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The politics behind the pandemic - II -The Asian Age

 
But is the Government doing anything about all these people dying?

Oh yes, lots of meetings and guidelines. The situation is improving.

The UK's response to Covid in terms of meetings cannot be faulted, but its decision-making and implementation was woeful as it continued to negotiate a path between two roads where the political one, achieving Brexit, is more paramount than controlling the pandemic. Endless expert meetings (twenty nine SAGE-Scientific Advisory Group for Emergencies meetings in the first three months-New Scientist, 27th April) never resulted in the government getting to grips in the first two months with the most contagious and virulent disease of the 21st century.

The initial meeting was held on 22nd January (Guardian, 27th April), with over fifty of the top scientists and consultants in attendance. Amongst them were two additional nominees, Dominic Cummings, the PM's chief political adviser and a highly divisive prime ministerial appointee along with Ben Warner, a Vote Leave campaign data scientist, both key figures in the previous Brexit campaign. Having political appointees on SAGE is unheard of but their attendance was regular and forceful, not the silent observers that No. 10 has portrayed them as (The Telegraph, 29th April). When names of SAGE attendees were released their names were withheld on personal request as have been the minutes of the meetings till now.

Until February nothing of consequence had happened in terms of lockdowns, PPE (Personal Protective Equipment) procurement, and testing or increasing hospital capacity. Boris ultimately attended his first Cobra meeting on 5th March. Previously he boasted at a press conference on 3rd March that 'people would be pleased to know that I have been shaking hands with everybody the other night' (New European, 3rd March). His first public Covid briefing (which has now become the daily ministerial musical chair show) on 16th March was light on information, as he and the cabinet never wished the disease to distract the populace and overshadow their singular achievement, i.e. Brexit.

Guidance for over 70s was given to self-isolate, and also the assurance that daily briefings would continue. By this time more than 1500 had been infected and 36 people had died. What remained unannounced was that many UK airlines had already curtailed their flights while other European countries like Spain, France, Italy, Germany had gone into lockdown.  Most importantly the fatal decision was taken to stop Covid testing on 12th March (Independent, 30th April) as demand was outstripping resources. These resources had been depleting for years, as NHS funding for staff, equipment and facilities had been systematically squeezed by a decade of Tory governance but this could not be revealed to a dying public (Euronews, 12th December 19).

The hollow argument still presented was that more NHS funding would require more taxes (as mentioned by Dr. Hillary on GMTV, 4th May), not that the existing tax revenue needed a more equitable distribution. Magically, the money was found four weeks later when £6.6 billion was allocated as emergency NHS funding (Specialised Medicine, 16th April), but sadly that required 11,000 additional deaths before the coffers were opened. 'Save the NHS' strapline was bizarrely sold to a gullible public, since the slogan should have been 'Save the Public'. Why save the institution, which is supposed to save lives? Because the NHS couldn't perform after having been the target of continuous underfunding and cost cutting (NHS funding info.), the strategy to ask patients not to go was like asking famine victims to eat less.

The official thinking clearly from Day 1 was that it would be a resource-driven containment strategy, targeted to project the illusion of 'meeting demand', not of assessing need in terms of true number of cases (hospitals and care homes combined)and gearing resources towards meeting that need while being transparent about official efforts and shortfalls.It would maintain the charade of adequacy and response to the crisis, keep society confined to their abodes, not overburden the creaky health service and give rise to any large scale social unrest AND also throw the ball in the public's court, i.e. if hospitals were overloaded it was their fault since everybody had been informed to stay away! During March and April even GP (general practitioner) consultation was significantly reduced so that calls resulted in endless answering loops and waiting time.

The expected effect of this was that critical patients with pre-existing conditions stayed away which upped the suffering if not the death rate, ultimately leading ministers and health officials in mid-May to beg patients to return to GPs and avoid another health crisis. The one stellar achievement of the government in setting up the 4000bed Nightingale hospital in London within ten days (ITV, 24th April) operated with only fifty-one patients before it was closed five weeks after opening. Saving the NHS had worked too well.

