For the start of our UK “Covid-19 messaging” series please click here.
This is the message Boris Johnson apparently wanted to impart to the citizens of England on May 22nd 2020:
Then came the news that BoJo’s “senior aide” Dominic Cummings had risked spreading the virus by driving from London to Durham. By the morning of May 24th the front pages of the “conservative” mainstream media looked like this, with thanks once again to Neil Henderson‘s Twitter feed:
On the evening of May 24th Boris retweeted a message from 10 Downing Street, then somewhat unusually stood behind the lectern at the Covid-19 daily briefing and refused to throw his top aide to the dogs. Try starting to watch the video at around 4:30:
The following morning I found myself agreeing with a Daily Mail headline for probably the first time in living memory:
Alternative points of view were less critical of Mr. Cummings’ actions:
I wonder how the Times’ promised “cabinet backlash” will pan out? I also cannot help but wonder how many Great British citizens will ignore the messages imparted in any future Tweets by Boris Johnson.
We have reported recently on both the United Kingdom’s attempts to meet their stated “100,000 tests per day by the end of April” target and the subsequent setting up of the “Independent SAGE” committee by Sir David King, which we initially dubbed the “Alternative SAGE” committee, or “Alt SAGE” for short.
The first Independent SAGE committee meeting will be broadcast on YouTube at 12:00 BST today. We cannot help but wonder if they will discuss the concept of “Mass Periodic Testing”, or MPT for short.
In Editor’s Choice of 19 March Godlee mentions the urgent need for increased capacity to test frontline healthcare workers serologically to verify their immunity to the covid-19 virus. Even more urgent is capacity for weekly viral detection in the whole UK population. This, together with intensive contact tracing, could enable the country to resume normal life immediately. The virus could only survive in those who are untested, and contact tracing would often lead to them. Within the tested population anyone infected would be detected within about a week (0 to 7 days plus sample transport and testing) of becoming infectious.
Prof. Peto’s suggestion involves testing the vast majority if the population of the UK for Covid-19 every week. His letter continues:
Centrally organised facilities with the capacity to test the entire UK population weekly (in 6 days at 10 million tests per day) can be made available much more quickly and cheaply than a vaccine, probably within weeks. This heroic but straightforward national effort would involve a crash programme to enlist all existing PCR (polymerase chain reaction) facilities, acquire or manufacture the PCR reagents, and agree protocols including a laptop program for barcode reading in smaller laboratories. The US Food and Drug Administration (FDA) has just authorised a test kit for detecting the Covid-19 virus that can be run on machines used in the NHS for HPV screening. Only laboratories that do PCR routinely would participate, subject to central quality control and at cost price. The Wellcome Sanger Institute, UK Biocentre, and smaller academic laboratories, together with all commercial facilities, should have enough machines or can get more immediately from the manufacturers. The 24-hour extra staffing to run their machines continuously would be bioscience students, graduates, and postgraduates familiar with PCR who already work in or near the laboratory. Processing capacity equivalent to 4000 Roche COBAS 8800 systems is needed, and the UK may already have both the machines and the trained staff in post or immediately available.
As you may have noticed, such a “heroic effort” has not yet begun. We have not yet achieved a consistent 100,000 tests per day, let alone the 10 million tests per day envisaged by Julian Peto. Skipping to his conclusion:
By the time the first test is done there may be more than a million infected people who must be treated or remain quarantined at home or in care until all residents at the address test negative. That unavoidable crisis for the NHS would be ameliorated by earlier diagnosis and treatment, and hence reduced pressure on intensive care, and by having all staff as well as patients tested regularly. Contacts of positive people who test negative could choose continued home quarantine or, at little extra risk, choose to join a group of up to 10 test-negative contacts (usually with other family members). Subsequent weekly national testing, together with behavioural changes and efficient contact tracing, would find progressively fewer infections and might soon be extended to a month. This emergency system would only be needed for about 2 months but could be rapidly reintroduced to control any future epidemic caused by a new virus.
