Category Archives: Covid-19

‘The Day the World went Mad’ – a review (3)

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No death from coronavirus is acceptable’ said Nicola Sturgeon in Scotland, while the idiot Health Minister for the North of Ireland stated that the health service could not turn away any Covid-19 patient.  When asked whether this meant that a cancer patient may die, he replied “Yes, that’s as black-and-white as it is.”

Mark Woolhouse describes the first remark, if taken literally, as making it ‘impossible to tackle the novel coronavirus epidemic in a rational manner’.   He goes on: ‘unfortunately, it was taken literally, and not only in Scotland, and that’s a large part of the reason why we ended up in lockdown.’

His argument is therefore that the lockdown policy wasn’t rational because it was impossible to find a balance between costs and benefits.  The Health Minister in the north of Ireland took it a step further and in effect claimed to throw all clinical judgement out the window by making Covid-19 patients a priority no matter what.

What sort of priority? Why a political priority of course!  One so obvious he did a U-turn, but only after the absurdity was too embarrassing.

While statistics were regularly produced on test numbers, infections, the R number and other covid metrics, the health cost of lockdown was ignored by invoking a simplistic health versus ‘the economy’ argument.  The need to protect the NHS, especially exposure of its inadequacies – due in part to Tory policy – covered up both the failure of the Covid policy and the performance of the NHS.  Woolhouse notes that during the first lockdown bed occupancy was 65 per cent between April and June while television news homed in on the small number of hospitals close to 100 per cent capacity.

Woolhouse reviews the harms of lockdown under the headings of health care provision, mental health, education, the economy and societal well-being.  He could have added the political effect of the government and state taking on dictatorial powers, frightening large sections of the population, and determining very basic activities that would never have been thought before to require some right in order to exercise.  These costs are nowhere near being evaluated and quantified even now and were all but ignored during lockdown.

Even the argument of prioritising health over ‘the economy’ had to ignore the health effects of austerity, including that an ‘additional 335,000 deaths were observed across Scotland, England & Wales between 2012 and 2019’, according to research at the University of Glasgow.  Marxists are often accused of wrongly exaggerating the importance of ‘the economy’ to social life but in this case some went further than anyone in claiming its inconsequence.

As we noted in the previous post, the first models assumed a disease with very different incidence from Covid-19, yet a later risk estimation algorithm analysed from the data of over six million people found that ‘the 5% of people predicted to be of greatest risk accounted for a staggering three-quarters of all deaths attributed to Covid-19’. It should therefore have been possible to target protection of the population in the same way the disease discriminated, and Woolhouse makes some suggestions how this could have been done, saving lives and money.

But politicians disagreed, and Michael Gove declared that ‘we are all at risk’ – ‘the virus does not discriminate’, while Health secretary Matt Hancock claimed one localised outbreak was ‘disproportionately’ affecting children.   They followed the views of certain experts who claimed, according to the BBC’s Newsnight programme, that ‘ a substantial number of people still do not feel sufficiently personally threatened . . . the perceived level of personal threat needs to be increased . . .’

The media themselves played their part by ‘regularly reporting rare tragedies involving low-risk individuals as if they were the norm.’  Then, of course, we had some on the left for whom all this was far, far too relaxed, if not a calculated conspiracy to weed out the unproductive members of the working class.

Woolhouse recounts his experience of the second lockdown, in which the failures of the first were largely repeated – ‘the case for a second lockdown in England remains weak to this day.’  On the issue of lockdown at Christmas at the end of 2020 he argued that ‘we could focus not on reducing the number of contacts but on making those contacts safe’, but states that ‘this idea did not gain hold in what became an increasingly hysterical debate.’

He observes that ‘as the second wave raged across mainland Europe, the zero Covid campaign faded away when even its most ardent supporters were forced to admit that zero was not a realistic target.’  Woolhouse, however, is obviously not familiar with all its advocates, for whom the last politically correct stance by the Chinese state has now been surrendered.  One recent article has claimed that China embraces ‘forever Covid’ when what is really happening is that Covid is embracing China as it was always going to do, with the only appropriate response being to prepare for it in the correct way.

The arrival of vaccines is presented by Woolhouse as the cavalry, and the fact that China has failed on this while pouring its energy into repressive lockdowns should be yet another lesson.  Many, however, will let the whole Covid-19-episode retreat into the distance that is known as the past and become ‘history’.

Woolhouse reviews the experience of several other countries, including Taiwan, New Zealand, and Sweden, which was prominently disparaged but which he defends.  He also addresses the experience in Africa, where he has interesting things to say but is less definitive.  He looks at alternatives but is critical of The Great Barrington Declaration, despite its emphasis on protecting the vulnerable, although it is not clear to me that his criticism is not compatible with a version of its general approach.  Of the UK’s science advisory team, he accepts that the following could have played a part in its failures: ‘group-think, unconscious bias, tunnel vision, hubris, discouragement of dissent and lack of diversity . . .’

Though disliking the term ‘lockdown sceptic’, which he thinks makes him sound like a ‘climate change denier’ or ‘flat earther’, he still declares ‘why I’m a lockdown sceptic.’  He describes what happened as ‘following the crowd even while it is stampeding in the wrong direction’ because changing course would mean admitting being wrong in the first place, although he notes that the case to do so was so compelling the World Health Organisation did so.

He lists the thigs he did not expect to happen in the pandemic, including many ignoring elementary principles of epidemiology or scientists abandoning their objectivity, and finally that the world would go mad.

‘But it did.’

concluded

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‘The Year the World went Mad’: a review (2)

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In his book Mark Woolhouse provides the story of the Covid-19 pandemic in Britain and his role as an advisor to the British and Scottish Governments.

His restrained story does not cover all aspects of the pandemic and the Governments’ response, but it is nevertheless pretty damning.  He notes that that Scottish Government didn’t set up its own expert advisory committee and have its first meeting until three days after the first lockdown, ‘by which time the course of the epidemic in Scotland and the UK . . . was pretty much set’. He criticises the World Health Organisation (WHO) for only declaring a pandemic until well into March, so undermining early action in the UK, and by which time he deems it also ‘pretty much irrelevant.’ 

In fact, WHO comes in for other scathing criticism, including for its approval of China’s strict lockdown policy – “China’s bold approach . . . has changed the course of a rapidly escalating and deadly epidemic’ it said at the end of February 2020, even as Covid-19 had already spread to forty-eight countries.  Nearly three years later China’s strict lockdown policy is falling apart and the call by the Director-General of WHO to follow its policy now looks foolish.

The UK had its own problems right from the start, including the assumption in its pre-existing planning that it was going to be fighting an influenza pandemic.  As Woolhouse puts it, the modelling group he sat on ‘had to contend with one challenge right away; it was set up to tackle the wrong disease.’

The difference this made can be seen in the models created to inform decisions on what action to take against the spread of the disease.  More appropriate for an influenza pandemic, the ‘new, bespoke coronavirus models’ included the impact of schools but not of care homes for the elderly.  Covid-19 was a disease massively disproportionately affecting the elderly, with the average age of death in the UK at 78 and 80 for deaths attributed to coronavirus, but having generally only mild effects on children.  The original influenza models also didn’t include lockdown.

Woolhouse says that ‘We’d done our homework, but we’d prepared for the wrong exam’.  He still claims that they ‘were useful tools’ but also that ‘I wouldn’t want decision-making to be over-reliant on models either’.  Unfortunately, he also says that ‘in March 2020 . . . you could easily get the impression that the UK government’s mantra of ‘following the science’ boiled down to following the models.  That’s how it looked and that’s how the media presented it.’

The models were used to produce an R number every week: the average number of cases generated by a single case. ‘The R monster turned out to be quite dangerous . . . The relentless focus on the R number detracted from the usual public health priorities of saving lives and preventing illness.’  This, for him, was part of a wider problem, accusing many scientists of ignoring elementary principles of epidemiology and abandoning objectivity and common sense.

One example, that was employed as an ignorant term of abuse also on the left, was the damning of ‘herd immunity’, and he criticises the editor of the leading medical journal ‘The Lancet’ for continuing ‘to rail against their straw man version of a herd immunity strategy.’

