The end of Lockdown and mass murder

Boris Johnsons has more or less announced the end of lockdown in his own incoherent way, while some on the left in Britain are claiming the advent of (further?) “mass murder.”

” Workers who do not feel safe returning to their job should continue to be paid by the furlough scheme.”

It must be said that thousands of people, especially the old, have died unnecessarily.  Their deaths could have been prevented by prompt and appropriate Government and State action.  Their deaths are to be laid at the door of both.

The article points out the undoubted incompetence, mendacity and utter shambles of the response to Covid-19, but on the face of it it makes little sense.  Workers are not afraid of mass murder, at least not the ones I work with or those I meet.  They fear, to a greater or lesser extent, catching Covid and being exposed to the risks involved.  Those risks for the majority of the population are small and most people know it.

Those who are vulnerable have a greater fear, of their being lumped in with the greater population on the way out of lockdown in the same way as they were in the way in: that is without proper appreciation of their vulnerability and the necessary measures to protect them.

By exaggerating the threat to the general population the threat to them was underestimated because it failed to adequately distinguish between them.  This lack of differentiation removed the focus on those most at risk, and then the price that they paid, by a Government that couldn’t protect them, so pretended it was going to protect everyone – by declaring instead that it was going to protect the NHS.

A policy of blanket opposition to a return to work does nothing to help.

First, everyone will have to go back to work before any possible second wave because the Government and employers will compel them and because the effects of continuing to pay people for not working will be worse.  The demand for furlough payments might seem revolutionary because it challenges the profitability of the capitalist system but if there is no real possibility of overthrowing capitalism in the next few months (pretty much a given for me) then simply proposing bankrupting the state and multiple businesses is not socialism but a form of nihilism.

Second, most workers are working and drawing a line in the sand over those not doing so, or like me working from home, is really to have missed the fact that the majority of workers have been working away throughout, and we would be facing many more deaths had they not done so.

In my own work, the local union committee is discussing with management how the staff are coping with working from home, and we have successfully argued that consultation on returning to work can wait until this is completed.  This is a reflection of the concerns of staff.  But as I have just said, this is unsustainable and the local union committee is clear that the issue will quickly turn to what terms we return on.  For a socialist the question is – how do we impose some control over that return?  No one, and certainly not me, will be declaring the potential advent of mass murder.

The virus has not inflicted the casualties many predicted.  It is clear most people have relatively little to be concerned about.  The point now is to protect the most vulnerable in a way that was not done before when the lockdown was first implemented.  Saying everyone is facing massive danger doesn’t help this task but detracts from it.  If the danger facing everyone is at this level why have the vulnerable suffered so much more?

Over half the deaths in the North and South of Ireland have been in care homes for older people and the failure to protect them has been repeated in many countries.  In the North of Ireland (and also in relation to services in the South) and in Britain, the NHS stopped doing its day job and became a National Covid Service.  Countless people will die because of this.  Countless, in the sense of very many and countless in the sense that many will not be identified as having died from lack of health services that they might otherwise have received. And this isn’t an issue belonging to the past.

The disastrous performance of health services resulted from their working to a political agenda determined by the Governments in power, whether it be the Tories in Britain, the unelected Fine Gael in the Irish State or the coalition of reactionaries in the North of Ireland.  For them the issue was one of political performance and credibility.  The Tories highjacked the NHS brand, so easily done since they are in charge of it; the Irish administrations did the same with perhaps less outrageous brass neck, and they all did what politicians do and fight a political campaign as well as a public health one.

The Tories showed their utter incompetence while Varadkar’s Fine Gael gained popularity with a combination of nationalism, fear, an overwrought initial threat of the virus that didn’t materialise, subsidies to workers and business; the fact lockdown hasn’t lasted too long, and of course the fact that the Irish State sits between its two greatest cultural and economic influences – Britain and the US – who are widely regarded as having f****d it up.

Now they face two issues.  The backlog of healthcare cases, which in both Irish States is horrendous, as it also is in Britain, and how to approach a second wave. Oh . . .  and how the bill for the lockdown is going to be paid and who is going to pay it.

If what I have heard about Belfast is correct and applies more widely, the health systems are still going to be focused on Covid and how they are going to address the second wave.  The excuses trotted out everywhere for the failure to protect the most vulnerable do not inspire confidence that they will receive the protection and support they need the next time, if there is one.

