Tag Archives: Coronavirus

In Covid’s Wake (3 of 6) The US as a laboratory

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The authors of In Covid’s Wake note that the United States formed a laboratory in which an experiment on the different approached to the Covid-19 pandemic was played out.  In Democrat controlled states the speed at which restrictions were imposed, the length of stay-at-home orders, length of school closures, and the stringency of Covid restrictions were all faster or greater.  The willingness of residents to be vaccinated was also greater.

The resulting pattern was noticed in late 2023:

  • Until vaccines became available, there was little difference in COVID death rates between blue states and red states.
  • After vaccines became available, there were clear differences, with red states having higher death rates.

The book therefore states that ‘variation in vaccination rates can account for fully 47 percent of state-by-state mortality.’  (In Covid’s Wake, p 140, 142) It also records that the lack of difference evident by the summer of 2020 ‘went broadly unreported, despite its inconsistency with the epidemiological models that had seen so much media coverage earlier in the year.’ One of these models reported “substantial reductions in peak attack rates “due to school closures”. (In Covid’s Wake, p 146, 148)

In the UK, a review of the literature to March 2023 reported that ‘there are still many uncertainties and unknowns’ while the Scottish official inquiry concluded that “there was insufficient evidence in 2020 –or alternatively no evidence.”  So even after the pandemic the authorities were claiming not to have learned much, if anything, about their basic approach. (In Covid’s Wake, p 154)

Some countries with light restrictions fared well while others didn’t; ‘Japan fared better than Australia and only slightly worse than New Zealand in terms of Covid mortality, despite never imposing a lockdown or widespread business closures nor making much use of Covid testing and contact tracing . . .  The underlying determinants of population health–poverty, education, comorbidity profile–shaped Covid pandemic outcomes far more reliably than non-pharmaceutical interventions.’ (In Covid’s Wake, p 157)

 In the US the two Democrat-leaning authors lament that ‘rather than learning from the policy experimentation that was taking place, decision-making about pandemic policy was rigidly ideological and moralized’.  Democrats didn’t learn about the absence of support for lockdowns and Republicans, or at least some of them, didn’t learn about the efficacy of vaccination.  For the two authors this failure of ‘partisan politics is the main lesson of the pandemic.

As for the left that advocated even more severe restrictions, there is no evidence that they ever, at any point, looked in the rear view mirror; Covid may as well never have happened.  The morally right are right–by definition.  The idea of having any sort of cost-benefit analysis was dismissed as involving a straight comparison between saving lives and saving money; ‘health versus wealth’ as the book puts it.  The world’s capitalist governments were charged with being more interested in the economy than public health and people’s lives.  Further shutting down the economy was being opposed, it was claimed, in order to protect capitalist profits, in the process risking workers’ lives. 

At the time this blog noted that capitalist economies produce commodities with a use value as well as an exchange value, without which they cannot assure their sale and realisation of profit. It was never clear just exactly what production was not ‘essential’ and could be shut down, and how massive reductions in production could be accomplished in order to achieve ‘zero-Covid’ while also creating correspondingly massive income flows for those now unproductively unemployed.

Even the view that the governments’ response was focused on maintain capitalist profits hardly squares with the single focus on public health by those state officials tasked with leading the response who consciously excluded economic and social experts. The mathematical models that were so influential only looked at the effects of policy on Covid transmission, hospitalisation and deaths.  None looked at the health, social and economic consequences of lockdown to see were its costs exceeding its benefits. A point not strongly made in the book is that with models predicting catastrophe this might seem understandable, but as we have noted, when the models failed to correspond with reality the experts doubled down on lockdown.

The media played its role by stating that the pandemic closed schools and travel etc., not that it was the lockdown, and that this was a choice.  Rather like wages causing unemployment or inflation, or the war in Ukraine causing high energy prices, the conditions and interventions that actually caused them were rendered invisible.

What also became invisible was that it was overwhelmingly white collar workers who were working from home.  Blue collar workers kept working and were a stranding rebuke to those who claimed that lockdown was needed to prevent ‘mass death.’  A left more in touch with this section of the working class might have appreciated this.  The authors of the book note that, while stoking fear of the pandemic, the lowest paid and vulnerable workers were expected to show up.  So did all those calling for ‘zero-covid’, unless they didn’t actually mean zero.