This criticism of the approach of many scientists is measured and unpolemical, and he presents it from an insider perspective in which models create scenarios and not predictions. He nevertheless finds a particular target in the Imperial College report number 9, which generated a worst-case scenario of half a million deaths in the UK by the end of July.  He admits to generating such a scenario himself.  ‘The problem was that these worst-case scenarios weren’t realistic and weren’t intended to be.’  This one however had the very real consequence of making lockdown ‘accepted as a necessity the first time it was proposed.’

The strategic objectives were presented as saving lives and protecting the NHS.  As Woolhouse notes, if this meant ‘trying to minimise deaths due to novel coronavirus while ignoring deaths from other causes, and if social distancing is the intervention of choice, then we don’t need a complex computer model to tell us what to do.’

Boris Johnson’s ‘flattening the curve’ to ‘protect the NHS’ had two problems according to him.  Firstly, flattening infections and hospitalisation reduced peak demand on NHS services but prolonged it, and the NHS couldn’t cope with either. The NHS therefore required more resources and, while it got new hospital facilities, these remained largely unused because it didn’t get the required staff.  Woolhouse claims the UK got what he predicted – ‘yo-yoing between intolerably severe restrictions and unsustainable pressure.’

In my own posts during the pandemic, I argued that protecting the NHS was attractive to politicians because it would also protect them from accountability for their prior policy of running the service down.  Ritual hand-clapping on the street became the substitute, while we are now invited to condemn NHS workers for striking to recover the fall in living standards incurred over the past number of years.  Perhaps these workers would be in a stronger position today if the failures of government had been exposed during the pandemic instead of demanding more of the same policy.

Woolhouse admits to supporting the introduction of the first lockdown despite concerns, because there was no other option on the table, he was unsure of the effect of earlier measures and he was not prepared to take the risk.  The central message of the book however is that lockdown was wrong and there was an alternative.  He argues that there were already marked shifts in people’s mobility before lockdown and that the latter ‘seems to have come late to the party and had surprisingly little effect.’  Imperial College published a counter-factual analysis ignoring this voluntary activity and exaggerating the effect of lockdown.  

Woolhouse notes some problems with its analysis.  Sweden never went into full lockdown but brought the epidemic under control. Imperial then claimed implausibly that its banning of mass gatherings had had the same effect. Other researchers came up with the quite different conclusion that the UK epidemic was already in decline before lockdown took effect.  He doubts that ‘anyone would claim now that the March 23rd lockdown saved anywhere near half a million lives.’

His alternative was to act earlier, but not to introduce the lockdown that was implemented, while lifting restrictions earlier.  ‘Lockdown was never going to solve the novel coronavirus problem, it just deferred it to another day, and it did so at a great cost.  Epidemiologists and modellers knew that it was going to be the case from the outset. It turned out policy-makers did not . . .’

‘Lockdown was conceived by the World Health Organisation and China as a means of eradicating novel coronavirus once and for all from the face of the earth. With hindsight, this plan was doomed from the outset . . . The world was given an intervention that only made sense in the context of eradication as the preferred means to control a disease that was clearly here to stay.’

Many on the left maintained this position – of zero-Covid – long after this was obvious, while the World Health Organisation eventually backed away from the policy.  In October 2020 it stated that ‘we really do appeal to all world leaders: stop using lockdown as your primary control method.’

As Woolhouse puts it – ‘tragically, this appeal came seven months too late and by that time a colossal amount of damage had already been done.’

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‘The Year the World went Mad’: a review (1)

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‘The Year the World went Mad; a scientific memoir’, Mark Woolhouse, Sandstone Press, 2022

The working class in Ireland and Britain face dramatic cost of living crises caused by inflation, and in the UK by austerity justified by claims that the public sector deficit has dramatically increased.  The BBC reports that ‘the cost of living is currently rising at its fastest rate in almost 40 years’ and that ‘the UK faces its biggest drop in living standards on record.’  This is ‘largely due to the war in Ukraine and the fallout of the pandemic’ says the BBC.

In Britain the sudden collapse of the pound following the Liz Truss/Kwasi Kwarteng budget was the result of large unfunded tax cuts that the international finance markets would not accept.  One reason they did not accept them was the previous massive expenditure arising from the Covid-19 pandemic.  In Britain and the North of Ireland the cost has been estimated as £376 billion, or 15 per cent of total Government debt and enough to fund over eight and a half years of a deficit that supposedly justifies the current austerity.

The war in Ukraine has resulted in sanctions by the West on Russia, which has in response limited energy supplies to the West.  Sanctions have also disrupted trade and increased many commodity costs, exacerbating the inflationary effect of state expenditure during Covid and the money printed through quantitative easing.  There was always going to be a price to be paid for the money spent as a result of the lockdown policy and sanctions on Russia and it is hardly a surprise that it is being imposed on working people.  What should be a surprise is that the Left should have opposed incurring these costs in the first place but didn’t.

In so far as the war in Ukraine goes, much of the Left has been an echo of Western Governments, which so far have been willing to incur the pain as long as it can be transferred on to rivals and/or dumped on workers.  The voices of the pro-war Left tend to mute when it comes to accepting responsibility for supporting the sanctions policy and consequent assault on working class living standards.

As far as the policy of lockdown during Covid is concerned, the problem would be massively worse had much Left advice to extend and deepen lockdown been accepted.  This book by a member of the British and Scottish Governments’ Covid-19 advisory bodies is a Professor of Epidemiology and a critic of both of their pandemic policies.  He is critical of the lockdown policy of both, of its health, social and economic costs, and insists there was a better way.

If his credentials are supposed to inspire confidence it should of course be remembered that there were many other scientists and medical experts who would disagree with his analysis and conclusions.  Appeals to authority are not going to take you very far.  It is necessary, as always, to think for yourself. His book is worth reviewing because he was an insider in the Governments’ responses and therefore in an advantageous position to recount their decisions and why they were made.  He can also provide background to the pandemic and the response to it but essentially his analysis backs up what was very largely known during lockdown and which led this blog and others to reject the consensus that lockdown was the only correct response.

As to why so much of the Left supported lockdown, this in itself is no pointer to a correct policy; we long ago left the terrain of seeking comfort in majority opinion on this end of the political spectrum.  Stalinism, social democracy and ultra-left sectarians have been making up the majority of it for a long time and even the last grouping almost invariably seeks maximum action by the state as the answer to immediate political and social problems, washed down with a heavy dose of scatological political prognoses based on the supposed radicalisation of the working class through a seemingly permanent capitalist catastrophe.

If capitalism is in permanent crisis then it would seem obviously impossible that the greatest political, social and health disasters are anything other than the immanent outcomes of capitalist economics and the calculated strategies of the representatives of the capitalist class.  This resulted in some on the left demanding even greater lockdowns because the existing ones were either a sham or simply inadequate.  This involved highlighting the potentially worst possible outcomes, repeating the greatest scares and calling for the most drastic actions.

Their recommended policy ignored the level of repression required to enforce their preferred extreme version of lockdown, and ignored the real costs of existing lockdowns and the very impossibility of achieving more restrictive enforcement. It ignored the stupidity of closing down production of goods and services while calling on the state to fund the incomes of workers who produce them so that they could buy the goods and services that they were being paid not to produce.  Anything else was denounced as sacrificing lives for profit, as if under capitalism the goods and services required to produce and reproduce life could be created any other way.

From this perspective the advantage of this book is that it is not in the least concerned with much of the disputation on the left, but may be read as a critique of their proposed approach from which they might at least ask–did we get it wrong?

Forward to part 2

Goodbye Covid-19?

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Common Cold Can Protect Against Infection by COVID-19 Virus

Professor Tim Colbourn of University College London was quoted in the ‘Financial Times’ (on 4 Jan) that it was “entirely reasonable to think that the burden of Covid can be reduced by 95 per cent in 2022, so that it’s no longer a top 10 health problem.  That would be a reasonable goal to end the pandemic.”

The article notes that ‘some experts view Omicron itself as a pointer to future evolution of the Sars-Cov-2 virus, as natural selection favours mutations that pass quickly and efficiently between people who already have some immune protection . . . These conclusions are supported by epidemiological evidence that the risk of severe disease is reduced by half or more with Omicron.’

The Director of the Wellcome Medical foundation, Jeremy Farrar, is quoted as saying that he was reassured at the prospect of Omicron taking over from Delta and that “I’d be more worried if you had different variants circulating at the same time.” 