Promises that cancelled and postponed services will be renewed are not completely reassuring when this is caveated with ‘explanations’ that re-creating these services will not be as quick as shutting them down, and that some services will return at much reduced capacity.

At the start of the lockdown it was argued that what was going on was not social distancing but physical distancing, and that this was a more accurate description.  But that has not really proved to be the case.  One metre or two depends on the expert medical advice you listen to.  The fear and confusion involved with Covid-19 has led to a situation of social distancing in which the State and mass media has imposed a climate of fear that has justified the most draconian restriction of civil and democratic rights, and without the protest it has deserved.

Dependence on the state and its propaganda that (some) socialists have lamented and opposed has grown enormously.  To oppose it has been seen as the preserve of the deranged right, who unfurled the banner of freedom only as outriders for that part of the capitalist class that most exploited it workforce or who otherwise wanted out of the lockdown as quickly as possible.  The left’s penchant for highlighting opposition to the far right kicked in with warnings that this would assist the secret project of less extreme Government leaders getting ready for implementing the same policy.

Only the protests against the state murder of George Floyd in the US, encapsulated in the Black Lives Matter protests, has shattered the instruction that the people must do as they are told.  Social distancing was more or less ignored.  Social isolation, whether in terms of ‘stay at home’ or unemployment, is no basis on which to create a working class movement, a task not suspended by the virus.

The left, or much of it, has saddled itself with a policy of maintaining a lockdown that largely doesn’t exist for many; will not exist for much longer; is unsupportable; that incurs costs workers will face paying or an almighty fight to oppose, and misses the main issue, which is not to extend lockdown but to try to help workers take some form of control over how it is ended, while accepting that it will and it must.

There is of course the alternative to what I have just said; that what I am advocating is a continuation of mass murder and that this is what we are about to face.

‘Protecting’ the NHS

I watched the BBC Panorama programme on the NHS and the Government failure to prepare properly for the Covid-19 pandemic, despite warnings.  It focused on its failure to stock and resupply adequate amounts of appropriate Personal Protection Equipment, and to spin the amount of PPE newly received by, for example, counting a pair of gloves as two items and including cleaning disposables as equipment.

The Tories cannot legitimately complain if they have made the NHS the centre of controversy because it is they who put it to the fore – ‘Protect the NHS’ is the slogan, with ‘success’ of its whole effort defined as the NHS not being overwhelmed by casualties of the virus.  It is important we don’t buy into this.

We are implored to ‘Protect the NHS’ when it is the function of the NHS to be the last line of defence for us.  Instead it has become the last place anyone wants to go.  Having scared everyone by the lockdown, vast numbers of existing and prospective patients have either been told not to attend, had their treatment cancelled or postponed, or have been unable to get diagnoses and tests they badly need.  The NHS isn’t dealing with them – it has been estimated that 18,000 extra deaths from cancer might result, currently around half of those recorded as dying from Coronavirus.

Not only has the NHS moved from defending us to us being exhorted to defend it, but the NHS is actually a threat, including to its own staff, over a hundred of whom have been estimated to have died from the virus.  While appointments and operations are cancelled, and Emergency Department attendances have collapsed, we are invited to acclaim the empty Nightingdale hospitals and empty beds as a success!  We are expected to recognise as successful an NHS that has become the site of infection and the one certain place to avoid unless you have absolutely no choice.

We are to applaud a service that has stopped being a National Health Service and become a National Covid Service following a transparently political agenda.  As I have written before, we are invited to ‘Protect the NHS’ when truthfully what we are invited to protect is the Government that has so denuded the NHS of resources for so long, and made such a mess of the current outbreak, that it simply cannot cope with doing its day job and deal with the virus at the same time.

By making sure that the NHS is able cope we ensure that the cuts and their effects are hidden despite the crisis; but rather than seeing this as a grotesque choice we have been forced to accept we have been invited to greet it as ‘success’, as Johnson so glibly and cynically put it.

And we do this because the NHS is one indivisible saintly entity without a bureaucracy that heads it, or an amoral Government that directs it, that unproblematically reflects the innate compassion of humanity – despite the evidence that doctors, nurses and purchasing managers have all complained that this organisation is failing its own staff never mind those it is there to serve.

The NHS, created to put an end to dependence on charitable provision, has become the biggest charity case in the country.  No doubt many people want to help, but the greatest help is not the individual resources many have had to fall back on but development of critical political consciousness.