The policy of lockdown was popular among trade unions and among the majority of their members.  The book records the Chicago Teachers’ Union tweeting that ‘the push to reopen schools is rooted in sexism, racism, and misogyny’, while the head of United Teachers of Los Angeles described school reopening as a recipe for propagating structural racism.’  (In Covid’s Wake, p132)

In fact, schools were not a vector for transmission while those workers tasked with continuing to work as normal probably included a large proportion of women and black workers.  Not for the first time politics based on identity got it wrong, ironically weakening the cause of women and black workers in the process.

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In Covid’s Wake (2 of 6): ‘mass death . . . is a benefit to be sought’

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The imposition of lockdown that was justified as ‘following the science’ did not quite achieve the consensus that the claim implied and there were a number of voices challenging it at an early stage.

One epidemiologist in the Washington Post stated that ‘of the first 1,023 people to die in Wuhan, China . . .  only one was younger than twenty.’  He wrote that “The high death rate from the coronavirus is driven almost exclusively by the oldest cases . . . the virus causes severe disease almost exclusively in older adults.”  In March 2020 an op-ed in the New York Times was entitled ‘Is Our Fight Against Coronavirus Worse than the Disease?’ (In Covid’s Wake, p 72). This blog also had enough information to point this out in March 2020. 

Unfortunately, ‘war’ had been declared on Covid-19 and the cliché that the first casualty of war is the truth proved only too true.  The consensus in the US was supported by Harvard’s Safra Center on Ethics, the right-wing American Enterprise Institute, and the ‘progressive’ Center for American Progress and focused on testing, tracing and quarantining the infected.  The policy that had previously been predicted to be unsuccessful was now the establishment view that brooked no dissent.  Yet it made little sense when the virus was already widespread, was asymptomatic while infectious and completely asymptomatic in many who had contracted it.

Sweden presented an alternative in which large gatherings were banned; people over seventy were advised to limit contacts with others; it was advised not visit to nursing homes, and recommended but not mandated that those who could work from home should do so.   Society-wide lockdown was not advised: “The storm was already here,” judged Sweden’s health authorities and what remained to be done “was to protect the most vulnerable.” No large-scale test-and-trace regimes were attempted.  Masks were never mandated. No stay-at-home orders or restrictions on movement were imposed’ and restaurants, gyms and schools for younger children and adolescents remained open. (In Covid’s Wake, p 85).

The head of Sweden’s Public Health Agency, Anders Tegnell, thought that “the world has gone mad” while ‘many thought Sweden had gone mad’ or ‘insane’.  The New York Times described Sweden as a “pariah” and some European media described it as like “a banana republic” (In Covid’s Wake, p 86-7).

The Great Barrington Declaration published online in October 2020 was another alternative view to Lockdown that pointed out the costs and proposed a policy of ‘Focused Protection’: “Our goal should therefore be to minimise mortality and social harm until we reach herd immunity.”  Those who had such immunity ‘could play an especially important role in helping the sick and frail.’ (In Covid’s Wake, p 96 & 97)

Herd immunity, however, became a term of abuse, as “simply unethical” and a call to “let it rip”.   It was ‘dangerous’ and came from ‘fringe’ and ‘maverick scientists.’ (p 74, 97 &106). One doctor, who had earlier in March gathered 800 signatures warning of the costs of lockdown had seemingly changed his mind; “I have no more fucks left to give.  Except those peddling pseudoscience, bankrolled by right-wing, libertarian assholes can kiss my queer ass …. This fucking Great Barrington Declaration is like a bad rash that just won’t go away.” (In Covid’s Wake, p 100)

The vitriol involved in such denunciations reflected not so much a long established scientific consensus as a moral consensus that had especially gripped the ‘left’, becoming the left position because the left had adopted it, assisted by most of the support for the Great Barrington Declaration coming from the right, confirming that this was indeed the right-wing position.  The effect was to close debate and remove critical thinking–in moralistic arguments there is simply no arguments in favour of the ‘bad’.