The article states that ‘another variant of the virus is a certainty and that while individual changes in the genetic code are random the environmental pressures that allow some to thrive are not.  This favours variants that transmit quickly while evading immune response but mutations that make the virus more lethal are unlikely to make it fitter and may even be a handicap.’

Jennifer Rohn, a cell biologist and UCL professor, said that “although you can imagine a deadly new variant emerging that’s more harmful . . . I don’t know how feasible that would be for this virus.  Sars-Cov-2 depends on infecting cells and it may already be close to the limits of its repertoire.”

The article notes that the view that the virus will become milder is ‘a matter of debate among scientists’, but quotes another professor of medicine at the University of East Anglia, Paul Hunter, that he is convinced this is true of coronaviruses.  “Sars-Cov-2 will continue to throw up new variants forever but our cellular immunity will build up protection against severe disease every time we’re infected. In the end we’ll stop worrying about it.”

Jeremy Farrar notes that there is a small risk of an evolutionary jump – “something out of left field that does not come from existing lineages”, the article states that ‘most experts regard it as extremely unlikely. “I’m much more scared of another pandemic caused by a new virus that we don’t yet know about than by some variant of Sars-Cov-2” says Tim Colbourn.

Since much of the left has taken a doomsday view of Covid-19 this is perhaps not good news for their perspectives.  How they can continue to argue for a zero-Covid policy – the article quotes a forecast of 3bn infections world-wide over the next two months – is a terrain I don’t really want to explore.  With perspective not far from the fictitious character Private Frazer of ‘Dad’s Army’, perhaps they will cling to a dialectical understanding of the non-linear revolutionary genetic leap that will confirm their pessimism.

They will not, in addition, be enamoured with the views of the former chairman of the UK’s vaccine taskforce, Dr. Clive Dix, who has said ‘Covid should be treated as an endemic virus similar to flu, and ministers should end mass-vaccination after the booster campaign.’

He effectively repeats the views of Dr. Gerald Barry in Dublin quoted in the previous post in calling ‘for a major rethink of the UK’s Covid strategy, in effect reversing the approach of the past two years and returning to a “new normality”.

“We need to analyse whether we use the current booster campaign to ensure the vulnerable are protected, if this is seen to be necessary,” he said. “Mass population-based vaccination in the UK should now end.”

‘The Guardian’ article goes on to report him saying that ministers should urgently back research into Covid immunity beyond antibodies to include B-cells and T-cells (white blood cells). This could help create vaccines for vulnerable people specific to Covid variants . . .  adding: “We now need to manage disease, not virus spread. So stopping progression to severe disease in vulnerable groups is the future objective.”’

The article quotes Professor Eleanor Riley, professor of immunology and infectious disease at the University of Edinburgh, saying: “Everything depends on whether another variant comes up.  A fourth dose or second booster of the existing vaccine probably isn’t going to achieve very much. The evidence is that immunity against severe disease is much longer lasting. The only justification for doing a second booster for the majority of the population would be if we saw clear evidence of people, five or six months after their booster, ending up in hospital with severe Covid.”

Most people will welcome these views, if only because it’s what they want to hear, as they are tired of lockdown and fed up with the restrictions on their lives.  One danger of pretending everyone has been equally in danger from Covid-19 was always that the vulnerable would be overlooked.  A continuing blanket assertion that we are all still threatened, including children, is worse than useless.

The left’s zero-Covid strategy has nowhere to go, except to expose its exponents as wild catastrophists whose ultra-left politics is exposed once again; supporting longer restrictions for which more and more people can see little justification.  Believing that socialist revolution can only arise out of crisis, they wrongly assume that every crisis requires revolutionary methods.  They do so in pursuit of relevance and sign of their revolutionary purity.  That social crisis has not shown itself conducive to working class politics was the subject of some of the earliest posts on this blog.

A continued forlorn and regressive campaign for zero-Covid will ignore the real issues that are arising, and will have to argue that individual, very basic, freedoms and civil rights should continue to be suppressed by the state.

The issues arising include other costs of lockdown, which will affect working people, and the young especially, for decades.  A left that wants this lockdown extended and deepened has no credibility in responding to these problems.

These costs include financial, health and educational losses.  Calls by the left for the government to pay for workers not to work exhibit all the ignorance often called out by conservatives and reactionaries.  Those workers genuinely at risk or sick must be fully protected but this requires that the rest of the working class actually continues to work.  Real mass lockdown of society is impossible.  Pretending that only ‘essential’ workers should continue to work divides the working class perniciously and reveals levels of ignorance about a division of labour under capitalism that makes the vast majority ‘essential’.

As for asking the government to pay, this reveals incredible confusion at multiple levels – illusions in the capitalist state; illusions in the power of money without workers producing goods and services to buy with this money; the effects of inflation on workers’ living standards in simply handing out money, and the fact that governments don’t pay for anything – they tax or borrow and pay back the latter with the former, unless of course they print money, but then see previous comment.

If any of what this left claimed was true for any length of time, the ‘property question’ which Marx said was key would not be the ‘leading question’ in socialist politics.

More immediately, socialists should support workers being back in the workplace, in order to strengthen their feelings of shared identity, interests, solidarity and organisation.  Concern about health and safety should be dealt with collectively, which is much easier to do if you actually work closely together.

The Health Service has failed – see this earlier post – but to say so is almost to be damned as impugning the staff who work in it, some of whom have made real sacrifices during the pandemic.  Unfortunately, the politicians and bureaucrats who have been responsible for the incapacity of health services to carry out their role have cynically hid behind them, substituting rhetoric about heroes and rituals of hand-clapping for an effective service.

The British left is especially bought into illusions in the NHS, which is a health bureaucracy that was exposed from the start as incapable of protecting even its own staff.  The overwork of many staff is testament to its essential nature as a medical bureaucratic creature of the state, which for socialists is first and foremost a capitalist state with operations, functions and direction determined by the requirements of its class character.

Much of the Irish left wants an Irish NHS, because health care in the South is two tier, in complete ignorance of the fact that the failure of the NHS in the North means that health care there is more and more two tier as well.

Health provision in the pandemic has undergone a real crisis, with services closed down or restricted, waiting lists increased and diagnoses not carried out.  Just like an economic crisis, no crisis goes to waste as far as those in power are concerned.  Simply defending the existing service and believing that more money is the answer is an illusion.

So, to answer the question – Covid-19 will only go away if a zero-Covid policy was possible and was implemented.  It isn’t possible so it isn’t going to happen.  Instead Covid-19 and the mistaken reaction to it will leave in its wake multiple problems.  We need to understand the reason for this mistaken reaction and what the correct approach now is to the current and future evolution of the disease.

Back to part 2

‘Lockdowns . . . a failure of public health policy.’

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Coronavirus: 133 patients in intensive care as pressure on hospitals builds

When University College Dublin virologist Dr Gerald Barry was interviewed by ‘The Irish Times’ and asked ­– why have we so many cases when we’re so highly boosted? – he said ‘Even asking the question points to the root of our problem in Ireland and in many parts of the world, we are using a tool that isn’t designed to stop infections and then wondering why it didn’t stop infections.’

‘I would strongly advocate for a complete reassessment of everything we have done to this point, identify everything else that could be done that would help, knock off everything that isn’t feasible or is unaffordable and do everything else.’

So we have failed? – ‘The problem with a “do more” strategy is that some countries that have demonstrably done less to curb the spread of infection, such as England, seem to be doing better overall.’

Just such a reassessment was recently reported in ‘The Guardian’ from Professor Mark Woolhouse, ‘one of the country’s leading epidemiologists’, who has written a forthcoming book, ‘The Year the World Went Mad: A Scientific Memoir’.  Lockdown, he says, ‘was a lazy solution to a novel coronavirus epidemic, as well as a hugely damaging one”.

The day Britain went mad is reported as when ‘the No 10 briefing in March 2020, cabinet minister Michael Gove warned the virus did not discriminate. “Everyone is at risk,” he announced.’  To which Woodhouse responds: “I am afraid Gove’s statement was simply not true. In fact, this is a very discriminatory virus. Some people are much more at risk from it than others. People over 75 are an astonishing 10,000 times more at risk than those who are under 15.”

 “We did serious harm to our children and young adults who were robbed of their education, jobs and normal existence, as well as suffering damage to their future prospects, while they were left to inherit a record-breaking mountain of public debt.  All this to protect the NHS from a disease that is a far, far greater threat to the elderly, frail and infirm than to the young and healthy.”