We are supposed not to pay attention to the censorship of NHS staff who complain about their lack of protection but invited to applaud every week the protection these people are supposed to give us.  We are simply to accept that cancer patients will not get their treatment because on balance they would then have their immune system too compromised if they became infected, which is only the proper choice if we already accept that they cannot be protected.

We are to ignore that the NHS has taken PPE from elderly care homes while moving infected patients from hospitals into them: ‘Protect the NHS’ does not apparently mean Protecting Social Care.  Their clients’ deaths weren’t even counted in the headline daily total until very recently.

It becomes ‘pragmatic’ to downgrade the level of PPE required by NHS and care staff because the real scientific advice, unencumbered by Tory political pressure, would demand a level of PPE that the NHS cannot provide.   So the ‘objective’ scientific advisors objectively become conspirators in covering up Tory austerity, neglect and incompetence.

This is a surreal world of spin and lies and suppression of facts, fairness and free expression that has worked because of fear and ignorance and lack of accountability, and because we really do rely on the NHS.

The Government has not been held to account by the Labour ‘opposition’, has only begun to face some media criticism recently, and has benefited from the social isolation of social distancing.  This distancing includes distancing from reality, substituted by what Marxists call reification and alienation that amplifies the worst media influences and instincts to defer to authority.  This authority would have us rally round flags standing either side of Government spokesmen who substitute for the primacy of the people clichéd totems of Britishness and itself.  Real solidarity is replaced by calls to the police by snitches reporting neighbours who don’t get out to clap the NHS and its workers.

So, in Belfast we were told that 15,000 people would die but now only 1,500.  We have appointments and procedures cancelled and postponed and over 70 Covid-19 beds created, that last week saw only around half occupied, while a further 200 plus have been set up.  A hotel has been taken over but only one floor is so far used.  Never mind, this may be ready for the next surge in September – October, which will perhaps translate as another Johnsonian ‘success’.  Ring for a service and you can be told that resources are being devoted to the treatment of Covid-19.  Appear in the City Hospital and find yourself inside a ‘clean’ area that unfortunately has just had red signing put up to indicate Covid-19 areas as the green signs disappear.  In some locations work is hectic while in others activity has hardly been lower and there are only the rituals of infection control.  Similar stories could be told across the NHS but it is all socially and politically invisible.

The NHS is a bureaucracy as well as a service, but it has become a saintly institution which it is blasphemous to criticise, and one that the Government has wrapped round itself to shield itself.  In the Orwellian world of 2020 those who have spent ten years weakening it are holding up the banner of its defence against those whom it should serve and have suffered from the years of austerity inflicted on it.  Just as NHS staff have been blamed for PPE shortages so patients are held responsible for its inadequacy.

It is therefore not ‘Our’ NHS.  It doesn’t even belong to those who work in it.  Working people should be asking themselves how all this is the case and what it is we really should be defending.  Socialists should ask themselves just what a genuinely socialist service would look like.  The NHS hasn’t been hijacked, it’s simply following orders

The Irish and British responses to Coronavirus – different or just equally bad?

The British Government’s approach to the Coronavirus has been the subject of much, almost smug, criticism on this side of the Irish Sea.  In the North nationalists, and not only they, have called for an all-island approach and rejection of the British strategy of ‘herd immunity’.  Every British failure has been criticised and the response of the Irish Government lauded.

This was boosted enormously by the speech of acting Taoiseach Leo Varadkar, standing between the Tricolour and flag of the European Union, in bright contrast to the performance of Boris Johnson, sandwiched between two union flags.  The serious and statesmanlike approach of Varadkar was taken as so much more apposite than the unpredictable and sometimes incoherent ramblings of the Tory leader.  The two countries were adopting very different approaches and there was no doubt which was the better, even if Varadkar did a Churchill by saying ‘never will so many ask so much of so few’.

However, when all is said and done there is more than a little bollocks to such a view.   There are certainly more similarities than differences, starting with the flag waving as the cover for a host of failures.

Ostensibly, the Irish approach is to avoid exposure of the population and to reprise the South Korean model of testing, contact tracing and then appropriate isolation.  It has also taken more extreme measures to lockdown the population, for example by limiting outside exercise to within 2 kilometres of the home, and appearing to close down its economic activity even more drastically than the British.