Who made the arguments defined what was right and not the arguments themselves so that ad hominem became de rigeur.  From liberal Democrats to the ultra-left, moral condemnation could not be strident enough: The Great Barrington Declaration became ‘A manifesto of death’; ‘mass death, is a benefit to be sought’; ‘the White House’s embrace of the document is a statement of intent for mass homicide’; ‘the ruling class’s drive to allow the mass infection of the population can be imposed only by violence’.  Those who defended it on the left were from ‘the pseudo-left’ while ‘the herd immunity policy has found support not only within the capitalist oligarchy, but among sections of the upper-middle class.’

The pandemic was an unprecedented suppression of the most basic civil rights employing the weapons of fear and state surveillance, yet the largest part of the left not only endorsed it, its policy was to intensify it.  This was the policy of ‘zero-covid’ that could only ‘be imposed by violence’ as lockdowns began to be relaxed in 2020, only to then be reimposed.

The left website above stated that ‘Workers around the world must welcome the categorical and courageous stand taken by public health experts in opposition to the ruling class’s policy of herd immunity’, except the experts were divided and previous advice stood squarely against lockdowns.  Not unsurprisingly, the moralistic and catastrophist argument proved more attractive to a left for whom socialism will only come through capitalist crisis and repression, through force of circumstances, and not through the building of a class conscious movement committed to socialism that is the result of years of political education, clarification and struggle.

The authors of the book note that ‘if recovery from infection would not afford immunity, it is not clear by what mechanism vaccines would confer immunity either.’ (In Covid’s Wake, p 102).  In June 2020 the World Health Organisation website defined herd immunity as “indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection.’ (In Covid’s Wake, p 104).  In November the reference to acquired immunity was removed.  The voice of ‘science’ was to be put in the service of government policy.

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Forward to part 3

In Covid’s Wake (1 of 6): the past is another country

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The Irish government report on how the state handled the Covid-19 pandemic is due to report at the end of the year, seven years after it reportedly arrived in Ireland.  The delay says a lot, as was the original announcement of the review by the government – that the review was to have a “no-blame” approach and would “not be a UK-style” inquiry.  It would not have statutory powers and would be an “evaluation” on the grounds that anything greater would drag on for years.  This was not an empty threat given the many previous tribunals of inquiry held by the state, but it rather loses conviction when it took so long to establish in the first place.

Scepticism over its role was heightened by it rejecting the stronger powers of the UK inquiry, but since this failed to question the basic approach to the pandemic adopted by the British government these in themselves would not have promised a full reckoning.   A spokesperson for a patient advocate group stated that ‘the Evaluation model protects policies and decision makers from any scrutiny at all’.  We shall see.

Two liberal (Democratic Party-type) US academics have published a new book that has much wider relevance than the US, including why it is important that we do not just forget about the whole thing. The book, not surprisingly, is controversial as the consensus it critiques has, also not surprisingly, not gone away.  The authors have responded to some criticism here.

It is said that the past is another country but since almost all other countries had the same experience this doesn’t displace it safely to the past, not least because its impact is still with us, never mind the possibility of any repetition.  

From the point of view of this blog the focus is on what the book implies for an evaluation of the approach taken by much of the left.  Those who have read the coverage during the pandemic will know that it was severely critical of the groupthink that overtook the left and was very much a minority, but not idiosyncratic, view.  The Left’s groupthink showed it incapable of challenging the politics of the state and mainstream bourgeois opinion across the world, putting forward a policy–‘Zero Covid’–that was actually much worse.

The suddenness and severity of actions taken by states meant that ‘just a few weeks after the lockdowns spread from China to Italy and elsewhere, 3.9 billion people–half the world’s population–were living under some form of quarantine.’ (In Covid’s Wake, p 3) What was also sudden was the adoption of the policy of lockdown that justified this approach.  Called “following the science”, it was adopted by overturning the science as it had previously been accepted and became the club to silence and stigmatise those who challenged or even questioned it.  The Left consensus simply adopted a more extreme version of this predominant approach.

Several non-pharmaceutical interventions (NPIs), including “contact tracing, quarantine of exposed individuals, entry and exit screening, [and] border closure” were “not recommended in any circumstances” in a World Health Organisation’s (WHO) assessment in November 2019 of NPI use in a respiratory pandemic.  Quarantine of individuals–never mind whole populations–was “not recommended because there is no obvious rationale for this measure in most Member States.” Contact tracing was considered some help in “isolated communities” in the “very early stages of a pandemic.” (In Covid’s Wake, p 29) Other assessments also questioned the use of NPIs, including after reviewing the experience of the 1918 Spanish flu pandemic.

