishness. Looking to explain why the Republic is doing comparatively well is painful to some-one with your world view – neo-liberalism, weak and small government and not having the NHS health care system are all factors why the Republic is a rich country and can direct more resources per head in times of an emergency.
    But hey, let’s not mention those things that make a country rich, because it does not suit your narrative today.
    Let’s mention that many other countries have handled this worse than the UK which is handling it worse than richer Ireland, but not develop any reasons as to why all these other countries are doing it wrong, let’s go anti-GB instead.
    And let’s not mention the NI government paper from November 2017 on pandemic preparedness when they said they would keep schools open ( this was when Varadkar was already Taoiseach ) in the event of such an eventuality, and note the non-objections then. Hey, Mr Varadkar, if you thought that was the wrong strategy from NI, your team should have spoken up then, not wait until now. Bloody after-timer.
    I don’t expect this to pass moderation, but if Sean does get to read it, it’s predictable stuff entirely fitting with your previous dodgings of important issues.

    1. Samuel Johnson -

      What an utterly puerile load of nonsense.

      Evidently it escaped your attention that the Irish govt has been focused on the *imminent* risk of a no-deal exit of the UK from the EU, not on the possible risk of a pandemic and preparedness for that. Brexit has occupied much of the state’s available bandwidth since the day the referendum was called so the idea that Varadkar, no less, would be reading about discrepancies in plans for school closures in the event of a pandemic is really quite laughable.

      As for the rest of your conspiracy-minded drivel, it’s not any better. A substantial reason that Ireland has handled some of the logistics better than the UK is, and thus has already been explicitly acknowledged by Varadkar and others, precisely because it has been able to activate contingency plans already drawn up. Literally, a case of substituting Covid-19 for Brexit.

      Ireland is fortunate in other respects too. Two lynch pins of the economy are IT services and healthcare related manufacturing (pharmaceuticals, medical devices etc).

      But, due to some chip on your shoulder, an Irishman pointing out ways in which the UK is out of step with most of the rest of the world, and with Ireland, is an intolerable insult and must be answered with an accusation of anti-British prejudice. Why? Because he’s Irish. And the Irish ought to know their place. Never mind that you fail to point to a single verifiable error in the post. Never mind that his profession, more than any other, is one grounded in objective fact and this very obviously influences his perspective and reasoning.

      Pitiful stuff.

      1. Graham -

        Well said Samuel. I’m sure PP (and Sean) would welcome a coherent, evidence-based critique for discussion, but this is just a rant, unfortunately.

  4. Julie Barber -

    Thank you, agreed on every level. I just wondered your views on why they didn’t worry about the huge impact on nhs and potential death of many doctors etc ?

    1. Sean Danaher -

      Julie
      thanks for the comment. My wife is an ITU consultant, but the same age as me and is semi-retired. She is in a high-risk group and the head of department will not allow her to work on the front line.

      I understand austerity is the issue – the NHS has been stripped to the bone over the last decade. It’s a total disgrace that they do not have state of the art PPE and completely false economy, which is likely to backfire on almost every level.

  5. Sean Danaher -

    Thanks, Samuel and Graham. We indeed very much welcome coherent, evidence-based critique. We certainly are not a blog that expects sycophantic praise and are very happy to correct any factual errors.

  6. Korhomme -

    Thanks, Seán; I think you are correct in looking at this through the eyes of Behavioural Science, etc. I suspect that when the Report from the inevitable Inquiry appears it will be very critical. And, while we will hear “lessons will be learned”, I suspect also that nothing will change.

    The Guardian has a report, apparently based on an article in the Telegraph about the UK’s pandemic strategy not being properly implemented:

    https://www.theguardian.com/politics/2020/mar/29/uk-strategy-to-address-pandemic-threat-not-properly-implemented

    The Financial Times has a “coronavirus latest” report with statistics etc; it’s updated daily:

    https://www.ft.com/coronavirus-latest

    1. Sean Danaher -

      Thanks, K for the very useful links. I do the UK has been complacent, but interestingly the Global Health Security Index https://www.ghsindex.org/ ranks the UK as the second most prepared country after the US. one has to wonder if the correct criteria are used as some of the countries that have coped best such as S. Korea, Japan and Singapore are ranked much lower.

      1. Korhomme -

        A further thought: the class system is much more evident in England than most other places. With it is the idea of a ‘natural party of government’ whose MPs and ministers seem largely drawn from the public school/Oxbridge schools of thought. I rather have the feeling that the upperish classes rather despite those that have to work.

        I’m sure there are elites in other countries, but somehow their influence is much greater in England.