The perception that this is a more responsible and sensible approach is one reason it has received popular support, although the same forces of compliance and deference apply in Ireland as much as in Britain.  Rallying round together in face of the enemy is a natural response even if it is conflated with rallying round a political leadership that has done nothing to deserve it.  And that is the most obvious similarity between the two countries.

But not only that.  The NHS has been subject to at least a decade of underfunding and misleadership that has led it to be woefully unprepared for any crisis, never mind this one. The current Fine Gael administration is the most openly right-wing and pro-free market of all the parties, which caused it to be decisively rejected at the last general election, not least because even in an economic boom the Irish health services are seen as a mess.

In February it was reported that 677,344 cases were on the waiting list with over 12,000 left on trolleys in January, the second worst month on record.  2019 was the worst year ever for hospital overcrowding as 118,367 patients were left without beds during the year.  This level of overcrowding showed that the Irish health system had insufficient capacity before the crisis and is utterly unprepared to deal with much greater demands now.  The ‘Irish Times’ reported on the front page of its 9 April edition that ‘emergency care doctors have expressed concern that the peak of the most critically ill coronavirus patients has yet to hit hospitals as existing intensive care units approach full capacity.’

As for the expected surge, the chief executive of Nursing Home Ireland has said that ‘nursing homes are effectively dealing with the surge that the hospitals were expecting.’  This has led to ‘clusters’ of the virus appearing in 137 nursing homes and other residential facilities, up from 4 on 21 March.  It is primarily the old who are dying, with the last reported median age of fatalities being 81.  The Irish State is proving no more capable of protecting its older citizens than the British.

The Irish health system is so bad the NHS is held up as an examplar, mainly because of the gross inequality in Ireland arising from health insurance that gives you greater access than public patients.

While, just like Britain, the policy is to protect the service, both states are near the bottom of hospital beds and ICU beds per capita.  The Government has hatched a deal to use private hospitals for public patients but this has led to protests from consultants that their private patients will not receive necessary treatment.

In both jurisdictions the Government has promised levels of testing that they have completely failed to deliver, which is possibly even more egregious in the case of Ireland given its so-called strategy. Johnson and his Government have gone from promising 250,000 tests a day, to promises of 100,000 by the end of the month (made at the start of it), while on 8 April Public Health England was reporting a testing capacity of 14,000.

In Ireland the Minister of Health promised 15,000 tests per day on March 19, while two weeks later the total was 1,500.  Almost a week after that, Dr Jack Lambert from the Mater Hospital in Dublin was asking ‘how can you talk about flattening the curve where you’re testing such small numbers of people and people are queuing up to get testing?’

In nursing homes some tests have taken 10 days or more for results to come through.  There are also reports of delays in tracing people having contact with those testing positive, making a total nonsense of the supposed strategy. Never mind, the Irish Minister of Health has promised action by the end of the month as well.

Shortages of Personal Protection Equipment exist in Ireland just as they exist in Britain, exposing health and care workers to the virus and onward transmission to the patients, clients and residents they care for.  Again, the chief executive of Nursing Home Ireland has said that nursing homes are suffering severe shortages, with just 51 receiving enough, and then only for three days normal usage, while 63 others are still waiting for a delivery.  Promises made by the Minister of Health to the sector have not been delivered.  Not that hospitals have all they need, St Vincent’s in Dublin has warned that it is facing ‘considerable difficulty’ in sourcing masks, and that the ‘ongoing availability of masks cannot be guaranteed’.

In Britain there are numerous reports of threats to NHS staff who go to the media to explain the consequences of Government failure.  Weekly clapping on behalf of NHS workers is evidence of widespread support for the service, but the silencing of NHS workers demonstrates that the NHS is not ‘our’ NHS; it is owned, run and controlled by the same state that has so abysmally failed to protect its own workers.  Were the NHS really an example of socialism we would not have its workers afraid to speak out – they would own, run, and control it and be able to speak openly.

In their place we have daily press conferences, where questions routinely don’t get answered, including by the experts, while data is misleading – the figures of those infected are next to worthless and the total number dying isn’t even accurate.  But at least in Britain they have daily press conferences where questions are asked, and there is a pretence at answering; the Irish Government has distinguished itself by its even greater secrecy, opposition to accountability or examination of its policies.  Instead, as everywhere else, moral commands induce moral outrage as a substitute for critical engagement.