Five weeks have elapsed since the letter was published, and an avoidable crisis for the NHS is still ongoing. According to Boris Johnson’s Twitter feed over the weekend:
Five – We must make sure that any adjustments to the current measures do not risk a second spike that would overwhelm the NHS. – 6/6
— Boris Johnson #StayHomeSaveLives (@BorisJohnson) May 3, 2020
When today’s lunch time meeting has concluded will the Alt SAGE committee have recommended an “end [to] the absurd, dystopian and tyrannical lockdown”, mass periodic testing or some alternative “middle way”?
Boris Johnson is expected to announce plans for easing the lockdown as early as this week after he returned to Downing Street on Sunday night to take full-time control of the coronavirus crisis.
The Prime Minister will on Monday morning chair his first meeting of the Covid-19 “war cabinet” since he wastaken to hospital more than three weeks ago, and is ready to resume his role hosting televised Number 10 press conferences.
I took a dim view of that suggestion on Twitter:
This morning the Prime Minister had returned to Downing Street from his country residence and gave this speech to the nation:
According to The Daily Telegraph’s Twitter feed this morning:
However according to The Independent’s Twitter feed:
Meanwhile according to The Times’ Twitter feed this morning:
Here are some of the Prime Minister’s actual words, transcribed from the recording above:
It follows that this is the moment of opportunity, this is the moment when we can press home our advantage. It is also the moment of maximum risk because I know that there will be many people looking now at our apparent success and beginning to wonder whether now is the time to go easy on those social distancing measures.
I know how hard and how stressful it has been to give up even temporarily those ancient and basic freedoms, not seeing friends, not seeing loved ones, working from home, managing the kids, worrying about your job and your firm.
So let me say directly also to British business, to the shopkeepers, to the entrepreneurs, to the hospitality sector, to everyone on whom our economy depends: I understand your impatience, I share your anxiety. And I know that without our private sector, without the drive and commitment of the wealth creators of this country, there will be no economy to speak of, there will be no cash to pay for our public services, no way of funding our NHS.
And yes I can see the long term consequences of lock down as clearly as anyone. And so yes I entirely share your urgency. It’s the government’s urgency. And yet we must also recognise the risk of a second spike, the risk of losing control of that virus and letting the reproduction rate go back over one, because that would mean not only a new wave of death and disease but also an economic disaster and we would be forced once again to slam on the brakes across the whole country and the whole economy and reimpose restrictions in such a way as to do more and lasting damage.
And so I know it is tough and I want to get this economy moving as fast as I can. But I refuse to throw away all the effort and the sacrifice of the British people and to risk a second major outbreak and huge loss of life and the overwhelming of the NHS. And I ask you to contain your impatience because I believe we are coming now to the end of the first phase of this conflict.
And in spite of all the suffering, we have so nearly succeeded. We defied so many predictions. We did not run out of ventilators or ICU beds. We did not allow our NHS to collapse. And on the contrary we have so far collectively shielded our NHS so that our incredible doctors and nurses and healthcare staff have been able to shield all of us from an outbreak that would have been far worse. And we collectively flattened the peak.
And so when we are sure that this first phase is over and that we are meeting our five tests – deaths falling, NHS protected, rate of infection down, really sorting out the challenges of testing and PPE, avoiding a second peak – then that will be the time to move on to the second phase in which we continue to suppress the disease and keep the reproduction rate, the R rate, down, but begin gradually to refine the economic and social restrictions and one by one to fire up the engines of this vast UK economy.
And in that process difficult judgements will be made and we simply cannot spell out now how fast or slow or even when those changes will be made though clearly the government will be saying much more about this in the coming days.
And I want to serve notice now that these decisions will be taken with the maximum possible transparency. And I want to share all our working and our thinking, my thinking, with you the British people. And of course, we will be relying as ever on the science to inform us, as we have from the beginning, but we will also be reaching out to build the biggest possible consensus, across business, across industry, across all parts of our United Kingdom, across party lines, bringing in opposition parties as far as we possibly can, because I think that is no less than what the British people would expect.
Which version of this Covid-19 “story” do you prefer to believe?