3) The harder they fall

[The third segment of the orange is being removed of its pith]

But I hear the Prime Minister got Covid? How did that happen? Is he in bad health?

Yes, he did, poor gentleman. He is OK now.

On 12th March Boris Johnson warned the country that as a result of Covid-19, 'families are going to lose loved ones before their time' and four days later (The Telegraph, 12th March) he requested everyone 'to stop non-essential contact with others and to stop all unnecessary travel'. 

This slow build-up towards the total lockdown finally announced on 23rd March was based on two cynical assumptions made at the beginning by the SAGE group of wise men. First, that 20,000 deaths would be a 'good number' as mentioned by Sir Patrick Vallance, 17th March (The Telegraph, 17th March) and second that 'herd immunity' (FT, 13th March) might be the way out of the pandemic by 'flattening the curve'.

Within a month Covid blew both scenarios out of the water. Revised models came back with much larger projections of 250,000 dead (FT, 16th March) and the grim fight to retrieve lost ground started. In the meantime, from 5th to 12th April, Boris entered hospital, infected by Covid and was largely saved by the care of two immigrant nurses 'who stood by my bedside' (Nursing Times, 12th April). The political irony was not lost on Covid or his critics.

[Eating the orange has stopped]

So, how many have died? Is anybody alive?

It's quite high, above 35,000, could reach 40,000.Yes, few of us are still alive…ha ha.

Death rates have been a contentious issue. Different measures and processes mean that they are notoriously difficult to monitor across nations, but that has also been the get-out clause for the UK Government. The USA has led in absolute numbers, but with a population six times greater than the UK, if simply extrapolated the UK's toll would be 216,000. Of course, the argument that other factors need to be taken into account, i.e. density, age, …etc., are trundled out by Whitehall but these can often go against the purveyors. Till 25th April, six weeks into the full blown pandemic, only hospital deaths were being reported on the threadbare excuse that care home and residential deaths could not be calculated in time though some other European countries were doing so.

Additionally, there are approximately 1.5 million people in care homes including residential homes (MHA, 1st April) as compared to 0.4 million in hospitals and thus it was incomprehensible why the government was focusing on hospitals rather than care homes, except for the fact that over many years, care homes and their inmates have been shunted out of the public view.

Hospitals use them as parking lots, moving patients with long-term health needs (often elderly people) to care homes thus 'freeing up' hospital resources for more critical, often younger and short-stay patients. Resources were not deployed and government guidelines until 12th March stated that'it was very unlikely' that people in care homes would get infected. On 13th March, new guidelines were issued though they remained non-mandatory. With 4% of the UK population and 40% of the national infection levels care homes were a time bomb waiting to explode.

The comparative chart of death rates started from the fifth briefing indicated that the UK was lower than other European countries, except Germany. As the UK's death rate climbed and the questions started to come in, it was politely pointed out that Belgium had a higher death rate without clarifying that they were including 'excess death' (deaths higher than the same period last year) figures within the Covid mortality numbers.

Other European countries were reporting deaths in care homes/residences, which the briefing panel said was extremely difficult to obtain and synchronise with daily numbers. When the UK government was reporting 17,000 deaths, reports suggested the true death toll was nearer to 41,000(Financial Times, 22nd April),a significant difference. The Cambridge Independent (5th May) reported that 'the excess death rate is a good proxy for the Covid-19 death rate. In 2020, the UK has recorded 42,900 excess deaths till April 24, compared to previous years - up 61 per cent.'

What's a care home? Have a lot died there?

It's a place that looks after old people. Seems to have more deaths.