Even that voice of the restrained and sober middle class, ‘The Irish Times’, has editorialised on the difficulty of obtaining information, e.g. on waiting times for test samples, on the backlog of tests, the state’s stock of protective equipment, the real-time state of ICUs, and how the virus is interacting with other conditions.  It has noted the ‘discomfort with scrutiny’ and Ministers’ requests that questions be sent in advance.

This follows the Executive’s attempt to shut down debate in the Dail, which was rejected.  This, from a Government without a mandate, that has shut down large parts of the economy sending unemployment rocketing; instituted strict limits on free movement, and introduced draconian measures that give the Garda the power to arrest you for refusing to obey instructions or to give your name and address.

We are informed that the decisive intervention that ensured the Garda got such powers was the Garda itself, through the Commissioner Drew Harris, ex of the Royal Ulster Constabulary and Police Service of Northern Ireland, recalling for me that the date of birth question was always the one that refusal to answer might lead you to being lifted by the RUC.

We can see that the Irish State has done nothing to warrant either the praise or trust it has received.  Yet it cannot hide forever from the inadequacies of the health system for which it is responsible. It will also not be able to make good its promise that the cost of shutting down the economy and temporarily supporting incomes  will not lead to austerity further down the line.  This is simply a lie.

At the same time as coronavirus has consumed attention, the politicians and media have been obsessing over the formation of a new Government, with the prospect of a coalition between the two reactionary civil war parties, ruled out so categorically, now looking more likely.  The complaint of both is that no other Party wants to join them, such is the distrust.  Except for Sinn Fein, which says a lot about all three.

However, rather than the problem being lack of a Government, the problem is lack of an opposition.  The trade union movement is disarmed because of state subsidies for those affected by unemployment although this is unsustainable and will not be sustained.  The left is in thrall to massive state intervention, which it talks and acts as if is some sort of socialism, when it is not.  The authoritarian measures are opposed but not vehemently because these have not yet become unpopular.  Not for the first time the potential to present an alternative is lost, because no alternative is presented.

Coronavirus – ‘we simply don’t know’

In my previous post I said that the initial disorientation caused by the eruption of SARs-CoV-2 was ‘evaporating’, but I got that wrong. I had hoped that what was happening was a recovery from an initial shock so that some rational inquiry would emerge among the general population.  This hasn’t happened, at least not as far as I can see.

In part this is due to the mass media, which has a story and are going to run with it; I’m reminded of that great film starring Kirk Douglas – ‘Ace in the Hole‘.  It also reflects the disintegration of the socialist and labour movement that there are no scientific organisations, milieu or debate that could focus and inform debate on what approach is in the interests of the mass of working people.  Instead we have dependence on the state which breeds deference and subservience instead of critical thought.  The illusions that arise are all the greater for their being based on real dependence.  I’d hoped that the healthy dislike and skepticism of Boris Johnson among many would lead people to be more critical, although there is still plenty of time for this.

I have stayed away from BBC News and current affairs, with the exception of the web site, for years and especially after seeing some of the coverage of Jeremy Corbyn, but I tuned in this past week to watch the Prime Minister broadcast announcing increased restrictions and the half hour ‘analysis’ afterwards.  If this is reflective of the rest of the coverage then I have missed nothing.  BBC journalists often complain about the ‘Westminster bubble’ but it is they who are the prime culprits in inflating it; when they are not talking about political personalities they are essentially talking about themselves.  I also watched one of the daily press conferences, and this was much more revealing.

None of the questions asked were answered and the two experts demonstrated that they were more skilful in not answering the question than Johnson.  What answers were given provided plenty of grounds for skepticism.  We were informed that ‘the science is coming from a low base’ and when asked whether it was true that perhaps half the population had the virus, as suggested by a study from Oxford University, the answer was ‘we simply don’t know.’

The Chief Medical Officer stated that it was ‘going to be a close run thing’ whether the health service could cope while another advisor Prof. Neil Ferguson expressed confidence that NHS capacity won’t be breached.  Johnson has got by by with promises that testing, protection equipment, and ventilators etc.will all be coming soon while also claiming that everything is going to plan.  The machinery of Government has ignored offers of ventilators while giving contracts to Brexit-supporting friends who don’t make them, just like it earlier gave shipping contracts to companies without ships.

It absents itself from cooperating with the EU, giving us all a taste of things to come, while lying about why it did it, the taste of things just past.  The only thing more personally aggravating is the silence from the British Labour Party, which is only interrupted by craven agreement with Tory policy and calls for ‘more’; which reminds me of another film – ‘Oliver Twist’.

