Tag: Lockdown

Categories
News

England’s Covid-19 Lockdown Redux

My apologies for the rather more than brief hiatus in this series of articles. One reason is that on June 18th The Guardian reported that:

The government has been forced to abandon a centralised coronavirus contact-tracing app after spending three months and millions of pounds on technology that experts had repeatedly warned would not work.

In an embarrassing U-turn, Matt Hancock said the NHS would switch to an alternative designed by the US tech companies Apple and Google, which is months away from being ready.

Another reason is that I am currently sat at my keyboard on Burrator Ward at Derriford Hospital in Plymouth, where I am recovering from a non trivial triple coronary artery bypass operation, and have just washed my hands in accordance with the instructions in the unisex toilets:

There are other reasons too, but for now let’s continue with the latest news from the Downing Street propaganda machine:

Amongst a variety of other words uttered during yesterday evening’s press conference Boris Johnson had this to say:

Even in the South West, where incidence was so low, and still is so low, it is now clear that current projections mean they will run out of hospital capacity in a matter of weeks unless we act.

And let me explain why the overrunning of the NHS would be a medical and moral disaster beyond the raw loss of life

Because the huge exponential growth in the number of patients – by no means all of them elderly, by the way – would mean that doctors and nurses would be forced to choose which patients to treat

Who would get oxygen and who wouldn’t

Who would live and who would die,

And doctors and nurses would be forced to choose between saving covid patients and non-covid patients

And the sheer weight of covid demand would mean depriving tens of thousands, if not hundreds of thousands, if not millions, of non-covid patients of the care they need

It is crucial to grasp this that the general threat to public health comes not from focusing too much on covid, but from not focusing enough, from failing to get it under control.

I am told that it is quite normal to experience a wide range of emotions when recovering from a major operation.

This morning I awoke in a howling rage. My blood pressure is currently 134/82.

[Edit – November 6th]

A video update from Ann James, Chief Executive of University Hospitals Plymouth NHS Trust:

Our [Covid-19] numbers are beginning to rise, and they’re rising quite quickly. So at a really important time, a critical time, we set out what our next steps are to make sure that we can keep everyone safe and supported during what I know is another really difficult time for everyone.

We have already needed to make some changes to the hospital. We’ve had to change the use of some of our wards as we increasingly care for a growing number of Covid patients, and we’re looking to change some of our other services.

Categories
News

Covid-19 Messaging in the United Kingdom

With apologies to Neil Henderson here is a sequential set of “front page news” headlines from the Great British mainstream media over the past four days:

When the Danse Macabre is over and the inevitable “second wave” of Covid-19 invades “This royal throne of kings, this sceptred isle” who do you suppose will take the blame?

Here is our glorious government’s alleged message du jour:

Plus some creative alternative messages gleaned from Twitter this morning:

[Edit – May 11th]

Here is the Daily Telegraph’s version of Boris Johnson’s speech to the once United Kingdom, pre-recorded then broadcast at 19:00 hours British Summer Time:

The mainstream media’s response this morning, via Helena Wilkinson for a change:

Categories
News

Easing the UK Covid-19 lockdown

The hints are dropping with greater frequency. My Member of Parliament writes to tell me that:

The Prime Minister has said today during Prime Ministers Questions that he will be setting out the next steps that the UK will take this coming Sunday. I await his comments with bated breath – as I am sure many others do.

I certainly have my breath bated! The note continues:

On the subject of tracing and tracking cases, the Health Secretary Matt Hancock said this yesterday:

“We are developing a new test, track and trace programme to help to control the spread of covid-19, and to be able to trace the virus better as it passes from person to person. This will bring together technology through an app, an extensive web of phone-based contract tracing and, of course, the testing needed ​to underpin all that. The roll-out has already started on the Isle of Wight, and I pay tribute to and thank the Islanders for the enthusiasm with which they have taken up the pilot. I hope that we learn a lot from the roll-out, so that we can take those learnings and roll the programme out across the whole country.”

