Boris Johnson, back in the saddle for two weeks after three of learning first-hand what Covid-19 is all about, has just had the roughest 24 hours of his premiership. His first attempt to ease the lockdown has been widely lambssted as muddled, posing more questions than it answered and provoking negative briefings from loyal Tory backbenchers and cabinet colleagues alike. He appears, in he words of Blair’s former spin doctor, Alastair Campbell, to be “running a campaign, not a crisis“,
The change of mantra from “stay at home” to “stay alert” represents slogans winning out over substance at Westminster. This goes much deeper than politics. True Kier Stalmer and all three devolved governments have dissociated themselves from this latest move. But when Unite’s Len McClusky sounds reasonable pleading for clarity so people can return to work and former government chief scientist David King questions whether science is driving such policies or scientists are being told what to advise, both objective soundness and consequential trust in it by the people seem under threat, Dominic Cummings attendance at SAGE meetings seems more than a straw in the wind.
From the start, Boris presented the lockdown as “flattening the sombrero” and thereby saving lives. What he was referring to was a chart of hospital admissions,, plotted day by day, would approximate a “Standard deviation Gaussian bell curve” This curves steep;y to a peak and down again, looking rather like a sombrero. Such a curve would be approximated bt plotting infection versus over time without any medical intervention, as shown in Chart 1.
What Boris meant was that the number of people requiring hospitalisation at the peak would swamp NHS resources. Chart 1 suggests a peak of almost 8m in a UK population of 65m.Note that herd immunity means the epidemic would effectively over by September.
Avoiding such overwhelming case numbers requires a long-term strategy, in which a lockdown is just a part. Even today’s 50-page follow-up detail to Boris’ announcement does not provide it—even a Tory committee chairs admits:
“We need far deeper strategic thinking. Lockdown was never part of our plan for dealing with pandemics. If an academic had proposed it, he would have been peer-reviewed away from such a conclusion.”
Nobody doubts the difficulty facing the government, but a muddled launch, using graphics drawn as if by a five-year-old is disappointing, giveb seven weeks of daily condescension which neither inspires the people with vision, nor treats them as adults. A more plausible “squashed sombrero” is shown in Chart 2.
In this chart, a lockdown on March 23rd is presumed to pull the R factor from 3 down to below 1, causing a peak of 300,000 cases (the probable number in early May) and a subsequent decline with “wobbles” back above 1 as the lockdown is released in stages. Note, however, that the trade-off is that cases are still running over 20,000 a year from now and that any relaxation would rapidly develop another peak.
There are a number of key factors that have yet to be dealt with that any successful strategy that seeks to change Chart 1 into Chart 2 (or better). The principal ten are::
- There is currently no cure, nor likely to be one this year —possibly ever.
- Release from lockdown is reckless, without testing and tracing.
- The ‘R’ factor us key but only guess without comprehensive testing and tracing.
- Far from being overwhelmed, the NHS is not being fully used when all Nightingale hospitals are empty and over 3,000 ICU beds are unused.
- “Flattening the sombrero” doesn’t reduce deaths; without antidote, it delays them.
- Throwing so many NHS resources at dealing with Covid-19 has curtailed many critical treatments and dissuaded others attending in fear of infection.
- Death rates have increased, roughly doubling from 48,000 to 78,000 per month. But only 24,000 are Covid-19-related, leaving 14,000 unexplained occurrences, many the result of 6 above. Above.
- Other countries may count differently but that’s no reason not to adopt the strategy from South Korea, New Zealand, Germany or Sweden who have successful ones.
- Treating 65m people as one bloc prevents huge geographic and demographic differences in infection rates and deaths being exploited to give faster release to some.
- Economic damage from dither is severe, is mounting and cannot be countered by furlough and loans that are neither sustainable, nor affordable.
Subsequent blogs will expand on these ten headings, with the hope of invigorating debate on this pivotal issue for our future. There are already alternate strategies to the shilpit apology for one emanating from Westminster. One of the more stimulating, if radical, is Ten Reasons to End the Lockdown Now, published in The Spectator.