At the end of February, the Government’s Rasputin – Dominic Cummings – is reported  to have outlined the government’s strategy as “herd immunity, protect the economy, and if that means some pensioners die, too bad.”  It is supposed to have resulted in that strategy being revised on foot of a report from Imperial College London.  This report considers that there are two possible strategies: mitigation and suppression, outlining evidence that the Government strategy was mistaken and that ‘suppression’ of the virus was the only way to avoid a ‘likely result’ of ‘hundreds of thousands of deaths’.

It describes as its main conclusion “that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over.”  The Government strategy therefore appears compromised because the health service can’t cope.  This is why the ‘strong and stable’ mantra of the latest Tory Prime Minister includes the dictum ‘protect the NHS’, which actually means protect the political fortunes of the Tory Government that fought the demands of junior doctors, cut nurses pay and inflicted a decade of unprecedented austerity on the NHS.

The difference between the two approaches is to move the R number, the average number of secondary cases which each antecedent case generates, to below 1, thus reducing the number affected over time.  It argues that only a strategy of suppression can do this.  The study recognises that the main challenge to this is that it has to be maintained indefinitely, until a vaccine becomes available; but it also suggests that there should be periodic relaxations of restrictions when infection numbers reduce and their reimposition when they increase again.

It may be doubted if such fine tuning is possible given lack of data on the extent of infection, the potentially misleading character of the data available as a true indicator of infection rates, and the risk that people will not find it easy or reasonable to open and shut down their lives at instruction from the Government.  The study itself notes that:

‘Once interventions are relaxed . . .  infections begin to rise, resulting in a predicted peak epidemic later in the year. The more successful a strategy is at temporary suppression, the larger the later epidemic is predicted to be in the absence of vaccination, due to lesser build-up of herd immunity.’

 

So what the report doesn’t do, as we can see, is condemn in principle the idea of ‘herd immunity’; in fact it notes that such an approach has been taken before,’by the world more generally in the 1957, 1968 and 2009 influenza pandemics’.

The report also doesn’t factor into its ‘suppression’ strategy the ‘enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term.’  It does assume that on recovery from infection individuals are immune to re-infection in the short term.

The significant assumption on which the study rests is an infection fatality rate (IFR) of 0.9%, based on an estimate of the experience in China. (It should be noted that the paper referenced in the Imperial College study states that ‘we obtain an overall IFR estimate for China of 0.66% (0.39%-1.33%), again with an increasing profile with age.’  That is, the application of the estimate of the IFR for the GB population derived from the estimate for China results in a figure over a third higher.)

The study then estimates the impact of the virus in age cohorts based on this figure and taking account of its increasing severity with age (for much more analysis of the full table see Boffy’s blog here):

Age group (years) Infection Fatality Ratio %
0 to 9           0.002
10 to 19           0.006
20 to 29.           0.03
30 to 39           0.08
40 to 49           0.15
50 to 59           0.6
60 to 69           2.2
70 to 79           5.1
80+           9.3

What this shows is that it is only for those aged 60 and above that the virus contains a significant risk.  As noted, the figures above rest on estimates for China and there has been criticism that decisions are being taken without reliable data. Others have pointed out that many cases of the virus have not been detected, because carriers have been asymptomatic or their symptoms were too mild to report:

‘Research published last week by Jeffrey Shaman of Columbia University in New York and his colleagues analysed the course of the epidemic in 375 Chinese cities between 10 January, when the epidemic took off, and 23 January, when containment measures such as travel restrictions were imposed.  The study concluded that 86 per cent of cases were “undocumented” – that is, asymptomatic or had only very mild symptoms (Science, doi.org/ggn6c2).’

The Imperial College report quotes unidentified cases as 40 to 50 per cent of infections, based on the experience of China and those returning on repatriation flights.

This would mean that the Infection Fatality Rate in the table above would be too high since deaths recorded would be a smaller proportion of those infected, many of whom were ‘undocumented’. This does not nullify the seriousness of the threat to those in older age groups, or to those with a suppressed immune system, or who rely on the immune system for effective treatment, such as targeted cancer drugs.  It means that this is where the real problem lies.

