Thursday, 28 January 2021

100 000 Deaths: the Indictment.

The landmark figure of 100 000 coronavirus related deaths was officially reached yesterday though I'd thought I'd seen the figure earlier. The Prime Minister has said he is "sorry," and he may be genuinely so, but it has the sound of the routine "sorry for your loss" which features on funeral condolence cards rather than an admission of responsibility for errors made.

Though the 100 000 deaths indicates not just lives cut short but  several hundred thousand grieving friends and relative, the total figure itself is not a measure of the competence with which the pandemic has been dealt.  For that  a more useful measure is number of deaths related to population size.  For that, on yesterday's figures, the UK comes fourth from the bottom, above San Marino (194 deaths per hundred thousand) Belgium (180) Slovenia 163) and UK (148) .

The table of related countries then reads:

UK:               148  deaths per  hundred thousand population

Italy:             142

US                128

France:         109

Germany:        64

Ireland:            61

Canada:          50

Australia:          3.6

New Zealand:  0.53 

World beaten rather than world-beating, Prime Minister Johnson refuses the Opposition's repeated requests for an enquiry into why we are doing so badly.  His argument is that the government needs to concentrate all its resources  on dealing with the pandemic - an argument that held no sway when it was suggested that the  Brexit transition period should be extended for a year.  

Given that one medical expert has predicted  there could easily be a further 50 000 deaths before control is achieved, it would seem to be in the nation's best interest, if not the government's reputation, that an enquiry  be held now in order to establish what went wrong and how to avoid similar errors in the future.

 On the whole criticisms of the government can be summed up in the phrases: "always behind the curve," "too little too late," with trust diminished through  "muddled messages" and a "bad examples," from those making the rules but not obeying them

Here's an outline, as comprehensive as I can make it, of the issues which  should be examined.

  •  inadequate funding of the NHS as a result of the of the austerity programme since 2010, so that it lacks the spare capacity to deal with a major emergency;
  • the failure to act on the  report of the Cygnus simulation of a pandemic in 2018;
  • the consequent lack of personal protective clothing and an effective planning, implementation  and communications network;
  • the  casual, even flippant, attitude towards the virus in the early stage (Johnson shaking hands with people possibly infected and his attendance at an international rugby match,  Goodwood held);
  • the  delayed lockdown in the Spring, 2020, which it is estimated cost 10 000 avoidable deaths;
  • discharge of elderly patients from hospitals to care homes without first testing them for Covid;
  • failure to complete  the promise of laptops to households without them to facilitate home learning;
  • inadequate restrictions on visitors from outside the UK;
  • the failure of the test and trace system outsourced to the private sector and costing £12bn;
  • contracts for services and supplies to apparently ill-qualified "friends" rather than through established procedures;
  • the less than adequate furlough scheme;
  • the premature exit from the first lockdown;
  • the "eat out to help out" scheme which helped spread the virus;
  • Dominic Cummings's trips to the North East and to Barnard Castle, and failure to sack or even censure him;
  • the insistence that  most university students resume their courses on campus;
  • the failure to have a "circuit breaker" in the October 2020 half-term; 
  • the failure of the tiered lockdown scheme;
  • the offer of a five day household mixing period permitted over Christmas, only reduced to one day at the last moment;
  • schools forced to return for the Spring term (cancelled after one day);
  •  the delayed New Year 2021 lockdown.

Further suggestions will be welcomed

 A fair-minded enquiry will no doubt rate some of the above as understandable and perhaps excusable. Most important is to examine the alleged trade off  between preventing the spread of the virus and keeping the economy going.  

Without it, however, the government continues to repeat its mistakes and tackles the pandemic though up-beat language rather than evidence-led thinking




  1. May I suggest, not opening up further and faster in the summer (pubs should have been open by May, for example) when the transmission-suppressing hot weather meant that the spread of the virus could have been encouraged, and therefore immunity built up in the population, without any danger of hospitals being overwhelmed, meaning we would have been in a better place to face the emergence of the Kentish Fever in the winter.

    1. I think you're referring to achieving "herd immunity" which, I understand, is now a discredited approach. In this month's Prospect Philip Ball et al write " 'herd immunity' was inapplicable to the management of a virus with a significant morality rate." In other words the opposite of what you assume would have happened: the hospitals would have been filled to overflowing.

    2. I think you're referring to achieving "herd immunity"

      No, I don't think that we could have safely built up all the way to the 'herd immunity' level in the summer (to avoid overwhelming the hospitals, and prior to the deployment of a working vaccine, we'd have to approach that level in a slow and controlled way, and it would have taken more than just a couple of months).

      But it is a fact that the hospitals were not anywhere close to being filled during the summer, whereas they were in the winter. It would therefore fairly obviously have been better if hospital demand could have been spread more evenly, by encouraging more spread during the summer so that by the time winter came more people were immune and therefore would not require hospital treatment.

      Just because you can't get all the way to the herd immunity threshold, doesn't mean that there isn't a benefit in a higher proportion of immunity versus a lower proportion.

      " 'herd immunity' was inapplicable to the management of a virus with a significant morality rate."

      Of course the mortality rate is only significant in certain sub-groups (those over 60, the clinically vulnerable). Outside those groups the mortality rate is insignificant. That fact matters to our response (and is informing, for example, the vaccine roll-out prioritisation of those groups where the fatality rate is significant).

    3. "Old lives matter," to adapt a phrase popular at the moment.

    4. "Old lives matter," to adapt a phrase popular at the moment.

      Yes, exactly. So we agree.

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