Monday, April 13, 2020

A second lockdown - which would be harsher and longer - is inevitable if we lift the current one prematurely, and if we don't start testing, tracing and isolating

Over the last couple of days, a number of people on social media have been collecting statements made by the Scottish government's scientific advisers prior to March, to demonstrate how irreconcilable they are with the statements they are making now and also with the facts on the ground that we all inescapably recognise.  Even as someone who has been following this closely, I was pretty stunned by how total some of the contradictions are.  Here's a selection...

Before mid-March: "Throughout this epidemic, it will be business as usual.  People will get ill, some people will get very ill, but we'll accept that and get on with our normal daily lives."

Now: "There can be no business as usual.  Stay home, protect the NHS, save lives."

Before mid-March: "We have no choice but to pursue herd immunity by allowing the virus to move through the entire population.  Even though this virus has only been around for three months, we know that people will rarely if ever get it twice, so as long as we successfully manage a massive epidemic now, it won't pop up again in future."

Now: "Pursuing herd immunity is not our strategy and has never been our strategy.  That would never have been viable because it is not known whether people who have been infected develop lasting immunity."

Before mid-March: "Large public gatherings are fine, because the evidence is that the virus is not transmitted in those settings, particularly if an event is outdoors.  Even if we eventually stop large gatherings, that'll simply be to free up capacity for the emergency services, not to slow the spread of the virus."

Now: "Any gathering of more than two people, even in the open air, puts lives at risk."

Before mid-March: "Closing schools would be positively harmful.  The virus does not spread among children, and key workers might have to stay off work to look after their children if schools are closed."

Now: "School closures have an important role to play in stopping the spread of virus between households."

I haven't heard any public acknowledgement of these U-turns.  That maybe speaks to a failure to treat people as adults, because there can be no doubt that ministers and their advisers privately realise that what they were previously saying has been proved comprehensively wrong.  My hope is that there is now an understanding that the big mistake prior to mid-March was to listen only to the exceptionalist "British science" and not heed the clear message of the World Health Organization that the virus must be suppressed and controlled by means of mass testing, contact tracing and ongoing social distancing. 

If that lesson has been learned, it would mean the Scottish Government using whatever leverage they have at this critical juncture to argue against the siren voices in Tory circles calling for a premature lifting of the lockdown.  Troublingly, however, Jason Leitch's appearance on breakfast TV this morning left the impression that all of the same mistakes may be about to be repeated, and that Scottish Government spokespeople will simply carry on faithfully echoing whatever is being said in London.  

Leitch talked of "balancing" the harm of lockdown with the harm caused by the virus.  He said at present the priority must be protecting people from the virus, but at some point that would change and the priority would shift to ending the harm caused by lockdown.  This is fundamentally flawed thinking, because these harms are not actually in competition with each other - they are all interrelated.  The countries that have avoided the harms caused by long, harsh lockdowns are the ones (most obviously South Korea, but there are others as well) that took the early action necessary to suppress the virus.  We, on the other hand, left schools open, actively encouraged people to go to large gatherings (yup, that was Jason Leitch on an earlier breakfast TV appearance), and abandoned testing and contact tracing.  That's why people are suffering from a full lockdown now.  They will suffer even more from an even longer, even harsher second lockdown at a later stage if we lift the current measures prematurely, because the NHS will very quickly find itself in total collapse and the government will once again be left with no other choice. 

What the Scottish Government should be saying privately and publicly is that lockdown must only end when a strategy is in place to keep the numbers of new infections persistently low.  By doing that, we don't have to 'balance' or 'prioritise' the harms caused by the virus and by lockdown - we'd be resolving both sets of harms simultaneously.

38 comments:

  1. After Salmond et al, just who in the Scottish Government IS competent?

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  2. It seems to me that the Scottish government has been mostly in step with the UK one, with a few exceptions, such as banning large gatherings sooner. This illustrates how dire the public message from the science advisors has been. NS has been clearer.