It is also recognised that all deaths of patients with the virus have not died because of it, just as it is well known that all men with prostate cancer will not die of it.  The Government advisor mentioned above noted that one half to two thirds of those dying might have died anyway.

So it is not just that the health service was, and still is, unprepared for a pandemic, which the Government knew, but that the various arrangements that are required to protect the most vulnerable are still not in place.  Lots of initiatives have come from outside Government, which can barely coordinate its own actions, and many of the grand schemes announced by it are like its promises on testing and equipment, they remain promises.  The second category of people who may suffer is therefore health service staff themselves if, as seems possible, they become exposed too much to the virus without adequate protection.

It is therefore clear that the strategy of suppression may go the way of the previous strategy of mitigation.  The Imperial College report states that its preferred strategy involving social distancing, home quarantine, case isolation at home and closure of schools should be in place for five months, not the 12 weeks spouted by Johnson.  It envisages maintenance of such policies for perhaps 18 months until a vaccine is discovered.  This raises the question whether the shift of NHS resources to treatment of the virus for such a long time would have implications for the treatment of other patients.

The report also states that ‘suppression policies are best triggered early in the epidemic’, and ‘for suppression, early action is important’, while the British and Irish Governments cannot be accused of acting quickly, and it also admits to ‘very large uncertainties around transmission of the virus.’

In accepting the difficulties of long term suppression policies it states that ‘social distancing of high-risk groups is predicted to be particularly effective at reducing severe outcomes given the strong evidence of an increased risk with age.’

The report ends by noting that ‘we emphasise that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.’

What should be clear is that the promises of the Government have a sell by date and a use by date; promises of delivery of tests and equipment and the mobilisation of additional staff and hundreds of thousands of volunteers will require that these are organised effectively.  If they are not then this will become a political challenge to the Tory Government that no amount of self-isolation will shield them from.

 

Fighting Coronavirus

An initial effect of Coronavirus in Ireland and Britain was one of disorientation, with uncertainty as to its impact and in particular its effect on those considered most vulnerable.  This is now evaporating.

The response of the British Government was a plan with four stages.

The first has passed and clearly failed.  It was called containment and was to involve trying to catch cases early and trace all contacts to avoid the spread of the infection.

The disease has spread and despite self-praise that the tracing system has been very effective there are an estimated 10,000 cases and no one knows who they are.  The disease has not been contained.

The second stage is called delay.  According to Sky News ‘this means the government will ramp up efforts to delay the spread of the illness’.  This however has only involved a recommendation that anyone with coronavirus symptoms, such as a continuous cough or high temperature, must stay at home for seven days, which appears not long enough to isolate the disease, and is anyway only a recommendation. School trips abroad should be stopped, while people over 70 with serious medical conditions should not go on cruises, which implies the problem is a foreign one that might be imported, and we are way past any such idea.

The second phase has therefore involved no actual measures so that the delay stage merely involves delaying a decision and a delay in doing anything.

This has been ignored by sporting and other bodies who have cancelled events, calling into question the Government’s strategy.  The Government, including Arlene Foster here in the North of Ireland, is hiding political decisions behind the advice of its experts.  Unfortunately, these experts are political appointments, and while Johnson gained credibility by their presence at his first press conference, their credibility will sink faster than his if they follow his agenda.  In Northern Ireland it was appropriate that the long-awaited report on the Renewable Heat Incentive scandal has just been published, reminding everyone of the lengths of stupidity that civil servants will go to in servicing their political masters.

The policies arising from the scientific advice that the British Government claims to be working from obviously conflict with that given in other countries, including the Irish State.  True to the traditions of the British state, this advice is a secret.  What we know is that Johnson appears sanguine that ‘many families will lose loved ones before their time’, and the mass media has played its role in preventing a tsunami of anger that this remark should have evoked.

On Thursday evening Radio 4 had an expert – ‘Chris’ – who continually referred to someone called ‘Boris’ as the font of all authority, as he defended the Governments’ strategy, and the interviewer gave the Government the deference it has so much enjoyed.  Social distancing measures were opposed because they could not be fully effective, but without the least recognition that less than perfect effectiveness in no argument in favour of no attempt at any effective action at all.  The strategy is clearly to allow the majority of the population to get infected in order for it to develop its own immunity and spare the health services from a task that it cannot cope with.

Delaying social distancing measures is supposed to delay the hit on the health service and flatten the impact on it; although it would appear to make more sense that the quick introduction of such steps would be much more likely to achieve this, while it also seems clear that no amount of realistically conceivable flattening will save it.