“We were mesmerised by the once-in-a-century scale of the emergency and succeeded only in making a crisis even worse. In short, we panicked. This was an epidemic crying out for a precision public health approach and it got the opposite.”

That Covid-19 is a disease that discriminates is a point made often on this blog and by others, which should have signaled that a blanket approach wasn’t warranted.  A recent paper analysing this has recently been published, which shows the disparity in effect by age, despite the difficulties in measurement. 

It records that in ‘Twenty-five seroprevalence surveys representing 14 countries were included . . . the median IFR [Infection Fatality Rate] in community-dwelling elderly and elderly overall was 2.9% (range 0.2%-6.9%) and 4.9% (range 0.2%-16.8%) . . . IFR was higher with larger proportions of people >85 years. Younger age strata had low IFR values (median 0.0013%, 0.0088%, 0.021%, 0.042%, 0.14%, and 0.65%, at 0-19, 20-29, 30-39, 40-49, 50-59, and 60-69 years . . .’

These IFRs have been calculated using data from 2020 and are therefore before widespread vaccination, at least in richer countries and before the less virulent Omicron variant.  We can therefore expect these numbers to have fallen not only due to vaccination but also better hospital treatment as lessons began to be learned about ventilation etc.  The paper notes that ‘absolute risk values still have substantial uncertainty’ and mentions the low number of elderly in the studies examined by the paper, but which might also reflect uncertainty about the total number of infections and number of deaths actually caused by Covid as opposed to deaths of people with Covid.

The link here to IFRs for various diseases shows that for the younger age groups Covid-19 is far down the list.  According to the European Centre for Disease Prevention and Control here Influenza (over all ages) appears more severe than Covid-19 for those aged below 30 although this also depends on the virus, host issues, and other factors.

The paper also notes that ‘besides age, comorbidities and lower functional status markedly affects COVID-19 death risk. Particularly elderly nursing home residents accounted for 30-70% of COVID-19 deaths in high-income countries in the first wave, despite comprising <1% of the population. IFR in nursing home residents has been estimated to be as high as 25%.’

Professor Woolhouse argues in ‘The Guardian‘ article that:

‘the country should have put far more effort into protecting the vulnerable. Well over 30,000 people died of Covid-19 in Britain’s care homes. On average, each home got an extra £250,000 from the government to protect against the virus . . .  “Much more should have been spent on providing protection for care homes,”

He ‘castigates the government for offering nothing more than a letter telling those shielding elderly parents and other vulnerable individuals in their own homes to take precautions,’ something this bloggers’ wife found particularly galling as medical personalities and politicians congratulated themselves and were congratulated by others for efforts on her and others’ behalf which consisted of nothing much more than a letter.

As ‘The Guardian’ goes on in reporting Woodhouse’s views ­– ‘The nation could have spent several thousand pounds per household on provision of routine testing and in helping to implement Covid-safe measures for those shielding others and that would still have amounted to a small fraction of the £300bn we eventually spent on our pandemic response, he argues. Indeed, Woolhouse is particularly disdainful of the neglect of “shielders”, such as care home workers and informal carers. “These people stood between the vulnerable and the virus but, for most of 2020, they got minimal recognition and received no help.”

The British Government, according to Woodhouse, thus “lacked a convincing plan for adequately protecting the more vulnerable members of society, the elderly and those who are immuno-compromised.”  

“Lockdowns aren’t a public health policy. They signify a failure of public health policy.”

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Forward to part 3

Covid-19 Delta – ‘the biggest hurricane that has ever hit Ireland’

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Ireland on cusp of fourth wave of Covid due to deadly Delta variant, NPHET warns - Irish Mirror Online

The Irish State has reached the milestone of 5,000 deaths associated with Covid-19 at the same time as it controversially announced that there will not be a reopening of indoor hospitality on 5 July as planned.

Two weeks ago a government source had said that “the narrative that our reopening will slow down is not true.’ However that was before the National Public Health Emergency Team (NPHET) presented advice to it that a pessimistic ‘scenario’ forecasted 2,000 deaths over three months, largely due to the new Delta variant of the disease, with advice that only vaccinated people and those who have had Covid should be allowed inside restaurants etc.

Such a measure was denounced as ‘absolutely bananas” by one opposition leader amid accusations that it was unworkable, discriminatory and potentially illegal, never mind the damage to the social bond that arises from everyone making sacrifices together.  Young people, it seemed, who predominantly serve in hospitality but are unvaccinated could serve, but not be served. Sinn Fein denounced the Government while more quietly accepting the decision; in this case talking more softly out of one corner of its mouth than the other. What would you do if faced with this dreaded forecast was the stock response from the governing parties.

While it was noted that NPHET had failed to factor into its assumptions newly allowed vaccination of younger people and there were calls for an independent audit of its modelling, plus claims that the Irish were an outlier in Europe in terms of indoor hospitality, by and large the figures were accepted without real challenge.  The Irish State has had one of the strictest and longest lockdowns in Europe but if many more people are no longer so scared as they were, there is no alternative critical view of State policy beyond making it harder.

There are a number of reasons for this including that the Irish State has done relatively well in relation to deaths:

State support payments to the unemployed and businesses have continued, and political opposition, including from the left, has been in favour of even tighter restrictions.  Such opposition as has declared itself, has been restricted to the far-right, including anti-Vaxxers who are easily dismissed but serve to make any other criticism easier to ignore.

The Irish economy is also set to grow by over 8%, according to the Central Bank, with this growth having less to do with base effects (the previous fall caused by lockdown making future growth easier statistically as well as economically) because the Irish economy has been hit less by Covid-19 despite the lockdown. The disproportionate presence of US multinationals, which includes companies in the pharmaceuticals, medical devices and IT sectors, has seen demand for their products increase.

An opinion poll in June reported that ‘fewer than one third of voters (32 per cent) agree that life should return “to the way it was before Covid” even after most people are vaccinated. Almost two-thirds (65 per cent) say that some precautions should remain in place, such as wearing masks in shops. Older voters remain significantly more cautious on this issue, with 79 per cent favouring continued precautions.’(Irish Times). The greater threat to older people goes a long way to explaining their particular concerns, as does the failure of the state to protect these people in its care or in private homes for which the state still has a responsibility.

That this number of people are so anxious is not a healthy sign, either from a psychological view or politically. A scared population is not one that is likely to be critical of state policy or seek to map out its own alternative. From a socialist viewpoint it is not conducive to independent thought by workers and rather affirms their social subordination.  In this case the attendant denial of very basic civil liberties emphasises it.

Given the current very low level of cases, hospitalisation and deaths, plus the summer season, the dire warning by the Minister of Health, that “the biggest hurricane that has ever hit Ireland is coming’ simply reaffirms all these negative effects of state policy. Although one must assume his remark excludes An Gorta Mór.

The Government’s decision rests heavily on the most pessimistic of four scenarios presented by NPHET:

The presentation by NPHET shows a wide variation between a central scenario of 187,000 cases in three months and 545 deaths, and the pessimistic scenario of 682,000 cases and 2,170 deaths.  Given the prevalence of the Delta variant, plus greater transmissibility by Alpha, it is the increase in social mixing that appears as the cause of the difference, but this is placing a big burden on indoor hospitality to make this the cause of such an increase.  It is the possibility of the pessimistic scenario that is nevertheless given as the reason, although no probability is presented and the message appears to be that no possibility is acceptable.

The Chief Medical Officer has admitted that advice from his Scottish equivalent is that the Delta variant presents less risk of hospitalisation even if it is more transmissible.  It is already well known that the virus is predominantly a threat to life to those who have other underlying health conditions.

The most recent figures published for the period up to 12 December 2020 report that 93.4% of deaths were of those with an underlying condition.  The figures for those who had Covid-19 and also had an underlying condition was 16.9% for those aged 25 – 34, 52.58% for those aged between 65 and 74, and 59.4% of those 75+.

Clearly it is older people who are most at risk and it is mainly older people who are dying.  The proportion of total deaths accounted for by 25 – 34 year-olds at 11 May 2021 was 0.81% while it was 15.5% for those aged 65 – 74, 33.75% for those aged 75 – 84, and 42.39% of those aged 85+.  In other words, 91.64% of deaths were of those aged 65 and over, but being over this age is not sufficient to have a severe risk posed, you also need to have a relevant underlying condition.