This meant that when China introduced lockdown “public health experts in the United States and elsewhere responded with shock and disbelief”. (In Covid’s Wake, p 50). Dire predictions from Imperial College in London and China’s draconian embrace of lockdown were the occasion for a complete change of approach by the WHO so that now there was no alternative to unprecedented restrictions on freedom of movement backed by massive social surveillance.

Previously inconceivable restrictions became moral imperatives supported by governments, health bureaucracies, health academics and the mainstream media; plus the majority of the left for whom the unprecedented was not unprecedented enough and the draconian not sufficiently draconian.  That China’s apparent success kept on being implemented until its population started revolting was all in the future.  The WHO’s mission to China found that it provided “vital lessons for the global response” and its measures were the only “proven to interrupt or minimize transmission”, while early predictions were made that it would succeed within three months. (In Covid’s Wake, p 56 &58)

The book records how dubious this claim must have been, including the knowledge that pandemics proceed in waves; millions of people had escaped lockdown in Wuhan, and there could be no confidence in the effect lockdown would have against the progress of a novel virus. The WHO made matters worse by stating that “globally, about 3.4% of reported Covid-19 cases have died”, although it could not know how many people had been infected so could not say what percentage of them had died.  Without acting to implement stringent NPIs the modellers of Imperial College predicted “approximately 500,000 deaths” in the UK “and 2.2M million in the US”, along with the collapse of heath systems. “Suppression” of the virus was the only “viable strategy”, with China again held up as the exemplar. (In Covid’s Wake, p 63 &64)

If this didn’t scare you, or rather ‘convince’ you, this might be because you might have known of Imperial College modellers’ previous poor record.  In 2006 it had predicted “catastrophe”, ‘forecasting 150 million deaths around the world’ as a result of the outbreak of avian flu.  Nevertheless, the book’s authors note that Imperial College Covid projections ‘captured the headlines and grabbed the attention of Covid policymakers, including President Donald Trump.’ (In Covid’s Wake, p 51)

Given the forces ranged against any possible dissent it is not surprising that the ‘global suspension of basic liberties was undertaken with widespread public support.’   This was despite the book stating that ‘it is important not to ascribe to policymakers’ views more coherence than they possessed with respect to the goals of the policies they pursued.  To some extent, policymakers failed to reckon with the choices between flattening the curve, attempting to contain the disease and eliminate it entirely, or suppressing the total number of infections over the whole course pf the pandemic.’ (In Covid’s Wake, p 67)

In my own city of Belfast, the local hospital was converted into a ‘Nightingale Hospital’ for Covid-19 patients and apparently more or less closed for most of everything else. While claiming that Covid-19 would close it if it was not protected, it partially closed itself.   Cancer patients could die but no Covid-19 patient could be refused.  Yet even this stupidity did not give pause for thought that this whole policy was the latest example of the ‘madness of crowds.’  Moral panics demand that doubters are immoral and with so much mainstream opinion on-side it is easy to excuse the left who supported it, except it was a failure; they demanded even more of the same, and they ignored, when they weren’t denouncing, alternative voices.

Forward to part 2

‘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

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?

People before Profit’s ‘Zero Covid-19’ Strategy

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This week the Dáil debated a motion tabled by opposition parties calling for a ‘zero-covid’ strategy.  It was supported by People before Profit and repeated a number of measures published in their strategy document.  Their approach has been supported by much of the Left in Ireland and in Britain. What can we make of it?

A number of questions are immediately raised that the strategy would have to answer. How long would lockdown have to last to achieve its objective; how much would this cost not only financially but also in the well-known drastic effects of lockdown, and what lives and health would be preserved by the strategy compared to the costs?  Is it demonstrated that the costs will not exceed the benefits?

You will search in vain for answers to any of these questions in the PbP document.

Government strategy is based on a balance of restrictive measures and permission to do certain things that have previously been taken for granted. It is accepted that this involves costs but also benefits that justify the costs, while some costs it refuses to accept.  The financial cost to the state in 2020 is estimated to have been €20 billion and Leo Varadkar has speculated that the final cost may be €50 billion.