Under pressure, deaths from 'all settings' (which include care homes and residences) were included in the daily national mortality numbers though again the under-reporting continued since testing was not done as a rule to establish cause of death outside hospitals. As an example, when questions were asked on 16th April of the number of NHS staff who had died, the Government mentioned 27 (ITV, 17th April) while photographs and names of over 40 staff members had already been collected. Education Minister, Grant Schapps, in the daily press briefing on14th May 2020, had the temerity to state, 'In the vast majority of the care homes Covid 19 has not been reported at all'. 

He was right, just as in the vast majority of the UK population Covid 19 has not been reported at all…because only 230,000 out of 60 million had got it. So why worry? This moronic logic was peddled for public consumption? On the one hand the government stated 'every death is one death too many' and on the other hand they were on the verge of saying, 'In the vast majority of Tories Covid 19 has not been reported at all'? Even less reason to worry, except Covid was simply getting its act together by end of March.

 April was the cruelest month of all as Covid's mortality numbers (expressed as deaths per million) surpassed all other countries. The official response was to see no evil and withdraw the death toll slide from the daily Covid briefings (Sky, 13th May).

The ping-pong on death rates continues and for the government the catch-all response is that 'there will be a full enquiry in due course and we will have the complete picture', knowing fully well that the average length of a public enquiry in the UK is three years and costs millions (Institute for Government, 5th December 17). By then Brexit will be fixed with a rusty nail to the door of the House of Commons, the buntings will be out and Boris will be basking in the afterglow of a complete exit.

[Restarted eating the orange, fifth segment]

In the UK they are experienced, must have been ready?

This was a big disease, difficult to be fully ready.

Code-named Exercise Cygnus, it took place in October 2016 and involved all major government departments, the NHS and local authorities across Britain. The exercise was designed to assess the government's readiness for a full-scale pandemic. It showed gaping holes in Britain's Emergency Preparedness, Resilience and Response (EPRR) plan stating that 'the demand for services outstripped the capacity of local responders, in the areas of excess deaths, social care and the NHS' (The Telegraph, 28th March), the very three areas that left the nation reeling during Covid. History cruelly repeated itself, and the painful reality was that none of the recommendations geared towards addressing 'surge requirements' were implemented.

The additional irony is that the same group is looking after the Covid response, which also discarded Cygnus's recommendations to increase PPE, a victim of the Tory's four-year austerity program during the Cameron years. The reason being peddled now is that the exercise was intended for flu while this is Covid. The fact is that both are Corona viruses and it speaks volumes that the exercise started and ended behind closed doors.

Besides procurement and build-up, even the management of existing PPE stock suffered as in a typical act of hubris, over 600,000 pieces of PPE were given to China in February, the very country which makes the maximum amount of PPE in the world. European countries decided to join forces and held four rounds of meetings on 31stJanuary, 4thFebruary, 2ndMarch and 13thMarch 'at which EU-wide health security issues arising from coronavirus were discussed and the bulk procurement of masks, gowns, and other laboratory equipment were discussed'. The UK did not attend and excuses, ranging from 'we were not informed' to 'the email went missing' were stated.

The unspoken attitude was 'One would rather die than join the European effort…even 'Let the people suffer rather than scupper Brexit…'.Meanwhile the ministerial habit of reporting in absolute numbers (5000 beds, $20 million for testing, 100, 000 tests per day… etc.) instead of percentages which clarify degree of demand met continued in the briefings.

A billion PPEs were reported to be in stock which included paper towels and 200,000 gloves that had been counted singly (Panorama, 27th April) instead of the gowns, visors and swabs that were urgently required. Emergency procurement from Turkey failed to meet the deadline (Yorkshire Evening Post, 21st April) and the patchwork of international procurement orders set in motion to meet increasing needs failed to meet requirements till to date.

4) Ransom for a King

[Segment six of the orange is vanishing, followed by a long pause]

You can hardly get tested in Bangladesh; at least anybody can get tested in the UK?

I heard that about Bangladesh. Over here it's not easy but getting better.

(To be continued…)


Saiful Islam is based in London