He added that “…the more people who download the app, the more people will protect themselves, their families and their communities.”

Here’s a recording of this evening’s Covid-19 daily briefing in Downing Street, hosted on this occasion by Robert Jenrick, Secretary of State for Housing, Communities and Local Government:

At 49:30 Keith Rossiter, representing the Western Morning News and Cornwall Live, asks some South West specific questions. One of his questions was:

Sir Patrick Vallance suggested on Tuesday that regions with fewer cases of Covid-19 could come out of lockdown early. How would that work and, if it were to be implemented, what support might there be for Devon and Cornwall Police – already over-stretched – to prevent a large scale invasion of the Westcountry?

Robert’s answer?

We’re providing additional funding to forces and the Home Secretary is speaking with national police chiefs to ensure they have the right guidance and consistent messaging they can use to enforce the lockdown rules when that’s required. As we’ve seen so far the vast majority of members of the public have chosen to do so and adhere to the messaging and most police forces have been able to support the lockdown measures through consent which is the way we want to do things in this country but in the isolated number of cases when this has not been possible they’ve had tools at their disposal to fine and enforce the lockdown.

So no confirmation that easing of the UK lockdown will start in South West England, but no denial either. Whilst we wait for Sunday’s announcement, here’s what Sir Patrick Vallance had to say yesterday. According to Cornwall Live:

England’s chief scientific adviser has hinted that rural regions, such as the Westcountry, might have their Covid-19 lockdown eased sooner than big cities.

Sir Patrick Vallance told MPs on the Health and Social Care Committee that the disease was more prevalent in cities and densely populated places than in rural areas.

But he acknowledged that a regional approach would require the flow of people between regions to be controlled.

Last month former health secretary Jeremy Hunt, who is now chair of the Health and Social Care Select Committee, named Cornwall as an area that could have its restrictions lifted before the rest of the UK.

[Edit – May 7th]

Does this retweet tell this morning’s horror story adequately?

Watch this space!

Categories
Testing

Mass Periodic Testing for Covid-19

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.

The idea was introduced by Professor Julian Peto from the London School of Hygiene and Tropical Medicine in a letter to the British Medical Journal on March 22nd 2020. Here is an extract:

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.

Roche cobas 8800 PCR testing system

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:

However according to today’s Daily Telegraph:

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”?

Watch this space!

Categories
News

Sir David King convenes Alt SAGE Covid-19 committee

Idly perusing the online version of The Sunday Times in anticipation of more BoJo bashing I instead stumbled across some discreet Dom bashing from an illustrious source. According to an article by Caroline Wheeler, Deputy Political Editor of the Sunday Times:

The government’s former chief scientific adviser is convening a rival panel of experts to offer advice on easing the lockdown.

Tomorrow Sir David King will chair the first meeting of the group, which is designed to act as an independent alternative to the government’s Scientific Advisory Group for Emergencies (SAGE).

The move comes after weeks of unease about the transparency of SAGE decision-making. It has emerged that 16 of the 23 known members of the committee, which meets in secret, are employed by the government.

The independent group will broadcast live on YouTube and take evidence from global experts. It aims to present the government with “robust, unbiased advice” and some evidence-based policies to tackle the Covid-19 pandemic.

The committee will formally submit its recommendations to the health and social care select committee, heaping pressure on Boris Johnson as he draws up the government’s lockdown exit strategy.

The whole idea sounds crazy, until you consider how the official Covid-19 daily briefings are already spinning like crazy!

Sir David also has his very own Twitter feed, via which he announced:

Getting back to Caroline, she added:

Speaking before tomorrow’s meeting, which will be followed by a news conference, King said: “Science is fundamentally a system based on peer review. When it comes to scientific advice of any kind, transparency is essential.”

He added: “I am not at all critical of the scientists who are putting advice before the government . . . but because there is no transparency the government can say they are following scientific advice but we don’t know that they are.”