NPHET has reported that cases amongst the eldest has fallen and lower than younger age groups, as this heat map shows:

This is due in good part to the vaccination programme prioritising by age but also by considerations of those most vulnerable.  The programme has also prioritised health care staff although this was supposed to be targeted to front line workers.  In the North not so much pretence was made and back-office support workers with no interaction with patients were vaccinated before, for example, immunosuppressed cancer patients.  The mantra of ‘protect the NHS’ reached a logical conclusion when bureaucrats came before extremely vulnerable patients. While the Southern vaccination programme has been beset by some scandal in which relatives of senior executives and others favoured by them have been vaccinated out of priority, the existence of similar in the North has gone unreported.  

In both jurisdictions the unchallenged requirement for vaccination of health care staff arises because both health systems have been incapable of implementing effective infection control.  In part this is because of the large number of Covid patients hospitalised but this in turn has been mainly due to the failure to protect older people, including those in care and nursing homes.  The Irish Government Covid-19 hub reported, as an example, that on Tuesday 11 May over half of hospitalised cases were in the over 65 age group.

In any case, the vaccination programme has gone a long way to protecting those most vulnerable.  Among these the rates of full vaccination are very high – 94% of those aged 80 and over, and 91% of those aged 70 – 79.  Among the 60 – 69 age group 43% are fully vaccinated while 93% have had one dose. Around 68 per cent of all adults have had one dose of the vaccine, while 45 per cent have had full vaccination.  This compares with Scotland where the incidence of infection, and by the Delta variant, has dramatically increased but existing relaxation of restrictions, including on indoor hospitality, have remained.

However, the argument of the government and NPHET is that the vaccination programme has not progressed sufficiently to reduce the risk and that it is younger people who must be increasingly targeted by the vaccination programme.

However, it is openly acknowledged that the dire warnings and continued restrictions are based on uncertainty about the possible number of cases, the number that will be hospitalised and the number of deaths.  NPHET has forecast 2,170 in the next three months in its pessimistic scenario, but this would mean an over 40 per cent increase in the existing death toll in a very short period, one-fifth the time of the preceding pandemic.  This, when the most vulnerable have received some sort of vaccination, so protecting them to a significant extent against both hospitalisation and death, and against a dominant variant we are informed involves less risk of hospitalisation.

There is a final reason to be wary of attempts to frighten the population and potentially introduce discriminatory measures against those who face least risk.  Leo Varadkar has written ‘that Ireland is among a small number of countries that includes in our numbers suspected and probable deaths from Covid even when the patient did not test positive or was not tested at all.’ 

The Northern Ireland Statistics Research Agency has reported that: 

‘There were 1,626 deaths registered up to 31st December 2020 where Covid‐19 was identified as the underlying cause of death (88.8% of the 1,831 Covid‐19 related deaths). For 157 out of these 1,626 deaths (9.7%), there were no pre‐existing conditions.’

‘In Scotland, 6.8% of deaths involving Covid‐19 from March to December 2020 had no pre‐existing conditions. In the same period, the Office for National Statistics found 12.5% and 17.2% of Covid‐19 deaths had no pre‐existing conditions in England and Wales respectively.’ 

‘The Health Protection Surveillance Centre in the Republic of Ireland found that those who died with confirmed Covid‐19 up to 12th December 2020, 93.4% reported an underlying medical condition. The differences in these proportions between countries could be due to differences in the methodology and demographic make‐up of each country.’ 

The definition employed by NISRA is that the ‘underlying cause of death’ is a ‘disease or injury which initiated the train of morbid events leading directly to death’. On its own Covid-19 causes few deaths yet the virus has assumed unprecedented power to freeze social activity and civil liberties.

All the factors that might cause the Irish State to have a better outcome have received little attention, including it having by far the lowest proportion of its population in the EU in the over 65s.  As has been pointed out, 500,000 Irish people left for Britain in the 1950s and a further 300,000 in the 1960s. How many of these died in Britain who might have done so in Ireland?

There is no evidence that identifying those at risk and protecting them has been seriously considered or modelled.  As I have noted in previous posts, the state has in fact failed these people in the guise of protecting everyone.  That other states have also failed similarly has acted as some protection for them.  

The issue isn’t that indoor hospitality has been postponed to whenever, or the unemployment or business failures that will result, or even that it has involved justification through discrimination.  The issue is that it is yet one more example of an ‘abundance of caution’ ignoring the associated abundance of cost.  Where is the modelling of the health and social cost of lockdown?  Where is NPHET’s and the Irish State’s pessimistic ‘scenario’ for it?

A year of Covid-19 (3) – the Irish experience of following ‘the science’

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Following ‘the science’ and its scientists that we looked at in the two previous posts does not look well in hindsight, as a short review of the course of the pandemic in the Irish State demonstrates.  In the early days these were forecasting 20,000 deaths, six times the current figure which is just over 3,300, and an even greater over-estimate than the influential Imperial College paper that forecast a possible 500,000 deaths in the UK.

At the start, what characterised the response, just like Britain, was complacency.  On 4 March the Chief Medical Officer Tony Holohan of the HSE stated that “as things stand” there was no reason why the St Patricks day festival could not go ahead, and he did not believe that it was proportionate to prevent Italian rugby fans from visiting Dublin for a cancelled match.  The attendance of thousands of Irish racegoers at the Cheltenham festival also went ahead.  From the point of view of the generalised lockdown that was later to be implemented this was a catalogue of mistakes.

The State supposedly had a policy of test and trace, in which all cases could be identified and followed up to ensure isolation.  The system and its resources were quickly shown to be inadequate, with it only subsequently being admitted that test and trace did not identify where infections came from.  Prof. Philip Nolan from the National Public Health Emergency Team (NPHET) stated that “we would like to go back and find out where people are getting the virus, but we don’t have the time or resources to pursue this academic exercise”.  In any case, in October researchers from Beaumont reported that up to two out of every three infections could be missed through poor technique when people are being swabbed.

At this early stage the policy on testing was confused: so to be tested before March 12 a person had to be symptomatic or either in close contact with a confirmed case or have travelled from an affected area. Then having one symptom was required, then the list of symptoms changed, and if this threshold was passed the person needed to be in a priority category.

These early mis-steps have led many to see the issue as being one of weak or incomplete implementation of policy rather than the policy being misconceived in the first place.  The record suggests the latter.

The island of Ireland could not isolate itself from the rest of the world so could not avoid importing the infection.  Having imported it, it was always going to be impossible to identify all cases since most were asymptomatic.  Social distancing and isolation of suspected cases was considered to be the equivalent of the mass quarantine implemented elsewhere but was not.  The measures adopted simply slowed the spread of the infection, justified to protect the health service, but with the by-product that doing so gave it time to mutate, as it did.

Much bigger ‘mis-steps’ were made at this time, again flowing not from failure to adequately implement policy but as a result of its conception. On March 6 the representative organisation of private nursing homes, Nursing Homes Ireland, (NHI) banned all visitors to its homes.  Four days later Tony Holohan of the NPHET questioned the closures “before they are really necessary” while the Department of Health only eventually gave approval to the action ten days after NHI had introduced the restrictions.

In early March Holohan was claiming that ‘we had reacted very early and with significant action compared to other countries’, although the performance of these other countries seemed to be held up as some sort of exculpation rather than a pointer to a failing common approach. For the Chief Medical Officer their response “in the first instance had to focus on dealing with community transmission of this virus.  There was simply no way of protecting nursing homes or any other institutional setting if we don’t control the spread of this infection in the community.”

NPHET later claimed that it was not until late March that research pointed to the threat of asymptomatic transmission in care homes although by the end of May Paul Reid, chief executive of the Health Service Executive (HSE), was acknowledging that “there are obvious gaps in clarity and responsibility in the overall governance and oversight of private nursing homes.”

By mid-April Holohan was stating that vulnerable groups in care settings were a priority, but by that time there were 330 outbreaks in residential cares facilities, with concern expressed about under-reporting.  While boasting of the “unprecedented level of support” given to homes the HSE was unable to provide up-to-date figures for deaths.

Not much later Holohan was stating that it was “not realistic to think we could keep it out of homes”, while by the end of April it was reported that 735 people had died in residential community settings.  By early May the mortality rate in nursing homes was three times that among the rest of population, accounting for 61 per cent of deaths (including those in other residential facilities).