    2. Samuel Johnson -

      Will an inquiry be inevitable? I suppose it depends on whether enough people die to make it impossible to resist demands but I have a hunch that it will have to be a great many.

      On Twitter I’ve see Sinn Féin supporters referring to “trials” for Ireland’s current caretaker govt, but this seems to me to be more a function of their sociopathic hatred for what they see as Ireland’s Tories rather than anything credible. Indeed, I’ve seen it called “advance schadenfreude” with added malice. The Irish govt reactions could indeed have been faster but the prospect of crucifying politicians who followed both national public health expert & WHO advice seems repugnant to me. It’s simply a given to these critics that the govt acted in bad faith.

      I don’t believe Leo Varadkar did so. But if I look at the performance of the Tories I can almost comprehend the intensity of the animus behind it. But not quite. It’s just too much of a stretch to believe that a qualified physician from a medical family, who partner is a physician, with in-laws (to be, on both sides) in the nursing profession, was cavalier with public health and deliberately and cynically prioritized the economy at the expense of lives. But I can and I do believe this of the Tories.

      As someone with scientific training, Varadkar is far better able to assess epidemiologal advice he’s given than Boris Johnson. But he’s now in the dock in some quarters in advance of allegedly avoidable deaths for, it seems, not having ruled by decree, something legally impossible and any attempt at which would have elicited screams of “Blueshirt” (a historical reference to an Irish fascist movement).

      The closing of the pubs was a case in point. It turned out legislation would be required and initially it wasn’t clear there’d be sufficient parliamentary support for it. While public opinion moved in favour the govt first negotiated voluntary closure, which was adhered to by almost all, then secured emergency legislation enabling it to have the requisite powers. British pubs didn’t close for more than another week.

      Other decrees allegedly culpably foregone involved two sporting events, Cheltenham (attended by thousands from Ireland) and the Ireland v Italy rugby match in Dublin – – canceled, but many Italians visited bringing Corona virus with them. Nobody was tested or quarantined on return from Cheltenham. Italians were allowed to visit. Hindsight may confirm these were mistakes but it’s worth bearing in mind

      1. No test for CV was readily available & practicable for border use
      2. The govt was & still is committed to an open border with NI in all circumstances.
      3. The Common Travel Area was and still is in effect and accounted for more traffic
      4. Many hundreds of Irish people, including children out of school during a break, were returning from skiing in Italy.
      5. Large nrs of tourists from the US had already arrived well ahead of St Patrick’s day (17th)

      Any idea of isolating the country instantly and effectively was fraught to impossible and would likely not have made a great difference. That it would to some extent be shutting the gate when the horse had bolted can be seen in this video:

      https://m.youtube.com/watch?v=Kas0tIxDvrg

      It shows that unless the border is fully impermeable restrictions simply delay the spread of infection likely already present (not that that necessarily vitiates doing so). Other measures such as social distancing, testing and tracing are more important.

      People returning to and visiting Ireland via Dublin Airport had their passports scanned and recorded electronically. Presumably, once testing becomes sufficiently scaled up, it may be possible to target most of those still in the country?

      In the meantime, the govt did a lot to get the message out to citizens about what they needed to do, and did so coherently, without any of the mixed messages seen in the UK. The headline from the start was TOGETHER WE CAN SAVE MANY LIVES. Most people complied with the advice.

      The advocates of putting the govt on trial seem to me, from their intemperate language, keen to exploit the not yet dead and to aspire to the kind of unaccountable authority the Tories appear to have actually granted themselves.

      Proportional representation will, however, likely ensure that Ireland’s angry left will be constrained. Some of its current anger likely flows from resentment at the govt’s rising popularity in a time of national emergency – – the so-called rally round the flag effect – – and more particularly at the govt’s resiling from a declared intention (pre-pandemic) to go into opposition. The intensity of the hostility toward the govt is out of proportion to that warranted in the US & UK–imo. Although I subscribe to Scandinavian levels of public service and taxation I confess I am repelled by punitive rhetoric about trials and imprisonment. As result I am alienated from an end of the political spectrum I could otherwise be sympathetic to. It’s Ireland’s version of “Enemies of the People” stuff, only more disturbing.

      We’ll certainly be having inquiries though, in every democracy I’d imagine.

      1. Sean Danaher -

        Living in Northumberland much of this has passed me by. Certainly compared to the UK and US, the Irish Government seems to be doing well.

        I’ no great fan of Fine Gael but they seem to be doing a decent job and I have every faith that they are doing their best.