The ‘zero-covid’ strategy means the balance is wrong but doesn’t say what the financial cost is of drastically shifting it (or the other non-financial costs e.g. deterioration in mental health, rise in domestic abuse and restriction of basic civil rights etc.).  The People before Profit (PbP) document calls for the ‘closure of all non-essential workplaces’ but doesn’t say what they are: how many more would be closed compared to the current lockdown?  Would the difference be significant?  What work is currently not essential and what would be the impact on the economy and the workers in the closed sectors?

PbP say that profits are being put before health but since we live in a capitalist society production is both for profit and to meet needs.  Socialists object that the former is an obstacle to satisfaction of the latter but they don’t claim that under capitalism needs can be met by closing down production for profit.  Even their organisation’s name seems an unconscious acceptance of this (and you could write a whole post on how incoherent that name is).

PbP says that Governments only care about people working and spending, but working class people care about these things as well, for quite obvious reasons, although this seems to escape those seeking to drastically reduce both.  Socialists of the Marxist variety also don’t believe that pieces of paper, or electronic data in bank computers, are a substitute for the actual production of the goods and services people use and consume.  The pieces of paper that capitalism presents as the universal equivalent of real wealth is useless without the production of that which really embodies the potential satisfaction of needs.

Their demand for economic security as a fundamental requirement of public health is equated with state welfare that has always been a permanent source of insecurity, as well as a more or less inadequate safety net.  Welfare systems are not meant to provide economic security for working class people and it fundamentally miseducates them to say they can.

So, the ‘zero-covid’ strategy doesn’t answer basic problems or objections.  To make big claims requires big arguments and big evidence but even obvious questions are ignored.

A second problem concerns the idea of the strategy itself.  It is called ‘zero-covid’ but appears to accept that you can’t get to a situation of absolutely zero.  Having reduced the number of cases to a low level it still envisages periodic eruptions of cases.  It does not mean ‘eradication’ but repeats that it does mean ‘elimination’, which means that control measures will still be required.  The problem is that for a zero-covid strategy these measures mean punishing lockdowns.

So, the ‘zero-covid’ strategy actually involves severe lockdown of indeterminate duration to reduce cases to very low numbers whereupon lockdown is relaxed, cases will again increase, which will require further lockdowns.  Its advocates think these lockdowns can be achieved by testing, tracking and isolation but widespread asymptomatic infection, incentives not to report, ineradicable errors in testing, more transmissible viral mutations, and drastic quarantine measures to impose isolation all point to something much more sweeping.

It should not be forgotten that cases reduced dramatically during the summer to something close to what I assume ‘zero-covid’ supporters would aim at, but was then replaced by an increasing number of cases giving rise to new lockdowns that the same supporters called to be more drastic.  Rather than the strategy looking like an alternative to repeated lockdowns it looks like a mutant variant of it, following what currently appears to be seasonal eruptions of infection.

The analogy used to describe the strategy provides something of an understanding of what is intended but analogies have a habit of leading to misunderstanding.  The example is put forward of a forest fire that requires maximum effort to put out, while recognising that embers may still remain that require to be put out when they again spark new localised fires.

The analogy fails because while forest fires destroy everything in their path the Covid-19 pandemic does not, and while new local fires can be quickly identified and ring-fenced new outbreaks of covid-19 are often without symptoms and can quickly become far from localised.

This brings us to a third failure of the strategy, which is really incredible but says a lot for its affinity to the current approach and its even worse failure to identify what the danger of the pandemic is.  While noting the importance of targeting Covid hotspots and ensuring the safety of vulnerable groups, it mentions in this category workers in meat plants, those in direct provision and migrant detention centres, and travellers and homeless people.  It fails to say anything at all about the vulnerable most at risk of dying.  Neither does the Dáil motion, which mentions that women are disproportionately bearing the burden of the pandemic.

Nothing is said about the median age of those dying being in their eighties or about over 90 per cent of fatalities having an underlying condition. Nothing is said about the scandalous multiple deaths in residential care homes, where older people should have been made safe.  Nothing about the failure of the state to secure them in its dedicated facilities or of the general failure of health services to protect them.  Nothing about the infection of older people by the heath service either in hospital or through then discharging them into homes.  Instead, infection rates in healthcare staff are put down to lack of money, as if infection control should not be a standing requirement.  The actions of the Health Service Executive has on the contrary demonstrated that this has not been seen as an absolute priority.