By the end of May the Department of Health had been warned by the health regulator of more than 200 “high risk” nursing homes, while receiving “just an acknowledgement” and “no response”.  NHI had quickly raised concerns around PPE and hospital discharges, but by late March 88 per cent of homes had bought either their own PPE or used home-made. Almost half of nursing homes said that they had to wait 10 days for test results to come back, and publication of cases in particular homes was not provided (unlike for hospitals).

By June it was apparent that nursing and other residential facilities were not the only health and social care facilities where infections were occurring.  At the start of the month, it was reported that more than 200 people had contracted coronavirus while in hospital in 102 outbreaks. By the end of August, it was also reported that about 90 per cent of all cases among over-65s were of nursing home residents (between March and end of June), amounting to almost 6,000 cases resulting in 968 deaths (56% of the total at that point).

By the beginning of the following month concern was again being expressed at the rise in cases among older people.  In early October a NPHET letter noted a ‘sustained increase’ in cases, with home residents accounting for more than half of the 1,810 virus-related deaths, but with Holohan again asserting that it was not possible to document all patterns of infection and that measures directed to the whole population were needed.

The Health Information and Quality Authority (HIQA) expressed concern that there was no “consistency of approach” on whether nursing home residents should be tested where staff had tested positive. The HSE chief clinical advisor claimed that older people could not be “siphoned off safely” but the chief inspector of HIQA stated later that “not all centres where staff have tested positive have undertaken a programme of resident testing.”

In November, NPHET priorities, according to Holohan, were protection of the most vulnerable, continued resumption of non-Covid health and social care services and education of children; but by mid-November it was reported that in the week up to Oct 31 there were 56 outbreaks of infection in nursing homes and 33 associated with hospitals.

Lockdown however appeared to be getting some results, even if this was little more than postponement rather than eradication. This was now success, as was the perceived protection of a health system unable to adequately do its own job of protection.

By the beginning of December the Irish state was hailed, especially by itself, as the best performing in Europe measured by the average number of new cases.  Unfortunately, even in success the most significant threat remained, with Holohan expressing concern at the level of infections in nursing homes despite the highest Level 5 lockdown.  Hospitals also remained a problem, and on 13 November it was reported that pre-admission tests for Covid that had been recommended for hospitals were not being practised by all.  Anne O’Connor, the chief operations officer of HSE, stated that guidance had been changed in the previous two weeks.

By December the problem with hospital acquired infection was continuing, with over 200 confirmed cases in the four weeks up to 13 December and more than 400 picking it up in hospital in two weeks in January.  By the new year the Irish State had gone from the being the best in Europe to being the worst in the world in terms of growth in cases.  The State went from 80,000 cases in nine months to doubling this total in three weeks.

Since there had been a partial opening before Christmas this was held up for blame but there remained no evidence that cafes, hairdressers or clothes’ shops were a problem; it was a question of a seasonal infection flourishing in its best environment with any human interaction facilitating spread.

Doing away with the latter altogether was the only logical extension of the existing policy and all the variations on the different social distancing rules were the proverbial number of angels dancing on the head of a pin.  Very few wanted to go there, and those who might would face the difficulty that closing down sites of infection might have to start with hospitals and nursing homes, with 100 outbreaks in the former from July to mid-December and 93 in the latter.  A study in mid-January reported that the rate of infection among hospital staff in Galway and Dublin was six times that of the local community.

Despite the months of restrictions and despite the worst-in-the-world figures there did not appear to be excess deaths.  The prevailing narrative appeared to tell a story that did not add up.  One aspect however appeared stubbornly consistent, the median age of those dying was reported in mid-January to be 82.  This outcome was consistent with the North despite its apparent different path, with people aged 75 and over accounted for 77.7 per cent of ‘coronavirus-related’ deaths and with 91.5 per cent having some pre-existing condition, Dementia and Alzheimer’s disease being the most common.

Back to part 2

A year of Covid-19 (1) – following ‘the science’

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On 20 April last year the lead story in ‘The Irish Times’ was a report of research led by an Irish scientist that there may have to be repeated waves of Covid-19 epidemics until enough of the population is infected to provide herd immunity.  At best there would be three more infection cycles before 60 per cent was infected, enough for immunity.

It reported intense debate on the subject, with World Health Organisation epidemiologists warning that there was no proof yet that having the infection would confer immunity for a significant period of time.  Later, when it was apparent that immunity did occur, the response was that the level of antibodies recorded in previously infected cases declined more or less rapidly so that immunity would also decline.  This however did not take account of the body’s reduced need for higher levels and its newly acquired capacity to ramp up again if required; it also did not take account of the role of T-cells in fighting infection.

The point however, is that herd immunity was not dismissed as beyond the pale and was not considered a euphemism for mass murder.  In fact, as the link to the debate below records, herd immunity is not so much a strategy as an outcome, the inevitable outcome of defeating the pandemic.  That it has been understood as anything else illustrates the impairment of critical thought that has accompanied the physical restrictions introduced by lockdown.

Throughout the pandemic, governments in Ireland, Britain and elsewhere have been keen to demand that people follow ‘the science’ (as they put it), backed up by certain scientists or doctors, usually on the state payroll, who have given authority to government policy even when it is sometimes reported that they don’t agree with it.

The appeal to authority, the idea that there is one ‘science’ with one rational direction available to policy makers, the unwillingness to debate, and repeated charges of lack of transparency; all these are very far from any scientific approach.  The debate here on what the correct approach should be is an example of what has not been presented to populations.  The effects of this have been many and not always acknowledged.

I recently had a disagreement on Facebook with a supporter of a ‘Zero-Covid’ strategy, who refused to accept our differences were political, claiming that there was a psychological issue involved with my approach (along with some other remarks I have committed to amnesia).  The alternative that I argued, of focused protection of the vulnerable and opposition to generalised lockdown, was not received as a legitimate one to be considered, but simply one to be condemned and damned as so mistaken as to be the product of some psychological imperfection.

What was remarkable was that the principal issue facing the world was argued as something above, beyond or otherwise disassociated from politics.  Marxists, and this guy is one of long standing, are supposed to base their ideas on the reality that science, morality and all aspects of human behaviour are permeated with politics.  Science has its political aspects and the actions of the Government and state obviously does, especially when they involve drastic restrictions on human activity.

So, to regard Covid-19 as a non-political issue is absurd.  That such an argument could arise on social media is not at all surprising since everything under the sun appears on it.  In this case however the response is not uncommon, and is a mirror reflection of the approach taken by almost all Governments, which is to deny legitimacy to any questioning of their policies.  We can see this clearly for example in the pathetic ‘opposition’ of Keir Starmer, whose only point of disagreement is that the lockdown policy of the Government has been implemented incompetently and incompletely.

The policy of inducing fear into the population is ably assisted by a willing media seeking the simple and the sensational, through stressing the lethal nature of the virus; repetition of statistics on cases, hospitalisation numbers and patients in intensive care; the numbers with ‘long-Covid’; the prominence given to sufferers among the young, and of course the rising number of deaths.

This goes along with a determined policy of down-playing the specificity of those most under threat, and claims that the virus is either out of control or will utterly swamp the health service.  The fear generated has enough truth behind it to get acceptance of actions that would in normal times have generated heated opposition; including cancelled urgent cancer operations and a policy of isolation of individuals that admits that increased domestic abuse and enormous deterioration in mental health will follow.  The cumulative effect in generating fear is to dampen and discourage further the exercise of people’s critical faculties.

Instead of opposing all this, much of the left has echoed it and amplified it, as my minor Facebook argument illustrated.  This Left demands stricter and longer lockdowns and ‘zero-Covid’, i.e. no cases and no deaths from Covid.  To state that there is an alternative approach to generalised lockdown, and admit that some deaths will almost certainly result, is to damn oneself out of one’s own mouth.  How dare you advocate a policy that accepts any deaths!

We will, for the moment, leave aside the obvious truth that the current lockdown policy has abysmally failed to prevent avoidable deaths, and that the ‘Zero-Covid’ policy has yet to indicate what injury and deaths would flow from its implementation.  It has failed to admit that it would have to be enforced; that the state would have to do the enforcing and that it would have to apply much enhanced powers of coercion to attempt to achieve it.  An additional result would be to limit further the space for open debate on different approaches and alternative futures following the pandemic.