        In the UK I have every faith in the NHS, the doctors, nurses, support staff etc. who are doing a stellar job, but HMG has been very slow to react.

  7. Samuel Johnson -

    This https://www.newstatesman.com/politics/uk/2020/04/real-reason-uk-government-pursued-herd-immunity-and-why-it-was-abandoned is the best account of the evolution of public policy and communication in the UK that I’ve seen so far.

    It puts a plausible gloss on what is in truth a series of terrible failures that collectively amounted to the UK being unable to respond effectively, and without which any errors of communication would quickly be irrelevant.

    Consider this account of how the NHS has been run to operate so close to maximum efficiency as to have little resilience in the form of spare capcity: https://members.tortoisemedia.com/2020/03/30/chris-cook-coronavirus-nhs-at-capacity/content.html?sig=keNLL8BRfhyxlRYS9-EoICk4I44jgZb_ahgq3Zdx6pY.

    I spoke yesterday to friend in Germany who is glad he is there rather than in the Netherlands where both of his sons are doctors. The Netherlands, although it has a very different healthcare system to the NHS, rationalized in much the same way as the NHS: closing its smaller hospitals and investing in bigger, supposedly better ones. A result was a loss of beds and of ICU beds in particular. This hasn’t happened in Germany. It may be a result of Germany’s federal governance that policy on such things cannot be dictated nationally – – I will inquire.

    Then there’s Covid-19 testing capabilities. The contrast between the UK and it’s neighbours is stark despite the UK being the leading research power in life sciences in Europe (a status damaged by the loss of the European Medicines Agency). The inability to deliver clearly comes down to governance shortcomings that are not credibly explained away by “global shortage of reagents”. The reverse transcriptase enzyme used in the PCR diagnostic test would likely be needed whatever virus was being tested for. So a failure to secure a supply when the number 1 risk on the national risk register was a pandemic caused by a respiratory virus looks like culpability on a grand scale – – a govt failing to discharge its most basic obligation, to protect its people from avoidable harm.

    The pandemic is providing us all with lessons in the utility of good governance. It should, finally, but at what a price, kill off the madness of the like American tax-cutting fanatic Grover Norquist who tirelessly promoted the idea that government should be “small enough to drag to the bathtub and drown”. It won’t happen easily. The anti-govt distemper is very virulent in the US. Hopefully, change in the UK will be easier and as radical as after a world war. I worry, though, that failure to reform oligarchic control of the media is a potential disabling factor.

    Which is why this is such a significant article: https://www.wired.com/story/why-dont-we-just-ban-targeted-advertising/

    It points to issues and prospective actions we knew were important, and to reforms we expected resistance to. The pandemic may be providing cover for some authoritarian power grabs now, but the appetite for better governance just may prove stronger.

  8. Samuel Johnson -

    This “Covid Report” on YouTube is worth a listen.

    https://youtu.be/05-jbrHRmrs

    Two journalists, Paul Mason and Afua Hirsch, speak with a group of medical experts on how the UK govt got things so disastrously wrong while claiming to be “following the science”. They weren’t. That is to say it wasn’t science as it’s normally understood.

    Some of the key things to emerge clearly here will be front and centre when the inevitable public inquiry happens.

  9. Samuel Johnson -

    This thread comparing Irish and UK responses and outcomes has gone somewhat viral

    https://twitter.com/laineydoyle/status/1249127908876128259?s=19

    Two cautionary comments from Ireland are worthwhile

    https://twitter.com/Care2much18/status/1249335769514336256?s=19

    https://twitter.com/stephenkinsella/status/1249339349310877696?s=19

    I’ve seen several dismiss the different impact (so far) of Covid-19 on Ireland and the UK as merely a matter of population density. This is simply nonsense. Dublin is more densely populated than London and over 40% of Ireland’s population live or work there. Comparison with Hong Kong underlines the point: 0.5 deaths per million people vs 314 in London so far (excluding, apparently, those who died in nursing homes).

    Overall, “so far”, seems the appropriate qualifier. Singapore’s experience of a 2nd wave shows that its too early for any reckoning, but what will matter en route to that is whether people trust their govt and whether it’s gaslighting them with the help of compliant media. One sad thing I’ve seen in reaction to the comparison made with Ireland (whose response has been subject, rightly, to strong criticism in Ireland) is a reflexive accusation that it’s motivated by anti-British sentiment. This is rubbish of course. The NHS is something, for all its faults, is something the Irish admire, and an awful lot of them have some first hand experience of it. It also discounts the Irish entitlement to have a view and to express it, given the potential risk of divergent approaches on the island of Ireland.

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