To say any of this would undermine the zero-covid approach advocated by PbP, including its reliance on the state and its determined refusal to accept the very limited risks posed to all but the identified vulnerable groups.  To do so might be seen to rob the situation of the sense of extreme crisis so necessary to its attempt to talk up the murderous policy of putting profit before people, and the hope that workers will wake up and smell the coffee.

What we therefore have is a strategy, not unlike the current one, that has ignored the real pandemic that has taken place, and has bought into the idea that it is a threat to everyone equally when patently it is not.  The priority given by the virus in killing people is ignored by a strategy that wants zero cases for everyone, and in doing so has ignored the priority of those whose lives are threatened by it.

The health bureaucracy has moulded its response in its own image to put itself in charge.  The left has moulded its response in the image of its own misguided political conceptions, including the potential benevolence of the capitalist state, despite that state’s obvious failure.  Which brings us to a last major failing of the strategy.

Again and again the state, especially in the form of a national health service, is held up as the answer when a quick look across the border will show that the NHS in the North has failed, has ceased to become a health service and become instead a covid-19 service.  The cost of this in future illness and death has not been a first concern.  Long waiting lists have become even longer while the latter is blamed on the former and previous failure becomes the excuse for its extension.

The PbP strategy is replete with references to the recruitment of new healthcare staff ‘to dramatically increase capacity’.  It wants ‘more public health specialists’ and to ‘recruit extra nurses and doctors’ but there are definite limits to how much can be done quickly.  Really significant increases cannot be created in months but only over years.  As an answer to the pandemic today it is a wish list that can only promise salvation sometime in the future.

It says the problem with the health services is ‘structural’ but then contradicts itself by saying it arises from lack of funding and ‘neoliberal’ management, and further contradicts itself by calling for the ‘nationalisation of private hospitals’, imposing the same structural model that has failed.

Because PbP believes that state ownership is socialist, and they think they’re socialists, then the solution is state ownership when the ‘structural’ problem is precisely this form of ownership and control.  An ownership and control beset by bureaucracy and bedevilled by narrow professional hierarchies and egos.

The problem is not a style of management but that health services are bureaucracies that privilege themselves, with the most powerful within them being best able to do so, including medical consultants who prioritise private work, although this is only one feature of the state capitalist service.  The policy of Governments to portray health service workers as heroes beyond all reproach is resisted by some staff but is pursued in order, not to protect the interests of these staff, but to protect the bureaucrats and politicians who govern the system.  The blinkered approach to the health system leads to mistakes such as the widespread responsibility for infection by hospitals and care homes being either ignored, downplayed or excused.

The absence of answers to key questions posed by the strategy; the inadequate understanding of what it would actually mean in Ireland; the failure to even identify the main threat from the pandemic, and the call for measures that cannot be implemented quickly enough to make the difference its authors say is needed; all this points to an underlying impotent political programme summed up at the end of the strategy document:

“. . . most of all, we will need to clearly articulate a vision for an alternative to the destructive instability of capitalism – in Ireland we can play our part by popularising the call for a Transformative Left Government that would reorganise the economy under democratic control, as part of an ambitious Just Transition. .  .  . A left government supported by people power and workers organised in fighting trade unions can deliver real change . . .”

Capitalism will not be changed by a ‘Left Government’, by a group of politicians seeking to transform society through wielding the power of a state that exists to defend it.  Neither can the economy be ‘reorganised’ top-down by such a Government that will in some way, somehow, then be subject to democratic control.  If anyone in PbP still subscribes to any of the fundamental ideas of Marxism they will know all this is false, and being false it is dishonest to sell such a strategy, which is why it is so threadbare.

It is not in any sense a socialist strategy either at the level of transforming society or in dealing with Covid-19, as ritual references to emulating New Zealand, Australia and Asian countries demonstrates. In what way are any of these socialist?  In what way are they safe from future infection, if it at any point they cease to separate themselves from the rest of the world in a way simply impossible for Ireland?  Australia itself provides evidence that there is no such thing as one big final lockdown that breaks the back of infection.  Numerous mutations in many countries belie the idea that these are necessarily foreign and can be avoided by border controls over any extended period.

The great advantage of the zero-covid strategy is that it presents an ideal outcome that compares brilliantly with any other potential approach; the more so since no cost is admitted and no account taken of any problems arising from, or consequences of, its practical implementation, even were such implementation possible in any relevant timescale.