The policy of the Left has not been to encourage scientific debate but to back one element of the consensus view that lockdowns are the answer.  The problem here is that there has been far from a free debate on what the best approach to dealing with Covid-19 is and not, as the left would have it, a refusal to follow through on what is so obviously the right, or rather only, one.

These two articles, here and here, show that there is no single and unequivocal scientific approach that supports lockdown.  Rather, there is an intensely political debate within the scientific community that has suffered from, but resisted, restrictions on discussion.  The result of the attempt to impose a single approach has been the development of what has been called ‘groupthink’, censorship and self-censorship and something of a climate of fear, in which critical thought is seen as criticism of the scientific establishment, which might be damaging to the careers of those who engage in it.

The inevitable uncertainties generated by a new viral infection requires engagement with the issues that the political establishment does not believe the population can handle, something the media reinforces with its superficial treatment of every issue.  The mechanisms and apparatus that circumscribes political argument has been easily employed to narrow debate on the right approach to dealing with the pandemic.  The idea that the issues around it are non-political is, to repeat, ludicrous.

This political debate has been grossly distorted by an anti-scientific assault by the far-right, typified by the often-imbecilic antics of Donald Trump, with his alternative denial of the virus, its importance, his success in dealing with it, and his recommendation about drinking bleach.  The mass base of scientific ignorance he mobilised in the US has been reflected everywhere to a greater or lesser extent.  The effect on rational criticism of the prevalent lockdown approach has been to prejudice reception of it and create a barrier to its discussion.  Sections of the left have joined in, unwittingly contributing to the anti-scientific shut-down of rational debate.  As with so many issues, the opposition to lockdown by sections of the right, whether of the crazed anti-vaxxers or libertarian conservatives, has been the cue for some on the left to take an opposing view.

We are over a year into the pandemic, about a year since it hit Europe, and there is no excuse for lack of debate on how to deal with it. Only episodically has one taken place in Ireland and like everywhere else, any alternative to lockdown has been subject to condemnation. It has had its own share of far-right sceptics that have made the task of challenging the lockdown consensus harder; but the fact is that the policy of lockdown has failed, and the experience of the last year has proved it, which is what we will review in the next post.

Forward to part 2

The Left and Covid crisis

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The policy of lockdowns has been approved by many on the left, with the additional argument that they have not been strict enough.  Some appear to believe that pandemic induced crises necessarily open up opportunities for revolutionary crises.  These are considered opportunities to mobilise the working class to resist attacks on its social position and turn it towards socialism.  Crises then become both the necessary and sufficient condition for political revolution.  What these sufficient and necessary conditions might actually be is not considered.  That question has been answered and is no longer a question.

Previous crises have not entailed socialist revolution, but rather than investigate why this is, the approach has been to lament the weakness of the revolutionary left and the treacherousness of existing working class leaders.  Crises therefore are expected to do much of the heavy lifting of working-class political consciousness, allied to an unexplained rise to prominence of revolutionary organisations.  Rather than see such crises as occasions of potential radicalisation which must be based on prior conditions giving rise to class consciousness, this consciousness is assumed to arise from crises itself and the spontaneous activity generated.  This latter activity is then fed by Left economic and political demands that further radicalises it.

This process however requires prior development of the working class, including organisation and consciousness which already disposes the working class to defend itself through ‘spontaneous’ mobilisation that rests on some prior socialist consciousness.  We know that a lack of such consciousness has not been overcome by crisis in itself because of previous decades of defeats of working-class struggle; from a sober assessment of current working-class consciousness and passivity, and from appreciation that the last real revolutionary period rested on this prior development of socialist organisation.  Of course, many struggles in this period were betrayed by reformist and Stalinist leaderships but these betrayals had precisely the effect of setting the working-class back decades.  It’s why continuing opposition to these political trends in the working-class movement is a continuing imperative.  But it is wrong to simply repeat the explanations of previous defeats that happened decades ago as applicable now to much later generations.

In demanding a more stringent lockdown the purveyors of this general view rally behind the most lurid and sensational predictions of the effects and deaths that will be caused by Covid. The pandemic itself has become a ruling class conspiracy – “as far as the ruling elite is concerned, if the old and infirm die and allow for further cuts to pensions and health care, that is to be regarded as a positive good.”  As has been pointed out: across the world capitalist governments have spent fortunes in response to the pandemic.  If their objective has been to save money they have failed abysmally. In Ireland and UK the state has borrowed billions and seen their debt mushroom as a result.

If their favoured policy of total lockdown requires emulation of the approach of China, Australia and New Zealand etc., as some have claimed, then why are these countries not also in on the conspiracy?

This left appears oblivious to the cost of lockdown in terms of deaths, illness and social and economic loss; and sliding over who suffers these costs: from the lost jobs, education, domestic violence and damage to menial health.  It may point to the massive and wasted expenditures on testing and tracing systems that don’t work, and from failed and corrupt contract awards for PPE etc., but what has facilitated this?

They don’t stop to consider how their approach supports the politicians and state bureaucrats who cancel cancer and other life-saving treatments in order to protect their politicised health choices, and a health system that is failing and for which these politicians and bureaucrats bear responsibility.  Instead, their demand for lockdown puts the onus on the population to accept the most restrictive forms of social control and denial of civil rights, opposition to which is another one of their conspicuous silences.

Instead they oppose the opening of schools, though children are not at significant risk and infections in schools are low (see here and here and here).   One organisation dismisses schools as a “child-minding service’ employed to force parents into work, oblivious to this being a service that many parents are very glad of. It complains of trillions going to corporations but ignores that this is a product of lockdown; or do they believe that the state would give money to furloughed workers and not corporations?  What would happen if they didn’t, would all these corporations survive?

This organisation proposes committees that “would provide the means to organize a Europe-wide general strike to compel the closure of schools and nonessential production and allow workers to shelter at home.”  A stay away from work in order to get paid to stay away from work!  Since when did the capitalist class pay for an indefinite general strike? And how would one be organised with the mass of workers at home and socially distancing?  How would any revolutionary potential of a general strike be realised, i.e. acknowledging that society cannot simply close down but must continue to run, raising the question of who runs the economy – who rules?  How would this be possible unless major sections of the working class were actually at work?

“Massive resources must be invested to provide a high standard of living to everyone throughout the pandemic, including the resources required to maintain online learning for students.”  But how could anything be invested if the workers required to deliver the investment are to stay at home?  Or is this yet another essential section of the working class that must work – like so many the total-lockdown supporters refuse to acknowledge.

“The claim that there is “no money” for such measures is a patent lie. Trillions of euros have been handed to the banks and corporations in bailouts since the beginning of the pandemic. The resources exist, but they are monopolized by a corporate and financial oligarchy.”  The utterly un-Marxist idea is again advanced that money can equal “resources” and that pieces of paper are of use without human labour to deliver the real goods and services for which they are exchanged.  And anyway, isn’t the monopolisation of productive resources by a separate class not called capitalism?

Indeed it is, which once again demonstrates that every intervention by the ultra-left telescopes into demanding the overthrow of capitalism.

“The fortunes of the rich must be expropriated and the major corporations transformed into public utilities, democratically controlled by the working class as part of the socialist reorganization of economic life on the basis of social need, not private profit.”  But how are “the major corporations” to be put under the control of the workers unless they are actually at work?

As we know, Covid-19 is a specific threat that must be defended against.  When advocates of total lockdown call young people having a party ‘granny killers’ they acknowledge this reality.  Yet the pretence is still made that everyone is equally threatened at least to such degree that no strategy must distinguish between those who are old and/or otherwise vulnerable and those who are relatively young and healthy.  Students must go home, schools must close and young people socialising is an existential threat.

What this does is weaken the protection of those most at risk because it calls into question any restrictions.  If there really was no significant differential impact then many thousands of young people would have died. They haven’t.  Many working class people, as I have noted in previous posts, and here in a previous comment by a reader, are ignoring the rules when it suits.  The left advocates of complete lockdown are really now following Bertolt Brecht when he said – should this left not just elect a new people?