The third Phase of the British Government’s plan is called research and has been described as follows – ‘if delaying the spread fails, the government will intensify its focus on finding out more about how the virus spreads and how those who are infected can be treated most effectively.  The government has put £40m into finding a vaccine for the virus, which is undergoing clinical testing and is likely still several months off.’

So only if the delay fails will the Government focus on finding out more about how the virus spreads and how those infected can be treated most effectively???  It is impossible to take this seriously, or rather, impossible to take the plan as a serious attempt to achieve what it purports to be its objective.

The final Phase is mitigate, which, according to Sky News again,‘implies this is essentially the worst-case scenario . . . during this phase the pressures on services and wider society may start to become significant and clearly noticeable. At this stage, the virus would be considered widespread.’

However, it is clear by now that whatever impact the Coronavirus has, it will be lessened, or ‘mitigated’, less by anything the Government does than by what people do themselves, including health service staff doing their jobs.  It is beyond doubt that they are not well prepared.

Nothing in the strategy is capable of explaining how health systems will be able to deal with the massive increase in cases involving those in vulnerable groups such as the elderly and those with suppressed immune systems.  Acute facilities will be unable to cope and Governments have long starved social care systems of funds even before the last decade of austerity.

Promises of additional money now are of limited use without concrete plans to quickly requisition buildings or begin to increase production of necessary medical supplies and equipment. And these will also require additional staff, who even now should be brought forward for training in some of the basic tasks that will be required, freeing up qualified medical and nursing staff to carry out more complex tasks.

Self-isolation can only work if many of those isolating are not totally isolated.  An efficient state would be identifying this need and the means of ensuring that these people receive the minimum help in terms of food and monitoring so that they are able to maintain their self-isolation.

To pose such tasks is to expose the weakness of the current health system and illuminate the truth that far from there being no such thing as society, as Thatcher and her acolytes would have it, we are all individuals who are nothing without it.  And the nature of that society determines how we survive and thrive as individuals.  A society that defers to a state that is essentially unaccountable and governed by a moronic narcissist like Trump, or sociopathic liar like Johnson, is not one that can respond adequately to the current threat.

A struggle is therefore required to fight this disease and protect our most vulnerable fellow workers and citizens.  Relying solely on the state, a top-down bureaucratic monster that now has monsters at its top, is not an option.  A campaign to demand an adequate response to the crisis from the state is therefore only one option.

I work in an office, for the state, and it took the local union committee to raise the question of dealing with the virus and its implications for vulnerable staff and their families before local management took even minimal action.  They were, and still are, waiting for orders from above, as everyone working for the state often does, at which point we are back in Renewable Heat Incentive-land.

In general, the union movement has failed to act as a movement (as has the British Labour Party), revealing the extent to which it is a purely sectional organisation and not a class movement; more and more a series of organisations hollowed out of active participants and dominated by bureaucrats.

Acting as a social mobilisation to protect the most vulnerable and isolated would make it appear relevant to many in the working class, to whom its current relevance is not that much.  In Ireland the high level of membership at least gives it the potential to play such a role, although no one can have much confidence that it will do so.

Instead community organisations, including the GAA in Ireland, could play a major role in identifying the most vulnerable and offering them support and assistance.

A pervasive social disease requires a wide social response that only organisations within and for the working class can hope to provide adequately.  This is the perspective that socialists should offer and advance.

In the meantime it is to be hoped that the Governments that have left their populations exposed without adequate protection pay a political price; that Johnson for example is reminded how his breezy cynicism promised that the county is “extremely well prepared” when it obviously is not.

While over half the country has bitterly opposed him as an inveterate liar, and most of the rest have regarded him similarly, the latter have at the same time also agreed with him and so supported him.  With Brexit this might have been easier to do as xenophobia could be employed to ‘fight’ the EU and the imagined hordes of foreigners and immigrants.  But Johnson’s lies will be no use against viral infection and neither will xenophobia and prejudice..

The virus will be with us for some time, if it ever disappears completely at all.  It will more and more become a political issue, as it should. While we all familiarise ourselves with viral infections and epidemiology, and seek to protect ourselves and those vulnerable that we love, we should not forget what our politics means in all circumstances.  The class struggle between oppressed and oppressor is sometimes open and sometimes hidden, but it always exists.