    The deaths in care homes are going to be catastrophic and I fear for the carers in that environment. I saw on Twitter a snippet on the Kate Adams show where someone said that the four major UK suppliers of PPE were now limiting supplies to NHS England and Social Care England, stopping the supply to carers in Scotland and Wales. This makes me sick to my stomach.

    Did they all decide that off the bat? How was this decision made?

    (And I can hardly believe something like *that* was on Call Kaye. Can you imagine Reporting Scotland running that story?)

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    1. I don't think she can believe it either. She seems to have acted quickly to change the subject.

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    2. Also heard this from somebody on the inside. Suppliers not honouring promises to Scotland's NHS. England being prioritised over Scotland and Wales.
      This isn't getting out to the MSM. Or maybe it's just not news.
      Up to now Rabb and Hancock look out of their debth compared to Nicola Sturgeon and her team.
      Time to speak out though on the inequity of PPE and medical supplies.
      Either we're in a Union where we benefit from pooling or we're in a pecking order where England always wins.

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    3. Well this has taken a bit of a twist. The Natioanal ran with the story. BBC have responded, calling it "a claim by the National" and reporting denials from the UK gov and Jason Leitch, who just said publically that this claim is "rubbish".

      Except... at the same time The Times Scotland have also gone with the story, claiming it's true. And, unlike the BBC, they've contacted one of the actual suppliers, who have confirmed its true. On top of this they are also showing screenshots of the suppliers' website, where it is written in black and white that they are now only supplying to Public Health England, with - quite literally - the phrase "sorry Scotland and Wales".

      I'm sorry but this is propaganda designed to cover up a situation for, presumably, political reasons - a situation that is threatening the lives of our carers.

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    4. A journalist just asked Nicola Sturgeon about this on the Scot gov press briefing, saying care homes are telling them than this was happening. And to be fair, incredibly, it was a journalist from Reporting Scotland.

      Unfortunately the second the First Minister started to give her answer, the BBC switched off the sound and had a presenter talk over her, so I couldn't learn what the answer was. The BBC then quickly cut back to the studio.

      Does anyone know where we can get an unedited version of these press briefings? Getting this information is going to be very important, particulatly for those of us working in care or with relatives in care homes.

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    5. Donald Macaskill, CEO of Scottish Care is standing by the comments made on Kaye Adams that Public Health England have instructed PPE firms not to supply Scotland or Wales. At least one PPE firm has explicitly confirmed this on their website.

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    6. I was watching BBC1 Scotland online (TV not working) and was told that would be continued on BBC Scotland. Switched over and it was. It lasted another 30 mins or so and was much more informative than whatever was on the BBC1 'Nationwide' news, I suspect.

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    7. I was watching it on the TV during lunch. Not sure which BBC channel (wife had it on).

      So the same Reporting Scotland journalist (Kirsty someone) ask the Chancellor Rishi Sunak about this claim PHE are stopping suppliers from selling vital PPE to Scotland. He quoted Leitch saying "we looked into it and we think it's rubbish". He then added, "there's no truth to this claim".

      Meanwhile Gompels Healthcare UK, one of the suppliers updated their website to explain that they were sorry but they had no choice - PHE had made that part of the criteria that they stop selling the PPE to Scotland.

      And Donald Macaskill has reiterated through Chris Musson of the Sun that no matter what politicians or chief medical officers say, Scottish Care members still can't buy PPE from their suppliers.

      None of this helps the care workers who can no longer order PPE from their normal UK suppliers and face looming shortages which will put their lives at greater risk.

      In the last few minutes a journalist tweeted that Germany has stepped in and will supply PPE to Scottish care workers. I sincerely hope that turns out to be true.

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  3. Absolutely correct, James. Mass testing, tracing, quarantine, and adequate supplies of protective equipment for those in need of it. If they actually manage to achieve ALL of that, then they can start thinking about alternative strategies, but not before.

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  4. I lost faith in Jason Leitch on Mother's day when I heard him pontificating on local radio and saying it was ok to visit but to keep your distance.
    At that point even Johnson had moved.
    Leitch needs replaced by someone who understands public health issues.