That is why it is also ideal, unreal and hollow.  Not so much transformative as transcendental.

A year of Covid-19 (4) – a tragedy to be forgiven?

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It’s almost as if someone has been reading these posts on the course of Covid-19 in Ireland.  Fintan O’Toole’s latest column (paywall) in ‘The Irish Times’ also notes some of the mistakes made in its early management and, while he treats the Irish approach as one of ad-libbing and improvisation, he lends a sympathetic ear to the early performance.  To what extent is this justified?

Well, let’s start with the scope afforded by this forgiveness: “when it’s all trial and error, no one should be tried for making an error – even when, as in the case of nursing homes and residential institutions – the flaws were fatal.”  But consider if we change the tense of the sentence – ‘even when . . . the flaws are fatal’.

‘Error’ he goes on to say ‘is moreover built into the structure of science . . . but science isn’t a set of certainties . . . to follow science is to follow evidence and with a new disease the evidence has been constantly evolving.’

Well, yes and no.  The important link between the worst effects of the virus and a person’s underlying conditions has been more and more understood.  On the other hand, as I noted at the end of the previous post – ‘one aspect . . . has appeared stubbornly consistent, the median age of those dying was reported in mid-January to be 82.’  Most recently, of over 1,500 deaths in care homes 369 were in January alone, a five-fold increase from December to January.

The Health Service Executive (HSE) noted on 21 January that the 27th of the month would be the anniversary of the first meeting of the National Public Health Emergency Team (NPHET), the crisis management team for the pandemic.  It was noted in April that no mention of nursing homes had been made in its first 11 meetings, with the HSE claiming that the Health Information and Quality Authority (HIQA) that attended the meetings were supposed to represent the interests of older people.

While boasting of the support given to care homes the HSE officials were at this time unable to provide up-to-date figures of deaths within them or a breakdown between state and private providers.  Neither did they answer as to whether any of the deaths could have been avoided.

Around the same time that NPHET was being set up a number of important academic papers were just being published on the effects of the new disease (here and here), including evidence of the effect of the pandemic in China.  The notable paper from Imperial College in London included further disclosure of the much greater threat to older people posed by the virus.  While the infection fatality rate was 0.002% for children aged 0 – 9, the rate for those 80+ was 9.3%, 4,650 times higher.  While these absolute figures were too high the relative differences remained.

Clearly avoiding infection was many multiples more important for older people than for the very young. Even between the age groups 40 – 49 and 60 – 69 the relative fatality rate was nearly 15 times higher for the latter group.  So protecting the older age groups was vital, which involved isolating them from potential infection.  How could these most vulnerable people be effectively separated?

Fortunately, many of these people were already relatively isolated in social care facilities, while identification of those in the community would be relatively straightforward.  Unfortunately, this relative isolation was not a protection.

While the health regulator was supposed to represent the interests of older people the HSE was there to protect the health of the whole population.  It became apparent however that the facilities they managed, controlled and regulated had become prime sites of infection, all while the NPHET engaged in interminable debate about opening or closing shops, hospitality, schools and workplaces etc.

When it wasn’t about the various levels of lockdown that were never applied at the levels specified, it was about testing and tracing, which didn’t identify where the virus was coming from and was later no longer advised for close contacts of confirmed cases.  So, what had been the point of it?

At the beginning of this year ‘senior sources’ were reporting the exhaustion of their approach, admitting that there was “not much else that can be done”, which didn’t stop the debate of vanishing returns continuing.  Today it revolves around rules for entry from outside the state, which is almost a moot point given the levels of domestic infection.  More honestly, it is being reported that ‘Ministers and senior officials’ view it as ‘more about politics than public health.’

Yet the places where around half of the deaths have occurred – residential homes and hospitals – are spared the outrage they properly deserve.  On 26 January it was reported that the level of infections among staff and patients in health care settings had never been higher.  And three days later the Chief Medical Officer was explaining that there was an “exceptionally elevated” infection rate among those aged over 85; that 55 recent deaths were associated with hospitals and 140 with nursing homes; and that we could “expect a large number of additional deaths in the coming weeks.”  Not much had changed over the year despite the ‘trial and error’ of ‘following the science.’