Dominic Cummings, a top aide to the prime minister, has attended the secret meetings of SAGE.

“Cummings is an adviser to the prime minister. And the chief scientific adviser is an adviser to the prime minister. So there are two voices from the scientific advisory group and I think that’s very dangerous because only one of the two understands the science,” King said.

The committee has a draft agenda and is seeking to end the pandemic “with the fewest casualties possible”.

Currently the YouTube URL at which tomorrow’s Alt SAGE meeting will be broadcast has not been revealed, so…..

[Edit – May 12th]

The Independent SAGE committee have just published their recommendations. We “retweeted” them forthwith!

To summarise the committee’s recommendations to Her Majesty’s Government concerning “Transitioning from lockdowns and closures”:

Four key components to managing transitions and modulating restrictive measures

  1. Public health and epidemiological considerations must drive the decision-making process.
  2. Available capacity for dual-track health system management to reinstate regular health services, while at the same time continuing to address COVID-19.
  3. Leveraging social and behavioural perspectives as tools for responsive engagement with populations.
  4. Social and economic support to mitigate the devastating effects of COVID-19 on individuals, families and communities.

Six conditions should be used as the basis to implement/adapt transitioning of measures

  1. Evidence shows that COVID-19 transmission is controlled.
  2. Sufficient public health and health system capacities are in place to identify, isolate, test and treat all cases, and to trace and quarantine contacts.
  3. Outbreak risks are minimized in high vulnerability settings, such as long-term care facilities (i.e. nursing homes, rehabilitative and mental health centres) and congregate settings.
  4. Preventive measures are established in workplaces, with physical distancing, handwashing facilities and respiratory etiquette in place, and potentially thermal monitoring.
  5. Manage the risk of exporting and importing cases from communities with high-risks of transmission.
  6. Communities have a voice, are informed, engaged and participatory in the transition.

Four cross-cutting mechanisms that are essential enablers throughout the transition process

  1. Governance of health systems.
  2. Data analytics to inform decisions.
  3. Digital technologies to support public health measures.
  4. Responsive communication with populations.

We “tweeted” a question to the powers that be:

We haven’t received an answer as yet.

Watch this space!

Categories
News

Boris Johnson returns to work

Last night an article by Gordon Rayner in the online edition of the Daily Telegraph assured us that:

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 was taken 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?

Categories
News

What Constitutes a “Reasonable Excuse”?

The United Kingdom’s National Police Chief’s Council has published new guidance on what constitutes a “reasonable excuse” to leave your residence during the current novel coronavirus lockdown. You can download a copy from:

https://www.college.police.uk/What-we-do/COVID-19/Documents/What-constitutes-a-reasonable-excuse.pdf

Of particular interest to me as a “silver surfer” is the part that states:

Exercise can come in many forms, including walks.

Exercise must involve some movement, but it is acceptable for a person to stop for a break in exercise.

It is lawful to drive for exercise.

Whilst surfing is not explicitly mentioned in the new document the current Police Commander for Cornwall has previously issued guidance on that form of exercise for the county:

According to “Cornwall’s top cop” before the new guidance was published:

Police BCU Commander for Cornwall, Temporary Chief Superintendant Ian Drummond-Smith said the recent guidance from the London-based National Police Chiefs Council was consistent with what his officers were doing on the ground but he reiterated that the public should not try and take advantage of the guidance.

He said: “Surfing has not been banned. It’s exercise and in Cornwall we know it’s a popular exercise. People can still surf. The question of driving a reasonable distance as per the NPCC guidelines, is ‘how far is reasonable’.

“The NPCC guidelines does not say whether you can or cannot drive to do your exercise. I am telling my officers people can surf and some may well drive to surf.”

Now all we denizens of the North Coast need to do is wait for the swell to be onshore and the wind to be offshore once again.

And to stay well over 2 meters away from anybody else with the same idea at the same time at the same beach!