Most people however do register the greater threat to older and vulnerable people but rather than this being informed, encouraged and organised it has more or less been ignored by the authorities when it comes to organisation of the response.  Tightening restrictions affects everyone, and in some ways young people more, and undifferentiated relaxation exposes older people more because it cannot be admitted that they should still be shielded or socially distanced; just in case everyone decides that is the way it should stay, that this is the correct approach that should now be implemented and those in charge have got it wrong.

This approach has failed in Ireland, Britain and across Europe and further afield.  Part of the left doubles down and says the lockdown is not tough enough, without weighing up the cost or admitting that total lockdown has never actually been implemented because it can’t.  You cannot close down society, which relies on the continuous labour of millions of workers.  Admission that ‘essential’ work must continue never admits the enormous extent of what this entails given the development of the forces of production and division of labour involved.

A blanket threat in many ways protects the authorities from blame for failure because Covid-19 becomes an all-embracing indiscriminate threat that is difficult to defend against because of this character.  It allows them to introduce harsh social restrictions and coercive powers that for most people are totally unnecessary, and which some on the left who, were they consistent, should support because (1) they should endorse a fair claim to be necessary and (2) totally warranted given the assumed threat.  What could be more important that saving lives?

The longer the pandemic lasts the more incredible become the demands for total lockdown and ‘zero-Covid’.  The failure of existing restrictions has been too great to inspire notions that just more of the same will be both successful and at an acceptable cost.  Given the attacks stored up for the future, there will be plenty of time to reflect on the lessons.

Covid before cancer. Or maybe not.

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The Northern Ireland Health minister was interviewed on the BBC here.  After first saying that he didn’t want anyone in the health service to be put in a position of making ethical decisions to deny essential medical treatment the interviewer told him that the Chief Executive of the Belfast Health Service Trust has said that they are already being made, and are life and death decisions.  Does Swann deny this or say he will investigate?  No.  He immediately and without hesitation attempts to justify something he said he didn’t want to happen, as if it hadn’t been happening.

He says that these decisions have to be made – “the ethical decision is could we turn a Covid patient away?  The answer is no.”  For other patients, “sorry your operation, your scope your diagnosis is going to have to be put off.”

When it is put to him that what he is saying is that a Covid patient won’t be turned away but that the result of this is that a cancer patient may die his answer is “yes, that’s as black and white as it is.”

So how is this ‘black and white’?  There has been no medical assessment provided that this blanket prioritisation is justified, in fact it is presented as if its justification is self-evident, an obvious ethical decision.  Except it’s not obvious and it is without justification, in both senses of that term – it has not been justified and any attempt to justify it would be wrong.

Swann says that we ‘cannot turn a Covid patient away’ but we already know that while over 50,000 people in the UK and over 3,000 in Ireland have died with Covid it is not at all clear how many of these have died of Covid.  So how can this particular disease be prioritised?

More people die of cancer than Covid-19.  There are around 165,000 deaths from cancer in the UK – that’s every year.  In 2018 over 4,000 people died of cancer in Northern Ireland.  In the Irish state over 9,000 die every year.

It cannot be because of the severity of the disease: cancer kills cancer patients because of their condition, while for most sufferers of Covid the disease is so mild they may not even know that they have had it.   If someone with Covid has a serious underlying condition making them vulnerable to death compared to a relatively healthy person with the same disease, what is it that makes the difference between survival and death?  Covid may be the proximate cause of death but Covid may not be the underlying condition without which death would not occur. If this is not considered an important distinction then presumably the health service and whole swathes of the economy will close down during the next flu season. A report from the Health Information Quality and Quality Authority shows that not all ‘Covid deaths’ should really be counted as such (see below).*

There is little that can be done to avoid many cancers; even those who don’t smoke, eat healthily and exercise fall prey to it.  Hospital treatment is necessary but can sometimes require less serious intervention if caught earlier, although this is precisely what is being deprioritised. Those most vulnerable to Covid on the other hand can take many of the measures we have all become accustomed to including social distancing etc.  The most vulnerable received shielding letters informing them of their vulnerability and measures they might want to take to limit exposure to infection.  Swann and his chief medical advisor have decided that these letters aren’t necessary this time but provided no real explanation why.  What has changed from the first lockdown?

Why is the protection of those most likely to suffer fatalities from Covid not the major focus of protection, support and prevention from these political leaders and bureaucrats?  Is it not really that, what both measures have in common – prioritisation of Covid patients within hospital and lack of focus on those most vulnerable – and what is being protected, as they have made clear repeatedly, is the NHS?   Protected from doing a job they know it will fail? And by their association, responsibility and accountability for it, protection of themselves?

The NHS in the North of Ireland is the worst in the UK.  There are, for example, more than 2,500 nursing vacancies.  As I have said before, Covid-19 may overwhelm the resources of the health service but is in itself not overwhelming.  It is only so because the NHS is already in crisis, and what we are asked to do is also to accept that we must collude in covering up this permanent crisis, including through regular speeches telling us how difficult it has been for the staff.

This message is all the more powerful, and successful, because it is largely true – many health service staff have been under enormous strain but this should not be an alibi for failure of the bureaucracy that is the NHS as an organisation.  As I have said before, the demand to protect the NHS, when it is supposed to be there to protect us, is an admission that this responsibility of the NHS will not be met.

The unjustified blanket prioritisation of Covid patients in hospital and the failure to issue shielding letters to the vulnerable are political decisions and have been successful because of a political campaign to justify lockdowns.  This has involved not only politicians but also senior health figures, who have given legitimacy to their decisions.  One such figure has been Gabriel Scally who has regularly intervened to argue that policies in the North and the South should be the same, as if two wrongs make a right.  He has stated that ‘the figures speak for themselves’ when it is well know that they don’t, and has stated that over 50,000 have died of the disease without recognition that dying with it is not the same as dying of it.  That such basic errors are repeated by a respected public health doctor illustrates the scope of the group think that has developed.

So egregious was the Health minister’s statement that the Department of Health put out a tweet entitled ‘Myth Buster’ with ‘myth number 1′ being “are Covid-19 patients being prioritised over other patients?” To which the answer was “No, they are not.  Patients are treated according to clinical priority.” Swann pitched in with “it is untrue and offensive for anyone to accuse frontline staff of prioritising one condition over another.”

Since it was Swann who said that prioritising was ‘black and white’ perhaps it is himself he is referring to as being offensive.  So who is right – the Department or the minister, and which version of the minister?

It would be difficult to deny that senior health staff would not be so stupid to as to admit such crass medical practice but easy to understand how Stormont politicians could grandstand with this level of idiocy and ineptitude.

The real problem is not that some politician has instructed hospital doctors to relegate individual cancer patients in order to prioritise Covid patients but that this is what has and will continue to happen by political decisions on allocation of resources that constrain individual medical assessments.  These individual decisions rely on higher level decisions on allocation of staff, wards and beds to deal with Covid that in the first wave witnessed empty Covid beds in the Nightingale hospital while other treatments were stopped.

Lockdown is a political decision involving an analysis not only of the disease but the potential impact of the response.  It is not a question of medical expertise determining the correct approach, even if one were naïve enough to believe that the medical profession is a paragon of virtue and wisdom.  The advocates of lockdown refer regularly to the number of cases, hospitalisation cases, numbers in ICU and deaths but rarely to the costs incurred by lockdown.  To do so would invite a critical debate they are ill prepared to have.  Swann’s mistake was to take soundbites to their logical conclusion and blurt it out.  It denotes the logic of the current approach but too crudely expresses its effects.

It is tempting to see in Swann’s first statement the chaos and breakdown of the functioning of the Stormont Executive that because of its reaction to the pandemic was seen for a while as an example of the political arrangements working.  No one is pretending they’re working now. However, the real political weakness lies not in the political primitiveness of Stormont but that such crass political interventions elicit no popular opposition. Unfortunately on this score looking for the left to offer one would be a complete waste of time, as we shall look at in the next post.

* HIQA: ‘The officially reported COVID-19 deaths may overestimate the true burden of excess mortality specifically caused by COVID-19. This may be due to the likely inclusion within official COVID-19 figures of people who were known to be infected with SARS-CoV-2 (coronavirus) at the time of death who were at or close to end-of–life independently of COVID-19 or whose cause of death may have been predominantly due to other factors.’

https://www.hiqa.ie/sites/default/files/2020-07/Analysis-of-excess-all-cause-mortality-in-Ireland-during-the-COVID-19-epidemic_0.pdf