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  5. Nobody knows yet what is the best action. Extensive lock down has its own risks, for example by scaring away people that need other care. I agree that extensive testing provides more information and if used correctly it should make it easier to avoid extreme restrictions. The spread of this disease appears surprisingly stochastic with similarly large regional variations in countries taking extreme measures as in those taking less extensive ones.

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    1. If you're talking partly about Sweden, I'd suggest part of the reason they haven't paid more heavily (yet) for their reckless approach is lower population density, and a higher percentage of single-person households. But they're certainly suffering a much higher death rate than other Nordic countries.

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    2. There is also very large variation within Sweden. The metropolitan Stocholm area has many more deaths and infections than anywherw else in Sweden, even Malmø and Gøteborg

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  6. Great article James, i don't often have the same political opinions as you, but your coverage of the Covid-19 pandemic has been excellent, keep up the good work.

    Daryl.

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  7. Every body in Scotland should listen to Nicola Sturgeon Reports. Every time I have listened to them she has always emphasized that the lock down will not be removed any time soon. She is not following Westminster.

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    1. Big Eater From PerthApril 13, 2020 at 6:52 PM

      I keep digesting these reports. I'm not going to say what William Purves is full of.

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    2. My fear is that the Scottish Government will be "bounced into it", if Sunak stops the government funding support for furlough at the end of May we'll have no choice but to reopen, we have no mechanism to raise those funds or pay furloughed workers ourself.

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  8. Scottish health service used to procure it’s own meds and equipments until T.May arrogated that devolved power back to London. There was not a peep in Jock media nor indeed much coming from First Minister .She rolled over. Now Unionist media in Scotland will beat the SNP over the year head with another media pile on.

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    1. I have found no evidence of this. Please supply links for confirmation please.

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  9. The Lord Of 5G TowersApril 13, 2020 at 8:27 PM

    The lockdown brings with it certain therapeutic aspects. There are more pigeons in the garden. And I'm getting a good night's sleep. Last night I had a dream that featured GWC, Priti Patel, Emma Little Pengelly, Random Totty and the illicit chartering of a private jet.

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  10. Good post, James.

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  11. Purves is a pure wee knob end. Knickerless is following the same advise as advised by the UK health experts.
    You Nazi scum are just ignoring respect for the dead from this viris and playing the long game of politics. I doubt a hand wash can be
    Invented to remove Nat si scum.

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    1. Someone got oot the wrang side o their scratcher.

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    2. Indeed. Poor, bitter, angry Covidia. Its Trumpian, toddler-like rages are hilarious.

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  12. The first think both SG and UKGov should do is ditch all their scientific advisers. UKGov should also ditch their CMO and deputy CMO.
    Then they should look at what Austria, Germany, Denmark, Norway and Slovenia are doing. North Korea, Taiwan and New Zealand never had that many cases and had manageable clusters - so they can't be of much help.
    But - we are so far behind in terms of loosening the lockdown preparations that we can't just catch up - lockdown is probably to stay for some time. In those countries the whole scientific community (from sociologists to epidemiologists) is engaged in advising the governments on what the next steps should be and is also communicating that to the public.
    Two most important things will be testing and contact tracing. Germany is now saying it will have to do 500.000 to 600.000 tests every day once the lockdown is loosened. UK should be doing then about 400.000 to 450.000 tests every day. Scotland should be doing about 35.000. Just for comparison - UK hasn't done that many tests all together from the beginning (and now it should them in a day?).
    Contact tracing has been completely abandoned in the UK (and Scotland unfortunately) in mid March. But - contact tracing is crucial if we are to loosen the lockdown. Every positive person's contacts have to be traced within a 12 hours window (so we need to have teams of people in every council doing just this) and those people should be put into isolation and then tested as well. Isolation has to be mandatory and enforced by police (i.e. - police checking up that people are in isolation). So - once we loosen up the lockdown we'll probably have about 5% of population who will be in isolation at every time for some time - either because they are positive or have been in contact with someone who is positive.