The state has incurred increased debt of around €20 billion in 2020 through various lockdowns but it is still unable to target resources effectively at the greatest problem: the daily death toll for Tuesday was the highest of the pandemic and the median age is still 80+.

It cannot be that a targeted prevention strategy would cost too much or that resources could not be prioritised – €2 billion would go a long way towards protecting older people never mind €20bn.  If even half the current death toll had been avoided and it was now around 1,750 who had died, would this justify the lockdown of society along with its enormous cost?  Would it not have been possible to identify those with the underlying conditions that make them vulnerable apart from advanced years, accounting for well over 90% of deaths? And would it then not have been possible to recognise the difference between those dying with Covid-19 and those from Covid-19?

But why would new problems be adequately addressed by the Irish health system when forever problems have not? When it turns out that the new problems are really the old ones?  As was pointed out by one TD early on, the Health Regulator – supposed to represent the interests of older people – had already reported that in care homes the compliance rates for risk assessment and infection control had fallen from 27 per cent to 23 per cent between 2017 and 2018.

Repeated problems identified have never been adequately addressed, with the HIQA complaining in November that nursing home residents were picking up the infection in hospitals and then being returned to their homes, while care home staff were being lost to contact tracing teams and agency staff were not being included in testing.

As Prof Sam McConkey, an infectious disease specialist with the Royal College of Surgeons, put it “nursing homes have been chronically under-staffed for several years.  They are going to have to start cherishing their staff as the most important thing they have.”  If staff were paid adequately they wouldn’t have to take second jobs, which might for example go some way to addressing the problem that staff weren’t turning up for testing and some were showing up for work while showing symptoms.

Some care homes were simply too small with too few resources. In some residential facilities for people with disabilities derogations were given to staff to continue working though they were identified as having possible close contact with infection.  They had not been tested and it was not clear when they would.

Yet, repeatedly bizarre statements have been issued by those in charge, including that NPHET was proposing setting up an infection-control team – in mid-December!  As if infection control was not a standard and routine hospital requirement. Or that there were difficulties in approving employment of nurses for care homes from India, Philippines and other countries outside Europe, reported in January, when many problems were the result of shortages of staff.

All this was occurring at the same time as repeated statements were made by the NPHET, which we noted in the previous post, that “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.” Then saying that vulnerable groups in care settings were a priority although also saying that it was “not realistic to think we could keep it out of homes.”

Unfortunately, seeking to prevent community infection through a generalised lockdown makes all talk of prioritisation a nonsense.  A general lockdown is precisely not to prioritise, and the actions and non-actions of the state are convincing evidence of this lack of ordering of risk.  To talk then, as O’Toole does, of inevitable mistakes is itself to fall into the error of identifying policy as simply mistakes.   Even in the case of vaccination, the representative body of private nursing homes has complained that just 10 per cent of the initial 77,000 vaccinations administered by mid-January were within nursing homes.

The identification, right from the start, that Covid-19 represented a specific threat should have been met with targeted and focused measures to protect those most vulnerable.  The ramshackle and incoherent attempt to lock everybody up, that cannot be sustained, has diverted attention away from this task.

That diversion continues with a false debate over a ‘Zero-Covid’ strategy, which is simply a variant of the current approach.  Like the existing approach, it targets what measures are required to support closing society instead of what measures are needed to keep it open.  It again ignores experience of just who is threatened and how specific measures might be implemented to protect them.

Both the current approach and its extension into a ‘Zero-Covid’ one can’t tell us how long we would have to be locked up for and how we could be sure that whatever metric of success is decided upon could be achieved on a sustainable basis.  What ‘Zero-Covid’ would gain in reducing deaths associated with Covid-19 would be more than offset by the costs of an intensified and indefinite lockdown, which if the advocates of it had been followed, would have been in place since March. Both ultimately can only be sold to an increasingly weary population by promising something that they can’t deliver: the development of the pandemic has had more to do with the weather than lockdown measures, and the end-point of immunity through vaccination may be illusory if new variants are impervious to the vaccines just developed.

In this case, and it may be the situation anyway, living with Covid-19 will be required and immunity through infection become the outcome, if not the objective.  In any case and in the meantime, the policy should be directed to protection of the most vulnerable.  In relation to the assessment of O’Toole, the prerequisites for forgiveness do not exist.

Back to part 3