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    1. Some good points there Martin. My daughter tested positive here in Estonia and during her mandatory 14-day self-quarantine she was contacted by the police twice. This was not in a threatening manner but in a spirit of, 1. do you understand what's going on and why?, 2. is there any assistance that we can offer?, 3. is there anyone we can contact for you?

      The whole affair in too wee, too poor, too stupid Estonia has been pretty well managed. The imposition of state of emergency was thought by many to be rather alarmist and early but the authorities have been proven correct by their prompt and decisive action. Early suggestions are that this action has broken the back of the virus spread with new cases dropping day by day and deaths becoming relatively few. Testing has been completed on approximately 2.5% of the population with testing available for anyone who presents with suspected symptoms and the case-fatality ratio is 2.1% compared to 12.5%+ in the UK. Contact tracing has been operated to an extent and my own daughter's case was predicted by this method a day or two ahead of her diagnosis.

      One particularly unique social distancing technique in Tallinn has been the decision of the City Government to extend public transport frequency and NOT curtail it. This has resulted in safe use of buses, trams, trains due to very sparsely occupied vehicles. But that is exactly the aim.

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    2. Yup. Caught a (pre-virus) episode of "Coast" yesterday in which the alleged historian with the flowing locks was graciously extolling the many advantages of Denmark, that neighbouring little country of ~5M folk just across the North Sea. Not "too wee, etc." for the hypocrite there, it seems...

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  13. Smaller countries like Estonia can move more swiftly.
    Scotland is not fully utilising that ad vantage by being in lock step with England.
    Jason Leitch seems too keen on this strategy.
    Nicola Sturgeon is right to say the exit plan may be different from RUK.
    Testing and tracing contacts was the best [Who] recommendation.
    Vetoed by London. Imposed de facto on Scotland.

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  14. ONS data for England & Wales out deaths upto 03/04

    England :5979 vs 3939 daily figures (+2040 52%)
    Wales: 236 vs 141 daily figures (+95 67%)

    England 383 deaths outside hospital (207 in care homes)
    |Wales 157 deaths outside hospital (9 in care homes)


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  15. Upto 3rd April deaths/1,000,000 based on Covid certificated deaths:

    England :106
    Wales: 75
    Scotland: 63
    NI: 29

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    1. The closer you are to England - the second most infected country in Europe - worse things are?

      Northern Ireland didn't see the flood of infected international arrivals from England just before the lockdown, which may well be where the difference comes from. It's not a holiday home destination outside of Rangers circles.

      For Scotland, 1 new infected case arriving from Windsor at the highland holiday home is the equivalent of 10 in England per capita.

      It's certainly going to be a problem if Scotland unlocks earlier than England. It needs to be able to quarantine intentional arrivals, including at Gretna.

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  16. Just got round to reading last week's Private Eye and saw news item about Private hospitals getting tons of money for taking on NHS overflow virus patients. Of course they should be doing this but lots of businesses are not getting anywhere near the support promised but somehow private hospitals are making a very fat profit on this - they should be getting no more than needed to match losses. I suspect ministers and other Tories have investment in this lot.

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    1. Private hospital deal with NHS England was done at cost- not sure about deals with the NHS in other nations:
      https://www.nursingtimes.net/news/coronavirus/nhs-brokers-deal-with-private-hospitals-to-gain-10000-nurses-23-03-2020/

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  17. The Lord Of 5G TowersApril 14, 2020 at 1:25 PM


    This lockdown's not all bad.

    Nosing around in the fridges I got a luxury cottage pie and some garlic bread for a total of £1.26 in Tesco yesterday.

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  18. Scotland starting to flatten out quite well now it would appear.

    https://www.bbc.co.uk/news/uk-scotland-52009463

    England's infection rate compared to here is really stark. For the same number of initial infections, they'd ballooned to 8 times the number of deaths / infections (3+ weeks earlier) as Scotland by this point. The gap continues to grow.

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